Follow-Up on Mental Illness in Medical Inpatients: Health Care Use and Self-Rated Health and Physical Fitness

Abstract Background Information about health care use and costs of cutaneous T-cell lymphoma (CTCL) patients is limited, particularly in a European setting. Methods In this population-wide study we set out to investigate prevalence, and trends in health care use in two CTCL subtypes, mycosis fungoides (MF) and Sézary syndrome (SS) over a time period of 19 years in 1998–2016 by using a nation-wide patient register containing data on all diagnosed MF and SS cases in Finland. Results The prevalence of diagnosed MF and SS rose from 2.04 to 5.38/100000, and from 0.16 to 0.36/100000 for MF and SS respectively during 1998–2016. We found a substantial decrease in inpatient treatment of MF/SS in the past two decades with a mean of 2 inpatient days/patient/year due to MF/SS in 2016, while the mean numbers of MF/SS related outpatient visits remained stable at 8 visits/year/patient. Most MF/SS-related outpatient visits occurred in the medical specialty of dermatology. In a ten-year follow-up after MF/SS diagnosis, the main causes for outpatient visits and inpatient stays were MF/SS itself, other cancers, and other skin conditions. Also cardiovascular disease and infections contributed to the number of inpatient days. Mean total hospital costs decreased from 11,600 eur/patient/year to 3600 eur/patient/year by year 4 of the follow-up, and remained at that level for the remainder of the 10-year follow-up. MF/SS accounted for approximately half of the hospital costs of these patients throughout the follow-up. Conclusions The nearly 3-fold increase in prevalence of diagnosed MF/SS during 1998–2016 puts pressure on the health care system, as this is a high-cost patient group with a heavy burden of comorbidities. The challenge can be in part answered by shifting the treatment of MF/SS to a more outpatient-based practice, and by adapting new pharmacotherapy, as has been done in Finland.

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Abstract PO-095: Improving informal caregivers and cancer survivors' psychological distress, symptom management and health care use follow-up interviews

10.1158/1538-7755.disp21-po-095 ◽

2022 ◽

Author(s):

Jennifer Traslavina Jimenez ◽

Ashley Green ◽

Keely Smith ◽

Echo L Warner ◽

Terry Badger ◽

...

Keyword(s):

Health Care ◽

Psychological Distress ◽

Cancer Survivors ◽

Symptom Management ◽

Informal Caregivers ◽

Health Care Use

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Socioeconomic position and mental health care use before and after first redeemed antidepressant and time until subsequent contact to psychologist or psychiatrists: a nationwide Danish follow-up study

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-020-01908-7 ◽

2020 ◽

Author(s):

Aake Packness ◽

Sonja Wehberg ◽

Lene Halling Hastrup ◽

Erik Simonsen ◽

Jens Søndergaard ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Socioeconomic Position ◽

Health Care Use ◽

Follow Up Study ◽

Before And After ◽

Mental Health Care Use

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Cost-effectiveness of neuromuscular ultrasound in focal neuropathies

Neurology ◽

10.1212/wnl.0000000000007602 ◽

2019 ◽

Vol 92 (23) ◽

pp. e2674-e2678 ◽

Cited By ~ 6

Author(s):

Ross Mandeville ◽

Arvin Wali ◽

Charlie Park ◽

Erik Groessl ◽

Francis O. Walker ◽

...

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Societal Perspective ◽

Short Form ◽

Controlled Trial ◽

Health Care Use ◽

Sensitivity Analyses ◽

Electrodiagnostic Testing ◽

Life Years

ObjectiveTo evaluate the cost-effectiveness of neuromuscular ultrasound (NMUS) for the evaluation of focal neuropathies.MethodsA prior prospective, randomized, double-blind controlled trial demonstrated that NMUS, when added to electrodiagnostic testing, resulted in improved clinical outcomes after 6 months of follow-up. From this study, we abstracted quality-adjusted life-years (QALYs) from the 36-item Short Form Health Survey and entered this health-utility estimate into a mixed trial and model-based cost-effectiveness analysis from the societal perspective. Costs of intervention (NMUS) were estimated from Medicare payment rates for Current Procedural Terminology codes. Health care use was otherwise estimated to be equal, but sensitivity analyses further examined this and other key assumptions. Incremental cost-effectiveness ratio (ICER) was used as the primary outcome with a willingness-to-pay threshold of $50,000 per QALY.ResultsThe predicted mean health outcome associated with use of NMUS was 0.079 QALY, and the mean cost was $37, resulting in an ICER of $463 per QALY. Results and conclusions remained robust across all sensitivity analyses, including variations in time horizon, initial distribution of health states, costs, and effectiveness.ConclusionsFrom a societal perspective, the addition of NMUS to electrodiagnostic testing when evaluating a focal neuropathy is cost-effective. A study of longer follow-up incorporating total health care use would further quantify the value of NMUS.ClinicalTrials.gov identifier:NCT01394822.

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Satisfaction with primary care and mental health care among individuals with severe mental illness in a rural area: a seven-year follow-up study of a clinical cohort

International Journal of Mental Health Systems ◽

10.1186/s13033-016-0064-8 ◽

2016 ◽

Vol 10 (1) ◽

Cited By ~ 11

Author(s):

Torleif Ruud ◽

Trond F. Aarre ◽

Berit Boeskov ◽

Per Ståle Husevåg ◽

Rigmor Klepp ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Illness ◽

Mental Health Care ◽

Severe Mental Illness ◽

Rural Area ◽

Clinical Cohort ◽

Follow Up Study

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Self-Rated Health and Subsequent Health Care Use among Military Personnel Returning from International Deployments

Military Medicine ◽

10.7205/milmed.169.2.128 ◽

2004 ◽

Vol 169 (2) ◽

pp. 128-133 ◽

Cited By ~ 6

Author(s):

David H. Trump ◽

P. Jeffrey Brady ◽

Cara H. Olsen

Keyword(s):

Health Care ◽

Military Personnel ◽

Health Care Use ◽

Self Rated Health

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Mental illness and health care use: a study among new neurological patients

General Hospital Psychiatry ◽

10.1016/j.genhosppsych.2004.10.005 ◽

2005 ◽

Vol 27 (2) ◽

pp. 119-124 ◽

Cited By ~ 14

Author(s):

Morten Steen Hansen ◽

Per Fink ◽

Lene Søndergaard ◽

Morten Frydenberg

Keyword(s):

Health Care ◽

Mental Illness ◽

Health Care Use ◽

Neurological Patients

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Emergency Health Care Use among Sociodemographic Groups of Children Presenting to Emergency Departments for Self-Harm in Alberta

CJEM ◽

10.1017/cem.2015.1 ◽

2015 ◽

Vol 17 (5) ◽

pp. 497-506

Author(s):

Amanda S. Newton ◽

Conrad I. Tsang ◽

Rhonda J. Rosychuk

Keyword(s):

Health Care ◽

First Nations ◽

Emergency Departments ◽

Population Based ◽

Health Care Use ◽

Administrative Databases ◽

Sociodemographic Differences ◽

Kaplan Meier ◽

Self Harm

AbstractObjectiveTo examine sociodemographic variations among children <18 years in (1) rates of self-harm visits to emergency departments (EDs) and (2) physician follow-up after the self-harm visit in Alberta.MethodsA retrospective, population-based cohort (2002–2011) of ED visits for self-harm by individuals <18 years was conducted using administrative databases from Alberta, Canada. Individuals were grouped by First Nations status or type of health care premium subsidy (family receipt of government subsidy, human services program subsidy, no subsidy received). Visits from 104 EDs were summarized by crude and directly standardized visit rates (DSVRs) per 100,000 individuals. Kaplan-Meier estimates for median estimated time to physician follow-up were calculated with 95% confidence intervals (CIs).ResultsDuring the study period, visit rates decreased with the exception of children from families receiving government-sponsored program subsidy (DSVRs 163/100,000 to 250/100,000;p=0.032). First Nations children had disproportionately fewer follow-up visits compared to other children. The median time to follow-up for First Nations children was 39 days (95% CI: 32, 48) compared to 16 days for children from families receiving no subsidy (95% CI: 14, 19), who had the shortest follow-up time after an ED visit.ConclusionsSociodemographic differences were evident in ED visit rates as well as the number of and time to physician follow-up visit. The disparities experienced by First Nations children in the follow-up period highlight an opportunity for culturally-grounded risk and needs assessment in the ED to determine and facilitate timely and appropriate follow-up care.

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Factors contributing to post-stroke health care utilization and costs. Secondary results from the Life After Stroke (LAST) study, a pragmatic randomized controlled trial

10.21203/rs.2.17944/v2 ◽

2020 ◽

Author(s):

Øystein Døhl ◽

Vidar Halsteinli ◽

Torun Askim ◽

Mari Gunnes ◽

Hege Ihle Hansen ◽

...

Keyword(s):

Health Care ◽

Health Care Costs ◽

Gait Speed ◽

Standard Care ◽

Controlled Trial ◽

Health Care Use ◽

Post Stroke ◽

Randomized Controlled ◽

Care Costs

Abstract Background The result from the Life After Stroke (LAST) study showed that an 18-month follow up program as part of the primary health care, did not improve maintenance of motor function for stroke survivors. In this study we evaluated whether the follow-up program could lead to a reduction in the use of health care compared to standard care. Furthermore, we analyse to what extent differences in health care costs for stroke patients could be explained by individual need factors (such as physical disability, cognitive impairment, age, gender and marital status), and we tested whether a generic health related quality of life (HRQoL) is able to predict the utilisation of health care services for patients post-stroke as well as more disease specific indexes. Methods The Last study was a multicentre, pragmatic, single-blinded, randomized controlled trial. Adults (age ≥18 years) with first-ever or recurrent stroke, community dwelling, with modified Rankin Scale <5. The study included 380 persons recruited 10 to 16 weeks post-stroke, randomly assigned to individualized coaching for 18 months (n=186) or standard care (n=194). Individual need was measured by the Motor assessment scale (MAS), Barthel Index, Hospital Anxiety and Depression Scale (HADS), modified Rankin Scale (mRS) and Gait speed. HRQoL was measured by EQ-5D-5L. Health care costs were estimated for each person based on individual information of health care use. Multivariate regression analysis was used to analyse cost differences between the groups and the relationship between individual costs and determinants of health care utilisation. Results There were higher total costs in the intervention group. MAS, Gait speed, HADS and mRS were significant identifiers of costs post-stroke, as was EQ-5D-5L. Conclusion Long term, regular individualized coaching did not reduce health care costs compared to standard care. We found that MAS, Gait speed, HADS and mRS were significant predictors for future health care use. The generic EQ-5D-5L performed equally well as the more detailed battery of outcome measures, suggesting that HRQoL measures may be a simple and efficient way of identifying patients in need of health care after stroke and targeting groups for interventions. Clinical Trial Registration : https://www.clinicaltrials.gov NCT01467206.

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