What is already known about this subject Obesity is highly prevalent and costly in the US. Obesity often leads to other comorbid conditions, including diabetes and hypertension. Obesity prevention efforts can reduce healthcare costs. What this study adds Obesity combined with other comorbidities significantly increases healthcare costs per patient visit. The combination of obesity and depression exacerbates costs. The most expensive series of chronic conditions in this study included obesity, diabetes, hypertension and depression. Our objectives were to determine payments made by commercial healthcare providers in the US for adults diagnosed with obesity, and those comorbid with any combination of selected chronic conditions. Using a commercial claims and encounters database (n = 3,562,717), we evaluated an adult study population that had at least one in-patient visit, outpatient visit or emergency department visit, and received a primary or secondary diagnosis of obesity. Persons were categorized by one or more comorbid diagnoses for diabetes mellitus, hypertension, depression or congestive heart failure. We adjusted for age and gender, and calculated the mean total net expenditures (in 2012, $US) for each combination of comorbid conditions based on individual visits to an in-patient, outpatient or emergency department setting. Among 50,717 claims with diagnosis of obesity, the mean net expenditure for in-patient and outpatient services was $ 1907 per patient per visit. Persons diagnosed with obesity and other comorbidities observed an increase in total net expenditures. Obesity and congestive heart failure observed the highest increase among single comorbidities at $ 5275. For persons with obesity and two other comorbidities, diabetes mellitus and depression was the highest at $ 15,226. The most expensive condition was obesity, diabetes mellitus, hypertension and depression at $ 15,733. Compared with average medical claims, persons diagnosed with obesity and other common chronic conditions experience significant increases in medical costs. These costs are often driven higher by time spent as in-patients. By controlling and reducing the prevalence of obesity, we may see significant decreases in medical expenditures.

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number of MMD were aggregated over one year of continuous erenumab treatment and compared to patients on no prevention, to estimate average migraine days (MD) per year. Patients on no prevention were assumed to remain at their baseline MMD. Results: Patients treated only with acute medication were predicted to suffer averages of 112.5 MD in EM and 239.5 MD in CM, over one year. Treated with erenumab, patients were predicted to avoid 39.8 MD and 87.8 MD in EM and CM, respectively, over one continuous year of treatment. ConClusions: The clinical burden of migraine to individual patients is high, and can be substantially reduced by treatment with erenumab. These MMD are associated with substantial costs of medical resource use, acute medication use and lost productivity, as well as impacts on patient functioning and quality of life. These outcomes should be considered when conducting economic evaluations of migraine preventives.

NCQA). Results: Considerable variation exists across these organizations with respect to measuring cardiovascular quality of care. A substantial variety of data elements: drug therapy, medical service events and diagnostic assessment are required across the measures with little agreement across the organizations. The highest concordance was between CMS and ACC, which shared three measures: 1) aspirin at arrival, 2) ARB for left ventricular system dysfunction, and 3) beta-blocker prescribed at discharge. The next level of concordance exists between CMS and NCQA, with two shared standards: 1) aspirin at arrival and 2) beta-blocker at discharge. CMS and PCPI had one common standard: beta-blocker at discharge. The remainder are single organization measures. ConClusions: This notable variation in quality of cardiovascular care metrics across organizations, where cumulative concordance is 5 of 17 measures, interferes with capturing an overall national picture of cardiovascular medical performance. Identifying the differences and similarities in quality healthcare metrics should be the first step in developing a broader set of common quality measures that would facilitate the study and monitoring of cardiovascular care across these organizations and the medical service providers they influence.

S89 guideline of systematic reviews, databases (Medline, Embase, Scopus, and Cochrane Library) were queried using the search terms "online patient community", "online health community", and "online health" + "community". Inclusion criteria were as follows: (1) published in a peer-reviewed journal with full text in English between 2008-2017, (2) included OPC as an intervention or exposure, (3) consisted of adult patients, and (4) captured at least one patient outcome. Studies that assessed weight loss or smoking cessation as an outcome and used social media sites (e.g., Facebook) as an OPC were excluded. At each step, abstracts and full-text articles were evaluated by at least two independent reviewers. Query results were compiled using RefWorks. ReSultS: Of the 420 studies queried from databases, 11 met all predefined criteria. Studies were conducted in the United States (64%), Europe (18%), and Asia (18%). The patient communities varied by disease state covered such as epilepsy (18%), asthma (9%), COPD (9%), and other chronic conditions. Study designs included randomized controlled trials (45%), non-randomized controlled trials (9%), and observational studies (45%). The most common method of measuring patient outcomes was through survey (91%) vs other objective measures. An improvement in patient outcomes was found in 73% of studies. ConCluSionS: Although most studies assessing the impact of OPC showed a beneficial result and studied populations with chronic conditions, it is difficult to further characterize populations that would benefit from OPC due to the lack of consistency among outcomes measured. Further research is warranted to identify the diverse patient populations that may be positively impacted by OPC.