Age-related difference in health care use and costs of patients with chronic kidney disease and matched controls: analysis of Dutch health care claims data

Abstract Background The financial burden of chronic kidney disease (CKD) is increasing due to the ageing population and increased prevalence of comorbid diseases. Our aim was to evaluate age-related differences in health care use and costs in Stage G4/G5 CKD without renal replacement therapy (RRT), dialysis and kidney transplant patients and compare them to the general population. Methods Using Dutch health care claims, we identified CKD patients and divided them into three groups: CKD Stage G4/G5 without RRT, dialysis and kidney transplantation. We matched them with two controls per patient. Total health care costs and hospital costs unrelated to CKD treatment are presented in four age categories (19–44, 45–64, 65–74 and ≥75 years). Results Overall, health care costs of CKD patients ≥75 years of age were lower than costs of patients 65–74 years of age. In dialysis patients, costs were highest in patients 45–64 years of age. Since costs of controls increased gradually with age, the cost ratio of patients versus controls was highest in young patients (19–44 years). CKD patients were in greater need of additional specialist care than the general population, which was already evident in young patients. Conclusion Already at a young age and in the earlier stages of CKD, patients are in need of additional care with corresponding health care costs far exceeding those of the general population. In contrast to the general population, the oldest patients (≥75 years) of all CKD patient groups have lower costs than patients 65–74 years of age, which is largely explained by lower hospital and medication costs.

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Effect of Chronic Kidney Disease and Comorbid Conditions on Health Care Costs: A 10-Year Observational Study in a General Population

American Journal of Nephrology ◽

10.1159/000272937 ◽

2010 ◽

Vol 31 (3) ◽

pp. 222-229 ◽

Cited By ~ 43

Author(s):

Sebastian E. Baumeister ◽

Carsten A. Böger ◽

Bernhard K. Krämer ◽

Angela Döring ◽

Dirk Eheberg ◽

...

Keyword(s):

Health Care ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

General Population ◽

Observational Study ◽

Health Care Costs ◽

Comorbid Conditions ◽

Care Costs

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Factors contributing to post-stroke health care utilization and costs. Secondary results from the Life After Stroke (LAST) study, a pragmatic randomized controlled trial

10.21203/rs.2.17944/v2 ◽

2020 ◽

Author(s):

Øystein Døhl ◽

Vidar Halsteinli ◽

Torun Askim ◽

Mari Gunnes ◽

Hege Ihle Hansen ◽

...

Keyword(s):

Health Care ◽

Health Care Costs ◽

Gait Speed ◽

Standard Care ◽

Controlled Trial ◽

Health Care Use ◽

Post Stroke ◽

Randomized Controlled ◽

Care Costs

Abstract Background The result from the Life After Stroke (LAST) study showed that an 18-month follow up program as part of the primary health care, did not improve maintenance of motor function for stroke survivors. In this study we evaluated whether the follow-up program could lead to a reduction in the use of health care compared to standard care. Furthermore, we analyse to what extent differences in health care costs for stroke patients could be explained by individual need factors (such as physical disability, cognitive impairment, age, gender and marital status), and we tested whether a generic health related quality of life (HRQoL) is able to predict the utilisation of health care services for patients post-stroke as well as more disease specific indexes. Methods The Last study was a multicentre, pragmatic, single-blinded, randomized controlled trial. Adults (age ≥18 years) with first-ever or recurrent stroke, community dwelling, with modified Rankin Scale <5. The study included 380 persons recruited 10 to 16 weeks post-stroke, randomly assigned to individualized coaching for 18 months (n=186) or standard care (n=194). Individual need was measured by the Motor assessment scale (MAS), Barthel Index, Hospital Anxiety and Depression Scale (HADS), modified Rankin Scale (mRS) and Gait speed. HRQoL was measured by EQ-5D-5L. Health care costs were estimated for each person based on individual information of health care use. Multivariate regression analysis was used to analyse cost differences between the groups and the relationship between individual costs and determinants of health care utilisation. Results There were higher total costs in the intervention group. MAS, Gait speed, HADS and mRS were significant identifiers of costs post-stroke, as was EQ-5D-5L. Conclusion Long term, regular individualized coaching did not reduce health care costs compared to standard care. We found that MAS, Gait speed, HADS and mRS were significant predictors for future health care use. The generic EQ-5D-5L performed equally well as the more detailed battery of outcome measures, suggesting that HRQoL measures may be a simple and efficient way of identifying patients in need of health care after stroke and targeting groups for interventions. Clinical Trial Registration : https://www.clinicaltrials.gov NCT01467206.

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PCV54 PATTERNS OF THERAPY, HEALTH CARE UTILIZATION, AND HEALTH CARE COSTS IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION (PAH) INITIATING THERAPY WITH SILDENAFIL: FINDINGS FROM RETROSPECTIVE ANALYSES OF ADMINISTRATIVE HEALTH CARE CLAIMS DATA

Value in Health ◽

10.1016/s1098-3015(11)72397-x ◽

2010 ◽

Vol 13 (7) ◽

pp. A351

Author(s):

MA Mychaskiw ◽

A Berger ◽

J Mardekian ◽

G Oster

Keyword(s):

Health Care ◽

Pulmonary Arterial Hypertension ◽

Health Care Utilization ◽

Arterial Hypertension ◽

Health Care Costs ◽

Claims Data ◽

Care Utilization ◽

Pulmonary Arterial ◽

Health Care Claims ◽

Care Costs

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Influence on the Health of the Partner Affected by Tumor Disease in the Wife or Husband Based on a Population-Based Register Study of Cancer in Sweden

Journal of Clinical Oncology ◽

10.1200/jco.2008.21.6788 ◽

2009 ◽

Vol 27 (28) ◽

pp. 4781-4786 ◽

Cited By ~ 47

Author(s):

Katarina Sjövall ◽

Bo Attner ◽

Thor Lithman ◽

Dennis Noreen ◽

Barbro Gunnars ◽

...

Keyword(s):

Prostate Cancer ◽

Health Care ◽

Cancer Patients ◽

Health Care Costs ◽

Cancer Diagnosis ◽

Health Care Use ◽

Psychiatric Diagnoses ◽

Male Partners ◽

Costs Of Care ◽

Care Costs

Purpose To examine health care use and health care costs among partners of persons with cancer. Patients and Methods Partners of patients with colon, rectal, lung, breast, and prostate cancer (N = 11,076) were identified via linked data from the Tumor Registry of Southern Sweden and Census Registry of Sweden. Health care use, total costs of health care, and diagnosis of the partner were studied before and after diagnosis of the cancer patient. Results Health care use for partners increased in terms of in-patient care after the cancer diagnosis. A significant increase was seen the second year for partners of patients with colon cancer (risk ratio [RR], 1.55; 95% CI, 1.28 to 1.87) and lung cancer (RR, 1.50; 95% CI, 1.26 to 1.79). Psychiatric diagnoses increased after the cancer diagnosis in the total sample, with a significant increase for partners of colon (RR, 2.66; 95% CI, 1.71 to 4.22), lung (RR, 3.16; 95% CI, 2.23 to 4.57), and prostate cancer patients (RR, 1.68; 95% CI, 1.32 to 2.15). Costs of care increased more than the consumer price index the two years after the cancer diagnosis. Costs of care increased most for male partners and especially for younger male partners (age 25 to 64 years) of patients with colon, rectal, and lung cancers. Conclusion The results showed increased health care costs and an increase in psychiatric diagnoses after the cancer diagnosis among partners of cancer patients. Further research is needed to learn more about the situation of the partner and to identify persons at risk of psychiatric morbidity. Knowledge is also needed on how to support the partner in the most efficient way.

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Reversing the Negative Genomic Effects of Aging with Short-Term Calorie Restriction

The Scientific World JOURNAL ◽

10.1100/tsw.2001.256 ◽

2001 ◽

Vol 1 ◽

pp. 544-546

Author(s):

Stephen R. Spindler

Keyword(s):

Health Care ◽

Health Care Costs ◽

Baby Boom ◽

Health Care Spending ◽

Short Term ◽

Age Related ◽

The Government ◽

Effects Of Aging ◽

Care Costs ◽

The U.S

According to government figures, total health care spending in the U.S. in 1999 was $1.316 trillion. The government projects an increase in health care costs to $2.176 trillion by 2008. If we project this growth rate to 2020, health care costs will reach $4.009 trillion. Today, people often spend more health care dollars during the last year of their lives than in all previous years combined. Medical treatment in the last few years of life is usually very expensive and often futile. With the baby-boom generation now moving through middle age, the prescription for the U.S. health care system will be disastrous unless we learn how to keep people healthier longer. This dramatic increase in health care costs leaves us with only one acceptable alternative to rationed health care or financial ruin — to discover interventions that make people functionally younger, healthier, and less susceptible to debilitating, age-related diseases.

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Health care costs of injury in the older population: a prospective multicentre cohort study in the Netherlands

BMC Geriatrics ◽

10.1186/s12877-020-01825-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Marjolein van der Vlegel ◽

Juanita A. Haagsma ◽

A. J. L. M. Geraerds ◽

Leonie de Munter ◽

Mariska A. C. de Jongh ◽

...

Keyword(s):

Health Care ◽

The Netherlands ◽

Health Care Costs ◽

Injury Severity ◽

Hospital Costs ◽

Health Care Use ◽

Trauma Patients ◽

Ageing Population ◽

Older Population ◽

Care Costs

Abstract Background With the ageing population, the number of older trauma patients has increased. The aim of this study was to assess non-surgical health care costs of older trauma patients and to identify which characteristics of older trauma patients were associated with high health care costs. Methods Trauma patients aged ≥65 years who were admitted to a hospital in Noord-Brabant, the Netherlands, were included in the Brabant Injury Outcome Surveillance (BIOS) study. Non-surgical in-hospital and up to 24- months post-hospital health care use were obtained from hospital registration data and collected with the iMTA Medical Consumption Questionnaire which patients completed 1 week and 1, 3, 6, 12 and 24 months after injury. Log-linked gamma generalized linear models were used to identify cost-driving factors. Results A total of 1910 patients were included in the study. Mean total health care costs per patient were €12,190 ranging from €8390 for 65–69 year-olds to €15,550 for those older than 90 years. Main cost drivers were the post-hospital costs due to home care and stay at an institution. Falls (72%) and traffic injury (15%) contributed most to the total health care costs, although costs of cause of trauma varied with age and sex. In-hospital costs were especially high in patients with high injury severity, frailty and comorbidities. Age, female sex, injury severity, frailty, having comorbidities and having a hip fracture were independently associated with higher post-hospital health care costs. Conclusions In-hospital health care costs were chiefly associated with high injury severity. Several patient and injury characteristics including age, high injury severity, frailty and comorbidity were associated with post-hospital health care costs. Both fall-related injuries and traffic-related injuries are important areas for prevention of injury in the older population.

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Health Care Utilisation and Attitudes towards Health Care in Subjects Reporting Environmental Annoyance from Electricity and Chemicals

Journal of Environmental and Public Health ◽

10.1155/2009/106389 ◽

2009 ◽

Vol 2009 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Frida Eek ◽

Juan Merlo ◽

Ulf Gerdtham ◽

Thor Lithman

Keyword(s):

Health Care ◽

General Population ◽

Health Care Costs ◽

Well Being ◽

Health Care Utilisation ◽

Subjective Well Being ◽

Health Care Consumption ◽

Negative Attitudes ◽

Care Utilisation ◽

Care Costs

Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT).Methods. Postal questionnaire (n= 13 604) and record linkage with population-based register on health care costs.Results. Despite significantly lower subjective well being and health than both the general population and HT group, the environmentally annoyed subjects had lower health care costs than the hypertension group. In contrast to the hypertension group, the environmentally annoyed subjects expressed more negative attitudes toward the health care than the general population.Conclusions. Despite their impaired subjective health and functional capacity, health care utilisation costs were not much increased for the environmentally annoyed group. This may partly depend on negative attitudes towards the health care in this group.

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Differences in Health Care Use and Costs Among Patients With Cancer Receiving Intravenous Chemotherapy in Physician Offices Versus in Hospital Outpatient Settings

Journal of Oncology Practice ◽

10.1200/jop.2016.012930 ◽

2017 ◽

Vol 13 (1) ◽

pp. e37-e46 ◽

Cited By ~ 10

Author(s):

Maxine D. Fisher ◽

Rajeshwari Punekar ◽

Yeun Mi Yim ◽

Arthur Small ◽

Joseph R. Singer ◽

...

Keyword(s):

Health Care ◽

Health Care Costs ◽

Metastatic Breast ◽

Health Care Use ◽

Lymphocytic Leukemia ◽

Charlson Comorbidity Index Score ◽

Hospital Outpatient ◽

Patients With Cancer ◽

Outpatient Settings ◽

Care Costs

Purpose: The current shift in site of care from community oncology practices to the hospital outpatient department to deliver oncology services may have significant implications for the economic and clinical outcomes of cancer care. Therefore, this study compares health care use and costs among patients with cancer receiving intravenous (IV) chemotherapy in physician offices (PO) versus in hospital outpatient settings (HOP). Methods: This retrospective study, which was based on medical and pharmacy claims data, included patients (age, 18 to 64 years) initiating IV chemotherapy/biologic treatment between January 1, 2006, and August 31, 2012, who were diagnosed with early or metastatic breast cancer, metastatic lung cancer, metastatic colorectal cancer, or non-Hodgkin lymphoma or chronic lymphocytic leukemia. Patients were assigned to PO or HOP groups on the basis of where they received > 95% of their IV cancer therapy. Results: The study sample included 18,740 patients (12,899 PO; 5,841 HOP) who had a mean age of 51.6 years and a Deyo-Charlson Comorbidity Index score of 5.37. Overall office visits (21.8 ± 13.8 PO v 21.2 ± 12.9, P < .005) and outpatient services (50.8 ± 35.5 PO v 48.5 ± 33.6, P < .001) were higher in the PO group than in the HOP group. Cancer-related inpatient hospitalizations (0.6 ± 1.2 PO v 0.7 ± 1.4 HOP, P = .002) were lower in the PO group than in the HOP group. Although quality-of-care metrics were similar between the HOP and PO groups, follow-up all-cause costs ($82,773 PO v $122,473 HOP) and cancer-related health care costs ($69,037 PO v $108,177 HOP) were higher in the HOP group than in the PO group. Conclusion: Despite similar resource use, all-cause and cancer-related health care costs in HOP were significantly higher compared with those in PO settings.

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