scholarly journals Direct medical costs of hospitalized patients with idiopathic pulmonary fibrosis in China

2019 ◽  
Author(s):  
Xiaofen Zheng ◽  
Bingbing Xie ◽  
Yan Liu ◽  
Ming Zhu ◽  
Shu Zhang ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Economic Burden ◽  
Medical Costs ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
Direct Medical Costs ◽  
Hospitalization Costs ◽  
The Mean

AbstractBackgroundIdiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia of unknown cause. The incidence of IPF is increasing year by year, as well as the mortality rates, which is really a burden both for the family and the society. However few data concerning the economic burden of the patients with IPF is available, especially in China.ObjectiveThis study aimed to examine the direct medical costs of hospitalized patients with IPF and to determine the contributing factors.MethodsThis retrospective analysis used the cost-of-illness framework in order to analyze the direct medical costs of patients with IPF. The study used data from the pneumology department of Beijing Chao-Yang Hospital affiliated to Capital Medical University from year 2012 to 2015. The direct medical costs included drug fee, auxiliary examination fee, treatment fee and other fee. Patients’ characteristics, medical treatment, and the direct medical costs were analyzed by descriptive statistics and multivariable regression.ResultsThere were 219 hospitalized patients meeting the diagnosis of IPF, 91% male. The mean age was 65 years old. For the direct medical costs of hospitalized patients with IPF, the mean(SD) of the total costs per IPF patient per admission was 14882.3 (30975.8)CNY. The largest parts were the examination fee of 6034.5 (15651.2)CNY and the drug fee of 5048.9 (3855.1)CNY. By regression analysis we found that length of stay, emergency treatment, ventilator use and being a Beijing native were significantly (P<0.05) associated with total hospitalization costs, and the length of stay had the biggest impact. Complications or comorbidities contributated to the direct medical costs as follows: respiratory failure with 30898.3CNY (P=0.004), pulmonary arterial hypertension(PAH) with 26898.2CNY (P=0.098), emphysema with 25368.3CNY (P=0.033), and high blood pressure with 24659.4CNY (P=0.026). Using DLCO or DLCO% pred to reflect the severity of IPF, there was no significant correlation between DLCO or DLCO% pred and patients’ direct medical costs. While, the worse the diffusion function, the higher the drug fee.ConclusionThis study showed that IPF has a major impact on the direct medical costs. Thus, appropriate long-term interventions are recommended to lower the economic burden of IPF.Strengths and limitations of this studyIt was the first time in China to discuss the economic burden of diseases and its influencing factors in patients with IPF.The results of this study might be of reference for the establishment of IPF disease-related medical policies in future.The retrospective cross-sectional design does not allow for establishing any causal relationships.It was a a single-center study, resulting a slightly smaller sample size. A large sample of multicenter studies is needed to confirm this.

scholarly journals Direct medical costs of hospitalized patients with idiopathic pulmonary fibrosis in a tertiary hospital in China

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Xiao-Fen Zheng ◽  
Bing-Bing Xie ◽  
Yan Liu ◽  
Ming Zhu ◽  
Shu Zhang ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Medical Costs ◽  
Tertiary Hospital ◽  
Hospitalized Patients ◽  
Direct Medical Costs

scholarly journals How do type 2 diabetes mellitus (T2DM)-related complications and socioeconomic factors impact direct medical costs? A cross-sectional study in rural Southeast China

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e020647 ◽  
Author(s):  
Haibin Wu ◽  
Karen N Eggleston ◽  
Jieming Zhong ◽  
Ruying Hu ◽  
Chunmei Wang ◽  
...  
Keyword(s):  
Socioeconomic Factors ◽  
Diabetes Management ◽  
Medical Costs ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Total Cost ◽  
Direct Medical Costs ◽  
The Mean

ObjectiveTo evaluate type 2 diabetes mellitus (T2DM)-related direct medical costs by complication type and complication number, and to assess the impacts of complications as well as socioeconomic factors on direct medical costs.DesignA cross-sectional study using data from the region’s diabetes management system, social security system and death registry system, 2015.SettingTongxiang, China.ParticipantsIndividuals diagnosed with T2DM in the local diabetes management system, and who had 2015 insurance claims in the social security system. Patients younger than 35 years and patients whose insurance type changed in the year 2015 were excluded.Main outcome measuresThe mean of direct medical costs by complication type and number, and the percentage increase of direct medical costs relative to a reference group, considering complications and socioeconomic factors.ResultsA total of 19 015 eligible individuals were identified. The total cost of patients with one complication was US$1399 at mean, compared with US$248 for patients without complications. The mean total cost for patients with 2 and 3+ complications was US$1705 and US$2994, respectively. After adjustment for socioeconomic confounders, patients with one complication had, respectively, 83.55% and 38.46% greater total costs for inpatient and outpatient services than did patients without complications. The presence of multiple complications was associated with a significant 44.55% adjusted increase in total outpatient costs, when compared with one complication. Acute complications, diabetic foot, stroke, ischaemic heart disease and diabetic nephropathy were the highest cost complications. Gender, age, education level, insurance type, T2DM duration and mortality were significantly associated with increased expenditures of T2DM.ConclusionsComplications significantly aggravated expenditures on T2DM. Specific kinds of complications and the presence of multiple complications are correlated with much higher expenditures. Proper management and the prevention of related complications are urgently needed to reduce the growing economic burden of diabetes.

scholarly journals Frequency of hospitalization of infants with bronchiolitis during 2017 in Puerto Madryn, Argentina

2021 ◽  
Author(s):  
Damián L. Taire ◽  
Bruno A. Pazos
Keyword(s):  
Length Of Stay ◽  
Hospital Readmissions ◽  
Basic Needs ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Place Of Origin ◽  
The Mean ◽  
Hospital Administrative

ABSTRACTIntroductionBronchiolitis is considered the most frequent disease in infants and still represents an important cause of morbidity and mortality worldwide. Despite its viral etiology, socioeconomic variables could influence the disease outcome. We aimed to determine the frequency of hospital discharge for bronchiolitis in a local Hospital in the city of Puerto Madryn, in the province of Chubut, Patagonia Argentina.Population and methodsWe performed a cross-sectional study that analyzed all hospitalized patients discharged for bronchiolitis in Hospital “Dr. Andrés R. Isola” during the year 2017 and based on data provided by the hospital administrative staff. The study variables were the length of stay, readmission rate and place of origin of hospitalized patients.ResultsA total of 120 patients were included. The median age was 4.45 months (3.9-5). The mean length-of-stay (LOS) was 7.30 days (5.52-9.08). Of the total number of patients, 24 (20%) had a LOS ≤3 days and 96 (80%) a >3 days. One hundred patients (88.33%) had no hospital readmissions and 10 patients (8.33%) had hospital readmissions. The median age of patients with readmissions was 4.2 months (2.69-5.71). The mean LOS during readmission was 17.3 days (5.25-29.35). Of the 120 hospitalized children, 100 infants (83.33%) live in areas identified as having “unsatisfied basic needs” in Puerto Madryn.ConclusionsThe overcrowding as a result of the demographic transformation on the frequency of hospitalization of infants with bronchiolitis was homogeneous within the Puerto Madryn population with “unsatisfied basic needs”.

scholarly journals Economic Burden of Gastric Cancer: A Case of Iran

2019 ◽  
Vol 26 (1) ◽  
pp. 107327481983718 ◽  
Author(s):  
Abed Eghdami ◽  
Rahim Ostovar ◽  
Abdosaleh Jafari ◽  
Andrew J. Palmer ◽  
Najmeh Bordbar ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Economic Burden ◽  
Insurance Coverage ◽  
Indirect Costs ◽  
Medical Costs ◽  
Cross Sectional ◽  
Direct Medical Costs ◽  
Illness Study ◽  
Therapeutic Services ◽  
Collection Form

Purpose: Today, cancers have become a major cause of mortality in developed and developing countries. Among various cancers, gastric cancer imposes a huge economic burden on patients, their families, and on the health-care system. This study aimed to determine the economic burden of gastric cancer in Kohgiluyeh and Boyer Ahmad province of Iran in 2016. Methods: This was a cross-sectional cost of illness study conducted in Kohgiluyeh and Boyer Ahmad province of Iran in 2016, using a prevalence-based approach. All patients were studied using the census method (N = 110). The required data on direct medical, direct nonmedical, and indirect costs were collected using a data collection form from the patients’ medical records, tariffs of diagnostic, and therapeutic services approved by the Ministry of Health and Medical Education in 2016. Results: The total cost and burden of gastric cancer in Kohgiluyeh and Boyer Ahmad province of Iran in 2016 were $US436 237, among which the majority were direct medical costs (59%). The highest costs among direct medical costs, direct nonmedical costs, and indirect costs were, respectively, related to the costs of medications used by the patients (35%), transportation (31%), and absence of patients’ families from work and daily activities caused by patient care (56%). Conclusion: Our study has revealed for the first time high costs of gastric cancer in Iran. To decrease the total costs and burden, the following suggestions can be made: increasing insurance coverage and government subsidies for purchasing necessary medications, providing the required specialized care and services related to cancer diseases such as gastric cancer in other provincial cities rather than just in capital cities, and so on.

scholarly journals Downregulation of exosomal let-7d and miR-16 in idiopathic pulmonary fibrosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Donato Lacedonia ◽  
Giulia Scioscia ◽  
Piera Soccio ◽  
Massimo Conese ◽  
Lucia Catucci ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Therapy Response ◽  
Down Regulation ◽  
Cross Sectional ◽  
Exosomal Mirnas ◽  
Different Types ◽  
Sectional Analysis ◽  
Made In

Abstract Background Idiopathic Pulmonary Fibrosis (IPF) is a degenerative interstitial lung disease with both a poor prognosis and quality of life once the diagnosis is made. In the last decade many features of the disease have been investigated to better understand the pathological steps that lead to the onset of the disease and, moreover, different types of biomarkers have been tested to find valid diagnostic, prognostic and therapy response predictive ones. In the complexity of IPF, microRNA (miRNAs) biomarker investigation seems to be promising. Methods We analysed the expression of five exosomal miRNAs supposed to have a role in the pathogenesis of the disease from serum of a group of IPF patients (n = 61) and we compared it with the expression of the same miRNAs in a group of healthy controls (n = 15). Results In the current study what emerged is let-7d down-regulation and, unexpectedly, miR-16 significant down-regulation. Moreover, through a cross-sectional analysis, a clustering of the expression of miR-16, miR-21 and miR-26a was found. Conclusions These findings could help the individuation of previously unknown key players in the pathophysiology of IPF and, most interestingly, more specific targets for the development of effective medications.

scholarly journals Comparison of healthcare resource utilization and medical costs between patients with seropositive and seronegative rheumatoid arthritis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110248
Author(s):  
Hyoungyoung Kim ◽  
Soo-Kyung Cho ◽  
Seongmi Choi ◽  
Seul Gi Im ◽  
Sun-Young Jung ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Quantile Regression ◽  
Healthcare Utilization ◽  
Medical Costs ◽  
Healthcare Resource Utilization ◽  
Medical Utilization ◽  
Cross Sectional ◽  
Direct Medical Costs ◽  
Using Data ◽  
Sectional Analysis

Objectives: To compare healthcare utilization and medical costs between patients with seronegative (SN) and seropositive (SP) rheumatoid arthritis (RA). Methods: We conducted a nationwide population study using the Korean health insurance claims database in 2016. We divided patients with RA into SN and SP groups and compared healthcare utilization including medications, medical utilization, and direct medical costs for 1 year between the groups in a cross-sectional analysis. Differences in costs between patients with SPRA and SNRA were assessed using the quantile regression model. We performed longitudinal analysis using data from 2012 and 2016 to examine changes over time. Results: A total of 103,815 SPRA and 75,809 SNRA patients were included in the analyses. The SPRA group used significantly more methotrexate (73.2% versus 30.3%) and biologic agents (7.9% versus 2.9%) than the SNRA group. The number of RA-related outpatient visits [6.0 ± 3.7 versus 4.4 ± 4.0 times/year, standardized difference (SD) = 0.41] and annual medical costs per patient ($1027 versus $450/year, SD = 0.25) were higher in the SPRA group than the SNRA group. Quantile regression results indicated that the incremental cost of seropositivity on total medical costs of RA patients gradually increased as medical costs approached the upper quantile. The annual direct medical costs for each patient between 2012 and 2016 increased in both groups: by 25.1% in the SPRA group and 37.6% in the SNRA group. Conclusion: Annual RA-related direct medical costs and RA-related healthcare utilization per patient are higher in patients with SPRA than those with SNRA.

scholarly journals Estimation and determinants of direct medical costs of ischaemic heart disease, stroke and hypertensive heart disease: evidence from two major hospitals in Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leopold Ndemnge Aminde ◽  
Anastase Dzudie ◽  
Yacouba N. Mapoure ◽  
Jacques Cabral Tantchou ◽  
J. Lennert Veerman
Keyword(s):  
Diabetes Mellitus ◽  
Heart Disease ◽  
Ischaemic Stroke ◽  
Ischaemic Heart Disease ◽  
Economic Burden ◽  
Hypertensive Heart Disease ◽  
Haemorrhagic Stroke ◽  
Medical Costs ◽  
Communicable Diseases ◽  
Direct Medical Costs

Abstract Background Cardiovascular disease (CVD) is the largest contributor to the non-communicable diseases (NCD) burden in Cameroon, but data on its economic burden is lacking. Methods A prevalence-based cost-of-illness study was conducted from a healthcare provider perspective and enrolled patients with ischaemic heart disease (IHD), ischaemic stroke, haemorrhagic stroke and hypertensive heart disease (HHD) from two major hospitals between 2013 and 2017. Determinants of cost were explored using multivariate generalized linear models. Results Overall, data from 850 patients: IHD (n = 92, 10.8%), ischaemic stroke (n = 317, 37.3%), haemorrhagic stroke (n = 193, 22.7%) and HHD (n = 248, 29.2%) were analysed. The total cost for these CVDs was XAF 676,694,000 (~US$ 1,224,918). The average annual direct medical costs of care per patient were XAF 1,395,200 (US$ 2400) for IHD, XAF 932,700 (US$ 1600) for ischaemic stroke, XAF 815,400 (US$ 1400) for haemorrhagic stroke, and XAF 384,300 (US$ 700) for HHD. In the fully adjusted models, apart from history of CVD event (β = − 0.429; 95% confidence interval − 0.705, − 0.153) that predicted lower costs in patients with IHD, having of diabetes mellitus predicted higher costs in patients with IHD (β = 0.435; 0.098, 0.772), ischaemic stroke (β = 0.188; 0.052, 0.324) and HHD (β = 0.229; 0.080, 0.378). Conclusions This study reveals substantial economic burden due to CVD in Cameroon. Diabetes mellitus was a consistent driver of elevated costs across the CVDs. There is urgent need to invest in cost-effective primary prevention strategies in order to reduce the incidence of CVD and consequent economic burden on a health system already laden with the impact of communicable diseases.

scholarly journals Initial therapeutic dose of corticosteroid for an acute exacerbation of IPF is associated with subsequent early recurrence of another exacerbation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ryo Yamazaki ◽  
Osamu Nishiyama ◽  
Sho Saeki ◽  
Hiroyuki Sano ◽  
Takashi Iwanaga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Therapeutic Dose ◽  
Early Recurrence ◽  
Time To Recurrence ◽  
Acute Exacerbations ◽  
Patient Groups ◽  
The Mean ◽  
Mean Time

AbstractSome patients with idiopathic pulmonary fibrosis (IPF) undergo recurrent acute exacerbations (AEs). This study aimed to elucidate the risk factors for recurrent AEs of IPF (AE-IPF). Consecutive patients with IPF admitted for their first AE-IPF between January 2008 and December 2018 were retrospectively recruited. Of 63 patients admitted for an AE-IPF and discharged alive, 9 (14.3%) developed a recurrence of AE within 1 year. The mean time to recurrence was 233 ± 103 days. Total doses (mg/month and mg/kg/month) of corticosteroids administered over day 1 to 30 after the AE were significantly higher in patients without recurrences of AE-IPF (5185 ± 2414 mg/month, 93.5 ± 44.0 mg/kg/month) than the doses in patients with recurrences (3133 ± 1990 mg/month, 57.2 ± 37.7 mg/kg/month) (p = 0.02 and p = 0.03, respectively). However, no differences were observed between the total doses of corticosteroids administered over days 31 to 60, 61 to 90, 91 to 120, and 151 to 180 after the AE. Furthermore, differences between the administration rates of immunosuppressive and antifibrotic treatments administered to the 2 patient groups were not significant. An increased total dose of corticosteroid administered over day 1 to 30 after an AE-IPF was associated with a decreased risk of subsequent recurrence of AE-IPF within 1 year after the first AE.

scholarly journals AB1190 DIRECT MEDICAL COSTS OF HOSPITALIZATION DURING THE MAINTENANCE THERAPY IN PATIENTS WITH ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS USING JAPANESE HEALTH INSURANCE DATABASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1885.2-1886
Author(s):  
R. Sakai ◽  
E. Tanaka ◽  
M. Harigai
Keyword(s):  
Health Insurance ◽  
Maintenance Therapy ◽  
Medical Costs ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Research Support ◽  
Chugai Pharmaceutical ◽  
Direct Medical Costs ◽  
The Mean ◽  
Health Insurance Database ◽  
Insurance Database

Background:Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) requires a long-term maintenance therapy (MT), often accompanied by hospitalization due to relapse and/or comorbidities such as infection1. However, data about direct medical costs of hospitalization during MT in patients with AAV is limited to date despite of an increasing concern about the economic burden of patients with AAV2-3.Objectives:To describe frequency of hospitalization and its direct medical costs during MT after the remission-induction therapy (RT) in patients with AAV using Japanese health insurance database.Methods:This retrospective longitudinal population-based study was conducted using claims data in Japan provided by Medical Data Vision Co., Ltd. We defined individuals as AAV cases receiving RT if they met all of the following: 1) having at least one ICD10 code (M300, M301, M313, or M318); 2) having at least one prescription of oral corticosteroids with prednisolone-equivalent dosage ≥30 mg/day, methylprednisolone pulse therapy, immunosuppressive drugs (cyclophosphamide [IVCY], methotrexate, or mycophenolate mofetil), or rituximab (RTX) during hospitalization between April 2008 and April 2017; and 3) having at least 7 days of hospitalization. The observation started from the next day of discharge from the first hospitalization for RT and ended at 24 months later, the month of loss of follow-up, or April 2017. We described the frequency of hospitalization and calculated direct medical costs (per month) during the observation. We analyzed medical costs from a societal perspective. We classified reasons of hospitalization into 3 categories; intensification of treatments for AAV, AAV MT including IVCY or RTX treatments, and comorbidities (infection, cardiovascular disease [CVD], malignancy, and others) using ICD10 codes plus treatments or interventions during the hospitalization.Results:In this study, 1,703 patients with AAV were included. The median [IQR] age was 72 [63, 79] years and 55.7% were female. The total number of hospitalization was 1,897 in 863 patients (50.7%). Among the hospitalizations, 296 hospitalization in 235 patients were categorized as intensification of treatments for AAV, 627 hospitalization in 297 patients were AAV MT, and 974 hospitalization in 572 patients were categorized as comorbidities. In the last category, infections were most frequent (220), followed by malignancy (54) and CVD (15). The mean direct medical costs per month was 20,945 EUR (1 EUR=125 JPY) in patients with hospitalization and 599 EUR in those without. Patients with hospitalization due to intensification of treatments for AAV had the highest direct medical costs (3,000 EUR), followed by those with hospitalization due to comorbidities (2,001 EUR), and those with hospitalization due to AAV MT (1,649 EUR).Conclusion:More than half of the patients had hospitalization during MT, and hospitalization due to comorbidities were most frequent. The mean direct medical costs in patients with at least one hospitalization was approximately 3.5 times as high as that in those without hospitalization.References:[1]Presse Med. 2015; 44:e251-e257[2]J. Rheumatol. 2015; 42:2383-91[3]Clin Exp Rheumatol.2019:137-43Acknowledgments:This work was supported by AMED under Grant Number JP17ek0109121.Disclosure of Interests:Ryoko Sakai Grant/research support from: Tokyo Women’s Medical University (TWMU) has received unrestricted research grants forDivision of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases from Ayumi Pharmaceutical Co. Ltd., Bristol Meyers Squib, Chugai Pharmaceutical Co. Ltd., Nippon Kayaku Co. Ltd., Taisho Toyama Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corp., and with which TWMU paid the salary of R.S., Eiichi Tanaka Consultant of: ET has received lecture fees or consulting fees from Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., Speakers bureau: ET has received lecture fees or consulting fees from Abbvie, Asahi Kasei pharma co., Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo Co., Eisai Pharmaceutical, Janssen Pharmaceutical K.K., Nippon Kayaku, Pfizer, Takeda Pharmaceutical, Taisho Toyama Pharmaceutical Co., and UCB Pharma., masayoshi harigai Grant/research support from: AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Nippon Kayaku Co., Ltd., and Teijin Pharma Ltd. MH has received speaker’s fee from AbbVie Japan GK, Ayumi Pharmaceutical Co., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., GlaxoSmithKline K.K., Kissei Pharmaceutical Co., Ltd., Oxford Immuotec, Pfizer Japan Inc., and Teijin Pharma Ltd. MH is a consultant for AbbVie, Boehringer-ingelheim, Kissei Pharmaceutical Co., Ltd. and Teijin Pharma.

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