Spoken Body

Poetics Today ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 261-279
Author(s):  
Rita Charon
Keyword(s):  
Health Care ◽  
Infinite Jest ◽  
Authentic Care ◽  
The Cost ◽  
Native Tongue

The linguistic, rhetorical, and metaphorical powers of language profoundly influence events of health care. Physicians are professionalized into their own isolating language at the cost of fluency in their native tongue. Translation is always inadequate. Physicians resort to ironizing detachment from patients to delude themselves that they will not sicken and die. David Foster Wallace’s Infinite Jest and the Wittgensteinian and enactive/embodied cognitive and phenomenological concepts that support his work offer models for clinicians committed to authentic care of patients.

The Cost of Health Care — Highlights from a Discussion about Economics and Reform

2009 ◽  
Vol 361 (15) ◽  
pp. 1421-1423 ◽  
Author(s):  
Atul A. Gawande ◽  
Elliott S. Fisher ◽  
Jonathan Gruber ◽  
Meredith B. Rosenthal
Keyword(s):  
Health Care ◽  
Cost Of Health Care ◽  
The Cost

Autism Spectrum Disorder: Essentials for a Dental Expert

2020 ◽  
Author(s):  
Reddy V
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Clinical History ◽  
Oral Health Care ◽  
Autism Spectrum ◽  
Patient Support ◽  
Specialized Knowledge ◽  
Support Strategies ◽  
Important Concern ◽  
The Cost

Unique is a method that could help diagnosing a psychiatry condition, such as autism, by properly completing a patient's clinical history, with a comprehensive physical examination. It is important to diagnose individuals with autism spectrum, since providing a good oral health care to these people requires that the dentist has specialized knowledge, an increased awareness and care while performing the treatment, and even patient support strategies which must be adapted to each case. Every patient with autism is different to the rest, which makes their diagnosis and treatment difficult. Likewise, not all dentists are qualified to provide a good oral health care to patients diagnosed with autism spectrum, so many families must fight with that barrier every day. Finally, not every person with autism, or their families, are able to afford the cost of dental care with a qualified dentist, which is an important concern for them.

scholarly journals Cost-effectiveness of TAS-102 plus bevacizumab versus TAS-102 monotherapy in patients with metastatic colorectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kiyoaki Sugiura ◽  
Yuki Seo ◽  
Takayuki Takahashi ◽  
Hideyuki Tokura ◽  
Yasuhiro Ito ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Combination Therapy ◽  
Metastatic Colorectal Cancer ◽  
Cost Effective ◽  
Model Parameters ◽  
Combination Regimen ◽  
The Cost

Abstract Background TAS-102 plus bevacizumab is an anticipated combination regimen for patients who have metastatic colorectal cancer. However, evidence supporting its use for this indication is limited. We compared the cost-effectiveness of TAS-102 plus bevacizumab combination therapy with TAS-102 monotherapy for patients with chemorefractory metastatic colorectal cancer. Method Markov decision modeling using treatment costs, disease-free survival, and overall survival was performed to examine the cost-effectiveness of TAS-102 plus bevacizumab combination therapy and TAS-102 monotherapy. The Japanese health care payer’s perspective was adopted. The outcomes were modeled on the basis of published literature. The incremental cost-effectiveness ratio (ICER) between the two treatment regimens was the primary outcome. Sensitivity analysis was performed and the effect of uncertainty on the model parameters were investigated. Results TAS-102 plus bevacizumab had an ICER of $21,534 per quality-adjusted life-year (QALY) gained compared with TAS-102 monotherapy. Sensitivity analysis demonstrated that TAS-102 monotherapy was more cost-effective than TAS-102 and bevacizumab combination therapy at a willingness-to-pay of under $50,000 per QALY gained. Conclusions TAS-102 and bevacizumab combination therapy is a cost-effective option for patients who have metastatic colorectal cancer in the Japanese health care system.

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

scholarly journals Why Do Some Firms Spend So Much on Medical Care? Accounting for Variation

2000 ◽  
Vol 3 (1) ◽  
Author(s):  
Matthew Eichner ◽  
Mark McClellan ◽  
David A. Wise
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Health Care Expenditures ◽  
Cost Of Treatment ◽  
Consistent Method ◽  
The Difference ◽  
The Cost ◽  
Cost Differences ◽  
Average Expenditure

We are engaged in a long-term project to analyze the determinants of health care cost differences across firms. An important first step is to summarize the nature of expenditure differences across plans. The goal of this article is to develop methods for identifying and quantifying those factors that account for the wide differences in health care expenditures observed across plans.We consider eight plans that vary in average expenditure for individuals filing claims, from a low of $1,645 to a high of $2,484. We present a statistically consistent method for decomposing the cost differences across plans into component parts based on demographic characteristics of plan participants, the mix of diagnoses for which participants are treated, and the cost of treatment for particular diagnoses. The goal is to quantify the contribution of each of these components to the difference between average cost and the cost in a given firm. The demographic mix of plan enrollees accounts for wide differnces in cost ($649). Perhaps the most noticeable feature of the results is that, after adjusting for demographic mix, the difference in expenditures accounted for by the treatment costs given diagnosis ($807) is almost as wide as the unadjusted range in expenditures ($838). Differences in cost due to the different illnesses that are treated, after adjusting for demographic mix, also accounts for large differences in cost ($626). These components of cost do not move together; for example, demographic mix may decrease expenditure under a particular plan while the diagnosis mix may increase costs.Our hope is that understanding the reasons for cost differences across plans will direct more focused attention to controlling costs. Indeed, this work is intended as an important first step toward that goal.

A comprehensive assessment of the cost of multiple sclerosis in the United States

1998 ◽  
Vol 4 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Kathryn Whetten-Goldstein ◽  
Frank A Sloan ◽  
Larry B Goldstein ◽  
Elizabeth D Kulas
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Insurance ◽  
Informal Care ◽  
Annual Cost ◽  
Lifetime Cost ◽  
The United States ◽  
Personal Health ◽  
Secondary Sources ◽  
The Cost

Comprehensive data on the costs of multiple sclerosis is sparse. We conducted a survey of 606 persons with MS who were members of the National Multiple Sclerosis Society to obtain data on their cost of personal health services, other services, equipment, and earnings. Compensation of such cost in the form of health insurance, income support, and other subsidies was measured. Survey data and data from several secondary sources was used to measure costs incurred by comparable persons without MS. Based on the 1994 data, the annual cost of MS was estimated at over $34 000 per person, translating into a conservative estimate of national annual cost of $6.8 billion, and a total lifetime cost per case of $2.2 million. Major components of cost were earnings loss and informal care. Virtually all persons with MS had health insurance, mostly Medicare/Medicaid. Health insurance covered 51 per cent of costs for services, excluding informal care. On average, compensation for earnings loss was 27 per cent. MS is very costly to the individual, health care system, and society. Much of the cost (57 per cent) is in the form of burdens other than personal health care, including earnings loss, equipment and alternations, and formal and informal care. These costs often are not calculated.

Principles of Cost-Effective Resource Allocation in Health Care organizations

1990 ◽  
Vol 6 (1) ◽  
pp. 93-103 ◽  
Author(s):  
Milton C. Weinstein
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Cost Effectiveness ◽  
Health Care Organizations ◽  
Cost Effective ◽  
Limited Resources ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Common Understanding ◽  
Analytical Errors

Cost-effectiveness analysis (CEA) is a method of economic evaluation that can be used to assess the efficiency with which health care technologies use limited resources to produce health outputs. However, inconsistencies in the way that such ratios are constructed often lead to misleading conclusions when CEAs are compared. Some of these inconsistencies, such as failure to discount or to calculate incremental ratios correctly, reflect analytical errors that, if corrected, would resolve the inconsistencies. Others reflect fundamental differences in the viewpoint of the analysis. The perspectives of different decision-making entities can properly lead to different items in the numerator and denominator of the cost-effectiveness (C/E) ratio. Producers and consumers of CEA need to be more conscious of the perspectives of analysis, so that C/E comparisons from a given perspective are based upon a common understanding of the elements that are properly included.

Health Care Cost Containment in Large American Cities

1989 ◽  
Vol 18 (1) ◽  
pp. 87-100 ◽  
Author(s):  
Perry Moore
Keyword(s):  
Health Care ◽  
Cost Containment ◽  
Local Governments ◽  
Health Care Cost ◽  
The United States ◽  
Public Agencies ◽  
The Public ◽  
Survey Results ◽  
The Cost ◽  
American Cities

This research provides information about the health care cost containment efforts of local governments and agencies across the United States, particularly in large American cities. Survey results indicate that while the public sector lags behind the private sector, public agencies are beginning to match the cost containment efforts of private employers. While initiation of these efforts represents considerable recent progress, their tangible benefits are not yet apparent.

Sign in / Sign up

Export Citation Format

Share Document