scholarly journals Household economic burden of childhood severe pneumonia in Bangladesh: a cost-of-illness study

2021 ◽  
pp. archdischild-2020-320834
Author(s):  
Marufa Sultana ◽  
Nur H Alam ◽  
Nausad Ali ◽  
A S G Faruque ◽  
George J Fuchs ◽  
...  
Keyword(s):  
Cost Of Illness ◽  
Economic Burden ◽  
Management Strategies ◽  
Productivity Loss ◽  
Severe Pneumonia ◽  
Health Facilities ◽  
Hospital Length Of Stay ◽  
Income Quintile ◽  
The Mean ◽  
Household Cost

ObjectiveTo estimate household cost of illness (COI) for children with severe pneumonia in Bangladesh.DesignAn incidence-based COI study was performed for one episode of childhood severe pneumonia from a household perspective. Face-to-face interviews collected data on socioeconomic, resource use and cost from caregivers. A micro-costing bottom-up approach was applied to calculate medical, non-medical and time costs. Multiple regression analysis was applied to explore the factors associated with COI. Sensitivity analysis explored the robustness of cost parameters.SettingFour urban and rural study sites from two districts in Bangladesh.PatientsChildren aged 2–59 months with severe pneumonia.Results1472 children with severe pneumonia were enrolled between November 2015 and March 2019. The mean age of children was 12 months (SD ±10.2) and 64% were male. The mean household cost per episode was US$147 (95% CI 141.1 to 152.7). Indirect costs were the main cost drivers (65%, US$96). Household costs for the poorest income quintile were lower in absolute terms, but formed a higher proportion of monthly income. COI was significantly higher if treatment was received from urban health facilities compared with rural health facilities (difference US$84.9, 95% CI 73.3 to 96.3). Child age, household income, healthcare facility and hospital length of stay (LoS) were significant predictors of household COI. Costs were most sensitive to hospital LoS and productivity loss.ConclusionsSevere pneumonia in young children is associated with high household economic burden and cost varies significantly across socioeconomic parameters. Management strategies with improved accessibility are needed particularly for the poor to make treatment affordable in order to reduce household economic burden.

scholarly journals Financial burden of HIV and TB among patients in Ethiopia: a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036892
Author(s):  
Lelisa Fekadu Assebe ◽  
Eyerusalem Kebede Negussie ◽  
Abdulrahman Jbaily ◽  
Mieraf Taddesse Taddesse Tolla ◽  
Kjell Arne Johansson
Keyword(s):  
Indirect Cost ◽  
Economic Burden ◽  
Financial Burden ◽  
Household Survey ◽  
Income Quintile ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Catastrophic Health Expenditures ◽  
The Mean ◽  
Substantial Economic Burden

ObjectivesHIV and tuberculosis (TB) are major global health threats and can result in household financial hardships. Here, we aim to estimate the household economic burden and the incidence of catastrophic health expenditures (CHE) incurred by HIV and TB care across income quintiles in Ethiopia.DesignA cross-sectional survey.Setting27 health facilities in Afar and Oromia regions for TB, and nationwide household survey for HIV.ParticipantsA total of 1006 and 787 individuals seeking HIV and TB care were enrolled, respectively.Outcome measuresThe economic burden (ie, direct and indirect cost) of HIV and TB care was estimated. In addition, the CHE incidence and intensity were determined using direct costs exceeding 10% of the household income threshold.ResultsThe mean (SD) age of HIV and TB patient was 40 (10), and 30 (14) years, respectively. The mean (SD) patient cost of HIV was $78 ($170) per year and $115 ($118) per TB episode. Out of the total cost, the direct cost of HIV and TB constituted 69% and 46%, respectively. The mean (SD) indirect cost was $24 ($66) per year for HIV and $63 ($83) per TB episode. The incidence of CHE for HIV was 20%; ranges from 43% in the poorest to 4% in the richest income quintile (p<0.001). Similarly, for TB, the CHE incidence was 40% and ranged between 58% and 20% among the poorest and richest income quintiles, respectively (p<0.001). This figure was higher for drug-resistant TB (62%).ConclusionsHIV and TB are causes of substantial economic burden and CHE, inequitably, affecting those in the poorest income quintile. Broadening the health policies to encompass interventions that reduce the high cost of HIV and TB care, particularly for the poor, is urgently needed.

Abstract 208: A Literature Review Of Indirect Cost Of Stroke

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Heesoo Joo ◽  
Mary G George ◽  
Jing Fang ◽  
Guijing Wang
Keyword(s):  
Literature Review ◽  
Indirect Cost ◽  
Cost Of Illness ◽  
Economic Burden ◽  
Productivity Loss ◽  
Indirect Costs ◽  
The Other ◽  
Research Articles ◽  
Original Research ◽  
Direct And Indirect Costs

Background: Stroke is not only a costly deadly disease, but also a leading cause of long-term disability. However, stroke associated indirect costs such as productivity loss and informal care cost have not been well studied. To better develop such studies and provide policy-relevant information, we conducted a literature review of indirect costs of stroke. Methods: We conducted a literature search using PubMed, MEDLINE and EconLit, complemented by Google Scholar search and cross-reference checking using key words of stroke, cerebrovascular disease, subarachnoid hemorrhage, intracerebral hemorrhage, cost of illness, productivity loss, indirect cost, economic burden, and informal caregiving. We identified original research articles published during 1990-2012 in English language peer reviewed journals for the review. Since the number of studies on indirect cost of stroke was small, we included cost-of-illness (COI) studies if they contained sufficient analyses of the indirect cost. We summarized the indirect costs by study type, cost categories, and study settings. Results: There were 31 original research articles investigating the indirect cost of stroke. Only 6 (19%) of these studies solely investigated the indirect cost; the other 25 (81%) studies were COI studies which included the indirect cost as a component. Of the 31 articles, six examined indirect costs in the US. Two of them focused solely on indirect costs. One study at a national level examined informal caregiving among elderly with stroke and estimated the annual cost of such care to be $6.1 billion in 1999. The other study for the State of California estimated lost productivity associated with stroke mortality in the State to be over $1 billion in 1991. The other four US studies suggested that the indirect costs will continue to increase in the coming decades, especially among African American and Hispanics, and that indirect costs might account for over 58% of the total cost of stroke. Due to diverse research methods, data, and cost definitions, the literature suggested a wide range of the indirect cost as a percentage of total stroke costs (2.6% - 71%) often with indirect cost as a significant cost component of stroke. Conclusions: While the literature indicated that the indirect cost accounted for a significant portion of the economic burden of stroke, there is a clear need to develop improved methods to study costs and to better use or establish relevant data sources for such studies. With the aging population and increasing survival rate of stroke, both direct and indirect costs of stroke are likely to increase greatly. Interventions for stroke prevention as well as for improving quality of life among stroke patients are needed to contain both direct and indirect costs associated with stroke. More research investigating the indirect costs will be helpful in guiding the development of such interventions to reduce the burden of stroke.

Cost of illness among patients with diabetic foot ulcer in secondary and tertiary health facilities in Kano, northwestern Nigeria

2015 ◽  
Author(s):  
Fakhraddeen Muhammad ◽  
Lateefah Pedro ◽  
Hassan Suleiman ◽  
Enikuomehin Adenike ◽  
Rahila Mukhtar ◽  
...  
Keyword(s):  
Cost Of Illness ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Health Facilities

scholarly journals Prevalence and socioeconomic burden of diabetes mellitus in South Korean adults: a population-based study using administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sung-Hee Oh ◽  
Hyemin Ku ◽  
Kang Seo Park
Keyword(s):  
South Korea ◽  
Diabetic Complications ◽  
Economic Burden ◽  
Productivity Loss ◽  
Diabetic Patients ◽  
Claims Database ◽  
South Korean ◽  
Subgroup Analyses ◽  
Per Capita ◽  
Capita Cost

Abstract Background Diabetes leads to severe complications and imposes health and financial burdens on the society. However, currently existing domestic public health studies of diabetes in South Korea mainly focus on prevalence, and data on the nationwide burden of diabetes in South Korea are lacking. The study aimed to estimate the prevalence and economic burden of diabetes imposed on the South Korean society. Methods A prevalence-based cost-of-illness study was conducted using the Korean national claims database. Adult diabetic patients were defined as those aged ≥20 years with claim records containing diagnostic codes for diabetes (E10-E14) during at least two outpatient visits or one hospitalization. Direct costs included medical costs for the diagnosis and treatment of diabetes and transportation costs. Indirect costs included productivity loss costs due to morbidity and premature death and caregivers’ costs. Subgroup analyses were conducted according to the type of diabetes, age (< 65 vs. ≥65), diabetes medication, experience of hospitalization, and presence of diabetic complications or related comorbidities. Results A total of 4,472,133 patients were diagnosed with diabetes in Korea in 2017. The average annual prevalence of diabetes was estimated at 10.7%. The diabetes-related economic burden was USD 18,293 million, with an average per capita cost of USD 4090 in 2019. Medical costs accounted for the biggest portion of the total cost (69.5%), followed by productivity loss costs (17.9%), caregivers’ costs (10.2%), and transportation costs (2.4%). According to subgroup analyses, type 2 diabetes, presence of diabetic complications or related comorbidities, diabetes medication, and hospitalization represented the biggest portion of the economic burden for diabetes. As the number of complications increased from one to three or more, the per capita cost increased from USD 3991 to USD 11,965. In inpatient settings, the per capita cost was ~ 10.8 times higher than that of outpatient settings. Conclusions South Korea has a slightly high prevalence and economic burden of diabetes. These findings highlight the need for effective strategies to manage diabetic patients and suggest that policy makers allocate more health care resources to diabetes. This is the first study on this topic, conducted using a nationally representative claims database in South Korea.

scholarly journals Healthcare Expenditures Associated with Heart Failure in Saudi Arabia: A Cost of Illness Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 988
Author(s):  
Ahmed Alghamdi ◽  
Eman Algarni ◽  
Bander Balkhi ◽  
Abdulaziz Altowaijri ◽  
Abdulaziz Alhossan
Keyword(s):  
Heart Failure ◽  
Saudi Arabia ◽  
Cost Of Illness ◽  
Economic Burden ◽  
Indirect Costs ◽  
Health Care Expenditures ◽  
Decision Makers ◽  
Hospitalization Costs ◽  
Illness Study ◽  
The Cost

Heart failure (HF) is considered to be a global health problem that generates a significant economic burden. Despite the growing prevalence in Saudi Arabia, the economic burden of HF is not well studied. The aim of this study was to estimate the health care expenditures associated with HF in Saudi Arabia from a social perspective. We conducted a multicenter cost of illness (COI) study in two large governmental centers in Riyadh, Saudi Arabia using 369 HF patients. A COI model was developed in order to estimate the direct medical costs associated with HF. The indirect costs of HF were estimated based on a human capital approach. Descriptive and inferential statistics were analyzed. The direct medical cost per HF patient was $9563. Hospitalization costs were the major driver in total spending, followed by medication and diagnostics costs. The cost significantly increased in line with the disease progression, ranging from $3671 in class I to $16,447 in class IV. The indirect costs per working HF patient were $4628 due to absenteeism, and $6388 due to presenteeism. The economic burden of HF is significantly high in Saudi Arabia. Decision makers need to focus on allocating resources towards strategies that prevent frequent hospitalizations and improve HF management and patient outcomes in order to lower the growing economic burden.

scholarly journals Economic Burden of Colorectal Cancer: A Case of Fars, Iran

2021 ◽  
Vol 28 ◽  
pp. 107327482110099
Author(s):  
Abdosaleh Jafari ◽  
Peyman Mehdi Alamdarloo ◽  
Mehdi Dehghani ◽  
Peivand Bastani ◽  
Ramin Ravangard
Keyword(s):  
Colorectal Cancer ◽  
Economic Burden ◽  
Purchasing Power Parity ◽  
Annual Cost ◽  
Low Cost ◽  
Direct Costs ◽  
Fars Province ◽  
Power Parity ◽  
Medical Sciences ◽  
The Mean

Among cancers, colorectal cancer is the third most common cancer in the world and the fourth leading cause of cancer deaths worldwide. Some studies have shown that the incidence of colorectal cancer is increasing in Iran and in Fars province. The present study aimed to determine the economic burden of colorectal cancer in patients referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences in 2019 from the patients’ perspective. This is a partial economic evaluation and a cost-of-illness study conducted cross-sectionally in 2019. All the patients with colorectal cancer who had been referred to the referral centers affiliated to Iran, Shiraz University of Medical Sciences, and had medical records were studied through the census method (N = 96). A researcher-made data collection form was used to collect the cost data. The prevalence-based and bottom-up approaches were also used in this study. The human capital approach was applied to calculate indirect costs. The mean annual cost per patient with colorectal cancer in the present study was $10930.98 purchasing power parity (PPP) (equivalent to 5745.29 USD), the main part of which was the medical direct costs (74.86%). Also, among the medical direct costs per patient, the highest were those of surgeries (41.7%). In addition, the mean annual cost per patient with colorectal cancer in the country was $ 116917762 PPP (equivalent to 61451621.84 USD) in 2019. Regarding the considerable economic burden of colorectal cancer and in order to reduce the costs, these suggestions can be made: increasing the number of specialized beds through the cooperation of health donors, establishing free or low-cost accommodation centers for patients and their companions near the medical centers, using the Internet and cyberspace technologies to follow up the treatment of patients, and increasing insurance coverage and government drug subsidies on drug purchase.

scholarly journals Hepatic steatosis: a risk factor for increased COVID-19 prevalence and severity—a computed tomography study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Asmaa Ali ◽  
Mona Hasan ◽  
Shaimaa Hamed ◽  
Amir Elhamy
Keyword(s):  
Hepatic Steatosis ◽  
Severe Disease ◽  
Severe Pneumonia ◽  
Liver Disorder ◽  
Control Group ◽  
Case Group ◽  
World Population ◽  
Positive Class ◽  
The Mean ◽  
And Control

Abstract Background Around 25% of the world population was affected by the metabolic-related fatty liver disorder. Hepatic steatosis is frequently observed in conjunction with hypertension, obesity comorbidities, and diabetes. We evaluate the hepatic steatosis frequency found in chest CT exams of COVID-19-positive cases compared to non-infected controls and evaluate the related increased prevalence and severity of COVID. Results Our research includes 355 subjects, 158 with positive PCR for COVID-19 (case group) and 197 with negative PCR and negative CT chest (control group). The mean age in the positive group was 50.6 ± 16 years, and in the control, it was 41.3 ± 16 years (p < 0.001). Our study consists of 321 men (90.5%) and 34 women (9.5%). The number of males in both cases and control groups was greater. In the case group, 93% men vs. 6.9% women, while in controls, 88.3% men vs.11.6% women, p < 0.001. CT revealed normal results in 55.5% of individuals (i.e., CORADs 1) and abnormal findings in 45.5% of participants (i.e., CORADs 2–5). In abnormal scan, CO-RADs 2 was 13.92%, while CO-RADs 3–4 were 20.89% of cases. CO-RADs 5 comprised 65.19% of all cases. Approximately 42.6% of cases had severe disease (CT score ≥ 20), all of them were CO-RADs 5. The PCR-positive class had a greater prevalence of hepatic steatosis than controls (28.5% vs.12.2%, p < 0.001). CO-RADs 2 represented 11.1%, CO-RADs 3–4 represented 15.6%, and CO-RADs 5 represented 73.3% in the hepatic steatosis cases. The mean hepatic attenuation value in the case group was 46.79 ± 12.68 and in the control group 53.34 ± 10.28 (p < 0.001). When comparing patients with a higher severity score (CT score ≥ 20) to those with non-severe pneumonia, it was discovered that hepatic steatosis is more prevalent (73.2% vs. 26.8%). Conclusions Steatosis was shown to be substantially more prevalent in COVID-19-positive individuals. There is a relation among metabolic syndrome, steatosis of the liver, and obesity, as well as the COVID-19 severity.

scholarly journals AB0490 IMPACT OF SPONDYLOARTHRITIS ON WORK PRODUCTIVITY: A REAL LIFE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1272.1-1272
Author(s):  
M. Ben Majdouba ◽  
S. Boussaid ◽  
S. Rekik ◽  
S. Jemmali ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Age At Onset ◽  
Productivity Loss ◽  
Diagnostic Delay ◽  
Work Productivity ◽  
Symptomatic Treatment ◽  
Work Outcomes ◽  
Joint Involvement ◽  
The Mean

Background:Work productivity of patients with spondyloarthritis is frequently affected by their disease.Objectives:We aim to identify disease-related factors associated with poor work productivity in patients with spondyloarthritis.Methods:A cross-sectional study was performed in patients with spondyloarthritis. Data on disease characteristics were collected as well as specific indices: Visual analogue scale (VAS) for fatigue and pain, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score with CRP (ASDAS-CRP), Bath Ankylosing Spondylitis Functionnel Index (BASFI) and Bath Ankylosing Spondylitis Metrology Index (BASMI). EuroQol-5D (EQ5D) was used to assess health-related quality of life. Work productivity was assessed by the Work Productivity and Activity Impairment scale (WPAI:SpA). Factors associated with presenteeism, absenteeism and work productivity loss were evaluated.Results:One hundred patients were enrolled (73 men and 27 women); mean age was 43.68 ± 10.3 years. Fifty nine percent of patients were employed, 26% were off work and 15% were retired of which 8% were in early retirement. Sixty seven percent of patients had ankylosing spondylitis, 17% had rheumatism associated with inflammatory bowel disease and 16% had psoriatic rheumatism. The average disease duration was 12.24 ± 8.73 years. Mean age at onset was 33.2 ± 10 years [18-59]. The average diagnostic delay was 2.41 ± 3 years; it was more than five years in 17% of cases. Sacroiliac pain has been noted in 69 patients, lumbar or cervical stiffness in 78 patients and peripheral joint involvement in 18 cases. Thirty one percent of patients had hip joint involvement and 49% had extra-articular manifestation. Fifty percent had inflammatory biological syndrome, 63% were treated with anti-TNFα and 58% needed symptomatic treatment regularly. The mean fatigue and pain VAS was respectively 5.58 ± 2.5 and 5.56 ± 2.9. The mean BASDAI was 4.4 ± 2.4, the average BASFI was 4.6 ± 2.7 and the average ASDAS-CRP was 2.77 ± 1.18. The mean BASMI was 4.4 ± 2.8. The mean EQ5D score was 0.485 ± 0.378. Among employed patients, mean absenteeism, presenteeism and work productivity loss was 21.8 ± 33.13%, 42 ± 32% and 46.5 ± 35.31%, respectively. These work outcomes were correlated to diagnostic delay ≥ 2 years (p<0.03), peripheral joint involvement (p=0.006), psoriasis (p=0.02), inflammatory biological syndrome (p<0.001), need of symptomatic treatment (p=0.001), fatigue and pain VAS ≥ 4 (p<0.001), BASDAI ≥ 4 (p<0.001), ASDAS-CRP ≥ 2.1 (p<0.001), BASFI ≥ 4 (p<0.001), BASMI ≥ 4 (p=0.002) and low EQ5D score (p<0.001). Work productivity loss was in addition correlated to age at onset < 25 years (p=0.03).Conclusion:Active disease, reduced physical function and poorer quality of life are associated with reduced work productivity. Early diagnosis and good disease management especially fatigue and pain can potentially improve work outcomes in patients with spondyloarthritis.Disclosure of Interests:None declared.

InHouse Call: Streamlining Communication to Optimize Efficiency and Patient Care in a Hospital (Preprint)

2021 ◽  
Author(s):  
George Schilling
Keyword(s):  
Pilot Study ◽  
Patient Outcomes ◽  
Economic Burden ◽  
Team Member ◽  
Average Amount ◽  
Traditional Methods ◽  
Poor Patient ◽  
Net Promoter Score ◽  
The Mean ◽  
Net Promoter

BACKGROUND Communication failures disrupt physician workflow, lead to poor patient outcomes, and are associated with significant economic burden. To increase efficiency with contacting a team member in a hospital, we designed an information directory app, InHouse Call. OBJECTIVE To describe the design of InHouse Call, objectively compare the usefulness of the app versus traditional methods (operator or pocket cards, etc.), and determine its subjective usefulness through user surveys and Net Promoter Score (NPS). METHODS Pilot study utilizing Before-After trials. The effectiveness of InHouse Call in connecting the user with a contact in the hospital was measured through timed trials comparing the amount of time spent in attempting to make the connection using traditional methods versus the app. Usability was measured through exit surveys and NPS. RESULTS The average time spent connecting to the correct contact using traditional methods was 59.5 seconds compared to 13.8 seconds when using InHouse Call. The degree of variance when using traditional methods was 1544.2 compared to 19.7 with InHouse Call. A call made using the traditional methods deviated from the mean by 39.3 seconds compared to 4.4 seconds when using InHouse Call. InHouse Call achieved an NPS of 95. CONCLUSIONS InHouse Call significantly reduced the average amount of time spent connecting with the correct contact as well as the variability to complete the task. The app garnered a high NPS and positive subjective feedback.

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