Economic burden of influenza illness among children under 5 years in Suzhou, China: Report from the cost surveys during 2011/12 to 2016/17 influenza seasons

Heart failure (HF) is considered to be a global health problem that generates a significant economic burden. Despite the growing prevalence in Saudi Arabia, the economic burden of HF is not well studied. The aim of this study was to estimate the health care expenditures associated with HF in Saudi Arabia from a social perspective. We conducted a multicenter cost of illness (COI) study in two large governmental centers in Riyadh, Saudi Arabia using 369 HF patients. A COI model was developed in order to estimate the direct medical costs associated with HF. The indirect costs of HF were estimated based on a human capital approach. Descriptive and inferential statistics were analyzed. The direct medical cost per HF patient was $9563. Hospitalization costs were the major driver in total spending, followed by medication and diagnostics costs. The cost significantly increased in line with the disease progression, ranging from $3671 in class I to $16,447 in class IV. The indirect costs per working HF patient were $4628 due to absenteeism, and $6388 due to presenteeism. The economic burden of HF is significantly high in Saudi Arabia. Decision makers need to focus on allocating resources towards strategies that prevent frequent hospitalizations and improve HF management and patient outcomes in order to lower the growing economic burden.

Download Full-text

Economic Burden of Influenza in Thailand: A Systematic Review

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/0046958020982925 ◽

2020 ◽

Vol 57 ◽

pp. 004695802098292

Author(s):

S. Kiertiburanakul ◽

W. Phongsamart ◽

T. Tantawichien ◽

W. Manosuthi ◽

P. Kulchaitanaroaj

Keyword(s):

Economic Burden ◽

Thai Population ◽

Population Demographics ◽

Productivity Costs ◽

Healthcare Facilities ◽

Macroeconomic Analysis ◽

High Incidence ◽

Lost Productivity ◽

Research Gap ◽

Influenza Illness

Thailand has a high incidence and high mortality rates of influenza. This study summarizes the evidence on economic burden or costs of influenza subsequent to the occurrence of influenza illness in the Thai population by specific characteristics such as population demographics, health conditions, healthcare facilities, and/or cost types from published literature. A systematic search was conducted in six electronic databases. All costs were extracted and adjusted to 2018 US dollar value. Out of 581 records, 11 articles (1 with macroeconomic analysis and 10 with microeconomic analyses) were included. Direct medical costs per episode for outpatients and inpatients ranged from US$4.21 to US$212.17 and from US$163.62 to US$4577.83, respectively, across distinct influenza illnesses. The overall burden of influenza was between US$31.1 and US$83.6 million per year and 50-53% of these estimates referred to lost productivity. Costs of screening for an outbreak of influenza at an 8-bed-intensive-care-unit hospital was US$38242.75 per year. Labor-sensitive sectors such as services were the most affected part of the Thai economy. High economic burden tended to occur among children and older adults with co-morbidities and to be related to complications, non-vaccinated status, and severe influenza illness. Strategies involving prevention, limit of transmission, and treatment focusing on aforementioned patients’ factors, containment of hospitalization expenses and quarantine process, and assistance on labor-sensitive economy sectors are likely to reduce the economic burden of influenza. However, a research gap exists regarding knowledge about the economic burden of influenza in Thailand.

Download Full-text

Economic burden of childhood diarrhea in Burundi

Global Health Research and Policy ◽

10.1186/s41256-021-00194-3 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Fulgence Niyibitegeka ◽

Arthorn Riewpaiboon ◽

Sitaporn Youngkong ◽

Montarat Thavorncharoensap

Keyword(s):

Economic Burden ◽

Cost Model ◽

Primary Treatment ◽

Management Program ◽

Community Based ◽

Factors Affecting ◽

Hospitalization Costs ◽

Illness Study ◽

The Cost ◽

Substantial Economic Burden

Abstract Background In 2016, diarrhea killed around 7 children aged under 5 years per 1000 live births in Burundi. The objective of this study was to estimate the economic burden associated with diarrhea in Burundi and to examine factors affecting the cost to provide economic evidence useful for the policymaking about clinical management of diarrhea. Methods The study was designed as a prospective cost-of-illness study using an incidence-based approach from the societal perspective. The study included patients aged under 5 years with acute non-bloody diarrhea who visited Buyenzi health center and Prince Regent Charles hospital from November to December 2019. Data were collected through interviews with patients’ caregivers and review of patients’ medical and financial records. Multiple linear regression was performed to identify factors affecting cost, and a cost model was used to generate predictions of various clinical and care management costs. All costs were converted into international dollars for the year 2019. Results One hundred thirty-eight patients with an average age of 14.45 months were included in this study. Twenty-one percent of the total patients included were admitted. The average total cost per episode of diarrhea was Int$109.01. Outpatient visit and hospitalization costs per episode of diarrhea were Int$59.87 and Int$292, respectively. The costs were significantly affected by the health facility type, patient type, health insurance scheme, complications with dehydration, and duration of the episode before consultation. Our model indicates that the prevention of one case of dehydration results in savings of Int$16.81, accounting for approximately 11 times of the primary treatment cost of one case of diarrhea in the community-based management program for diarrhea in Burundi. Conclusion Diarrhea is associated with a substantial economic burden to society. Evidence from this study provides useful information to support health interventions aimed at prevention of diarrhea and dehydration related to diarrhea in Burundi. Appropriate and timely care provided to patients with diarrhea in their communities and primary health centers can significantly reduce the economic burden of diarrhea. Implementing a health policy to provide inexpensive treatment to prevent dehydration can save significant amount of health expenditure.

Download Full-text

Cost Assessment of Inpatient Care Episodes of Stroke in Romania

Frontiers in Public Health ◽

10.3389/fpubh.2020.605919 ◽

2020 ◽

Vol 8 ◽

Author(s):

László Lorenzovici ◽

Andrea Székely ◽

Marcell Csanádi ◽

Péter Gaál

Keyword(s):

Economic Burden ◽

Inpatient Care ◽

Management Control ◽

Stroke Patients ◽

Healthcare Budget ◽

Management Control System ◽

Number Of Patients ◽

Level Of Economic Development ◽

The Cost ◽

Gross Costing

Introduction: Stroke is the second leading cause of death worldwide and Romania is no exception. There is a high economic burden associated with the treatment of stroke patients, which puts pressure on the healthcare budget. This study aims to measure the inpatient treatment costs of stroke patients in Romania.Methods: Our retrospective analysis follows stroke patients in six Romanian hospitals at different progressivity level from different regions. Patients are identified from the official hospital databases, reported for reimbursement purposes. Mean inpatient costs incurred with the treatment of these stroke patient episodes are calculated using the gross costing method. The cost data are derived from the management control system of the study hospitals.Results: 3,155 patient episodes of stroke were identified in the study hospitals. The average cost per stroke inpatient care episode sums up to EUR 995.57 (95% CI: EUR 963.74—EUR 1 027.39) in 2017, while the overall yearly healthcare burden adds up to EUR 140 million, representing 2.18% of the total national health insurance budget and a cost of EUR 7.15 per capita.Conclusion: The hospital cost of stroke inpatient care episode in Romania is high and it represents a sizable part of the healthcare budget, but it is among the lowest in Europe, which can mainly be explained by the level of economic development of the country. As both the number of patients and the cost of acute care are expected to increase in the future, the economic burden of stroke is also expected to increase.

Download Full-text

National Economic Burden Associated with Management of Periodontitis in Malaysia

International Journal of Dentistry ◽

10.1155/2016/1891074 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Tuti Ningseh Mohd Dom ◽

Rasidah Ayob ◽

Khairiyah Abd Muttalib ◽

Syed Mohamed Aljunid

Keyword(s):

Societal Perspective ◽

Economic Burden ◽

Census Data ◽

Adult Population ◽

National Level ◽

Indirect Costs ◽

Treatment Costs ◽

High Prevalence ◽

National Economic ◽

The Cost

Objectives. The aim of this study is to estimate the economic burden associated with the management of periodontitis in Malaysia from the societal perspective.Methods. We estimated the economic burden of periodontitis by combining the disease prevalence with its treatment costs. We estimated treatment costs (with 2012 value of Malaysian Ringgit) using the cost-of-illness approach and included both direct and indirect costs. We used the National Oral Health Survey for Adults (2010) data to estimate the prevalence of periodontitis and 2010 national census data to estimate the adult population at risk for periodontitis.Results. The economic burden of managing all cases of periodontitis at the national level from the societal perspective was approximately MYR 32.5 billion, accounting for 3.83% of the 2012 Gross Domestic Product of the country. It would cost the nation MYR 18.3 billion to treat patients with moderate periodontitis and MYR 13.7 billion to treat patients with severe periodontitis.Conclusion. The economic burden of periodontitis in Malaysia is substantial and comparable with that of other chronic diseases in the country. This is attributable to its high prevalence and high cost of treatment. Judicious application of promotive, preventive, and curative approaches to periodontitis management is decidedly warranted.

Download Full-text

PRESIDENT'S MESSAGE

PEDIATRICS ◽

10.1542/peds.30.1.157 ◽

1962 ◽

Vol 30 (1) ◽

pp. 157-158

Author(s):

Carl C. Fischer

Keyword(s):

Whooping Cough ◽

American People ◽

Practice Of Medicine ◽

The Subject ◽

The Government ◽

The Individual ◽

The Cost ◽

Federal Assistance ◽

Children Under 5

REGARDLESS of how we, as individual physicians, may feel about the role of the federal government in the individual practice of medicine, the time has long since passed when we can afford the luxury of ignoring it. In past years the influence of the government on medicine has been mostly in general areas and perhaps least of all in that of pediatrics; but under the present administration there has been a decided change. For this reason it seems necessary to me to call to the attention of all Fellows of the Academy the particular items in President Kennedy's message of February 26, 1962, which relate specifically to the practice of Pediatrics. These may be considered to be three in number: The first of these dealt with the subject of immunization. On this topic President Kennedy said: I am asking the American people to join in a nationwide vaccination program to stamp out these four diseases (whooping cough, diphtheria, tetanus, and poliomyelitis) encouraging all communities to immunize both children and adults, keep them immunized and plan for the routine immunization of children yet to be born. To assist the states and local communities in this effort over the next 3 years, I am proposing legislation authorizing a program of federal assistance. This program would cover the full cost of vaccines for all children under 5 years of age. It would also assist in meeting the cost of organizing the vaccination drives begun during this period, and the cost of extra personnel needed for certain special tasks.

Download Full-text

Use of mHealth Devices to Screen for Atrial Fibrillation: Cost-Effectiveness Analysis (Preprint)

10.2196/preprints.20496 ◽

2020 ◽

Author(s):

Godwin D Giebel

Keyword(s):

Atrial Fibrillation ◽

Cost Effectiveness ◽

Economic Burden ◽

Health Care Systems ◽

Anticoagulation Therapy ◽

Risk Scores ◽

Increased Risk ◽

Care Systems ◽

Additional Costs ◽

The Cost

BACKGROUND With an estimated prevalence of around 3% and an about 2.5-fold increased risk of stroke, atrial fibrillation (AF) is a serious threat for patients and a high economic burden for health care systems all over the world. Patients with AF could benefit from screening through mobile health (mHealth) devices. Thus, an early diagnosis is possible with mHealth devices, and the risk for stroke can be markedly reduced by using anticoagulation therapy. OBJECTIVE The aim of this work was to assess the cost-effectiveness of algorithm-based screening for AF with the aid of photoplethysmography wrist-worn mHealth devices. Even if prevented strokes and prevented deaths from stroke are the most relevant patient outcomes, direct costs were defined as the primary outcome. METHODS A Monte Carlo simulation was conducted based on a developed state-transition model; 30,000 patients for each CHA2DS2-VASc (Congestive heart failure, Hypertension, Age≥75 years, Diabetes mellitus, Stroke, Vascular disease, Age 65-74 years, Sex category [female]) score from 1 to 9 were simulated. The first simulation served to estimate the economic burden of AF without the use of mHealth devices. The second simulation served to simulate the economic burden of AF with the use of mHealth devices. Afterwards, the groups were compared in terms of costs, prevented strokes, and deaths from strokes. RESULTS The CHA2DS2-VASc score as well as the electrocardiography (ECG) confirmation rate had the biggest impact on costs as well as number of strokes. The higher the risk score, the lower were the costs per prevented stroke. Higher ECG confirmation rates intensified this effect. The effect was not seen in groups with lower risk scores. Over 10 years, the use of mHealth (assuming a 75% ECG confirmation rate) resulted in additional costs (€1=US $1.12) of €441, €567, €536, €520, €606, €625, €623, €692, and €847 per patient for a CHA2DS2-VASc score of 1 to 9, respectively. The number of prevented strokes tended to be higher in groups with high risk for stroke. Higher ECG confirmation rates led to higher numbers of prevented strokes. The use of mHealth (assuming a 75% ECG confirmation rate) resulted in 25 (7), –68 (–54), 98 (–5), 266 (182), 346 (271), 642 (440), 722 (599), 1111 (815), and 1116 (928) prevented strokes (fatal) for CHA2DS2-VASc score of 1 to 9, respectively. Higher device accuracy in terms of sensitivity led to even more prevented fatal strokes. CONCLUSIONS The use of mHealth devices to screen for AF leads to increased costs but also a reduction in the incidence of stroke. In particular, in patients with high CHA2DS2-VASc scores, the risk for stroke and death from stroke can be markedly reduced.

Download Full-text

Economic Burden of Diabetes in Urban Indians

The Open Ophthalmology Journal ◽

10.2174/1874364101408010091 ◽

2014 ◽

Vol 8 (1) ◽

pp. 91-94 ◽

Cited By ~ 10

Author(s):

Pablo Chandra ◽

Bageshri Gogate ◽

Parikshit Gogate ◽

Nilesh Thite ◽

Abhay Mutha ◽

...

Keyword(s):

Indirect Cost ◽

Direct Cost ◽

Economic Burden ◽

Significant Proportion ◽

Class Iii ◽

Lower Middle Class ◽

Average Percentage ◽

Diet Control ◽

The Cost ◽

Class Iv

Purpose : To find out the average economic burden of medical care on a patient with diabetes in Pune, India Methods : A semi-open ended questionnaire followed by interview was conducted with patients attending diabetes and ophthalmic out-patient departments. They were asked regarding the duration of diabetes, methods undertaken for blood sugar control and the amount they spend on consultations, laboratory tests, medicines and procedures if any within past year. Expenditure was classified as direct cost (cost of medicines, doctor’s fees, investigations, lasers and surgery) and indirect cost (travel, diet control, health classes and loss of wages). Data was collected regarding the socioeconomic status according to Kuppaswamy classification. Results : 219 patients participated of whom 129 were males (58.9%). Average annual direct cost of diabetes treatment was Rs 8,822 of which 52.1% was spend on medicines, 3.2% was spend on lasers, 12.6% was spend on surgical procedures, 11.6% spent on investigations and 10.4% was spend on clinician fees. Average annual indirect cost was Rs. 3949 of which 3.4% was spend on travelling purpose, 0.4% was spent on health classes, 4.9% was spent on diet control and 91.3% was loss of wages. Average expenditure done by lower middle class was 23.7% of their income. Average percentage of income for direct and indirect cost was 3.6% and 1.4% respectively. The cost of the treatment formed1.3% of the annual income for those in Socio-economic class I, 1.7% in class II, 3.7% in class III and 23.7% in class IV. Conclusion : The cost of managing diabetes was a significant proportion of the patients’ income, especially for those on lower socio-economic scale (class IV).

Download Full-text