scholarly journals Subcutaneous specific immunotherapy: Economic implications from the perspective of statutory health insurance – a population-based cost-effectiveness estimation

2018 ◽  
Vol 2 (01) ◽  
pp. 111-120
Author(s):  
T. Reinhold ◽  
S. Willich ◽  
B. Brüggenjürgen
Keyword(s):  
Health Insurance ◽  
Cost Effectiveness ◽  
Specific Immunotherapy ◽  
Statutory Health Insurance ◽  
Population Based ◽  
Economic Implications ◽  
Subcutaneous Specific Immunotherapy

scholarly journals Cost and outcomes of the ultrasound screening program for birth defects over time: a population-based study in France

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036566
Author(s):  
Clément Ferrier ◽  
Babak Khoshnood ◽  
Ferdinand Dhombres ◽  
Hanitra Randrianaivo ◽  
Isabelle Perthus ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cost Effectiveness ◽  
Birth Defects ◽  
Screening Programme ◽  
Population Based ◽  
Ultrasound Screening ◽  
Cost Effectiveness Ratio ◽  
Population Based Study ◽  
Prenatal Detection ◽  
The Cost

ObjectiveTo assess trends in the average costs and effectiveness of the French ultrasound screening programme for birth defects.DesignA population-based study.SettingNational Public Health Insurance claim database.ParticipantsAll pregnant women in the ‘Echantillon Généraliste des Bénéficiaires’, a permanent representative sample of 1/97 of the individuals covered by the French Health Insurance System.Main outcomes measuresTrends in the costs and in the average cost-effectiveness ratio (ACER) of the screening programme (in € per case detected antenatally), per year, between 2006 and 2014. incremental cost-effectiveness ratio (ICER) from 1 year to another were also estimated. We assessed costs related to the ultrasound screening programme of birth defects excluding the specific screening of Down’s syndrome. The outcome for effectiveness was the prenatal detection rate of birth defects, assessed in a previous study. Linear and logistic regressions were used to analyse time trends.ResultsDuring the study period, there was a slight decrease in prenatal detection rates (from 58.2% in 2006 to 55.2% in 2014; p=0.015). The cost of ultrasound screening increased from €168 in 2006 to €258 per pregnancy in 2014 (p=0.001). We found a 61% increase in the ACER for ultrasound screening during the study period. ACERs increased from €9050 per case detected in 2006 to €14 580 per case detected in 2014 (p=0.001). ICERs had an erratic pattern, with a strong tendency to show that any increment in the cost of screening was highly cost ineffective.ConclusionEven if the increase in costs may be partly justified, we observed a diminishing returns for costs associated with the prenatal ultrasound screening of birth defects, in France, between 2006 and 2014.

scholarly journals Healthcare provision, functional ability and quality of life after proximal femoral fracture - ’ProFem': Study protocol of a population-based, prospective study based on individually linked survey and statutory health insurance data

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028144
Author(s):  
Silke Andrich ◽  
Michaela Ritschel ◽  
Gabriele Meyer ◽  
Falk Hoffmann ◽  
Astrid Stephan ◽  
...  
Keyword(s):  
Health Insurance ◽  
Prospective Study ◽  
Hospital Discharge ◽  
Statutory Health Insurance ◽  
Public Information ◽  
Femoral Fractures ◽  
Population Based ◽  
Healthcare Provision ◽  
Health Insurance Data ◽  
Patient Reported

IntroductionProximal femoral fractures (PFF) are among the most frequent fractures in older people. However, the situation of people with a PFF after hospital discharge is poorly understood. Our aim is to (1) analyse healthcare provision, (2) examine clinical and patient-reported outcomes (PROs), (3) describe clinical and sociodemographic predictors of these and (4) develop an algorithm to identify subgroups with poor outcomes and a potential need for more intensive healthcare.Methods and analysisThis is a population-based prospective study based on individually linked survey and statutory health insurance (SHI) data. All people aged minimum 60 years who have been continuously insured with the AOK Rheinland/Hamburg and experience a PFF within 1 year will be consecutively included (SHI data analysis). Additionally, 700 people selected randomly from the study population will be consecutively invited to participate in the survey. Questionnaire data will be collected in the participants’ private surroundings at 3, 6 and 12 months after hospital discharge. If the insured person considers themselves to be only partially or not at all able to take part in the survey, a proxy person will be interviewed where possible. SHI variables include healthcare provision, healthcare costs and clinical outcomes. Questionnaire variables include information on PROs, lifestyle characteristics and socioeconomic status. We will use multiple regression models to estimate healthcare processes and outcomes including mortality and cost, investigate predictors, perform non-responder analysis and develop an algorithm to identify vulnerable subgroups.Ethics and disseminationThe study was approved by the ethics committee of the Faculty of Medicine, Heinrich-Heine-University Düsseldorf (approval reference 6128R). All participants including proxies providing written and informed consent can withdraw from the study at any time. The study findings will be disseminated through scientific journals and public information.Trial registration numberDRKS00012554.

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