Comparative analysis of the economic costs of treating patients with non-infectious diseases of internal osteosynthesis

2020 ◽  
Vol 22 (4) ◽  
pp. 156-160
Author(s):  
V. V. Khominets ◽  
V. Yu. Tegza ◽  
I. V. Foos ◽  
E. M. Pugaev

A comparative analysis of the economic costs of revision surgical treatment of 121 patients with non-infectious complications of internal osteosynthesis and 59 patients who underwent primary osteosynthesis for fractures of the long bones of the limbs with an uncomplicated course was carried out. General economic costs include direct and indirect costs. It was found that the total costs for the treatment of patients suffering from non-infectious complications of internal osteosynthesis of the long bones of the extremities, who are in the clinic of military traumatology and orthopedics. G.I. Turner of the Military Medical Academy in the period from 2007 to 2018 revision surgery was performed, amounted to 279637238 rubles, which corresponds to 2311051,55 rubles per patient. At the same time, the total costs for the treatment of patients with fractures of the long bones of the extremities without complications amounted to 44960873 rubles (762048,69 rubles per patient). The total cost per patient with a non-infectious complication of internal osteosynthesis of the femur was 2540499,54 rubles (483824,85 straight, 2056674,69 indirect), of the leg bones 2333762,17 rubles (474501,47 straight, 1859260,70 indirect), the humerus 1830362,75 rubles (399942 straight, 1430420,75 indirect), the bones of the forearm 1804664,6 rubles (339700 straight, 1464964,6 indirect). It was revealed that due to failures after primary osteosynthesis of limb fractures and complications, the costs associated with the direct and indirect costs of their treatment increase. In this regard, further research is needed to improve the treatment of complications of internal osteosynthesis and to develop a set of measures for their prevention. This is important both for the patient and for the health care system as a whole.

Crisis ◽  
2007 ◽  
Vol 28 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Brendan Kennelly

Abstract. Objective: To calculate the costs of suicide in Ireland. Method: The paper identifies all episodes of suicide in Ireland in 2001 and 2002, and projects the economic costs arising from these episodes over subsequent years. All prices have been converted to 2001 euros. Both direct and indirect costs were calculated. Indirect costs included both the cost of lost output and human costs. Results: The total cost of suicide is estimated at over Euro 906 million in 2001, and over Euro 835 million in 2002 (in 2001 prices). This is equivalent to a little under 1% of the gross national product in Ireland for those years. Conclusions: The results show that investment in health education and health promotion can be justified on the basis of the costs associated with suicide in Ireland. These costs fall on individuals, families, and society. The huge human cost of suffering associated with suicide can also be prevented through appropriate intervention to prevent death occurring. It is important that any suicide prevention strategy should include an evaluative framework to ensure that investment occurs in the areas most likely to generate the highest returns in term of suicides prevented and lives saved.


2020 ◽  
Vol 9 (3) ◽  
pp. 369-376
Author(s):  
N. G. Doronin ◽  
S. N. Khoroshkov ◽  
M. V. Naumenko

The aim of the study is the comparative analysis of the long-term results of treatment of extra-articular fractures of the long bones in HIV-infected and non-HIV-infected patients.Material and methods. In the presented study, a comparative analysis of the results of surgical treatment of 90 HIV-infected and 112 HIV-uninfected patients with extra-articular fractures of the long bones of the extremities aged from 23 to 54 years was performed.Results. HIV-infected patients are mainly characterized by non-infectious complications from the postoperative wound (formation of seromas, hematomas, dehiscence of the edges of wounds, delayed healing), aseptic loosening and migration of fixators, and delayed consolidation of fractures. The presence of statistically significant relationships between the factors characterizing the course of HIV infection (stage of the disease, the number of CD4 + lymphocytes, the ratio of CD4/CD8 + lymphocytes, viral load) and the risk of postoperative complications was revealed.Conclusion. Thus, the use of standard algorithms for determining the tactics and method of treatment of extra-articular fractures of the long bones of the extremities in HIV-infected patients leads to a significant number of unsatisfactory treatment results (up to 31.1%). For HIV-infected patients, the most typical complications are postoperative wounds, impaired fracture consolidation processes and aseptic loosening of metal fixators, which can lead to the development of infectious complications without proper attention. Expansion of research in this area with an increase in the number of observed contingents will make it possible to develop a scientifically based scale for predicting the development of possible postoperative complications in this category of patients.


2016 ◽  
Vol 10 (2-3) ◽  
pp. 107-117
Author(s):  
Jantine Voordouw ◽  
Gerrit Antonides ◽  
Margaret Fox ◽  
Inma Cerecedo ◽  
Javier Zamora ◽  
...  

Background: Recent studies show that food hypersensitivity, such as food allergy or food intolerance, has the potential to affect direct, indirect and intangible economic costs experienced by individuals and their families. This research assesses the direct and indirect economic costs of food hypersensitivity at the household level in the Netherlands, Poland, and Spain. Methods:  A self-administered postal survey was conducted (n=1558). Respondents with food hypersensitivity were clinically diagnosed cases recruited through clinical centres in Poland and Spain. In the Netherlands, food hypersensitivity cases were recruited through hospitals, patient organisations and advertisements. The controls formed the baseline sample and were obtained from households in which none of the members had food hypersensitivity. The monetary value of indirect costs, forgone time, was calculated using the opportunity cost method. The indirect and direct costs were expressed in purchasing power parity. Analysis of co-variance on the cost items was used to test the within-country differences between respondents with food hypersensitivity and respondents without food hypersensitivity, as well as across the three countries. Results: The average total direct and indirect costs across all countries for families with food hypersensitive family members are not higher than for households without food hypersensitive members. However, the intangible costs for food hypersensitive individuals appear to be higher than for individuals in the control group.Conclusions: These results do not support the hypothesis that all food allergies incur high costs to the individual. However, being hypersensitive to foods may have a negative impact on quality of life compared to people who are not food hypersensitive.


2020 ◽  
Author(s):  
Patrick V Katana ◽  
Amina Abubakar ◽  
Moses K. Nyongesa ◽  
Derrick Ssewanyana ◽  
Paul Mwangi ◽  
...  

Abstract Background: Eighty per cent of perinatally HIV infected (PHI) adolescents live in sub-Saharan Africa (sSA), a setting also characterized by huge economic disparities. Caregiving is crucial to the management of chronic illness such as HIV/AIDS, but the economic costs and mental disorders borne by caregivers of PHI adolescents often go unnoticed. In this study, we evaluated economic costs, coping strategies and association between economic cost and mental health functioning of caregivers of perinatally HIV infected adolescents in Kilifi, Kenya. Methods: We used a cost of illness descriptive analysis approach to determine the economic burden and Patient Health Questionnaire (PHQ-9) to assess the caregivers’ mental health. Cross-sectional data were collected from 121 primary caregivers of PHI adolescents in Kilifi using a structured cost questionnaire. Economic costs (direct and indirect costs) were measured from primary caregivers’ perspective. We used descriptive statistics in reporting the results of this study. Results: Average monthly direct and indirect costs per primary caregiver was Ksh 2,784.51 (USD 27.85). Key drivers of direct costs were transportation (66.5%) and medications (13.8%). Total monthly costs represented 28.8% of the reported caregiver monthly earnings. Majority of the caregivers borrowed resources to cope with high economic burden. About 10.7% of primary caregivers reported depressive symptoms. Caregivers with positive depression screen (PHQ-9 score ≥10) had high average monthly direct and indirect costs. However, this was not statistically different compared to costs incurred by caregivers who screened negative for depressive symptoms. Conclusion: Our study indicates that HIV/AIDS is associated with a significant economic burden for caregivers of adolescents living with HIV. Results underscore the need for developing economic empowerment and social support programmes that reduce the economic burden of caring for perinatally infected adolescent. These efforts may improve the mental health and quality of life of caregivers of adolescents living with HIV.


2019 ◽  
Author(s):  
Patrick V Katana ◽  
Amina Abubakar ◽  
Moses K. Nyongesa ◽  
Derrick Ssewanyana ◽  
Paul Mwangi ◽  
...  

Abstract Background: Eighty per cent of perinatally HIV infected (PHI) adolescents live in sub-Saharan Africa (SSA), a setting also characterized by huge economic disparities. Caregiving is crucial to the management of chronic illness such as HIV/AIDS, but the economic costs and mental disorders borne by caregivers of PHI adolescents often go unnoticed. In this study, we evaluated economic costs, coping strategies and association between economic cost and mental health functioning of caregivers of perinatally HIV infected adolescents in Kilifi, Kenya. Methods: We used a cost of illness descriptive analysis approach and mental health was assessed using the Patient Health Questionnaire (PHQ-9). Cross-sectional data were collected from 121 primary caregivers of PHI adolescents in Kilifi using a structured cost questionnaire. Economic costs (direct costs and indirect costs) were measured from primary caregivers’ perspective. We used descriptive statistics in reporting the results of this study. Results: Average monthly direct and indirect costs per primary caregiver was Ksh 2,784.51 (USD 27.85). Key drivers of direct costs were transportation (66.5%) and medications (13.8%). Total monthly costs represented 28.8% of the reported caregiver monthly earnings. Majority of the caregivers borrowed resources to cope with high economic burden. About 10.7% of primary caregivers reported depressive symptoms. Caregivers with positive depression screen (PHQ-9 score ≥10) had high average monthly direct and indirect costs. However, this was not statistically different compared to costs incurred by caregivers who screened negative for depressive symptoms. Conclusion: Our study indicates that HIV/AIDS is associated with a significant economic burden for caregivers of adolescents living with HIV. These high economic burdens seem to negatively influence the mental health of caregivers of adolescents living with HIV. Results underscore the need for developing economic empowerment and social support programmes that reduce the economic burden of caring for perinatally infected adolescent. These efforts may improve the mental health and quality of life of caregivers of adolescents living with HIV.


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