scholarly journals Economic consequences of the overuse of short-acting beta-adrenergic agonists (SABA) in the treatment of asthma in Spain

2021 ◽  
Vol 33 (2) ◽  
Author(s):  
A Valero ◽  
J Molina ◽  
J Nuevo ◽  
S Simon ◽  
M Capel ◽  
...  
Keyword(s):  
Resource Use ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
National Health System ◽  
Asthma Severity ◽  
Healthcare Resource Use ◽  
Beta Adrenergic ◽  
Short Acting ◽  
Asthma Patients ◽  
The Relationship

Objective: To determine the relationship between short-acting beta-adrenergic agonist (SABA) overuse and healthcare resource use and costs in asthma patients in routine clinical practice. Methods: A longitudinal retrospective study in Spanish primary and specialized care using the BIG-PAC® Medical Records Database was conducted. Asthma patients ≥12 years of age who attended ≥ 2 consultations during 2017 and had 1-year follow-up data available were included. Main outcomes were demographics, comorbidities, medication, clinical and healthcare resource use and costs. The relationship between SABA overuseand healthcare costs, and between asthma severity and healthcare costs was determined. Results: This SABA use IN Asthma (SABINA) study included 39,555 patients, mean (standard deviation, SD) age 49.8 (20.7) years; 64.2% were female. Charlson comorbidity index was 0.7 (1.0). SABA overuse (≥ 3 canisters/year) was 28.7% (95% CI: 27.7–29.7), with an overall mean number of 3.3 (3.6) canisters/year. Overall, 5.1% of patients were prescribed ≥12 canisters/year. SABA overuse was correlated with healthcare costs (ρ = 0.621; p < 0.001).The adjusted mean annual cost/patient, according to the Global Initiative for Asthma (GINA 2019) classification of asthma severity, was €2,231, €2,345, €2,735, €3,473, and €4,243,for GINA steps 1−5, respectively (p < 0.001). Regardless of asthma severity, SABA overuse yielded a significant increase in healthcare costs per patient and year (€5,702 vs. €1,917, p < 0.001) compared with recommended use (< 2 canisters/year). Conclusions: SABA overuse yields greater costs for the Spanish National Health System. Costs increased according to asthma severity.

scholarly journals Healthcare resource use in patients of the Australian Transition Care Program

2015 ◽  
Vol 39 (4) ◽  
pp. 411 ◽  
Author(s):  
Tracy A. Comans ◽  
Nancye M. Peel ◽  
Ian D. Cameron ◽  
Leonard Gray ◽  
Paul A. Scuffham
Keyword(s):  
Resource Use ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Hospital Costs ◽  
Care Program ◽  
Healthcare Resource Use ◽  
Admission Rates ◽  
Care Recipients ◽  
Transition Care ◽  
The Cost

Objective The aim of the present study was to describe, from the perspective of the healthcare funder, the cost components of the Australian Transition Care Program (TCP) and the healthcare resource use and costs for a group of transition care clients over a 6-month period following admission to the program. Methods A prospective cohort observational study of 351 consenting patients entering community-based transition care at six sites in two states in Australia from November 2009 to September 2010 was performed. Patients were followed up 6 months after admission to the TCP to ascertain current living status and hospital re-admissions over the follow-up period. Cost data were collected by transition care teams and from administrative data (hospital and Medicare records). Results The TCP provides a range of services with most costs attributed to provision of personal care support, case management, physiotherapy and occupational therapy. Most healthcare costs up to 6 months after transition care admission were incurred from the hospital admission leading to transition care and from re-admissions. Orthopaedic conditions incurred the highest costs, with many of these for elective procedures and others resulting from falls. Hospital re-admission rates in the present study were 10% lower than in a previous evaluation of the TCP. Over 6 months, approximately 40% of patients in the study were re-admitted to hospital at an average cost of A$7038. Conclusions Although the cost of the TCP is relatively high, it may have some impact on reducing hospital re-admissions and preventing or delaying residential care admissions. What is known about the topic? A majority of healthcare costs occur in older age. What does this paper add? Hospital costs, both initial and re-admissions, are the major contributor to healthcare costs in transition care recipients. Orthopaedic conditions are the most expensive to treat and neurological conditions are the most variable. What are the implications for practitioners? Reducing the length of hospitalisation and reducing re-admissions for older frail people is a key economic concern for health services. Services such as the TCP aim to do both; however, the evidence that this is effective is limited. Streamlining referrals to transition care to enable earlier access and involving the transition care provider in re-admission decisions may help reduce healthcare costs in future.

Household Members of Persons with Alzheimer's Disease: Health Conditions, Healthcare Resource Use, and Healthcare Costs

2014 ◽  
Vol 62 (3) ◽  
pp. 435-441 ◽  
Author(s):  
Brandon T. Suehs ◽  
Sonali N. Shah ◽  
Cralen D. Davis ◽  
Jose Alvir ◽  
Warachal E. Faison ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Resource Use ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Health Conditions ◽  
Healthcare Resource Use ◽  
Household Members

scholarly journals The direct costs of overdiagnosed asthma in a longitudinal population-based study

2018 ◽  
Author(s):  
Bryan C. Ng ◽  
Mohsen Sadatsafavi ◽  
Abdollah Safari ◽  
J. Mark FitzGerald ◽  
Kate M. Johnson
Keyword(s):  
Resource Use ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Medication Use ◽  
Population Based ◽  
Healthcare Resource Use ◽  
Asthma Diagnosis ◽  
Physician Visits ◽  
Direct Healthcare Costs ◽  
Physician Diagnosis

ABSTRACTObjectivesA current diagnosis of asthma cannot be objectively confirmed in many patients with physician-diagnosed asthma. Estimates of resource use in overdiagnosed cases of asthma are necessary to measure the burden of overdiagnosis and evaluate strategies to reduce this burden. We assessed the difference in asthma-related healthcare resource use between patients with a confirmed asthma diagnosis and those with asthma ruled out.DesignPopulation-based prospective cohort study.SettingParticipants were recruited through random-digit dialling of both landlines and mobile phones in BC, Canada.ParticipantsWe included 345 individuals ≥12 years of age with a self-reported physician diagnosis of asthma which was confirmed by a bronchodilator reversibility or methacholine challenge test at the end of the 12-month follow-up.Primary and secondary outcome measuresSelf-reported annual asthma-related direct healthcare costs (2017 Canadian dollars), outpatient physician visits, and medication use from the Canadian healthcare system perspective.ResultsAsthma was ruled out in 86 (24.9%) participants. Average annual asthma-related direct healthcare costs for participants with confirmed asthma were $497.9 (SD $677.9), and $307.7 (SD $424.1) for participants with asthma ruled out. In the adjusted analyses, a confirmed diagnosis was associated with higher direct healthcare costs (Relative Ratio [RR]=1.60, 95%CI 1.14-2.22), increased rate of specialist visits (RR=2.41, 95%CI 1.05-5.40) and reliever medication use (RR=1.62, 95%CI 1.09-2.35), but not primary care physician visits (p=0.10) or controller medication use (p=0.11).ConclusionsA quarter of individuals with a physician diagnosis of asthma did not have asthma after objective re-evaluation. These participants still consumed a significant amount of asthma-related healthcare resources. The population-level economic burden of asthma overdiagnosis could be substantial.Strengths and limitations of this studyParticipants were recruited through random sampling of the general population in the province of British Columbia.Asthma diagnosis was confirmed or ruled out using sequential guideline-recommended objective airway tests.Healthcare resource use was self-reported, potential recall bias may have led to reduced accuracy.The study was unable to evaluate the indirect costs of overdiagnosis or the cost-savings from correcting the diagnosis.The generalizability of the results may be limited by regional differences in medical costs and practices.

scholarly journals Hypothermia for perinatal asphyxia: trial-based resource use and costs at 6–7 years

2018 ◽  
Vol 104 (3) ◽  
pp. F285-F292 ◽  
Author(s):  
Oliver Rivero-Arias ◽  
Oya Eddama ◽  
Denis Azzopardi ◽  
A David Edwards ◽  
Brenda Strohm ◽  
...  
Keyword(s):  
Intensive Care ◽  
Resource Use ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Perinatal Asphyxia ◽  
Control Group ◽  
Hypothermia Group ◽  
The Impact ◽  
The Relationship

ObjectiveTo assess the impact of hypothermic neural rescue for perinatal asphyxia at birth on healthcare costs of survivors aged 6–7 years, and to quantify the relationship between costs and overall disability levels.Design6–7 years follow-up of surviving children from the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) trial.SettingCommunity study including a single parental questionnaire to collect information on children’s healthcare resource use.Patients130 UK children (63 in the control group, 67 in the hypothermia group) whose parents consented and returned the questionnaire.InterventionsIntensive care with cooling of the body to 33.5°C for 72 hours or intensive care alone.Main outcome measuresHealthcare resource usage and costs over the preceding 6 months.ResultsAt 6–7 years, mean (SE) healthcare costs per child were £1543 (£361) in the hypothermia group and £2549 (£812) in the control group, giving a saving of −£1005 (95% CI −£2734 to £724). Greater levels of overall disability were associated with progressively higher costs, and more parents in the hypothermia group were employed (64% vs 47%). Results were sensitive to outlying observations.ConclusionsCost results although not significant favoured moderate hypothermia and so complement the clinical results of the TOBY Children study. Estimates were however sensitive to the care requirements of two seriously ill children in the control group. A quantification of the relationship between costs and levels of disability experienced will be useful to healthcare professionals, policy makers and health economists contemplating the long-term economic consequences of perinatal asphyxia and hypothermic neural rescue.Trial registration numberThis study reports on the follow-up of the TOBY clinical trial: ClinicalTrials. gov number NCT01092637.

scholarly journals Cohort study of healthcare use, costs and diagnoses from onset to 6 months after discharge for takotsubo syndrome in Sweden

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e027814 ◽  
Author(s):  
Sara Wallström ◽  
Inger Ekman ◽  
Elmir Omerovic ◽  
Kerstin Ulin ◽  
Hanna Gyllensten
Keyword(s):  
Primary Care ◽  
Resource Use ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Takotsubo Syndrome ◽  
Healthcare Resource Use ◽  
Direct Healthcare Costs ◽  
The Mean ◽  
Discharge From Hospital

ObjectiveLittle is known about the economic impact of takotsubo syndrome (TS) for patients and the health system after initial discharge from hospital. Therefore, the aim of this study was to describe the healthcare resource use and calculate direct healthcare costs for TS, from hospitalisation to 6 months after discharge, and explore the distribution of costs between TS and other diagnoses among patients with TS.Method, participants and settingCohort study investigating direct healthcare costs from hospitalisation, open specialised outpatient and primary care. Healthcare resource use during 6 months after diagnosis with TS was collected for 58 consecutive patients from the Regional Patient Register. Incidence-based direct healthcare costs, in 2015 values, were calculated using diagnosis-related group weights and unit costs from national statistics on healthcare costs.ResultsThe mean length of hospital stay was 10.2 days, index 6.4 and re-admissions 3.8 days. The mean number of follow-up encounters per patient was 15.6, of which two-thirds was specialised outpatient and one-third was primary care. This resulted in an average cost of €10 360. Of this, costs of €8026 (77.5%) occurred during encounters for which at least one of the registered conditions was cardiovascular. Costs differed little according to background characteristics.ConclusionThis study shows that patients utilise hospital, specialised outpatient and primary care after discharge for TS. Most direct healthcare costs relate to cardiac diagnoses. Patients with TS would probably benefit from a supportive follow-up programme after discharge from hospital.

The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use: Results from an Observational Study (ASSESS)

2016 ◽  
Vol 13 (5) ◽  
pp. 561-568 ◽  
Author(s):  
Marc Miravitlles ◽  
Heinrich Worth ◽  
Juan José Soler-Cataluña ◽  
David Price ◽  
Fernando De Benedetto ◽  
...  
Keyword(s):  
Observational Study ◽  
Resource Use ◽  
Healthcare Resource ◽  
Healthcare Resource Use ◽  
Copd Exacerbations ◽  
The Relationship

scholarly journals THU0546 HEALTHCARE COSTS OF NOT ACHIEVING REMISSION IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 513.2-513
Author(s):  
M. Bergman ◽  
L. Zhou ◽  
P. Patel ◽  
R. Sawant ◽  
J. Clewell ◽  
...  
Keyword(s):  
Resource Use ◽  
Healthcare Costs ◽  
Index Date ◽  
Healthcare Resource ◽  
Medical Costs ◽  
Direct Costs ◽  
Healthcare Resource Use ◽  
Outpatient Visits ◽  
Number Of Visits ◽  
The Impact

Background:Guidelines recommend sustained remission as a treatment goal for patients with rheumatoid arthritis (RA). However, only one-third of patients are known to achieve this goal with current treatments. A few studies have evaluated the impact of remission in a real-world setting, but evidence is limited to the elderly population.Objectives:To understand the impact of remission on healthcare costs by comparing overall and RA-related direct healthcare costs and resource use in patients with RA who maintain vs those who do not maintain remission using a real-world database.Methods:Data for this retrospective cohort study were derived from Optum electronic health records linked to claims from commercial and Medicare Advantage health plans in the United States. Patients with ≥2 diagnoses for RA, ≥1 Disease Activity Score 28 (DAS28-CRP/ESR) or Routine Assessment of Patient Index Data 3 (RAPID3) measurement, and continuous medical and pharmacy coverage 6 months before and 1 year after the index date were included. Two cohorts were created: remission and non-remission. Remission was defined as DAS28 <2.6 or RAPID3 ≤3.0. In the remission cohort, the index date was defined as the first date remission was achieved. In the non-remission cohort, the index date was defined as the first date of DAS28 or RAPID3 measurement. Outcomes were all-cause and RA-related total, medical, and prescription costs; healthcare resource use (number of inpatient, emergency department [ED], outpatient, and other visits); and number of prescriptions within 1 year of index date. A weighted generalized linear model and binomial regression were used to estimate adjusted annual direct costs and healthcare resource use, respectively. Confounding between cohorts due to age, sex, race and comorbidities using the Elixhauser index was controlled for in the models.Results:A total of 335 patients with RA (remission cohort: 125; non-remission cohort: 210) met the study inclusion criteria. Annual all-cause total direct costs in the remission cohort were significantly less than in the non-remission cohort ($30,427 vs $38,645, respectively; cost ratio (CR)=0.79; 95% CI: 0.63, 0.99). All-cause medical costs were significantly lower in the remission cohort than in the non-remission cohort (Figure 1); furthermore, among all-cause medical costs, outpatient visit costs were significantly lower in the remission than in the non-remission cohort. All-cause resource use (mean number of visits) was less in the remission vs non-remission cohort: inpatient (0.23 vs 0.63; visit ratio (VR)=0.36; 95% CI: 0.19, 0.70), ED (0.36 vs 0.77; VR=0.47; 95% CI: 0.30, 0.74), and outpatient visits (20.7 vs 28.5; VR=0.73; 95% CI: 0.62, 0.86). Annual RA-related total direct costs were similar in both cohorts (Figure 2); however, RA-related medical costs were numerically lower in the remission vs non-remission cohort ($8,594 vs $10,002, respectively; CR=0.86; 95% CI: 0.59, 1.25). RA-related resource use (mean number of visits) was less in the remission vs non-remission cohort: inpatient (0.15 vs 0.22; VR=0.67; 95% CI: 0.35, 1.30), ED (0.04 vs 0.13; VR=0.31; 95% CI: 0.10, 0.95), and outpatient visits (5.4 vs 7.4; VR=0.72; 95% CI: 0.58, 0.91).Conclusion:Significant economic burden was associated with patients who did not maintain remission compared with those who maintained remission. Although outpatient visits were the driver of medical costs in both groups studied in this analysis, the contribution of outpatient visits was greater among those who did not maintain remission.Acknowledgments:Financial support for the study was provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the abstract. All authors contributed to the development of the publication and maintained control over the final content. Medical writing services were provided by Joann Hettasch of JK Associates Inc., a member of the Fishawack Group of Companies, and funded by AbbVie.Disclosure of Interests:Martin Bergman Shareholder of: Johnson & Johnson – stockholder, Consultant of: AbbVie, BMS, Celgene Corporation, Genentech, Janssen, Merck, Novartis, Pfizer, Sanofi – consultant, Speakers bureau: AbbVie, Celgene Corporation, Novartis, Pfizer, Sanofi – speakers bureau, Lili Zhou Shareholder of: AbbVie, Employee of: AbbVie, Pankaj Patel Shareholder of: AbbVie, Employee of: AbbVie, Ruta Sawant Shareholder of: AbbVie, Employee of: AbbVie, Jerry Clewell Shareholder of: AbbVie, Employee of: AbbVie, Namita Tundia Shareholder of: AbbVie, Employee of: AbbVie

scholarly journals Comorbidities and healthcare costs and resource use of patients with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) in the Japan medical data vision database

2021 ◽  
Author(s):  
Shuji Terai ◽  
Amy Buchanan-Hughes ◽  
Alvin Ng ◽  
I-Heng Lee ◽  
Ken Hasegawa
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Resource Use ◽  
Nonalcoholic Steatohepatitis ◽  
Fatty Liver Disease ◽  
Healthcare Costs ◽  
Healthcare Resource ◽  
Medical Data ◽  
Healthcare Resource Use ◽  
Nonalcoholic Fatty Liver

Abstract Background This study examined demographics, comorbidities and healthcare resource use (HCRU) and costs among Japanese patients with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). Methods We conducted a repeated cross-sectional analysis of the Medical Data Vision (MDV) claims database, from January 2011 to March 2018. Demographics were described at index date and by calendar year; a “NASH” subpopulation included patients with ≥ 1 claim for NASH at any time. Prevalence of pre-specified comorbidities of interest and data-emergent top comorbidities were estimated. All-cause HCRU and costs were quantified by calendar year. Outcomes were compared between 2011 and 2017 using partially overlapping t tests. Results 58,958 patients (mean age 61.6 years; 55.5% male) were included. 1139 patients (2%) were in the NASH subpopulation. At baseline, comorbid cardiovascular disease (69.4%), diabetes (62.1%) and hyperlipidaemia (54.4%) were most prevalent; comorbidity prevalence increased with age. Mean outpatient visits decreased from 9.36 per patient in 2011 to 7.80 in 2017; mean inpatient admissions increased (both p < 0.001 for 2011 vs 2017). Mean total all-cause healthcare costs ranged from ¥322,206 to ¥340,399 per patient per year between 2011 and 2017. Although total all-cause healthcare costs did not change significantly (p = 0.552), cost burden shifted from the outpatient to inpatient setting between 2011 and 2017. All-cause healthcare resource use/costs were generally higher for the NASH subgroup compared with the overall population. Conclusions There is a high burden of disease among Japanese NAFLD/NASH patients, including a high prevalence of comorbidities which generally increase with age. Accordingly, substantial all-cause HCRU and costs were incurred.

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