scholarly journals Variation in the Cost of Radiation Therapy Among Medicare Patients With Cancer

2015 ◽  
Vol 11 (5) ◽  
pp. 403-409 ◽  
Author(s):  
Anthony J. Paravati ◽  
Isabel J. Boero ◽  
Daniel P. Triplett ◽  
Lindsay Hwang ◽  
Rayna K. Matsuno ◽  
...  

Factors unrelated to the individual patient accounted for the majority of variation in the cost of radiation therapy, suggesting potential inefficiency in health care expenditure.

2011 ◽  
Vol 29 (20) ◽  
pp. 2821-2826 ◽  
Author(s):  
Didem S.M. Bernard ◽  
Stacy L. Farr ◽  
Zhengyi Fang

Purpose To compare the prevalence of high out-of-pocket burdens among patients with cancer with other chronically ill and well patients, and to examine the sociodemographic characteristics associated with high burdens among patients with cancer. Methods The sample included persons 18 to 64 years of age who received treatment for cancer, taken from a nationally representative sample of the US population from the 2001 to 2008 Medical Expenditure Panel Survey. We examined the proportion of persons living in families with high out-of-pocket burdens associated with medical spending, including insurance premiums, relative to income, defining high health care (total) burden as spending more than 20% of income on health care (and premiums). Results The risk of high burdens is significantly greater for patients with cancer compared with other chronically ill and well patients. We find that 13.4% of patients with cancer had high total burdens, in contrast to 9.7% among those with other chronic conditions and 4.4% among those without chronic conditions. Among nonelderly persons with cancer, the following were associated with higher out-of-pocket burdens: private nongroup insurance, age 55 to 64 years, non-Hispanic black, never married or widowed, one child or no children, unemployed, lower income, lower education level, living in nonmetropolitan statistical areas, and having other chronic conditions. Conclusion High burdens may affect treatment choice and deter patients from getting care. Thus, although a detailed patient-physician discussion of costs of care may not be feasible, we believe that an awareness of out-of-pocket burdens among patients with cancer is useful for clinical oncologists.


2020 ◽  
Vol 41 (S1) ◽  
pp. s234-s234
Author(s):  
Kristin Sims ◽  
Roger Stienecker

Background: Since 1991, US tuberculosis (TB) rates have declined, including among health care personnel (HCP). Non–US born persons accounted for approximately two-thirds of cases. Serial TB testing has limitations in populations at low risk; it is expensive and labor intensive. Method: We moved a large hospital system from facility-level risk stratification to an individual risk model to guide TB screening based on Tuberculosis Screening, Testing, and Treatment of US Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. This process included individual TB risk assessment, symptom evaluation, TB testing for M. tuberculosis infection (by either IGRA or TST) for HCP without documented evidence of prior LTBI or TB disease, with an additional workup for TB disease for HCP with positive test results or symptoms compatible with TB disease. In addition, employees with specific job codes deemed high risk were required to undergo TB screening. Result: In 2018, this hospital system of ~10,000 employees screened 7,556 HCP for TB at a cost of $348,625. In 2019, the cost of the T Spot test increased from $45 to $100 and the cost of screening 5,754 HCP through October 31, 2019, was $543,057. In 2020, it is anticipated that 755 HCP will be screened, saving the hospital an estimated minimum of $467,557. The labor burden associated with employee health personnel will fall from ~629.66 hours to 62.91 hours. The labor burden associated with pulling HCPs from the bedside to be screened will be reduced from 629.66 hours to 62.91 hours as well. Conclusion: Adoption of the individual risk assessment model for TB screening based on Tuberculosis Screening, Testing, and Treatment of US Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019 will greatly reduce financial and labor burdens in healthcare settings when implemented.Funding: NoneDisclosures: None


Author(s):  
Inkollu Gowri Ramya Sri ◽  
Sravani Konduru ◽  
Pravallika Madiraju ◽  
Jetty Bindu Mahitha ◽  
V. Koteswara Rao

Among many applications enabled by the Internet of Things (IoT), smart and connected health care is a particularly important one. Networked sensors, either worn on the body or embedded in our living environments, make possible the gathering of rich information indicative of our physical and mental health. Captured on a continual basis, aggregated, and effectively mined, such information can bring about a positive transformative change in the health care landscape. In particular, the availability of data until now coupled with a new generation of intelligent processing algorithms can: (a) facilitate an evolution in the practice of medicine, from the current post facto diagnose-and treat reactive paradigm, to a proactive framework for prognosis of diseases at an incipient stage, coupled with prevention, cure, and overall management of health instead of disease, (b) enable personalization of treatment and management options targeted particularly to the specific circumstances and needs of the individual, and (c) help reduce the cost of health care while simultaneously improving outcomes. In this paper, we highlight the opportunities and challenges for IOT in realizing this vision of the future of health care.


2020 ◽  
Vol 23 (13) ◽  
pp. 2395-2401 ◽  
Author(s):  
Mohammad E Hoque ◽  
Azaher A Molla ◽  
Dewan ME Hoque ◽  
Kurt Z Long ◽  
Abdullah A Mamun

AbstractObjective:To estimate the economic burden of overweight in Bangladesh.Design:We used data from Household Income and Expenditure Survey, 2010. A prevalence-based approach was used to calculate the population attributable fraction (PAF) for diseases attributable to overweight. Cost of illness methodology was used to calculate annual out of pocket (OOP) expenditure for each disease using nationally representative survey data. The cost attributable to overweight for each disease was estimated by multiplying the PAF by annual OOP expenditure. The total cost of overweight was estimated by adding PAF-weighted costs of treating the diseases.Setting:Nationwide, covering the whole of Bangladesh.Participants:Individuals whose BMI ≥ 25 kg/m2.Results:The total cost attributable to overweight in Bangladesh in 2010 was estimated at US$147·38 million. This represented about 0·13 % of Bangladesh’s Gross Domestic Product and 3·69 % of total health care expenditure in 2010. The sensitivity analysis revealed that the total cost could be as high as US$334 million or as low as US$71 million.Conclusions:A substantial amount of health care resource is devoted to the treatment of overweight-related diseases in Bangladesh. Effective national strategies for overweight prevention programme should be established and implemented.


2017 ◽  
Vol 11 (6) ◽  
pp. 137-151 ◽  
Author(s):  
Людмила Горшкова ◽  
Lyudmila Gorshkova

Assessing the effectiveness of health care expenditure is a major economic task. The most important indicator to assess the effectiveness of health care costs is the expected life expectancy (ELE). Infant mortality is also closely related to DLE. The article substantiates the logarithmic model of the dependence of ELE from health care expenditure (per person for a particular year). Each country is represented by a point on the coordinate plane with an ordinate equal to the ELE in this country and an abscissa equal to the health care expenditure in it. The modeling logarithmic curve is taken as the theoret-ical threshold of the cost-effectiveness: the higher the curve is the point repre-senting the country, the more effective the health care costs in this country, and the lower the threshold curve, the costs are more unprofitable. It is shown that the dependence of ELE from GDP (or GRP by regions of Russia) is not so obvious: although there is a tendency to such a dependence, but with a large number of drop-out values. Despite the achievement of the highest average expected life expectancy in Russia in the country's history, it is significantly lower than in developed countries. The main causes of low expected life expectancy at birth are unsatisfactory health indicators, and as a result, high incidence and disability. Traumatism on the roads and suicides are one of the significant reasons for the low expected life expectancy in Russia and are significantly higher than similar indicators in other countries. The article shows the close correlation between the cost of health care per person and expected life expectancy. However, in the Russian Federation, the share of public expenditure in the structure of aggregate health expenditure is decreasing. Social insurance funds are more than half of the health care public expenditure. The author reveals considerable regional differences in health spending per person and average expected life expectancy. The article highlights the insufficient level of health care costs in Russia as a whole and in regions.


CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S41
Author(s):  
V.V. Puri ◽  
K. Dong ◽  
B.H. Rowe ◽  
S.W. Kirkland ◽  
C. Vandenberghe ◽  
...  

Introduction: Active substance use and unstable housing are both associated with increased emergency department (ED) utilization. This study examined ED health care costs among a cohort of substance using and/or homeless adults following an index ED visit, relative to a control ED population. Methods: Consecutive patients presenting to an inner-city ED between August 2010 and November 2011 who reported unstable housing and/or who had a chief presenting complaint related to acute or chronic substance use were evaluated. Controls were enrolled in a 1:4 ratio. Participants’ health care utilization was tracked via electronic medical record for six months after the index ED visit. Costing data across all EDs in the region was obtained from Alberta Health Services and calculated to include physician billing and the cost of an ED visit excluding investigations. The cost impact of ED utilization was estimated by multiplying the derived ED cost per visit by the median number of visits with interquartile ranges (IQR) for each group during follow up. Proportions were compared using non-parametric tests. Results: From 4679 patients screened, 209 patients were enrolled (41 controls, 46 substance using, 91 unstably housed, 31 both unstably housed and substance using (UHS)). Median costs (IQR) per group over the six-month period were $0 ($0-$345.42) for control, $345.42 ($0-$1139.89) for substance using, $345.42 ($0-$1381.68) for unstably housed and $1381.68 ($690.84-$4248.67) for unstably housed and substance using patients (p<0.05). Conclusion: The intensity of excess ED costs was greatest in patients who were both unstably housed and presenting with a chief complaint related to substance use. This group had a significantly larger impact on health care expenditure relative to ED users who were not unstably housed or who presented with a substance use related complaint. Further research into how care or connection to community resources in the ED can reduce these costs is warranted.


Author(s):  
Prithvirajsinh Parmar ◽  
Himan Patel ◽  
Ashvin Mishra ◽  
Miteshkumar Malaviya ◽  
Keyur Parmar

It’s becoming clearer that medicine is not one-size-fits-all. The problem with the traditional or present way of medical treatment is that they are created for and tested on a large group of people. The medicines are prescribed so broadly that they don’t work for everyone. Some drugs work very well for certain people and some not. In ancient times, medicine was practiced according to the signs and symptoms presented by the patient and were solely based on the individual knowledge of the physician and thus were called intuition medicine. Nowadays, medicine is based on the evidence produced by scientific research, including clinical trials, which is designated as evidence-based medicine. In the future, medicine will be practiced according to algorithms that will take into consideration the patient's characteristics, such as their genome, epigenetics, and lifestyle, constituting personalized medicine. Doctors use information about you -- your genes, lifestyle, and environment -- along with the characteristics of your disease to select treatments that are most likely to work for you. Health care has transmuted since the decline in mortality caused by infectious diseases as well as chronic and non-contagious diseases, with a direct impact on the cost of public health and individual health care. The evolution of medicine has increased the life expectancy of humans. Personalized medicine is the new way of thinking about medicines. In this review, we will see how Personalized medicine will transform healthcare, how Artificial intelligence and personalized medicine working together towards better healthcare, personalized medicine in the pharmaceutical industry, its vision for the future, and its application in various diseases.


2020 ◽  
Vol 49 (1_suppl) ◽  
pp. 154-157
Author(s):  
L.A. Hunt

As radiation therapy is needed by approximately 50% of patients with cancer there needs to be ongoing research to ensure that radiation therapy targets the tumour effectively and minimises potential side effects. Major advances in radiation therapy, due to improvements in engineering and computing, have made it more precise, reducing side effects and improving cancer control. Patients need to be informed of its risks, both short and long term, to enable them to be active participants in their cancer treatment path.


2007 ◽  
Vol 227 (5-6) ◽  
Author(s):  
Walter Ried

SummaryThis paper investigates the impact of population aging, driven by medical progress, upon agespecific expenditure on health care. In a model set up in discrete time, individuals at each age may catch a lethal disease which, upon receiving appropriate medical treatment, nevertheless involves a mortality risk. The incidence of lethal diseases, the associated survival probability conditional upon treatment, and health care expenditure conditional upon health status may all depend on an individual’s history of health status in the past.Medical progress is taken to involve an increase in the survival probability of a specified lethal disease. First, this produces a direct effect on age-specific health care expenditure to the extent that progress affects the cost of treatment of the disease. Second, indirect effects may also arise relating to individuals who, having survived the disease at some prior age, change the structure of individuals alive at current age. Specifically, these “new survivors” may influence age-specific expenditure either through changes in the incidence of lethal diseases or in the associated treatment cost. The sign of an indirect effect crucially depends on health care expenditure for “new survivors” relative to their peers.The analysis yields a number of general results with respect to the impact of medical progress on the age profile of health care expenditure. For example, both compression of morbidity and expansion of morbidity are hypotheses which relate to “new survivors” such that they fail to account for the total effect of progress on age-specific expenditure.


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