Health-Care Utilization as a Proxy in Disability Determination (2018) / Chapter Skim
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Appendix C: Literature Review - Report Summaries by Body System
Appendix C: Literature Review - Report Summaries by Body System
Pages 109-140
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From page 109... ...
Thus, most of the papers included in this appendix link health-care utilizations with disease severity. The committee focused on summarizing papers that were based on nationwide data, large samples, and study populations of working-age adults in the United States, but for body systems on which there was a paucity of literature, the committee also described papers that did not fit those criteria, such as ones that looked at mortality as an end point, ones that used study populations outside the United States, and ones that had a mean population age over 65 years.
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, of 285,661 people admitted to emergency departments (EDs) for proximal humerus fracture in 2010 and 2011 to identify predictors of hospital admission compared with direct discharges to home.
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One study on ED visits by deaf patients is presented to provide evidence on types of utilization that are more or less probable for particular medical conditions. A retrospective cohort study in an outpatient center in Rochester, New York, compared 200 randomly selected deaf users of American Sign Language (ASL)
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In a multicenter, cross-sectional study of 127 patients (mostly males) whose mean age was 67 years, the authors analyzed numerous factors associated with hospital admission by using a logistic regression model.
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. They investigated factors associated with hospitalization for COPD exacerbations by using Cox proportional hazards and adjusting for a wide array of demographic and clinical variables.
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. All patients had at least one of the following chronic conditions: diabetes mellitus, congestive heart failure (CHF)
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Heart Failure and Cardiomyopathy A 2013 systematic review evaluated the effects of social factors on hospital readmissions or mortality in which HF was an initial diagnosis (Calvillo-King et al., 2013)
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, sedentary lifestyle (HR: 1.44, 95% CI: 0.92– 3 The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a well-established instrument used to evaluate the health status of heart failure (HF)
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. In blacks, risk factors for incident HF were higher diastolic blood pressure, higher body mass index, lower high-density lipoprotein cholesterol, and kidney disease.
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A study of adverse events and later health-care utilization by patients who had a previous hospitalization for acute coronary syndrome (ACS) used data from a large commercial managedcare system in the United States (Korsnes et al., 2015)
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(2015) describes trends in hospitalizations from 2000 to 2012 that resulted from aortic valve–related discharges in people 60 years old and older.
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(2013) investigated outcomes beyond survival, including functional status and health-related quality of life, and compared transcatheter aortic valve replacement (TAVR)
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Resource utilizations examined included physician visits, ED visits, hospitalizations, and GERD-related prescription-drug use. The authors found that as symptom severity increased, there was a significant increase in some health-care utilizations and a decrease in productivity by some measures.
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(2013) sought to identify predictors of work disability in patients who had inflammatory bowel disease (IBD)
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(2013) conducted a retrospective analysis to create a tool to predict 30-day readmissions for heart failure in people who had non-dialysis-dependent CKD.
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(2010) studied ED visits and hospital admissions for sickle-cell crises in a retrospective cohort study of more than 20,000 subjects over a 2-year period by using HCUP data from 2005–2006.
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Functional independence was measured on a scale of 1–7 in which 1 indicated a requirement of total assistance and 7 indicating complete independence. The authors found that of patients who were 54.5–72.5 years old and had less than 22.5 percent TBSA burns, those who had a BMI greater than 25.15 had an average FIM score of 3.778, whereas those who had a BMI less than 25.15 had an average FIM score of 5.400.
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The authors found depression to be significantly associated with time to first severe hypoglycemic episode. The study provided further evidence that comorbidities are important in associating health-care utilizations with disease severity in diabetes patients.
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(2010) examined health-care utilization and lost work productivity among those who reported chronic sleep maintenance insomnia characterized by nighttime awakenings (CINA)
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MENTAL DISORDERS The committee initially identified 125 abstracts of potential interest and retrieved 53 fulltext articles for review. The two studies that linked health-care utilization with impairment severity associated with mental disorders are discussed below.
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From page 129... ...
investigated 30-day readmissions after surgery for primary and secondary spinal tumors in a study that used a national registry to evaluate incidence and predictors of readmissions, adverse events, and reoperations. Data on 2,207 patients from the National Surgical Quality Improvement Program registry were analyzed to identify predictors of study outcomes on the basis of demographics, tumor characteristics, preoperative functional status, comorbidities, laboratory measures, and hospital factors related to the surgery.
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The study is important in that it documented the effects of cancer on work disability, although it noted that, unlike other chronic conditions, disability is commonly caused by treatment that results in chronic pain and poor functional outcomes rather than by the disease itself. Another study reported that cancer survivors under 65 years old were more than 3 times more likely to be unable to work because of a health condition than those who had no history of cancer or other chronic diseases (Hewitt et al., 2003)
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. Those papers described risk factors for reduced QOL of cancer survivors, but direct associations with health-care utilization were not reported.
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The study suggested that frequency of outpatientclinic use might reflect disease severity in HIV patients. The committee's literature search found one study that linked prescription medication utilization with disease severity in people who had immune disorders.
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2012. Factors associated with hospital admission for exacerbation of chronic obstructive pulmonary disease.
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2013. Beyond adding years to life: Health-related quality-of-life and functional outcomes in patients with severe aortic valve stenosis at high surgical risk undergoing transcatheter aortic valve replacement.
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2008. Hospital admission rates among men and women with symptoms of chronic bronchitis and airflow limitation corresponding to the gold stages of chronic obstructive pulmonary disease -- a population-based study.
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2015. Factors associated with hospital admission for proximal humerus fracture.
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2013. Clinical and economic burden of emergency department visits due to gastrointestinal diseases in the United States.
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2012. Sickle cell disease in California: Sociodemographic predictors of emergency department utilization.
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2009. Urban-rural differences in work disability following occupational injury: Are they related to differences in healthcare utilization?
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