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  1. Article ; Online: Healthcare cost associations of patients who use illicit drugs in Florida: a retrospective analysis.

    Ryan, Jessica L / Rosa, Veronica R

    Substance abuse treatment, prevention, and policy

    2020  Volume 15, Issue 1, Page(s) 73

    Abstract: Background: Illicit drug use increases visits to the hospital. Research is limited on the costs of these healthcare visits by illicit drug.: Methods: Florida's Agency for Health Care Administration's emergency department and inpatient datasets from ... ...

    Abstract Background: Illicit drug use increases visits to the hospital. Research is limited on the costs of these healthcare visits by illicit drug.
    Methods: Florida's Agency for Health Care Administration's emergency department and inpatient datasets from 2016 to 2018 were analyzed. Adults who used an illicit drug were included in the study population resulting in 709,658 observations. Cost-to-charge ratios were used to estimate healthcare costs. Linear regression analyzed associations of illicit drugs with total healthcare cost.
    Results: Total healthcare costs are estimated at $6.4 billion over the 3 year period. Medicare paid for the most patient care ($2.16 billion) with Medicaid and commercial insurance each estimated at $1.36 billion. Cocaine (9.25%) and multiple drug use (6.12%) increased the costs of an ED visit compared to a patient with cannabis SUD. Opioids (23.40%) and inhalants use (16.30%) increased the costs of inpatient compared to cannabis SUD.
    Conclusion: Healthcare costs are high of patients with illicit drug SUD and poisoning, over half of which are paid for with tax payer dollars and to an unknown degree hospital write-offs. Injuries and illness of patients using cocaine and multiple drugs are associated with more expensive ED patient care and opioids and inhalants are associated with more expensive inpatient care.
    MeSH term(s) Adult ; Aged ; Drug Overdose/economics ; Emergency Service, Hospital/economics ; Female ; Florida ; Health Expenditures/statistics & numerical data ; Humans ; Illicit Drugs ; Male ; Medicaid/economics ; Medicare/economics ; Mental Disorders/epidemiology ; Middle Aged ; Retrospective Studies ; Socioeconomic Factors ; Substance-Related Disorders/complications ; Substance-Related Disorders/economics ; United States
    Chemical Substances Illicit Drugs
    Language English
    Publishing date 2020-09-29
    Publishing country England
    Document type Journal Article
    ISSN 1747-597X
    ISSN (online) 1747-597X
    DOI 10.1186/s13011-020-00313-2
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  2. Article: Aquacel Ag Advantage/Ag+ Extra and Cutimed Sorbact in the management of hard-to-heal wounds: a cohort study.

    Dissemond, Joachim / Aare, Kristina / Ozer, Kerem / Gandhi, Divay / Ryan, Jessica L / DeKoven, Mitch

    Journal of wound care

    2023  Volume 32, Issue 10, Page(s) 624–633

    Abstract: Objective: To compare Aquacel Ag Advantage/Ag+ Extra (Aquacel Ag+) (Convatec, UK) and Cutimed Sorbact (Sorbact) (Essity, US) dressings indicated for the treatment of patients with venous leg ulcers (VLUs), diabetes foot ulcers (DFUs) and pressure ... ...

    Abstract Objective: To compare Aquacel Ag Advantage/Ag+ Extra (Aquacel Ag+) (Convatec, UK) and Cutimed Sorbact (Sorbact) (Essity, US) dressings indicated for the treatment of patients with venous leg ulcers (VLUs), diabetes foot ulcers (DFUs) and pressure injuries (PIs) for clinical performance and outcomes using real-world evidence in Germany and the US.
    Method: This study was a chart audit review of patients who used either Aquacel Ag+ or Sorbact dressings in the 24 months prior to October 2022. Healthcare providers with access to electronic medical records and charts were asked to capture data via patient record forms. The quantitative data were analysed.
    Results: Findings in Germany were comparable between Aquacel Ag+ and Sorbact with regards to wound description, management and treatment outcomes, including percent area reduction and wound closure. A difference was that a greater proportion of Sorbact patients required surgery (0% versus 11%; p=0.039). In the US, a greater proportion of wounds were worsening before dressing in the Aquacel Ag+ cohort (49% versus 34%; p=0.010). A multinomial logistic regression yielded the result that patients who received Aquacel Ag+ were 3.53 times more likely to have the wound completely healed (p=0.033).
    Conclusion: Both Aquacel Ag+ and Sorbact dressings are widely used in Germany and the US for patients with VLUs, DFUs and PIs. Our study found two important differences: patients who used Aquacel Ag+ were less likely to need further surgery in Germany; and in the US, there were significantly higher odds that wounds would completely heal with Aquacel Ag+ dressings compared to Sorbact.
    MeSH term(s) Humans ; Carboxymethylcellulose Sodium/therapeutic use ; Cohort Studies ; Bandages ; Wound Healing ; Treatment Outcome ; Diabetic Foot/drug therapy ; Varicose Ulcer/therapy
    Chemical Substances Carboxymethylcellulose Sodium (K679OBS311)
    Language English
    Publishing date 2023-10-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 1353951-6
    ISSN 0969-0700
    ISSN 0969-0700
    DOI 10.12968/jowc.2023.32.10.624
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  3. Article ; Online: Assessing Area-Level Deprivation as a Proxy for Individual-Level Social Risks.

    Brown, Erika M / Franklin, Stephanie M / Ryan, Jessica L / Canterberry, Melanie / Bowe, Andy / Pantell, Matt S / Cottrell, Erika K / Gottlieb, Laura M

    American journal of preventive medicine

    2023  Volume 65, Issue 6, Page(s) 1163–1171

    Abstract: Introduction: Concerns about the opportunity costs of social screening initiatives have led some healthcare organizations to consider using social deprivation indices (area-level social risks) as proxies for self-reported needs (individual-level social ... ...

    Abstract Introduction: Concerns about the opportunity costs of social screening initiatives have led some healthcare organizations to consider using social deprivation indices (area-level social risks) as proxies for self-reported needs (individual-level social risks). Yet, little is known about the effectiveness of such substitutions across different populations.
    Methods: This analysis explores how well the highest quartile (cold spot) of three different area-level social risk measures-the Social Deprivation Index, Area Deprivation Index, and Neighborhood Stress Score-corresponds with six individual-level social risks and three risk combinations among a national sample of Medicare Advantage members (N=77,503). Data were derived from area-level measures and cross-sectional survey data collected between October 2019 and February 2020. Agreement between individual and individual-level social risks, sensitivity values, specificity values, positive predictive values, and negative predictive values was calculated for all measures in summer/fall 2022.
    Results: Agreement between area and individual-level social risks ranged from 53% to 77%. Sensitivity for each risk and risk category never exceeded 42%; specificity values ranged from 62% to 87%. Positive predictive values ranged from 8% to 70%, and negative predictive values ranged from 48% to 93%. There were modest performance discrepancies across area-level measures.
    Conclusions: These findings provide additional evidence that area-level deprivation indices may be inconsistent indicators of individual-level social risks, supporting policy efforts to promote individual-level social screening programs in healthcare settings.
    MeSH term(s) Aged ; Humans ; Cross-Sectional Studies ; Health Facilities ; Medicare ; Policy ; United States ; Social Deprivation ; Risk-Taking
    Language English
    Publishing date 2023-06-10
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 632646-8
    ISSN 1873-2607 ; 0749-3797
    ISSN (online) 1873-2607
    ISSN 0749-3797
    DOI 10.1016/j.amepre.2023.06.006
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    Zs.A 2096: Show issues Location:
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  4. Article: Inpatient and emergency department costs from sports injuries among youth aged 5-18 years.

    Ryan, Jessica L / Pracht, Etienne E / Orban, Barbara Langland

    BMJ open sport & exercise medicine

    2019  Volume 5, Issue 1, Page(s) e000491

    Abstract: Objective: To analyse the financial costs from sports injuries among inpatients and emergency department (ED) patients aged 5-18 with a focus on Medicaid patients.: Methods: Fixed-effects linear regression was used to assess the association of ... ...

    Abstract Objective: To analyse the financial costs from sports injuries among inpatients and emergency department (ED) patients aged 5-18 with a focus on Medicaid patients.
    Methods: Fixed-effects linear regression was used to assess the association of patient factors with cost of injury from sports. Florida Agency for Health Care Administration data from 2010 to 2014 were used, which included all inpatient and ED patients aged 5-18 years who had a sports injury.
    Results: Over 5 years, sports injuries in Florida youth cost $24 million for inpatient care and $87 million for ED care. Youth averaged $6039 for an inpatient visit and $439 for an ED visit in costs from sports injuries. Sports injuries for Medicaid-insured youth cost $10.8 million for inpatient visits and $44.2 million for ED visits.
    Conclusion: Older athletes and males consistently have higher healthcare costs from sports. Baseball, basketball, bike riding, American football, roller-skating/skateboarding and soccer are sports with high costs for both ED patients and inpatients and would benefit from prevention programmes. Injuries from non-contact sport participants are few but can have high costs. These athletes could benefit from prevention programmes as well.
    Language English
    Publishing date 2019-03-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2817580-3
    ISSN 2055-7647
    ISSN 2055-7647
    DOI 10.1136/bmjsem-2018-000491
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  5. Article ; Online: Sickle Cell Disease in an Older Adult Population: A Retrospective Review of Health Care Resource Utilization.

    Ryan, Jessica L / Rastegar, Jeremiah S / Dobbins, Jessica M / Peikes, Deborah N / Theodorou, Anna / Garcia, Brian / Loy, Bryan / Bell, Ebony / Olayiwola, J Nwando

    Population health management

    2024  Volume 27, Issue 2, Page(s) 120–127

    Abstract: Sickle cell disease (SCD) has a history of health inequity, as patients with SCD are primarily Black and often marginalized from the health care system. Although recent health care and treatment advancements have prolonged life expectancy, it may be ... ...

    Abstract Sickle cell disease (SCD) has a history of health inequity, as patients with SCD are primarily Black and often marginalized from the health care system. Although recent health care and treatment advancements have prolonged life expectancy, it may be insufficient to support the complex needs of the growing population of older adults with SCD. This retrospective study used a cohort (
    MeSH term(s) Humans ; Aged ; United States/epidemiology ; Middle Aged ; Retrospective Studies ; Emergency Service, Hospital ; Medicare ; Hospitalization ; Delivery of Health Care ; Pain ; Anemia, Sickle Cell/complications ; Anemia, Sickle Cell/epidemiology ; Anemia, Sickle Cell/therapy
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2454546-6
    ISSN 1942-7905 ; 1942-7891
    ISSN (online) 1942-7905
    ISSN 1942-7891
    DOI 10.1089/pop.2023.0268
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    Zs.A 5170: Show issues Location:
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  6. Article ; Online: Association of Trauma Alert Response Charges With Volume and Hospital Ownership Type in Florida.

    Ryan, Jessica L / Pracht, Etienne E / Langland-Orban, Barbara

    Health services research and managerial epidemiology

    2018  Volume 5, Page(s) 2333392818797793

    Abstract: Objective: The purpose was to analyze the association of trauma volume and hospital trauma center (TC) ownership type with trauma alert (TA) response charges, which are billed for activation of the trauma team to the emergency department (ED).: ... ...

    Abstract Objective: The purpose was to analyze the association of trauma volume and hospital trauma center (TC) ownership type with trauma alert (TA) response charges, which are billed for activation of the trauma team to the emergency department (ED).
    Methods: All Florida ED and inpatients who were billed a TA charge from 2012 to 2014 were included (62 974 observations). Multiple linear regression, controlling for patient and hospital factors, was used to identify associations between TA charges and trauma volume and hospital ownership type. Severity elasticity of trauma response charges was calculated by ownership type.
    Results: Trauma volume had a significant, inverse relationship with TA charges. For-profit (FP) hospitals had significantly higher TA charges and government-owned hospitals had significantly lower TA charges relative to private not-for-profits. For-profit trauma response charges were inelastic to severity, that is, charges did not change with changes in severity.
    Conclusion: Higher TA charges were associated with lower patient volumes, as well as at FP TCs. Further, only FP TCs used alert charges that were not associated with injury severity. Adding new TCs that reduce volume at existing TCs is expected to increase TA charges, especially if they are FP TCs.
    Language English
    Publishing date 2018-09-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2805732-6
    ISSN 2333-3928 ; 2333-3928
    ISSN (online) 2333-3928
    ISSN 2333-3928
    DOI 10.1177/2333392818797793
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  7. Article ; Online: Association of Health-Related Social Needs With Quality and Utilization Outcomes in a Medicare Advantage Population With Diabetes.

    Ryan, Jessica L / Franklin, Stephanie M / Canterberry, Melanie / Long, Charron L / Bowe, Andy / Roy, Brandy D / Hessler, Danielle / Aceves, Benjamin / Gottlieb, Laura M

    JAMA network open

    2023  Volume 6, Issue 4, Page(s) e239316

    Abstract: Importance: Recent research highlights the association of social determinants of health with health outcomes of patients with type 2 diabetes (T2D).: Objective: To examine associations between health-related social needs (HRSNs) and health care ... ...

    Abstract Importance: Recent research highlights the association of social determinants of health with health outcomes of patients with type 2 diabetes (T2D).
    Objective: To examine associations between health-related social needs (HRSNs) and health care quality and utilization outcomes in a Medicare Advantage population with T2D.
    Design, setting, and participants: This cross-sectional study used medical and pharmacy claims data from 2019. An HRSN survey was given between October 16, 2019, and February 29, 2020, to Medicare Advantage beneficiaries. Inclusion criteria were diagnosis of T2D, age of 20 to 89 years, continuous Medicare Advantage enrollment in 2019, and response to the HRSN survey. Data were analyzed between June 2021 and January 2022.
    Exposures: Enrollment in Medicare Advantage, diagnosis of T2D, and completion of a survey on HRSNs.
    Main outcomes and measures: Quality outcomes included diabetes medication adherence, statin adherence, completion of a glycated hemoglobin (HbA1c) laboratory test in the past 12 months, and controlled HbA1c. Utilization outcomes included all-cause hospitalization, potentially avoidable hospitalization, emergency department discharge, and readmission.
    Results: Of the 21 528 Medicare Advantage beneficiaries with T2D included in the study (mean [SD] age, 71.0 [8.3] years; 55.4% women), most (56.9%) had at least 1 HRSN. Among the population with T2D reporting HRSNs, the most prevalent were financial strain (73.6%), food insecurity (47.5%), and poor housing quality (39.1%). In adjusted models, loneliness (odds ratio [OR], 0.85; 95% CI, 0.73-0.99), lack of transportation (OR, 0.80; 95% CI, 0.69-0.92), utility insecurity (OR, 0.86; 95% CI, 0.76-0.98), and housing insecurity (OR, 0.78; 95% CI, 0.67-0.91) were each associated with lower diabetes medication adherence. Loneliness and lack of transportation were associated with increased emergency visits (marginal effects of 173.0 [95% CI, 74.2-271.9] and 244.6 [95% CI, 150.4-338.9] emergency visits per 1000 beneficiaries for loneliness and transportation, respectively). Food insecurity was the HRSN most consistently associated with higher acute care utilization (marginal effects of 84.6 [95% CI, 19.8-149.4] emergency visits, 30.4 [95% CI, 9.5-51.3] inpatient encounters, and 17.1 [95% CI, 4.7-29.5] avoidable hospitalizations per 1000 beneficiaries).
    Conclusions and relevance: In this cross-sectional study of Medicare Advantage beneficiaries with T2D, some HRSNs were associated with care quality and utilization. The results of the study may be used to direct interventions to the social needs most associated with T2D health outcomes and inform policy decisions at the insurance plan and community level.
    MeSH term(s) Humans ; Female ; Aged ; United States/epidemiology ; Young Adult ; Adult ; Middle Aged ; Aged, 80 and over ; Male ; Medicare Part C ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/therapy ; Cross-Sectional Studies ; Glycated Hemoglobin ; Hospitalization
    Chemical Substances Glycated Hemoglobin
    Language English
    Publishing date 2023-04-03
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.9316
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  8. Article ; Online: The Probability of Hospitalizations for Mild-to-Moderate Injuries by Trauma Center Ownership Type.

    Pracht, Etienne E / Langland-Orban, Barbara / Ryan, Jessica L

    Health services research

    2017  Volume 53, Issue 1, Page(s) 35–48

    Abstract: Objective: To corroborate anecdotal evidence with systematic evidence of a lower threshold for admission among for-profit hospitals.: Data sources: The study used Florida emergency department and hospital discharge datasets for 2012 to 2014. The ... ...

    Abstract Objective: To corroborate anecdotal evidence with systematic evidence of a lower threshold for admission among for-profit hospitals.
    Data sources: The study used Florida emergency department and hospital discharge datasets for 2012 to 2014. The treatment variable of interest was for-profit-designated trauma center status. The dependent variable indicated whether a patient with mild-to-moderate injuries was admitted after presenting as a trauma alert and then discharged to home. A separate analysis was conducted of discharges that had a 1-day length of stay.
    Study design: Generalized estimation equations with logistic distribution models were used to control for the confounding influences and developed for four groups of patients: ICISS = 1 (no probability of mortality), ICISS ≥ 0.99, ICISS ≥ 0.95, and ICISS ≥ 0.85 (zero to 15 percent probability of mortality, which includes all mild and moderate injury patients).
    Principal findings: For the ICISS = 1 and ICISS ≥ 0.99 models, the centers' for-profit status was the most important predictor. In the ICISS ≥ 0.95 and ICISS ≥ 0.85 models, injury type played a more important role, but for-profit status remained important. For patients with a 1-day stay, for-profit status was associated with an even higher probability of hospitalization.
    Conclusions: Considerable differences exist between for-profit and not-for-profit trauma centers concerning hospitalization among the study population, which may be explained by supplier-induced demand.
    MeSH term(s) Age Factors ; Continental Population Groups ; Emergency Service, Hospital/statistics & numerical data ; Florida ; Hospital Bed Capacity/statistics & numerical data ; Hospitalization/statistics & numerical data ; Humans ; Insurance Coverage/statistics & numerical data ; Insurance, Health/statistics & numerical data ; Ownership/statistics & numerical data ; Sex Factors ; Socioeconomic Factors ; Trauma Centers/statistics & numerical data ; Trauma Severity Indices ; Wounds and Injuries/mortality ; Wounds and Injuries/therapy
    Language English
    Publishing date 2017-01-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 410435-3
    ISSN 1475-6773 ; 0017-9124
    ISSN (online) 1475-6773
    ISSN 0017-9124
    DOI 10.1111/1475-6773.12646
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