scholarly journals Association of opioid use disorder with healthcare utilization and cost in a public health system

2021 ◽  
Author(s):  
Oren Miron ◽  
Noam Barda ◽  
Ran Balicer ◽  
Ariel Kor ◽  
Shaul Lev-Ran
Keyword(s):  
Public Health ◽  
Health System ◽  
Healthcare Cost ◽  
Healthcare Costs ◽  
Public Health System ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Public Healthcare ◽  
Opioid Use ◽  
Cost Difference

Background and objectives: To quantify the healthcare costs associated with opioid use disorder among members in a public healthcare system, and compare them to healthcare costs in the general population. Methods: Retrospective cohort study in inpatient and outpatient care settings of Israel's largest public healthcare provider (that covers 4.7 million members). Participants included 1,173 members who had a diagnosis of opioid use disorder in the years between 2013 and 2018. Each patient was matched with 10 controls based on age and sex. The main outcome was monthly healthcare costs. Results: The mean monthly healthcare cost of members with opioid use disorder was $1,102 compared to $211 among controls (5.2-fold difference; 95% confidence interval [CI]: 4.6-6.0). After excluding members with heroin related diagnoses before the index date (in order to focus on prescription opioids), this healthcare cost ratio did not substantially change (4.6-fold; 95%-CI: 3.9-5.4). Members with opioid use disorder under the age of 65 years had a cost difference of 6.1-fold (95%-CI: 5.2-7.1), while those 65 years and older experienced cost difference of 3.4-fold (95%-CI: 2.6-4.5). The category with the highest cost for members with opioid use disorder was inpatient services, which was 8.7-fold (95%-CI 7.2-10.4) greater than among controls. Conclusions: Healthcare costs among individuals with opioid use disorder in a public health system were substantially higher than among controls, at least partially attributed to prescription opioid use disorder. Differences were greater among individuals younger than 65 years, highlighting the importance of preventing and treating opioid use disorder among younger adult populations.

scholarly journals Social Stigma Toward Persons With Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health–Oriented Policies

2017 ◽  
Vol 68 (5) ◽  
pp. 462-469 ◽  
Author(s):  
Alene Kennedy-Hendricks ◽  
Colleen L. Barry ◽  
Sarah E. Gollust ◽  
Margaret E. Ensminger ◽  
Margaret S. Chisolm ◽  
...  
Keyword(s):  
Public Health ◽  
Social Stigma ◽  
Public Support ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Prescription Opioid Use

scholarly journals Risk Factors and Diagnosis of Diabetic Foot Ulceration in Users of the Brazilian Public Health System

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Hígor Chagas Cardoso ◽  
Ana Laura de Sene Amâncio Zara ◽  
Suélia de Siqueira Rodrigues Fleury Rosa ◽  
Gabriel Alves Rocha ◽  
João Victor Costa Rocha ◽  
...  
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Health System ◽  
Diabetic Foot ◽  
Soft Tissues ◽  
Public Health System ◽  
Public Healthcare ◽  
Cross Sectional ◽  
Foot Ulceration ◽  
Chi Squared

Background. An individual with diabetes mellitus (DM) has an approximately 25% risk of developing ulcerations and/or destruction of the feet’s soft tissues. These wounds represent approximately 20% of all causes of hospitalizations due to DM. Objective. To identify the factors for the development of diabetic foot ulceration (DFU) among individuals treated by the Brazilian public health system. Methods. This cross-sectional study was conducted on individuals with diabetes mellitus, aged above 18 years, of both sexes, and during July-October 2018 within a public healthcare unit in Brazil. All participants were assessed based on their socioeconomic, behavioral, and clinical characteristics, along with vascular and neurological evaluations. All participants were also classified according to the classification of risk of developing DFU, in accordance with the International Working Group on the Diabetic Foot (IWGDF). Statistical analyses were conducted using the chi-squared test, chi-squared test for trend, and Fisher’s exact test, with a significance level of 5% (p<0.05). Results. The study consisted of 85 individuals. The DFU condition was prevalent in 10.6% of the participants. Adopting the classification proposed by IWGDF, observed risks for stratification categories 0, 1, 2, and 3 were 28.2%, 29.4%, 23.5%, and 8.2%, respectively. A statistically significant (p<0.05) association was observed between the development of DFU and the following variables: time since the diagnosis of diabetes and the appearance of the nails, humidity, and deformations on the feet. Conclusion. The present study found an elevated predominance of DM patients in the Brazilian public health system (SUS) featuring cutaneous alterations that may lead to ulcers; these individuals had elevated risks of developing DFU. Furthermore, it was revealed that the feet of patients were not physically examined during treatment.

Implications for Poor Public Healthcare System of South Korea Revealed in MERS Outbreak

2018 ◽  
Vol 9 (4) ◽  
pp. 20-28
Author(s):  
MyungHee Kim
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health System ◽  
Healthcare System ◽  
Community Health Centers ◽  
Public Health System ◽  
Health Centers ◽  
Public Healthcare ◽  
Public Healthcare System ◽  
The Public

This article aims to prevent the possible recurrence of the Middle East Respiratory Syndrome (MERS) by understanding the status of South Korea's public healthcare system through a literature review. In addition, it presents measures to reinforce the public health system by analyzing the roles and limitations of the health authority, which plays a key role in preventing the spread of this infectious disease, through their response to the recent MERS outbreak in the country. Based on the analysis, the results showed the following implications: (1) Community health centers need to expand and reinforce their functions. It is important to publish response manuals at the national level and regularly educate and train medical service providers on infectious disease control, especially against diseases such as MERS. Accordingly, manpower and facilities must be developed. (2) Public hospitals located in regional hubs must expand to establish a public healthcare system. Public healthcare and emergency healthcare systems should be established by connecting community health centers, regional hub hospitals, and national university hospitals. The improvements in the facility must to be supported to help increase the efficiency of public health system. (3) Awareness among people must increase with respect to the prevention of infectious diseases and managing direct contact with infected patients. Most importantly, education and training on infectious disease prevention must be regularly provided to the public, and social support systems and programs must be organized for the infected people who are in self-isolation.

scholarly journals Age-related macular degeneration and resource utilization in the Brazilian public healthcare system: a real-world retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liane Touma-Falci ◽  
Carlos Augusto Moreira-Neto ◽  
Alexandre Chater Taleb ◽  
Marcela Bach Prieto ◽  
Thais Packer ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Macular Degeneration ◽  
Resource Utilization ◽  
Real World ◽  
Public Health System ◽  
Age Related Macular Degeneration ◽  
Public Healthcare ◽  
Antiangiogenic Treatment ◽  
Age Related

Abstract Background Age-related macular degeneration (AMD) is a disease that causes damage in the macular region of the retina, leading to irreversible blindness. This study aims to understand the profile and care of patients with AMD and its cost at the Brazilian public health system to identify AMD-care needs. Methods This is a retrospective observational study of AMD with real-world data from the Brazilian public healthcare system, using DATASUS claim databases. Patients with AMD were selected from 01/Jan/2014 to 31/Jan/2020; had at least one claim of ICD10 code H35.3 (Degeneration of macula and posterior pole), and were submitted to one of two procedures exclusively available for AMD patients - optical coherence tomography (OCT) and medical treatment of retinal disease (antiangiogenic); aged ≥18 years at first ICD10 claim, and presenting at least 1 year of follow-up in the database. We described patients’ characteristics, healthcare resource utilization and cost, and the antiangiogenic intravitreal treatment received by AMD patients, including the number of doses and interval time between them. Results Patients searching for AMD treatment since 2014 were mostly females (59%), white (61%), and a mean age of 72 years. They were mainly located in the Southeast (87%), and few patients were found in the North (1%) and Central-West (1.5%) regions, probably reflecting where the Brazilian guideline to treat AMD (Protocolo Clínico e Diretrizes Terapêuticas - PCDT) was incorporated as routine care for AMD. The average antiangiogenic dose of 2.5 antiangiogenic therapies within a year was below the expected. Most injections had an interval time of 20 to 40 days between doses, although some patients were treated more than 100 days. Another setback is that patients traveled longer distances for OCT and antiangiogenic treatment than overall AMD-healthcare, between 10 and 100 km. Conclusions AMD patients seem to be undertreated, as they receive a mean of 2.5 doses of antiangiogenic treatment within a year. Inequalities among regions are evident, as the Southeast and South regions comprise almost all patients receiving the treatment from the public health system, probably reflecting the region with more access to AMD care according to PCDT recommendations.

India as a Pioneer of Innovation

2018 ◽  
Keyword(s):  
Public Health ◽  
Health System ◽  
Informal Economy ◽  
Urban Poor ◽  
Public Health System ◽  
Low Cost ◽  
Social Enterprises ◽  
Specific Context ◽  
Innovation Project ◽  
Context Specific

What does innovation mean to and in India? What are the predominant areas of innovation for India, and under what situations do they succeed or fail? This book addresses these all-important questions arising within diverse Indian contexts: informal economy, low-cost settings, large business groups, entertainment and copyright-based industries, an evolving pharma sector, a poorly organized and appallingly underfunded public health system, social enterprises for the urban poor, and innovations for the millions. It explores the issues that promote and those that hinder the country’s rise as an innovation leader. The book’s balanced perspective on India’s promises and failings makes it a valuable addition for those who believe that India’s future banks heavily on its ability to leapfrog using innovation, as well as those sceptical of the Indian state’s belief in the potential of private enterprise and innovation. It also provides critical insights on innovation in general, the most important of which being the highly context-specific, context-driven character of the innovation project.

scholarly journals Epidemic of plague amidst COVID-19 in Madagascar: efforts, challenges, and recommendations

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Abdullahi Tunde Aborode ◽  
Ana Carla dos Santos Costa ◽  
Anmol Mohan ◽  
Samarth Goyal ◽  
Aishat Temitope Rabiu ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Healthcare Sector ◽  
The Face ◽  
Endemic Areas

AbstractThe plague has been wreaking havoc on people in Madagascar with the COVID-19 pandemic. Madagascar’s healthcare sector is striving to respond to COVID-19 in the face of a plague outbreak that has created a new strain on the country’s public health system. The goal and activities of the gradual epidemic of plague in Madagascar during COVID-19 are described in this research. In order to contain the plague and the COVID-19 pandemic in this country, we have suggested long-term recommendations that can help to contain the outbreak so that it may spread to non-endemic areas.

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