American journal of industrial medicine · 2014
The upper respiratory pyramid: early factors and later treatment utilization in World Trade Center exposed firefighters.
СтатьяПоддержка NIH: внешняя программаПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод пока не подготовлен
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Niles Justin K, Webber Mayris P, Liu Xiaoxue, Zeig-Owens Rachel, Hall Charles B, Cohen Hillel W, Glaser Michelle S, Weakley Jessica, Schwartz Theresa M, Weiden Michael D, Nolan Anna, Aldrich Thomas K, Glass Lara, Kelly Kerry J, Prezant David J
Аннотация
BACKGROUND: We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers.
METHODS: We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points.
RESULTS: Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period.
CONCLUSIONS: Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs.
METHODS: We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points.
RESULTS: Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period.
CONCLUSIONS: Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs.
Предметные рубрики MeSH
AdultAnalysis of VarianceChronic DiseaseDrug CostsFirefightersForecastingHealth ServicesHealth Services Needs and DemandHoarsenessHumansInhalation ExposureLaryngoscopyMaleMiddle AgedNasal ObstructionNeeds AssessmentNew York CityOccupational ExposureOtolaryngologyOtorhinolaryngologic Surgical ProceduresPharyngitisRescue WorkRhinitisSeptember 11 Terrorist AttacksSinusitisSurveys and QuestionnairesTime Factors