scholarly journals Direct and indirect costs of families with a child with acute lymphoblastic leukaemia in an academic hospital in China: a cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030511
Author(s):  
Yijiong Ren ◽  
Xin Li
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Rural Families ◽  
Indirect Costs ◽  
Urban Families ◽  
Medical Costs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Direct And Indirect Costs ◽  
Three Phase

ObjectivesTo estimate the direct and indirect costs in families with a child with acute lymphoblastic leukaemia (ALL) in China.DesignA single-site, cross-sectional survey of primary caregiver of a child with ALL was performed.Setting and participantsWe analysed the total costs incurred on the completion of the first three-phase treatment (induction, consolidation and intensification), which requires intensive hospitalisation. Eligible patients were (1) diagnosed with ALL between 2010 and 2012 at Shanghai Children’s Medical Center (SCMC), (2) aged 0–14 years at diagnosis and (3) completed the first three-phase treatment at SCMC. The data were collected between October 2014 and December 2014.Outcome measuresWe decomposed the total costs into three categories: (1) direct medical costs, which were further divided into outpatient and inpatient costs; (2) direct non-medical costs, which referred to expenses incurred in relation to the illness; and (3) indirect costs due to productivity loss.ResultsA total of 161 patients were included in the study. Direct medical costs accounted for about 51.7% of the overall costs, and the rest of 48.3% of the total costs were attributed to direct non-medical costs and indirect costs. Regarding families with different household registration type (rural vs urban), the total costs were significantly different between the two groups (US$36 125 vs US$25 593; p=0.021). Specifically, urban families incurred significantly larger indirect costs than rural families (US$12 343 vs US$4157; p=0.018). Although the direct non-medical costs were not significantly different, urban families spent more money on hygiene cleaning products and auxiliary treatment equipment (p=0.041) and gifts and treats (p=0.034) than rural families.ConclusionsThe financial burden faced by the Chinese families with a child with ALL was tremendous, and the distributions of costs among the three categories were different between urban and rural families.

scholarly journals Direct non-medical and indirect costs of diabetes and its associated complications in Vietnam: an estimation using national health insurance claims from a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e032303 ◽  
Author(s):  
Thi Tuyet Mai Kieu ◽  
Hong Nhung Trinh ◽  
Huy Tuan Kiet Pham ◽  
Thanh Binh Nguyen ◽  
Junice Yi Siu Ng
Keyword(s):  
Health Insurance ◽  
Indirect Costs ◽  
Premature Mortality ◽  
Medical Costs ◽  
Second Phase ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Secondary Sources ◽  
Working Age ◽  
The Impact

ObjectiveThe prevalence of diabetes in Vietnam has increased from 2.5% in 2007 to 5.5% in 2017, but the burden of direct non-medical and indirect costs is unknown. The objective of this study was to estimate the direct non-medical costs and indirect costs due to type 2 diabetes mellitus (T2DM) and its associated complications among Vietnam Health Insurance System (VHIS) enrollees in Vietnam.DesignThe first phase was a cross-sectional survey of patients with T2DM. In the second phase, data from the previous phase were used to predict direct non-medical costs and presenteeism costs of VHIS enrollees diagnosed with T2DM based on demographic and clinical characteristics in 2017. The human-capital approach was used for the calculation of indirect costs.Setting and participantsThis study recruited 315 patients from a national hospital, a provincial hospital and a district hospital aged 18 or above, diagnosed with T2DM, enrolled in VHIS, and having at least one visit to hospitals between 1 June and 30 July 2018. The VHIS dataset contained 1,395,204 patients with T2DM.Outcome measuresThe direct non-medical costs and presenteeism were collected from the survey. Absenteeism costs were estimated from the VHIS database. Costs of premature mortality were calculated based on the estimates from secondary sources.ResultsThe total direct non-medical and indirect costs were US$239 million in 2017. Direct non-medical costs were US$78 million, whereas indirect costs were US$161 million. Costs of absenteeism, presenteeism and premature mortality corresponded to 17%, 73% and 10% of the indirect costs. Patients incurred annual mean direct non-medical costs of US$56. Annual mean absenteeism and presenteeism costs for patients in working age were US$61 and US$267, respectively.ConclusionsThe impact of T2DM on direct non-medical and indirect costs on diabetes is substantial. Direct non-medical and absenteeism costs were higher in patients with complications.

scholarly journals Cost analysis of informal care: estimates from a national cross-sectional survey in Sweden

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Björn Ekman ◽  
Kevin McKee ◽  
Joana Vicente ◽  
Lennart Magnusson ◽  
Elizabeth Hanson
Keyword(s):  
Informal Care ◽  
Adult Population ◽  
Informal Caregivers ◽  
Indirect Costs ◽  
Direct Costs ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Income Loss ◽  
Cross Sectional ◽  
Direct And Indirect Costs

Abstract Background Over the past decades, informal care has increased in most OECD-countries. Informal care is costly to caregivers and to society in the form of lost income and direct costs of providing care. Existing evidence suggests that providing informal care affects caregivers’ overall health. However, estimates of the social costs of informal care based on national data on individuals are currently scarce. Objective This study contributes to the existing evidence on the costs of informal care by estimating the direct and indirect costs to caregivers using a purposive national household survey from Sweden. Methods Adopting a bottom-up, prevalence approach, the direct and indirect costs are estimated using the survey data and the value of working time and leisure time from existing sources. Results The results suggest that around 15% of the adult population of Sweden provide informal care and that such care costs around SEK 152 billion per year (around 3% of GDP; USD 16,3 billion; EUR 14,5 billion), or SEK 128000 per caregiver. Around 55% of costs are in the form of income loss to caregivers. The largest cost items are reduced work hours and direct costs of providing informal care. Replacing informal caregivers with professional care providers would be costly at around SEK 193,6 billion per year. Conclusions Findings indicate that, even in a country with a relatively generous welfare system, significant resources are allocated toward providing informal care. The costing analysis suggests that effective support initiatives to ease the burden of informal caregivers may be cost-effective.

The Direct and Indirect Costs of Treating the Victims of the 2016 Nice Terror Attacks in a Single Pediatric Hospital

2021 ◽  
pp. 1-4
Author(s):  
Federico Solla ◽  
Eytan Ellenberg ◽  
Virginie Rampal ◽  
Julien Margaine ◽  
Charles Musoff ◽  
...  
Keyword(s):  
Indirect Costs ◽  
Medical Costs ◽  
Pediatric Hospital ◽  
Terror Attack ◽  
Direct And Indirect Costs ◽  
Terror Attacks ◽  
Direct Medical Costs ◽  
Annual Budget ◽  
The Difference ◽  
The Cost

Abstract Objective: To analyze the cost of the terror attack in Nice in a single pediatric institution. Methods: We carried out descriptive analyses of the data coming from the Lenval University Children’s Hospital of Nice database after the July 14, 2016 terror attack. The medical cost for each patient was estimated from the invoice that the hospital sent to public insurance. The indirect costs were calculated from the hospital’s accounting, as the items that were previously absent or the difference between costs in 2016 versus the previous year. Results: The costs total 1.56 million USD, corresponding to 2% of Lenval Hospital’s 2016 annual budget. Direct medical costs represented 9% of the total cost. The indirect costs were related to human resources (overtime, sick leave), revenue shortfall, and security and psychiatric reinforcement. Conclusion: Indirect costs had a greater impact than did direct medical costs. Examining the level and variety of direct and indirect costs will lead to a better understanding of the consequences of terror acts and to improved preparation for future attacks.

The Risk of Catastrophic Health Expenditures Due to Direct Non-Medical Costs in Patients: A Study of the Outpatients in Qazvin, Iran

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Saeed Asefzadeh ◽  
Bahman Ahadi Nezhad ◽  
Saeed Norouzi
Keyword(s):  
Health Expenditures ◽  
Medical Costs ◽  
Healthcare Services ◽  
Disease Diagnosis ◽  
Cross Sectional Survey ◽  
Diagnostic Laboratory ◽  
Cross Sectional ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
Catastrophic Expenditures

Background: Out-of-pocket payment encompasses the costs that patients pay for healthcare services, which is an inefficient approach to healthcare financing as it may lead to poverty. Objectives: The present study aimed to determine the risk of catastrophic health expenditures due to non-medical costs in the outpatients in Qazvin, Iran. Methods: This cross-sectional survey was conducted on 341 outpatients referring to the internists of Velayat Hospital and Bu-Ali Sina Hospital in Qazvin. The required data were collected using a researcher-made questionnaire and the prescriptions of the patients. Out-of-pocket payments were defined as the direct medical and non-medical costs within one month. Results: The mean out-of-pocket payments of the patients in one month was 49.97 dollars, 75.8% of which covered direct medical cost (disease diagnosis and treatment), and 24.2% covered direct non-medical costs to receive health services. The highest out-of-pocket payments were for diagnostic/laboratory tests (50.3%), medications (21.5%), and transportation (18.2%). In addition, the exposure rate to catastrophic expenditures was estimated at 31%, and the patients with lower income had less exposure compared to those without incomes. Conclusions: According to the results, direct non-medical costs were associated with the increased out-of-pocket payments of the patients, which in turn led to the higher rates of catastrophic expenditures.

scholarly journals Direct and Indirect Costs Associated With Non-invasive Treatments in Obesity and Overweight Patients

2021 ◽  
Author(s):  
Saman Maaroufi ◽  
Mina Golestani ◽  
Mohammad Alizadeh ◽  
Ali Imani ◽  
Koustuv Dalal
Keyword(s):  
Public Health Problem ◽  
Indirect Costs ◽  
Medical Costs ◽  
Herbal Remedies ◽  
Direct And Indirect Costs ◽  
Non Invasive ◽  
Basic Diet ◽  
Obesity And Overweight ◽  
Significant Difference ◽  
Clinical Records

Abstract Background: Obesity and overweight are a global public health problem causing several chronic diseases which can lead to various degrees of morbidity and mortality. These medical conditions cause economic costs and complications. The purpose of the present study to estimate the direct and indirect costs incurred by obese and overweight patients with non-invasive treatments in Tabriz, north-western Iran.Methods: The number of 247 patients were studied by cross-sectional approach and used cost of illness's prevalence approach assessing the total costs (direct and indirect) of obesity and overweight through interview and assessing relevant clinical records. The study conducted over three months from December 2018 to February 2019 in Tabriz, capital of East Azerbaijan province, Iran. Direct costs included hospitalization, para-clinical medications and outpatient visits for treatment of obesity and overweight. Loss of productivity, days of restricted activity and days in bed, cost of wasting time, transportation costs and nursing expenditure were estimated as indirect costs in the present study. For estimating direct and indirect costs, we used the bottom-up costing approach. The foreign exchange rate used in the analysis was 42000 Iranian Rial = 1US$ (December-February 2018).Results: The mean three months cost per patient is 38529697 IRR (equivalent to $91.73 USD), Direct medical costs have a most significant part of total costs with 36765292 IRR (87.53USD) per three months (95%). Direct non-medical costs were 1380484 IRR (3.28USD) per patient (4%) and indirect costs were estimated 383981 IRR ($0.9USD) per patient (1%). The results of the analysis of variance showed that there was a significant difference between the four strategies in three months. Among the therapeutic strategies, the most changes in body mass index (BMI) occurred in patients who used Basic diet with several types of medicines strategy (p<0.001). Tukey post hoc showed BMI Changes in a patient with a Basic diet with herbal remedies was minimum (p<0.001). According to results in the first month, BMI has a significant reduction over three months. Regarding costs, the analysis showed that Patients who used the Basic diet strategy incurred the lowest costs (p<0.001) and the highest costs are related to patients with a Basic diet with several types of medicines (p<0.001).Conclusions: The results of the present study are useful in improving health policymakers and researchers in motivating to do more studies in particular for adopting new policies depending on the level of insurance coverage and their problems which patients deal with during the treatment period.

Direct and indirect costs of home healthcare in Japan: A cross‐sectional study

2020 ◽  
Vol 28 (3) ◽  
pp. 1109-1117
Author(s):  
Shiori Tomita ◽  
Eri Hoshino ◽  
Keisuke Kamiya ◽  
Osugi Yasuhiro ◽  
Mahbubur Rahman
Keyword(s):  
Indirect Costs ◽  
Cross Sectional Study ◽  
Home Healthcare ◽  
Sectional Study ◽  
Cross Sectional ◽  
Direct And Indirect Costs

Oncologists’ perceptions of cost and cancer care in India: A comparison of private practice (PPOs) and non-private practice oncologists (NPPOs).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17562-e17562
Author(s):  
Manisha Bhattacharya ◽  
Erika Paige Hamilton ◽  
Yousuf Zafar
Keyword(s):  
Private Practice ◽  
Standard Care ◽  
Indirect Costs ◽  
Treatment Decision ◽  
Cost Of Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Treatment Decision Making ◽  
Referral Practices ◽  
Reducing Costs

e17562 Background: Cancer incidence is increasing in India, where most patients lack health insurance. Little is known about how out-of-pocket costs affect cancer treatment decision-making by Indian physicians and patients. Methods: We conducted a cross-sectional survey of PPOs and NPPOs in 6 Indian metropolitan areas. Oncologists were surveyed about cost of care and cost discussions with patients. Descriptive statistics and Fisher’s exact tests were used to describe differences in cost perceptions and discussions. Results: 59 oncologists were surveyed (61% response). 78% (n=46) were men. 59% (n=34) were PPOs, and 41% (n=25) were NPPOs. Oncologists routinely discussed cost with their patients (96%, n=57); PPOs and NPPOs were equally likely to do so (p=1.00). According to oncologists, patients seeing NPPOs or PPOs were equally likely to discuss costs before deciding on treatment (p=0.14). 55% (n=32/58) of oncologists discussed cost with patients before prescribing diagnostic tests, and 79% (n=46/58) discussed cost before making treatment decisions. PPOs were more likely than NPPOs to believe that costs may discourage patients from presenting for an initial cancer evaluation (88% vs. 44%; p=0.0009). However, 71% of NPPOs (vs 44% of PPOs; p=0.06) believed that, once diagnosed, more than half of their patients found costs to be a barrier to receiving standard care. Oncologists reported the most costly components of care for their patients to be: 1) chemotherapy; 2) radiotherapy and diagnostic imaging (tied); 4) surgery; 5) indirect costs from lost wages and inpatient admission (tied). When asked about how to reduce costs, oncologists identified: lowering chemotherapy prices (88%, n=52); judicious use/ lowering cost of diagnostics (36%, n=21); optimizing the referral process (22%, n=13). Insurance/subsidies were identified by 15% (n=8). Conclusions: Cost is routinely discussed by Indian patients and oncologists across care settings. Cost can be a deterrent to initial evaluation and a barrier to receiving standard care. Oncologists more commonly suggested reducing costs of diagnostics and therapeutics, rather than expanding insurance or changing referral practices.

scholarly journals Association of Myeloid Aberrant Antigens and the Presence of BCR-ABL Gene Re-arrangements in ALL Patients

2020 ◽  
Vol 4 (1) ◽  
pp. 13-15
Author(s):  
Md. Shafiul Azam ◽  
Khaza Amirul Islam ◽  
Sharmin Mafruha ◽  
Mirza Golam Sarwar ◽  
Md. Salahuddin Shah ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Selection Criteria ◽  
Cross Sectional Study ◽  
Rt Pcr ◽  
Genetic Abnormality ◽  
Chain Reaction ◽  
Cross Sectional ◽  
Polymerase Chain ◽  
Made In

Background: BCR-ABL translocation is the most common genetic abnormality associated with adult Acute Lymphoblastic Leukaemia (ALL) with poor outcome. Objective: The aim of the study was to determine the association of myeloid aberrant antigens and the presence of BCR-ABL gene rearrangements in acute lymphoblastic leukaemia (ALL) patients in our context. Method: A total of 38 ALL patients were included in this cross-sectional study from August 2018 to July 2019 according to selection criteria. BCR-ABL was detected by Real Time-Polymerase Chain Reaction (RT-PCR). Results: The median age at diagnosis was 27.5 years with male (76.3%) predominance. Aberrant myeloid markers, e.g.CD13 was present in 9(64.3%) patients who were BCR-ABL positive which was statistically significant (p:<0.05). Conclusion: Early suspicion about BCR-ABL positivity can be made in ALL patients who show aberrant myeloid expression.

scholarly journals Catastrophic costs of Tuberculosis care in a population with internal migrants in China

2020 ◽  
Author(s):  
Qi Jiang ◽  
Liping Lu ◽  
Jianjun Hong ◽  
Xiaoping Jin ◽  
Qian Gao ◽  
...  
Keyword(s):  
Health Insurance ◽  
Household Income ◽  
Indirect Costs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Internal Migrant ◽  
Total Household Income ◽  
Before And After ◽  
Internal Migrants ◽  
Treatment Package

Abstract Background Although a free diagnosis and baseline treatment package was offered for tuberculosis (TB), hidden costs incurred by patients and their households could worsen their socio-economic and health status, particularly for migrants. We estimated the prevalence of catastrophic cost of TB patients and its associated factors in an urban population with internal migrants in China. Methods A cross-sectional survey was conducted to enroll culture-confirmed pulmonary TB patients in Songjiang district, Shanghai, between December 1, 2014, and December 31, 2015. Consenting participants completed a questionnaire, which collected direct and indirect costs before and after the diagnosis of TB. The catastrophic cost was defined as the annual expenses of TB care that exceeds 20% of total household income. We used logistic regression to identify factors associated with catastrophic costs. Results Overall, 248 drug-susceptible TB patients were enrolled, with 70% (174 of 248) of them being internal migrants. Migrant patients were significantly younger compared to resident patients. The total costs were 25,824 ($3,689) and 13,816 ($1,974) Chinese Yuan (RMB) for resident and internal migrant patients, respectively. The direct medical cost comprised about 70% of the total costs among both migrant and resident patients. Overall, 55% (132 of 248) of patients experienced high expenses ( > 10% of total household income), and 22% (55 of 248) experienced defined catastrophic costs. However, the reimbursement for TB care only reduced the prevalence of catastrophic costs to 20% (49 of 248). More than half of the internal migrants had no available health insurance (52%, 90 of 174). Hospitalizations, no available insurance, and older age contributed significantly to the occurrence of catastrophic costs. Conclusions. The catastrophic cost of TB service cannot be overlooked, despite the free policy. Migrants have difficulties benefiting from health insurance in urban cities. Interventions, including expanded medical financial assistance, are needed to secure universal TB care.

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