John Edelsberg

Prevalence and Economic Burden of Bronchiectasis

We employed a retrospective cohort design to estimate the prevalence and economic burden of bronchiectasis. Data were obtained from the health-care claims processing systems of more than 30 US health plans (with a combined total of 5.6 million covered lives) and spanned the period January 1, 1999, to December 31, 2001. Study subjects consisted of all persons who were aged ≥18 years in 2001 and had diagnoses of bronchiectasis between 1999 and 2001; those with diagnoses of cystic fibrosis were excluded. For purposes of comparison, a cohort of persons without diagnoses of bronchiectasis was randomly selected and matched on age, sex, geographic region, and comorbid conditions. Prevalence of bronchiectasis ranged from 4.2 per 100,000 persons aged 18–34 years to 271.8 per 100,000 among those aged ≥75 years. Prevalence was higher among women than men at all ages. Persons with bronchiectasis averaged 2.0 (95% confidence interval 1.7–2.3) additional days in hospital, 6.1 (6.0–6.1) additional outpatient encounters, and 27.2 (25.0–29.1) more days of antibiotic therapy than those without the disorder in 2001; average total medical-care expenditures were

Trends in US hospital admissions for skin and soft tissue infections.

5681 (

Long-term mortality and medical care charges in patients with severe sepsis.

4862–

Lifetime health and economic benefits of weight loss among obese persons.

6593) higher for bronchiectasis patients. Our findings suggest that over 110,000 persons in the United States may be receiving treatment for bronchiectasis, resulting in additional medical-care expenditures of

Estimated Economic Costs of Obesity to U.S. Business

630 million annually.

The Cost of Treatment of Skeletal-Related Events in Patients with Bone Metastases from Lung Cancer

Using data from the 2000–2004 US Healthcare Cost and Utilization Project National Inpatient Sample, we found that total hospital admissions for skin and soft tissue infections increased by 29% during 2000–2004; admissions for pneumonia were largely unchanged. These results are consistent with recent reported increases in community-associated methicillin-resistant Staphylococcus aureus infections.

Economic costs of nonmedical use of prescription opioids.

ObjectiveTo estimate long-term mortality and medical care charges among patients with severe sepsis. DesignRetrospective cohort study. SettingLarge, integrated, geographically diverse, U.S. health-insurance claims database covering three million lives annually. PatientsAll persons with bacterial or fungal infections and acute organ dysfunction (severe sepsis) who were hospitalized between January 1, 1991, and August 31, 2000. InterventionsNone. Measurements and Main ResultsAll patients were followed from the date of hospitalization with severe sepsis (index admission) to August 31, 2000, disenrollment from the health plan, or death, whichever occurred first. Measures of interest included mortality and medical care charges and were estimated for the index admission, the 90- and 180-day periods following the index admission, and annually thereafter (up to 5 yrs), using techniques of survival analysis. A total of 16,019 patients were identified who met study entrance criteria. Most patients (81.2%) were ≥65 yrs of age; 53.4% were men. Mortality was 21.2% for the index admission, 51.4% at 1 yr, and 74.2% at 5 yrs. Mean cumulative total medical care charges were

Clinical and economic burden of pneumococcal disease in older US adults.

44,600 for the index admission,

Clinical and economic consequences of failure of initial antibiotic therapy for hospitalized patients with complicated skin and skin-structure infections.

78,500 at 1 yr, and

Are Shorter Courses of Filgrastim Prophylaxis Associated with Increased Risk of Hospitalization

118,800 at 5 yrs. Hospitalization accounted for the largest component of total medical care charges. ConclusionsMortality and economic costs are high in patients with severe sepsis, during the period of acute illness as well as subsequently.