Noelle-Angelique Molinari

Herpes Zoster Incidence Among Insured Persons in the United States, 1993–2006: Evaluation of Impact of Varicella Vaccination

BACKGROUND herpes zoster (HZ) is caused by reactivation of latent varicella zoster virus and is often associated with substantial pain and disability. Baseline incidence of HZ prior to introduction of HZ vaccine is not well described, and it is unclear whether introduction of the varicella vaccination program in 1995 has altered the epidemiology of HZ. We examined trends in the incidence of HZ and impact of varicella vaccination on HZ trends using a large medical claims database. METHODS medical claims data from the MarketScan databases were obtained for 1993-2006. We calculated HZ incidence using all persons with a first outpatient service associated with a 053.xx code (HZ ICD-9 code) as the numerator, and total MarketScan enrollment as the denominator; HZ incidence was stratified by age and sex. We used statewide varicella vaccination coverage in children aged 19-35 months to explore the impact of varicella vaccination on HZ incidence. RESULTS HZ incidence increased for the entire study period and for all age groups, with greater rates of increase 1993-1996 (P < .001). HZ rates were higher for females than males throughout the study period (P < .001) and for all age groups (P < .001). HZ incidence did not vary by state varicella vaccination coverage. CONCLUSIONS HZ incidence has been increasing from 1993-2006. We found no evidence to attribute the increase to the varicella vaccine program.

Health Benefits, Risks, and Cost-Effectiveness of Influenza Vaccination of Children

Vaccinating children aged 6–23 months, plus all other children at high-risk, will likely be more effective than vaccinating all children against influenza.

Health Care Expenditures for Infants and Young Children with Down Syndrome in a Privately Insured Population

OBJECTIVE To use health care insurance claims data from a privately insured population to estimate health care use and expenditures for infants and children aged 0 to 4 years with Down syndrome. STUDY DESIGN Data from the 2004 Medstat MarketScan database were used to estimate medical care use and expenditures related to inpatient admissions, outpatient services, and prescription drug claims for children with and those without Down syndrome. Costs were further stratified by the presence or absence of a congenital heart defect (CHD). RESULTS The mean medical costs for infants and children with Down syndrome were

High costs of influenza: direct medical costs of influenza disease in young children.

36384 during 2004; median medical costs were

Comparison of 3 Infrared Thermal Detection Systems and Self-Report for Mass Fever Screening

11164. Mean and median medical costs for children 0 to 4 years of age with Down syndrome were 12 to 13 times higher than for children without Down syndrome. For infants with Down syndrome and CHDs, mean and median costs were 5 to 7 times higher than for infants with Down syndrome who did not have CHDs. CONCLUSIONS These findings may facilitate future assessments of the effect of the Down syndrome on the health care system.

National estimates of medical costs incurred by nonelderly cancer patients.

This study determined direct medical costs for influenza-associated hospitalizations and emergency department (ED) visits. For 3 influenza seasons, children <5 years of age with laboratory-confirmed influenza were identified through population-based surveillance. The mean direct cost per hospitalized child was

Indirect, out-of-pocket and medical costs from influenza-related illness in young children

5402, with annual cost burden estimated at

Out-of-Pocket Costs of Childhood Immunizations: A Comparison by Type of Insurance Plan

44 to

Mass screening for fever in children: a comparison of 3 infrared thermal detection systems.

163 million. Factors associated with high-cost hospitalizations included intensive care unit (ICU) admission and having an underlying high-risk condition. The mean medical cost per ED visit was

Quantifying bias in a health survey: modeling total survey error in the national immunization survey.

512, with annual ED cost burden estimated at