Typhoid and Paratyphoid Cost of Illness in Pakistan: Patient and Health Facility Costs From the Surveillance for Enteric Fever in Asia Project II

Abstract Background The objective of this study was to estimate the cost of illness from enteric fever (typhoid and paratyphoid) at selected sites in Pakistan. Methods We implemented a cost-of-illness study in 4 hospitals as part of the Surveillance for Enteric Fever in Asia Project (SEAP) II in Pakistan. From the patient and caregiver perspective, we collected direct medical, nonmedical, and indirect costs per case of enteric fever incurred since illness onset by phone after enrollment and 6 weeks later. From the health care provider perspective, we collected data on quantities and prices of resources used at 3 of the hospitals, to estimate the direct medical economic costs to treat a case of enteric fever. We collected costs in Pakistani rupees and converted them into 2018 US dollars. We multiplied the unit cost per procedure by the frequency of procedures in the surveillance case cohort to calculate the average cost per case. Results We collected patient and caregiver information for 1029 patients with blood culture–confirmed enteric fever or with a nontraumatic terminal ileal perforation, with a median cost of illness per case of US $196.37 (IQR, US $72.89–496.40). The median direct medical and nonmedical costs represented 8.2% of the annual labor income. From the health care provider perspective, the estimated average direct medical cost per case was US $50.88 at Hospital A, US $52.24 at Hospital B, and US $11.73 at Hospital C. Conclusions Enteric fever can impose a considerable economic burden in Pakistan. These new estimates of the cost of illness of enteric fever can improve evaluation and modeling of the costs and benefits of enteric fever prevention and control measures, including typhoid conjugate vaccines.

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Typhoid and Paratyphoid Cost of Illness in Bangladesh: Patient and Health Facility Costs From the Surveillance for Enteric Fever in Asia Project II

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1334 ◽

2020 ◽

Vol 71 (Supplement_3) ◽

pp. S293-S305 ◽

Cited By ~ 1

Author(s):

Nelly Mejia ◽

Sarah W Pallas ◽

Samir Saha ◽

Jamal Udin ◽

K M Ishtiaque Sayeed ◽

...

Keyword(s):

Cost Of Illness ◽

Economic Burden ◽

Enteric Fever ◽

Unit Cost ◽

Indirect Costs ◽

Public Health Policies ◽

Illness Onset ◽

Illness Study ◽

The Cost ◽

Substantial Economic Burden

Abstract Background We conducted a cost of illness study to assess the economic burden of pediatric enteric fever (typhoid and paratyphoid) in Bangladesh. Results can inform public health policies to prevent enteric fever. Methods The study was conducted at 2 pediatric health facilities in Dhaka. For the patient and caregiver’s perspective, we administered questionnaires on costs incurred from illness onset until the survey dates to caregivers of patients with blood culture positive cases at enrollment and 6 weeks later to estimate the direct medical, direct nonmedical, and indirect costs. From the perspective of the health care provider, we collected data on quantities and prices of resources used by the 2 hospitals to estimate the direct medical economic costs to treat a case of enteric fever. We collected costs in Bangladeshi takas and converted them into 2018 US dollars. We multiplied the unit cost per procedure by the frequency of procedures in the surveillance case cohort to calculate the average cost per case. Results Among the 1772 patients from whom we collected information, the median cost of illness per case of enteric fever from the patient and caregiver perspective was US $64.03 (IQR: US $33.90 –$173.48). Median direct medical and nonmedical costs per case were 3% of annual labor income across the sample. From the perspective of the healthcare provider, the average direct medical cost per case was US $58.64 (range: US $37.25 at Hospital B, US $73.27 at Hospital A). Conclusions Our results show substantial economic burden of enteric fever in Bangladesh, with higher costs for patients receiving inpatient care. As antimicrobial resistance increases globally, the cost of illness could increase, due to more expensive and potent drugs required for treatment.

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Delayed Tuberculosis Diagnosis in a Low Incidence Country and its Effect on Cost of Care

10.21203/rs.3.rs-1138557/v1 ◽

2021 ◽

Author(s):

James O'Connell ◽

Niamh Reidy ◽

Cora McNally ◽

Debbi Stanistreet ◽

Eoghan de Barra ◽

...

Keyword(s):

Health Care ◽

Health Care Provider ◽

Care Provider ◽

Delayed Diagnosis ◽

Signs And Symptoms ◽

Cost Of Care ◽

Global Priority ◽

Low Incidence ◽

The Cost ◽

Health Care Records

Abstract Background Tuberculosis elimination (TB) is a global priority that requires high-quality timely care to be achieved. In low TB incidence countries such as Ireland, delayed diagnosis is common. Despite cost being central to policy making, it is not known if delayed care affects care cost among TB patients in a low-incidence setting. Methods Health care records of patients with signs and symptoms of TB evaluated by a tertiary service in Ireland between July 1st 2018 and December 31st 2019 were reviewed to measure and determine predictors of patient-related delays, health care-provider related delay and the cost of TB care. Benchmarks against which the outcomes were compared were derived from the literature. Results Thirty-seven patients were diagnosed with TB and 51% (19/37) had pulmonary TB (PTB). The median patient-related delay was 60 days among those with PTB, greater than the benchmark derived from the literature (38 days). The median health care provider-related delay among patients with PTB was 16 days and, although similar to the benchmark (median 22 days, minimum 11 days, maximum 36 days) could be improved. The health care-provider related delay among patients with EPTB was 66 days, greater than the benchmark (42 days). The cost of care was €8298, and while similar to that reported in the literature (median €9,319, minimum €6,486, maximum €14,750) could be improved. Patient-related delay among those with PTB predicted care costs. Conclusion Patient-related and health care-related delays in TB diagnosis in Ireland must be reduced. Initiatives to do so should be resourced.

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The current status of sexually transmitted infections/reproductive tract infections in Vadodara City: Health-care provider perspective

Indian Journal of Community Medicine ◽

10.4103/ijcm.ijcm_382_18 ◽

2019 ◽

Vol 44 (3) ◽

pp. 247

Author(s):

NikhilkumarJagdishbhai Patel ◽

VihangS Mazumdar

Keyword(s):

Health Care ◽

Sexually Transmitted Infections ◽

Health Care Provider ◽

Care Provider ◽

Reproductive Tract ◽

Current Status ◽

Reproductive Tract Infections ◽

Sexually Transmitted ◽

Provider Perspective ◽

Tract Infections

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Custo efetividade da auditoria concorrente em uma operadora de saúde

Revista de Administração em Saúde ◽

10.23973/ras.75.162 ◽

2019 ◽

Vol 19 (75) ◽

Author(s):

Ana Fátima Souza Melo de Andrade ◽

Luiza Nauane Borges Benevides

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Hospital Stay ◽

Health Care Provider ◽

Care Provider ◽

Economic Losses ◽

Correlation Technique ◽

Strong Positive Correlation ◽

Care Providers ◽

The Cost

A busca por qualidade, faturamento correto da conta hospitalar e redução de gastos indevidos é a perspectiva atual das operadoras de saúde. Nessa linha de pensamento, o objetivo principal foi analisar a redução de custos hospitalares de uma operadora de saúde do estado de Sergipe, Brasil, entre janeiro e outubro de 2018, por meio da auditoria concorrente. Trata-se de um estudo descritivo, com abordagem quanti-qualitativa, do tipo relato de experiência. A análise qualitativa tratou-se de observações a partir da vivência como profissional. Na análise quantitativa, utilizou-se da estatística univariada para descrição dos indicadores e das variações. Para identificar a relação entre o indicador econômico, financeiro e os de qualidade, foi utilizada a técnica de correlação de Pearson. Como resultado, analisou-se que as glosas recuperaram perdas econômicas, mas não aumentaram de forma linear o custo efetividade para a operadora de saúde. Houve correlação moderada negativa (p<0,001) entre permanência hospitalar e custo-efetividade da auditoria concorrente. Enquanto que a desospitalização obteve uma correlação positiva forte (p<0,001), com o custo efetividade da auditoria concorrente. A partir destes dados, concluiu-se que o crescimento da desospitalização e a diminuição da permanência hospitalar impactaram no aumento da eficácia da auditoria concorrente.Palavras-chave: Auditoria de Enfermagem. Avaliação de Custo-Efetividade. Economia e Organizações de Saúde. ABSTRACTThe search for quality, correct billing of the hospital bill and reduction of undue expenses is the current perspective of health care providers. In this line of thought, the main objective was to analyze the reduction of hospital costs of a health care provider in the state of Sergipe, Brazil, between January and October of 2018, through a concurrent audit. This is a descriptive study, with quantitative-qualitative approach, of the type of experience report. The qualitative analysis was about observations from the experience as a professional. In the quantitative analysis, univariate statistics were used to describe indicators and variations. In order to identify the relationship between economic, financial and quality indicators, the Pearson correlation technique was used. As a result, it was analyzed that the glosses recovered economic losses, but did not linearly increase the cost effectiveness for the health care provider. There was a moderate negative correlation (p <0.001) between hospital stay and cost-effectiveness of the concurrent audit. While the de-hospitalization obtained a strong positive correlation (p <0.001), with the cost effectiveness of the concurrent audit. Based on these data, it was concluded that the increase in de-hospitalization and the decrease in hospital stay had an impact on the effectiveness of the concurrent audit. Keywords: Nursing Audit. Cost-effectiveness Evaluation. Health Care Economics and Organizations.

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Costs and Cost Effectiveness of a Health Care Provider–Directed Intervention to Promote Colorectal Cancer Screening Among Veterans

Journal of Clinical Oncology ◽

10.1200/jco.2005.02.6278 ◽

2005 ◽

Vol 23 (34) ◽

pp. 8877-8883 ◽

Cited By ~ 22

Author(s):

Michael S. Wolf ◽

Karen A. Fitzner ◽

Eowyn F. Powell ◽

Kathryn R. McCaffrey ◽

A. Simon Pickard ◽

...

Keyword(s):

Colorectal Cancer ◽

Health Care ◽

Information Technology ◽

Cost Effectiveness ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Health Care Provider ◽

Care Provider ◽

Sensitivity Analyses ◽

The Cost

Purpose Colorectal cancer screening is underused, particularly in the Veterans Affairs (VA) population. In a randomized controlled trial, a health care provider–directed intervention that offered quarterly feedback to physicians on their patients' colorectal cancer screening rates led to a 9% increase in colorectal cancer screening rates among veterans. The objective of this secondary analysis was to assess the cost effectiveness of the colorectal cancer screening promotion intervention. Methods Providers in the intervention arm attended an educational workshop on colorectal cancer screening and received confidential feedback on individual and group-specific colorectal cancer screening rates. The primary end point was completion of colorectal cancer screening tests. Sensitivity analyses investigated cost-effectiveness estimates varying the data collection methods, costs of labor and technology, and the effectiveness of the intervention. Results Rates of colorectal cancer screening for the intervention versus control arms were 41.3% v 32.4%, respectively (P < .05). The incremental cost-effectiveness ratio was $978 per additional veteran screened based on feedback reports generated from manual review of records. However, if feedback reports could be generated from information technology systems, sensitivity analyses indicate that the cost-effectiveness estimate would decrease to $196 per additional veteran screened. Conclusion An intervention based on quarterly feedback reports to physicians improved colorectal cancer screening rates at a VA medical center. This intervention would be cost effective if relevant data could be generated by existing information technology systems. Our findings may have broad applicability because a 2005 Medicare initiative will provide the VA electronic medical record system as a free benefit to all US physicians.

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Typhoid and Paratyphoid Cost of Illness in Nepal: Patient and Health Facility Costs From the Surveillance for Enteric Fever in Asia Project II

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1335 ◽

2020 ◽

Vol 71 (Supplement_3) ◽

pp. S306-S318 ◽

Cited By ~ 1

Author(s):

Nelly Mejia ◽

Taiwo Abimbola ◽

Jason R Andrews ◽

Krista Vaidya ◽

Dipesh Tamrakar ◽

...

Keyword(s):

Healthcare Provider ◽

Cost Of Illness ◽

Economic Burden ◽

Enteric Fever ◽

Healthcare Providers ◽

Indirect Costs ◽

Economic Cost ◽

Prevention Measures ◽

Illness Onset ◽

The Cost

Abstract Background Enteric fever is endemic in Nepal and its economic burden is unknown. The objective of this study was to estimate the cost of illness due to enteric fever (typhoid and paratyphoid) at selected sites in Nepal. Methods We implemented a study at 2 hospitals in Nepal to estimate the cost per case of enteric fever from the perspectives of patients, caregivers, and healthcare providers. We collected direct medical, nonmedical, and indirect costs per blood culture–confirmed case incurred by patients and their caregivers from illness onset until after enrollment and 6 weeks later. We estimated healthcare provider direct medical economic costs based on quantities and prices of resources used to diagnose and treat enteric fever, and procedure frequencies received at these facilities by enrolled patients. We collected costs in Nepalese rupees and converted them into 2018 US dollars. Results We collected patient and caregiver cost of illness information for 395 patients, with a median cost of illness per case of $59.99 (IQR, $24.04–$151.23). Median direct medical and nonmedical costs per case represented ~3.5% of annual individual labor income. From the healthcare provider perspective, the average direct medical economic cost per case was $79.80 (range, $71.54 [hospital B], $93.43 [hospital A]). Conclusions Enteric fever can impose a considerable economic burden on patients, caregivers, and health facilities in Nepal. These new estimates of enteric fever cost of illness can improve evaluation and modeling of the costs and benefits of enteric fever–prevention measures.

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Diabetes Patient Education: A Health Care Provider Perspective

The Diabetes Educator ◽

10.1177/014572178601200208 ◽

1986 ◽

Vol 12 (2) ◽

pp. 126-130 ◽

Cited By ~ 5

Author(s):

Roger S. Mazze

Keyword(s):

Health Care ◽

Health Care Provider ◽

Care Provider ◽

Diabetes Patient ◽

Preventive Health ◽

Psychosocial Status ◽

Knowledge And Skills ◽

Provider Perspective ◽

Provider Knowledge ◽

And Behavior

Diabetes patient educa tion, a preventive health service, is an integral component of the overall program of care for the diabetic patient. Affecting both biomedical and psychosocial status, it may be analyzed through its knowledge- and behavior-based com ponents. Both are impor tant to the overall result, and each involves distinct provider knowledge and skills for successful, effec tive application. This application optimally in cludes a reproducible process involving a needs assessment, educational content planning, im plementation strategies, and appropriate evaluative methods. Familiarity with these concepts and tech niques will benefit the interested health care provider.

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