Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization

Objective Determine the impact of long-term non-surgical weight loss maintenance on clinical relevance for osteoarthritis, cancer, opioid use, and depression/anxiety and healthcare resource utilization. Methods A cohort of adults receiving primary care within Geisinger Health System between 2001–2017 was retrospectively studied. Patients with ≥3 weight measurements in the two-year index period and obesity at baseline (BMI ≥30 kg/m2) were categorized: Obesity Maintainers (reference group) maintained weight within +/-3%; Weight Loss Rebounders lost ≥5% body weight in year one, regaining ≥20% of weight loss in year two; Weight Loss Maintainers lost ≥5% body weight in year one, maintaining ≥80% of weight loss. Association with development of osteoarthritis, cancer, opioid use, and depression/anxiety, was assessed; healthcare resource utilization was quantified. Magnitude of weight loss among maintainers was evaluated for impact on health outcomes. Results In total, 63,567 patients were analyzed including 67% Obesity Maintainers, 19% Weight Loss Rebounders, and 14% Weight Loss Maintainers; median follow-up was 9.7 years. Time until osteoarthritis onset was delayed for Weight Loss Maintainers compared to Obesity Maintainers (Logrank test p <0.0001). Female Weight Loss Maintainers had a 19% and 24% lower risk of developing any cancer (p = 0.0022) or obesity-related cancer (p = 0.0021), respectively. No significant trends were observed for opioid use. Weight loss Rebounders and Maintainers had increased risk (14% and 25%) of future treatment for anxiety/depression (both <0.0001). Weight loss maintenance of >15% weight loss was associated with the greatest decrease in incident osteoarthritis. Healthcare resource utilization was significantly higher for Weight Loss Rebounders and Maintainers compared to Obesity Maintainers. Increased weight loss among Weight Loss Maintainers trended with lower overall healthcare resource utilization, except for hospitalizations. Conclusions In people with obesity, sustained weight loss was associated with greater clinical benefits than regained short-term weight loss and obesity maintenance. Higher weight loss magnitudes were associated with delayed onset of osteoarthritis and led to decreased healthcare utilization.

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Healthcare resource utilization and associated cost of patients with bone metastases from solid tumors who are naïve to bone-targeting agents: a comparative analysis of patients with and without skeletal-related events

The European Journal of Health Economics ◽

10.1007/s10198-020-01247-z ◽

2021 ◽

Vol 22 (2) ◽

pp. 243-254

Author(s):

Fränce Hardtstock ◽

Zeki Kocaata ◽

Thomas Wilke ◽

Axel Dittmar ◽

Marco Ghiani ◽

...

Keyword(s):

Bone Metastases ◽

Solid Tumors ◽

Resource Utilization ◽

Inpatient Care ◽

Healthcare Resource ◽

Cohort Analysis ◽

Healthcare Resource Utilization ◽

Bone Targeting ◽

Skeletal Related Events ◽

The Impact

Abstract Background This study analyzes the impact of skeletal-related events (SRE) on healthcare resource utilization (HCRU) and costs incurred by patients with bone metastases (BM) from solid tumors (ST), who are therapy-naïve to bone targeting agents (BTAs). Methods German claims data from 01/01/2010 to 30/06/2018 were used to conduct a retrospective comparative cohort analysis of BTA-naive patients with a BM diagnosis and preceding ST diagnosis. HCRU and treatment-related costs were compared in two matched cohorts of patients with and without a history of SREs, defined as pathological fracture, spinal cord compression, surgery to bone and radiation to bone. The first SRE was defined as the patient-individual index date. Conversely, for the non-SRE patients, index dates were assigned randomly. Results In total, 45.20% of 9,832 patients reported experiencing at least one SRE (n = 4444) while 54.80% experienced none (n = 5388); 2,434 pairs of SRE and non-SRE patients were finally matched (mean age: 70.87/71.07 years; females: 39.07%/38.58%). Between SRE and non-SRE cohorts, significant differences in the average number of hospitalization days per patient-year (35.80/30.80) and associated inpatient-care costs (14,199.27€/10,787.31€) were observed. The total cost ratio was 1.16 (p < 0.001) with an average cost breakdown of 23,689.54€ and 20,403.27€ per patient-year in SRE and non-SRE patients. Conclusion The underutilization of BTAs within a clinical setting poses an ongoing challenge in the real-world treatment of BM patients throughout Germany. Ultimately, the economic burden of treating SREs in patients with BM from ST was found to be considerable, resulting in higher direct healthcare costs and increased utilization of inpatient care facilities.

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One-year mirror-image study of the impact of olanzapine long-acting injection on healthcare resource utilization and costs in severe schizophrenia

Psychiatry Research ◽

10.1016/j.psychres.2018.09.041 ◽

2018 ◽

Vol 270 ◽

pp. 205-210 ◽

Cited By ~ 2

Author(s):

Mylène Fefeu ◽

Pierre De Maricourt ◽

Arnaud Cachia ◽

Nicolas Hoertel ◽

Marie-Noëlle Vacheron ◽

...

Keyword(s):

Resource Utilization ◽

Healthcare Resource ◽

Healthcare Resource Utilization ◽

Mirror Image ◽

Image Study ◽

One Year ◽

Long Acting ◽

The Impact

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The impact of influenza and influenza-like illness on productivity and healthcare resource utilization in a working population

Occupational Medicine ◽

10.1093/occmed/48.2.85 ◽

1998 ◽

Vol 48 (2) ◽

pp. 85-90 ◽

Cited By ~ 105

Author(s):

M. Keech ◽

A. J. Scott ◽

P. J. J. Ryan

Keyword(s):

Resource Utilization ◽

Healthcare Resource ◽

Healthcare Resource Utilization ◽

Working Population ◽

Influenza Like Illness ◽

The Impact

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Impact of tuberculosis on mortality and healthcare resource utilization in cancer patients: A nationwide inpatient sample analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e13625 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e13625-e13625

Author(s):

Ishaan Vohra ◽

Prasanth Lingamaneni ◽

Vatsala Katiyar ◽

Krishna Rekha Moturi ◽

Sindhu Janarthanam Malapati ◽

...

Keyword(s):

Cancer Patients ◽

Resource Utilization ◽

Nationwide Inpatient Sample ◽

Healthcare Resource ◽

Healthcare Resource Utilization ◽

Health Concern ◽

Hospital Charges ◽

Solid Organ ◽

Nationwide Inpatient Sample Database ◽

Increased Risk

e13625 Background: Tuberculosis (TB) is a major public health concern. Patients with malignancy are at increased risk of developing TB as a result of depressed cellular immunity. The aim of the study is to analyze the prevalence, mortality and healthcare resource utilization of cancer patients with TB. Methods: Adult patients with malignancy and TB (cases) were identified using ICD10 code from Nationwide Inpatient Sample database 2017 and their data was compared to cancer patients without TB (controls). Univariate and multivariable logistic and Poisson regression models were used to analyze mortality and healthcare resource utilization. Results: Among 2,099,294 adult cancer patients admitted in 2017, 1115 were found to have TB. Majority (84%) had pulmonary TB. Mean age of patients was 60.3 years with 65% males and white predominance (33%). Overall prevalence of TB in cancer population was 51.3/100,000 patients, with highest being in Hodgkin lymphoma (182.6/100,000) followed by and MDS/ MPN patients (113.2/100,000) (p < 0.01). Among solid organ malignancies, lung cancer had the highest prevalence of TB (92.1/100,000). After adjusting for the demographic and patient related variables, TB was found to be an independent risk factor for mortality in cancer patients (adjusted HR 1.7, 95% CI 1.13-2.66, p = 0.017). The mortality of cases during inpatient stay was 10.2% compared to 6.2% in controls. The mean length of stay for cases was 12.4 days vs 6.3 days in controls (adjusted coef +6.12, 95% CI 3.64-8.59, P < 0.001) and mean hospital charges in cases was $136,026 vs $67,381 in controls (adjusted coef 68,680, 95% CI 39,053.5-98,306.9, p < 0.001). On multivariate analysis, predictors of mortality in cancer patients with TB were older age, malnutrition, uninsured status, higher Charlson comorbidity score ( = > 3), ICU care, venous thrombo-embolism and Acute renal failure requiring dialysis. Conclusions: TB significantly increases the morbidity and mortality in cancer patients. Widespread TB screening, prompt recognition of infection and treatment can considerably reduce health care costs. [Table: see text]

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Impact of Oxycodone HCl Extended-release Formulary Restrictions on Extended-release Opioid Market Share, Healthcare Resource Utilization and Costs in Commercial and Medicare Plans

Journal of Health Economics and Outcomes Research ◽

10.36469/9800 ◽

2017 ◽

Vol 5 (1) ◽

pp. 75-88

Author(s):

Rolin L. Wade ◽

Chi-Chang Chen ◽

Ajita P. De ◽

Jaren C. Howard

Keyword(s):

Resource Utilization ◽

Market Share ◽

Extended Release ◽

Healthcare Resource ◽

Office Visit ◽

The United States ◽

Healthcare Resource Utilization ◽

Unintended Consequences ◽

Health Plans ◽

The Impact

Background: Previous research demonstrated that utilization management (UM) such as prior authorization (PA) or non-formulary (NF) restrictions may reduce pharmacy costs when designed and applied appropriately to certain drug classes. However, such access barriers may also have unintended consequences. Few studies systemically analyzed the impact of major UM strategies to extended-release (ER) opioids on different types of health plans. Objective: This study evaluated, from payer perspective, the impact of formulary restrictions (PA, NF, or step therapy [ST]) for branded oxycodone HCl extended release (OER) on market share, and healthcare resource utilization/costs in ER opioids patients for multiple types of health plans in the United States. Methods: This retrospective, longitudinal case-control study analyzed prescription and outpatient medical claims data (2012 to 2015) for adult ER opioid patients from US plans (commercial,/Medicare, national/regional) that instituted OER PA, NF, or ST. Patients from each restricted plan (cases) were matched to patients in an unrestricted plan (controls) on key patient characteristics. ER opioid market share and healthcare resource utilization/costs for both cases and controls were evaluated for the 6-month period before and after the formulary restriction dates. A difference-in-differences (DiD) approach was utilized to evaluate change in the total per patient per month (PPPM) healthcare utilization and costs. Results: The study comprised 1622 (national commercial PA), 2020 (regional commercial PA), 34 703 (national commercial ST), and 4372 (national Medicare NF) cases and equivalent number of controls. OER market share decreased after the formulary restrictions, with the national Medicare NF plan showing the greatest decrease (9.2%). DiD analyses indicated that PPPM office visit change in the PA and NF plans were non-significant (decreased by 0.1 and 0.2, P>0.05), but significant in the ST plan (increased by 0.1, P=0.0001). For most plans, no significant total monthly cost change was observed; PPPM costs decreased by $48.74 and $59.87 in ST and regional PA plans and increased by $37.90 in national NF plans (all P>0.05). Conclusions: This study observed that despite reducing the market share of OER, OER formulary restrictions had negligible impact on overall ER opioid utilization, and did not result in substantial pharmacy/medical cost savings.

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