PP79 Impact Of Hidradenitis Suppurativa On Healthcare Resource Utilization

2019 ◽  
Vol 35 (S1) ◽  
pp. 52-52
Author(s):  
Larissa de Araujo Costa Andrade ◽  
Ricardo Moreira ◽  
Vinicius Vitale
Keyword(s):  
Health Services ◽  
Resource Utilization ◽  
Inpatient Care ◽  
Hidradenitis Suppurativa ◽  
Healthcare Resource ◽  
Unit Cost ◽  
Healthcare Resource Utilization ◽  
Public Healthcare ◽  
Strong Impact ◽  
Total Cost

IntroductionHidradenitis suppurativa (HS) is a debilitating, chronic inflammatory skin disease characterized by painful nodules and abscesses. HS has a strong impact on patient quality of life. In Brazil, the prevalence of HS is estimated at 0.4 percent. Medical and surgical treatments have low effectiveness and disease recurrence is common, which affects health system costs. This study aimed to assess how HS patients utilize medical care (emergency and inpatient care) in Brazil and to describe the all-cause costs.MethodsData were retrieved from a public healthcare claims database (DATASUS), which provides access to information regarding health services and costs. Data from DATASUS were used to perform a cost-identification analysis on patients with HS who used health services over a two-year period. A retrospective bottom-up approach was used to estimate direct costs, multiplying the amount of each medical resource consumed by its unit cost.ResultsOver the two-year period, 90 patients (16%) with HS received inpatient care (151 procedures) at a total cost of BRL 83,520 (USD 21,715). Surgeries were the most frequently performed (73% of total) and expensive procedures, costing BRL 73,122 (USD 19,011; 88% of total costs), followed by clinical treatments (BRL 8,354 [USD 2,172]; 10%), and physician consulting (BRL 1,659 [USD 431]; 2%). For the 500 patients treated in the emergency department (total cost BRL 3,027 [USD 787]), the most frequently received services were physician consulting (34%), nursing care (12%), and minor surgeries (11%). Each patient received, on average, three procedures over the two-year period.ConclusionsHS is a high-burden disease, as demonstrated by the high healthcare resource utilization among patients. Since DATASUS is a public database, the costs presented reflect a government reference price and do not consider local costs, which is a limitation of this study. Health managers should be aware of this finding, although further research is needed to investigate the effect of healthcare utilization on patient outcomes.

scholarly journals Healthcare resource utilization and associated cost of patients with bone metastases from solid tumors who are naïve to bone-targeting agents: a comparative analysis of patients with and without skeletal-related events

2021 ◽  
Vol 22 (2) ◽  
pp. 243-254
Author(s):  
Fränce Hardtstock ◽  
Zeki Kocaata ◽  
Thomas Wilke ◽  
Axel Dittmar ◽  
Marco Ghiani ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Solid Tumors ◽  
Resource Utilization ◽  
Inpatient Care ◽  
Healthcare Resource ◽  
Cohort Analysis ◽  
Healthcare Resource Utilization ◽  
Bone Targeting ◽  
Skeletal Related Events ◽  
The Impact

Abstract Background This study analyzes the impact of skeletal-related events (SRE) on healthcare resource utilization (HCRU) and costs incurred by patients with bone metastases (BM) from solid tumors (ST), who are therapy-naïve to bone targeting agents (BTAs). Methods German claims data from 01/01/2010 to 30/06/2018 were used to conduct a retrospective comparative cohort analysis of BTA-naive patients with a BM diagnosis and preceding ST diagnosis. HCRU and treatment-related costs were compared in two matched cohorts of patients with and without a history of SREs, defined as pathological fracture, spinal cord compression, surgery to bone and radiation to bone. The first SRE was defined as the patient-individual index date. Conversely, for the non-SRE patients, index dates were assigned randomly. Results In total, 45.20% of 9,832 patients reported experiencing at least one SRE (n = 4444) while 54.80% experienced none (n = 5388); 2,434 pairs of SRE and non-SRE patients were finally matched (mean age: 70.87/71.07 years; females: 39.07%/38.58%). Between SRE and non-SRE cohorts, significant differences in the average number of hospitalization days per patient-year (35.80/30.80) and associated inpatient-care costs (14,199.27€/10,787.31€) were observed. The total cost ratio was 1.16 (p < 0.001) with an average cost breakdown of 23,689.54€ and 20,403.27€ per patient-year in SRE and non-SRE patients. Conclusion The underutilization of BTAs within a clinical setting poses an ongoing challenge in the real-world treatment of BM patients throughout Germany. Ultimately, the economic burden of treating SREs in patients with BM from ST was found to be considerable, resulting in higher direct healthcare costs and increased utilization of inpatient care facilities.

Healthcare Resource Utilization and Costs of Mild, Moderate, and Severe Depression in the Workforce in the United States

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
H. Birnbaum ◽  
R. Kessler ◽  
V. Joish ◽  
D. Kelley ◽  
R. Ben-Hamadi ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Clinical Severity ◽  
Medical Services ◽  
Depression Severity ◽  
Treatment Adequacy

Objective:Document the healthcare resource utilization and costs by severity for persons in the workforce with major depressive disorder (MDD).Methods:Using the National Comorbidity Survey-Replication data, workforce respondents (n=4,465) were categorized by clinical severity (not clinically depressed, mild, moderate, severe) using standard scales (CIDI/QIDS-SR). Outcomes measured over 12 months included prevalence of medical services/antidepressant use, average number of visits and days on antidepressants, prevalence of treatment adequacy, and medical/drug costs. Costs represent insurer payments to providers and were estimated by weighting utilization measures by unit costs obtained for similar services used by depressed patients in a U.S. employer claims database for the corresponding period (2000-2001). Outcomes were compared across depression severity groups using multivariate analyses adjusting for demographics.Results:Among the 539 depressed workforce respondents, 13.8% were mildly, 38.5% moderately and 47.7% severely depressed. A significant association existed between severity and prevalence of mental health services usage (19.1%, 27.2%, and 40.3% respectively, p< 0.01) and average number of mental health practitioner visits. The use of antidepressants increased with depression severity (21.1%, 27.3%, and 39.5% respectively, p< 0.01). Similarly, the adequacy of mental health services increased with depression severity (6.2%, 11.8%, and 21.3% respectively, p< 0.05). Average 12-month costs per MDD patient were substantially higher for severe vs. mild (mental health services: $697 vs. $388; general medical services: $138 vs. $53; anti-depressant usage $256 vs. $88).Conclusions:Among workforce respondents, there was a significant association between depression severity and treatment usage and costs, and between treatment adequacy and severity.

scholarly journals Healthcare Resource Utilization with Rasburicase in the Management of Patients with Tumor Lysis in the Outpatient Setting: Results from a Community Oncology Cohort

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3401-3401
Author(s):  
Ali McBride ◽  
Melissa Hagan ◽  
Mei Xue ◽  
Robert E Smith
Keyword(s):  
Resource Utilization ◽  
Clinical Characteristics ◽  
Healthcare Resource ◽  
Outpatient Setting ◽  
Healthcare Resource Utilization ◽  
Inpatient Setting ◽  
Total Cost ◽  
Tumor Lysis ◽  
Chemotherapy Group ◽  
Community Oncology

BACKGROUND and OBJECTIVE: Tumor lysis syndrome (TLS), a potentially fatal oncologic complication, can have a significant clinical and economic impact to patients and the healthcare system. The aim of this analysis was to examine healthcare resource utilization in patients treated with rasburicase for the management of tumor lysis in the outpatient versus inpatient setting. METHODS: Adult patients were selected from the Integra Connect Database (IC) if they were treated with rasburicase between January 1, 2017 and March 31, 2019. The IC database comprises clinical and financial records for more than 750,000 community oncology patients, including 25,000 active Oncology Care Model participants representing approximately 20% of the unique beneficiaries in this Medicare model. Patients treated in the outpatient setting were divided into 3 groups: Primary Prophylaxis- treatment with rasburicase administered days 0-2 of chemotherapy (Group A), Early Reactive- rasburicase administered days 3-5 of chemotherapy (Group B), and Late Reactive- rasburicase administered after day 5 of chemotherapy (Group C). Inpatients were divided into 2 groups: Inpatient TLS Treatment- patients admitted and treated for TLS with rasburicase and who had not received rasburicase as part of their outpatient chemotherapy regimen (Group D) and Inpatient Chemotherapy- patients admitted for chemotherapy who were given rasburicase (Group E). Demographic, clinical characteristics including tumor types, lab values, and dose information were collected. Total cost of rasburicase was calculated as mean drug cost per patient. All variables were summarized descriptively as mean (SD), median (min and max) or counts (percentages). RESULTS: A total of 265 patients treated with rasburicase were included in the analysis. Of those, 189 patients received rasburicase in the outpatient setting vs 76 in the inpatient setting. None of the 189 patients in Groups A, B, and C who received outpatient rasburicase required admission due to TLS. Patient demographic and clinical characteristics, as well as rasburicase utilization, were similar between cohorts (Table 1 and Table 2). Our results show that while 54% of patients in Groups B, C, and D were initially treated with allopurinol, these patients were switched to rasburicase, indicating failure of allopurinol alone. The total cost of rasburicase trended lower in the outpatient vs inpatient setting ($9,287 vs $11,959). However, a more appropriate comparator to this cost is the published data for charges incurred for inpatient treatment of TLS, shown to be $151,9171 CONCLUSIONS: TLS continues to impact patients with diagnoses and chemotherapy regimens at intermediate and high risk for development of this syndrome. This study demonstrates that allopurinol is frequently inadequate and replacement with rasburicase is needed. We found rasburicase to be effective from both a clinical and a cost perspective in preventing TLS-related hospitalization. While rasburicase is most efficiently employed as primary prevention, close monitoring of patients allows effective reactive utilization evidenced by none of the outpatients in this study who received rasburicase were admitted for TLS. This study highlights the opportunity for greater utilization of rasburicase in the outpatient setting, as a means to lower the total cost of care. 1. Pathak et al. Blood. 2017; 130:3390 Disclosures McBride: teva: Consultancy; Sandoz: Consultancy; Sanofi Genzyme: Consultancy.

Healthcare resource utilization and total cost of care in older patients with acute myeloid leukemia ineligible for intensive chemotherapy.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 72-72
Author(s):  
Thomas William LeBlanc ◽  
Arpamas Seetasith ◽  
Michelle E Choi ◽  
Andy Surinach ◽  
Tu My To ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Older Patients ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Cost Of Care ◽  
Cost Driver ◽  
Intensive Chemotherapy ◽  
Total Cost ◽  
Main Cost Driver

72 Background: Limited data are available on the economic burden of care for older patients with AML ineligible for intensive chemotherapy. This study aimed to evaluate healthcare resource utilization (HRU) and total cost of care (TCC) in this population. Methods: A retrospective observational study of Surveillance, Epidemiology, and End Results data (Jan 1, 2010 – Dec 31, 2015) linked to Medicare claims (up to Dec 31, 2017). Patients were ≥ 60 years old; newly diagnosed with AML; had ≥ 12 months of continuous Part A and B coverage before diagnosis; and initiated treatment on a hypomethylating agent: azacytidine (AZA) or decitabine (DEC) ≤ 90 days after diagnosis, or best supportive care (BSC). HRU (hospitalization, monitoring, transfusions, office visits, emergency department [ED] visits) and TCC reported in per patient per month (PPPM) were evaluated. Results: Among 3,905 patients identified, 877 (22%) received AZA, 899 (23%) received DEC, 2,129 (55%) received BSC. At a mean follow-up of 4.1 month (mo), mean TCC in BSC was $22,479.48 PPPM (standard deviation [SD]: $20,183.72). Hospitalization was the main cost driver (83.7% of TCC) in BSC, followed by Part B services and transfusions. At a mean follow-up of 11.9 vs. 13.0 mo, and mean treatment duration both at 5.4 mo, the mean TCC was $15,805.76 PPPM (SD: $19,368.16) in AZA vs. $20,518.71 PPPM (SD: $23,400.68) in DEC. All HRU decreased after AZA or DEC treatment initiation, except an increase in hospitalizations after treatment discontinuation (Table). During treatment on AZA and DEC, the main cost driver was hospitalization (60.7% vs. 60.9%) followed by drug costs and transfusions. After treatment discontinuation, hospitalization remained the main cost driver (77.2% vs. 78.9%) followed by transfusions and Part B services. Conclusions: This study quantifies the sizeable TCC in older patients with AML ineligible for intensive chemotherapy with hospitalization as the primary cost driver. Novel treatments that reduce hospitalizations, transfusions, and Part B services could lower the burden to the overall healthcare system. [Table: see text]

scholarly journals Healthcare resource utilization and costs associated with anogenital warts in Morocco

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Myriam Berrada ◽  
Ryan Holl ◽  
Tidiane Ndao ◽  
Goran Benčina ◽  
Siham Dikhaye ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Public Hospitals ◽  
Medical Attention ◽  
Public Healthcare ◽  
Total Annual Cost ◽  
Delphi Panel ◽  
Anogenital Warts

Abstract Background Human papillomavirus (HPV), primarily genotypes 6 and 11, cause the majority of cases of anogenital warts (AGW). Although benign, AGW are associated with a substantial economic and psychosocial burden. Several vaccines have been developed to prevent HPV. The objective of this study was to describe the epidemiology and healthcare resource utilization of AGW in Morocco, as well as the associated costs of treatment from the public healthcare perspective. Methods This was a descriptive analysis of questionnaire data obtained via a Delphi panel. The panel consisted of 9 physicians practicing in public hospitals in Morocco (4 dermatologists and 5 obstetricians/gynecologists). The questionnaire collected data on physician and practice characteristics, diagnostic tests and procedures, treatments, and follow-up (including recurrence) of patients with AGW. Questionnaire items on which ≥ 70% of respondents agreed were considered as having consensus. Costs associated with diagnosis, treatment, and follow-up were calculated in Moroccan dirham (MAD) and converted to euros (€) based on official national price lists for public hospitals and the HCRU estimates from the questionnaire. Results The physician-estimated prevalence of AGW in Morocco was 1.6%-2.6% in women and 2.0%-5.3% in men. A mean (median) of 6.4 (4) patients per month per physician sought medical attention for AGW. Simple observation was the most common diagnostic method for AGW in both men and women, and excision was the most prescribed therapy (75%), requiring a mean of 2 visits. Recurrence occurred in approximately 27% of patients. The cost per case of managing AGW, including recurrence, was estimated at 2182–2872 MAD (€207–272) for women and 2170–2450 MAD (€206–233) for men. The total annual cost of medical consultations for AGW in Morocco ranged from 3,271,877 MAD to 4,253,703 MAD (€310,828–404,102). Conclusions Expert consensus indicates that AGW represent a significant burden to the Moroccan public healthcare system. These data can inform policy makers regarding this vaccine-preventable disease.

Cost of treatment failure in patients with chronic lymphocytic leukemia: Results of a large U.S. observational study.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 22-22
Author(s):  
Mekre Senbetta ◽  
Marie-Noelle Robitaille ◽  
R. Scott McKenzie ◽  
Patrick Lefebvre
Keyword(s):  
Stem Cell ◽  
Resource Utilization ◽  
Stem Cell Transplant ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Lymphocytic Leukemia ◽  
Cell Transplant ◽  
Average Total Cost ◽  
Total Cost ◽  
Hospitalization Costs

22 Background: Patients with chronic lymphocytic leukemia (CLL) who eventually experience disease progression are offered a limited choice of treatments. This retrospective observational study assesses healthcare resource utilization and costs in patients with CLL who have received one prior therapy and experience treatment failure (TF). Methods: Adult patients with ≥1 diagnosis of CLL and ≥1 claim for a medication used to treat CLL were identified in the IMS PharMetrics Plus database (01/2008 – 09/2013). Patients were excluded if they had evidence of a non-hematologic malignancy, used a non-CLL antineoplastic agent, or received a stem cell transplant during the 12-month baseline period. TF was identified based on earliest occurrence of one of the following events: initiation of a new treatment for CLL that was not part of the 1st-line therapy, resumption of any CLL treatment following a minimum of 3-month break in treatment, stem cell transplant, radiotherapy, hospital mortality, or hospice care. Resource utilization was reported as monthly incidence rates, and costs were reported in 2013 $US per patient per month (PPPM), comparing patients with and without TF. Results: A total of 6,015 patients with CLL were identified (mean patient age: 63 years old; proportion female: 36%), of which 2,734 (45%) experienced TF. Patients with TF tended to require more OP visits (3.2 vs. 2.5). Average total cost PPPM was $7,850 for patients with TF and $4,555 for patients without TF. The main cost drivers were outpatient (OP) costs ($4,355 for patients with TF; $3,022 for patients without TF) and hospitalization costs ($2,659 for patients with TF; $1,038 for patients without TF). Once adjusted for baseline characteristics, average total cost difference between patients with and without TF was $3,757 PPPM. This difference was largely due to hospitalization (45%) and to OP costs (46%). Conclusions: Patients with CLL experiencing TF appear to require more OP visits and to be associated with higher OP and hospitalization costs PPPM compared to those without TF. These data help in our understanding of the healthcare resource utilization and costs associated with the treatment of patients with CLL.

scholarly journals Healthcare Resource Utilization Among Patients With Non-Surgical Refractory Low Back Pain in the United States: A Retrospective Analysis of Health Insurance Claims Data

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Charis Spears ◽  
Sarah E Hodges ◽  
Musa Kiyani ◽  
Zidanyue Yang ◽  
Ryan Edwards ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Low Back ◽  
Outpatient Services ◽  
Total Cost ◽  
Median Total Cost ◽  
Annual Total

Abstract INTRODUCTION The economic burden of low back pain (LBP) in the US is estimated between $84.1 and $624.8 billion. Some patients with LBP that persists despite conventional medical management are ineligible for spine surgery and are considered to have non-surgical refractory back pain (NSRBP). We investigated the healthcare resource utilization (HCRU) of patients with NSRBP. METHODS The IBM MarketScan® Research databases were queried for adult patients with a diagnosis of LBP, excluding instability (eg, spondylolisthesis) and non-mechanical etiologies, and negative history of failed back surgery syndrome or spine surgery within the study period (2009-2016). For a patient to qualify as refractory, we required utilization for >30 d of pain medications (prescribed within 2 wk of diagnosis) or non-pharmacologic therapies within the 3 to 24 mo following initial diagnosis. Annual total costs, including inpatient and outpatient service costs and outpatient medication costs, were calculated for 2 yr. RESULTS Among 50 801 patients, median total cost was $3,755 (IQR $1,299, $9,108) at 1 yr pre-diagnosis, reached $6,622 (IQR $2,723, $13,978) at 1 yr, and decreased to $5,977 (IQR $2,311, $13,307) at 2 yr. Costs were highest for patients with Medicare Supplemental (N = 7,053): median total cost was $10,198 (IQR $5,517, $18,584) at 1 yr, decreasing in the second year to $9,407 (IQR $4,737, $18,330). Outpatient services accounted for the majority of all costs. The proportion of patients with ≥4 outpatient visits for LBP was 56.6% within the first 6 mo, 50.0% in the 1st year, and 68.5% in the 2nd year. CONCLUSION For patients with NSRBP, the median annual total cost at 1 yr almost doubled the 1-yr prediagnosis cost and decreased for the 2nd year; most costs were due to outpatient services. Patients with Medicare Supplemental incurred the highest total costs. Most patients saw outpatient providers multiple times in the first 6 mo and throughout the 2 yr.

Inpatient mortality and healthcare resource utilization of nontraumatic intracerebral hemorrhage complications in the US

2021 ◽  
pp. 1-10
Author(s):  
Christine Park ◽  
Lefko T. Charalambous ◽  
Zidanyue Yang ◽  
Syed M. Adil ◽  
Sarah E. Hodges ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Resource Utilization ◽  
Cerebral Edema ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Inpatient Mortality ◽  
Total Cost ◽  
Venous Thromboembolic Events ◽  
The Us ◽  
Tract Infections

OBJECTIVENontraumatic, primary intracerebral hemorrhage (ICH) accounts for 2 million strokes worldwide annually and has a 1-year survival rate of 50%. Recent studies examining functional outcomes from ICH evacuation have been performed, but limited work has been done quantifying the incidence of subsequent complications and their healthcare economic impact. The purpose of this study was to quantify the incidence and healthcare resource utilization (HCRU) for major complications that can arise from ICH.METHODSThe IBM MarketScan Research databases were used to retrospectively identify patients with ICH from 2010 to 2015. Complications examined included cerebral edema, hydrocephalus, venous thromboembolic events (VTEs), pneumonia, urinary tract infections (UTIs), and seizures. For each complication, inpatient mortality and HCRU were assessed.RESULTSOf 25,322 adult patients included, 10,619 (42%) developed complications during the initial admission of ICH: 22% had cerebral edema, 11% hydrocephalus, 10% pneumonia, 6% UTIs, 5% seizures, and 5% VTEs. The inpatient mortality rates at 7 and 30 days for each complication of ICH ranked from highest to lowest were hydrocephalus (24% and 32%), cerebral edema (15% and 20%), pneumonia (8% and 18%), seizure (7% and 13%), VTE (4% and 11%), and UTI (4% and 8%). Hydrocephalus had the highest total cost (median $92,776, IQR $39,308–$180,716) at 7 days post–ICH diagnosis and the highest cumulative total cost (median $170,839, IQR $91,462–$330,673) at 1 year post–ICH diagnosis.CONCLUSIONSThis study characterizes one of the largest cohorts of patients with nontraumatic ICH in the US. More than 42% of the patients with ICH developed complications during initial admission, which resulted in high inpatient mortality and considerable HCRU.

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