Estimating the Direct Medical Cost, Length of Stay and Impact of Reimbursement Change on Health Care Associated Infections

Background: The Ethiopian health care system since 2005 has encouraged safe enhanced obstetrical care. However, hospital delivery has remained expensive for poor households due to hidden costs. Hidden costs are the costs that are not accounted for in direct hospital costs. The aim of this study was to estimate the hidden costs of institutional delivery and to identify its associated factors. Methods: A health facility–based cross-sectional study was conducted in the Bale zone from August 13 to September 2, 2018. Exit interviews were conducted among women who gave birth at the selected hospitals. A total of 390 women from 1 referral hospital and 2 general hospitals were included into the study. Systematic sampling technique was used to select study participants. Multiple linear regression analysis was done to identify the predictors of the hidden cost of institutional delivery. Result: The median hidden cost of institutional delivery was 877.5 ETB (32.03 USD). The median of the direct medical cost of normal delivery was 280 ETB (10.21 USD) while the direct nonmedical cost was 230 ETB (8.40 USD). For cesarean section, the median direct medical cost was 292 ETB (10.66 USD) while indirect costs were 591 ETB (21.60 USD). For forceps delivery, the direct medical cost was 362 ETB (13.21 USD) while the direct medical cost was 360 (13.14 USD). Distance of household from the hospital (β = 0.165), length of stay at the hospital (β = 0.050), mode of delivery (β = −0.067), and family monthly income (β = 0.201) were the explanatory variables significantly associated with the hidden cost. Conclusion: This study showed hidden cost of facility-based delivery was high. Distance, length of stay, income, and mode of delivery were the predictor of hidden cost. Ethiopian health care system should consider the hidden costs for pregnant women and their families.

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EVALUATION OF PHARMACOECONOMIC DIRECT COST IN DIABETES PATIENTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i4.8510 ◽

2017 ◽

Vol 10 (4) ◽

pp. 38

Author(s):

Venkateswarlu Konuru ◽

Kamala Sangam ◽

Anifa Mohammed ◽

Swathi Kanneganti

Keyword(s):

Health Care ◽

Diabetic Patient ◽

Direct Medical Cost ◽

Medical Cost ◽

Average Cost ◽

Health Care Cost ◽

Vascular Complications ◽

Illness Study ◽

Total Average Cost ◽

Total Average

Objective: Diabetes Mellitus (DM) is a major cause of disability, morbidity and mortality Worldwide. The objective of this study is to evaluate the Pharmacoeconomic direct health care cost in type II Diabetes with complications and Diabetes alone: A cost of illness study. Methods: A Prospective observational study was conducted for one year at the Care diabetes Center; Warangal. The enrolled patients were followed and the information collected contains: total direct costs, which include direct medical costs and direct nonmedical cost. The data observed was analyzed for the average cost incurred in treating the diabetic patient. Results: The total average costs per diabetic patient without complications was Rs. 8695.7±1341, this includes the average direct medical cost Rs. 6366.50± 561.12, the average lab cost Rs. 1368.84±64.8, the average direct non Medical Cost was Rs. 960.36±14.04 compared to those with DM complications,the total average cost was Rs. 12960.73±549.96 for macro vascular complications, Rs. 11039.11±265.36 for micro vascular complications. To treat Diabetes with comorbidities which include both micro and macro complications the total average cost was Rs. 16658.13±1393.44, the average direct medical cost was Rs. 14071.77±2884.68, the average lab cost Rs. 1628.04±51, the average direct non Medical Cost was Rs.958.32±13.08. The costs were found to increase progressively with the increase in the number of complications. Costs also differed significantly across the types of complications. Conclusion: Our study concludes that the cost of Diabetes with complications resulted about 2 times higher than compared to Diabetes alone.Key words: Cost analysis; diabetes; economics; health care; direct medical cost; non medical cost

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PHARMACOECONOMIC EVALUATION OF ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AT A TERTIARY CARE TEACHING HOSPITAL IN NORTH KARNATAKA, INDIA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i5.24814 ◽

2018 ◽

Vol 11 (5) ◽

pp. 463 ◽

Cited By ~ 1

Author(s):

Rahul S ◽

Abhinand Cr ◽

Nikithareddy B ◽

Jayachandra K ◽

Lakshmi P ◽

...

Keyword(s):

Health Care ◽

Direct Medical Cost ◽

Medical Cost ◽

Pharmacoeconomic Evaluation ◽

Research Centre ◽

Total Direct Cost ◽

Chronic Obstructive ◽

Total Direct Medical Cost ◽

Copd Patients ◽

Acute Exacerbations

Objective: The objective of the study was to evaluate the burden of cost in patients of acute exacerbations of chronic obstructive lung disease (COPD).Methods: A prospective, observational study was conducted in COPD patients over a period of 6 months in general medicine and pulmonary wards of Navodaya Medical College Hospital and Research Centre, Raichur, Karnataka, India. Direct medical and non-medical cost were included in the burden of cost. From the drug rate manual of hospital, cost for drugs and investigation were calculated.Results: Overall 100 COPD patients were enrolled in which 92 were male and 8 were female with a mean age of 60.33±10.98. The patients participated in this study were stayed in the hospital with mean±standard deviation (SD) value of 9±3. Minimum total direct medical cost was Rs. 1149.00 and maximum was Rs. 13,510.00 with a mean±SD 3297.48±1634.226, in which medicine cost was high (mean 2746.63). Minimum total direct non-medical cost was Rs. 100.00 and maximum was Rs. 3470.00 with a mean±SD 700.7±487.121, in which food expenses was high (mean 549.55). Maximum total direct cost was Rs.16,980.00 and minimum was 1349.00 with a mean± SD 3998.18±1921.47. Direct medical cost contributes 79.56% and direct non-medical cost contribute 20.44% of total direct cost.Conclusion: COPD has a substantial impact on health-care costs particularly for hospitalization. Exacerbation prevention resulting in reduced need for inpatient care could lower costs. The development of pharmacoeconomic is at an infancy stage in India at the moment, despite the rapid growth of clinical research. In a country with scarce resources and an ever-growing population with diverse health-care needs, health economics (Pharmacoeconomic evaluation) plays a pivotal role in determining the delivery of equitable and cost-effective health services.

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Attributable Length of Stay, Mortality Risk, and Costs of Bacterial Health Care–Associated Infections in Australia: A Retrospective Case-cohort Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1228 ◽

2020 ◽

Author(s):

X J Lee ◽

A J Stewardson ◽

L J Worth ◽

N Graves ◽

T M Wozniak

Keyword(s):

Health Care ◽

Length Of Stay ◽

Respiratory Tract ◽

Respiratory Tract Infections ◽

Hospital Admissions ◽

Care Hospital ◽

Retrospective Case ◽

Health Care Associated Infections ◽

Tract Infections ◽

The Impact

Abstract Background Unbiased estimates of the health and economic impacts of health care–associated infections (HAIs) are scarce and focus largely on patients with bloodstream infections (BSIs). We sought to estimate the hospital length of stay (LOS), mortality rate, and costs of HAIs and the differential effects on patients with an antimicrobial-resistant infection. Methods We conducted a multisite, retrospective case-cohort of all acute-care hospital admissions with a positive culture of 1 of the 5 organisms of interest (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, or Enterococcus faecium) from 1 January 2012 through 30 December 2016. Data linkage was used to generate a data set of statewide hospital admissions and pathology data. Patients with bloodstream, urinary, or respiratory tract infections were included in the analysis and matched to a sample of uninfected patients. We used multistate survival models to generate LOS, and logistic regression to derive mortality estimates. Results We matched 20 390 cases to 75 635 uninfected control patients. The overall incidence of infections due to the 5 studied organisms was 116.9 cases per 100 000 patient days, with E. coli urinary tract infections (UTIs) contributing the largest proportion (51 cases per 100 000 patient days). The impact of a UTI on LOS was moderate across the 5 studied pathogens. Resistance significantly increased LOS for patients with third-generation cephalosporin-resistant K. pneumoniae BSIs (extra 4.6 days) and methicillin-resistant S. aureus BSIs (extra 2.9 days). Consequently, the health-care costs of these infections were higher, compared to corresponding drug-sensitive strains. Conclusions The health burden remains highest for BSIs; however, UTIs and respiratory tract infections contributed most to the health-care system expenditure.

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Extra length of stay and costs because of health care–associated infections at a German university hospital

American Journal of Infection Control ◽

10.1016/j.ajic.2015.09.005 ◽

2016 ◽

Vol 44 (2) ◽

pp. 160-166 ◽

Cited By ~ 30

Author(s):

Habibollah Arefian ◽

Stefan Hagel ◽

Steffen Heublein ◽

Florian Rissner ◽

André Scherag ◽

...

Keyword(s):

Health Care ◽

Length Of Stay ◽

University Hospital ◽

Health Care Associated Infections

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Direct medical cost of acute stroke a Nhan Dan Gia Dinh hospital in 2020 and some influencing factors

Journal of Health and Development Studies ◽

10.38148/jhds.0503skpt20-121 ◽

2021 ◽

Vol 05 (03) ◽

pp. 19-27

Author(s):

Quynh Nguyen ◽

◽

Van Tan Vo

Keyword(s):

Ischemic Stroke ◽

Length Of Stay ◽

Acute Stroke ◽

Direct Medical Cost ◽

Influencing Factors ◽

Medical Cost ◽

Economic Burden ◽

Hemorrhagic Stroke ◽

Mechanical Thrombectomy ◽

Stroke Treatment

Objective : Describe the direct medical cost of acute stroke a Nhan Dan Gia Dinh hospital in 2020 and some influencing factors. Methods: Design of cross-sectional descriptive study, conducted two steps: quantitative research to describe the direct medical cost of acute stroke with the patient's medical records and hospital discharge payment slip: cerebral infarction stroke and cerebral hemorrhagic stroke from 3/2020 to 10/2020. And qualitative research analyzes factors affecting direct medical cost of acute stroke: hospital managers, doctor and nurse, the patients. Main findings: The study performed a sample size of 249 and results: Direct medical cost for treatment of ischemic stroke: 13.260.620 VND, treatment of ischemic stroke with alteplase: 21.026.494 VND, treatment of ischemic stroke with alteplase and mechanical thrombectomy: 120.521.658 VND, treatment of ischemic stroke with mechanical thrombectomy: 73.979.558 VND, treatment of ischemic stroke without revascularization: 5,250,087 VND, treatment of hemorrhagic stroke: 6,305,926 VND. Influencing factors include: age, type of stroke, treatment, length of stay in the intensive care unit, and length of stay. Conclusions: Our study evaluated economic burden of stroke which had significant consequences for patients and society. This study provided evidences for decision makers to implement healthcare policies for stroke prevention and management to reduce the economic burden of stroke in Vietnam. Keywords: direct medical cost, acute stroke, stroke subtypes, length of stay, treatment

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Health care resources utilization and costs associated with different clinical stages of chronic hepatitis B in Egypt

Egyptian Liver Journal ◽

10.1186/s43066-021-00162-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jackleen Azer Abd El-Halim ◽

Gihan Ismael Gewaifel ◽

Eman Ahmed Fawzy Darwish ◽

Ahmed Maher Ramadan ◽

Gihan Hamdy ElSisi

Keyword(s):

Health Care ◽

Chronic Hepatitis ◽

Direct Medical Cost ◽

Medical Cost ◽

Medical Costs ◽

Age Group ◽

High Quality ◽

Health Care Resources ◽

Direct Medical Costs ◽

And Control

Abstract Introduction Chronic hepatitis B (CHB) is associated with many serious clinical and social consequences. Despite Egypt being classified as a country of low endemicity, the infection is associated with a 15–25% risk of premature death from liver cancer or end-stage liver disease. The national committee of treatment and control of viral hepatitis has already offered a high-quality service for the diagnosis and treatment of CHB on a free basis. The current study aims to estimate the health care resources utilization and the annual direct medical cost associated with different clinical stages of CHB-related disease in Egypt. Methodology The data was retrieved through record review for three months in the General Administration of Hepatitis Viruses Control, Egypt. Then, the data was extrapolated to the population level by multiplying the prevalence in Egypt with a focus on the productive age groups (25–59 years). Results The cost and utilization of different health care resources increase with disease progression. The total annual direct medical costs due to CHB in Egypt is 21.3 L.E. Billion (4.7 Int$ billion/year) for the management of estimated 1,420,700 CHB patients. The direct medical costs among the productive age group (25–59 years) constitute more than half of the total cost (57%). The highest disease burden is encountered among (25–29 years) age group; 2.695 L.E. billion (0.59 Int$ billion/year). Despite liver transplantation phase being associated with the highest annual cost/patient, the number of patients in this stage is the lowest. Then, it only constitutes 0.04% of the disease direct medical cost in the country. The chronic hepatitis clinical stage constitutes 57.26% of the disease direct medical cost in Egypt’s working age group. Conclusion Strengthening the preventive and control measures is mandatory to alleviate the disease’s direct medical costs. Close monitoring of the chronic hepatitis stage is mandatory to prevent disease progression. Enhancement of vaccination efforts will lower the disease prevalence and its cost. The universal health insurance system which is gradually implemented in Egypt nowadays will be a cornerstone in relieving the economic stresses by allowing more access to high-quality health care services.

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