scholarly journals PHARMACOECONOMIC EVALUATION OF ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AT A TERTIARY CARE TEACHING HOSPITAL IN NORTH KARNATAKA, INDIA

2018 ◽  
Vol 11 (5) ◽  
pp. 463 ◽  
Author(s):  
Rahul S ◽  
Abhinand Cr ◽  
Nikithareddy B ◽  
Jayachandra K ◽  
Lakshmi P ◽  
...  
Keyword(s):  
Health Care ◽  
Direct Medical Cost ◽  
Medical Cost ◽  
Pharmacoeconomic Evaluation ◽  
Research Centre ◽  
Total Direct Cost ◽  
Chronic Obstructive ◽  
Total Direct Medical Cost ◽  
Copd Patients ◽  
Acute Exacerbations

Objective: The objective of the study was to evaluate the burden of cost in patients of acute exacerbations of chronic obstructive lung disease (COPD).Methods: A prospective, observational study was conducted in COPD patients over a period of 6 months in general medicine and pulmonary wards of Navodaya Medical College Hospital and Research Centre, Raichur, Karnataka, India. Direct medical and non-medical cost were included in the burden of cost. From the drug rate manual of hospital, cost for drugs and investigation were calculated.Results: Overall 100 COPD patients were enrolled in which 92 were male and 8 were female with a mean age of 60.33±10.98. The patients participated in this study were stayed in the hospital with mean±standard deviation (SD) value of 9±3. Minimum total direct medical cost was Rs. 1149.00 and maximum was Rs. 13,510.00 with a mean±SD 3297.48±1634.226, in which medicine cost was high (mean 2746.63). Minimum total direct non-medical cost was Rs. 100.00 and maximum was Rs. 3470.00 with a mean±SD 700.7±487.121, in which food expenses was high (mean 549.55). Maximum total direct cost was Rs.16,980.00 and minimum was 1349.00 with a mean± SD 3998.18±1921.47. Direct medical cost contributes 79.56% and direct non-medical cost contribute 20.44% of total direct cost.Conclusion: COPD has a substantial impact on health-care costs particularly for hospitalization. Exacerbation prevention resulting in reduced need for inpatient care could lower costs. The development of pharmacoeconomic is at an infancy stage in India at the moment, despite the rapid growth of clinical research. In a country with scarce resources and an ever-growing population with diverse health-care needs, health economics (Pharmacoeconomic evaluation) plays a pivotal role in determining the delivery of equitable and cost-effective health services.

scholarly journals EVALUATION OF PHARMACOECONOMIC DIRECT COST IN DIABETES PATIENTS

2017 ◽  
Vol 10 (4) ◽  
pp. 38
Author(s):  
Venkateswarlu Konuru ◽  
Kamala Sangam ◽  
Anifa Mohammed ◽  
Swathi Kanneganti
Keyword(s):  
Health Care ◽  
Diabetic Patient ◽  
Direct Medical Cost ◽  
Medical Cost ◽  
Average Cost ◽  
Health Care Cost ◽  
Vascular Complications ◽  
Illness Study ◽  
Total Average Cost ◽  
Total Average

Objective:  Diabetes Mellitus (DM) is a major cause of disability, morbidity and mortality Worldwide. The objective of this study is to evaluate the Pharmacoeconomic direct health care cost in type II Diabetes with complications and Diabetes alone: A cost of illness study. Methods:  A Prospective observational study was conducted for one year at the Care diabetes Center; Warangal. The enrolled patients were followed and the information collected contains: total direct costs, which include direct medical costs and direct nonmedical cost. The data observed was analyzed for the average cost incurred in treating the diabetic patient. Results:  The total average costs per diabetic patient without complications was Rs. 8695.7±1341,  this includes the average direct medical cost Rs. 6366.50± 561.12, the average lab cost Rs. 1368.84±64.8, the average direct non Medical Cost was Rs. 960.36±14.04 compared to  those with DM complications,the total average cost was Rs. 12960.73±549.96 for macro vascular complications, Rs. 11039.11±265.36 for micro vascular complications. To treat Diabetes with comorbidities which include both micro and macro complications the total average cost was  Rs. 16658.13±1393.44, the average direct medical cost was Rs. 14071.77±2884.68, the average lab cost Rs. 1628.04±51, the average direct non Medical Cost was Rs.958.32±13.08. The costs were found to increase progressively with the increase in the number of complications. Costs also differed significantly across the types of complications. Conclusion: Our study concludes that the cost of Diabetes with complications resulted about 2 times higher than compared to Diabetes alone.Key words:  Cost analysis; diabetes; economics; health care; direct medical cost; non medical cost

scholarly journals Hidden Costs of Hospital-Based Delivery Among Women Using Public Hospitals in Bale Zone, Southeast Ethiopia

2019 ◽  
Vol 10 ◽  
pp. 215013271989644
Author(s):  
Melese Merga ◽  
Tilahun Fufa Debela ◽  
Tesfamichael Alaro
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Direct Medical Cost ◽  
Health Care System ◽  
Medical Cost ◽  
Institutional Delivery ◽  
Mode Of Delivery ◽  
Hidden Cost ◽  
Bale Zone ◽  
Care System

Background: The Ethiopian health care system since 2005 has encouraged safe enhanced obstetrical care. However, hospital delivery has remained expensive for poor households due to hidden costs. Hidden costs are the costs that are not accounted for in direct hospital costs. The aim of this study was to estimate the hidden costs of institutional delivery and to identify its associated factors. Methods: A health facility–based cross-sectional study was conducted in the Bale zone from August 13 to September 2, 2018. Exit interviews were conducted among women who gave birth at the selected hospitals. A total of 390 women from 1 referral hospital and 2 general hospitals were included into the study. Systematic sampling technique was used to select study participants. Multiple linear regression analysis was done to identify the predictors of the hidden cost of institutional delivery. Result: The median hidden cost of institutional delivery was 877.5 ETB (32.03 USD). The median of the direct medical cost of normal delivery was 280 ETB (10.21 USD) while the direct nonmedical cost was 230 ETB (8.40 USD). For cesarean section, the median direct medical cost was 292 ETB (10.66 USD) while indirect costs were 591 ETB (21.60 USD). For forceps delivery, the direct medical cost was 362 ETB (13.21 USD) while the direct medical cost was 360 (13.14 USD). Distance of household from the hospital (β = 0.165), length of stay at the hospital (β = 0.050), mode of delivery (β = −0.067), and family monthly income (β = 0.201) were the explanatory variables significantly associated with the hidden cost. Conclusion: This study showed hidden cost of facility-based delivery was high. Distance, length of stay, income, and mode of delivery were the predictor of hidden cost. Ethiopian health care system should consider the hidden costs for pregnant women and their families.

scholarly journals Neutrophil proteases alter the interleukin-22-receptor-dependent lung antimicrobial defence

2015 ◽  
Vol 46 (3) ◽  
pp. 771-782 ◽  
Author(s):  
Antoine Guillon ◽  
Youenn Jouan ◽  
Deborah Brea ◽  
Fabien Gueugnon ◽  
Emilie Dalloneau ◽  
...  
Keyword(s):  
Chronic Obstructive ◽  
Dependent Lung ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Interleukin 22 ◽  
Copd Patients ◽  
Acute Exacerbations ◽  
Underlying Mechanisms

Chronic obstructive pulmonary disease (COPD) is punctuated by episodes of infection-driven acute exacerbations. Despite the life-threatening nature of these exacerbations, the underlying mechanisms remain unclear, although a high number of neutrophils in the lungs of COPD patients is known to correlate with poor prognosis. Interleukin (IL)-22 is a cytokine that plays a pivotal role in lung antimicrobial defence and tissue protection. We hypothesised that neutrophils secrete proteases that may have adverse effects in COPD, by altering the IL-22 receptor (IL-22R)-dependent signalling.Using in vitro and in vivo approaches as well as reverse transcriptase quantitative PCR, flow cytometry and/or Western blotting techniques, we first showed that pathogens such as the influenza virus promote IL-22R expression in human bronchial epithelial cells, whereas Pseudomonas aeruginosa, bacterial lipopolysaccharide or cigarette smoke do not. Most importantly, neutrophil proteases cleave IL-22R and impair IL-22-dependent immune signalling and expression of antimicrobial effectors such as β-defensin-2. This proteolysis resulted in the release of a soluble fragment of IL-22R, which was detectable both in cellular and animal models as well as in sputa from COPD patients with acute exacerbations.Hence, our study reveals an unsuspected regulation by the proteolytic action of neutrophil enzymes of IL-22-dependent lung host response. This process probably enhances pathogen replication, and ultimately COPD exacerbations.

scholarly journals Fibrinogen is a promising biomarker for chronic obstructive pulmonary disease: evidence from a meta-analysis

2020 ◽  
Vol 40 (7) ◽  
Author(s):  
Bo Zhou ◽  
Shufang Liu ◽  
Danni He ◽  
Kundi Wang ◽  
Yunfeng Wang ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Data Extraction ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Acute Exacerbations ◽  
Global Initiative

Abstract Backgrounds: Some studies have reported association of circulating fibrinogen with the risk of chronic obstructive pulmonary disease (COPD), and the results are conflicting. To yield more information, we aimed to test the hypothesis that circulating fibrinogen is a promising biomarker for COPD by a meta-analysis. Methods: Data extraction and quality assessment were independently completed by two authors. Effect-size estimates are expressed as weighted mean difference (WMD) with 95% confidence interval (95% CI). Results: Forty-five articles involving 5586/18604 COPD patients/controls were incorporated. Overall analyses revealed significantly higher concentrations of circulating fibrinogen in COPD patients than in controls (WMD: 84.67 mg/dl; 95% CI: 64.24–105.10). Subgroup analyses by COPD course showed that the degree of increased circulating fibrinogen in patients with acute exacerbations of COPD (AECOPD) relative to controls (WMD: 182.59 mg/dl; 95% CI: 115.93–249.25) tripled when compared in patients with stable COPD (WMD: 56.12 mg/dl; 95% CI: 34.56–77.67). By COPD severity, there was a graded increase in fibrinogen with the increased severity of COPD relative to controls (Global Initiative for Obstructive Lung Disease (GOLD) I, II, III, and IV: WMD: 13.91, 29.19, 56.81, and 197.42 mg/dl; 95% CI: 7.70–20.11, 17.43–40.94, 39.20–74.41, and −7.88 to 402.73, respectively). There was a low probability of publication bias. Conclusion: Our findings indicate a graded, concentration-dependent, significant relation between higher circulating fibrinogen and more severity of COPD.

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