scholarly journals Cost of Cleft Team Care at an Academic Children’s Hospital

2021 ◽  
pp. 105566562110468
Author(s):  
Jennifer Lee ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
Sibyl Scheve ◽  
Cheryl Grellner ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Financial Burden ◽  
Insurance Plan ◽  
Successful Completion ◽  
Multiple Stakeholders ◽  
Hospital Administrators ◽  
Team Care ◽  
Care Visit ◽  
Patient Retention ◽  
Out Of Pocket Costs

Background The financial burden of cleft-craniofacial team care is substantial, and high costs can hinder successful completion of team care. Solution Collaboration with multiple stakeholders including providers, insurers, and patient guardians, as well as hospital administrators, is critical to increase patient retention and improve final clinical outcomes. What We Do That is New At our cleft and craniofacial center, charges for a team care visit fall into one of three categories—hospital fees, professional fees, or external fees. There are four types of hospital fees depending on (1) whether the patient is new or returning, and (2) whether the patient saw ≤4 or ≥5 providers. To further elucidate the financial burden (out-of-pocket costs) directly borne by families of children with cleft lip and/or palate, we conducted a retrospective review of billing records of team care visits made between September 2019 and March 2020. Out-of-pocket costs for a single team care visit (on a commercial insurance plan) ranged from $4 to approximately $1220 and had a median (IQR) of $445 ($118, $749).

P053 VARIATIONS IN HEALTHCARE UTILIZATION PATTERNS AMONG HIGH RISK INFLAMMATORY BOWEL DISEASE PATIENTS ENROLLED IN HIGH DEDUCTIBLE HEALTH PLANS

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S67-S68
Author(s):  
Jeffrey Berinstein ◽  
Shirley Cohen-Mekelburg ◽  
Calen Steiner ◽  
Megan Mcleod ◽  
Mohamed Noureldin ◽  
...  
Keyword(s):  
At Risk ◽  
Resource Utilization ◽  
Time Trends ◽  
Healthcare Costs ◽  
Insurance Plan ◽  
High Resource ◽  
Patients At Risk ◽  
Inflammatory Bowel ◽  
Ed Visits ◽  
Out Of Pocket Costs

Abstract Background High-deductible health plan (HDHP) enrollment has increased rapidly over the last decade. Patients with HDHPs are incentivized to delay or avoid necessary medical care. We aimed to quantify the out-of-pocket costs of Inflammatory Bowel Disease (IBD) patients at risk for high healthcare resource utilization and to evaluate for differences in medical service utilization according to time in insurance period between HDHP and traditional health plan (THP) enrollees. Variations in healthcare utilization according to time may suggest that these patients are delaying or foregoing necessary medical care due to healthcare costs. Methods IBD patients at risk for high resource utilization (defined as recent corticosteroid and narcotic use) continuously enrolled in an HDHP or THP from 2009–2016 were identified using the Truven Health MarketScan database. Median annual financial information was calculated. Time trends in office visits, colonoscopies, emergency department (ED) visits, and hospitalizations were evaluated using additive decomposition time series analysis. Financial information and time trends were compared between the two insurance plan groups. Results Of 605,862 with a diagnosis of IBD, we identified 13,052 patients at risk for high resource utilization with continuous insurance plan enrollment. The median annual out-of-pocket costs were higher in the HDHP group (n=524) than in the THP group (n=12,458) ($1,920 vs. $1,205, p<0.001), as was the median deductible amount ($1,015 vs $289, p<0.001), without any difference in the median annual total healthcare expenses (Figure 1). Time in insurance period had a greater influence on utilization of colonoscopies, ED visits, and hospitalization in IBD patients enrolled in HDHPs compared to THPs (Figure 2). Colonoscopies peaked in the 4th quarter, ED visits peaked in the 1st quarter, and hospitalizations peaked in the 3rd and 4th quarter. Conclusion Among IBD patients at high risk for IBD-related utilization, HDHP enrollment does not change the cost of care, but shifts healthcare costs onto patients. This may be a result of HDHPs incentivizing delays with a potential for both worse disease outcomes and financial toxicity and needs to be further examined using prospective studies.

scholarly journals Out-of-Pocket Costs and Perceived Financial Burden Associated with Prostate Cancer Treatment in a Quebec Remote Area: A Cross-Sectional Study

2020 ◽  
Vol 28 (1) ◽  
pp. 26-39
Author(s):  
Abir El-Haouly ◽  
Anais Lacasse ◽  
Hares El-Rami ◽  
Frederic Liandier ◽  
Alice Dragomir
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
University Education ◽  
School Level ◽  
Sectional Study ◽  
Cross Sectional ◽  
Perceived Burden ◽  
Out Of Pocket Costs

Background: In publicly funded healthcare systems, patients do not pay for medical visits but can experience costs stemming from travel or over-the-counter drugs. We lack information about the extent of this burden in Canadian remote regions. This study aimed to: (1) describe prostate cancer-related out-of-pocket costs and perceived financial burden, and (2) identify factors associated with such a perceived burden among prostate cancer patients living in a remote region of the province of Quebec (Canada). Methods: A cross-sectional study was conducted among 171 prostate cancer patients who consulted at the outpatient clinic of the Centre Hospitalier de Rouyn-Noranda. Results: The majority of patients (83%) had incurred out-of-pocket costs for their cancer care. The mean total cost incurred in the last three months was $517 and 22.3% reported a moderate, considerable or unsustainable burden. Multivariable analysis revealed that having incurred higher cancer-related out-of-pocket costs (OR: 1.001; 95%CI: 1.001–1.002) private drug insurance (vs. public, OR: 5.23; 95%CI: 1.13–24.17) was associated with a greater perceived financial burden. Having better physical health-related quality of life (OR: 0.95; 95%CI: 0.913–0.997), a university education (vs. elementary/high school level, OR: 0.03; 95%CI: 0.00–0.79), and an income between $40,000 and $79,999 (vs. ≤ $39,999, OR: 0.15; 95%CI: 0.03–0.69) were associated with a lower perceived burden. Conclusion: Prostate cancer patients incur out-of-pocket costs even if they were diagnosed many years ago and the perceived burden is significant. Greater attention should be paid to the development of services to help patients manage this burden.

scholarly journals Role of Multiple Stakeholders in Value Co-creation and Effects on Medical Tourism

2020 ◽  
Vol 9 (1) ◽  
pp. 18-26
Author(s):  
Prabal Chakraborty ◽  
Moumita Poddar
Keyword(s):  
Medical Tourism ◽  
Service Providers ◽  
Home Country ◽  
Healthcare Sector ◽  
Infrastructure Development ◽  
Multiple Stakeholders ◽  
Creation Process ◽  
The Relationship ◽  
Patient Retention

Medical tourism is a continuously growing industry, and hospitals of the home country are the service providers for the foreign patients. Hospitals are focusing on quality improvement, infrastructure development, networking, and cost minimizations to attract foreign patients due to stiff competitions. Prahalad and Ramaswamy (2004) explained value co-creation, which ultimately achieved through Dialogue, Access, Risk, Transparency) DART concept. Another seminal research in this arena is the development of “service-dominant logic” concept by Vargo and Lusch (2004). The purpose of this article is to understand the collaboration of multiple stakeholders in co-creation process in the context of healthcare sector, which ultimately effects medical tourism. Our study also suggests a model that demonstrates the relationship between the factors responsible for brand co-creation in medical tourism and patient retention in multispecialty hospitals. We took help from past literatures to frame the model. Our study conceptualizes the collaboration of multiple stakeholders for value co-creation in the healthcare sector which ultimately affects Medical Tourism and proposes a framework. This study also examines role of patients and multiple stakeholders in value co-creation process and model we proposed where we explained the factors responsible for brand co-creation in medical tourism and patients’ retention. The result of the study—in line with the study performed by Dijk, Antonides, and Schillewaertz (2014), we may conclude that “co-creation has an element in marketing and branding strategies of an organization.”

Perspectives and practices of oncology providers in addressing financial toxicity.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18342-e18342
Author(s):  
Meera Vimala Ragavan ◽  
Divya Ahuja Parikh ◽  
Manali I. Patel
Keyword(s):  
Cost Effectiveness ◽  
Financial Burden ◽  
Cost Of Care ◽  
Extensive Literature ◽  
Financial Toxicity ◽  
Clinical Practices ◽  
Oncology Providers ◽  
Attending Physicians ◽  
Out Of Pocket Costs ◽  
Available Resources

e18342 Background: Few studies have evaluated the perspectives and clinical practices of oncology providers in regards to assisting patients with financial toxicity. Our study sought to assess providers’ attitudes regarding their role in addressing patients’ financial concerns, understand practice patterns in discussing cost of care, and obtain feedback on potential interventions to help address existing barriers. Methods: We developed an 18-question electronic, anonymous survey informed by an extensive literature search and piloted with three physicians with health services research experience. We emailed the survey to 75 attending physicians in Medical Oncology, Hematology, and Radiation Oncology, 117 advance practice practitioners (APPs) and 46 trainees. Responses during the study period 12/12/2018-1/31/2019 were analyzed. Results: A total of 71 (response rate of 30%) participants completed the survey, including 31 attending physicians, 28 APPs, and 12 trainees. Sixty-two percent of participants agreed that oncology providers should openly discuss cost of care with patients. There was wide variation in opinion around whether providers should offer the same treatment recommendations to all patients regardless of cost, with one third stating they agreed, one third stating they disagreed, and one third stating they were neutral. Sixty-one percent of participants did not use any cost-effectiveness tools in decision making. Sixty-three percent of respondents stated that a gap in knowledge of out of pocket costs was the number one barrier to helping patients avoid financial toxicity. The highest ranked intervention of those listed was a guide on available resources for patients with financial needs, voted for by 70% of respondents. Conclusions: Providers identified many barriers at our institution to discussing cost of care, including lack of transparency of out of pocket costs and lack of awareness of available resources. Providers were overwhelmingly interested in incorporating institutional resources and cost-effectiveness tools into their clinical practices. These findings can inform provider-level interventions to better address the financial burden patients face with their cancer care.

scholarly journals The Financial Burden of Opioid-Related Abuse among Surgical and Non-Surgical Patients in Florida: A Longitudinal Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9127
Author(s):  
Jing Xu ◽  
Nazik M. A. Zakari ◽  
Hanadi Y. Hamadi ◽  
Sinyoung Park ◽  
Donald Rob Haley ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Financial Burden ◽  
Opioid Abuse ◽  
Opioid Use ◽  
Retrospective Case ◽  
Discharge Data ◽  
Hospital Administrators ◽  
Icd 10 ◽  
Longitudinal Study Design ◽  
Insight Into

Florida is one of the eight states labeled as a high-burden opioid abuse state and is an epicenter for opioid use and misuse. The aim of our study was to measure multi-year total room charges and costs billed for opioid abuse-related events and to compare the costs of inpatient opioid abusers and non-opioid abusers for Florida hospitals from 2011 to 2017. We constructed a retrospective case-control longitudinal study design on inpatient administrative discharge data across 173 hospitals. Opioid abuse was defined using both ICD-9-CM and ICD-10-CM systems. We found a statistically significant association between opioid abuse diagnosis and total room charge. On average, opioid abuse status increased the room charges by 8.1%. We also noticed year-to-year variations in opioid abuse had a remarkable influence on hospital finances. We showed that since 2015, the differences significantly increased from 4–5% to 13–14% for both room charges and cost, which indicates the financial burden due to opioid abuse becoming more frequent. These findings are important to policymakers and hospital administrators because they provide crucial insight into Florida’s opioid crisis and its economic burden on hospitals.

scholarly journals Cleft and Craniofacial Multidisciplinary Team Clinic: A Look at Attrition Rates for Patients With Complete Cleft Lip and Palate and Nonsyndromic Single-Suture Craniosynostosis

2019 ◽  
Vol 56 (10) ◽  
pp. 1287-1294 ◽  
Author(s):  
Danielle C. Cooper ◽  
Erin C. Peterson ◽  
Cheryl G. Grellner ◽  
Sybill D. Naidoo ◽  
Gary B. Skolnick ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cox Regression ◽  
The United States ◽  
Attrition Rates ◽  
Personalized Care ◽  
Team Care ◽  
Lost To Follow Up ◽  
Single Suture

Objective: To evaluate attrition rates prior to expected completion of team care for children with complete cleft lip and palate (cleft) or nonsyndromic single-suture craniosynostosis (synostosis). Design: A single-institution retrospective review of attendance data from 2002 to 2016. Setting: Single cleft and craniofacial center in the United States. Patients/Participants: A sample of 983 patients with either cleft or synostosis. Patients who were more than 2 to 3 years from their last visit were considered lost to follow-up. Patients with cleft older than 16 years or synostosis over 11 years were considered graduated from team care. Results: Survival analysis shows that in our patients with cleft, 25% leave before age 8 and over 60% are lost from team by age 16. In patients with synostosis, 25% leave before age 6 and 45% are lost by age 11. Cox regression showed underrepresented minorities being 1.7 times more likely to become lost in the cleft group (hazard ratio: 1.66, 95% confidence interval [CI]: 1.01-2.74). Conclusions: Overall, attrition rates were high at our institution. Many patients are lost to follow-up prior to receiving key medical interventions. Improved family education and personalized care are needed to help ensure continuity of care.

scholarly journals Out-of-pocket costs are on the rise for commonly prescribed neurologic medications

Neurology ◽  
2019 ◽  
Vol 92 (22) ◽  
pp. e2604-e2613 ◽  
Author(s):  
Brian C. Callaghan ◽  
Evan Reynolds ◽  
Mousumi Banerjee ◽  
Kevin A. Kerber ◽  
Lesli E. Skolarus ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Financial Burden ◽  
Health Plans ◽  
Cost Information ◽  
Neurologic Diseases ◽  
Medication Costs ◽  
Out Of Pocket Expenses ◽  
Medium Cost ◽  
Health Care Claims ◽  
Out Of Pocket Costs

ObjectiveTo determine out-of-pocket costs for neurologic medications in 5 common neurologic diseases.MethodsUtilizing a large, privately insured, health care claims database from 2004 to 2016, we captured out-of-pocket medication costs for patients seen by outpatient neurologists with multiple sclerosis (MS), peripheral neuropathy, epilepsy, dementia, and Parkinson disease (PD). We compared out-of-pocket costs for those in high-deductible health plans compared to traditional plans and explored cumulative out-of-pocket costs over the first 2 years after diagnosis across conditions with high- (MS) and low/medium-cost (epilepsy) medications.ResultsThe population consisted of 105,355 patients with MS, 314,530 with peripheral neuropathy, 281,073 with epilepsy, 120,720 with dementia, and 90,801 with PD. MS medications had the fastest rise in monthly out-of-pocket expenses (mean [SD] $15 [$23] in 2004, $309 [$593] in 2016) with minimal differences between medications. Out-of-pocket costs for brand name medications in the other conditions also rose considerably. Patients in high-deductible health plans incurred approximately twice the monthly out-of-pocket expense as compared to those not in these plans ($661 [$964] vs $246 [$472] in MS, $40 [$94] vs $18 [$46] in epilepsy in 2016). Cumulative 2-year out-of-pocket costs rose almost linearly over time in MS ($2,238 [$3,342]) and epilepsy ($230 [$443]).ConclusionsOut-of-pocket costs for neurologic medications have increased considerably over the last 12 years, particularly for those in high-deductible health plans. Out-of-pocket costs vary widely both across and within conditions. To minimize patient financial burden, neurologists require access to precise cost information when making treatment decisions.

Financial toxicity of cancer treatment at a diverse county hospital.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 76-76
Author(s):  
Divya Ahuja Parikh ◽  
Meera Vimala Ragavan ◽  
Debeshi Maitra ◽  
Sangeeta Aggarwal ◽  
Manali I. Patel
Keyword(s):  
Sex Education ◽  
Low Income ◽  
Cancer Care ◽  
Financial Burden ◽  
Education Level ◽  
Financial Toxicity ◽  
Demographic Information ◽  
Significant Difference ◽  
The Cost ◽  
Out Of Pocket Costs

76 Background: The rising costs of cancer care increasingly results in financial distress for patients and their families. Low-income patients face a greater burden of financial toxicity, but few studies have characterized what factors contribute to this, and what interventions can relieve toxicity. Methods: From October 2017 to December 2017, we used a validated COST survey tool to understand the extent of financial burden that patients with cancer experience. We surveyed patients who receive their oncology care in a medical system that serves predominantly minority and low-income patients in Santa Clara County. We collected demographic information including sex, education level, ethnicity, income, insurance status, monthly out of pocket costs (OOPC) and employment status prior to diagnosis. We used a multivariable linear regression to study the association between the patient factors and financial burden as demonstrated by the COST score. All data were analyzed using Stata 14. Results: Demographic information is presented in Table 1. A total of 152 patients completed all 11 items of the COST survey. In the multivariate model, there was no significant difference in COST score by sex, education level, or ethnicity. However, income ≤$25,000 was associated with higher COST scores (p = 0.019), as was higher monthly OOPC (p = 0.003). Medicare patients and patients who were employed prior to diagnosis tended to have higher COST scores although not quite statistically significant (p = 0.057, p = 0.083). Conclusions: Patient-reported financial toxicity is an unmet concern among patients in this single institution study with a high proportion of underinsured patients. Higher OOPC and low income was associated with a higher financial burden. These findings suggest that patients would benefit from targeted interventions to mediate out of pocket costs of cancer care.[Table: see text]

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