Medical treatment cost effective in IHD

1998 ◽  
Vol 190 (1) ◽  
pp. 6-6
2018 ◽  
Vol 9 (1) ◽  
pp. 258-260
Author(s):  
Fatema Akhter Banu ◽  
BH Nazma Yasmeen ◽  
Shahriar Parvez ◽  
SK Akbar Hossain

Background : Ischemic Heart Disease (IHD) requires long term treatment which poses huge financial burden.It is very difficult for the patients of developing countries to maintain the treatment costs of IHD.Objectives : To estimate the medical treatment cost and to find out the coping ways of that in Ischemic Heart Disease patients.Methods: A descriptive type of cross sectional study was done during January 2014 to December 2014 at medical out-patient department of National Institute of Cardiovascular Disease (NICVD), Dhaka. Data were collected by using a pre-tested, semi-structured Questionnaire. Medical cost was calculated by drug cost, consultation cost, laboratory investigation cost, surgical cost, hospital cost and food cost. Data analysis was performed by using SPSS software version 20.Results : Out of 201 patients, majority (64.7%) were in the age group of 40-59 years. Most (92.54%)of them were male. Majority (56.2%) of the respondents had monthly family income of Tk. 10001-20000. Among all patients 43.8%spent total medical cost was with a range from Tk.50001-180000. 85.71%, 81.8%, 69.9% and 66.71% had coped with families by life style change whose monthly Tk. 20001-50000,Tk. 50001-100000, Tk. 10001-20000, Tk. 5000-10000 respectively. Coping ways in family by compromising treatment cost of other family members was minimum 0.0% within the income group Tk.5000-10000, which was statistically significant (p<0.05).Conclusion : The study concluded that the largest component of medical cost of IHD was the surgical cost which includes coronary angiogram, PTCA and bypass surgery. The patient compensate the burden of medical treatment cost of IHD from family savings, personal income, selling of property, personal loan, donation, health insurance and by Life style change, Reduction of food cost,and reducing social contact.Northern International Medical College Journal Vol.9(1) July 2017: 258-260


2018 ◽  
Vol 11 (2) ◽  
pp. 775-787
Author(s):  
Girija Kumari ◽  
Vikram Singh ◽  
Saurabh Dahiya ◽  
Ashok Kumar Jhingan ◽  
Bimal Chhajer

Diabetes is a costly, lifestyle disorder which increases the burden of disease and deteriorates the Health-Related Quality of Life (HRQOL) of diabetes patients and this study was conducted to assess the effect of lifestyle intervention on medical treatment cost and HRQOL in type 2 diabetes mellitus (T2DM) patients. This quasi-experimental prospective study was conducted in Delhi Diabetes Research Center, New Delhi and included 224 T2DM patients. Patients were divided into LMC and usual care group on the basis of receiving or not receiving lifestyle modification counseling. The follow-up of both groups was done at 6th and 12th months. Collected data were analyzed through IBM, SPSS software v 21 for mean, median (min-max), SD, t-test and Wilcoxon scores (rank sums) test. The results of this study showed a statistically significant reduction in diabetes medication costs, hospitalization and surgery costs in the LMC group as compared to the usual care group. The significant improvement was also observed in HRQOL domains which includes - physical functioning (62.40±6.738 to 83.67 ± 5.4920), physical health (35.30±22.069 to 64.50±13.62), emotional problem (37.90±28.93 to71.46±16.75), energy (54.31±11.858 to 80.75 ± 15.52), emotional well-being (63.06± 9.828 to 85.79±6.36), social functioning (38.848±20.805 to 65.54±8.39) and general health (54.51±11.679 to 82.398± 11.7) at 12th month follow up in LMC group. The ADS score also showed significant improvement in overall HRQOL of LMC group. This study concludes that lifestyle intervention may improve HRQOL and reduce medical treatment cost of T2DM patients.


1998 ◽  
Vol 3 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Michael Lavender ◽  
Neil Craig ◽  
Ron Kerr ◽  
Denise Howel

Objectives: To investigate the benefit of carotid endarterectomy relative to medical treatment, by comparing the outcome for different groups of patients following transient ischaemic attacks. Methods: A Markov model was used to describe the survival and quality of life of patients treated for a transient ischaemic attack. The benefit is measured in terms of quality adjusted life months (QALMs). The outcome was estimated using a computer simulation with parameters based on published studies on the probability of events following treatment. The benefit of carotid endarterectomy was explored using a baseline set of parameters and a sensitivity analysis. Results: The baseline scenario of a 65-year-old male patient with the model factors set at an intermediate level showed a benefit for surgery of 3 QALMs compared with medical treatment alone. The sensitivity analysis showed that the most favourable combination of factors had a benefit of 13.4 QALMs and the least favourable a loss of 2 QALMs. Of all 128 factor combinations, 79.9% showed a benefit for surgery, 5.5% showed equal benefit, and 15.6% showed a benefit for medical treatment. Conclusions: Computer simulations have the potential for deriving estimates of benefit for different patient groups from the results of clinical trials. Combined with reliable information on costs, the technique could also demonstrate variations in cost-effectiveness for these groups. For patients following a transient ischaemic attack, the results from this simulation and limited cost information suggest that carotid endarterectomy is unlikely to be a cost-effective intervention in the UK for many patient groups despite a reduction in the risk of stroke.


2015 ◽  
Vol 6 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Hanna Norrlid ◽  
Peter Dahm ◽  
Gunnel Ragnarson Tennvall

AbstractBackground and aimsChronic pain is a life altering condition and common among elderly persons. The 7-day buprenorphine patch could be a suitable treatment for managing chronic pain of moderate severity in elderly patients in Sweden.The objective of this analysis was to investigate the cost-effectiveness of the 7-day buprenorphine patch, versus no treatment, in patients >50 years old who suffer from moderate pain in a health economic perspective. An additional aim was to evaluate how the cost-effectiveness is affected by the choice of EQ-5D weights.MethodsThe annual treatment cost and the potential gains in health-related quality of life (HRQoL) of buprenorphine, compared to no treatment, were evaluated. Original EQ-5D data were collected from four clinical reference studies at baseline and at the final visit. Treatment effects on HRQoL were then assessed using both UK and Swedish EQ-5D weights. Annual treatment costs were calculated based on costs of physician visits and pharmaceuticals.The optimal treatment dose was 10-15 μg/h and the analysis was hence performed on both a 10- and a 15 μg/h buprenorphine patch.ResultsThe analysis of buprenorphine treatment resulted in improved HRQoL in all reference studies, irrespective of choice of EQ-5D weight set. The change in quality adjusted life years (QALYs) varied with a gain of 0.042-0.118 using the UK weights and 0.020-0.051 with the Swedish weights. The average annual treatment cost was SEK14454 for the 10μg/h patch and SEK17 017 for the 15 μg/h patch, while cost for the no-treatment alternative was SEK 9 960. The base case incremental cost-effectiveness ratios (ICER) with the UK weights were SEK 40000-SEK 170000 and SEK 90000-SEK 350000 when applying the Swedish weights. The corresponding ICER-span in the sensitivity analysis was SEK 15 000-SEK 400 000 when applying the UK weights and SEK 30 000-SEK 840 000 with the Swedish weights (SEK 100 is about €11).ConclusionsThe results imply that the 7-day buprenorphine patch may be a cost-effective treatment of moderate chronic pain in patients over 50 years of age. The UK and the Swedish EQ-5D weights generated vastly different HRQoL estimates but buprenorphine remains cost-effective regardless choice of weight set.


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