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MESSIAS TBON, MAGNANI M, PIMENTEL TC, SILVA LMD, ALVES J, GADELHA TS, MORGANO MA, PACHECO MTB, OLIVEIRA MEGD, QUEIROGA RDCRDE. Typical Brazilian cheeses: safety, mineral content and adequacy to the nutritional labeling. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.37121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Li Y, Jasani F, Su D, Zhang D, Shi L, Yi SS, Pagán JA. Decoding Nonadherence to Hypertensive Medication in New York City: A Population Segmentation Approach. J Prim Care Community Health 2020; 10:2150132719829311. [PMID: 30767604 PMCID: PMC6378427 DOI: 10.1177/2150132719829311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: Nearly one-third of adults in New York City (NYC) have high blood pressure and many social, economic, and behavioral factors may influence nonadherence to antihypertensive medication. The objective of this study is to identify profiles of adults who are not taking antihypertensive medications despite being advised to do so. Methods: We used a machine learning–based population segmentation approach to identify population profiles related to nonadherence to antihypertensive medication. We used data from the 2016 NYC Community Health Survey to identify and segment adults into subgroups according to their level of nonadherence to antihypertensive medications. Results: We found that more than 10% of adults in NYC were not taking antihypertensive medications despite being advised to do so by their health care providers. We identified age, neighborhood poverty, diabetes, household income, health insurance coverage, and race/ethnicity as important characteristics that can be used to predict nonadherence behaviors as well as used to segment adults with hypertension into 10 subgroups. Conclusions: Identifying segments of adults who do not adhere to hypertensive medications has practical implications as this knowledge can be used to develop targeted interventions to address this population health management challenge and reduce health disparities.
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Affiliation(s)
- Yan Li
- 1 The New York Academy of Medicine, New York, NY, USA.,2 Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Foram Jasani
- 1 The New York Academy of Medicine, New York, NY, USA
| | - Dejun Su
- 3 University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | - Stella S Yi
- 6 New York University School of Medicine, New York, NY, USA
| | - José A Pagán
- 1 The New York Academy of Medicine, New York, NY, USA.,7 New York University, New York, NY, USA.,8 University of Pennsylvania, Philadelphia, PA, USA
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Langton JM, Wong ST, Burge F, Choi A, Ghaseminejad-Tafreshi N, Johnston S, Katz A, Lavergne R, Mooney D, Peterson S, McGrail K. Population segments as a tool for health care performance reporting: an exploratory study in the Canadian province of British Columbia. BMC FAMILY PRACTICE 2020; 21:98. [PMID: 32475339 PMCID: PMC7262753 DOI: 10.1186/s12875-020-01141-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/14/2020] [Indexed: 11/26/2022]
Abstract
Background Primary care serves all age groups and individuals with health states ranging from those with no chronic conditions to those who are medically complex, or frail and approaching the end of life. For information to be actionable and guide planning, there must be some population disaggregation based on differences in expected needs for care. Promising approaches to segmentation in primary care reflect both the breadth and severity of health states, the types and amounts of health care utilization that are expected, and the roles of the primary care provider. The purpose of this study was to assess population segmentation as a tool to create distinct patient groups for use in primary care performance reporting. Methods This cross-sectional study used administrative data (patient characteristics, physician and hospital billings, prescription medicines data, emergency department visits) to classify the population of British Columbia (BC), Canada into one of four population segments: low need, multiple morbidities, medically complex, and frail. Each segment was further classified using socioeconomic status (SES) as a proxy for patient vulnerability. Regression analyses were used to examine predictors of health care use, costs and selected measures of primary care attributes (access, continuity, coordination) by segment. Results Average annual health care costs increased from the low need ($ 1460) to frail segment ($10,798). Differences in primary care cost by segment only emerged when attributes of primary care were included in regression models: accessing primary care outside business hours and discontinuous primary care (≥5 different GP’s in a given year) were associated with higher health care costs across all segments and higher continuity of care was associated with lower costs in the frail segment (cost ratio = 0.61). Additionally, low SES was associated with higher costs across all segments, but the difference was largest in the medically complex group (cost ratio = 1.11). Conclusions Population segments based on expected need for care can support primary care measurement and reporting by identifying nuances which may be lost when all patients are grouped together. Our findings demonstrate that variables such as SES and use of regression analyses can further enhance the usefulness of segments for performance measurement and reporting.
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Affiliation(s)
- Julia M Langton
- Centre for Health Services and Policy Research, The University of British Columbia (UBC), 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Sabrina T Wong
- Centre for Health Services and Policy Research, The University of British Columbia (UBC), 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.,School of Nursing, UBC, Vancouver, Canada
| | - Fred Burge
- Department of Family Medicine, Dalhousie University, Halifax, NS, Canada
| | - Alexandra Choi
- Centre for Health Services and Policy Research, The University of British Columbia (UBC), 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Niloufar Ghaseminejad-Tafreshi
- Centre for Health Services and Policy Research, The University of British Columbia (UBC), 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Sharon Johnston
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Alan Katz
- Department of Family Medicine and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ruth Lavergne
- Faculty of Health Science, Simon Fraser University, Burnaby, BC, Canada
| | - Dawn Mooney
- Centre for Health Services and Policy Research, The University of British Columbia (UBC), 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Sandra Peterson
- Centre for Health Services and Policy Research, The University of British Columbia (UBC), 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy Research, The University of British Columbia (UBC), 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. .,School of Population and Public Health, UBC, Vancouver, BC, Canada.
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Matera J, Luna AS, Batista DB, Pimentel TC, Moraes J, Kamimura BA, Ferreira MVS, Silva HL, Mathias SP, Esmerino EA, Freitas MQ, Raices RS, Quitério SL, Sant'Ana AS, Silva MC, Cruz AG. Brazilian cheeses: A survey covering physicochemical characteristics, mineral content, fatty acid profile and volatile compounds. Food Res Int 2018; 108:18-26. [DOI: 10.1016/j.foodres.2018.03.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/04/2018] [Accepted: 03/04/2018] [Indexed: 02/07/2023]
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