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Naihui Zhou

Iowa State University, Columbia University, New York City Health and Hospitals Corporation



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Ronald Low

New York City Health and Hospitals Corporation, MetroPlus, New York University



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Shunsuke Ito

New York City Health



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Van Dunn

MetroPlus



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38 – Applications in Biological and Health Data

Effects of Beta Blockers on Hospital Admission Rates and Cost

Sponsor: Biometrics Section
Keywords: beta blockers, zero-inflated, count data, negative-binomial

Naihui Zhou

Iowa State University, Columbia University, New York City Health and Hospitals Corporation

Ronald Low

New York City Health and Hospitals Corporation, MetroPlus, New York University

Shunsuke Ito

New York City Health

Van Dunn

MetroPlus

Objective: We study the effect of beta blocker use by New York City MetroPlus health plan patients on hospital admissions and cost. Methods: To model admissions, we used a zero-inflated negative binomial regression model. We modeled total medical costs with a log linear regression model with Gamma distribution. Medical costs were calculated by summing charges for hospital admissions, clinic and emergency department visits, professional charges, and drug prescriptions paid by insurance. Explanatory variables include comorbidities, gender, age, socioeconomic factors and drug usage. Results: Beta1-specific blockers with odds ratio of 2.58 (2.13-3.14) and nonselective beta blockers of 1.69 (1.21-2.36) are positively associated with the occurrence of hospital admission (zero inflation component). We did not find interaction effects with COPD or depression. Nor did we find a relationship between beta blocker usage rate of hospital admission regression component). A cost ratio of 1.5376 (1.4197, 1.6652) for beta1 blocker takers and non-takers is found for the COPD population. Increased cost of beta blocker therapy is also significant in depression patients. Conclusions: We found statistically significant relationship between beta blocker use and lack of hospital admission (zero inflation component), but not with the hospital admission rate among COPD and depression patients. Beta blocker use is associated with higher total cost.

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