Statistical Information System Research Articles

Home- and community-based care in the new generation of Medicaid administrative data

AbstractThis study aimed to assess the quality of Home and Community-Based Services (HCBS) data elements within the Transformed Medicaid Statistical Information System Analytical File (TAF) and to devise strategies for improving its research usability. Analyzing Medicaid TAF data from 2016 to 2018, we conducted a retrospective data quality analysis, focusing specifically on HCBS-related data elements. Through secondary data analysis, we identified significant challenges, including considerable missingness and inconsistencies that hamper the effective use of TAF for research purposes. Despite these issues, we developed three approaches that enabled us to identify 94% of known 1915(c) waiver claims as HCBS. Our study also revealed considerable cross-state variations in data quality, prompting specific recommendations for utilizing HCBS data within TAF. Ultimately, the study concludes that while challenges exist, applying our recommended strategies can yield data of acceptable quality for most states, particularly in identifying HCBS usage and classifying them into service categories. Given the growing importance of home-based care, there is a pressing need to prioritize improvements in TAF’s HCBS data quality to better inform policy and practice.

Black-White Disparities in Asthma Hospitalizations and ED Visits Among Medicaid-Enrolled Children.

Asthma is a common, potentially serious childhood chronic condition that disproportionately afflicts Black children. Hospitalizations and emergency department (ED) visits for asthma can often be prevented. Nearly half of children with asthma are covered by Medicaid, which should facilitate access to care to manage and treat symptoms. We provide new evidence on racial disparities in asthma hospitalizations and ED visits among Medicaid-enrolled children. We used comprehensive Medicaid claims data from the Transformed Medicaid Statistical Information System. Our study population included 279 985 Medicaid-enrolled children with diagnosed asthma. We identified asthma hospitalizations and ED visits occurring in 2019. We estimated differences in the odds of asthma hospitalizations and ED visits for non-Hispanic Black versus non-Hispanic white children, adjusting for sex, age, Medicaid eligibility group, Medicaid plan type, state, and rurality. In 2019, among Black children with asthma, 1.2% had an asthma hospitalization and 8.0% had an asthma ED visit compared with 0.5% and 3.4% of white children with a hospitalization and ED visit, respectively. After adjusting for other characteristics, the rates for Black children were more than twice the rates for white children (hospitalization adjusted odds ratio 2.45, 95% confidence interval 2.23-2.69; ED adjusted odds ratio 2.42; 95% confidence interval 2.33-2.51). There are stark racial disparities in asthma hospitalizations and ED visits among Medicaid-enrolled children with asthma. To diminish these disparities, it will be important to implement solutions that address poor quality care, discriminatory treatment in health care settings, and the structural factors that disproportionately expose Black children to asthma triggers and access barriers.

The Mexican Beekeeping Agri-food System: A descriptive analysis

O production in Mexico. Design/Methodology/Approach: We used the Food Balance Sheet obtained from the FAOSTAT website and the statistics of livestock production in Mexico recovered from the website of the Servicio de Información Agrícola y Pesquera (SIAP). We chose ten variables: production, import, export, per capita consumption, number of hives, production volume, economic value, price paid to producers, yield, and revenue per unit. The analysis describes the variables in the last recorded year at a global and local level, as well as the changes and trends according to the available historical records. Results: In 2019, Mexico held the ninth place in honey production with 64,000 t and had the capacity to export around 50 % of said production. Between 2006 and 2016, the number of hives increased by 6 %, while production volume and yield decreased by 1.6 % and 7.5 %. In contrast, the economic value, the price paid to producers, and the revenue per unit increased by 14 %, 5.7 %, and 8.5 %. Study limitations/Implications: This type of study relies on records of statistical information systems, whose availability depends on the variable of interest. Findings/Conclusions:In Mexico, beekeeping is practiced throughout the country, making it self-sufficient in terms of domestic honey consumption while allowing its participation in the international market. Therefore, the country has optimization opportunities, especially in the central and northern areas, that have the lowest number of hives and production volume levels

Development of Russia’s industry: Some regularities and prospects

Industry is the substratum of material production and the economy as a whole. Numerous discussions about the need for new industrialisation make us turn again to the analysis of the state of industrial potential and results of industrial development in Russia. The study aims to explain the performance of the Russian industry in terms of the most relevant and aggregated indicators characterising its functioning, and to formulate its long-term development tasks. The methodological basis of the study is the theory of industrial development. Methods of planning and industrial analysis are used. The evidence is the data for 2012–2022 retrieved from the Federal State Statistics Service of the Russian Federation and the Unified Interdepartmental Statistical Information System. The research concludes about the ‘contracted’ development of the Russian industry. The growth rate of the gross value added is more significantly impacted by the dynamics of fixed capital rather than that of labour. Yet the labour contributed greatly to the creation of the new value, which indicates the predominance of labour-intensive technologies, or obsolete capital-intensive technologies. The study empirically confirms that some periods saw a ‘paradox of rapid industrialisation’, that is, a substantially lower rate of economic growth against a higher growth of industry and modernisation of its fixed assets. The general conclusion is that when conducting industrial policy, it is necessary to influence the state of the labour and capital factors in the manufacturing sectors. The industrialisation of the Russian economy needs to be oriented towards the technological substitution through the creation of new fixed assets; in addition, the losses of greatly reduced labour potential should be compensated. A promising avenue is the organisation of analytical planning for the state-owned industry and indicative planning for private industries along with the adoption of a law on the state sector.

The highest-cost Medicaid enrollees with sickle cell disease had annual health care expenditures nearing $200 000.

Sickle cell disease (SCD) is a painful chronic blood disorder that causes serious complications and comorbidities, often leading to premature death. SCD impacts millions of people worldwide, including an estimated 100 000 in the United States, most of whom are Black or Latino. We analyzed Medicaid enrollment, claims, and encounter data via the Transformed Medicaid Statistical Information System (T-MSIS) to examine the 2021 health care utilization and spending of Medicaid enrollees with SCD. Our analysis found that Medicaid enrollees with SCD have high annual medical and pharmacy expenditures that are not evenly distributed across the population. Among the most severe enrollees with genotypes eligible for clinical trials, those in the top 5% of health care spending incurred, on average, nearly $200 000 per year for this chronic condition.

COVID-19 Medicaid Continuous Enrollment Provision Yielded Gains In Postpartum Continuity Of Coverage.

The Medicaid continuous enrollment provision mandated by the Families First Coronavirus Response Act of 2020 effectively prohibited the termination of enrollees from Medicaid during the COVID-19 public health emergency, including people enrolled in Medicaid during pregnancy. Using data from the Transformed Medicaid Statistical Information System, we found that the rate of continuous Medicaid enrollment during the twelve months postpartum increased from 59.3percent for births during March-December 2018 to 90.7percent for births during March-December 2020, when the public health emergency was in effect. This corresponds to approximately 430,000 fewer people losing Medicaid coverage after pregnancy and an average of more than 2.5 months of additional postpartum enrollment. These findings indicate that states that have extended or that plan to extend pregnancy-related Medicaid eligibility in the postpartum year are likely to experience significant gains in continuity of coverage.

Тенденции смертности от внешних причин населения Европейского Севера за 2010–2021 годы

The purpose of this research was to assess the status and identify the specific features of population mortality from external causes in the Arkhangelsk Region, Nenets Autonomous Area and Komi Republic for the period of 2010–2021. Materials and methods. Information about external cause mortality in the above regions for the period under study was obtained from the statistical monitoring databases of the Russian Federation – Unified Interdepartmental Statistical Information System – as well as from the official websites of the Main Directorate for Traffic Safety of the Ministry of Internal Affairs of Russia, and Federal State Statistics Service. Mathematicalstatistical and information-analytical methods were used in the paper. Results. In 2010–2021, the Arkhangelsk Region saw a steady downward trend in road traffic mortality; however, its average mortality rates remained at a higher level compared to the Nenets Autonomous Area and Komi Republic. During the period under study, the highest suicide rate among the regions was observed in the Nenets Autonomous Area: an average of 44 cases per 100,000 population annually, while in the Komi Republic and Arkhangelsk Region it was 30 % lower, i.e., 30.8 and 30.7 cases per 100,000 population, respectively. A better situation was observed in terms of homicide mortality, which decreased significantly between 2010 and 2021 in the regions under study. During the same period, mortality rates due to accidental alcohol poisoning dropped in all three regions; however, the average rate remained higher than the national average: 23.8, 12.2 and 26.1 cases per 100,000 population in the Arkhangelsk Region, Nenets Autonomous Area and Komi Republic, respectively. Dynamics of mortality from occupational injuries over the 12 years in the regions under study is insignificant and overall is similar to the national dynamics.

Foster Care Involvement Among Youth With Intellectual and Developmental Disabilities

Youth with intellectual and developmental disabilities (I/DD) are more likely to be placed in foster care than other youth. Examining the clinical and sociodemographic characteristics of youth with I/DD in the foster care system is critical for identifying disparities and understanding service needs. To produce a population-level analysis of youth with I/DD in foster care that examines differences in rates of foster care involvement based on race, ethnicity, age, and sex. This cross-sectional study involved all individuals with I/DD 21 years and younger enrolled in Medicaid through foster care in 2016 via data from Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) for all 50 US states and Washington, DC. As a key insurer of I/DD services and foster care, Medicaid claims offer a timely population-level analysis. Youth with I/DD were grouped into diagnostic subgroups: autism spectrum disorder (ASD) only, intellectual disability only, or ASD and ID. The data analysis took place from July 2022 to September 2023. TAF data contain Medicaid enrollment information by month with a binary indicator of foster care involvement, and eligibility files identify race, ethnicity, age, and sex. The period prevalence of foster care involvement was determined among I/DD youth by diagnostic subgroups using an intersectional approach across race, ethnicity, age, and sex. Logistic regression examined associations between risk for foster care involvement and race, ethnicity, age, and sex. A total of 39 143 youth with I/DD had foster care involvement in 2016. Black youth (adjusted odds ratio [aOR], 1.37; 95% CI, 1.28-1.47) and females (aOR, 1.18; 95% CI, 1.1-1.27) had increased likelihood for foster care involvement. The likelihood for foster care involvement increased with age in all groups relative to the age group 0 to 5 years old. This study found that among youth with I/DD, Black youth and females faced higher risk for foster care involvement, and the likelihood of foster care involvement increased with age. There is an urgent need for research that focuses on addressing system-level factors that drive increased risk. Understanding the specific health needs of Black and female youth with I/DD is critical to ensure the formation, implementation, and monitoring of equitable delivery of health services.

Spatial-Temporal Analysis of Road Accidents in Haraz Road Using Spatial Statistics and Geographical Information System

Spatial-Temporal Analysis of Road Accidents in Haraz Road Using Spatial Statistics and Geographical Information System

Medicare, Medicaid, and dual enrollment for adults with intellectual and developmental disabilities.

Given high rates of un- and underemployment among disabled people, adults with intellectual and developmental disabilities rely on Medicaid, Medicare, or both to pay for healthcare. Many disabled adults are Medicare eligible before the age of 65 but little is known as to why some receive Medicare services while others do not. We described the duration of Medicare enrollment for adults with intellectual and developmental disabilities in 2019 and then compared demographics by enrollment type (Medicare-only, Medicaid-only, dual-enrolled). Additionally, we examined the percent in each enrollment type by state, and differences in enrollment type for those with Down syndrome. 2019 Medicare and Medicaid claims data for all adults (≥18 years) in the US with claim codes for intellectual disability, Down syndrome, or autism at any time between 2011 and 2019. Administrative claims cohort. Data were from the Transformed Medicaid Statistical Information System Analytic Files and Medicare Beneficiary Summary files. In 2019, Medicare insured 582,868 adults with identified intellectual disability, autism, or Down syndrome. Of 582,868 Medicare beneficiaries, 149,172 were Medicare only and 433,396 were dual-enrolled. Most Medicare enrollees were enrolled as child dependents (61.5%) Medicaid-only enrollees (N = 819,256) were less likely to be white non-Hispanic (58.5% white non-Hispanic vs. 72.9% white non-Hispanic in dual-enrolled), more likely to be Hispanic (19.6% Hispanic vs. 9.2% Hispanic in dual-enrolled) and were younger (mean 34.2 years vs. 50.5 years dual-enrolled). There is heterogeneity in public insurance enrollment which is associated with state and disability type. Action is needed to ensure all are insured in the program that works for their healthcare needs.

Measuring quality of dental care during pregnancy

BackgroundThe authors aimed to develop and validate 2 Dental Quality Alliance measures of dental care access during pregnancy (Utilization of Services During Pregnancy, Oral Evaluation During Pregnancy) using claims and enrollment data and to report performance on these measures for a sample of Medicaid and Children’s Health Insurance Program beneficiaries. MethodsThe authors used Transformed Medicaid Statistical Information System enrollment and claims data for 7,767,806 people enrolled in 5 state Medicaid programs and Children’s Health Insurance Programs during 2018. The authors used split-half reliability testing to assess measure reliability. The authors calculated 95% CIs to assess statistically significant variation in performance between programs. ResultsThe intraclass correlation coefficient used to assess agreement between the split samples was 0.992 (95% CI, 0.941 to 0.999; P < .0001) for Utilization of Services During Pregnancy and 0.983 (95% CI, 0.879 to 0.998; P < .0001) for Oral Evaluation During Pregnancy. Performance scores ranged from 20% through 34% of beneficiaries receiving any dental service during pregnancy (Utilization of Services During Pregnancy) and from 14% through 23% of beneficiaries receiving a periodic or comprehensive oral evaluation during pregnancy (Oral Evaluation During Pregnancy), with statistically significant differences between programs. ConclusionsThe measures reliably assessed access to dental services and can distinguish performance between programs. Practical ImplicationsThese measures can be used to advance population health by means of supporting national efforts to improve access to dental care during pregnancy.

Pediatric Medical Subspecialist Use in Outpatient Settings

A first step toward understanding whether pediatric medical subspecialists are meeting the needs of the nation's children is describing rates of use and trends over time. To quantify rates of outpatient pediatric medical subspecialty use. This repeated cross-sectional study of annual subspecialist use examined 3 complementary data sources: electronic health records from PEDSnet (8 large academic medical centers [January 1, 2010, to December 31, 2021]); administrative data from the Healthcare Integrated Research Database (HIRD) (14 commercial health plans [January 1, 2011, to December 31, 2021]); and administrative data from the Transformed Medicaid Statistical Information System (T-MSIS) (44 state Medicaid programs [January 1, 2016, to December 31, 2019]). Annual denominators included 493 628 to 858 551 patients younger than 21 years with a general pediatric visit in PEDSnet; 5 million beneficiaries younger than 21 years enrolled for at least 6 months in HIRD; and 35 million Medicaid or Children's Health Insurance Program beneficiaries younger than 19 years enrolled for any amount of time in T-MSIS. Calendar year and type of medical subspecialty. Annual number of children with at least 1 completed visit to any pediatric medical subspecialist in an outpatient setting per population. Use rates excluded visits in emergency department or inpatient settings. Among the study population, the proportion of girls was 51.0% for PEDSnet, 51.1% for HIRD, and 49.3% for T-MSIS; the proportion of boys was 49.0% for PEDSnet, 48.9% for HIRD, and 50.7% for T-MSIS. The proportion of visits among children younger than 5 years was 37.4% for PEDSnet, 20.9% for HIRD, and 26.2% for T-MSIS; most patients were non-Hispanic Black (29.7% for PEDSnet and 26.1% for T-MSIS) or non-Hispanic White (44.9% for PEDSnet and 43.2% for T-MSIS). Annual rates for PEDSnet ranged from 18.0% to 21.3%, which were higher than rates for HIRD (range, 7.9%-10.4%) and T-MSIS (range, 7.6%-8.6%). Subspecialist use increased in the HIRD commercial health plans (annual relative increase of 2.4% [95% CI, 1.6%-3.1%]), but rates were essentially flat in the other data sources (PEDSnet, -0.2% [95% CI, -1.1% to 0.7%]; T-MSIS, -0.7% [95% CI, -6.5% to 5.5%]). The flat PEDSnet growth reflects a balance between annual use increases among those with commercial insurance (1.2% [95% CI, 0.3%-2.1%]) and decreases in use among those with Medicaid (-0.9% [95% CI, -1.6% to -0.2%]). The findings of this cross-sectional study suggest that among children, 8.6% of Medicaid beneficiaries, 10.4% of those with commercial insurance, and 21.3% of those whose primary care is received in academic health systems use pediatric medical subspecialty care each year. There was a small increase in rates of subspecialty use among children with commercial but not Medicaid insurance. These data may help launch innovations in the primary-specialty care interface.

An overview of tobacco use in France: Observed trends and new challenges

This article reports changes in tobacco and vaping consumption in France over the last thirty years and the issues they raise for public authorities in terms of prevention and management of the social and health consequences. This report is the result of a joint analysis by Santé publique France (SpF) and the French Monitoring Center for Drugs and Drug Addiction (OFDT). It shows that there has been a “generational shift” in tobacco consumption and social representations of cigarettes since the mid-2010s, with a sharp decline in tobacco initiation among adolescents, which has become less common and reported at an older age, which was one of the objectives of the national tobacco reduction plans. However, smoking remains fairly stable among adults, predominantly among men, with gaps between men and women persisting since the early 2000s. Beyond the gender gap, social disparities in consumption remain significant, both among youth and adults. However, while the prevalence of smoking is no longer increasing, the prevalence of vaping is rising, which is a public health concern since some of these practices involve nicotine consumption. This also entails the risk of a “renormalization” of the act of smoking, a matter of concern for health authorities in France as in other European countries. The analysis concludes that the statistical information system and qualitative surveys need to be adapted to ensure a reliable monitoring of the situation, taking into account the rapid transformations of the market.

Weathering the Storm: Syringe Services Program Laws and Human Immunodeficiency Virus During the COVID-19 Pandemic

Background: Syringe services programs (SSPs) are community-based prevention programs that provide a range of harm reduction services to persons who inject drugs. Despite their benefits, SSP laws vary across the United States. Little is known regarding how legislation surrounding SSPs may have influenced HIV transmission over the COVID-19 pandemic, a period in which drug use increased. This study examined associations between state SSP laws and HIV transmission among the Medicaid population before and after the COVID-19 pandemic. Methods: State-by-month counts of new HIV diagnoses among the Medicaid population were produced using administrative claims data from the Transformed Medicaid Statistical Information System from 2019 to 2020. Data on SSP laws were collected from the Prescription Drug Abuse Policy System. Associations between state SSP laws and HIV transmission before and after the start of the COVID-19 pandemic were evaluated using an event study design, controlling for the implementation of COVID-19 nonpharmaceutical interventions and state and time fixed effects. Results: State laws allowing the operation of SSPs were associated with 0.54 (P = 0.044) to 1.18 (P = 0.001) fewer new monthly HIV diagnoses per 100,000 Medicaid enrollees relative to states without such laws in place during the 9 months after the start of the COVID-19 pandemic. The largest effects manifested for population subgroups disproportionately affected by HIV, such as male and non-Hispanic Black Medicaid enrollees. Conclusion: Less restrictive laws on SSPs may have helped mitigate HIV transmission among the Medicaid population throughout the COVID-19 pandemic. Policymakers can consider implementing less restrictive SSP laws to mitigate HIV transmission resulting from future increases in injection drug use. Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Prescription medication use during pregnancy in the United States from 2011 to 2020: trends and safety evidence.

Medication use during pregnancy has increased in the United States despite the lack of safety data for many medications. This study aimed to inform research priorities by examining trends in medication use during pregnancy and identifying gaps in safety information on the most commonly prescribed medications. We identified population-based cohorts of commercially (MarketScan 2011-2020) and publicly (Medicaid Analytic eXtract/Transformed Medicaid Statistical Information System Analytic Files 2011-2018) insured pregnancies ending in live birth from 2 health care utilization databases. Medication use was based on filled prescriptions between the date of last menstrual period through delivery, as well as the period before the last menstrual period and during specific trimesters. We also included a cross-sectional representative sample of pregnancies ascertained by the National Health and Nutrition Examination Survey (2011-2020), with information on prescription medication use during the preceding month obtained through maternal interviews. Teratogen Information System was used to classify the available evidence on teratogenic risk. Among over 3 million pregnancies, the medications most commonly dispensed at any time during pregnancy were analgesics, antibiotics, and antiemetics. The top medications were ondansetron (16.8%), amoxicillin (13.5%), and azithromycin (12.4%) in MarketScan, nitrofurantoin (22.2%), acetaminophen (21.3%; mostly as part of acetaminophen-hydrocodone products), and ondansetron (19.5%) in Medicaid Analytic eXtract/Transformed Medicaid Statistical Information System Analytic Files, and levothyroxine (5.0%), sertraline (2.9%), and insulin (2.9%) in the National Health and Nutrition Examination Survey group. The most commonly dispensed suspected teratogens during the first trimester were antithyroid medications. The use of antidiabetic and psychotropic medications has continued to increase in the United States during the last decade, opioid dispensation has decreased by half, and antibiotics and antiemetics continue to be common. For one-quarter of medications, there is insufficient evidence available to characterize their safety profile in pregnancy. There is a need for more drug research in pregnant patients. Future research should focus on anti-infectives with high utilization and limited level of evidence on safety for use during pregnancy. Although lack of evidence is not evidence of safety concerns, it does not indicate risk either. In many instances, the benefits outweigh the risks when these medications are used clinically, and some of the medications with no proven safety may be necessary to treat patients.

Regional import substitution policy amid economic sanctions: The case of the Republic of Tatarstan

The exhaustion of the traditional raw material export model, which results in a growing dependence of the core economic industries on imported goods and components, makes it increasingly relevant to develop tools for finding promising areas of import substitution. The paper proposes a methodology for assessing imported commodity groups to identify the priority areas for import substitution in a region. The theoretical framework of the study includes comparative and competitive advantage theories, as well as the concepts of production concentration, clusters, and industrial complexes. The research methods of economic-statistical, structural analyses and clustering were applied. The statistical data were retrieved from the Federal Customs Service of the Russian Federation, the Federal State Statistics Service (Rosstat), and the Unified Interdepartmental Statistical Information System (EMISS). The proposed methodology was tested using the case of imports and exports in the Republic of Tatarstan in 2013–2021. We identified four key commodity clusters for import substitution, which account for more than 40 % of the region’s current imports, these are 1) the important localized import-dependent commodity groups a) having potential for import substitution in the region (tools, petroleum products), b) promising for import substitution in the RF (equipment and mechanical devices, furniture), as well as 2) the important non-specific import-dependent commodities a) having potential for import substitution (paints, electrical machines), and b) promising for import substitution (milk, clothing). The largest producers of the Republic of Tatarstan were identified for each cluster. Matrix modeling showed that some commodity groups are positioned in the area of the region’s low specialization, low localization and share of imports, which are typically grouped into three additional clusters that do not require enhanced policy on import substitution: growing import-dependent goods (grain, etc.), goods requiring no particular attention (silk, wool, etc.), and significant import-dependent goods (essential oils, etc.). The research findings can be used by regional ministries and departments when making strategic decisions on import substitution.

Association of Medicaid Expansion Under the Affordable Care Act With Medicaid Coverage in the Prepregnancy, Prenatal, and Postpartum Periods.

We evaluated how the Affordable Care Act (ACA) Medicaid eligibility expansion affected perinatal insurance coverage patterns for Medicaid-enrolled beneficiaries who gave birth overall and by race/ethnicity. We also examined state-level heterogeneous impacts. Using the 2011-2013 Medicaid Analytic eXtract and the 2016-2018 Transformed Medicaid Statistical Information System Analytic File databases, we identified 1.4 million beneficiaries giving birth in 2012 (pre-ACA expansion cohort) and 1.5 million in 2017 (post-ACA expansion cohort). We constructed monthly coverage rates for the two cohorts by state Medicaid expansion status and obtained difference-in-differences estimates of the association of Medicaid expansion with coverage overall and by race/ethnicity group (non-Hispanic White, non-Hispanic Black, and Hispanic). To explore state-level heterogeneous impacts, we divided the expansion and non-expansion states into groups based on the differences in the income eligibility limits for low-income parents in each state between 2012 and2017. Medicaid expansion was associated with 13 percentage points higher coverage in the 9 to 12months before giving birth, and 11 percentage points higher coverage at 6 to 12months postpartum. Hispanic birthing individuals had the greatest relative increases in coverage, followed by non-Hispanic White and non-Hispanic Black individuals. In Medicaid expansion states, those who experienced the greatest increases in income eligibility limits for low-income parents generally saw the greatest increases in coverage. In non-expansion states, there was less heterogeneity between state groupings. Pregnancy-related Medicaid eligibility did not have major changes in the 2010s. However, states' adoption of ACA Medicaid expansion after 2012 was associated with increased Medicaid coverage before, during, and after pregnancy. The increases varied by race/ethnicity and across states.

Cohort Differences in Occupational Retention among Computer Science Degree Holders: Reassessing the Role of Family

Although women’s representation in science, technology, engineering, and mathematics (STEM) employment has increased significantly over the past few decades, their presence remains low in fields like computer science. Using the National Science Foundation’s Scientists and Engineers Statistical Data System (SESTAT), this paper assesses the factors shaping employment in STEM and non-STEM occupations among men and women with bachelor’s degrees in computer science. Our results reveal that women with degrees in computer science are far less likely than their male counterparts to be employed in STEM occupations, particularly in computer science jobs. But family factors do not have the expected association with employment in computer science jobs. Men who are parents and childless women are more likely to work in non-STEM jobs versus computer science jobs, relative to childless men. Furthermore, the gender gap in employment in computer science jobs is larger among those graduating in the new millennium, suggesting that other factors are at play.

노후 산업단지 유형화와 유형별 특성 분석

The government has implemented a variety of regeneration projects for old industrial complexes and declined regions. Due to the promotion of policies and projects focused on each target place, however, there is a lack of policy linkages among them. This study intends to categorize old industrial complexes nationwide and analyze the characteristics of each type while considering industrial complexes and surrounding regions. Ten indicators are selected to implement the principal component analysis using data from the national industrial complex status, industrial location information system, and statistical geographic information system. Based on the factor score produced by the principal component analysis, the cluster analysis indicates that there are four types of old industrial complexes: large sustaining and developing complex type, small growing complex type, old declining complex type and region-linked complex type. The old declining industrial complex continues to decline due to weak economy of both the complexes and surrounding areas, and the residential environment. Industrial restructuring and industrial complex regeneration projects are needed to strengthen the competitiveness of the complexes. Regeneration strategies for each type of industrial complex is required in consideration of the physical and economic characteristics of both the complexes and the surrounding areas.

Comparing approaches to identify live births using the Transformed Medicaid Statistical Information System.

To evaluate the performance of different approaches for identifying live births using Transformed Medicaid Statistical Information System Analytic Files (TAF). The primary data source for this study were TAF inpatient (IP), other services (OT), and demographic and eligibility files. These data contain administrative claims for Medicaid enrollees in all 50 states and the District of Columbia from January 1, 2018 to December 31, 2018. We compared five approaches for identifying live birth counts obtained from the TAF IP and OT data with the Centers for Disease Control and Prevention (CDC) Natality data-the gold standard for birth counts at the state level. The five approaches used varying combinations of diagnosis and procedure, revenue, and place of service codes to identify live births. Approaches 1 and 2 follow guidance developed by the Centers for Medicare and Medicaid Services (CMS). Approaches 3 and 4 build on the approaches developed by CMS by including all inpatient hospital claims in the OT file and excluding codes related to delivery services for infants, respectively. Approach 5 applied Approach 4 to only the IP file. Approach 4, which included all inpatient hospital claims in the OT file and excluded codes related to infants to identify deliveries, achieved the best match of birth counts relative to CDC birth record data, identifying 1,656,794 live births-a national overcount of 3.6%. Approaches 1 and 3 resulted in larger overcounts of births (20.5% and 4.5%), while Approaches 2 and 5 resulted in undercounts of births (-3.4% and -6.8%). Including claims from both the IP and OT files, and excluding codes unrelated to the delivery episode and those specific to services rendered to infants improves accuracy of live birth identification in the TAF data.