Office-based Physician Visits by Patients with Diabetes Increase

July 31, 2014

Diabetes is a chronic condition which affects nearly 29 million Americans and is a major cause of other chronic conditions, including heart disease, eye disease, and stroke. Diabetes was the seventh leading U.S. cause of death in 2009 and 2010. Management of diabetes costs nearly $245 billion annually, and patients with diabetes have medical expenditures approximately 2.3 times higher than those for patients without diabetes.

A new NCHS report shows the trend from 2005 through 2010 for visits to office-based physicians by patients with diabetes, and describes age differences in the utilization of health care by patients with diabetes in 2010.

Key Findings from the Report:

  • Office-based physician visits by patients with diabetes increased 20%, from 94.4 million in 2005 to 113.3 million in 2010, but the rate did not change between 2005 and 2010.
  • The visit rate for diabetes increased with age and averaged 1,380 visits per 1,000 persons aged 65 and over in 2010.
  • A majority of visits made by patients with diabetes (87%) were by those with multiple chronic conditions, and the number of chronic conditions increased with advancing age.
  • Medications were prescribed or continued at a majority of visits (85%) made by patients with diabetes, with the number of medications prescribed or continued increasing as age increased.

 


Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006-10

July 30, 2014

NCHS has just released a report, “Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006-10,” which provides an in-depth look at the approximately 10,000 weather related deaths that occurred in the U.S. over that five-year span. In particular, the report examined the following causes of death: exposure to excessive natural heat (including heat stroke, sun stroke, or all); exposure to excessive natural cold (including hypothermia); and deaths attributed to floods, storms, or lightning.

NCHS has tallied weather-related deaths for years, but because of changes in the International Classification of Diseases (ICD) coding system over time, comparing past decades of weather-related deaths is difficult, if not impossible, particularly for deaths from excessive heat and cold.

DEATHS BY LIGHTNING ON THE DECLINE?

The CDC WONDER data base allows users to research these causes of death, in some cases going back to 1968. A look at the number of lightning deaths shows that from 1968 to 1978 there were 1,253 deaths from being struck by lightning – an annual average of about 114 deaths over that 11-year span. From 1979 to 1998, there were 1,589 lightning deaths, an annual average of about 79.5 deaths over that two-decade period. From 1999 to 2005, there were 365 lightning deaths, an annual average of a little over 52 deaths per year. The new 2006-2010 report shows 182 lightning deaths over that five-year span – an annual average of about 36.5 deaths per year. And 2011 data – the last year for available national data – show that 24 people were killed by lightning in the U.S. that year. So are lightning deaths on the decline in the U.S.? It would appear so.

Lightning deaths, which have had a single, independent ICD code for over the past four-plus decades, are the only of these weather-related deaths that are somewhat comparable.

STORMS & FLOODS – “CATACLYSMS”

From 1968 to 1978, the ICD-8 codes lumped both storms and floods together with other natural disasters like earthquakes and mudslides into one “Cataclysm” category. The ICD-9 codes (1979-1998) separated storms and floods from earthquakes, mudslides, etc. and during that 20-year period documented that storms and floods accounted for about 80% of all “cataclysm” deaths from (WONDER shows there were 2,196 deaths from storms and floods from 1979 to 1998 – an annual average of about 110 deaths per year). From 1968 to 1978, there were 2,683 deaths from all cataclysms – including any that were earthquakes, mudslides, etc.

From 1999 to 2005, there were 1,431 deaths from storms and floods, an annual average of over 204 deaths per year. However, 2005 was the year of Hurricane Katrina (and the less lethal but also devastating Hurricane Rita), which resulted in a spike in the number of these deaths. In the new 2006-2010 study, there were 464 deaths from storms and floods – an annual average of just under 93 deaths per year.

Comparing excessive heat and excessive cold-related deaths over the long term becomes virtually impossible using the WONDER data base, as prior to 1979 there was no distinction made between deaths from heat and cold that were weather-related vs. man-made.


QuickStats: Rate of Nonfatal Fall Injuries Receiving Medical Attention by Age Group – United States, 2012

July 29, 2014

In 2012, the U.S. rate of nonfatal fall injuries receiving medical attention was 43 per 1,000 population. Rates increased with age for adults aged ≥18 years. Adults aged 18–44 years had the lowest rate of falls (22 per 1,000), and the rate for those aged 75 years or older were higher (121 per 1,000) than for all other age groups.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6329a8.htm


Reasons for Emergency Room Use Among U.S. Children: National Health Interview Survey, 2012

July 29, 2014

Emergency rooms (ERs) are intended to provide care for acute and life-threatening medical conditions for people of all ages, but use is highest among older adults and young children. In 2012, 18% of children aged 0–17 years visited the ER at least once in the past year. Rising health care costs make it important to understand the reasons that families with children seek ER care, rather than less expensive office-based or outpatient care.

Families visiting the ER at night or on weekends may have different characteristics or reasons for using the ER than those who visit during the day. Previous research among adults found that the majority visited the ER because “only a hospital could help,” or the “doctor’s office [was] not open.”

A new report provides comparable statistics on reasons for children’s ER use.

Key Findings from the Report:

 

  • In 2012, children with Medicaid coverage were more likely than uninsured children and those with private coverage to have visited the emergency room (ER) at least once in the past year.
  • About 75% of children’s most recent visits to an ER in the past 12 months took place at night or on a weekend, regardless of health insurance coverage status.
  • The seriousness of the medical problem was less likely to be the reason that children with Medicaid visited the ER at their most recent visit compared with children with private insurance.
  • Among children whose most recent visit to the ER was for reasons other than the seriousness of the medical problem, the majority visited the ER because the doctor’s office was not open.

 


Perception of Weight Status in U.S. Children and Adolescents Aged 8–15 Years, 2005–2012

July 29, 2014

Childhood obesity is a major public health problem associated with many adverse health outcomes in adulthood. During 2011–2012, nearly 17% of children and adolescents were obese. Weight status misperception occurs when the child’s perception of their weight status differs from their actual weight status based on measured height and weight. Accurate weight status self-perception has been linked to appropriate weight control behaviors in youth.

The National Health and Nutrition Examination Survey data for children and adolescents aged 8–15 years offers an opportunity to examine weight perception status in this age group.

Key Findings from the Report:

 

  • About 30% of children and adolescents aged 8–15 years in the United States misperceive their weight status. Weight status misperception is more common among boys (32.3%) than girls (28.0%).
  • About one-third of Mexican-American (34.0%) and non-Hispanic black (34.4%) children and adolescents misperceive their weight status compared with non-Hispanic white children and adolescents (27.7%).
  • Approximately 81% of overweight boys and 71% of overweight girls believe they are about the right weight.
  • Nearly 48% of obese boys and 36% of obese girls consider themselves to be about the right weight.

 


STATCAST: April – June 2014

July 23, 2014

Rural Residents Who Are Hospitalized in Rural and Urban Hospitals: United States, 2010

July 18, 2014

In 2010, 17% of the U.S. population lived in rural (nonmetropolitan) areas. Many rural areas are medically underserved due to physician (especially specialist) shortages. Rural hospitals often are small, with a low volume of services, and have difficulty remaining financially viable under the regular hospital prospective payment system. Special Medicare hospital payment categories have been established so that rural residents have access to hospital care without traveling to urban areas. The share of rural residents’ hospitalizations that take place in urban (metropolitan) compared with rural hospitals has been of interest for a number of years. Those who go to urban hospitals have been described as “bypassing” rural hospitals.

A new NCHS report compares characteristics of rural residents who stay in rural areas with those who travel to urban areas for their inpatient care.

Key Findings from the Report:

  • Sixty percent of the 6.1 million rural residents who were hospitalized in 2010 went to rural hospitals; the remaining 40% went to urban hospitals.
  • Rural residents who remained in rural areas for their hospitalization were more likely to be older and on Medicare compared with those who went to urban areas.
  • Almost three-quarters of rural residents who traveled to urban areas received surgical or nonsurgical procedures during their hospitalization (74%), compared with only 38% of rural residents who were hospitalized in rural hospitals.
  • More than 80% of rural residents who were discharged from urban hospitals had routine discharges (81%), generally to their homes, compared with 63% of rural residents discharged from rural hospitals.

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