scholarly journals Using a Problem/Case-Based Learning Program to Increase First and Second Year Medical Students’ Discussions of Health Care Cost Topics

2019 ◽  
Vol 6 ◽  
pp. 238212051989117 ◽  
Author(s):  
Samara B Ginzburg ◽  
Jessica Schwartz ◽  
Susan Deutsch ◽  
David E Elkowitz ◽  
Robert Lucito ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Health Care Costs ◽  
Educational Program ◽  
Health Care Cost ◽  
Case Conferences ◽  
Case Based Learning ◽  
Second Year ◽  
Care Costs ◽  
Case Based

Background: The rising costs of health care in the United States are unsustainable and gaps in physician knowledge of how to provide care at a lower cost remains a contributing factor. It has been suggested that learning about health care costs should be incorporated into existing, already overburdened medical school curricula. Objective: To increase the discussion of health care costs among first and second year medical students, we added a component of health care cost education to an existing problem/case-based learning (PBL/CBL) program without adding curricular time. Design: A total of 98 medical students participated in this study throughout the first 2 years of their educational program. Students were charged with researching and discussing health care cost topics as part of their weekly PBL/CBL case conferences. Faculty facilitators tracked each student’s participation in discussions of health care cost topics as well as how often students initiated new conversations about health care cost topics during their case conferences. Results: 100% of students engaged in conversations about health care cost topics throughout their first and second year PBL/CBL program. In addition, students increasingly initiated new conversations about health care cost topics as they progressed through their courses from the first to the second year ( R2 = 0.887, P < .01). Conclusions: Sensitizing medical students early during their educational program to incorporate health care cost topics into their PBL/CBL case conferences proved an effective means for having them engage in conversations related to health care costs. These results offer a new, time-efficient option for incorporating health care cost topics for schools with PBL/CBL programs.

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

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.

Australian Schizophrenia Care and Assessment Programme: Real-World Schizophrenia: Economics

2007 ◽  
Vol 41 (10) ◽  
pp. 819-829 ◽  
Author(s):  
Paul B. Fitzgerald ◽  
William Montgomery ◽  
Anthony R. de Castella ◽  
Kate M. Filia ◽  
Sacha L. Filia ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Real World ◽  
Indirect Costs ◽  
Considerable Proportion ◽  
First Year ◽  
The Third ◽  
Assessment Programme ◽  
Second Year ◽  
Care Costs

Objective: The treatment of patients with schizophrenia consumes a considerable proportion of health service budgets, yet there have been few attempts to prospectively analyse the costs associated with this condition. Amid the current debate about where to invest scarce treatment resources to achieve optimal outcomes, real-world studies, such as the Schizophrenia Care and Assessment Programme (SCAP) contrast with hypothetically based models and provide comprehensive and broad-ranging data. Method: Direct health-care costs were prospectively studied in a cohort of 347 patients with schizophrenia in Dandenong, Australia over 3 years. Indirect costs were estimated from patient self-reported information. Results: The average annual societal cost was AU$32 160 per participant in the first year of the study, AU$27 190 in the second year and AU$29 181 in the third year. Indirect costs accounted for 46% of the total costs in the first year, 52% of the total costs in the second year and 50% of the total costs in the third year. The most expensive component of treatment was inpatient hospital care, which accounted for 42%, 34% and 36% of the total costs in the first, second and third year, respectively. Conclusions: Considerable resources are required for the provision of treatment for patients with schizophrenia. But for the majority of people in this cohort, funding assertive treatment programmes and measures to reduce hospitalization was accompanied with enhanced functioning and quality of life, as well as a reduction in long-term societal and government costs. The distribution of health-care costs is highly skewed, with a relatively small proportion of patients (39%) consuming the majority of resources (80%). Improving rates of employment for this patient group could hold substantial benefits in reducing the overall economic and personal impact of this disorder.

scholarly journals Opinion of undergraduate medical students of North Karnataka on case based learning for teaching Medical Microbiology

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Sudheendra Kulkarni ◽  
Chandrakant Chillarge ◽  
Kumar Sai Sailesh
Keyword(s):  
Medical Students ◽  
Likert Scale ◽  
Medical Sciences ◽  
Undergraduate Medical Students ◽  
Practical Applications ◽  
Medical Microbiology ◽  
Case Based Learning ◽  
Second Year ◽  
Self Administered Questionnaire ◽  
Case Based

The present study was undertaken to observe the student's opinion regarding the case based learning for teaching medical microbiology. The study was conducted in the Department of Microbiology, Bidar Institute of Medical sciences, Bidar, North Karnataka. 100 second, year MBBS students were included in the study. Students were exposed to case based lecture (topic-H.Pylori). After the Case based learning (CBL), the opinion of students was taken by using self administered questionnaire with 5 point likert scale. In the present study most of the student's preferred case based learning. We recommend including CBL as a part and parcel of medical microbiology curriculum for better understanding of subject and for practical applications.

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.

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.

scholarly journals Increasing Prevalence and Direct Health Care Cost of Inflammatory Bowel Disease Among Adults: A Population-Based Study From a Western Canadian Province

2021 ◽  
Author(s):  
Jessica Amankwah Osei ◽  
Juan Nicolás Peña-Sánchez ◽  
Sharyle A Fowler ◽  
Nazeem Muhajarine ◽  
Gilaad G Kaplan ◽  
...  
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Health Care Costs ◽  
Bowel Disease ◽  
Health Care Cost ◽  
Population Based ◽  
Annual Increase ◽  
Average Annual Increase ◽  
Inflammatory Bowel ◽  
Care Costs

Abstract Objectives Our study aimed to calculate the prevalence and estimate the direct health care costs of inflammatory bowel disease (IBD), and test if trends in the prevalence and direct health care costs of IBD increased over two decades in the province of Saskatchewan, Canada. Methods We conducted a retrospective population-based cohort study using administrative health data of Saskatchewan between 1999/2000 and 2016/2017 fiscal years. A validated case definition was used to identify prevalent IBD cases. Direct health care costs were estimated in 2013/2014 Canadian dollars. Generalized linear models with generalized estimating equations tested the trend. Annual prevalence rates and direct health care costs were estimated along with their 95% confidence intervals (95%CI). Results In 2016/2017, 6468 IBD cases were observed in our cohort; Crohn’s disease: 3663 (56.6%), ulcerative colitis: 2805 (43.4%). The prevalence of IBD increased from 341/100,000 (95%CI 340 to 341) in 1999/2000 to 664/100,000 (95%CI 663 to 665) population in 2016/2017, resulting in a 3.3% (95%CI 2.4 to 4.3) average annual increase. The estimated average health care cost for each IBD patient increased from $1879 (95%CI 1686 to 2093) in 1999/2000 to $7185 (95%CI 6733 to 7668) in 2016/2017, corresponding to an average annual increase of 9.5% (95%CI 8.9 to 10.1). Conclusions Our results provide relevant information and analysis on the burden of IBD in Saskatchewan. The evidence of the constant increasing prevalence and health care cost trends of IBD needs to be recognized by health care decision-makers to promote cost-effective health care policies at provincial and national levels and respond to the needs of patients living with IBD.

scholarly journals Managing health care in Australia: Steps on the health care roundabout?

2003 ◽  
Vol 9 (3) ◽  
pp. 105 ◽  
Author(s):  
Peter Harvey
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Population Health ◽  
Health Care Costs ◽  
Health Care Cost ◽  
Illness Management ◽  
Health Care Market ◽  
Coordinated Care ◽  
Management Skills ◽  
Care Costs

This paper explores some of the lessons of the coordinated care trials in Australia in the context of managed care in America and asks how do we best manage our finite health care dollars for the most equitable and effective outcomes for whole populations? The COAG trial in Australia tested a more structured process for managing the care of patients with chronic illness and postulated that currently fragmented health system funding could be pooled around individual patient need, and managed for improved economic outcomes and patient wellbeing. There is little doubt, following this initiative and much work in other countries, that as health care costs rise, for a range of reasons, improvements are needed in the management of our resources if we are to control rising health care costs. We also know that chronic illness, much of which is preventable and avoidable, is the major component in the rising health care cost equation and a factor likely to consume around 75% of our health dollars in the future. Much chronic illness can be prevented through social and population health strategies and we know that even if chronic illness can?t be prevented, it can be managed better through community-based chronic illness management programs. These programs rely on information, education, patient lifestyle and behaviour change, and on patients developing improved self-management skills. But, what is the best way to manage population health in Australia and ensure equity and fairness in the health care market as we evolve new approaches, especially to the management of chronic illness?

Malnutrition-Related Health Care Cost in Japan: An Analysis of Health Insurance Claims Data

2019 ◽  
Vol 31 (7) ◽  
pp. 594-602
Author(s):  
Sumito Ogawa ◽  
Tatsuya Hosoi ◽  
Masahiro Akishita ◽  
Ataru Igarashi
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Costs ◽  
Health Care Cost ◽  
International Classification Of Diseases ◽  
Health Insurance Data ◽  
Classification Of Diseases ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Care Costs

The objective of our study is to evaluate the prevalence and health care cost of malnutrition in Japan. Using the health insurance data, we defined 2 types of malnutrition, strictly diagnosed malnutrition (SDM) and disease-associated malnutrition (DAM) by International Classification of Diseases 10th Revision. We also analyzed the health care costs by body mass index (BMI) data from medical checkups. The nationwide prevalence of SDM was estimated 0.8%, and that of SDM plus DAM was 2.9%. The total annual health care cost for SDM patients in Japan was $14.5 billion, representing 4.3% of the national health expenditures in 2014; the excess cost for patients with SDM was estimated to be $9.7 billion. The health care costs became high among the patients with either low BMI or high BMI. Because of the rapidly aging population, actions are urgently needed to avoid increasing the current high health care costs of malnutrition.

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