scholarly journals Costs for Schizopsychotic Patients in Sweden

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
L. Helldin ◽  
F. Hjärthag ◽  
M. Lothgren ◽  
C. Hjortsberg
Keyword(s):  
Patient Care ◽  
Indirect Costs ◽  
Premature Death ◽  
Direct Costs ◽  
Cost Driver ◽  
Local Municipality ◽  
Cost Item ◽  
Cost Variability ◽  
Inpatient And Outpatient Care ◽  
At Home

As part of the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), 200 patients diagnosed with schizophrenia, schizoaffective disorder or delusional disorder, are studied. the aim is to provide up-to-date costs for a defined patient population with schizopsychotic disorders in Sweden.We identify the actual clinical management of illness and explain cost variability. Costs are combined with information on outcomes and severity of the disorder.Total costs per patient-year amount to 62.320 Euro. Direct costs correspond to 41% and indirect costs to 59% of total costs. Inpatient and outpatient care corresponds to 7% each of total costs, while costs for special housing and assistance at home is estimated to 22% of total costs. Medication only corresponds to 3% of total costs.We conclude that costs differ between patients depending on illness severity. Also a reallocation has taken place during the last 15 years between different cost items, from direct costs to indirect costs and from in-patient care at hospitals to out-patient care and assistance at home. the main cost driver is indirect costs due to decreased working ability and premature death. Special housing and home-assistance is the second largest cost item. In-patient care corresponds to 7% of total costs, which 15 years ago amounted to 50% of total costs. This reflects the change in care of schizopsychotic patients. Instead of treating patients at institutions, patients are now to a large extent living in their own housing but often receiving some kind of assistance at home provided by the local municipality.

scholarly journals Unbalanced Treatment Costs of Breast Cancer in China: Implications From the Direct Costs of Inpatient and Outpatient Care in Liaoning Province

2021 ◽  
Author(s):  
Zihua Ma ◽  
Gongman Deng ◽  
Zhaolin Meng ◽  
Yanan Ma ◽  
Huazhang Wu
Keyword(s):  
Breast Cancer ◽  
Cost Containment ◽  
Outpatient Care ◽  
Direct Costs ◽  
Treatment Costs ◽  
Cost Driver ◽  
Liaoning Province ◽  
Inpatient Cost ◽  
Health Institutions ◽  
Inpatient And Outpatient Care

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.

scholarly journals The Economic Burden of Cancers Attributable to Infection in the Republic of Korea: A Prevalence-Based Study

2020 ◽  
Vol 17 (20) ◽  
pp. 7592
Author(s):  
Thi Xuan Trinh Nguyen ◽  
Minji Han ◽  
Moran Ki ◽  
Young Ae Kim ◽  
Jin-Kyoung Oh
Keyword(s):  
Cancer Patients ◽  
Economic Burden ◽  
Productivity Loss ◽  
Population Attributable Fraction ◽  
Indirect Costs ◽  
Premature Death ◽  
Direct Costs ◽  
Income Loss ◽  
Future Income ◽  
The Republic

Infection is a major cause of cancers. We estimated the economic burden of cancers attributable to infection in 2014 in Korea, where cancer causing infection is prevalent, but the economic burden of it has never been examined. Cancer patients were defined as those having made medical claims as recorded by the National Health Insurance Service, which is a mandatory insurance for all citizen. We multiplied the costs by the population-attributable fraction for each type of cancer. The study included direct and indirect costs, where direct costs comprised direct medical and non-medical costs of inpatients and outpatients, while indirect costs were estimated by identifying future income loss due to premature death, productivity loss during hospitalization/outpatient visits, and job loss. In 2014, there were 100,054 infection-related cancer patients, accounting for 10.7% of all Korean cancer cases for that year. Direct costs of cancers associated with infection stood at nearly USD 676.9 million, while indirect costs were much higher at USD 2.57 billion. The average expenditure of a typical patient was USD 32,435. Economic burden of cancers attributable to infection is substantial in Korea, accounting for 0.23% of the national gross domestic product and 1.36% of national healthcare expenditure in 2014.

The economic burden of depression in Sweden from 1997 to 2005

2007 ◽  
Vol 22 (3) ◽  
pp. 146-152 ◽  
Author(s):  
Patrik Sobocki ◽  
Ingrid Lekander ◽  
Fredrik Borgström ◽  
Oskar Ström ◽  
Bo Runeson
Keyword(s):  
Sick Leave ◽  
Economic Burden ◽  
Early Retirement ◽  
Indirect Costs ◽  
Direct Costs ◽  
Cost Driver ◽  
Health Concern ◽  
The Past ◽  
Swedish Society ◽  
The Cost

AbstractBackgroundDepression is one of the most common causes of disability and is associated with substantial reductions in the individual's quality of life. The aim of this study was to estimate the economic burden of depression to Swedish society from 1997 to 2005.Materials and MethodsThe study was conducted in a cost-of-illness framework, measuring both the direct cost of providing health care to depressive patients, and the indirect costs as the value of production that is lost due to morbidity or mortality. The costs were estimated by a prevalence and top-down approach.ResultsThe cost of depression increased from a total of €1.7 billion in 1997 to €3.5 billion in 2005, representing a doubling of the burden of depression to society. The main reason for the cost increase is found in the significant increase in indirect costs due to sick leave and early retirement during the past decade, whereas direct costs were relatively stable over time. In 2005, indirect costs were estimated at €3 billion (86% of total costs) and direct costs at €500 million (16%). Cost of drugs was estimated at €100 million (3% of total cost).ConclusionThe cost of depression is substantial to society and the main cost driver is indirect costs due to sick leave and early retirement. The cost of depression has doubled during the past eight years making it a major public health concern for the individuals afflicted, carers and decision makers.

scholarly journals Economic burden of main Noncommunicable diseases in the Russian Federation in 2016

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Kontsevaya ◽  
Y Balanova ◽  
M Khudyakov ◽  
A Myrzamatova ◽  
D Mukaneeva ◽  
...  
Keyword(s):  
Health Care ◽  
Russian Federation ◽  
Economic Burden ◽  
Indirect Costs ◽  
Premature Death ◽  
Direct Costs ◽  
Noncommunicable Diseases ◽  
Economic Losses ◽  
Years Of Life Lost ◽  
The Russian Federation

Abstract Aim To estimate the economic burden of noncommunicable diseases (NCDs) in the Russian Federation (RF) in 2016, including the direct costs and the economic losses caused by reduced productivity. Material and Methods We included 4 diseases: cardiovascular, type 2 diabetes, cancer and chronic pulmonary disease (COPD). We used the official statistics data collected by Ministry of health on the number of patients, health care resources utilization (hospitalizations, emergency visits, outpatients’ visits). The costs of health care were obtained from health insurance fund. Directs nonmedical costs included disabilitypayments, calculated based on the number of disabled persons from each group and by the amount of the disability allowance. Indirect costs (economic losses) included decreased productivity due to premature mortality and disability. The potential years of life lost (PYLL) were calculated using the number of life years lost due todeath and disability due to NCDs before 70 years. Human capital approach was used, and calculation were based on the GDP per person. Results Number of PYLL due to premature death from NCDs was estimated to be 8,0 million years. Economic burden because of NCDs in 2016 in the RF reached 3,3 trillion (45.9 billion €), which is equivalent of 3.9% of GDP for this year. Direct costs were responsible only for 13% of losses, indirect costs for 87% of the total burden. CVD were responsible for 81,4% of burden, cancer – for 7,1%, diabetes - 6,5% and COPD for 5,0%. Conclusions The economic burden because of NCDs in the RF in 2016 was 3.3 trillion (3.9% of GDP). Such the significant economic burden and absence of positive dynamics is a strong argument for increasing investments in the prevention and treatment of NCDs. Key messages Number of PYLL due to premature death from NCDs was estimated to be 8,0 million years. Economic burden because of NCDs in 2016 in the RF reached 3,3 trillion (45.9 billion €), which is equivalent of 3.9% of GDP for this year.

scholarly journals Treatment-Resistant Depression and Major Depression With Suicide Risk – The Cost of Illness and Burden of Disease

2021 ◽  
Author(s):  
Rute Dinis Sousa ◽  
Miguel Gouveia ◽  
Catarina Nunes-da-Silva ◽  
Ana Rodrigues ◽  
Graça Cardoso ◽  
...  
Keyword(s):  
Major Depression ◽  
Burden Of Disease ◽  
Suicide Risk ◽  
Disease Burden ◽  
Indirect Costs ◽  
Premature Death ◽  
Direct Costs ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression

Abstract Introduction: Treatment-Resistant Depression (TRD) and Major Depression with Suicide Risk (MDSR) are types of depression with relevant effects on the health of the population and a potentially significant economic impact. This study estimates the burden of disease and the costs of illness attributed to Treatment-Resistant Depression and Major Depression with Suicide Risk in Portugal.Methods: The disease burden for adults was quantified in 2017 using the Disability-Adjusted Life Years (DALYs) lost. Direct costs related to the health care system and indirect costs were estimated for 2017, with indirect costs resulting from the reduction in productivity. Estimates were based on multiple sources of information, including the National Epidemiological Study on Mental Health, the Hospital Morbidity Database, data from the Portuguese National Statistics Institute on population and causes of death, official data on wages, statistics on the pharmaceutical market, and qualified opinions of experts.Results: The estimated prevalence of TRD, MDSR, and both types of depression combined was 79.4 thousand, 52.5 thousand, and 11.3 thousand patients, respectively. The disease burden (DALY) due to the disability generated by TRD alone, MDSR alone, and the joint prevalence was 25.2 thousand, 21 thousand, and 4.5 thousand respectively, totaling 50.7 thousand DALYs. The disease burden due to premature death by suicide was 15.6 thousand DALYs. The estimated total disease burden was 66.3 thousand DALYs.In 2017, the annual direct costs with TRD and MDSR were estimated at € 30.8 million, with the most important components being medical appointments and medication. The estimated indirect costs were much higher than the direct costs. Adding work productivity losses due to reduced employment, absenteeism, presenteeism, and premature death, a total cost of € 1,1 billion was obtained.Conclusions: Although TRD and MDSR represent relatively small direct costs for the health system, they have a relevant disease burden and extremely substantial productivity costs for the Portuguese economy and society, making TRD and MDSR priority areas for achieving health gains.

Gender-Specific Burden of the Economic Cost of Victimization

2020 ◽  
pp. 208-223
Author(s):  
Samuel Kolawole Olowe
Keyword(s):  
Violence Against Women ◽  
Partner Violence ◽  
Sexual Exploitation ◽  
Indirect Costs ◽  
Economic Cost ◽  
Premature Death ◽  
Direct Costs ◽  
Sexual Offences ◽  
Genital Mutilation ◽  
Effects Of Violence

This chapter explores the impact of specific burden of the economic cost of victimization on gender. Gender-related victimization is disproportionately concentrated on women and girls. Forms include sexual assaults, intimate-partner violence, incest, genital mutilation, homicide, trafficking for sexual exploitation, and other sexual offences. Costs of violence against women are widespread throughout society. Every recognizable effect of violence has a cost whether it is direct or indirect. Direct costs come from the use of goods and services for which a monetary exchange is made. Direct costs exist for capital, labour, and material inputs. Indirect costs stem from effects of violence against women that have an imputed monetary exchange, such as lost income or reduced profit. Effects of violence against women also include intangible costs such as premature death and pain and suffering for which there is no imputed monetary value in the economy.

scholarly journals Direct and indirect costs and cost-driving factors of Tuberous sclerosis complex in children, adolescents, and caregivers: a multicenter cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Janina Grau ◽  
Johann Philipp Zöllner ◽  
Susanne Schubert-Bast ◽  
Gerhard Kurlemann ◽  
Christoph Hertzberg ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Direct Cost ◽  
Nursing Care ◽  
Tuberous Sclerosis Complex ◽  
Indirect Costs ◽  
Mtor Inhibitors ◽  
Direct Costs ◽  
Driving Factors ◽  
Care Level ◽  
Organ Manifestations

Abstract Background Tuberous sclerosis complex (TSC), a multisystem genetic disorder, affects many organs and systems, characterized by benign growths. This German multicenter study estimated the disease-specific costs and cost-driving factors associated with various organ manifestations in TSC patients. Methods A validated, three-month, retrospective questionnaire was administered to assess the sociodemographic and clinical characteristics, organ manifestations, direct, indirect, out-of-pocket, and nursing care-level costs, completed by caregivers of patients with TSC throughout Germany. Results The caregivers of 184 patients (mean age 9.8 ± 5.3 years, range 0.7–21.8 years) submitted questionnaires. The reported TSC disease manifestations included epilepsy (92%), skin disorders (86%), structural brain disorders (83%), heart and circulatory system disorders (67%), kidney and urinary tract disorders (53%), and psychiatric disorders (51%). Genetic variations in TSC2 were reported in 46% of patients, whereas 14% were reported in TSC1. Mean total direct health care costs were EUR 4949 [95% confidence interval (95% CI) EUR 4088–5863, median EUR 2062] per patient over three months. Medication costs represented the largest direct cost category (54% of total direct costs, mean EUR 2658), with mechanistic target of rapamycin (mTOR) inhibitors representing the largest share (47%, EUR 2309). The cost of anti-seizure drugs (ASDs) accounted for a mean of only EUR 260 (5%). Inpatient costs (21%, EUR 1027) and ancillary therapy costs (8%, EUR 407) were also important direct cost components. The mean nursing care-level costs were EUR 1163 (95% CI EUR 1027–1314, median EUR 1635) over three months. Total indirect costs totaled a mean of EUR 2813 (95% CI EUR 2221–3394, median EUR 215) for mothers and EUR 372 (95% CI EUR 193–586, median EUR 0) for fathers. Multiple regression analyses revealed polytherapy with two or more ASDs and the use of mTOR inhibitors as independent cost-driving factors of total direct costs. Disability and psychiatric disease were independent cost-driving factors for total indirect costs as well as for nursing care-level costs. Conclusions This study revealed substantial direct (including medication), nursing care-level, and indirect costs associated with TSC over three months, highlighting the spectrum of organ manifestations and their treatment needs in the German healthcare setting. Trial registration: DRKS, DRKS00016045. Registered 01 March 2019, http://www.drks.de/DRKS00016045.

scholarly journals POS0530 HOW DOES MULTIMORBIDITY IMPACT ON THE DIRECT AND INDIRECT COSTS IN PATIENTS WITH RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 498.3-499
Author(s):  
P. H. Hsieh ◽  
C. Geue ◽  
O. Wu ◽  
E. McIntosh
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Employment Status ◽  
Functional Disability ◽  
Hospital Admissions ◽  
Information Service ◽  
Indirect Costs ◽  
Direct Costs ◽  
Direct And Indirect Costs ◽  
The Impact

Background:Comorbidities are prevalent in patients with rheumatoid arthritis (RA) and associated with worse outcomes as well as higher economic burden. Little is known about the impact of multimorbidity on the direct and indirect costs of RA. Evidence of the incremental scale of these multimorbidity costs will usefully inform RA interventions and policies.Objectives:The aim of this study was to describe how multimorbidity impacts on the cost-of-illness, including direct and indirect costs, in patients with RA.Methods:The Scottish Early Rheumatoid Arthritis (SERA) is a registry of patients newly presenting with RA since 2011. It contains data on patient characteristics, clinical outcomes, health-related quality of life, and employment status data. These data were linked to routinely recorded hospital admissions and primary care prescribing data. Direct costs were estimated by applying relevant unit costs to healthcare resource use quantities. Indirect cost estimates were obtained from information on employment status and hospital admissions, valued by age and sex specific wages. Two-part models (probit followed by generalized linear model) were used to estimate direct and indirect costs, adjusting for age, gender, and functional disability. The Charlson Comorbidity Index (CCI) score was calculated using patient ICD-10 diagnoses from hospital records. The number of comorbidities was categorized into “RA alone”, “single comorbidity” and “multimorbidity (>1 comorbidity)”.Results:Data were available for 1,150 patients, 65.7% were female and a mean age of 57.5±14 years. The majority of patients only had RA (54.1%), followed by a single comorbidity (23.4%) and multimorbidity (22.5%). Annual total costs were significantly higher for patients with multimorbidity (£6,669 95% CI £4,871-£8,466; OR 11.3 95% CI 8.14-15.87) and for patients with a single comorbidity (£2,075 95% CI £1,559-£2,591; OR 3.52 95% CI 2.61-4.79), when compared with RA alone (£590). The excess costs were mainly driven by direct costs (£6,281 versus £1,875 versus £556). Although the difference in indirect costs between patients with multimorbidity and a single comorbidity were not statistically significant (£1,218 versus £914, p=0.11), patients with multimorbidity were associated with significantly higher costs than those with RA only (£594, p<0.01).Conclusion:The presence of comorbidity contributes significant excess to both direct and indirect costs among RA patients. In particular, patients with multimorbidity incurred substantially higher direct costs than those with a single comorbidity or RA only.Acknowledgements:The study analysed the data from the Scottish Early Rheumatoid Arthritis (SERA) study with a linkage to routinely recorded health data from Information Service Division, National Service Scotland. We would like to thank all the patients, clinical and nursing colleagues who have contributed their time and support to the study, the SERA steering committee for the approval, and Allen Tervit from the Robertson Centre for Biostatistics, University of Glasgow for the timely technical supports.Disclosure of Interests:Ping-Hsuan Hsieh: None declared, Claudia Geue: None declared, Olivia Wu Consultant of: OW has received consultancy fees from Bayer, Lupin and Takeda outside the submitted work., Emma McIntosh: None declared

scholarly journals The physiological costs of reproduction in small mammals

2007 ◽  
Vol 363 (1490) ◽  
pp. 375-398 ◽  
Author(s):  
John R Speakman
Keyword(s):  
Life History ◽  
Small Mammals ◽  
Morphological Changes ◽  
Life History Evolution ◽  
Indirect Costs ◽  
Direct Costs ◽  
Costs Of Reproduction ◽  
Dominant Component ◽  
Trade Offs ◽  
Almost All

Life-history trade-offs between components of fitness arise because reproduction entails both gains and costs. Costs of reproduction can be divided into ecological and physiological costs. The latter have been rarely studied yet are probably a dominant component of the effect. A deeper understanding of life-history evolution will only come about once these physiological costs are better understood. Physiological costs may be direct or indirect. Direct costs include the energy and nutrient demands of the reproductive event, and the morphological changes that are necessary to facilitate achieving these demands. Indirect costs may be optional ‘compensatory costs’ whereby the animal chooses to reduce investment in some other aspect of its physiology to maximize the input of resource to reproduction. Such costs may be distinguished from consequential costs that are an inescapable consequence of the reproductive event. In small mammals, the direct costs of reproduction involve increased energy, protein and calcium demands during pregnancy, but most particularly during lactation. Organ remodelling is necessary to achieve the high demands of lactation and involves growth of the alimentary tract and associated organs such as the liver and pancreas. Compensatory indirect costs include reductions in thermogenesis, immune function and physical activity. Obligatory consequential costs include hyperthermia, bone loss, disruption of sleep patterns and oxidative stress. This is unlikely to be a complete list. Our knowledge of these physiological costs is currently at best described as rudimentary. For some, we do not even know whether they are compensatory or obligatory. For almost all of them, we have no idea of exact mechanisms or how these costs translate into fitness trade-offs.

scholarly journals The Economic Burden of Coronavirus Disease 2019 (COVID-19): Evidence from Iran

2020 ◽  
Author(s):  
Mohsen Ghaffari Darab ◽  
Khosro Keshavarz ◽  
Elnaz Sadeghi ◽  
Javad Shahmohamadi ◽  
Zahra Kavosi
Keyword(s):  
Economic Burden ◽  
Indirect Costs ◽  
Premature Death ◽  
University Hospital ◽  
Fars Province ◽  
Income Loss ◽  
Cross Sectional ◽  
Accounting Information Systems ◽  
Economic Production ◽  
The Mean

Abstract This study aimed to estimate both direct medical and indirect costs of treating the Coronavirus disease 2019 (COVID-19) from a societal perspective in the patients at a referral hospital in Fars province as well as the economic burden of COVID-19 in Iran in 2020.Methods:This is a partial economic evaluation and a cross-sectional cost-description study conducted descriptively-analytically and based on the data of the COVID-19 patients referred to a referral university hospital in Fars province between March and July 2020. The data were collected by examining the patients' records and accounting information systems. The subjects included all the inpatients with COVID-19 (477 individuals) who admitted to the medical centre during the four months. Bottom-up costing, incidence-based and income-based human capital approaches were used as the main methodological features of this study.Results: The mean direct medical costs were estimated 28,240,025,968 Rials ($ 1,791,172) in total and 59,203,409 Rials ($ 3,755) per person, a significant part of which (41 %) was that of intensive and general care beds (11,596,217,487 Rials equal to $ 735,510. (The second to which were the costs of medicines and medical consumables (28 %). The mean indirect costs including income loss due to premature death, economic production loss due to hospitalization and job absenteeism during recovery course were estimated 129,870,974 Rials ($ 11634) per person. Furthermore, the economic burden of the disease in the country for inpatient cases with the definitive diagnosis was 22,688,925,933,095 Rial equal to $ 1,439,083,784.Conclusion: The results of this study showed that the severe status of the disease would bring about the extremely high cost of illness in this case. It is estimated that the high prevalence rate of COVID-19 has been imposing a heavy economic burden on the country and health system directly that may result in rationing or painful cost-control approaches.

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