The Distribution of Health Care Costs and Their Statistical Analysis for Economic Evaluation

1998 ◽  
Vol 3 (4) ◽  
pp. 233-245 ◽  
Author(s):  
Andrew Briggs ◽  
Alastair Gray
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Care Cost ◽  
Cost Data ◽  
Parametric Methods ◽  
Patient Level Data ◽  
Patient Level ◽  
Level Data ◽  
Care Costs ◽  
Non Parametric

Objective: Where patient level data are available on health care costs, it is natural to use statistical analysis to describe the differences in cost between alternative treatments. Health care costs are, however, commonly considered to be skewed, which could present problems for standard statistical tests. This review examines how authors report the distributional form of health care cost data and how they have analysed their results. Method: A review of cost-effectiveness studies that collected patient-level data on health care costs. To supplement the review, five datasets on health care costs are examined. Consideration is given to the use of parametric methods on the transformed scale and to non-parametric methods of analysing skewed cost data. Results: Since economic analysis requires estimation in monetary units, the usefulness of transformation-based methods is limited by the inability to retransform cost differences to the original scale. Non-parametric rank sum methods were also found to be of limited use for economic analysis, partly due to the focus on hypothesis testing rather than estimation. Overall, the non-parametric approach of bootstrapping was found to offer a useful test of the appropriateness of parametric assumptions and an alternative method of estimation where those assumptions were found not to hold. Conclusions: Guidelines for the analysis of skewed health care cost data are offered.

scholarly journals THU0548 THE ECONOMIC BURDEN OF ANKYLOSING SPONDYLITIS IN SPAIN. RESULTS OF THE SPANISH ATLAS 2017

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 514.2-514
Author(s):  
M. Merino ◽  
O. Braçe ◽  
A. González ◽  
Á. Hidalgo-Vega ◽  
M. Garrido-Cumbrera ◽  
...  
Keyword(s):  
Health Care ◽  
Ankylosing Spondylitis ◽  
Health Care Costs ◽  
Health Care Cost ◽  
Labour Productivity ◽  
General Health Questionnaire ◽  
Indirect Costs ◽  
Productivity Losses ◽  
The Cost ◽  
Care Costs

Background:Ankylosing Spondylitis (AS) is a disease associated with a high number of comorbidities, chronic pain, functional disability, and resource consumption.Objectives:This study aimed to estimate the burden of disease for patients diagnosed with AS in Spain.Methods:Data from 578 unselected patients with AS were collected in 2016 for the Spanish Atlas of Axial Spondyloarthritis via an online survey. The estimated costs were: Direct Health Care Costs (borne by the National Health System, NHS) and Direct Non-Health Care Costs (borne by patients) were estimated with the bottom-up method, multiplying the resource consumption by the unit price of each resource. Indirect Costs (labour productivity losses) were estimated using the human capital method. Costs were compared between levels of disease activity using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score (<4 or low inflammation versus ≥4 or high inflammation) and risk of mental distress using the 12-item General Health Questionnaire (GHQ-12) score (<3 or low risk versus ≥3 or high risk).Results:The average annual cost per patient with AS in 2015 amounted to €11,462.3 (± 13,745.5) per patient. Direct Health Care Cost meant an annual average of €6,999.8 (± 9,216.8) per patient, to which an annual average of €611.3 (± 1,276.5) per patient associated with Direct Non-Health Care Cost borne by patients must be added. Pharmacological treatment accounted for the largest percentage of the costs borne by the NHS (64.6%), while for patients most of the cost was attributed to rehabilitative therapies and/or physical activity (91%). The average annual Indirect Costs derived from labour productivity losses were €3,851.2 (± 8,484.0) per patient, mainly associated to absenteeism. All categories showed statistically significant differences (p<0.05) between BASDAI groups (<4 vs ≥4) except for the Direct Non-Healthcare Cost, showing a progressive rise in cost from low to high inflammation. Regarding the 12-item General Health Questionnaire (GHQ-12), all categories showed statistically significant differences between GHQ-12 (<3 vs ≥3), with higher costs associated with higher risk of poor mental health (Table 1).Table 1.Average annual costs per patient according to BASDAI and GHQ-12 groups (in Euros, 2015)NDirect Health CostsDirect Non-Health CostsIndirect CostsTotal CostBASDAI<4917,592.0*557.32,426.5*10,575.8*≥43769,706.9*768.05,104.8*15,579.7*Psychological distress (GHQ-12)<31468,146.8*493.6*3,927.2*12,567.6*≥32609,772.9*807.2*4,512.3*15,092.5*Total5786,999.8611.33,851.211,462.3* p <0.05Conclusion:Direct Health Care Costs, and those attributed to pharmacological treatment in particular, accounted for the largest component of the cost associated with AS. However, a significant proportion of the overall costs can be further attributed to labour productivity losses.Acknowledgments:Funded by Novartis Farmacéutica S.A.Disclosure of Interests:María Merino: None declared, Olta Braçe: None declared, Almudena González: None declared, Álvaro Hidalgo-Vega: None declared, Marco Garrido-Cumbrera: None declared, Jordi Gratacos-Masmitja Grant/research support from: a grant from Pfizzer to study implementation of multidisciplinary units to manage PSA in SPAIN, Consultant of: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly, Speakers bureau: Pfizzer, MSD, ABBVIE, Janssen, Amgen, BMS, Novartis, Lilly

Modeling Public Health Care Expenditure Using Patient Level Data: Empirical Evidence from Italy

2016 ◽  
Author(s):  
Vincenzo Atella ◽  
Federico Belotti ◽  
Valentina Conti ◽  
Claudio Alberto Cricelli ◽  
Joanna Kopinska ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Empirical Evidence ◽  
Health Care Expenditure ◽  
Public Health Care ◽  
Patient Level Data ◽  
Patient Level ◽  
Level Data

Health care costs of physical inactivity in Canadian adults

2012 ◽  
Vol 37 (4) ◽  
pp. 803-806 ◽  
Author(s):  
Ian Janssen
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Physical Inactivity ◽  
Health Care Cost ◽  
Care Costs

The purpose of this study was to provide a contemporary estimate of the health care cost of physical inactivity in Canadian adults. The health care cost was estimated using a prevalence-based approach. The estimated direct, indirect, and total health care costs of physical inactivity in Canada in 2009 were $2.4 billion, $4.3 billion, and $6.8 billion, respectively. These values represented 3.8%, 3.6%, and 3.7% of the overall health care costs.

A Labor-Management Approach to Health Care Cost Savings: The Peoria Experience

1998 ◽  
Vol 27 (1) ◽  
pp. 23-37
Author(s):  
Patrick A. Parsons ◽  
Jerry Belcher ◽  
Tom Jackson
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Care Cost ◽  
Quality Of Work Life ◽  
Care Plan ◽  
Management Approach ◽  
Labor Management ◽  
Positive Effects ◽  
The City ◽  
Care Costs

Health care costs and the nature of the benefits package are an issue that plagues most jurisdictions. Written in a cooperative effort to reflect the perspectives of the labor and management co-chairs, Peoria's story is an example of the cooperation that has developed in that city. In addition to describing a remarkable city-wide effort to reduce health care costs and maintain an attractive benefit package, the article shows how success on a topic of importance to the parties and the community can sow the seeds of a broader cooperative relationship that improves services, quality of work life and the nature of the labor-management relationship. By agreement, the city and labor unions took the health care plan off the bargaining table, and instead, gave it to a city-wide joint committee, which solved the crisis and manages this difficult issue. Among other advances that mark a change from the past, the positive effects from the dramatic success in health care has contributed to a first-ever, five-year negotiated settlement between the city and the firefighters. Read about how Peoria accomplished this change by bold risk taking and by carefully nurturing the effort.

Direct Health Care Cost and Work Incapacity Related to Complex Regional Pain Syndrome in Switzerland: A Retrospective Analysis from 2008 to 2015

Pain Medicine ◽  
2019 ◽  
Vol 20 (8) ◽  
pp. 1559-1569 ◽  
Author(s):  
Stefan Markus Scholz-Odermatt ◽  
François Luthi ◽  
Maria Monika Wertli ◽  
Florian Brunner
Keyword(s):  
Health Care ◽  
Complex Regional Pain Syndrome ◽  
Health Care Costs ◽  
Health Care Cost ◽  
Rare Condition ◽  
Pain Syndrome ◽  
Treatment Costs ◽  
Insurance Costs ◽  
Increased Risk ◽  
Care Costs

Abstract Objective First, to determine the number of accident-related complex regional pain syndrome (CRPS) cases from 2008 to 2015 and to identify factors associated with an increased risk for developing CRPS. Second, to analyze the duration of work incapacity and direct health care costs over follow-up periods of two and five years, respectively. Design Retrospective data analysis. Setting Database from the Statistical Service for the Swiss National Accident Insurances covering all accidents insured under the compulsory Swiss Accident Insurance Law. Subjects Subjects were registered after an accident between 2008 and 2015. Methods Cases were retrospectively retrieved from the Statistical Service for the Swiss National Accident Insurances. Cases were identified using the appropriate International Classification of Diseases, 10th Revision, codes. Results CRPS accounted for 0.15% of all accident cases. Age, female gender (odds ratio [OR] = 1.53, 95% confidence interval [CI] = 1.47–1.60), and fracture of the forearm (OR = 38, 95% CI = 35–42) were related to an increased risk of developing CRPS. Over five years, one CRPS case accumulated average insurance costs of $86,900 USD and treatment costs of $23,300 USD. Insurance costs were 19 times and treatment costs 13 times the average costs of accidents without CPRS. Within the first two years after the accident, the number of days lost at work was 20 times higher in patients with CRPS (330 ± 7 days) than in patients without CRPS (16.1 ± 0.1 days). Two-thirds of all CRPS cases developed long-term work incapacity of more than 90 days. Conclusion CRPS is a relatively rare condition but is associated with high direct health care costs and work incapacity.

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