Thanks to John D. Johnson from Summerville, Georgia the breed is still with us today. He gathered the best dogs he could find throughout the rural South and bred them back into popularity among his family and other rural families. His father bred the American Bulldog before John did and they have bred them longer than any other in any part of the world.
Data sources include national surveys, Medicare standard analytical files, and one of the largest claims databases for the commercially insured population in the U. For the cost categories analyzed, care for people with diagnosed diabetes accounts for 1 in 4 health care dollars in the U.
The growth in diabetes prevalence and medical costs is primarily among the population aged 65 years and older, contributing to a growing economic cost to the Medicare program. The estimates in this article highlight the substantial financial burden that diabetes imposes on society, in addition to intangible costs from pain and suffering, resources from care provided by nonpaid caregivers, and costs associated with undiagnosed diabetes.
Introduction Diabetes imposes a substantial burden on society in the form of higher medical costs, lost productivity, premature mortality, and intangible costs in the form of reduced quality of life.
The estimated economic burden associated with diagnosed diabetes in the U. Furthermore, there continue to be changes in the demographics of the population with diabetes, health care use and delivery patterns, technology, medical costs, insurance coverage, and economic conditions that affect the economic burden associated with diabetes.
This study updates previous estimates, with the goal to quantify the economic burden of diabetes at the national and state levels in Such information can help inform and motivate strategies to reduce diabetes prevalence and burden. Research Design and Methods The methodology used is similar to that of previous diabetes burden studies sponsored by the American Diabetes Association 14with updated data sources and modifications to refine the analyses where appropriate.
Although the primary A comparison of american healthways and renal care group of this analysis is the national economic burden of disease, the national estimates are calculated by summing the state-level estimates that reflect variation across states in demographics, health risk factors and lifestyle choices, prices, and economic outcomes.
State-level estimates of diabetes prevalence and costs are provided in Supplementary Table A All cost and utilization estimates are extrapolated to the U.
Inputs to the study include both state-level and national-level data. Supplementary Table A-1 describes how these data sources are used along with their respective strengths and limitations as pertinent to this study.
Government employees and military personnel and dependents with insurance are counted under private insurance. The reason for modeling the large number of strata reflects differences in diabetes prevalence and costs across these strata and that different data sources are used to estimate diabetes prevalence for people residing in the community, in a residential care facility, or in a nursing home.
We use random sampling with replacement to statistically match each person in the ACS with a similar person in a file containing patient health information and risk factors. These sources do not contain diabetes status for children. To estimate diabetes prevalence inwe scaled the state estimates based on population growth between and by demographic group.
For validation, when we apply prevalence rates for each strata demographic, insurance, state to the population, our national estimate of diagnosed diabetes is slightly higher than that reported by the Centers for Disease Control and Prevention CDC Our higher estimate possibly reflects that our analysis incorporates data from residential care and nursing facilities, whereas the CDC estimate is based on a representative sample of the noninstitutionalized population.
Estimating the Direct Medical Cost Attributed to Diabetes We estimate health resource use among the population with diabetes in excess of resource use that would be expected in the absence of diabetes.
Diabetes also increases the cost of treating general conditions that are not directly related to diabetes. Therefore, only the relevant portion of health care expenditures for these medical conditions is attributed to diabetes. The approach used to quantify the excess health resource use associated with diabetes was influenced by four data limitations: Because of these limitations, we estimate diabetes-attributed costs using one of two approaches for each cost component.
Etiological fractions estimate the excess use of health care services among the diabetes population relative to a similar population that does not have diabetes. Both approaches used in this study are equivalent under a reasonable set of assumptions.
However, the first approach cannot be used with some national data sources analyzed—e. The etiological fraction is calculated using the diagnosed diabetes prevalence P and the relative rate ratio R: The rate ratio for hospital inpatient days, emergency visits, and ambulatory visits represents how annual per capita health service use for the population with diabetes compares to the population without diabetes: Diabetes and its comorbidities are correlated with other patient characteristics such as demographics and body weight.
The dNHI data contain a complete set of medical claims for more than 31 million commercially insured beneficiaries in and allows patient records to be linked during the year and across health delivery settings.
This allows us to identify people with a diabetes ICD-9 The Hines Bulldog, German Rottweiler, American Bandogge, and South African Boerboel together with the Neapolitan Mastiff were used to form the American Molossus.
The goal of the founder was to make a great family pet and protector. May 10, · The HCG was similar to the program participant group in demographic characteristics, medical costs, and health care use.
However, patients in the HCG had lower rates of receiving appropriate tests, particularly . ACC Members Show High Level of Satisfaction. American College of Cardiology (ACC) members remain satisfied with the organization and its goals of transforming cardiovascular care and helping members thrive in any .
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