Impact of the COVID-19 pandemic on treatment for mental health needs: a perspective on service use patterns and expenditures from commercial medical claims data.

OBJECTIVE: To examine changes in use patterns, cost of healthcare services before and after the outbreak of the COVID-19 pandemic, and their impacts on expenditures for patients receiving treatment for depression, anxiety, eating disorders, and substance use. METHODS: This cross-sectional study employed statistical tests to analyze claims in MarketScan® Commercial Database in March 2020-February 2021 and quarterly from March 2020 to August 2021, compared to respective pre-pandemic periods. The analysis is based on medical episodes created by the Merative™ Medical Episode Grouper (MEG). MEG is a methodology that groups medical and prescription drug claims to create clinically relevant episodes of care. RESULTS: Comparing year-over-year changes, proportion of patients receiving anxiety treatment among all individuals obtaining healthcare services grew 13.7% in the first year of the pandemic (3/2020-2/2021) versus 10.0% in the year before the pandemic (3/2019-2/2020). This, along with a higher growth in price per episode (5.5% versus 4.3%) resulted in a greater increase in per claimant expenditure ($0.61 versus $0.41 per month). In the same periods, proportion of patients receiving treatment for depression grew 3.7% versus 6.9%, but per claimant expenditure grew by same amount due to an increase in price per episode (4.8%). Proportion of patients receiving treatment for anorexia started to increase 21.1% or more in the fall of 2020. Patient proportion of alcohol use in age group 18-34 decreased 17.9% during the pandemic but price per episode increased 26.3%. Patient proportion of opioid use increased 11.5% in March-May 2020 but decreased or had no significant changes in subsequent periods. CONCLUSIONS: We investigated the changes in use patterns and expenditures of mental health patients before and after the outbreak of the COVID-19 pandemic using claims data in MarketScan®. We found that the changes and their financial impacts vary across mental health conditions, age groups, and periods of the pandemic. Some changes are unexpected from previously reported prevalence increases among the general population and could underlie unmet treatment needs. Therefore, mental health providers should anticipate the use pattern changes in services with similar COVID-19 pandemic disruptions and payers should anticipate cost increases due, in part, to increased price and/or service use.

Robust discovery of periodically expressed genes using the laplace periodogram.

BACKGROUND: Time-course gene expression analysis has become important in recent developments due to the increasingly available experimental data. The detection of genes that are periodically expressed is an important step which allows us to study the regulatory mechanisms associated with the cell cycle. RESULTS: In this work, we present the Laplace periodogram which employs the least absolute deviation criterion to provide a more robust detection of periodic gene expression in the presence of outliers. The Laplace periodogram is shown to perform comparably to existing methods for the Sacharomyces cerevisiae and Arabidopsis time-course datasets, and to outperform existing methods when outliers are present. CONCLUSION: Time-course gene expression data are often noisy due to the limitations of current technology, and may include outliers. These artifacts corrupt the available data and make the detection of periodicity difficult in many cases. The Laplace periodogram is shown to perform well for both data with and without the presence of outliers, and also for data that are non-uniformly sampled.

A joint estimation approach for two-tone image deblurring by blind deconvolution.

A new statistical method is proposed for deblurring two-tone images, i.e., images with two unknown grey levels, that are blurred by an unknown linear filter. The key idea of the proposed method is to adjust a deblurring filter until its output becomes two tone. Two optimization criteria are proposed for the adjustment of the deblurring filter. A three-step iterative algorithm (TSIA) is also proposed to minimize the criteria. It is proven mathematically that by minimizing either of the criteria, the original (nonblurred) image, along with the blur filter, will be recovered uniquely (only with possible scale/shift ambiguities) at high SNR. The recovery is guaranteed not only for i.i.d. images but also for correlated and nonstationary images. It does not require a priori knowledge of the statistical parameters or the tone values of the original image; neither does it require a priori knowledge of the phase or other special information (e.g., FIR, symmetry, nonnegativity, etc.) about the blur filter. Numerical experiments are carried out to test the method on synthetic and real images.