11 research outputs found
Murine Typhus in Austin, Texas, USA, 2008
Physicians should be alert for possible cases in this area
Inferring school district learning modalities during the COVID-19 pandemic with a hidden Markov model
In this study, learning modalities offered by public schools across the
United States were investigated to track changes in the proportion of schools
offering fully in-person, hybrid and fully remote learning over time. Learning
modalities from 14,688 unique school districts from September 2020 to June 2021
were reported by Burbio, MCH Strategic Data, the American Enterprise
Institute's Return to Learn Tracker and individual state dashboards. A model
was needed to combine and deconflict these data to provide a more complete
description of modalities nationwide.
A hidden Markov model (HMM) was used to infer the most likely learning
modality for each district on a weekly basis. This method yielded higher
spatiotemporal coverage than any individual data source and higher agreement
with three of the four data sources than any other single source. The model
output revealed that the percentage of districts offering fully in-person
learning rose from 40.3% in September 2020 to 54.7% in June of 2021 with
increases across 45 states and in both urban and rural districts. This type of
probabilistic model can serve as a tool for fusion of incomplete and
contradictory data sources in support of public health surveillance and
research efforts.Comment: 25 pages, 4 figure
Annual Cost of U.S. Hospital Visits for Pediatric Abusive Head Trauma
Abstract We estimated the frequency and direct medical cost from the provider perspective of U.S. hospital visits for pediatric abusive head trauma (AHT). We identified treat-and-release hospital emergency department (ED) visits and admissions for AHT among patients aged 0-4 years in the Nationwide Emergency Department Sample and Nationwide Inpatient Sample (NIS), 2006-2011. We applied cost-to-charge ratios and estimated professional fee ratios from Truven Health MarketScan 1 to estimate per-visit and total population costs of AHT ED visits and admissions. Regression models assessed cost differences associated with selected patient and hospital characteristics. AHT was diagnosed during 6,827 (95% confidence interval [CI] [6,072, 7,582]) ED visits and 12,533 (95% CI [10,395, 14,671]) admissions (28% originating in the same hospital's ED) nationwide over the study period. The average medical cost per ED visit and admission were US31,901 (error bound: 29,536), respectively (2012 USD). The average total annual nationwide medical cost of AHT hospital visits was US$69.6 million (error bound: 56.9-82.3 million) over the study period. Factors associated with higher per-visit costs included patient age <1 year, males, coexisting chronic conditions, discharge to another facility, death, higher household income, public insurance payer, hospital trauma level, and teaching hospitals in urban locations. Study findings emphasize the importance of focused interventions to reduce this type of high-cost child abuse