scholarly journals Direct healthcare costs of lip, oral cavity and oropharyngeal cancer in Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246475
Author(s):  
Vanessa Milani ◽  
Ana Laura de Sene Amâncio Zara ◽  
Everton Nunes da Silva ◽  
Larissa Barbosa Cardoso ◽  
Maria Paula Curado ◽  
...  
Keyword(s):  
Healthcare Costs ◽  
Health Sector ◽  
National Health System ◽  
Health Resources ◽  
Indirect Costs ◽  
International Classification Of Diseases ◽  
Outpatient Procedures ◽  
Classification Of Diseases ◽  
Direct Healthcare Costs ◽  
The Cost

The efficiency of public policies includes the measurement of the health resources used and their associated costs. There is a lack of studies evaluating the economic impact of oral cancer (OC). This study aims to estimate the healthcare costs of OC in Brazil from 2008 to 2016. This is a partial economic evaluation using the gross costing top-down method, considering the direct healthcare costs related to outpatients, inpatients, intensive care units, and the number of procedures, from the perspective of the public health sector. The data were extracted from the Outpatient and Inpatient Information System of the National Health System, by diagnosis according to the 10th Revision of the International Classification of Diseases, according to sites of interest: C00 to C06, C09 and C10. The values were adjusted for annual accumulated inflation and expressed in 2018 I$ (1 I$ = R$2,044). Expenditure on OC healthcare in Brazil was I$495.6 million, which was composed of 50.8% (I$251.6 million) outpatient and 49.2% (I$244.0 million) inpatient healthcare. About 177,317 admissions and 6,224,236 outpatient procedures were registered. Chemotherapy and radiotherapy comprised the largest number of procedures (88.8%) and costs (94.9%). Most of the costs were spent on people over 50 years old (72.9%) and on males (75.6%). Direct healthcare costs in Brazil for OC are substantial. Outpatient procedures were responsible for the highest total cost; however, inpatient procedures had a higher cost per procedure. Men over 50 years old consumed most of the cost and procedures for OC. The oropharynx and tongue were the sites with the highest expenditure. Further studies are needed to investigate the cost per individual, as well as direct non-medical and indirect costs of OC.

scholarly journals Cost of Venous Thromboembolic Disease in Patients with Lung Cancer: Costecat Study

2021 ◽  
Vol 18 (2) ◽  
pp. 394
Author(s):  
Ana Rosa Rubio-Salvador ◽  
Vicente Escudero-Vilaplana ◽  
José Antonio Marcos Rodríguez ◽  
Irene Mangues-Bafalluy ◽  
Beatriz Bernardez ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Venous Thromboembolism ◽  
Healthcare Costs ◽  
Hospital Admissions ◽  
Health Resources ◽  
Pharmacoeconomic Study ◽  
First Episode ◽  
Venous Thromboembolic ◽  
Direct Healthcare Costs ◽  
The Cost

Background: Patients with lung cancer (LC) are at significantly higher risk of developing venous thromboembolism (VTE), which may lead to increased use of health resources and the cost of management. The main aim of the study was to determine the cost of the management of VTE events in patients with LC treated with Low Molecular Weight Heparins (LMWH) in Spain. Methods: Costecat was an, observational, ambispective pharmacoeconomic study. Patients with LC, with a first episode of VTE (symptomatic or incidental) in treatment with LMWH, were recruited from six third-level hospitals and followed up for six months. Sociodemographic, clinical and resource use variables of VTE-related implications and its treatment were collected. Direct healthcare costs and direct non-healthcare costs were recorded. Data collection was documented in an electronic case report. Unit costs were obtained from national databases. Costs (€2018) were estimated from the healthcare perspective. Statistical analysis was performed using the statistical program R 3.4.3 version (30 November 2017). Results: Forty-seven patients were included. Mean age was 65.4 years, 66.0% were male. The percentage of patients with LC who had metastatic disease was 78.7%. Twenty-three patients (48.9%) needed hospital admissions due to thromboembolic episode. Total average cost of patients with cancer associated VTE (CAT) was €109,696.6 per patient/semester. The hospitalizations represent 65.8% of total costs (7207.3 € SD 13,996.9 €), followed by LMWH therapy which represents 18.6% (2033.8 € SD:630.5 €). Conclusions: Venous thromboembolism episodes induce an economic impact on patients and healthcare systems. Direct healthcare costs are the major burden of the total cost, in which hospitalizations are the main drivers of cost.

scholarly journals Blood Conservation in Neurosurgery: Erythropoietin and Autologous Donation

2014 ◽  
Vol 41 (5) ◽  
pp. 583-589 ◽  
Author(s):  
Alexander McGirr ◽  
Katerina Pavenski ◽  
Bhanu Sharma ◽  
Michael D. Cusimano
Keyword(s):  
Significant Proportion ◽  
International Classification Of Diseases ◽  
Recombinant Erythropoietin ◽  
Blood Conservation ◽  
Retrospective Case ◽  
Transfusion Requirements ◽  
Classification Of Diseases ◽  
Matching Criteria ◽  
The Cost ◽  
Rbc Transfusion

AbstractBackgroundNeurosurgery may involve significant blood loss and frequently requires allogeneic red blood cell (RBC) transfusion. Preoperative recombinant erythropoietin (EPO) may be used to improve erythroid status and recovery, and used either alone or in combination with preoperative autologous donation (PAD) it may reduce exposure to allogeneic RBC. We wished to study the use of EPO with and without PAD and the risk of RBC transfusion in neurosurgery.MethodsUsing a retrospective case-control design, 57 patients who received EPO preoperatively were matched 2:1 for age, sex, year of surgery, and International Classification of Diseases code most responsible for surgery (three were excluded because of stringent matching criteria, leaving 54 cases and 108 comparison subjects). Thirty-two cases participated in PAD. Medical and anesthetic records as well as laboratory investigations were reviewed and extracted.ResultsAllogeneic RBC exposure was identical for EPO cases and comparison subjects (18.5%). Concomitant PAD and EPO did not reduce allogeneic RBC exposure (21.9%), and resulted in a greater number of RBC units transfused. Last recorded hemoglobin levels suggested that autologous RBCs were not more liberally used. Patients who engaged in PAD and EPO suffered from iatrogenic anemia. A significant proportion (58.6%) of the autologous RBCs was ultimately not used and discarded.ConclusionFurther research is needed to determine the efficacy of EPO in neurological surgery. PAD does not appear to reduce the risk of allogeneic RBC transfusion, despite concomitant EPO. Indeed, PAD resulted in iatrogenic anemia and increased transfusion requirements. The cost-effectiveness of blood conservation efforts in neurosurgery deserves additional research.

scholarly journals The cost of health care in Serbia according to the international classification of diseases for the period from 2004 to 2009

2011 ◽  
Vol 58 (3) ◽  
pp. 127-138 ◽  
Author(s):  
Milena Gajic-Stevanovic ◽  
Snezana Dimitrijevic ◽  
Slavoljub Zivkovic ◽  
Nevenka Teodorovic ◽  
Darinka Perisic-Rajnicke
Keyword(s):  
Health Care ◽  
Comparative Analysis ◽  
International Classification Of Diseases ◽  
Financial Information ◽  
Cost Of Health Care ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Cost ◽  
Circulatory Diseases

Introduction. As the part of research on costs in the health care system, there is a growing interest in the world for the estimating costs for the treatment of disease. This value represents the burden that a particular disease or group of diseases puts on the society. Until the year 2000, when the Organization for Economic Countries Development (OECD) established a System of Health Accounts (SHA), there was not even approximate methodological guide for calculating the cost of the disease. The aim of this study was to determine the costs of health care in the Republic of Serbia according to the major International Classification of Diseases (ICD-10) and to provide a comparative cost analysis for the treatment of diseases in the period from 2004 to 2009. Material and Methods. A retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia and financial information provided by the Health Insurance Fund in the period 2004-2009 was performed. Financial information and data on hospital services, outpatient, home health care, ancillary health care services, drug consumption and consumer goods in healthcare were analyzed using SHA methodology. Results. Results showed that during the observation period, the maximum cost of health care in Serbia by main classification of ICD-10 was achieved in 2009 and it was RSD 144,150,456,906.00 (? 1,503,321,134; $ 2,160,253,219) and the minimal cost was achieved in 2004 - the amount being RSD 49,546,211,470.00 (? 628,086,723; $ 855,203,134). Results showed that in 2004 the highest costs were allocated to circulatory diseases (18.98%), followed by neoplasm (11.12%), and lowest for congenital anomalies (0.64%). In 2009, the highest costs were allocated to circulatory diseases (18.87%), infectious and parasitic diseases (11.20%), diseases of digestive system (9.26%) nervous system diseases (9.20%), and neoplasm (8.88%), whereas the minimal funds were allocated for congenital anomalies (0.33%). Conclusion. Comparative analysis showed that the value of overall spending in healthcare increased three times in 2009 as compared to 2004.

scholarly journals Costs of the management of hemophilia A with inhibitors in Spain

2021 ◽  
Vol 8 ◽  
pp. 35-42
Author(s):  
Santiago Bonanad ◽  
María Teresa Álvarez ◽  
Ramiro Núñez ◽  
José Luis Poveda ◽  
Beatriz Gil ◽  
...  
Keyword(s):  
Healthcare Costs ◽  
Pediatric Patients ◽  
Hemophilia A ◽  
Productivity Loss ◽  
National Health System ◽  
Indirect Costs ◽  
Factor Vii ◽  
Direct And Indirect Costs ◽  
On Demand ◽  
Bypassing Agents

Introduction: Emicizumab is a first-in-class monoclonal antibody, recently authorized for the treatment of hemophilia A with inhibitors. This study aims to estimate the direct and indirect costs of the management of hemophilia A with inhibitors, in adult and pediatric patients, including the prophylaxis with emicizumab. Methods: We calculated the costs of the on-demand and prophylactic treatments with bypassing agents (activated prothrombin complex concentrate and recombinant activated factor VII) and the emicizumab prophylaxis, from the societal perspective, over 1 year. The study considered direct healthcare costs (drugs, visits, tests, and hospitalizations), direct non-healthcare costs (informal caregivers), and indirect costs (productivity loss). Data were obtained from a literature review and were validated by an expert group. Costs were expressed in 2019 euros. Results: Our results showed that the annual costs of the prophylactic treatment per patient varied between €543,062.99 and €821,415.77 for adults, and €182,764.43 and €319,826.59 for children, while on-demand treatment was €532,706.84 and €789,341.91 in adults, and €167,523.05 and €238,304.71 in pediatric patients. In relation to other prophylactic therapies, emicizumab showed the lowest costs, with up to a 34% and 43% reduction in the management cost of adult and pediatric patients, respectively. It reduced the bleeding events and administration costs, as this drug is less frequently administered by subcutaneous route. Emicizumab prophylaxis also decreased the cost of other healthcare resources such as visits, tests, and hospitalizations, as well as indirect costs. Conclusion: In comparison to prophylaxis with bypassing agents, emicizumab reduced direct and indirect costs, resulting in cost savings for the National Health System and society.

scholarly journals Symptom rating scales for schizophrenia and other primary psychotic disorders in ICD-11

2017 ◽  
Vol 27 (3) ◽  
pp. 219-224 ◽  
Author(s):  
J. W. Keeley ◽  
W. Gaebel
Keyword(s):  
Negative Symptoms ◽  
Rating Scales ◽  
Psychotic Disorders ◽  
Rating Scale ◽  
Field Testing ◽  
International Classification Of Diseases ◽  
Severity Rating ◽  
Classification Of Diseases ◽  
The Cost ◽  
Symptom Rating

The subtype system for categorising presentations of schizophrenia will be removed from International Classification of Diseases 11th Revision. In its place will be a system for rating six domains of psychotic disorder pathology: positive symptoms, negative symptoms, depressive symptoms, manic symptoms, psychomotor symptoms and cognitive symptoms. This paper outlines the rationale and description of the proposed symptom rating scale, including current controversies. In particular, the scale could adopt either a 4-point severity rating or a 2-point presence/absence rating. The 4-point scale has the advantage of gathering more information, but potentially at the cost of reliability. The paper concludes by describing the field testing process for evaluating the proposed scale.

scholarly journals Clinical and Economic Burden of Antineutrophil Cytoplasmic Antibody–associated Vasculitis in the United States

2015 ◽  
Vol 42 (12) ◽  
pp. 2383-2391 ◽  
Author(s):  
Karina Raimundo ◽  
Amanda M. Farr ◽  
Gilwan Kim ◽  
George Duna
Keyword(s):  
Economic Burden ◽  
Healthcare Costs ◽  
Fold Increase ◽  
Antineutrophil Cytoplasmic Antibody ◽  
International Classification Of Diseases ◽  
The United States ◽  
Administrative Databases ◽  
Classification Of Diseases ◽  
Associated Conditions

Objective.To describe the prevalence of major relapse and healthcare costs among patients with granulomatosis with polyangiitis (GPA); to find patients with microscopic polyangiitis (MPA) in administrative databases, because no MPA diagnosis code exists; and to describe the clinical and economic burden associated with MPA.Methods.Adults (≥ 18 yrs) with ≥ 2 diagnoses of GPA [International Classification of Diseases-9-Clinical Modification (ICD-9-CM 446.4)] during 2009–2013 were extracted from the Truven Health MarketScan Commercial and Medicare Supplemental databases. Evidence of major relapse (based on the Birmingham Vasculitis Activity Score) and healthcare costs were collected during 12-month and 24-month followup periods. Adults with ≥ 2 diagnoses of unspecified arteritis (ICD-9-CM 447.6) were found as potential patients with MPA and additional criteria based on clinical input were applied to refine the sample. Major relapse-associated conditions and healthcare costs in the 6 months pre- and post-diagnosis were measured. Costs were inflated to 2013 US$.Results.A total of 2784 patients with GPA were found and 18.7% experienced a major relapse in the 12-month followup period. The patients with a major relapse incurred higher average all-cause (12-month: $88,065 vs $30,682; p < 0.0001) and GPA-related costs (12-month: $61,636 vs $15,748; p < 0.0001) than patients without a relapse. Trends were consistent over the 24-month followup period. There were 612 incident patients with MPA. Following MPA diagnosis, healthcare costs nearly doubled ($30,166 vs $56,642; p < 0.0001).Conclusion.In a real-world setting, patients with GPA who experience major relapse have higher economic burden, compared to patients without a relapse. MPA diagnosis was associated with nearly a 2-fold increase in healthcare costs.

Trends in Morbidity, Mortality, and Cost of Hospitalizations Associated With Infectious Disease Sequelae of the Opioid Epidemic

2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S451-S457
Author(s):  
Joseph R Coyle ◽  
Melissa Freeland ◽  
Seth T Eckel ◽  
Adam L Hart
Keyword(s):  
Substance Use ◽  
Healthcare Costs ◽  
International Classification Of Diseases ◽  
Time Frame ◽  
Surveillance Systems ◽  
Opioid Epidemic ◽  
Discharge Disposition ◽  
Hospitalization Costs ◽  
Classification Of Diseases

Abstract Background Increases in fatal drug poisonings and hepatitis C infections associated with the opioid epidemic are relatively well defined, because passive surveillance systems for these conditions exist. Less described is the association between the opioid epidemic and skin, soft-tissue, and venous infections (SSTVIs), endocarditis, sepsis, and osteomyelitis. Methods Michigan hospitalizations between 2016 and 2018 that included an International Classification of Diseases, Tenth Revision, Clinical Modification, code indicating substance use were examined for codes indicative of infectious conditions associated with injecting drugs. Trends in these hospitalizations were examined, as were demographic characteristics, discharge disposition, payer, and cost data. Results Among hospitalized patients with a substance use diagnosis code, endocarditis, osteomyelitis, sepsis, and SSTVI hospitalizations increased by 33%, 35%, 24%, and 12%, respectively between 2016 and 2018. During this time frame, 1257 patients died or were discharged to hospice. All SSTVI hospitalizations resulted in &gt;$1.3 billion in healthcare costs. Public insurance accounted for more than two-thirds of all hospitalization costs. Conclusions This study describes a method for performing surveillance for infection-related sequelae of injection drug use. Endocarditis, osteomyelitis, sepsis, and SSTVI hospitalizations have increased year over year between 2016 and 2018. These hospitalizations result in significant morbidity, mortality, and healthcare costs and should be a focus of future surveillance and prevention efforts.

Incremental Costs for Psoriasis and Psoriatic Arthritis in a Population-based Cohort in Southern Sweden: Is It All Psoriasis-attributable Morbidity?

2016 ◽  
Vol 43 (3) ◽  
pp. 640-647 ◽  
Author(s):  
Sofia Löfvendahl ◽  
Ingemar F. Petersson ◽  
Elke Theander ◽  
Åke Svensson ◽  
Caddie Zhou ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Productivity Loss ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Drug Costs ◽  
Productivity Losses ◽  
Classification Of Diseases ◽  
A Minor ◽  
The Cost

Objective.To estimate incremental costs for patients with psoriasis/psoriatic arthritis (PsO/PsA) compared to population-based referents free from PsO/PsA and estimate costs attributable specifically to PsO/PsA.Methods.Patients were identified by International Classification of Diseases, 10th ed., codes for PsO/PsA using information from 1998 to 2007 in the Skåne Healthcare Register, covering healthcare use for the population of the Skåne region of Sweden. For each patient, 3 population-based referents were selected. Data were retrieved from Swedish registers on healthcare, drugs, and productivity loss. The human capital method was used to value productivity losses. Mean annual costs for 2008 to 2011 were assessed from a societal perspective.Results.We identified 15,283 patients fulfilling the inclusion criteria for PsO [n = 12,562, 50% women, mean age (SD) 52 (21) yrs] or PsA [n = 2721, 56% women, mean age 54 (16) yrs] and included 45,849 referents. Mean annual cost per patient with PsO/PsA was 55% higher compared to referents: €10,500 vs €6700. The cost was 97% higher for PsA compared to PsO. Costs due to productivity losses represented the largest share of total costs, ranging from 52% for PsO to 60% for PsA. Biological drug costs represented 10% of the costs for PsA and 1.6% for PsO. The proportion of cost identified as attributable to PsO/PsA problems was greatest among the patients with PsA (drug costs 71% and healthcare costs 31%).Conclusion.Annual mean incremental societal cost per patient was highest for PsA, mainly because of productivity losses and biological treatment. A minor fraction of the costs were identified as attributable to PsO/PsA specifically, indicating an increased morbidity in these patients that needs to be further investigated.

The cost of prostate cancer care to society and to patients in the United States.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 116-116 ◽  
Author(s):  
Nicholas George Zaorsky ◽  
John Lin ◽  
Djibril Ba ◽  
Joel E Segel ◽  
Heath B. Mackley ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Cancer Patient ◽  
Prostate Cancer Patient ◽  
Low Complexity ◽  
International Classification Of Diseases ◽  
The United States ◽  
Office Visits ◽  
Classification Of Diseases ◽  
The Cost

116 Background: Our objectives are to characterize prostate cancer patient resource consumption and cost (I) to society, in 1 calendar year; and (II) to the patient, 1 year after his diagnosis. Methods: The MarketScan database was used to summarize cost, including gross payment to provider for service, copayment, and deductibles. We identified the top 20 Current Procedural Terminology (CPT) codes to characterize which procedures drove costs for both objectives. For Objective I, diagnoses were identified in 1 calendar year (2014); codes and their costs for all patients were calculated. For Objective II, diagnoses were set at time = 0, and all CPT and International Classification of Diseases codes were characterized 1 year after diagnosis (2012-2013). Results: For objective I, there were 95,642 procedures totalling $38,696,423. The plurality of procedures were hospital consultations, level 2 (i.e. history + physical + straightforward decision-making; 17,103 performed, average $80 each, total $1,418,954) and level 3 (+ low complexity decision-making; 9,726 performed; average $127 each, total $1,232,928). The most costly procedure to society was a radical prostatectomy (8,883 performed, average $2,003 each, total $17,694,508) with accompanying anesthesia (7,960 performed, average $1262 each, total $10,048,653). For objective II (characterized in Table), the mean payment per month was $2,794, including mean gross cost $2,673, mean copayment $32, and mean deductible $46. Conclusions: The typical cost of therapy to a prostate cancer patient is $2,800/month after diagnosis, primarily from surgery (constituting the majority of cost to society) and subsequently from office visits (constituting the plurality of procedures). Societal measures to reduce cost should be aimed at the operating room and consultations.[Table: see text]

scholarly journals Care cost for pregnant and parturient women with diabetes and mild hyperglycemia

2012 ◽  
Vol 46 (2) ◽  
pp. 334-343 ◽  
Author(s):  
Ana Claudia Molina Cavassini ◽  
Silvana Andrea Molina Lima ◽  
Iracema Mattos Paranhos Calderon ◽  
Marilza Vieira Cunha Rudge
Keyword(s):  
National Health System ◽  
Indirect Costs ◽  
Southeastern Brazil ◽  
Delivery Care ◽  
Outpatient Basis ◽  
Direct And Indirect Costs ◽  
Mild Hyperglycemia ◽  
Diabetes Center ◽  
The Cost ◽  
Care Costs

OBJECTIVE: To compare inpatient and outpatient care costs for pregnant/parturient women with diabetes and mild hyperglycemia. METHODS: A prospective observational quantitative study was conducted in the Perinatal Diabetes Center in the city of Botucatu, Southeastern Brazil, between 2007 and 2008. Direct and indirect costs and disease-specific costs (medications and tests) were estimated. Thirty diet-treated pregnant women with diabetes were followed up on an outpatient basis, and 20 who required insulin therapy were hospitalized. RESULTS: The cost of diabetes disease (prenatal and delivery care) was US$ 3,311.84 for inpatients and US$ 1,366.04 for outpatients. CONCLUSIONS: Direct and indirect costs as well as total prenatal care cost were higher for diabetic inpatients while delivery care costs and delivery-postpartum hospitalization were similar. Prenatal and delivery-postpartum care costs were higher for these patients compared to those paid by Brazilian National Health System.

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