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CBO — Updated Death and Injury Rates of U.S. Military Personnel During the Conflicts in Iraq and Afghanistan: Working Paper 2014-08

December 18, 2014 Comments off

Updated Death and Injury Rates of U.S. Military Personnel During the Conflicts in Iraq and Afghanistan: Working Paper 2014-08
Source: Congressional Budget Office

In Operation Iraqi Freedom, which ended on August 31, 2010, some 3,482 hostile deaths occurred among U.S. military personnel and 31,947 people were wounded in action (WIA). More than 1,800 hostile deaths occurred during Operation Enduring Freedom (in Afghanistan and surrounding countries) through November 2014; about 20,000 more people were wounded in action.

In the Iraq conflict, a larger proportion of wounded personnel survived their wounds than was the case during the Vietnam War, but the increased survival rates are not as high as some studies have asserted. Prior to the surge in troop levels that began in early 2007, the survival rate was 90.4 percent in Iraq—compared with 86.5 percent in Vietnam.

Amputation rates are difficult to measure consistently, but I estimate that 2.6 percent of all WIA and 9.0 percent of medically-evacuated WIA from the Iraq and Afghanistan theaters combined resulted in the major loss of a limb.

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CRS — A Guide to U.S. Military Casualty Statistics: Operation Inherent Resolve, Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom (November 20, 2014)

December 9, 2014 Comments off

A Guide to U.S. Military Casualty Statistics: Operation Inherent Resolve, Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

This report presents statistics regarding U.S. military casualties in the active missions Operation Inherent Resolve (OIR, Iraq and Syria) and Operation Enduring Freedom (OEF, Afghanistan), as well as operations that have ended, Operation New Dawn (OND, Iraq) and Operation Iraqi Freedom (OIF, Iraq). This report includes statistics on post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), amputations, evacuations, and the demographics of casualties. Some of these statistics are publicly available at the Department of Defense’s (DOD’s) website and others have been obtained through contact with experts at DOD.

This report will be updated as needed.

FBI Releases 2013 Statistics on Law Enforcement Officers Killed and Assaulted

December 2, 2014 Comments off

FBI Releases 2013 Statistics on Law Enforcement Officers Killed and Assaulted
Source: Federal Bureau of Investigation

According to statistics collected by the FBI, 76 law enforcement officers were killed in line-of-duty incidents in 2013. Of these, 27 law enforcement officers died as a result of felonious acts, and 49 officers died in accidents. In addition, 49,851 officers were victims of line-of-duty assaults. Comprehensive data tables about these incidents and brief narratives describing the fatal attacks and selected assaults resulting in injury are included in the 2013 edition of Law Enforcement Officers Killed and Assaulted, released today.

United States Life Tables, 2010 (November 6, 2014)

November 10, 2014 Comments off

United States Life Tables, 2010 (PDF)
Source: National Center for Health Statistics

Objectives—
This report presents complete period life tables for the United States by race, Hispanic origin, and sex, based on age-specific death rates in 2010.

Methods—
Data used to prepare the 2010 life tables are 2010 final mortality statistics; April 1, 2010 population estimates based on the 2010 decennial census; and 2010 Medicare data for persons aged 66-99. The methodology used to estimate the 2010 life tables was first implemented with data year 2008. The methodology used to estimate the life tables for the Hispanic population remains unchanged from that developed for the publication of life tables by Hispanic origin for data year 2006.

Results—
In 2010, the overall expectation of life at birth was 78.7 years. Between 2009 and 2010, life expectancy at birth increased for all groups considered. Life expectancy increased for both males (from 76.0 to 76.2) and females (80.9 to 81.0) and for the white population (78.8 to 78.9), the black population (74.7 to 75.1), the Hispanic population (81.1 to 81.4), the non-Hispanic white population (78.7 to 78.8), and the non-Hispanic black population (74.4 to 74.7).

International Comparisons of Infant Mortality and Related Factors: United States and Europe, 2010

November 7, 2014 Comments off

International Comparisons of Infant Mortality and Related Factors: United States and Europe, 2010 (PDF)
Source: National Center for Health Statistics

Infant mortality is an important indicator of the health of a nation because it is associated with a variety of factors such as maternal health, quality and access to medical care, socioeconomic conditions, and public health practices (1–3). After a plateau from 2000 to 2005 (4), the U.S. infant mortality rate declined from 6.87 infant deaths per 1,000 live births in 2005 to 6.07 in 2011 (5,6). Yet, the United States’ infant mortality rate remains higher than for most other developed countries (7). This report compares infant mortality rates between the United States and selected European countries and assesses the impact on infant mortality differences of the percentage of preterm births and gestational age-specific infant mortality rates.

HHS OIG — Medicare Paid for HIV Drugs for Deceased Beneficiaries

October 31, 2014 Comments off

Medicare Paid for HIV Drugs for Deceased Beneficiaries
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
Under the Medicare Part D program, CMS contracts with private insurance companies, known as sponsors, to provide prescription drug coverage to beneficiaries who choose to enroll. OIG has had ongoing concerns about Medicare paying for drugs and services after a beneficiary has died.
Drugs that treat the human immunodeficiency virus (HIV) can be a target for fraud, waste, and abuse, primarily because they can be very expensive. Although this report focuses on HIV drugs, the issues raised are relevant to all Part D drugs.

HOW WE DID THIS STUDY
We based this study on an analysis of Prescription Drug Event (PDE) records for HIV drugs in 2012. Part D sponsors submit these records to CMS for each drug dispensed to beneficiaries enrolled in their plans. Each record contains information about the drug, beneficiary, pharmacy, and prescriber. We used the Beneficiary Enrollment Database, the Social Security Administration’s Death Master File, and Accurint’s Death Records to identify beneficiaries’ dates of death.

WHAT WE FOUND
Medicare paid for HIV drugs for over 150 deceased beneficiaries. CMS’s current practices allowed most of these payments to occur. Specifically, CMS has edits (i.e., systems processes) in place that reject PDE records for drugs with dates of service more than 32 days after death. CMS’s practices allow payment for drugs that do not meet Medicare Part D coverage requirements. Most of these drugs were dispensed by retail pharmacies.
This review looked only at HIV drugs, which account for one-quarter of one percent of all Part D drugs in 2012. However, our findings have implications for all drugs because Medicare processes PDE records for all drugs the same way. Considering the enormous number of Part D drugs, a change in practice would affect all Part D drugs and could result in significant cost savings for the program and for taxpayers.

WHAT WE RECOMMEND
We recommend that CMS change its practice of paying for drugs that have a date of service within 32 days after the beneficiary’s death. CMS should eliminate or-if necessary for administrative processing issues-shorten the window in which it accepts PDE records for drugs dispensed after a beneficiary’s death. Such a change would prevent inappropriate payments for drugs for deceased beneficiaries and lead to cost savings for the program and for taxpayers. CMS concurred with our recommendation.

Milk intake and risk of mortality and fractures in women and men: cohort studies

October 29, 2014 Comments off

Milk intake and risk of mortality and fractures in women and men: cohort studies
Source: British Medical Journal

Objective
To examine whether high milk consumption is associated with mortality and fractures in women and men.

Design
Cohort studies.

Setting
Three counties in central Sweden.

Participants
Two large Swedish cohorts, one with 61 433 women (39-74 years at baseline 1987-90) and one with 45 339 men (45-79 years at baseline 1997), were administered food frequency questionnaires. The women responded to a second food frequency questionnaire in 1997.

Main outcome measure
Multivariable survival models were applied to determine the association between milk consumption and time to mortality or fracture.

Results
During a mean follow-up of 20.1 years, 15 541 women died and 17 252 had a fracture, of whom 4259 had a hip fracture. In the male cohort with a mean follow-up of 11.2 years, 10 112 men died and 5066 had a fracture, with 1166 hip fracture cases. In women the adjusted mortality hazard ratio for three or more glasses of milk a day compared with less than one glass a day was 1.93 (95% confidence interval 1.80 to 2.06). For every glass of milk, the adjusted hazard ratio of all cause mortality was 1.15 (1.13 to 1.17) in women and 1.03 (1.01 to 1.04) in men. For every glass of milk in women no reduction was observed in fracture risk with higher milk consumption for any fracture (1.02, 1.00 to 1.04) or for hip fracture (1.09, 1.05 to 1.13). The corresponding adjusted hazard ratios in men were 1.01 (0.99 to 1.03) and 1.03 (0.99 to 1.07). In subsamples of two additional cohorts, one in males and one in females, a positive association was seen between milk intake and both urine 8-iso-PGF2α (a biomarker of oxidative stress) and serum interleukin 6 (a main inflammatory biomarker).

Conclusions
High milk intake was associated with higher mortality in one cohort of women and in another cohort of men, and with higher fracture incidence in women. Given the observational study designs with the inherent possibility of residual confounding and reverse causation phenomena, a cautious interpretation of the results is recommended.

See also: Editorial – Milk and Mortality

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