PROBLEMS OF ASSESSING THE HEALTH CARE COSTS EFFECTIVENESS

2017 ◽  
Vol 11 (6) ◽  
pp. 137-151 ◽  
Author(s):  
Людмила Горшкова ◽  
Lyudmila Gorshkova
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health Care Costs ◽  
Public Expenditure ◽  
Health Care Expenditure ◽  
Important Indicator ◽  
Life Expectancy At Birth ◽  
Logarithmic Curve ◽  
The Cost ◽  
Care Costs

Assessing the effectiveness of health care expenditure is a major economic task. The most important indicator to assess the effectiveness of health care costs is the expected life expectancy (ELE). Infant mortality is also closely related to DLE. The article substantiates the logarithmic model of the dependence of ELE from health care expenditure (per person for a particular year). Each country is represented by a point on the coordinate plane with an ordinate equal to the ELE in this country and an abscissa equal to the health care expenditure in it. The modeling logarithmic curve is taken as the theoret-ical threshold of the cost-effectiveness: the higher the curve is the point repre-senting the country, the more effective the health care costs in this country, and the lower the threshold curve, the costs are more unprofitable. It is shown that the dependence of ELE from GDP (or GRP by regions of Russia) is not so obvious: although there is a tendency to such a dependence, but with a large number of drop-out values. Despite the achievement of the highest average expected life expectancy in Russia in the country's history, it is significantly lower than in developed countries. The main causes of low expected life expectancy at birth are unsatisfactory health indicators, and as a result, high incidence and disability. Traumatism on the roads and suicides are one of the significant reasons for the low expected life expectancy in Russia and are significantly higher than similar indicators in other countries. The article shows the close correlation between the cost of health care per person and expected life expectancy. However, in the Russian Federation, the share of public expenditure in the structure of aggregate health expenditure is decreasing. Social insurance funds are more than half of the health care public expenditure. The author reveals considerable regional differences in health spending per person and average expected life expectancy. The article highlights the insufficient level of health care costs in Russia as a whole and in regions.

scholarly journals DETERMINANTS OF SUCCESSFUL TRANSFORMATION OF THE MEDICAL SYSTEM IN THE EU AND UKRAINE: COMPARATIVE ANALYSIS

2021 ◽  
Author(s):  
Pavlo Ivanchov
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health Care Costs ◽  
Health Care Expenditures ◽  
Well Being ◽  
Economic Security ◽  
Medical System ◽  
State Management ◽  
Life Expectancy At Birth ◽  
Care Costs

The need to study the effectiveness of the health care system in developed countries in order to assess the state of development of the medical system and analyze the key determinants of its effective transformation is emphasized in the article. The idea, that general indicator that characterizes the efficiency of the medical industry is the indicator of life expectancy, is determined. The dependences of the level of life expectancy on the level of well-being and total health care costs are studied. It was found that life expectancy significantly depends on the level of real gross domestic product per capita at the purchasing power parity of the population in countries with lower levels of socio-economic security and quality of life, a lower life expectancy is recorded. It has been determined that increasing health care expenditures to a certain level has a positive impact on the efficiency of the medical sector, although it depends more on the scheme of attracting and allocating financial resources. In addition, the dynamics of the development of medical systems in Eastern Europe by indicators of life expectancy at birth, the level of expenditures on medicine in general and funding schemes, the share of health care costs “out of pocket”, the level of costs for medical facilities and reimbursement medicines for the population, etc. are analyzed. It is determined that the experience of countries similar in level of socio-economic development to Ukraine can be extrapolated to the domestic practice of state management of the medical 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

What's Cheaper Than Pediatric Care?

PEDIATRICS ◽  
1976 ◽  
Vol 58 (5) ◽  
pp. 772-772
Author(s):  
Richard M. Narkewicz
Keyword(s):  
Health Care ◽  
Child Care ◽  
Health Care Costs ◽  
Pediatric Care ◽  
Continuing Care ◽  
Well Child Care ◽  
Fee Structure ◽  
The Cost ◽  
Care Costs

In these days of rising health care costs, the finger has been pointed at physicians as the cause of these increases. Because of these charges each physician should look critically at his own fee structure and try to compare it with other commodities in today's budgets. I have done just that. In totaling the cost of complete well-child care for a child and continuing care through the age of 20 years, I was surprised to find that in the present fee structure it costs a family $464.25.

Consumer Cost-Sharing as a Means to Reduce Health Care Costs

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 168-170
Author(s):  
Stephen M. Davidson ◽  
John P. Connelly ◽  
R. Don Blim ◽  
James E. Strain ◽  
H. Doyl Taylor
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Cost Sharing ◽  
Cost Of Care ◽  
National Commission ◽  
Insurance Policies ◽  
National Medical ◽  
Use Of Services ◽  
The Cost ◽  
Care Costs

The National Commission on the Cost of Medical Care1 states in part (Recommendation 2) that "insurance policies should include provisions through which the consumer shares in the cost of care received, at the time of service, for selected benefits and for selected groups...." These cost-sharing provisions are expected to reduce national medical care expenditures by encouraging consumers to reduce their use of services in order to avoid paying additional money out of their own pockets. They will thus moderate the demand-inducing tendency of insurance, leading the rational consumer to seek only necessary services and to forego those services contributing to what is believed to be over-utilization. As the Commission states in its supporting statement:

scholarly journals CONSUMER BEHAVIOUR, OBESITY AND SOCIAL COSTS. THE CASE OF ITALY

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Paola Mancini ◽  
Giuseppe Marotta ◽  
Concetta Nazzaro ◽  
Biagio Simonetti
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Consumer Behaviour ◽  
Social Impact ◽  
Multiple Correspondence Analysis ◽  
Health Care Expenditure ◽  
Overweight And Obesity ◽  
Social Costs ◽  
Least Squares Regression ◽  
Care Costs

This study analyses the social impact of obesity, focusing on the direct costs and, in particular,on the health-care expenditure. Using different socio-demographic variables and through theuse of Multiple Correspondence Analysis and Partial Least Squares Regression, the analysis: i)confirms the increase of the incidence of overweight and obesity when moving from Northernto Southern Italy; ii) identifies the main variables related to the growth of obesity; iii) highlightsa positive relationship between BMI and health-care costs and an incidence of 6% on theregional health-care costs. These findings confirm the need to define suitable guidelines fordecision makers and practitioners and to introduce mandatory regulations forcing companiesto effectuate product reformulation and achieve food safety. Indeed, asymmetric informationand consumer behaviour make investing in product reformulation undesirable for companiesbecause the use of attractive brands is more effective in influencing the purchasing decisionseven of a conscious consumer. Uninformed consumers often cling to the national brands,which sometimes, behind an image of familiarity and identity, may hide harmful ingredients(hydrogenated fats) or excessive quantities of certain ingredients (sugar, salt, saturatedfat) responsible for an unbalanced diet. Therefore, this justifies the introduction of bindingregulations.Keywords: Consumer Behaviour; Obesity; Social Costs; Health-Care Expenditure; MultivariateModel.

scholarly journals Burden of health behaviours and socioeconomic position on health care expenditure in Ontario

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 303
Author(s):  
Douglas G. Manuel ◽  
Carol Bennett ◽  
Richard Perez ◽  
Andrew S. Wilton ◽  
Adrian Rohit Dass ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Health Care Costs ◽  
Health Behaviour ◽  
Socioeconomic Position ◽  
Healthcare Costs ◽  
Cost Model ◽  
Health Care Expenditure ◽  
Health Behaviours ◽  
Care Costs

Background: Smoking, unhealthy alcohol consumption, poor diet and physical inactivity are leading risk factors for morbidity and mortality, and contribute substantially to overall healthcare costs. The availability of health surveys linked to health care provides population-based estimates of direct healthcare costs. We estimated health behaviour and socioeconomic-attribute healthcare costs, and how these have changed during a period when government policies have aimed to reduce their burden.  Methods: The Ontario samples of the Canadian Community Health Surveys (conducted in 2003, 2005, and 2007-2008) were linked at the individual level to all records of health care use of publicly funded healthcare. Generalized linear models were estimated with a negative binomial distribution to ascertain the relationship of health behaviours and socioeconomic risk factors on health care costs. The multivariable cost model was applied to unlinked, Ontario CCHS samples for each year from 2004 to 2013 to examine the evolution of health behaviour and socioeconomic-attributable direct health care expenditures over a 10-year period. Results: We included 80,749 respondents, aged 25 years and older, and 312,952 person-years of follow-up. The cost model was applied to 200,324 respondents aged 25 years and older (CCHS 2004 to 2013). During the 10-year period from 2004 to 2013, smoking, unhealthy alcohol consumption, poor diet and physical inactivity attributed to 22% of Ontario’s direct health care costs. Ontarians in the most disadvantaged socioeconomic position contributed to 15% of the province’s direct health care costs. Combined, these health behaviour and socioeconomic risk factors were associated with 34% ($134 billion) of direct health care costs (2004 to 2013). Over this time period, we estimated a 1.9% reduction in health care expenditure ($5.0 billion) attributable to improvements in some health behaviours, most importantly reduced rates of smoking. Conclusions: Adverse health behaviours and socioeconomic position cause a large direct health care system cost burden.

Abstract MP76: Assessing the Impact of the "Health Bucks" Program on Cardiovascular Disease in New York City: A Modeling Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Heesun Eom ◽  
Stella S Yi ◽  
Daniel Bu ◽  
Rienna Russo ◽  
Brandon Bellows ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
New York ◽  
New York City ◽  
Health Care Costs ◽  
York City ◽  
Fruits And Vegetables ◽  
The Cost ◽  
The Impact ◽  
Care Costs

Background: Low fruit and vegetable (FV) consumption is considered one of the leading causes of deteriorating health outcomes, and has been linked to obesity, diabetes, and cardiovascular disease. Yet, few adults in New York City (NYC) consume the daily recommended amounts. In order to address the need for fresh and affordable fruits and vegetables, the NYC Department of Health and Mental Hygiene has implemented the “Health Bucks” program, which provides low-income population with coupons that can be used to purchase fruits and vegetetabls. Previous studies have shown the impact of the Health Bucks program on fruit and vegetable consumption; however, it is unclear how the program would influence cardiovascular health and the associated health care costs in the long term. Objective: To estimate the health and economic impact of the Health Bucks program using a validated microsimulation model of cardiovascular disease (CVD) in NYC. Methods: We used the Simulations for Health Improvement and Equity (SHINE) CVD Model to estimate the impact of the Health Bucks program on lifetime CVD events and direct medical costs (2019 USD). We considered different program strengths by assuming the program can reduce the cost of fruits and vegetables by 20%, 30%, and 40%. Population characteristics were estimated based on data from the 2013-2014 NYC Health and Nutrition Examination Survey. CVD risk factor trajectories and risk of incident CVD events were derived from six pooled longitudinal US cohorts. Policy effects were derived from the literature. We run 1,000 simulations to account for uncertainties in the parameter. We discounted costs by 3% and reported health care costs in 2019 dollars. Results: A Health Bucks program that can reduce the cost of fruits and vegetables by 20%, 30%, and 40% would prevent 2,690 (95% CI: -14,793, 20,173), 27,386 (95% CI: 9,967, 44,805), and 50,014 (95% CI: 15,227, 50,014) coronary heart disease events, respectively, over the simulated lifetimes of the NYC population. The program would also prevent 47,469 (95% CI: 35,008, 59,931), 59,127 (95% CI: 46,676, 71,579), and 85,359 (95% CI: 72,902, 97,815) stroke events based on the price reduction level. The program would result in savings in health care costs, ranged from $937 million to $1.8 billion based on the price reduction level over the lifetime or from $19 million to $37 million annually. Conclusions: We projected that the Health Bucks program could prevent a significant number of CVD events among adults in NYC and yield substantial health care cost savings. Public health practitioners and policymakers may consider adopting this program in other locations.

The cost of health care in Western countries

2010 ◽  
pp. 111-116
Author(s):  
Joseph White
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Policy Issue ◽  
Equal Access ◽  
Industrial Countries ◽  
Western Countries ◽  
Cost Of Health Care ◽  
Decent Society ◽  
The Cost ◽  
Care Costs

All advanced industrial countries socialize most health care costs because their citizens view relatively equal access to such care as a mark of a decent society. This makes the costs of health care a policy issue, because governments need to relate costs to revenues, and there are limits to the willingness of citizens, especially wealthier citizens, to pay for others....

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