scholarly journals Generalized Propensity Score Matching with Multilevel Treatment Options

10.36469/9847 ◽  
2013 ◽  
Vol 1 (1) ◽  
pp. 1-13
Author(s):  
Onur Baser
Keyword(s):  
Health Care ◽  
Propensity Score ◽  
Health Services ◽  
Combination Therapy ◽  
Propensity Score Matching ◽  
Health Care Costs ◽  
Multivariate Regression ◽  
Treatment Options ◽  
Care Costs ◽  
Multilevel Treatment

Background: Although conventional form of propensity score matching (PSM) is widely used in outcomes research field, its application on multilevel treatment is limited.</p> Objectives: This article reviews PSM and illustrates their use when there are more than two treatment choices, which is very common in health services research. Methods: Generalized PSM technique was applied to commercial claims data to estimate the treatment effect of reliever only, controller only and combination therapy of patients with asthma. The propensity score is estimated using multinomial logistic regression. The outcome variable was total annual health care costs. Inverse probability weighting was applied to calculate risk adjusted costs. Results are compared with multivariate regression analysis, where the generalized linear model is used with gamma family and log link function. Results: Based on the study’s definitions of an asthma episode, we obtained a sample that included 25,124 patients in fee-for-service (FFS) plans and 6,603 patients in non-FFS plans. Under each plan type, patients who were prescribed three different treatment options were significantly different in terms of their demographic and clinical characteristics. Compared to combination therapy under FFS group, the difference of the total health care costs among reliever therapy and controller only group was significant ($728 and $1,216, respectively). Under non-FFS group, reliever only therapy totaled $1,266; controller only therapy was $1,959, and combination therapy totaled $1,933. Although the cost difference between reliever only and combination therapy was significant, there was no evidence that combination therapy cost more than controller only therapy. There were no significant differences in the multi-level propensity score adjusted results and multivariate regression results. Conclusion: This analysis presents the potential value of generalized PSM methods in health services when there are multilevel treatment options.

scholarly journals Health Services Use and Health Care Costs of Obese and Nonobese Individuals

2004 ◽  
Vol 164 (19) ◽  
pp. 2135 ◽  
Author(s):  
Marsha A. Raebel ◽  
Daniel C. Malone ◽  
Douglas A. Conner ◽  
Stanley Xu ◽  
Julie A. Porter ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Costs ◽  
Health Services Use ◽  
Care Costs ◽  
Services Use

scholarly journals A unique partnership between a health system’s insurance plan and the Integrative Medicine Department benefits patients and helps control costs

2016 ◽  
Vol 5 (4) ◽  
pp. 61
Author(s):  
Maureen M Anderson ◽  
Karen Armstrong ◽  
Katherine Nori Janosz ◽  
Michael Tocco ◽  
Nancy A DeVore ◽  
...  
Keyword(s):  
Health Care ◽  
Integrative Medicine ◽  
Health Care Costs ◽  
Treatment Options ◽  
Cost Savings ◽  
Clinical Results ◽  
Insurance Plan ◽  
Effective Care ◽  
Wide Range ◽  
Care Costs

Health care costs continue to increase, affecting patients and insurance providers. Complementary health approaches are increasingly used to augment traditional medicine, and integrative medicine (IM) incorporates these complementary approaches into traditional patient care. The IM Department was established in our institution in 2004 and now offers a wide range of services to patients. Our institution offers health care coverage to all benefit-eligible hospital personnel and their eligible dependents. The use of IM has had a surprising and beneficial effect on the health care costs of this small, self-insured health plan. We found that the coverage of certain IM modalities for specific conditions had positive clinical results and resulted in significant cost savings to the insurance plan. At the same time, this partnership supports patients by providing appropriate and effective care, and we have seen success in terms of patient recovery and patient satisfaction. Here, we present the history of the relationship between the insurance plan and the IM Department, how the coverage of IM modalities has expanded, and the current practice at our institution. We demonstrate that this innovative relationship has benefitted patients and resulted in cost-savings for the insurance provider. Therefore, this partnership will continue to expand, thus providing patients with a wide range of treatment options and effective care.

scholarly journals Health Literacy Levels and Affecting Factors of Patients Who Applied to A University Hospital Polyclinic

2019 ◽  
Vol 8 (1) ◽  
pp. 27-35
Author(s):  
Burkay Yakar ◽  
Mehtap Gömleksiz ◽  
Edibe Pirinççi
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Services ◽  
Health Care Costs ◽  
The Elderly ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Affecting Factors ◽  
Cross Sectional ◽  
Care Costs

Aim: It is known that increasing health literacy can increase people's quality of life, enable them to benefit from health services more effectively and contribute to reducing health care costs. Inadequate health literacy has been reported to lead to insufficient health information, high risk of ill health, low level of understanding of treatment methods and increase in health care costs. Today, increasing number of chronic diseases, increasing the elderly population and increasing the budget allocated to health services have also increased the importance of health literacy levels. In this context, it is aimed to investigate health literacy levels and factors affecting our country. Methods: Our cross-sectional study was conducted in voluntary patients who applied to the family medicine outpatient clinic of a university. In our study, sociodemographic questionnaire form and Turkish Health Literacy Scale were used for data collection. Chi-square test was used for statistical analysis and p Results: 225 volunteers were included in our study. 62,1% of them were women. The mean score of the health literacy scale was 25.5±10.2. 50.6% of the participants were inadequate, and 25.1% of them had problematic health literacy level. The level of health literacy was found to be significantly lower in women, who had low education level, who were married and had children and who had vision problems. Conclusion: The data obtained from our study showed that our health literacy levels are low. We need to develop policies that increase our levels

Total healthcare, treatment, and supportive care costs among metastatic pancreatic cancer (MPC) patients (pts) treated with either nab-paclitaxel/gemcitabine (nab-P+G) or FOLFIRINOX (FFX) in the first-line (1L) setting.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 20-20
Author(s):  
Brian Ung ◽  
Manish Patel ◽  
Corey Pelletier ◽  
Quanhong Ni
Keyword(s):  
Health Care ◽  
Supportive Care ◽  
Health Care Costs ◽  
Treatment Options ◽  
Secondary Malignancy ◽  
Health Plans ◽  
First Line ◽  
Data Mart ◽  
Treatment Administration ◽  
Care Costs

20 Background: The economic burden of MPC is substantial while treatment options are limited. This study compared treatment, supportive care, and total health care costs in MPC pts who initiated nab-P+G or FFX in a large insured US population. Methods: A retrospective study was conducted using claims from the Clinformatics Data Mart Database. Adults who had ≥2 claims for PC, ≥1 claim with a secondary malignancy, completed >1 cycle of nab-P+G or FFX as 1L between 1/1/2013 and 12/31/2015, and had continuous enrollment in health plans for ≥6 months prior to and 3 months following the start of 1L, were selected. Total health care costs and MPC-related treatment costs were measured per patient per month (PPPM) during 1L. Results: 216 MPC pts met selection criteria ( nab-P+G, n=139; FFX, n=77). Pts on nab-P+G were significantly older (mean age: 67.6 vs. 61.4 years; p<0.001) vs. FFX. nab-P+G pts incurred similar total health care costs but less supportive care and treatment administration costs vs. FFX (table). The nab-P+G group had a significantly lower proportion of pts who received peg-filgrastim (13.7% vs. 50.6%; p<0.001); with lower PPPM number of fills (0.11 vs. 0.71; p<0.001), anti-emetics (92.8% vs. 100%; p=0.0154), and hydration procedures (63.3% vs. 98.7%; p=0.0001), but a higher proportion received oral opioids (66.2% vs. 54.5%, p=0.0066) during 1L. Conclusions: Total health care costs were similar. nab-P+G pts had higher chemotherapy drug costs while FFX pts had higher treatment administration and supportive care costs. [Table: see text]

scholarly journals Direct Health Care Costs, Health Services Utilization, and Outcomes of Biliary Atresia

2020 ◽  
Vol 70 (4) ◽  
pp. 436-443
Author(s):  
Shabnaz Siddiq ◽  
Carolina Jimenez-Rivera ◽  
M. Ellen Kuenzig ◽  
Isac Lima ◽  
Michael T. Geraghty ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Biliary Atresia ◽  
Health Care Costs ◽  
Health Services Utilization ◽  
Services Utilization ◽  
Care Costs
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