scholarly journals Discovering the cost of care: consumer, provider, and retailer surveys shed light on the determinants of malaria health-seeking behaviours

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Amruta Dixit ◽  
Ming-Chieh Lee ◽  
Brittany Goettsch ◽  
Yaw Afrane ◽  
Andrew K. Githeko ◽  
...  
Keyword(s):  
Cost Of Care ◽  
Health Seeking ◽  
Consumer Provider ◽  
The Cost ◽  
Shed Light

GSS 2011 Linked with TIFF: Exploring the Cost of Child Care in Canada and the Use of the Child Care Tax Benefit

2019 ◽  
Vol 12 (1) ◽  
pp. 81-103
Author(s):  
Leanne Findlay ◽  
Dafna Kohen
Keyword(s):  
Child Care ◽  
General Social Survey ◽  
Cost Of Care ◽  
Indigenous Identity ◽  
Social Survey ◽  
The Cost ◽  
Care Costs ◽  
Compare And Contrast ◽  
Employment Characteristics ◽  
Different Sources

Affordability of child care is fundamental to parents’, in particular, women’s decision to work. However, information on the cost of care in Canada is limited. The purpose of the current study was to examine the feasibility of using linked survey and administrative data to compare and contrast parent-reported child care costs based on two different sources of data. The linked file brings together data from the 2011 General Social Survey (GSS) and the annual tax files (TIFF) for the corresponding year (2010). Descriptive analyses were conducted to examine the socio-demographic and employment characteristics of respondents who reported using child care, and child care costs were compared. In 2011, parents who reported currently paying for child care (GSS) spent almost $6700 per year ($7,500 for children age 5 and under). According to the tax files, individuals claimed just over $3900 per year ($4,700). Approximately one in four individuals who reported child care costs on the GSS did not report any amount on their tax file; about four in ten who claimed child care on the tax file did not report any cost on the survey. Multivariate analyses suggested that individuals with a lower education, lower income, with Indigenous identity, and who were self-employed were less likely to make a tax claim despite reporting child care expenses on the GSS. Further examination of child care costs by province and by type of care are necessary, as is research to determine the most accurate way to measure and report child care costs.

scholarly journals Budget Impact Analysis of Anticoagulation Clinics in Patients with Atrial Fibrillation under Chronic Therapy with Oral Anticoagulants

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
William Uribe-Arango ◽  
Juan Manuel Reyes Sánchez ◽  
Natalia Castaño Gamboa
Keyword(s):  
Atrial Fibrillation ◽  
Impact Analysis ◽  
Budget Impact ◽  
Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Group Versus ◽  
Cost Of Care ◽  
Chronic Therapy ◽  
Colombian Government ◽  
The Cost

Objectives To assess budget impact of the implementation of an anticoagulation clinic (AC) compared to usual care (UC), in patients with non-valvular atrial fibrillation (NVAF). Method A decision tree was designed to analyze the cost and events rates over a 1-year horizon. The patients were distributed according to treatment, 30% Direct Oral Anticoagulant (DOAC) regimens and the rest to warfarin. The thromboembolism and bleeding were derived from observational studies which demonstrated that ACs had important impact in reducing the frequency of these events compared with UC, due to higher adherence with DOACs and proportion of time in therapeutic range (TTR) with warfarin. Costs were derived from the transactional platform of Colombian government, healthcare authority reimbursement and published studies. The values were expressed in American dollars (USD). The exchanged rate used was COP $3.693 per dollar. Results During 1 year of follow-up, in a cohort of 228 patients there were estimated 48 bleedings, 6 thromboembolisms in AC group versus 84 bleedings, and 12 thromboembolisms events in patients receiving UC. Total costs related to AC were $126 522 compared with $141 514 in UC. The AC had an important reduction in the cost of clinical events versus UC ($52 085 vs $110 749) despite a higher cost of care facilities ($74 436 vs $30 765). A sensibility analysis suggested that in the 83% of estimations, the AC produced savings varied between $27 078 and $135 391. Conclusions This study demonstrated that AC compared with UC, produced an important savings in the oral anticoagulation therapy for patients with NVAF.

scholarly journals Use of past care markers in risk-adjustment: accounting for systematic differences across providers

2021 ◽  
Author(s):  
Laura Anselmi ◽  
Yiu-Shing Lau ◽  
Matt Sutton ◽  
Anna Everton ◽  
Rob Shaw ◽  
...  
Keyword(s):  
Risk Adjustment ◽  
Fixed Effects ◽  
Goodness Of Fit ◽  
Reporting Quality ◽  
Cost Of Care ◽  
Local Health ◽  
Administrative Records ◽  
Practice Level ◽  
Improve Model ◽  
The Cost

AbstractRisk-adjustment models are used to predict the cost of care for patients based on their observable characteristics, and to derive efficient and equitable budgets based on weighted capitation. Markers based on past care contacts can improve model fit, but their coefficients may be affected by provider variations in diagnostic, treatment and reporting quality. This is problematic when distinguishing need and supply influences on costs is required.We examine the extent of this bias in the national formula for mental health care using administrative records for 43.7 million adults registered with 7746 GP practices in England in 2015. We also illustrate a method to control for provider effects.A linear regression containing a rich set of individual, GP practice and area characteristics, and fixed effects for local health organisations, had goodness-of-fit equal to R2 = 0.007 at person level and R2 = 0.720 at GP practice level. The addition of past care markers changed substantially the coefficients on the other variables and increased the goodness-of-fit to R2 = 0.275 at person level and R2 = 0.815 at GP practice level. The further inclusion of provider effects affected the coefficients on GP practice and area variables and on local health organisation fixed effects, increasing goodness-of-fit at GP practice level to R2 = 0.848.With adequate supply controls, it is possible to estimate coefficients on past care markers that are stable and unbiased. Nonetheless, inconsistent reporting may affect need predictions and penalise populations served by underreporting providers.

Origins of the insulin crisis: how a century of price-fixing controversies affects the cost of care today

The Lancet ◽  
2021 ◽  
Vol 398 (10313) ◽  
pp. 1793-1795
Author(s):  
Rachel J Strodel ◽  
Jeremy A Greene
Keyword(s):  
Cost Of Care ◽  
The Cost

Physicians' Interactions with Pharmaceutical Companies

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 281-282
Author(s):  
LEWIS H. MARGOLIS
Keyword(s):  
Medical Care ◽  
Cost Of Care ◽  
Pharmaceutical Companies ◽  
Cost Of Drugs ◽  
The Cost

In Reply.— In my essay1 I suggested that the acceptance of gifts from pharmaceutical companies violates a duty of justice because gifts represent resources inappropriately taken from patients through the added costs of the drugs that they buy. Dr Procopio raises the larger question of how other types of promotional activities increase the cost of drugs in particular and medical care in general. His letter makes clear, however, that the contribution of an activity such as the distribution of samples to the cost of care is difficult to determine because several different purposes are served.

Modifiable Factors and Delays Associated with Neonatal Deaths and Stillbirths in Jordan: Findings from Facility-Based Neonatal Death and Stillbirth Audits

2021 ◽  
Author(s):  
Mohammad S. Alyahya ◽  
Yousef S. Khader ◽  
Nihaya A Al-Sheyab ◽  
Khulood K. Shattnawi ◽  
Omar F. Altal ◽  
...  
Keyword(s):  
Cost Of Care ◽  
Delay Model ◽  
Case Review ◽  
Contributing Factors ◽  
Neonatal Deaths ◽  
Staff Members ◽  
Danger Signs ◽  
Modifiable Factors ◽  
Review Form ◽  
The Cost

Objective This study employed the “three-delay” model to investigate the types of critical delays and modifiable factors that contribute to the neonatal deaths and stillbirths in Jordan. Study Design A triangulation research method was followed in this study to present the findings of death review committees (DRCs), which were formally established in five major hospitals across Jordan. The DRCs used a specific death summary form to facilitate identifying the type of delay, if any, and to plan specific actions to prevent future similar deaths. A death case review form with key details was also filled immediately after each death. Moreover, data were collected from patient notes and medical records, and further information about a specific cause of death or the contributing factors, if needed, were collected. Results During the study period (August 1, 2019–February 1, 2020), 10,726 births, 156 neonatal deaths, and 108 stillbirths were registered. A delay in recognizing the need for care and in the decision to seek care (delay 1) was believed to be responsible for 118 (44.6%) deaths. Most common factors included were poor awareness of when to seek care, not recognizing the problem or the danger signs, no or late antenatal care, and financial constraints and concern about the cost of care. Delay 2 (delay in seeking care or reaching care) was responsible for nine (3.4%) cases. Delay 3 (delay in receiving care) was responsible for 81 (30.7%) deaths. The most common modifiable factors were the poor or lack of training that followed by heavy workload, insufficient staff members, and no antenatal documentation. Effective actions were initiated across all the five hospitals in response to the delays to reduce preventable deaths. Conclusion The formation of the facility-based DRCs was vital in identifying critical delays and modifiable factors, as well as developing initiatives and actions to address modifiable factors. Key Points

scholarly journals Improved Value of Individual Prenatal Care for the Interdisciplinary Team

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Ella Damiano ◽  
Regan Theiler
Keyword(s):  
Prenatal Care ◽  
Retrospective Chart Review ◽  
Median Number ◽  
Interdisciplinary Teams ◽  
Cost Of Care ◽  
Coordination Of Care ◽  
Primary Endpoints ◽  
Number Of Visits ◽  
The Cost ◽  
Testing And Counseling

Objective. Innovative models of prenatal care are needed to improve pregnancy outcomes and lower the cost of care. We sought to increase the value of traditional prenatal care by using a new model (PodCare) featuring a standardized visit schedule and coordination of care within small interdisciplinary teams in an academic setting. Methods. Prenatal providers and clinic staff were divided into four “Pods”. Testing and counseling topics were assigned to visits based on gestational age. Interdisciplinary weekly Pod meetings provided coordination of care. A retrospective chart review was performed. The primary endpoints were the number of prenatal care visits and number of providers seen. Results. After PodCare implementation, more patients choose care with the low-risk physician team (42% compared to 26%). Study subjects included 85 women in 2013 and 165 women in 2014. The median number of visits decreased from 13 to 10 (p < 0.00004) and the median number of providers seen decreased from 7 to 5 (p < 0.0000008). Conclusion. PodCare increased the value of individual prenatal care by decreasing the number of visits, increasing continuity, and providing care coordination. The model provides a robust experience in interdisciplinary care. The PodCare model may be successful at other academic institutions.

scholarly journals The End of Responsible Relative Liability

1987 ◽  
Vol 54 (2) ◽  
pp. 171-175 ◽  
Author(s):  
Mark C. Weber
Keyword(s):  
Life Skills ◽  
Developmentally Disabled ◽  
Cost Of Care ◽  
The State ◽  
Recent Case ◽  
Disabled Children ◽  
Residential Placement ◽  
Handicapped Children ◽  
The Cost

Responsible relative liability laws exist to shift some of the cost of care of residentially placed handicapped children from the state to the children's parents. Because residential placement of handicapped children, particularly developmentally disabled children, would not be undertaken but for the need to teach these children life skills, the Education for the Handicapped Act would dictate that these placements be free of cost to parents. Recently, the courts have resolved the tension between the preexisting state-responsible relative laws and the Education for the Handicapped Act. Ruling in favor of the parents, they have invalidated the responsible relative charges. This article describes the conflict, its resolution in the recent case Parks v. Pavkovic, and some of the implications of that decision.

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