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[Accidental death in advanced age].

In 1989 accidental death of 72 persons with an age of at least 60 years were determined at the Institute for Legal Medicine in Hamburg. 41 of them (57%) died by traffic accident. In those cases 18 of them died from pneumonia or embolism of lung as a result to be laid low. The causal connection and phenomenoms of those complications are described and problems of medicine, social-security payment and insurance benefit of the elder age are discussed.

Pernicious anemia in childhood.

Two children from different families with pernicious anemia are described. The defect appears to be the lack of intrinsic factor in the acid gastric juice. The correct diagnosis and proper therapy are essential for insuring a normal growth and development. Studies performed in other members of both families failed to reveal any hematologic disorder. The prolonged and close follow-up of the first case enabled the authors to assist in the birth of a normal offspring.

Sleep duration, sleep-wake schedules, and social jetlag among corporate employees in Japan: Age- and gender-based comparisons of wearable device data (2019-2022).

OBJECTIVES: Insufficient sleep has been linked to cardiovascular events and mortality, yet most prior studies rely on self-reported sleep duration. Large-scale longitudinal studies based on objective sleep measurements remain scarce. This study aimed to describe 3-year sleep-wake patterns, including total sleep time (TST) and social jetlag, using data from a validated wearable device (Fitbit), and to compare these patterns by gender, age, weekday versus weekend, and fiscal year. METHODS: The study included 20,886 corporate employees insured by Japanese health insurance associations with JMDC …

Effects of COVID-19 pandemic on incidence of asthma exacerbation in an urban population.

The long-term effects of the COVID-19 pandemic on asthma exacerbations across sociodemographic groups is unknown. We conducted a retrospective cohort study of 162,113 asthma patients within the Montefiore Health System from March 2018 to February 2024 to evaluate pandemic-related changes in exacerbation risk across demographic, socioeconomic, and social determinant subgroups. Difference-in-differences logistic regression compared pre-pandemic (2018-2020) and late-pandemic (2022-2024) periods by age, sex, race and ethnicity, income, insurance, and unmet social needs. Interrupted time series reg…

Protecting the Integrity and Quality of the Medicare Advantage Program: A Position Paper From the American College of Physicians.

Medicare Advantage (MA), the private plan option within Medicare, now enrolls more than half of all beneficiaries and is projected to keep expanding. The American College of Physicians (ACP) assesses the ethical and policy dimensions of this growth and its implications for the delivery of fair, high-quality, and fiscally responsible care to older adults and persons with disabilities. Payment and risk adjustment policies have created vulnerabilities to overpayment and favorable risk selection, whereas quality measurement remains fragmented and overly complex. Beneficiaries often face challenges

Facilitators and Challenges in Oral Health Care for Iranian Patients Undergoing Opioid Maintenance Treatment: A Qualitative Study.

INTRODUCTION: This qualitative study aimed to explore the challenges and enablers of oral health care for patients receiving opioid maintena … it is better to provide special centers for these people with trained personnel to treat them with insurance coverage.

Нейромиелитное расстройство спектра в Германии. Анализ данных о частотности, распространенности, методах лечения и диагностическом совпадении с множественным склерозом.

Нейромиелитные расстройства спектра (NMOSD) являются редкими аутоиммунными заболеваниями центральной нервной системы. Оценки распространенности в мире сильно различаются, а данные по Германии являются ограниченными. ЦЕЛИ: Оценка распространенности, частотности, диагностических параметров, комордного кодирования с множественным склерозом (MS) и схем лечения в Германии. Мы проанализировали данные о претензиях в связи с медицинским страхованием в Германии (приблизительно) 9 million - лица; 2015-2022). Случаи НМОСБ были выявлены ICD-10-GM код G36.0. Была проведена оценка динамики, диагностических

Совпадение в аннотации оригинала
BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSD) are rare autoimmune diseases of the central nervous system. Global prevalence es … tiple sclerosis (MS), and treatment patterns in Germany. METHODS: We analyzed German BARMER health insurance claims data (approximately 9 million persons; 2015-2022). NMOSD cases were identified by ICD-10-GM code G36.0. Frequencies, diagnostic settings, comorbid MS coding (G35.-), and treatment patterns (Anatomical Therapeutic Chemical codes) were assessed …

Disparities in periodontitis risk and healthcare use among individuals with disabilities in Korea: a retrospective cohort study.

BACKGROUND: We analyzed the relationship between disability status and periodontal disease, focusing on disparities in healthcare utilisation, including outpatient visits and hospitalisation rates, among disability types and severities. METHODS: This study used data from the National Health Insurance Service(NHIS) of Korea, which includes comprehensive records of the insured population. We examined 966,200 individuals with disabilities, grouped into five categories, and applied propensity score matching to compare with a matched control population. Periodontal disease was defined by the Korea…

Disparities in Out-of-Pocket Expenditures Among Hospitalized Patients With COVID-19 in Iran: A Decomposition Analysis of Inequality.

OBJECTIVES: Limited information is available on the extent of inequality in out-of-pocket (OOP) expenditures among patients with COVID-19 in … ts with COVID-19. Additionally, examination of inequality across population subgroups revealed that insurance status and type, clinical characteristics, and temporal patterns of hospitalization significantly contributed to the observed disparities in OOP expenditures among patients with COVID-19. CONCLUSIONS: This study highlights the enduring impact of in …

Identifying Barriers to Personal Medical Preparedness for Hurricanes among Adults with Hypertension.

OBJECTIVES: Experts recommend preparedness to manage chronic diseases in case of disaster-related resource disruption. This study's goal is to identify factors underlying personal medical preparedness (PMP) among participants from a hurricane-prone region. METHODS: A cross-sectional survey was completed during the 2023 Atlantic hurricane season with 120 insured adults age ≥50 in Southeast Louisiana with hypertension and ≥1 regular medication. PMP was measured using the validated Household Emergency Preparedness Instrument Access and Functional Needs Section (HEPI-AFN). Multivariable logistic

Epidemiology and the Medical Burden of Diabetic Foot Ulcers Especially in Patients With Infection-A Population-Based Analysis From Germany.

Due to limited data on the epidemiology of diabetic foot ulcers (DFU) in Germany, especially for those infected, the study determined the prevalence and incidence of DFU and the associated medical burden. Anonymised claims data of 3.3 million insured lives were sourced from a statutory health insurance fund. Patients with DFU between 04/01/2016 and 12/31/2019 were selected (n = 7764) and divided into patients with/without infection/with prophylactic use of antibiotics. Outcome variables were described categorically. Two-sided t-tests and chi-squared tests (p < 0.05) were performed. The prevale…

Risk Factors for Development of Type 2 and Prediabetes in Children During the COVID-19 Pandemic.

BACKGROUND: During the COVID-19 pandemic, there was a rise in the incidence of type 2 diabetes (T2D) and prediabetes in children and teenagers. We investigated whether new risk factors for diabetes in children emerged during the pandemic period. METHODS: Using health records of a large, integrated health system, we evaluated the incidence of new-onset T2D and prediabetes in patients aged 0-19 years from 2020 to 2023. We utilised descriptive statistics, chi-square and multivariable logistic regressions to predict the risk of T2D and prediabetes. RESULTS: Compared to children with normal weigh

Administrative Claims Data Show Increased Morbidity Risk For US Adults In Same-Sex Versus Different-Sex Relationships.

Studies have found that sexual minority populations more often report worse overall health, lower health-related quality of life, and greater risk for disability than their heterosexual counterparts. This study used a novel approach to identify people in same-sex relationships, using insurance administrative claims data, and compared the prevalence of morbidity in that population with its prevalence in the population of those in different-sex relationships. This observational retrospective cohort study used the Merative MarketScan Research Database, which pooled data from private insurers from…

Strengths and limitations of non-survey-based data sources for assessing adult vaccination coverage in the United States.

INTRODUCTION: Non-survey-based data sources (e.g. electronic health records, administrative claims) have been used to estimate vaccination c … among individuals with chronic health conditions. While several data sources used continuous health insurance enrollment to define the study population, doing so limited generalizability to stably insured populations. Methods for obtaining race and ethnicity data were complex and potentially subject to bias. None of the reviewed studies presented any formal …

Validity of Self-reported Participation in Cancer Screenings and Health Checkups in Japan.

BACKGROUND: The participation rate for screening is regarded as a useful indicator for preventing cancer and cardio-metabolic disease. However, the validity of self-reported screening participation has not yet been thoroughly evaluated in Japan. We aimed to examine its validity using the municipal screening records among the Japanese population. METHODS: We included 3,060 men and 3,860 women insured by the National Health Insurance for residents aged <75 years or the Medical Care System for the Elderly aged ≥75 years in the Chikusei area of the Japan Public Health Center-based Prospective Stu…

Long-Acting Reversible Contraception (LARC) and Early Childbearing Revisited: Births and Birth Intendedness After LARC Removal in a State Medicaid Population (2012-2020).

Objectives. To analyze births and birth intendedness after long-acting reversible contraception (LARC) removal among Medicaid-insured women. Methods. We linked all Delaware women with a Medicaid-covered LARC removal in 2012 to 2020 (n = 8047) to birth records and to Pregnancy Risk Assessment Monitoring System (PRAMS) pregnancy intendedness survey responses (n = 241). Results. Births within 3 years of a Medicaid-covered LARC removal were much more likely to be to women in their 20s compared with all Medicaid births (63.5% vs 53.4%; P < .001). The intended proportion for births within 3 years of

[Access to medicines for the treatment of systemic arterial hypertension and type 2 diabetes mellitus in the Brazilian population: data from the 2019 Brazilian National Health Survey].

This study aimed to measure access to medicines for the treatment of systemic arterial hypertension and type 2 diabetes mellitus in Brazil a … older age, lower income, lower schooling, very poor self-rated health and not having private health insurance. Access to insulin, on the other hand, was most often via the public health service (69.7%), and the factors that most negatively influenced this access were black/mixed-race skin color, lower income, very poor self-rated health and not having priva …

The Contribution of Noncommunicable and Infectious Diseases to the Effect of Depression on Mortality: A Longitudinal Causal Mediation Analysis.

BACKGROUND: The increased prevalence of physical diseases among individuals with mental illness contributes to their increased risk of mortality. However, the mediating role of specific diseases in the effect of mental illness on mortality is not well understood. METHOD: We conducted a longitudinal causal mediation analysis using data from beneficiaries of a South African medical insurance scheme from 2011 to 2020. We estimated the overall effect of major depressive disorder (MDD) on mortality and evaluated reductions in this overall effect through hypothetical interventions on the risks of m…

Cost burden among the CF population in the United States: A focus on debt, food insecurity, housing and health services.

BACKGROUND: Advancements in the cystic fibrosis (CF) field have resulted in longer lifespans for individuals with CF. This has led to more responsibility for complex care regimens, frequent health care, and prescription medication utilization that are costly and may not be fully covered by health insurance. There are outstanding questions about unmet medical needs among the U.S. population with CF and how the financial burden of CF is associated with debt, housing instability, and food insecurity. METHODS: Researchers developed the CF Health Insurance Survey (CF HIS) to survey a convenience s…

Increased Demand for Pharmaceutical Drugs Containing Potassium Iodide In Connection with the Russia-Ukraine Conflict.

The current conflict between Russia and Ukraine increased concerns in the German population of a release of radioactive substances, e.g.radioactive iodine. A high dose of potassium iodide (PI) may prevent accumulation of radioactive iodine in the thyroid gland. Therefore, the German government keeps a sufficient quantity of PI in stock for public supply in case of an emergency. We investigated ambulatory drug dispensing rates of PI and found that the total dispensing of PI (statutory health insurance (SHI), private health insurance (PHI), and overthe-counter (OTC)) increased by 106% from Febru…