Do Orbital Implants Differ in Complication Rates: A Retrospective Study of 88 Patients, and an Argument for Cost-Effective Practices in the Face of Rising Health Care Costs

2021 ◽  
Author(s):  
Husayn F. Ramji ◽  
Nathan W. Blessing ◽  
Jeremy F. Tan ◽  
Annie Moreau
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Cost Effective ◽  
Complication Rates ◽  
Cost Effective Approach ◽  
Significant Difference ◽  
The Face ◽  
Orbital Blowout Fractures ◽  
Care Costs

AbstractOperative repair of orbital fractures utilizes implants constructed of a plethora of materials that vary in cost. Surgeon preference as well as fracture complexity may dictate the implant chosen. In this study, we retrospectively compared the complication rates of the four most common types of implants utilized at our institution. We found no significant difference in complication rates in our sample of 88 patients. Additionally, the least expensive implant was as effective as the most expensive implant in addressing isolated orbital blowout fractures. This situation is not unique to the field of oculoplastics. As evidenced from published literature in other areas of surgery, from orthopaedics to orthodontics, cheaper alternatives often afford similar outcomes as more expensive options. We herein argue that a cost-effective approach should be considered while still allowing for high quality of care, in the face of rising health care costs and health disparities in America.

scholarly journals Health Care Costs: On the Rise Again

2003 ◽  
Vol 17 (2) ◽  
pp. 125-148 ◽  
Author(s):  
Sherry Glied
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
New Technologies ◽  
Private Insurance ◽  
National Income ◽  
Insurance Market ◽  
The Face ◽  
Private And Public ◽  
Care Costs

Since 1999, health care costs have been growing faster than national income. This rapid growth has occurred as the ability of private and public purchasers to reduce service utilization and bargain for lower prices has fallen, insurers have recouped lost profits through higher premiums, and new technologies have driven up costs throughout the sector. Private insurance market responses to these rising costs may lead to reductions in the number of people with insurance and to increased fragmentation of the insurance market. Over time, technological change in medicine both increases costs and improves the quality of care. The challenge for public policy is to maintain insurance and some degree of equity in the face of these rising costs.

Is it cost-effective to add erlotinib to gemcitabine in advanced pancreatic cancer?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6048-6048 ◽  
Author(s):  
S. S. Grubbs ◽  
P. A. Grusenmeyer ◽  
N. J. Petrelli ◽  
R. J. Gralla
Keyword(s):  
Health Care ◽  
Pancreatic Cancer ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Health Care Costs ◽  
Advanced Pancreatic Cancer ◽  
Cost Effective ◽  
Significant Difference ◽  
The Impact ◽  
Care Costs

6048 Background: Single agent gemcitabine has been considered the standard of care in advanced pancreatic cancer since 1996. A recent 569 patient randomized trial comparing gemcitabine alone with gemcitabine + erlotinib as first line therapy found a small but statistically significant difference in survival (6.0 vs 6.4 months, respectively, p = .028). The impact on survival may be small, but with nearly 33,000 new cases of pancreatic cancer per year, the impact on health care costs with the use of the combined regimen may be large. Using the known survival data and costs, we analyzed the incremental cost-effectiveness of adding erlotinib. Methods: Costs for a six month course of gemcitabine were developed using Medicare reimbursement from the January, 2006 CMS Drug Payment Table and Physician Fee Schedule assuming no change in infusion reimbursement. Since erlotinib is not approved as a Medicare Part B drug, costs were developed from wholesale and retail sources. Drug dosing and schedules were based on the clinical trial protocol leading to approval. Incremental cost effectiveness of adding erlotinib was calculated. Results: Six month course of gemcitabine alone costs $23,493. The addition of erlotinib increases cost by $12,156 wholesale or $16,613 retail. Given an increase of 0.4 months in median survival over gemcitabine alone, the addition of erlotinib costs $364,680 per year of life gained (YLG) wholesale and $498,379/YLG retail. Sensitivity analyses were conducted assuming shorter therapy of 4 and 5 months. In order to be cost effective even at the $100,000/YLG level, six months of erlotinib would have to be reduced to 20% of the current retail cost (lowered to $18.52 per tablet.) Conclusions: Adding erlotinib to gemcitabine does not approach cost effectiveness at even the highest year per life gained parameters. Such impacts on health care costs, especially for very small gains, become more pressing as all health care costs continue to increase. [Table: see text] [Table: see text]

User Fees for Health Care: Why a Bad Idea Keeps Coming Back (Or, What's Health Got to Do With It?)

1995 ◽  
Vol 14 (2) ◽  
pp. 360-390 ◽  
Author(s):  
Robert G. Evans ◽  
Morris L. Barer ◽  
Greg L. Stoddart
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Final Analysis ◽  
User Fees ◽  
Care Providers ◽  
Positive Effects ◽  
The Face ◽  
Care Costs

ABSTRACTCalls for user fees in Canadian health care go back as far as the debate leading up to the establishment of Canada's national hospital insurance program in the late 1950s. Although the rationales have shifted around somewhat, some of the more consistent claims have been that user fees are necessary as a source of additional revenue for a badly underfunded system, that they are necessary to control runaway health care costs, and that they will deter unnecessary use (read abuse) of the system. But the real reasons that user fees have been such hardy survivors of the health policy wars, bear little relation to the claims commonly made for them. Their introduction in the financing of hospital or medical care in Canada would be to the benefit of a number of groups, and not just those one usually thinks of. We show that those who are healthy, and wealthy, would join health care providers (and possibly insurers) as net beneficiaries of a reintroduction of user fees for hospital and medical care in Canada. The flip side of this is that those who are indigent and ill will bear the brunt of the redistribution (for that is really what user fees are all about), and seniors feature prominently in those latter groups. Claims of other positive effects of user fees, such as reducing total health care costs, or improving appropriateness or accessibility, simply do not stand up in the face of the available evidence. In the final analysis, therefore, whether one is for or against user fees reduces to whether one is for or against the resulting income redistribution.

scholarly journals Costing Methodology and Key Drivers of Health Care Costs Within Economic Analyses in Musculoskeletal Community and Primary Care Services: A Systematic Review of the Literature

2020 ◽  
Vol 11 ◽  
pp. 215013271989976
Author(s):  
Roanna Burgess ◽  
James Hall ◽  
Annette Bishop ◽  
Martyn Lewis ◽  
Jonathan Hill
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Costs ◽  
Community Settings ◽  
Outpatient Visits ◽  
Key Drivers ◽  
Gp Visits ◽  
Economic Analyses ◽  
Care Costs

Background: Identifying variation in musculoskeletal service costs requires the use of specific standardized metrics. There has been a large focus on costing, efficiency, and standardized metrics within the acute musculoskeletal setting, but far less attention in primary care and community settings. Objectives: To ( a) assess the quality of costing methods used within musculoskeletal economic analyses based primarily in primary and community settings and ( b) identify which cost variables are the key drivers of musculoskeletal health care costs within these settings. Methods: Medline, AMED, EMBASE, CINAHL, HMIC, BNI, and HBE electronic databases were searched for eligible studies. Two reviewers independently extracted data and assessed quality of costing methods using an established checklist. Results: Twenty-two studies met the review inclusion criteria. The majority of studies demonstrated moderate- to high-quality costing methods. Costing issues included studies failing to fully justify the economic perspective, and not distinguishing between short- and long-run costs. Highest unit costs were hospital admissions, outpatient visits, and imaging. Highest mean utilization were the following: general practitioner (GP) visits, outpatient visits, and physiotherapy visits. Highest mean costs per patient were GP visits, outpatient visits, and physiotherapy visits. Conclusion: This review identified a number of key resource use variables that are driving musculoskeletal health care costs in the community/primary care setting. High utilization of these resources (rather than high unit cost) appears to be the predominant factor increasing mean health care costs. There is, however, need for greater detail with capturing these key cost drivers, to further improve the accuracy of costing information.

scholarly journals Cerebral palsy in Canada, 2011-2031: results of a microsimulation modelling study of epidemiological and cost impacts

2020 ◽  
Vol 40 (2) ◽  
pp. 25-37
Author(s):  
Nana Amankwah ◽  
Maryam Oskoui ◽  
Rochelle Garner ◽  
Christina Bancej ◽  
Douglas G. Manuel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Cerebral Palsy ◽  
Health Care Costs ◽  
Health Related Quality ◽  
Incidence And Mortality ◽  
Related Quality ◽  
Health Related ◽  
Care Costs

Introduction The objective of our study was to present model-based estimates and projections on current and future health and economic impacts of cerebral palsy in Canada over a 20-year time horizon (2011–2031). Methods We used Statistics Canada’s Population Health Model (POHEM)–Neurological to simulate individuals’ disease states, risk factors and health determinants and to describe and project health outcomes, including disease incidence, prevalence, life expectancy, health-adjusted life expectancy, health-related quality of life and health care costs over the life cycle of Canadians. Cerebral palsy cases were identified from British Columbia’s health administrative data sources. A population-based cohort was then used to generate the incidence and mortality rates, enabling the projection of future incidence and mortality rates. A utility-based measure (Health Utilities Index Mark 3) was also included in the model to reflect various states of functional health to allow projections of health-related quality of life. Finally, we estimated caregiving parameters and health care costs from Canadian national surveys and health administrative data and included them as model parameters to assess the health and economic impact of cerebral palsy. Results Although the overall crude incidence rate of cerebral palsy is projected to remain stable, newly diagnosed cases of cerebral palsy will rise from approximately 1800 in 2011 to nearly 2200 in 2031. In addition, the number of people with the condition is expected to increase from more than 75 000 in 2011 to more than 94 000 in 2031. Direct health care costs in constant 2010 Canadian dollars were about $11 700 for children with cerebral palsy aged 1–4 years versus about $600 for those without the condition. In addition, people with cerebral palsy tend to have longer periods in poorer health-related quality of life. Conclusion Individuals with cerebral palsy will continue to face challenges related to an ongoing need for specialized medical care and a rising need for supportive services. Our study offers important insights into future costs and impacts associated with cerebral palsy and provides valuable information that could be used to develop targeted health programs and strategies for Canadians living with this condition.

The lower the quality of life the higher health care costs in irritable Bowel syndrome

2001 ◽  
Vol 120 (5) ◽  
pp. A636
Author(s):  
Paul Enck ◽  
Petra Ilgenstein ◽  
Andrea Spannheimer ◽  
Bertold Ries ◽  
Olaf Pirk
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Irritable Bowel Syndrome ◽  
Health Care Costs ◽  
Irritable Bowel ◽  
Care Costs

The lower the quality of life the higher health care costs in irritable Bowel syndrome†

2001 ◽  
Vol 120 (5) ◽  
pp. A636-A636
Author(s):  
P ENCK ◽  
P ILGENSTEIN ◽  
A SPANNHEIMER ◽  
B RIES ◽  
O PIRK
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Irritable Bowel Syndrome ◽  
Health Care Costs ◽  
Irritable Bowel ◽  
Care Costs

scholarly journals IN4 HERPES ZOSTER-ASSOCIATED ILLNESSES, QUALITY OF LIFE AND HEALTH-CARE COSTS AMONG 180 THAI PATIENTS

2010 ◽  
Vol 13 (7) ◽  
pp. A505
Author(s):  
K Aunhachoke ◽  
V Bussaratid ◽  
P Chirachanakul ◽  
B Chua-Intra ◽  
J Dhitavat ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Herpes Zoster ◽  
Health Care Costs ◽  
Care Costs
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