The Boomers Are Coming: A Total Cost of Care Model of The Impact of Population Aging on The Cost of Chronic Conditions in The United States

The primary objective of this study is to provide an updated analysis of the cost of screening for ovarian cancer in the United States. Here, we use updated information from the University of Kentucky Ovarian Cancer Screening Trial in conjunction with new modifying factors such as U.S. national estimates of the cost of care (Truven Health MarketScan Database), recently published estimates of earnings lost due to ovarian cancer death and estimates of federal income taxes paid on those earnings. In total, 326,998 screens were performed during the Kentucky trial from 1987 to 2019. At a cost of $56 per screen, we estimate that the total base cost to operate the program over the last 32 years is $18,311,888. When accounting for the surgical cost of 381 false-positive cases, the total cost of the screening program increases by $3,030,474. However, these costs are offset by the benefit of treating more early-stage ovarian cancer in the screened population, with a total cost advantage of $4,016,475 at our institution (Kentucky) or $1,525,050 ($725,700–$3,312,650) (U.S.) nationally. Additionally, program costs are offset by approximately $3,549,000 due to the potential earnings gained by the 26 women whose lives have been saved with screening. Furthermore, the cost of the program is offset by the federal tax dollars paid on the recovered earnings and amounts to $383,292. Ultimately, the net adjusted total cost of the Kentucky screening program is an estimated $13,393,595 at our institution or $15,885,020 ($13,978,068–$16,799,083) nationally. Thus, the adjusted cost per screen is an estimated $40.96 in Kentucky or $48.58 ($42.75–$51.37) nationally.

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The Impact of Regional Differences in Prices and Wages on Economic Growth: The United States in 1890

The Journal of Economic History ◽

10.1017/s0022050700096303 ◽

1979 ◽

Vol 39 (1) ◽

pp. 69-85 ◽

Cited By ~ 7

Author(s):

Philip R. P. Coelho ◽

James F. Shepherd

Keyword(s):

United States ◽

Well Being ◽

The United States ◽

City Size ◽

Cost Of Living ◽

Real Wages ◽

Industrial Growth ◽

Wage Earners ◽

The Cost ◽

The Impact

Differences in regional prices and wages are examined for the United States in 1890, together with the relationship between the cost of living and city size, and the determinants of regional industrial growth. Results indicate that regional cost-of-liying differences were sufficiently large so that money wages cannot be used for purposes of comparing the economic well-being of wage earners across regions. Except for the South, money wages and the cost of living were positively correlated. The relative differences in money wages, however, were greater; consequently real wages in high wage-price areas were generally higher.

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American Society of Clinical Oncology Guidance Statement: The Cost of Cancer Care

Journal of Clinical Oncology ◽

10.1200/jco.2009.23.1183 ◽

2009 ◽

Vol 27 (23) ◽

pp. 3868-3874 ◽

Cited By ~ 346

Author(s):

Neal J. Meropol ◽

Deborah Schrag ◽

Thomas J. Smith ◽

Therese M. Mulvey ◽

Robert M. Langdon ◽

...

Keyword(s):

United States ◽

Health Care ◽

Clinical Oncology ◽

Cancer Care ◽

Cost Effective ◽

The United States ◽

Cost Of Care ◽

High Quality ◽

American Society ◽

The Cost

Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates in the United States. In parallel with these advances have come significant increases in the cost of cancer care. It is well established that the cost of health care (including cancer care) in the United States is growing more rapidly than the overall economy. In part, this is a result of the prices and rapid uptake of new agents and other technologies, including advances in imaging and therapeutic radiology. Conventional understanding suggests that high prices may reflect the costs and risks associated with the development, production, and marketing of new drugs and technologies, many of which are valued highly by physicians, patients, and payers. The increasing cost of cancer care impacts many stakeholders who play a role in a complex health care system. Our patients are the most vulnerable because they often experience uneven insurance coverage, leading to financial strain or even ruin. Other key groups include pharmaceutical manufacturers that pass along research, development, and marketing costs to the consumer; providers of cancer care who dispense increasingly expensive drugs and technologies; and the insurance industry, which ultimately passes costs to consumers. Increasingly, the economic burden of health care in general, and high-quality cancer care in particular, will be less and less affordable for an increasing number of Americans unless steps are taken to curb current trends. The American Society of Clinical Oncology (ASCO) is committed to improving cancer prevention, diagnosis, and treatment and eliminating disparities in cancer care through support of evidence-based and cost-effective practices. To address this goal, ASCO established a Cost of Care Task Force, which has developed this Guidance Statement on the Cost of Cancer Care. This Guidance Statement provides a concise overview of the economic issues facing stakeholders in the cancer community. It also recommends that the following steps be taken to address immediate needs: recognition that patient-physician discussions regarding the cost of care are an important component of high-quality care; the design of educational and support tools for oncology providers to promote effective communication about costs with patients; and the development of resources to help educate patients about the high cost of cancer care to help guide their decision making regarding treatment options. Looking to the future, this Guidance Statement also recommends that ASCO develop policy positions to address the underlying factors contributing to the increased cost of cancer care. Doing so will require a clear understanding of the factors that drive these costs, as well as potential modifications to the current cancer care system to ensure that all Americans have access to high-quality, cost-effective care.

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Economic Cascades and the Costs of a Business-as-Usual Approach to COVID-19

10.20944/preprints202101.0200.v1 ◽

2021 ◽

Author(s):

Peter Roopnarine ◽

David Goodwin ◽

Maricela Abarca ◽

Joseph Russack

Keyword(s):

United States ◽

Economic Model ◽

The United States ◽

Industrial Sector ◽

Economic Losses ◽

Economic Systems ◽

Usual Approach ◽

The Cost ◽

Business As Usual ◽

The Impact

Shelter-in-place policies and the closure of non-essential workplaces intended to disrupt transmission of the SARS-COV-2 virus are effective approaches to combating COVID-19. They have, however, caused record levels of unemployment in the United States, raising questions of whether mitigation is more societally damaging than the disease. Here we use a coupled epidemiological-economic model to estimate the impact on employment of an unmitigated, business-as-usual approach to the pandemic. We compared unemployment between March-August 2020 in ten Californian socio-economic systems (SESs) to unemployment forecast by a model of industrial sector inter-dependencies subjected to unmitigated outbreaks of COVID-19. We found that economic losses are unavoidable because disease-driven losses propagate economically through SESs, amplifying losses to the disease. While model forecasts are generally lower than actual unemployment, jobs savings would come at the cost of greatly increased worker mortality. The costs would also be disproportionately greater among smaller and inland SESs.

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Waste-to-Energy Project Economics and Financing: A Look Into the Factors Influencing the Future

14th Annual North American Waste-to-Energy Conference ◽

10.1115/nawtec14-3186 ◽

2006 ◽

Author(s):

Jeffrey F. Clunie

Keyword(s):

United States ◽

The United States ◽

Fuel Oil ◽

Waste To Energy ◽

Recent Analysis ◽

Economic Factors ◽

The Future ◽

The Cost ◽

The Impact

This paper focuses on significant changes in the overall economics of waste-to-energy (WTE) during the last 30 years. The WTE industry in this country has seen several different business cycles occur since 1975, as different market drivers have caused the industry to rise and fall. This paper compares: (1) those economic factors that were in play in 1975, when the first WTE facility in the United States was built, and the industry was in its infancy; (2) the factors at play when the WTE industry was at its height in 1990; and (3) some of the factors that caused the industry’s steep downward trend since 1994, when the last greenfield WTE facility in the United States was built. The paper will identify changes that have occurred with regard to the pricing of electricity and the ability of public sectors to charge non-market-based tipping fees. The paper discusses the drivers of 2006 and focuses on completed economic factors to be considered when comparing WTE with other waste disposal means. The paper discusses the drivers of 2006 and whether the industry is finally poised to begin an upward turn in the cycle. The paper focuses on the impact of the cost of diesel fuel oil on the overall economics of long-haul transfer, and how that is likely to impact the future development of WTE facilities. The paper also presents a case study of a recent analysis that was undertaken for two counties that were evaluating the financial viability of WTE as compared to other disposal options.

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The Cost of the First World War to the United States

Inquiry@Queen's Undergraduate Research Conference Proceedings ◽

10.24908/iqurcp.9921 ◽

2018 ◽

Author(s):

Kristen Tannas

Keyword(s):

United States ◽

Economic Growth ◽

Indirect Cost ◽

The United States ◽

First World War ◽

World War ◽

The First World War ◽

The Cost ◽

The Impact ◽

First World

In this paper, a calculation of cost of the First World War to the United States is performed with the aim of evaluating the impact of the War on the American economy. The method used to make this calculation is based on the work of economic historians Claudia Goldin and Frank Lewis, who studied the cost of the American Civil War. This method involves the calculation first of the “direct cost” of the war, which represents the value of economic losses made up of war expenditures, casualties and the opportunity cost of drafted soldiers. The “indirect cost” of the War is also calculated to measure the impact of the War on American economic growth by projecting economic growth in a hypothetical world where the First World War did not occur and comparing it to the economic growth actually experienced in the United States. This calculation is meant to capture any positive effects that the War may have had. For the calculations, data was drawn from a number of primary sources including censuses and government documents. The results of both of these calculations show that the First World War had a negative impact on American growth and represented a massive drain of economic resources. In particular, the indirect cost calculation shows that American growth slowed considerably in the decade following the War. This result is significant as it contradicts the common view of the postwar period prior to the Great Depression as being one of great prosperity in the United States.

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Abstract TP423: Trends of Hospitalization Cost of Aneurysmal Subarachnoid Hemorrhage in the United States

Stroke ◽

10.1161/str.48.suppl_1.tp423 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Sumul Modi ◽

Kavit Shah ◽

Muhammad Affan ◽

Rizwan Tahir ◽

Panayiotis Varelas ◽

...

Keyword(s):

United States ◽

Ischemic Stroke ◽

Subarachnoid Hemorrhage ◽

Respiratory Failure ◽

Aneurysmal Subarachnoid Hemorrhage ◽

The United States ◽

Male Gender ◽

Cost Of Care ◽

Hospitalization Cost ◽

The Cost

Background: Recent large scale studies describing the trends of hospitalization cost secondary to aneurysmal subarachnoid hemorrhage (aSAH) in the United States are lacking. We performed this study to discover these trends and the factors affecting the cost of hospitalization. Methods: The Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project from year 2002 to 2013 was searched for patients with a primary diagnosis of subarachnoid hemorrhage International Classification of Diseases - Ninth Revision (ICD-9) code 430) who underwent either clipping or coiling of an aneurysm. Patients with traumatic intracranial hemorrhage, arteriovenous malformation, arteriovenous fistula, cost of care ≤ 0, discharge to another hospital, and any missing variables were excluded. The cost of hospitalization was calculated using total charge and cost-to-charge ratio provided by HCUP, and then was adjusted for inflation (for the year 2016) utilizing the Consumer Price Index inflation calculator. Univariate and multivariable linear regression analysis was performed on selected variables to identify the factors associated with a higher cost of care. The multivariable model was adjusted for calendar year, medical comorbidities (using the Charlson Comorbidity Index), hospital location (urban or rural) and hospital teaching status (teaching or non-teaching). Results: We identified 20,905 patients with aSAH over the course of the 12 years. The mean and the median costs of hospitalization were $80,859 and $66,274, respectively. The median cost increased from $53,697 in 2002 to $73,901 in 2013 (p<0.001). Cost was also noted to increase by $2690 with the male gender, $18,877 with the presence of an acute ischemic stroke, $33,942 with the presence of respiratory failure and $18,464 with the requirement of ventriculostomy (all p<0.001). Every decade increase in age was associated with $3022 reduction in the cost (P<0.001). Conclusion: Among the factors we studied, higher hospitalization cost was independently associated with the male gender and the presence of ischemic stroke, respiratory failure and the requirement of ventriculostomy. Older age was associated with a lower hospitalization cost.

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Costs of medical care for mesothelioma

Rare Tumors ◽

10.1177/2036361319863498 ◽

2019 ◽

Vol 11 ◽

pp. 203636131986349 ◽

Cited By ~ 1

Author(s):

Eric Borrelli ◽

Zachary Babcock ◽

Stephen Kogut

Keyword(s):

United States ◽

Medical Care ◽

Medical Cost ◽

The United States ◽

Healthcare Research ◽

Cost Of Care ◽

Discharge Data ◽

System A ◽

The Cost ◽

Mean Cost

Malignant mesothelioma is a rare and devastating form of cancer with an increasing economic burden. We sought to describe the direct cost burden of mesothelioma to the US health system. A systematic literature review was performed to locate published estimates of the medical cost of mesothelioma. In addition, we performed an analysis of hospital discharge data from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. We also reviewed publicly available legal settlements. We found that published estimates of the cost of medical care for mesothelioma are sparse, and differ with respect to nation, timeframe, and types of cost included. For the year 2014 in the United States, we estimated a mean cost per mesothelioma hospitalization of US$24,124 (95% confidence interval: US$20,819–US$28,983) and a total cost for hospital care of US$44,214,835. In conclusion, we found that reports describing the direct medical cost of care for mesothelioma in the United States are lacking, yet the per-patient cost of care is substantial, as evidenced by analyses of inpatient care and legal settlements.

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