Predictors of latent tuberculosis infection treatment completion in the US private sector

An analysis of administrative claims data

Erica Lynn Stockbridge, Thaddeus L. Miller, Erin K. Carlson, Christine Ho

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Factors that affect latent tuberculosis infection (LTBI) treatment completion in the US have not been well studied beyond public health settings. This gap was highlighted by recent health insurance-related regulatory changes that are likely to increase LTBI treatment by private sector healthcare providers. We analyzed LTBI treatment completion in the private healthcare setting to facilitate planning around this important opportunity for tuberculosis (TB) control in the US. Methods: We analyzed a national sample of commercial insurance medical and pharmacy claims data for people ages 0 to 64 years who initiated daily dose isoniazid treatment between July 2011 and March 2014 and who had complete data. All individuals resided in the US. Factors associated with treatment completion were examined using multivariable generalized ordered logit models and bivariate Kruskal-Wallis tests or Spearman correlations. Results: We identified 1072 individuals with complete data who initiated isoniazid LTBI treatment. Treatment completion was significantly associated with less restrictive health insurance, age < 15 years, patient location, use of interferon-gamma release assays, non-poverty, HIV diagnosis, immunosuppressive drug therapy, and higher cumulative counts of clinical risk factors. Conclusions: Private sector healthcare claims data provide insights into LTBI treatment completion patterns and patient/provider behaviors. Such information is critical to understanding the opportunities and limitations of private healthcare in the US to support treatment completion as this sector's role in protecting against and eliminating TB grows.

Original languageEnglish
Article number662
JournalBMC Public Health
Volume18
Issue number1
DOIs
StatePublished - 29 May 2018

Fingerprint

Insurance Claim Review
Latent Tuberculosis
Private Sector
Therapeutics
Isoniazid
Health Insurance
Delivery of Health Care
Tuberculosis
Interferon-gamma Release Tests
Immunosuppressive Agents
Insurance
Health Personnel
Public Health
Logistic Models
HIV

Keywords

  • Administrative data
  • Claims data
  • Epidemiology
  • Health service delivery
  • Isoniazid
  • LTBI
  • Latent tuberculosis infection
  • Medication adherence
  • Public health practice
  • Treatment completion

Cite this

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title = "Predictors of latent tuberculosis infection treatment completion in the US private sector: An analysis of administrative claims data",
abstract = "Background: Factors that affect latent tuberculosis infection (LTBI) treatment completion in the US have not been well studied beyond public health settings. This gap was highlighted by recent health insurance-related regulatory changes that are likely to increase LTBI treatment by private sector healthcare providers. We analyzed LTBI treatment completion in the private healthcare setting to facilitate planning around this important opportunity for tuberculosis (TB) control in the US. Methods: We analyzed a national sample of commercial insurance medical and pharmacy claims data for people ages 0 to 64 years who initiated daily dose isoniazid treatment between July 2011 and March 2014 and who had complete data. All individuals resided in the US. Factors associated with treatment completion were examined using multivariable generalized ordered logit models and bivariate Kruskal-Wallis tests or Spearman correlations. Results: We identified 1072 individuals with complete data who initiated isoniazid LTBI treatment. Treatment completion was significantly associated with less restrictive health insurance, age < 15 years, patient location, use of interferon-gamma release assays, non-poverty, HIV diagnosis, immunosuppressive drug therapy, and higher cumulative counts of clinical risk factors. Conclusions: Private sector healthcare claims data provide insights into LTBI treatment completion patterns and patient/provider behaviors. Such information is critical to understanding the opportunities and limitations of private healthcare in the US to support treatment completion as this sector's role in protecting against and eliminating TB grows.",
keywords = "Administrative data, Claims data, Epidemiology, Health service delivery, Isoniazid, LTBI, Latent tuberculosis infection, Medication adherence, Public health practice, Treatment completion",
author = "Stockbridge, {Erica Lynn} and Miller, {Thaddeus L.} and Carlson, {Erin K.} and Christine Ho",
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Predictors of latent tuberculosis infection treatment completion in the US private sector : An analysis of administrative claims data. / Stockbridge, Erica Lynn; Miller, Thaddeus L.; Carlson, Erin K.; Ho, Christine.

In: BMC Public Health, Vol. 18, No. 1, 662, 29.05.2018.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Predictors of latent tuberculosis infection treatment completion in the US private sector

T2 - An analysis of administrative claims data

AU - Stockbridge, Erica Lynn

AU - Miller, Thaddeus L.

AU - Carlson, Erin K.

AU - Ho, Christine

PY - 2018/5/29

Y1 - 2018/5/29

N2 - Background: Factors that affect latent tuberculosis infection (LTBI) treatment completion in the US have not been well studied beyond public health settings. This gap was highlighted by recent health insurance-related regulatory changes that are likely to increase LTBI treatment by private sector healthcare providers. We analyzed LTBI treatment completion in the private healthcare setting to facilitate planning around this important opportunity for tuberculosis (TB) control in the US. Methods: We analyzed a national sample of commercial insurance medical and pharmacy claims data for people ages 0 to 64 years who initiated daily dose isoniazid treatment between July 2011 and March 2014 and who had complete data. All individuals resided in the US. Factors associated with treatment completion were examined using multivariable generalized ordered logit models and bivariate Kruskal-Wallis tests or Spearman correlations. Results: We identified 1072 individuals with complete data who initiated isoniazid LTBI treatment. Treatment completion was significantly associated with less restrictive health insurance, age < 15 years, patient location, use of interferon-gamma release assays, non-poverty, HIV diagnosis, immunosuppressive drug therapy, and higher cumulative counts of clinical risk factors. Conclusions: Private sector healthcare claims data provide insights into LTBI treatment completion patterns and patient/provider behaviors. Such information is critical to understanding the opportunities and limitations of private healthcare in the US to support treatment completion as this sector's role in protecting against and eliminating TB grows.

AB - Background: Factors that affect latent tuberculosis infection (LTBI) treatment completion in the US have not been well studied beyond public health settings. This gap was highlighted by recent health insurance-related regulatory changes that are likely to increase LTBI treatment by private sector healthcare providers. We analyzed LTBI treatment completion in the private healthcare setting to facilitate planning around this important opportunity for tuberculosis (TB) control in the US. Methods: We analyzed a national sample of commercial insurance medical and pharmacy claims data for people ages 0 to 64 years who initiated daily dose isoniazid treatment between July 2011 and March 2014 and who had complete data. All individuals resided in the US. Factors associated with treatment completion were examined using multivariable generalized ordered logit models and bivariate Kruskal-Wallis tests or Spearman correlations. Results: We identified 1072 individuals with complete data who initiated isoniazid LTBI treatment. Treatment completion was significantly associated with less restrictive health insurance, age < 15 years, patient location, use of interferon-gamma release assays, non-poverty, HIV diagnosis, immunosuppressive drug therapy, and higher cumulative counts of clinical risk factors. Conclusions: Private sector healthcare claims data provide insights into LTBI treatment completion patterns and patient/provider behaviors. Such information is critical to understanding the opportunities and limitations of private healthcare in the US to support treatment completion as this sector's role in protecting against and eliminating TB grows.

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