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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).

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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

Bicyclist Fatalities a Growing Problem for Key Groups

October 28, 2014 Comments off

Bicyclist Fatalities a Growing Problem for Key Groups
Source: Governors Highway Safety Association

The number of bicyclists killed on U.S. roadways is trending upward, particularly for certain subsets of the population, according to a report released today by the Governors Highway Safety Association (GHSA). GHSA’s Spotlight on Highway Safety: Bicyclist Safety notes that yearly bicyclist deaths increased 16 percent between 2010 and 2012, while overall motor vehicle fatalities increased just one percent during the same time period.

The report’s author, former Insurance Institute for Highway Safety Chief Scientist Dr. Allan Williams, analyzed current and historical fatality data to uncover bicyclist crash patterns. There have been some remarkable changes. For example, adults 20 and older represented 84 percent of bicyclist fatalities in 2012, compared to only 21 percent in 1975. Adult males comprised 74 percent of the total number of bicyclists killed in 2012.

Bicycle fatalities are increasingly an urban phenomenon, accounting for 69 percent of all bicycle fatalities in 2012, compared with 50 percent in 1975. These changes correlate with an increase in bicycling commuters – a 62 percent jump since 2000, according to 2013 Census Bureau data.

While bicyclists killed in motor vehicle crashes increased in 22 states between 2010 and 2012, six states – California, Florida, Illinois, New York, Michigan and Texas – represented 54 percent of all fatalities.

UK — Gestation-specific Infant Mortality, 2012

October 17, 2014 Comments off

Gestation-specific Infant Mortality, 2012
Source: Office for National Statistics

Key Findings

  • Babies born in 2012 had an infant mortality rate of 3.9 deaths per 1,000 live births, compared to 4.4 deaths per 1,000 live births for babies born in 2008.
  • For babies born at term (between 37 and 41 weeks gestation), the infant mortality rate was 1.4 deaths per 1,000 live births.
  • The infant mortality rate for babies born pre-term (between 24 and 36 weeks) in 2012 was 23.6 deaths per 1,000 live births. This was almost 16% lower than the rate for pre-term babies born in 2008 (27.6 deaths per 1,000 live births).
  • The infant mortality rate for babies born to mothers aged 40 years and over was 4.8 deaths per 1,000 live births.
  • For babies born to mothers aged less than 20 years, the infant mortality rate was 5.7 deaths per 1,000 live births.
  • The infant mortality rate for babies born pre-term was higher for single births than for multiple births (24.8 and 19.9 deaths per 1,000 live births respectively).\
  • Infant mortality rates by ethnic group were highest for babies in the Bangladeshi and Black Caribbean groups (6.9 deaths per 1,000 live births).

Sofas and Infant Mortality

October 16, 2014 Comments off

Sofas and Infant Mortality
Source: Pediatrics

OBJECTIVE:
Sleeping on sofas increases the risk of sudden infant death syndrome and other sleep-related deaths. We sought to describe factors associated with infant deaths on sofas.

METHODS:
We analyzed data for infant deaths on sofas from 24 states in 2004 to 2012 in the National Center for the Review and Prevention of Child Deaths Case Reporting System database. Demographic and environmental data for deaths on sofas were compared with data for sleep-related infant deaths in other locations, using bivariate and multivariable, multinomial logistic regression analyses.

RESULTS:
1024 deaths on sofas made up 12.9% of sleep-related infant deaths. They were more likely than deaths in other locations to be classified as accidental suffocation or strangulation (adjusted odds ratio [aOR] 1.9; 95% confidence interval [CI], 1.6–2.3) or ill-defined cause of death (aOR 1.2; 95% CI, 1.0–1.5). Infants who died on sofas were less likely to be Hispanic (aOR 0.7; 95% CI, 0.6–0.9) compared with non-Hispanic white infants or to have objects in the environment (aOR 0.6; 95% CI, 0.5–0.7) and more likely to be sharing the surface with another person (aOR 2.4; 95% CI, 1.9–3.0), to be found on the side (aOR 1.9; 95% CI, 1.4–2.4), to be found in a new sleep location (aOR 6.5; 95% CI, 5.2–8.2), and to have had prenatal smoke exposure (aOR 1.4; 95% CI, 1.2–1.6). Data on recent parental alcohol and drug consumption were not available.

CONCLUSIONS:
The sofa is an extremely hazardous sleep surface for infants. Deaths on sofas are associated with surface sharing, being found on the side, changing sleep location, and experiencing prenatal tobacco exposure, which are all risk factors for sudden infant death syndrome and sleep-related deaths.

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