scholarly journals Economic burden of diabetes in France between 2012 and 2017 based on French national claim database

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Denis ◽  
A Aguadé ◽  
T Lesuffleur ◽  
L Pestel ◽  
M Nicolas ◽  
...  
Keyword(s):  
Process Control ◽  
Economic Burden ◽  
General Scheme ◽  
Health Care Expenditure ◽  
Ageing Process ◽  
Claim Database ◽  
Medical Visit ◽  
Top Down ◽  
Number Of Patients ◽  
A Priority

Abstract Background The aim of this study is to assess the economic burden of diabetes in France based on a top-down allocation of health care expenditure, and to analyze structure and trends of expenditure between 2012 and 2017. Methods Using information about 57 millions of individuals from the general scheme insurance database (87% of the French population), we applied algorithms based on ICD-10 diagnoses, long-term diseases, and specific treatments. All reimbursed expenditure (drugs, medical visit and other ambulatory care, hospitalization, disability/sickness benefits) were extracted for each individual. A top-down method was used to allocate expenditure to diabetes. To analyze trends, we applied the same methodology from 2012 through 2017. Results In 2016 (results for 2017 will be available for the conference), among the 137 billion euros reimbursed, 6.8 billion (5%) were attributed to diabetes and 3.2 million people were concerned (5.5% of the population). Drugs represented the main expenditure item (31% of the average annual expenditure per patient related to diabetes), followed by nursing (18%) and medical devices (17.5%). From 2012 to 2016, the number of people with diabetes increased by 11.4% (+322 700) with an increase by 2.7%/year, the expenditure attributed to diabetes increased by 2.3%/year. The average expenditure per patient in 2016 was about €2150, slightly decreasing from 2012, mainly due to price controls on antidiabetics drugs which permits to limit expenditure growth. Conclusions Our study shows the high economic burden of diabetes in France with a detailed analysis of expenditures and their main drivers. With the arrival of innovation and predicted increase of the number of patients partly related to ageing process, control of expenditure must be a priority. The developed tool will help decision makers to monitor the burden of diabetes but also to provide stakeholders with a better understanding of trends and regulating actions. Key messages Diabetes represents a high proportion of healthcare expenditure in France. With the arrival of innovation and predicted increase of the number of patients partly related to ageing process, control of expenditure must be a priority.

scholarly journals Economic burden of cardiovascular diseases from 2012 to 2017 based on French national claim database

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Nicolas ◽  
L Pestel ◽  
S Rivière ◽  
A Rachas ◽  
C Gastaldi-Menager
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Economic Burden ◽  
General Scheme ◽  
Claim Database ◽  
Total Expenditure ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Chronic Coronary Heart Disease ◽  
And Control

Abstract Background The purpose of this study was to assess the economic burden of cardiovascular diseases (CVDs) in France by analysing the structure and the growth of expenditure attributed to these diseases between 2012 and 2017. Methods For each year, 11 CVDs were identified from SNDS data using algorithms based on long-term disease registry and hospitalization diagnoses, applied to the population of national health insurance general scheme beneficiaries. The individuals’ expenditure (26 different items) reimbursed for hospitalisations, ambulatory care and cash payments were included. A top-down method was used to attribute expenditure to each considered groups of diseases based on the average expenditure by disease calculated for individuals with only one disease. To analyse trends, we applied the same methodology from 2012 to 2017. Results In 2017, of the €140.1 billion reimbursed, €14.0 billion (10.0%) were attributed to the care of 4.0 million people with a CVD (7.0% of the population). Short-stay hospitalisations accounted for 33% of this total expenditure. This proportion was higher for acute CVD (coronary syndrome: 64%, stroke: 56%, heart failure: 65%, pulmonary embolism: 69%) but also for valvular heart disease (50.0%). Medications represented almost 13% of the expenditure attributed to all CVDs, and up to 25% for chronic coronary heart disease. Disability pension essentially concerned sequelae of stroke (12% of the expenditure attributed to this disease). Between 2012 and 2017, the total expenditure attributed to CVDs increased by 3.3% per year, mainly due to the annual mean increase of the number of patients over the period (+3.1%). Conclusions These results demonstrate the high economic burden of CVDs in France with a detailed analysis of expenditures and their main drivers. The developed tool will help decision makers to monitor the burden of these diseases but also to provide stake holders with a better understanding of trends and regulating actions. Key messages Economic burden of CVD in France is high: 10% of healthcare expenditure. Implementation of public health policy to prevent CVD and control risk factors must be a priority.

scholarly journals Economic burden of cancer from 2012 to 2017 based on the French national claim database (SNDS)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Verboux ◽  
L Pestel ◽  
M Nicolas ◽  
T Lesuffleur ◽  
A Rachas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Ambulatory Care ◽  
Economic Burden ◽  
General Scheme ◽  
Significant Proportion ◽  
Claim Database ◽  
Average Annual Cost ◽  
Analyze Structure ◽  
Active Cancer

Abstract Background The aim of this study is to assess the economic burden of active cancer in France and to analyze structure and trends of expenditure between 2012 and 2017. Methods Using information about 57 millions of individuals from the general scheme insurance database (86% of the French population) and applying 5 specifically developed medical algorithms (for lung, colon, breast, prostate and other cancers), we identified all people with active cancer. All reimbursed expenditure (hospitalization, ambulatory care, disability/sickness benefits) were extracted for each individual. To analyze trends, we applied the same methodology from 2012 through 2017. Results In 2016 (results for 2017 will be available for the conference), among the 137 billion euros reimbursed by the general assurance scheme, 13 billion (10%) were related to active cancer and 1.2 million people were concerned (2% of the population). About 2.3 billion euros (2%) were related to breast cancer (189,000 people), 1.4 billion euros (1%) for colon cancer (123,000 people), 1.4 billion euros (1%) for lung cancer (77,000 people) and 1 billion (0.8%) for prostate cancer (167,000 people). Hospitalizations represented the main expenditure for colon (71%), lung (61%) and breast cancer (56%). Concerning prostate cancer, hospitalizations stood for 36% while ambulatory care represented 62%. From 2012 to 2016, the expenditure related to active cancer increase by 4.4%/year due to both an increase in patients and in the average annual cost per patient (both +2.2% per year). Focusing on breast cancer, average expenditure increased by 3.2% per year from 10,700€ per year per patient to 12,200€ per year per patient. Conclusions Our study demonstrates the high economic burden of active cancer in France with a detailed analysis of expenditures. The developed tool will help to monitor the burden of these diseases and to implement public health policies. Key messages Active cancers account for a significant proportion of healthcare expenditure in France. Knowing this weight allows designing and implementing public policies adapted to the situation.

scholarly journals Cost Assessment of Inpatient Care Episodes of Stroke in Romania

2020 ◽  
Vol 8 ◽  
Author(s):  
László Lorenzovici ◽  
Andrea Székely ◽  
Marcell Csanádi ◽  
Péter Gaál
Keyword(s):  
Economic Burden ◽  
Inpatient Care ◽  
Management Control ◽  
Stroke Patients ◽  
Healthcare Budget ◽  
Management Control System ◽  
Number Of Patients ◽  
Level Of Economic Development ◽  
The Cost ◽  
Gross Costing

Introduction: Stroke is the second leading cause of death worldwide and Romania is no exception. There is a high economic burden associated with the treatment of stroke patients, which puts pressure on the healthcare budget. This study aims to measure the inpatient treatment costs of stroke patients in Romania.Methods: Our retrospective analysis follows stroke patients in six Romanian hospitals at different progressivity level from different regions. Patients are identified from the official hospital databases, reported for reimbursement purposes. Mean inpatient costs incurred with the treatment of these stroke patient episodes are calculated using the gross costing method. The cost data are derived from the management control system of the study hospitals.Results: 3,155 patient episodes of stroke were identified in the study hospitals. The average cost per stroke inpatient care episode sums up to EUR 995.57 (95% CI: EUR 963.74—EUR 1 027.39) in 2017, while the overall yearly healthcare burden adds up to EUR 140 million, representing 2.18% of the total national health insurance budget and a cost of EUR 7.15 per capita.Conclusion: The hospital cost of stroke inpatient care episode in Romania is high and it represents a sizable part of the healthcare budget, but it is among the lowest in Europe, which can mainly be explained by the level of economic development of the country. As both the number of patients and the cost of acute care are expected to increase in the future, the economic burden of stroke is also expected to increase.

Review of Current Literature on the Economic Burden of Clostridium difficile Infection

2009 ◽  
Vol 30 (1) ◽  
pp. 57-66 ◽  
Author(s):  
Erik R. Dubberke ◽  
Albert I. Wertheimer
Keyword(s):  
Clostridium Difficile ◽  
Economic Burden ◽  
International Classification Of Diseases ◽  
The United States ◽  
Diagnosis Code ◽  
Number Of Patients ◽  
Classification Of Diseases ◽  
Control And Prevention ◽  
Healthcare Associated

Clostridium difficile is well recognized as the most common infectious cause of healthcare-associated diarrhea. Since 2000, this pathogen has demonstrated an increased propensity to cause more frequent and virulent illness that is often refractory to treatment. An analysis by the Centers for Disease Control and Prevention revealed that, in the United States, the number of patients discharged from hospitals who received the International Classification of Diseases, Ninth Revision discharge diagnosis code for C. difficile infection (CDI) more than doubled from 2000 to 2003. Unpublished data indicate that this trend has continued and that more than 250,000 US hospitalizations were associated with CDI in 2005. A previously uncommon hypervirulent strain of C. difficile is thought to contribute, in part, to the dramatic increase in the incidence and severity of the infection. Although the economic impact of the disease is believed to be profound and is expected to increase, data on the costs associated with CDI are scarce. To more completely assess its economic burden, we performed a review of available literature that reported costs associated with the infection.

scholarly journals Is it beneficial to the state to provide insulin-treated diabetic patients with public funds for self-monitoring blood glucose?

10.14341/7077 ◽  
2017 ◽  
Vol 20 (2) ◽  
pp. 108-118
Author(s):  
Larisa Dmitrievna Popovich ◽  
Marina Vladimirovna Shestakova ◽  
Elena Georgievna Potapchik ◽  
Alexander Yur'evich Mayorov ◽  
Olga Konstantinovna Vikulova
Keyword(s):  
Blood Glucose ◽  
Economic Burden ◽  
Economic Benefits ◽  
Diabetic Patients ◽  
Public Funds ◽  
Self Monitoring ◽  
Blood Glucose Test ◽  
Number Of Patients ◽  
Glucose Test ◽  
Two Measures

Background.In Russia, the prevalence of diabetes continues to increase with the growing diabetes epidemic. In recent years, the paradigm of diabetes treatment has been changing, with patients increasingly becoming equal participants in the treatment process, through the introduction of self-monitoring blood glucose (SMBG). Several clinical studies have demonstrated a positive relationship between SMBG and the decline of the epidemiological and economic burden of diabetes. At present, the procurement of public funds for SMBG is below the specified level in Russia. Aims.To investigate the potential macroeconomic benefits of public health resource allocation and the use of planned state investments to fund SMBG in insulin-treated diabetic patients. Materials and methods.This study was conducted with data from insulin-treated diabetic patients. The epidemiological burden of this cohort was determined by the following indicators: the number of patients and the incidence of complications resulting from diabetes, disability, mortality, age and sex. The economic benefits were evaluated by the implementation of two measures: (1) procurement of public funds for the purchase of means for SMBG in patients with insulin-treated diabetes and (2) the use of highly accurate blood glucose metres. To evaluate economic burden, the epidemiological burden was translated into monetary terms using cost-of-illness. Economic benefits were defined as reductions in economic burden. Results.The economic benefits of public-funded blood glucose test strips for insulin-treated diabetic patients exceeded the required additional investments for their purchase by 1.5 fold. A significant reduction in the inaccuracy of blood glucose metres from 20% to 10% may reduce the economic burden by 9.36 billion RUB. The combined state benefits from the implementation of both measures would significantly decrease the economic burden of diabetes to 29.2 billion RUB. Conclusions. Increased procurement of public funds for SMBG in insulin-treated diabetic patients would bring economic benefits that far exceed the required investments.

scholarly journals Economic Burden of Non-Alcoholic Steatohepatitis with Significant Fibrosis in Thailand

2020 ◽  
Author(s):  
Pochamana Phisalprapa ◽  
Ratthanon Prasitwarachot ◽  
Chayanis Kositamongkol ◽  
Pranaidej Hengswat ◽  
Weerachai Srivanichak ◽  
...  
Keyword(s):  
Economic Burden ◽  
Financial Burden ◽  
Lifetime Cost ◽  
Sensitivity Analyses ◽  
Thai Population ◽  
Lifetime Horizon ◽  
Middle Income ◽  
Significant Fibrosis ◽  
Alcoholic Steatohepatitis ◽  
Number Of Patients

Abstract Background: Non-alcoholic steatohepatitis (NASH) has been recognised as a significant form of chronic liver disease and a common cause of cirrhosis and hepatocellular carcinoma, resulting in a considerable financial burden on healthcare resources. Currently, there is no information regarding the economic burden of NASH in low- and middle-income countries (LMICs). The aim of this study was to estimate the economic burden of NASH in Thailand as a lesson learned for LMICs.Methods: To estimate the healthcare costs and prevalence of NASH with significant fibrosis (fibrosis stage ≥ 2) in the general Thai population, an eleven-state lifetime horizon Markov model with 1-year cycle length was performed. The model comprised Thai population aged 18 years and older. The cohort size was based on Thailand Official Statistic Registration Systems. The incidence of NASH, transitional probabilities, and costs-of-illness were based on previously published literature, including systematic reviews and meta-analyses. The age-specific prevalence of NASH was based on Thai NASH registry data. Costs were expressed in 2019 US Dollars ($). As we undertook analysis from the payer perspective, only direct medical costs were included. All future costs were discounted at an annual rate of 3%. A series of sensitivity analyses were performed.Results: The estimated total number of patients with significant NASH was 2.9 million cases in 2019, based on a NASH prevalence of 5.74%. The total lifetime cost of significant NASH was $15.2 billion ($5,147 per case), representing approximately 3% of the 2019 GDP of Thailand. The probabilistic sensitivity analysis showed that the lifetime costs of significant NASH varied from $11.4 billion to $18.2 billion.Conclusions: The economic burden associated with NASH is substantial in Thailand. This prompts clinicians and policy makers to consider strategies for NASH prevention and management.

The impact of 2013 UK NICE guidelines on the management of varicose veins at the Heart of England NHS Foundation Trust, Birmingham, UK

2016 ◽  
Vol 31 (9) ◽  
pp. 612-616 ◽  
Author(s):  
Huw OB Davies ◽  
Matthew Popplewell ◽  
Gareth Bate ◽  
Lisa Kelly ◽  
Katy Darvall ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Health Care Expenditure ◽  
Evidence Based ◽  
Foam Sclerotherapy ◽  
Number Of Patients ◽  
Group 2 ◽  
Uk National Health Service ◽  
The Uk ◽  
The Impact ◽  
Group 1

Objective Although varicose veins are a common cause of morbidity, the UK National Health Service and private medical insurers have previously sought to ration their treatment in a non-evidence based manner in order to limit health-care expenditure and reimbursement. In July 2013, the UK National Institute for Health and Care Excellence published new national Clinical Guidelines (CG168) to promote evidence-based commissioning and management of varicose veins. The aim of this study was to evaluate the impact of CG168 on the referral and management of varicose veins at the Heart of England NHS Foundation Trust, Birmingham, UK. Methods Interrogation of a prospectively gathered database, provided by the Heart of England NHS Foundation Trust Performance Unit, of patients undergoing interventions for varicose veins since 1 January 2012. Patients treated before (group 1) and after (group 2) publication of CG168 were compared. Results There were 253 patients, 286 legs (48% male, mean (range) age 54 (20–91) years) treated in group 1, and 417 patients, 452 legs, (46% male, mean (range) age 54 (14–90) years) treated in group 2, an increase of 65%. CG168 was associated with a significant reduction in the use of surgery (131 patients (52%) group 1 vs. 127 patients (30%) group 2, p = 0.0003, χ2), no change in endothermal ablation (30 patients (12%) group 1 vs. 45 patients (11%) group 2), a significant increase in ultrasound-guided foam sclerotherapy (92 patients (36%) group 1 and 245 patients (59%) group 2, p = 0.0001, χ2) and an increase in treatment for C2/3 disease (53% group 1 and 65.2% group 2, p = 0.0022, χ2). Conclusions Publication of National Institute for Health and Care Excellence CG168 has been associated with a significant increase (65%) in the number of patients treated, referral at an earlier (CEAP C) stage and increased use of endovenous treatment. CG 168 has been highly effective in improving access to, and quality of care, for varicose veins at Heart of England NHS Foundation Trust.

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