Hypoparathyroidism is a rare endocrine disorder whose incidence and prevalence have not been well defined. This study aimed to 1) estimate the number of insured adult patients with hypoparathyroidism in the United States and 2) obtain physician assessment of disease severity and chronicity. Prevalence was estimated through calculation of diagnoses of hypoparathyroidism in a large proprietary health plan claims database over a 12-month period from October 2007 through September 2008 and projected to the US insured population. Incidence was also calculated from the same database by determining the proportion of total neck surgeries resulting in either transient (6 months) or chronic (>6 months) hypoparathyroidism. A physician primary market research study was conducted to assess disease severity and determine the percentage of new nonsurgical patients with hypoparathyroidism. Incidence data were entered into an epidemiologic model to derive an estimate of prevalence. The diagnosis-based prevalence approach estimated 58,793 insured patients with chronic hypoparathyroidism in the United States. The surgical-based incidence approach yielded 117,342 relevant surgeries resulting in 8901 cases over 12 months. Overall, 7.6% of surgeries resulted in hypoparathyroidism (75% transient, 25% chronic). The prevalence of chronic hypoparathyroidism among insured patients included in the surgical database was estimated to be 58,625. The physician survey found that 75% of cases treated over the past 12 months were reported due to surgery and, among all thyroidectomies and parathyroidectomies and neck dissections performed in a year, 26% resulted in transient hypoparathyroidism and 5% progressed to a chronic state. In conclusion, the two claims-based methods yielded similar estimates of the number of insured patients with chronic hypoparathyroidism in the United States (58,700). The physician survey was consistent with those calculations and confirmed the burden imposed by hypoparathyroidism.

OBJECTIVES:To compare the quality of diabetes care across non-Hispanic whites and Blacks and Hispanics in the United States using selected American Diabetes Association standards of care. There are few studies using large federal databases evaluating disparities among racial/ethnic groups in diabetes care. The last one was conducted using the Medication Expenditure Panel Survey 2000-2001 cohort. This study provides a more comprehensive assessment of the Standards. METHODS: Data from the National Health and Nutritional Examination Survey 2009-2010 cohort was used to compare quality markers such as diabetes-related access to care (physician and diabetes specialists visits), medical care (self-monitoring, treatment, dietary habits, laboratories) and co-morbidities (prevalence, treatment and monitoring) across the racial/ ethnic groups. We used one-way ANOVA and chi-square test to compare continuous and discrete variables across Whites, Blacks, Hispanics and other. RESULTS: Overall this group had a mean age of 61Ϯ14, 51% were male, 60% had no more than a high school diploma, and 55% had an income Ͻ$35,000. Only age and education level were different across groups(pϽ0.05). Average blood pressure and total cholesterol levels were at goal except for hemoglobin A1c which was 7.3%Ϯ1.7 and different across groups(pϭ0.003). We found that the use of insulin, frequency of blood glucose monitoring, foot and exam in the last year, nurse educator/nutritionist/dietitian visits, and diabetic retinopathy, hypertension and hyperlipidemia diagnoses were significantly different across groups(all pϽ0.05). CONCLUSIONS: A possible relationship between race/ethnicity and adherence to various standards of diabetes care may exist. A more rigorous epidemiologic study is needed to confirm our findings.