| Autor: |
Rebman AW; Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland., Wang L; Johns Hopkins HealthCare LLC, Glen Burnie, Maryland., Yang T; Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland., Marsteller JA; Johns Hopkins HealthCare LLC, Glen Burnie, Maryland.; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland., Murphy SME; Johns Hopkins HealthCare LLC, Glen Burnie, Maryland., Uriyo M; Johns Hopkins HealthCare LLC, Glen Burnie, Maryland., Mihm EA; Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland., Weinstein ER; Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland., Fagan P; Johns Hopkins HealthCare LLC, Glen Burnie, Maryland., Aucott JN; Division of Rheumatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland. |
| Abstrakt: |
The epidemiology of Lyme disease has been examined utilizing insurance claims from privately insured individuals; however, it is unknown whether reported patterns vary among the publicly insured. We examined trends in incidence rates of first Lyme disease diagnosis among 384,652 Maryland Medicaid recipients enrolled from July 2004 to June 2011. Age-, sex-, county-, season-, and year-specific incidence rates were calculated, and mixed-effects multiple logistic regression models were used to study the relationship between Lyme disease diagnosis and these variables. The incidence rate in our sample was 97.65 cases per 100,000 person-years (95% confidence interval (CI): 91.53, 104.06), and there was a 13% average annual increase in the odds of a Lyme disease diagnosis (odds ratio = 1.13, 95% CI: 1.09, 1.17; P < 0.001). Incidence rates for males and females were not significantly different, though males were significantly more likely to be diagnosed during high-season months (relative risk (RR) = 1.24, 95% CI: 1.06, 1.44) and less likely to be diagnosed during low-season months (RR = 0.63, 95% CI: 0.46, 0.87) than females. Additionally, adults were significantly more likely than children to be diagnosed during low-season months (RR = 1.59, 95% CI: 1.19, 2.12). While relatively rare in this study sample, Lyme disease diagnoses do occur in a Medicaid population in a Lyme-endemic state. |
