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Analyses of idiopathic pulmonary fibrosis (IPF) inpatients in the United States

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Title
Analyses of idiopathic pulmonary fibrosis (IPF) inpatients in the United States
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Policelli
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Christopher
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Christopher Policelli
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author
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Srinivasan
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Shankar
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Shankar Srinivasan
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Advisory Committee
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chair
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Coffman
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Frederick
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Frederick Coffman
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Advisory Committee
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internal member
Name (type = personal)
NamePart (type = family)
Haddad
NamePart (type = given)
Richard
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Richard Haddad
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Advisory Committee
Role
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outside member
Name (type = corporate)
NamePart
Rutgers University
Role
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degree grantor
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NamePart
School of Health Professions
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school
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Text
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theses
OriginInfo
DateCreated (qualifier = exact)
2016
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2016-05
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2016
Place
PlaceTerm (type = code)
xx
Language
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eng
Abstract (type = abstract)
Idiopathic pulmonary fibrosis (IPF) is a rapidly progressive immune mediated lung disorder that leads to death in the majority of patients, regardless of treatment, within 3-5 years of diagnosis. 1-3 Pulmonary fibrosis is often the final common pathway of many known causes of interstitial lung disease, such as sarcoidosis, silicosis, drug reactions, infections and collagen vascular diseases. The overall goal of the project is to identify the factors and costs associated with IPF patients in terms of mortality, length of stay and costs in different types of clinical settings across the United States. We used data rom the Nationwide Inpatient Sample (NIS) for calendar years 2007-2012 to perform a series of analyses to identify any factors and costs associated with IPF patients, particularly those pertaining to mortality, length of stay (LOS), and costs across the various clinical settings in the US. A series of parametric and non-parametric methods were used. Parametric methods included linear regression models, correlation analysis using Pearson correlation coefficients, paired and unpaired t-tests, and one-way ANOVA. A series of non-parametric methods were also used including: Wilcoxon rank sum tests, Mann-Whitney tests, Spearman correlations, and Kruskal-Wallis tests. Descriptive analyses were employed to compute sample mean, median, standard deviation, and interquartile ranges for study variables. Finally, binary outcomes and categorical variables were examined using the following: logistic regression models, chi-square tests, contingency coefficients, and McNemar’s test. We found a mean expenditure per IPF patient of $68,925 (standard deviation = $16,4049), with a median of $28,257. We found the distribution of total charges to be significantly different from the normal distribution (p<0.001). Further investigation revealed a maximum charge of $4,162,849, which is approximately six times as high as the 99th percentile total charge of and 147 times as high as the median. These results indicate that the distribution of total costs are skewed heavily by a relative few patients with extremely high bills. LOS also varied wildly with the mean stay being 7.84 days with a standard deviation of 13.60 days. LOS ranged from zero days to 1158 days, which corroborates our conclusion about the distribution of total costs. The patient who stayed 1158 days was hospitalized for 858 days more than any other patient. The next highest LOS values were 300 days, 250 days, 196 days, and 160 days, which further plays to our notion of the extremely expensive few. LOS varied in a statistically significant way between white and black patients (p<0.05). Only 11.2% of all patients in the data set died during the study period (11.2% of whites, 9.5% of blacks, 11.2% Hispanics, 12.2% of Asian/Pacific Islander, 13.0% of Native Americans). Finally, only 12% of all IPF patients passed away, while slightly more (13.8%) of all IIP patients died during the study period.
Subject (authority = RUETD)
Topic
Biomedical Informatics
Subject (authority = ETD-LCSH)
Topic
Pulmonary fibrosis
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TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
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TitleInfo
Title
School of Health Professions ETD Collection
Identifier (type = local)
rucore10007400001
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ETD_7343
Identifier (type = doi)
doi:10.7282/T3JH3P9P
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electronic resource
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application/pdf
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text/xml
Note
Supplementary File:
Extent
1 online resource (xii, 103 p. : ill.)
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = statement of responsibility)
by Christopher Policelli
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Policelli
GivenName
Christopher
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2016-05-10 10:45:40
AssociatedEntity
Name
Christopher Policelli
Role
Copyright holder
Affiliation
Rutgers University. School of Health Related Professions
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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