scholarly journals A Review of Measles Outbreak Cost Estimates From the United States in the Postelimination Era (2004–2017): Estimates by Perspective and Cost Type

2020 ◽  
Vol 71 (6) ◽  
pp. 1568-1576
Author(s):  
Jamison Pike ◽  
Andrew J Leidner ◽  
Paul A Gastañaduy
Keyword(s):  
United States ◽  
Indirect Costs ◽  
Health Department ◽  
The United States ◽  
Public Health Department ◽  
Median Cost ◽  
Cost Estimates ◽  
Measles Outbreak ◽  
Measles Outbreaks ◽  
The Cost

Abstract Despite the elimination of measles in the United States (US) in the year 2000, cases continue to occur, with measles outbreaks having occurred in various jurisdictions in the US in 2018 and 2019. Understanding the cost associated with measles outbreaks can inform cost-of-illness and cost-effectiveness studies of measles and measles prevention. We performed a literature review and identified 10 published studies from 2001 through 2018 that presented cost estimates from 11 measles outbreaks. The median total cost per measles outbreak was $152 308 (range, $9862–$1 063 936); the median cost per case was $32 805 (range, $7396–$76 154) and the median cost per contact was $223 (range, $81–$746). There were limited data on direct and indirect costs associated with measles. These findings highlight how costly measles outbreaks can be, the value of this information for public health department budgeting, and the importance of more broadly documenting the cost of measles outbreaks.

scholarly journals SWK-11. ASSESSMENT OF THE INDIRECT COSTS ASSOCIATED WITH PROTON THERAPY TREATMENT FOR ALBERTA PATIENTS REFERRED OUT OF COUNTRY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii466-iii466
Author(s):  
Karina Black ◽  
Jackie Middleton ◽  
Sunita Ghosh ◽  
David Eisenstat ◽  
Samor Patel
Keyword(s):  
United States ◽  
Proton Therapy ◽  
Malignant Tumors ◽  
Indirect Costs ◽  
The United States ◽  
Current Data ◽  
Opportunity Costs ◽  
Proton Treatment ◽  
Out Of Pocket Expenses ◽  
The Cost

Abstract BACKGROUND Proton therapy for benign and malignant tumors has dosimetric and clinical advantages over photon therapy. Patients in Alberta, Canada are referred to the United States for proton treatment. The Alberta Heath Care Insurance Plan (AHCIP) pays for the proton treatment and the cost of flights to and from the United States (direct costs). This study aimed to determine the out-of-pocket expenses incurred by patients or their families (indirect costs). METHODS Invitation letters linked to an electronic survey were mailed to patients treated with protons between 2008 and 2018. Expenses for flights for other family members, accommodations, transportation, food, passports, insurance, and opportunity costs including lost wages and productivity were measured. RESULTS Fifty-nine invitation letters were mailed. Seventeen surveys were completed (28.8% response rate). One paper survey was mailed at participant request. Nine respondents were from parent/guardian, 8 from patients. All patients were accompanied to the US by a family member/friend. Considerable variability in costs and reimbursements were reported. Many of the accompanying family/friends had to miss work; only 3 patients themselves reported missed work. Time away from work varied, and varied as to whether it was paid or unpaid time off. CONCLUSIONS Respondents incurred indirect monetary and opportunity costs which were not covered by AHCIP when traveling out of country for proton therapy. Prospective studies could help provide current data minimizing recall bias. These data may be helpful for administrators in assessing the societal cost of out-of-country referral of patients for proton therapy.

scholarly journals Measuring the Cost of Bailouts

2019 ◽  
Vol 11 (1) ◽  
pp. 85-108 ◽  
Author(s):  
Deborah Lucas
Keyword(s):  
United States ◽  
Direct Cost ◽  
Financial Institutions ◽  
The United States ◽  
Theoretical Framework ◽  
Sharp Contrast ◽  
Total Direct Cost ◽  
Cost Estimates ◽  
Regulatory Burden ◽  
The Cost

This review develops a theoretical framework that highlights the principles governing economically meaningful estimates of the cost of bailouts. Drawing selectively on existing cost estimates and augmenting them with new calculations consistent with this framework, I conclude that the total direct cost of the 2008 crisis-related bailouts in the United States was on the order of $500 billion, or 3.5% of GDP in 2009. The largest direct beneficiaries of the bailouts were the unsecured creditors of financial institutions. The estimated cost stands in sharp contrast to popular accounts that claim there was no cost because the money was repaid, and with claims of costs in the trillions of dollars. The cost is large enough to suggest the importance of revisiting whether there might have been less expensive ways to intervene to stabilize markets. At the same time, it is small enough to call into question whether the benefits of ending bailouts permanently exceed the regulatory burden of policies aimed at achieving that goal.

scholarly journals An Economic Analysis of Two Grafted Tomato Transplant Production Systems in the United States

2010 ◽  
Vol 20 (4) ◽  
pp. 794-803 ◽  
Author(s):  
Cary L. Rivard ◽  
Olha Sydorovych ◽  
Suzanne O'Connell ◽  
Mary M. Peet ◽  
Frank J. Louws
Keyword(s):  
United States ◽  
Production Systems ◽  
Indirect Costs ◽  
The United States ◽  
Production Costs ◽  
Labor Costs ◽  
Commercial Farming ◽  
Economic Production ◽  
Certified Organic ◽  
The Cost

The grafting of herbaceous vegetables is an emerging development in the United States. This report provides an estimate of the variable costs of grafting within U.S. tomato (Solanum lycopersicum) transplant production systems. Grafted and nongrafted plants were propagated at two commercial farming operations in Ivanhoe, NC (NC) and Strasburg, PA (PA) and the farm in NC produced certified organic transplants. Detailed economic production sequences were generated for each site, and grafted and nongrafted transplant production costs were $0.59 and $0.13 in NC, and $1.25 and $0.51 in PA, respectively. Direct costs associated with grafting (e.g., grafting labor, clips, chamber, etc.) accounted for 37% to 38% of the added cost of grafting, and grafting labor was 11.1% to 14.4% of the cost of grafted transplant production. Seed costs represented 52% and 33% of the added cost of grafting at the two sites, and indirect costs (e.g., soil, trays, and heating) accounted for 10% and 30% of the added cost of grafting. Our findings suggest that under current seed prices and with similar production practices, the feasibility of grafting in the United States is not disproportionately affected by domestic labor costs. Additionally, the economic models presented in this report identify the cost of production at various transplant stages, and provide a valuable tool for growers interested in grafted tomato transplant production and utilization.

scholarly journals The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler
Keyword(s):  
United States ◽  
Health Reform ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Reform Plan ◽  
The Difference ◽  
The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

Importance of Behavioral and Psychological Symptoms of Dementia in Primary Care

2000 ◽  
Vol 12 (S1) ◽  
pp. 67-72 ◽  
Author(s):  
William H. Coleman
Keyword(s):  
United States ◽  
Primary Care ◽  
Psychological Distress ◽  
Direct Relationship ◽  
Psychological Symptoms ◽  
The United States ◽  
Comprehensive Treatment ◽  
The Cost ◽  
Number Of Individuals ◽  
Behavioral And Psychological Symptoms

There is a direct relationship between years lived beyond age 65 and the number of individuals diagnosed with dementia, primarily Alzheimer's disease (AD). The occurrence of AD has no socioeconomic, geographical, or ethnic limitations. The problem is worldwide. Its magnitude is demonstrated by the following facts: (a) approximately 6% to 8% of persons 65 years or older have AD, and the prevalence of the disease doubles each 5 years after 60 years of age; (b) 30% of 85-year-old individuals can be expected to have the disease; (c) AD affects an estimated 4 million people in the United States, and is expected to affect approximately 14 million Americans within the next few decades; (d) AD patients average 6 to 10 years of comprehensive treatment from symptom onset to death; (e) AD is the fourth leading cause of mortality among elderly Americans, more than 100,000 each year; (f) caregiver attempts at management of the behavioral and psychological symptoms of AD result in up to 50% developing significant psychological distress themselves; and (g) the cost for the management of AD patients is estimated to be between US $80 billion and US $120 billion annually. Primary care is essential for the appropriate diagnosis and treatment of the complex set of behavioral and psychological symptoms of dementia (BPSD) associated with AD.

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