scholarly journals Economic Analysis of Rotavirus-Associated Diarrhea in the Metropolitan Toronto and Peel Regions of Ontario

2002 ◽  
Vol 13 (3) ◽  
pp. 167-174 ◽  
Author(s):  
P Jacobs ◽  
LG Shane ◽  
K Fassbender ◽  
EL Wang ◽  
R Moineddin ◽  
...  

OBJECTIVE: To measure the economic cost of rotavirus- associated diarrhea for a selected group of families, in a nonexperimental setting, and to estimate the factors that influence these costs.DESIGN: Use and other socioeconomic data from a family survey (the Pediatric Rotavirus Epidemiology Study for Immunization) of children who tested positive for rotavirus were collected for the metropolitan Toronto and Peel regions of Ontario during the rotavirus season of 1997-1998. Service costs were estimated from provider data. A statistical regression analysis was used to explain the variances of provincial health care costs, prescription drug costs and indirect (work-loss) costs.SETTING: Data were collected in hospitals, emergency rooms, paediatric practices, primary care clinics and licensed daycare centres. Hospital coverage was wide, but community coverage was not.PATIENTS AND OTHER PARTICIPANTS: Children with diarrhea were tested for rotavirus. Those who tested positive and whose parents consented for their children to participate were included in the study.INTERVENTIONS: NoneMAIN OUTCOME MEASURES: The main outcomes were provincial health care costs, drug costs, nonmedical costs and thenumber of days of work missed by parents per child, as well as factors that determine these costs.RESULTS: Children in the most severe category incurred costs of $2,663/person, and those in the least severe categories incurred costs of approximately $350/person. The most important determinant to explain provincial health care costs was the number of health problems that the child had before having rotavirus. Costs due to work loss of parents were considerable for children in all severity groups and were influenced by family working conditions.CONCLUSIONS: When considering the economic implications of rotavirus, prior health status should be considered and indirect costs should be recognized for their importance.

2016 ◽  
Vol 20 (3) ◽  
pp. 515-523 ◽  
Author(s):  
John Paul Ekwaru ◽  
Arto Ohinmaa ◽  
Sarah Loehr ◽  
Solmaz Setayeshgar ◽  
Nguyen Xuan Thanh ◽  
...  

AbstractObjectivePublic health decision makers not only consider health benefits but also economic implications when articulating and issuing lifestyle recommendations. Whereas various estimates exist for the economic burden of physical inactivity, excess body weight and smoking, estimates of the economic burden associated with our diet are rare. In the present study, we estimated the economic burden attributable to the inadequate consumption of vegetables and fruit in Canada.DesignWe accessed the Canadian Community Health Survey to assess the inadequacy in the consumption of vegetables and fruit and published meta-analyses to assemble risk estimates for chronic diseases. Based on these inadequacy and risk estimates, we calculated the population-attributable fraction and avoidable direct and indirect costs to society. Direct costs include those for hospital care, physician services and drugs in 2015.ResultsAbout 80 % of women and 89 % of men consume inadequate amounts of vegetables and fruit. We estimated this to result in an economic burden of $CAN 3·3 billion per year, of which 30·5 % is direct health-care costs and 69·5 % is indirect costs due to productivity losses. A modest 1 percentage point annual reduction in the prevalence of inadequate vegetables and fruit consumption over the next 20 years would avoid approximately $CAN 10·8 billion, and an increase of one serving of vegetables and fruit per day would avoid approximately $CAN 9·2 billion.ConclusionsFurther investments in the promotion of vegetables and fruit will prevent chronic disease and substantially reduce direct and indirect health-care costs.


Author(s):  
Jonne T. H. Prins ◽  
Mathieu M. E. Wijffels ◽  
Sophie M. Wooldrik ◽  
Martien J. M. Panneman ◽  
Michael H. J. Verhofstad ◽  
...  

Abstract Purpose This study aimed to examine population-based trends in the incidence rate, health care consumption, and work absence with associated costs in patients with rib fractures. Methods A retrospective nationwide epidemiologic study was performed with data from patients with one or more rib fractures presented or admitted to a hospital in the Netherlands between January 1, 2015 and December 31, 2018 and have been registered in the Dutch Injury Surveillance System (DISS) or the Hospital Discharge Registry (HDR). Incidence rates were calculated using data from Statistics Netherlands. The associated direct health care costs, costs for lost productivity, and years lived with disability (YLD) were calculated using data from a questionnaire. Results In the 4-year study period, a total of 32,124 patients were registered of which 19,885 (61.9%) required hospitalization with a mean duration of 7.7 days. The incidence rate for the total cohort was 47.1 per 100,000 person years and increased with age. The mean associated direct health care costs were €6785 per patient and showed a sharp increase after the age of 75 years. The mean duration of work absence was 44.2 days with associated mean indirect costs for lost productivity of €22,886 per patient. The mean YLD was 0.35 years and decreased with age. Conclusion Rib fractures are common and associated with lengthy HLOS and work absenteeism as well as high direct and indirect costs which appear to be similar between patients with one or multiple rib fractures and mostly affected by admitted patients and age.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 514.2-514
Author(s):  
M. Merino ◽  
O. Braçe ◽  
A. González ◽  
Á. Hidalgo-Vega ◽  
M. Garrido-Cumbrera ◽  
...  

Background:Ankylosing Spondylitis (AS) is a disease associated with a high number of comorbidities, chronic pain, functional disability, and resource consumption.Objectives:This study aimed to estimate the burden of disease for patients diagnosed with AS in Spain.Methods:Data from 578 unselected patients with AS were collected in 2016 for the Spanish Atlas of Axial Spondyloarthritis via an online survey. The estimated costs were: Direct Health Care Costs (borne by the National Health System, NHS) and Direct Non-Health Care Costs (borne by patients) were estimated with the bottom-up method, multiplying the resource consumption by the unit price of each resource. Indirect Costs (labour productivity losses) were estimated using the human capital method. Costs were compared between levels of disease activity using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score (<4 or low inflammation versus ≥4 or high inflammation) and risk of mental distress using the 12-item General Health Questionnaire (GHQ-12) score (<3 or low risk versus ≥3 or high risk).Results:The average annual cost per patient with AS in 2015 amounted to €11,462.3 (± 13,745.5) per patient. Direct Health Care Cost meant an annual average of €6,999.8 (± 9,216.8) per patient, to which an annual average of €611.3 (± 1,276.5) per patient associated with Direct Non-Health Care Cost borne by patients must be added. Pharmacological treatment accounted for the largest percentage of the costs borne by the NHS (64.6%), while for patients most of the cost was attributed to rehabilitative therapies and/or physical activity (91%). The average annual Indirect Costs derived from labour productivity losses were €3,851.2 (± 8,484.0) per patient, mainly associated to absenteeism. All categories showed statistically significant differences (p<0.05) between BASDAI groups (<4 vs ≥4) except for the Direct Non-Healthcare Cost, showing a progressive rise in cost from low to high inflammation. Regarding the 12-item General Health Questionnaire (GHQ-12), all categories showed statistically significant differences between GHQ-12 (<3 vs ≥3), with higher costs associated with higher risk of poor mental health (Table 1).Table 1.Average annual costs per patient according to BASDAI and GHQ-12 groups (in Euros, 2015)NDirect Health CostsDirect Non-Health CostsIndirect CostsTotal CostBASDAI<4917,592.0*557.32,426.5*10,575.8*≥43769,706.9*768.05,104.8*15,579.7*Psychological distress (GHQ-12)<31468,146.8*493.6*3,927.2*12,567.6*≥32609,772.9*807.2*4,512.3*15,092.5*Total5786,999.8611.33,851.211,462.3* p <0.05Conclusion:Direct Health Care Costs, and those attributed to pharmacological treatment in particular, accounted for the largest component of the cost associated with AS. However, a significant proportion of the overall costs can be further attributed to labour productivity losses.Acknowledgments:Funded by Novartis Farmacéutica S.A.Disclosure of Interests:María Merino: None declared, Olta Braçe: None declared, Almudena González: None declared, Álvaro Hidalgo-Vega: None declared, Marco Garrido-Cumbrera: None declared, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly


2007 ◽  
Vol 10 (3) ◽  
pp. A100-A101
Author(s):  
MS Duh ◽  
JF Fowler ◽  
L Rovba ◽  
S Buteau ◽  
L Pinheiro ◽  
...  

Dermatology ◽  
2019 ◽  
Vol 235 (5) ◽  
pp. 372-379 ◽  
Author(s):  
Simon Francis Thomsen ◽  
Lone Skov ◽  
Rikke Dodge ◽  
Morten Storling Hedegaard ◽  
Jakob Kjellberg

Background: To date, there are no nationwide studies of the social and economic burden of psoriasis to patients in Denmark. Incentives for health care management based on patient-related outcomes and value (IMPROVE) in psoriasis and psoriatic arthritis is a project aimed at assisting movement from activity-based to outcome-based health care management. One of the key objectives in IMPROVE is to describe the disease-associated socioeconomic burden of psoriasis. Methods: A case-matched study of the impact of psoriasis on patients’ income, employment and health care costs in Denmark was performed. The IMPROVE study was a retrospective analysis of patients with a hospital diagnosis of psoriasis identified from the Danish National Patient Registry (NPR). In total, 13,025 psoriasis patients and 25,629 matched controls were identified from the NPR. Data from psoriasis patients and matched controls were compared for social and economic factors including income, employment, health care costs and risk of comorbidities. Results: Psoriasis was associated with increased health care costs (mean annual costs +116% compared to control, p < 0.001), peaking in the year of referral to hospital for psoriasis and sustained thereafter. Both direct and indirect costs were significantly higher for patients with psoriasis than controls (p < 0.001). In the years before and immediately following hospital diagnosis, the rates of employment were lower in psoriasis patients than controls. Comorbidities, including cardiovascular (odds ratio 1.93 [95% CI 1.77–2.09]) and psychiatric conditions (odds ratio 2.61 [95% CI 2.30–2.97]), were more prevalent in patients with psoriasis than controls. Conclusion: In Denmark, psoriasis has a significant impact on health care costs, income and employment, and is associated with a range of comorbidities.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J S Bundgaard ◽  
U M Mogensen ◽  
S Christensen ◽  
U M Ploug ◽  
R Roerth ◽  
...  

Abstract Background Heart failure (HF) imposes a large burden on the individual as well as society and the aim of this study was to investigate the economic burden attributed to direct and indirect costs of patients with HF before, at, and after time of diagnosis. Methods Using Danish nationwide registries we identified all patients >18 years with a first-time diagnosis of HF from 1998–2016 and matched them 1:1 with a control group from the background population on age, gender, marital status, and educational level. The economic analysis of the total costs after diagnosis was based on direct costs including hospitalization, procedures, medication, and indirect costs including social welfare and lost productivity to estimate the annual cost of HF. Results We included a total of 176,067 HF patients with a median age of 76 years, and 55% were male. Patients with HF incurred an average of €17,039 in sum of total annual direct (€11,926) and indirect (€5,113) health-care costs peaking at year of diagnosis compared to €5,936 in the control group with the majorityattributable to inpatient admissions. The total annual net costs including social transfer after index HF were €11,957 higher in patients with HF compared to controls and the economic consequences increased markedly 2 years prior to the diagnosis of HF (Figure 1). Conclusion Patients with HF impose significantly higher total annual health-care costs compared to a matched control group with findings evident more than 2 years prior to HF diagnosis Acknowledgement/Funding Novartis


2007 ◽  
Vol 41 (10) ◽  
pp. 819-829 ◽  
Author(s):  
Paul B. Fitzgerald ◽  
William Montgomery ◽  
Anthony R. de Castella ◽  
Kate M. Filia ◽  
Sacha L. Filia ◽  
...  

Objective: The treatment of patients with schizophrenia consumes a considerable proportion of health service budgets, yet there have been few attempts to prospectively analyse the costs associated with this condition. Amid the current debate about where to invest scarce treatment resources to achieve optimal outcomes, real-world studies, such as the Schizophrenia Care and Assessment Programme (SCAP) contrast with hypothetically based models and provide comprehensive and broad-ranging data. Method: Direct health-care costs were prospectively studied in a cohort of 347 patients with schizophrenia in Dandenong, Australia over 3 years. Indirect costs were estimated from patient self-reported information. Results: The average annual societal cost was AU$32 160 per participant in the first year of the study, AU$27 190 in the second year and AU$29 181 in the third year. Indirect costs accounted for 46% of the total costs in the first year, 52% of the total costs in the second year and 50% of the total costs in the third year. The most expensive component of treatment was inpatient hospital care, which accounted for 42%, 34% and 36% of the total costs in the first, second and third year, respectively. Conclusions: Considerable resources are required for the provision of treatment for patients with schizophrenia. But for the majority of people in this cohort, funding assertive treatment programmes and measures to reduce hospitalization was accompanied with enhanced functioning and quality of life, as well as a reduction in long-term societal and government costs. The distribution of health-care costs is highly skewed, with a relatively small proportion of patients (39%) consuming the majority of resources (80%). Improving rates of employment for this patient group could hold substantial benefits in reducing the overall economic and personal impact of this disorder.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4220-4220
Author(s):  
Shrividya Iyer ◽  
Peter C Trask ◽  
Gordon Siu ◽  
Jack Mardekian

Abstract Abstract 4220 Objective: To estimate health care resource use and related costs in patients with chronic myeloid leukemia (CML). Methods: A retrospective cohort analysis was conducted using the Thomson Reuters MarketScan Commercial Claims and Encounters and Medicare Supplemental databases, which is composed of medical and pharmacy claims for approximately 43 million beneficiaries. Cases with at least 2 medical claims associated with a diagnosis of CML (ICD-9-CM code: 205.1) between Jan 1, 2002 and Dec 31, 2009 were extracted from the database. Index date was defined as the date of the first diagnosis of CML. A minimum of six months pre-index and 12 months post index enrollment was required. Disease and non-disease related utilization and costs were estimated. Resource utilization was calculated from index date to last available claims data point and then annualized per patient. Results: A total of 2583 patients were identified with an average follow up of 2.7 years. The mean age of the cohort was 59 years, and 45% were female. Proportions of patients having at least one inpatient, outpatient, and ER CML related visit were found to be 32.4%, 94.9%, and 15.1%, respectively. The average number of visits (standard deviation [SD]) per patient year was found to be 1.3 (1.4) and 1.6 (2.4) for inpatient and ER visits, respectively, among patients who had at least one visit. Average number (SD) of outpatient and office visits per patient year was found to be 40.6 (34.5) and 15.3 (11.6), respectively. Average number of prescriptions filled for CML was 3.3 per patient year. Disease-related health care costs ($23,166) constituted 36% of the total health care costs ($64,441) per patient year. Inpatient ($24,462 ± 77,429), outpatient ($24,391 ± 48,439), and prescription drug costs ($15,588 ± 18,327) accounted for 38%, 38%, and 24% of the total health care costs, respectively. CML drug costs accounted for 73% of the prescription drug costs. Conclusion: Cost burden of chronic myeloid leukemia are substantial. Effective disease management could help reduce resource utilization and cost while improving overall disease outcomes. Disclosures: Iyer: Pfizer: Employment. Trask:Pfizer Inc (at time of work completion): Employment; Sanofi: Employment. Mardekian:Pfizer Inc: Employment, Equity Ownership.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17514-17514
Author(s):  
E. Q. Wu ◽  
W. Feng ◽  
S. Johnson ◽  
N. Beaulieu ◽  
P. Cremieux ◽  
...  

17514 Background: Not adhering to treatment (tx) may lead to suboptimal outcomes. This study examined associations between medical costs and IM compliance in CML pts. Methods: CML pts under age 65 were identified with ICD-9 diagnosis code (205.1X) using MarketScan Commercial Claims data between 1/1/02–12/31/05. Pts were required to be continuously enrolled in the 4 months prior to (baseline) and the 6 months following (study period) IM initiation. CML severity was categorized into 3 groups by diagnosis of CML and related comorbidities. Compliance was defined by medication possession ratio (MPR=total days of IM supply in the study period divided by 180), and stratified into 3 groups (low: <65%, medium: 65–95%, high: 95–100%). Tx interruption was defined as tx gap of 30 or more consecutive days in the study period. Costs for inpatient (IP), ER, outpatient (OP) services and OP drugs during the study period were adjusted to 2005 dollars. Costs, the number of IP admissions and hospital days were compared across different levels of tx compliance using Wilcoxon tests. A generalized linear model (GLM) was also used to compare costs controlling for age, sex, CML severity, Charlson comorbidity index, year of IM start, etc. Results: The study sample consisted of 404 pts. Compared to the high MPR group, pts in the low MPR group incurred 1.6 times the average total health care costs (p <.001), 5.9 times the IP costs (p<.001), 2.6 times the OP costs (p=.722), 2.1 times the non-IM drug costs (p<.001), and 0.39 times the IM drug costs (p<.001). Compared to the high MPR pts, low MPR pts had on average 3.8 times the IP admissions (p<.001), and 7.3 times the IP days (p<.001). Comparing costs of pts interrupting tx versus those who did not showed similar trends. GLM regression showed that 6-month total health care costs per patient in the low MPR group were 1.4 times (p<.01) those of the high MPR group. Pts who had tx interruption had 1.3 times the total health care costs (p<.01) compared to those who did not. Conclusions: This study shows that better IM compliance was associated with significantly lower health care costs in CML pts, especially for IP costs. Further analyses will be conducted to confirm whether lower compliance leads to more hospitalizations. No significant financial relationships to disclose.


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