Direct costs of both inpatient and outpatient care for all type cancers: The evidence from Beijing, China

Background: The increasing incidence of breast cancer and its financial burden highlights the need for controlling treatment costs. This study aimed to assess the direct costs of inpatient and outpatient care for breast cancer patients in Liaoning Province to provide a policy reference for cost containment. Methods: Based on the System of Health Accounts 2011 (SHA 2011), systematic data collection was conducted via multistage stratified cluster random sampling. A total of 1160 health institutions, including 83 hospitals, 16 public health institutions, 120 primary health institutions, and 941 outpatient institutions were enrolled in 2017. A database was established containing 20 035 patient-level medical records from the information system of these institutions. Curative care expenditure (CCE)was calculated, and generalized linear modeling was performed to determine cost-related factors. Results: In 2017, the CCE for breast cancer was approximately CNY 830.19 million (US$122.96 million) in Liaoning province (0.7% of the total health expenditure and 9.9% of cancer-related healthcare costs). Inpatient care costs were estimated to be CNY 617.27 million (US$91.42 million), accounting for 74.4% of the CCE for breast cancer, almost three times as large as outpatient costs (25.6%). The average inpatient and outpatient costs for breast cancer were estimated to be CNY 12 108 (US$1793) and CNY 829 (US$123) per visit. Medication cost was the main cost driver, which comprised 84.0% of the average outpatient cost and 37.2% of the mean inpatient cost. Conclusion: Breast cancer imposes a large economic burden on patients and the social health insurance system. Results show an irrational cost pattern of inpatient and outpatient services, with patients relying excessively on inpatient services for treatment. Promoting outpatient care whenever relevant is conducive to cost containment and rational utilization of resources.

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Hepatitis C prevalence in HIV-infected individuals: a comparison of inpatient and outpatient care

International Journal of STD & AIDS ◽

10.1177/0956462414521169 ◽

2014 ◽

Vol 25 (11) ◽

pp. 806-811

Author(s):

Ziqiang Zhu ◽

Teena Dhir ◽

Myat Soe ◽

Linda Green ◽

Ning Jiang

Keyword(s):

Hepatitis C ◽

Outpatient Care ◽

Inpatient And Outpatient Care

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New Trends in Inpatient and Outpatient Care in Europe

Epidemiology and Community Psychiatry ◽

10.1007/978-1-4684-4700-2_59 ◽

1985 ◽

pp. 399-402

Author(s):

John H. Henderson

Keyword(s):

Outpatient Care ◽

Inpatient And Outpatient Care

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Abstract WMP109: Transitional Care Matrix to Improve the Coordination of Stroke Care Between Inpatient and Outpatient Care Settings

Stroke ◽

10.1161/str.50.suppl_1.wmp109 ◽

2019 ◽

Vol 50 (Suppl_1) ◽

Author(s):

Katelyn Skeels ◽

Lester Y Leung

Keyword(s):

Outpatient Care ◽

Transitional Care ◽

Stroke Care ◽

Inpatient And Outpatient Care

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Cost of schizophrenia: direct costs and use of resources in the State of São Paulo

Revista de Saúde Pública ◽

10.1590/s0034-89102006000200017 ◽

2006 ◽

Vol 40 (2) ◽

pp. 304-309 ◽

Cited By ~ 12

Author(s):

Raquel Jales Leitão ◽

Marcos Bosi Ferraz ◽

Ana Cristina Chaves ◽

Jair J Mari

Keyword(s):

Public Sector ◽

Outpatient Care ◽

Direct Costs ◽

Sao Paulo ◽

The State ◽

Public Hospitals ◽

Total Direct Cost ◽

São Paulo ◽

Regular Treatment ◽

The Public

OBJECTIVE: To estimate the direct costs of schizophrenia for the public sector. METHODS: A study was carried out in the state of São Paulo, Brazil, during 1998. Data from the medical literature and governmental research bodies were gathered for estimating the total number of schizophrenia patients covered by the Brazilian Unified Health System. A decision tree was built based on an estimated distribution of patients under different types of psychiatric care. Medical charts from public hospitals and outpatient services were used to estimate the resources used over a one-year period. Direct costs were calculated by attributing monetary values for each resource used. RESULTS: Of all patients, 81.5% were covered by the public sector and distributed as follows: 6.0% in psychiatric hospital admissions, 23.0% in outpatient care, and 71.0% without regular treatment. The total direct cost of schizophrenia was US$191,781,327 (2.2% of the total health care expenditure in the state). Of this total, 11.0% was spent on outpatient care and 79.2% went for inpatient care. CONCLUSIONS: Most schizophrenia patients in the state of São Paulo receive no regular treatment. The study findings point out to the importance of investing in research aimed at improving the resource allocation for the treatment of mental disorders in Brazil.

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A review of the applications for involuntary admissions made to the Mental Health Review Boards by institutions in Gauteng in 2008

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v16i4.254 ◽

2010 ◽

Vol 16 (4) ◽

pp. 6

Author(s):

M Y H Moosa ◽

F Y Jeenah

Keyword(s):

Mental Health ◽

Health Care Professionals ◽

Outpatient Care ◽

Inpatient Care ◽

Psychiatric Hospitals ◽

Department Of Health ◽

Massive Scale ◽

Inpatient And Outpatient Care ◽

Health Review ◽

Review Boards

Aim. To review applications for involuntary admissions made to the Mental Health Review Boards (MHRBs) by institutions in Gauteng.Method. A retrospective review of the register/database of the two review boards in Gauteng for the period January - December 2008. All applications for admissions (involuntary and assisted inpatient) and outpatient care (involuntary and assisted), and periodic reports for continued care (inpatient or outpatient care) were included.Results. During the study period the two MHRBs received a total of 3 803 applications for inpatient care, of which 2 526 were for assisted inpatient care (48.1% regional hospitals, 29.6% specialised psychiatric hospitals, 22.2% tertiary academic hospitals). Of the applications for involuntary inpatient care, 73.1% were from the specialised psychiatric hospitals (65.2% from Sterkfontein Hospital). Applications for outpatient care, treatment and rehabilitation (CTR) numbered 1 226 (92% assisted outpatient CTR). Although the health establishments in northern Gauteng applied for more outpatient CTR compared with those in southern Gauteng (879 v. 347, respectively), the ratios of assisted to involuntary outpatient applications for CTR for each region were similar (approximately 12:1 and 9:1, respectively). The boards received 3 805 periodic reports for prolonged CTR (93.5% inpatient, 6.5% outpatient), in the majority of cases for assisted CTR.Conclusion. The study suggests that in the 4 years since the promulgation of the MHCA in 2004 , there have been significant strides towards implementation of the procedures relating to involuntary admission and CTR by all stakeholders. Differences in levels of implementation by the various stakeholders may result from differences in knowledge, perceptions, attitudes and understanding of their roles and therefore indicate the need for education of mental health care professionals and the public on a massive scale. The Department of Health also needs to invest more funds to improve mental health human resources and infrastructure at all health establishments.

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Explosive Zunahme der häuslichen Krankenpflege bei Beatmeten und Tracheotomierten

DMW - Deutsche Medizinische Wochenschrift ◽

10.1055/a-0805-5284 ◽

2019 ◽

Vol 144 (04) ◽

pp. 282-285 ◽

Cited By ~ 2

Author(s):

Dieter Köhler

Keyword(s):

Home Care ◽

Outpatient Care ◽

Organizational Structures ◽

Interface Problems ◽

Discharge Management ◽

Additional Costs ◽

Long Term Ventilation ◽

Inpatient And Outpatient Care

AbstractSince 2005, invasive long-term ventilation in Germany has increased significantly from around 1000 to 20 000 patients in Germany. Due to complex home care, the health care system incurs additional costs of around 4 billion euros per year. In addition, in the last 2 – 3 years more tracheostomized patients have been discharged home without ventilation (usually after stroke), and they receive the same complex home care. These patients have almost never been given the chance of a professional weaning trial by a weaning center. They are discharged from hospitals directly into the care. As a result, the quality of care is significantly worse than traditional care with structured discharge management via a weaning center. The solutions are difficult to find due to the interface problems between inpatient and outpatient care and the different organizational structures with different delivery systems. Possible solutions are shown, but most of them require a change in the law.

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