Abstract 144: Cost of Cardiovascular Disease Episodes among Patients with Hypertension

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Alejandro Arrieta ◽  
Nan Qiao ◽  
John R Woods ◽  
Stephen J Jay ◽  
Emir Veledar ◽  
...  
Keyword(s):  
Age Groups ◽  
Medical Costs ◽  
Insurance Claims ◽  
Insurance Plan ◽  
Total Direct Medical Cost ◽  
Hypertensive Patients ◽  
Direct Medical Costs ◽  
Before And After ◽  
Insurance Claims Data ◽  
Ischemic Attack

Background: Because of its high prevalence and direct contribution to cardiovascular diseases (CVD), hypertension is among the most expensive components of CVD, representing nearly 50% of the total direct medical cost of CVD in the U.S. Yet, little is known about the per-patient cost of CVD episodes among hypertensives. Methods: This study used insurance claims data from over 16,000 individuals diagnosed with hypertension and enrolled in a private health insurance plan between 2008 and 2010. About one million medical and pharmacy insurance claims generated by these hypertensive patients were extracted for the analysis. Six CVD were included in the study: Myocardial infarction (MI), unstable angina (UA), stable angina (SA), transient ischemic attack (TIA), stroke, and congestive heart failure (CHF). Direct medical costs (ambulatory, emergency, hospital visits and medications) for each CVD were obtained on a weekly basis over 26 weeks before and after a recorded CVD episode. Per-patient direct medical costs were estimated by taking a before-after difference in cost, corrected by censoring due to deaths and insurance plan exits. Average costs were segmented by age groups (40-64 and 65 or over). Costs were adjusted to 2010 U.S. dollars. Results: The most expensive CVD episode among hypertensives was UA ($17,704; 95%CI $11,632-22,644), followed by MI ($13,480; 95%CI $8,328-18,752), stroke ($13,223; 95%CI $8,080-17,556), CHF ($12,462; 95%CI $9,734-15,335), SA ($6,991; 95%CI $4,178-9,947), and TIA ($5,787; 95%CI $2,671-9,670). CVD costs converged to pre-event cost levels within the next 4 to 14 months after the recorded CVD episode. Some CVD costs (CHF, UA, MI) rose 1 to 3 weeks before the recorded event, while others (stroke, TIA, SA) clearly started during the week of the recorded event (see Figure 1 comparing CHF and stroke). For the former, pre-event costs explained up to 30% of total costs. Conclusions: Cost estimates of CVD episodes among hypertensive patients are consistent with results from the scarce literature in this area. Moreover, our study finds evidence of increased medical resource utilization weeks before the recording of the CVD episode. Omitting these pre-event costs leads to an underestimate of the true costs of CVD.

Impact of copayment elimination on annual and biennial screening mammography utilization among rural U.S. women.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6503-6503
Author(s):  
Jeffrey M. Peppercorn ◽  
Stephanie B. Wheeler ◽  
Kevin Houck ◽  
Bercedis Peterson ◽  
Victor Villagra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Rural Women ◽  
Age Groups ◽  
Screening Mammography ◽  
Prior History ◽  
Insurance Claims ◽  
Financial Barriers ◽  
Before And After ◽  
Insurance Claims Data ◽  
The Impact

6503 Background: Early detection of breast cancer through mammography screening leads to earlier stage at diagnosis and improved survival. Previous research has shown that rural American women are less likely to receive screening mammography compared to their urban counterparts. Copayments for mammography are a potential barrier to screening, and elimination of copayments may improve screening rates. We examined annual (aSMU) and biennial (bSMU) screening mammography utilization and the impact of copayment elimination among rural U.S. women. Methods: Using the insurance claims database of the National Rural Electric Cooperative Association (NRECA), which insures over 100,000 electrical workers and their families nationally, we identified all women ages 40 to 64 with no prior history of invasive breast cancer or DCIS (based on ICD-9 codes) and captured claims for aSMU and bSMU between 1999 and 2009. Changes in screening over time were assessed for the periods before and after NRECA elimination of copayments for screening mammography in January, 2006. Chi-squared tests were used to compare aSMU and bSMU rates by age group. All p-values are two-sided. Results: During this time period, over 20,000 women ages 40 to 64 received health insurance through NRECA each year. From 1999 to 2009, aSMU increased from 38.1% to 49.5%, while bSMU increased from 57.2% to 68.1%. Screening increased significantly following elimination of copayments in 2006 (p = 0.0004). Specifically, for the period 2006-2007 compared to 2004-2005, the percentage of women undergoing at least biennial screening increased from 60.9 to 68.8% (p < 0.0001), with absolute differences in screening by age ranging from an increase of 5.3% among women 40-45, to 10% among women 60 – 64. Conclusions: Evaluation of insurance claims data from rural US populations reveals that a large percentage of rural women ages 40 to 64 do not undergo even biennial breast cancer screening. Elimination of copayments improves both annual and biennial screening rates in all age groups, but does not eliminate all barriers. Further investigation is ongoing to understand financial and non-financial barriers to screening and attitudes towards current screening recommendations.

scholarly journals Treatment pattern and direct medical costs of pediatric outpatients with actuate respiratory infection at X hospital in Jambi

2020 ◽  
Vol 16 (2) ◽  
pp. 196-203
Author(s):  
Hendri Pranata ◽  
Rasmaladewi Rasmaladewi ◽  
Mukhlis Sanuddin
Keyword(s):  
Direct Medical Cost ◽  
Respiratory Infection ◽  
Medical Cost ◽  
Pediatric Patients ◽  
Supportive Therapy ◽  
Medical Costs ◽  
Total Direct Medical Cost ◽  
Direct Medical Costs ◽  
Retrospective Data Collection ◽  
Pediatric Outpatients

Introduction: Acute respiratory infection is common among the general public. Such disease and its associated symptoms encourage higher consumption of medicine. Varied medications for ARI patients incur different costs of each patient, which eventually lead to higher healthcare costs. Objectives: To identify the treatment patterns and direct medical costs among ARI pediatric patients at X Hospital in Jambi. Methods: This research was an observational study with retrospective data collection. The samples were collected in 2018. Results: The results showed that the most-frequently administered antibiotic for ARI pediatric patients was cefixime (29.17%), while the most-commonly used supportive therapy for ARI pediatric patients was the combination of antihistamines, antipyretics-analgesics, decongestant, and corticosteroid (16.67%). The total direct medical cost to ARI pediatric patients was IDR 191,097. Conclusion: The mean direct medical cost for ARI therapy was IDR 191,097. More administered therapy resulted in higher medical costs. Keywords: ARI, child, antibiotics, direct medical costs

scholarly journals Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

2019 ◽  
Author(s):  
Izumi Kawachi ◽  
Shuichi Okamoto ◽  
Mariko Sakamoto ◽  
Hiroyuki Ohta ◽  
Yusuke Nakamura ◽  
...  
Keyword(s):  
Health Insurance ◽  
Medical Cost ◽  
Claims Data ◽  
Medical Costs ◽  
Insurance Claims ◽  
Total Medical Cost ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims ◽  
Relapse Rates

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

scholarly journals Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Izumi Kawachi ◽  
Shuichi Okamoto ◽  
Mariko Sakamoto ◽  
Hiroyuki Ohta ◽  
Yusuke Nakamura ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Insurance ◽  
Medical Cost ◽  
Claims Data ◽  
Medical Costs ◽  
Insurance Claims ◽  
Total Medical Cost ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results Four thousand three hundred seventy-four MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from ¥87,640 (US$787.7 or €723.0 as of May 2017) to ¥102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from ¥23,039 (US$207.1 or €190.1) to ¥51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (¥424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (¥119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. Although this study does not show the direct causality between DMT and reduction of relapse rates/fewer hospitalizations among MS patients, a reduction in hospital costs has been revealed concomitantly with the increasing prevalence of DMT.

scholarly journals Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

2019 ◽  
Author(s):  
Izumi Kawachi ◽  
Shuichi Okamoto ◽  
Mariko Sakamoto ◽  
Hiroyuki Ohta ◽  
Yusuke Nakamura ◽  
...  
Keyword(s):  
Health Insurance ◽  
Medical Cost ◽  
Claims Data ◽  
Medical Costs ◽  
Insurance Claims ◽  
Total Medical Cost ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims ◽  
Relapse Rates

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

scholarly journals Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database

2019 ◽  
Author(s):  
Izumi Kawachi ◽  
Shuichi Okamoto ◽  
Mariko Sakamoto ◽  
Hiroyuki Ohta ◽  
Yusuke Nakamura ◽  
...  
Keyword(s):  
Health Insurance ◽  
Medical Cost ◽  
Claims Data ◽  
Medical Costs ◽  
Insurance Claims ◽  
Total Medical Cost ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims ◽  
Relapse Rates

Abstract Background In this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data. Methods We analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis. Results 4,374 MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from \87,640 (US$787.7 or €723.0 as of May 2017) to \102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from \23,039 (US$207.1 or €190.1) to \51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (\424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (\119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost. Conclusion Concomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. There is currently a lack of evidence for direct causality between DMT and reduction of relapse rates. However, even if DMT cannot be directly shown to be the cause of lower relapse rates and fewer hospitalizations among MS patients, a better quality of life for MS patients and a reduction in hospital costs have been achieved concomitantly with the increasing prevalence of DMT.

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