scholarly journals Provision of Dermatologic Care in a Universal Health Care System: A 17-Year Review

2021 ◽  
pp. 120347542110081
Author(s):  
Alexandra Finstad ◽  
Nouf Almuhanna ◽  
Raed Alhusayen

Background Limited data is available on the burden of dermatologic disease including disease distribution and providers of care. Research is needed to facilitate health care planning and improve patient care. Objectives To investigate the demographics and economics of the provision of dermatologic care in a universal health care system from fiscal year 2000 to 2016. Methods A retrospective population-based analysis was performed on physician billing claims for dermatologic conditions from April 1, 2000 to March 31, 2017. Data came from the province of Ontario’s universal health care plan claims records accessed through IntelliHealth. Results Dermatologic claims made up 3.6% of all physician claims, with a 20% increase seen over time. The cost of dermatologic claims increased by 70% between fiscal 2000 and 2016, with the average cost per claim increasing by 41%. However, the cost of dermatologic claims as a percentage of all health care claims experienced a decline from 3.5% in fiscal 2000 to 2.8% in fiscal 2016. Over the study period, family physicians submitted 56% to 62% of dermatologic claims, dermatologists 24% to 29%, pediatricians 3% to 4%, and internists 1%. Overall, internists billed the highest average cost per dermatologic claim ranging from $39 in 2000 to $60 in 2016, followed by pediatricians at $33 to $58, dermatologists at $28 to $39, and family physicians at $23 to $30. Conclusions The demographic and economic burden of dermatologic disease is changing over time, with implications for health care planning, advancing medical education, and patient care.

2011 ◽  
Vol 29 (12) ◽  
pp. 1587-1591 ◽  
Author(s):  
Thi H. Ho ◽  
Lisa Barbera ◽  
Refik Saskin ◽  
Hong Lu ◽  
Bridget A. Neville ◽  
...  

Purpose To describe trends in the aggressiveness of end-of-life (EOL) cancer care in a universal health care system in Ontario, Canada, between 1993 and 2004, and to compare with findings reported in the United States. Methods A population-based, retrospective, cohort study that used administrative data linked to registry data. Aggressiveness of EOL care was defined as the occurrence of at least one of the following indicators: last dose of chemotherapy received within 14 days of death; more than one emergency department (ED) visit within 30 days of death; more than one hospitalization within 30 days of death; or at least one intensive care unit (ICU) admission within 30 days of death. Results Among 227,161 patients, 22.4% experienced at least one incident of potentially aggressive EOL cancer care. Multivariable analyses showed that with each successive year, patients were significantly more likely to encounter some aggressive intervention (odds ratio, 1.01; 95% CI, 1.01 to 1.02). Multiple emergency department (ED) visits, ICU admissions, and chemotherapy use increased significantly over time, whereas multiple hospital admissions declined (P < .05). Patients were more likely to receive aggressive EOL care if they were men, were younger, lived in rural regions, had a higher level of comorbidity, or had breast, lung, or hematologic malignancies. Chemotherapy and ICU utilization were lower in Ontario than in the United States. Conclusion Aggressiveness of cancer care near the EOL is increasing over time in Ontario, Canada, although overall rates were lower than in the United States. Health system characteristics and patient or physician cultural factors may play a role in the observed differences.


HPB ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 319-327 ◽  
Author(s):  
Linn S. Nymo ◽  
Kjetil Søreide ◽  
Dyre Kleive ◽  
Frank Olsen ◽  
Kristoffer Lassen

Cancer ◽  
2020 ◽  
Vol 126 (20) ◽  
pp. 4545-4552
Author(s):  
Laura E. Davis ◽  
Natalie G. Coburn ◽  
Julie Hallet ◽  
Craig C. Earle ◽  
Ying Liu ◽  
...  

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