scholarly journals Universal drug coverage and socioeconomic disparities in health care costs among persons with diabetes

2020 ◽  
Author(s):  
Wanrudee Isaranuwatchai ◽  
Ghazal S. Fazli ◽  
Arlene S. Bierman ◽  
Lorraine L. Lipscombe ◽  
Nicholas Mitsakakis ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Socioeconomic Status ◽  
Health Care Costs ◽  
Health Care Expenditures ◽  
Drug Coverage ◽  
Younger Adults ◽  
Physician Visits ◽  
Neighborhood Socioeconomic Status ◽  
Care Costs

<b>Objective: </b>To examine whether neighborhood socioeconomic status (SES) is a predictor of non-drug-related health care costs among Canadian adults with diabetes, and if so, whether SES disparities in costs are reduced after age 65, when universal drug coverage commences as an insurable benefit. <p><b>Methods: </b>Administrative health databases were used to examine publicly-funded health care expenditures among 698,113 younger (20-64 years) and older adults (≥65 years) with diabetes in Ontario from April 2004 to March 2014. Generalized linear models were constructed to examine relative and absolute differences in health care costs (total and non-drug-related) across neighborhood socioeconomic status (SES) quintiles, by age, adjusting for differences in age, sex, diabetes duration, and comorbidity. </p> <p><b>Results:</b> Unadjusted costs per person-year in the lowest (Q1) versus highest (Q5) SES quintile were 39% higher among younger adults ($5,954 vs. $4,270 Canadian dollars), but only 9% higher among older adults ($10,917 vs. $9,993). Adjusted non-drug costs (primarily for hospitalizations and physician visits) were $1,569 per person-year higher among younger adults in Q1 vs. Q5 (modeled relative cost difference: +35.7%) and $139.3 million per year among all individuals in Q1. Scenarios in which these excess costs per person-year were decreased by ≥10% or matched the relative difference among seniors suggested a potential for savings in the range of $26.0 to $128.2 million per year among all lower SES adults under age 65 (Q1-4). </p> <p><b>Conclusions: </b>Socioeconomic status is a predictor of diabetes-related health care costs in our setting, more so among adults under age 65, a group that lacks universal drug coverage under Ontario’s health care system. Non-drug related health care costs were more than one-third higher in younger, low SES adults, translating to >$1 billion more in health care expenditures over 10 years.</p>

scholarly journals Universal drug coverage and socioeconomic disparities in health care costs among persons with diabetes

2020 ◽  
Author(s):  
Wanrudee Isaranuwatchai ◽  
Ghazal S. Fazli ◽  
Arlene S. Bierman ◽  
Lorraine L. Lipscombe ◽  
Nicholas Mitsakakis ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Socioeconomic Status ◽  
Health Care Costs ◽  
Health Care Expenditures ◽  
Drug Coverage ◽  
Younger Adults ◽  
Physician Visits ◽  
Neighborhood Socioeconomic Status ◽  
Care Costs

<b>Objective: </b>To examine whether neighborhood socioeconomic status (SES) is a predictor of non-drug-related health care costs among Canadian adults with diabetes, and if so, whether SES disparities in costs are reduced after age 65, when universal drug coverage commences as an insurable benefit. <p><b>Methods: </b>Administrative health databases were used to examine publicly-funded health care expenditures among 698,113 younger (20-64 years) and older adults (≥65 years) with diabetes in Ontario from April 2004 to March 2014. Generalized linear models were constructed to examine relative and absolute differences in health care costs (total and non-drug-related) across neighborhood socioeconomic status (SES) quintiles, by age, adjusting for differences in age, sex, diabetes duration, and comorbidity. </p> <p><b>Results:</b> Unadjusted costs per person-year in the lowest (Q1) versus highest (Q5) SES quintile were 39% higher among younger adults ($5,954 vs. $4,270 Canadian dollars), but only 9% higher among older adults ($10,917 vs. $9,993). Adjusted non-drug costs (primarily for hospitalizations and physician visits) were $1,569 per person-year higher among younger adults in Q1 vs. Q5 (modeled relative cost difference: +35.7%) and $139.3 million per year among all individuals in Q1. Scenarios in which these excess costs per person-year were decreased by ≥10% or matched the relative difference among seniors suggested a potential for savings in the range of $26.0 to $128.2 million per year among all lower SES adults under age 65 (Q1-4). </p> <p><b>Conclusions: </b>Socioeconomic status is a predictor of diabetes-related health care costs in our setting, more so among adults under age 65, a group that lacks universal drug coverage under Ontario’s health care system. Non-drug related health care costs were more than one-third higher in younger, low SES adults, translating to >$1 billion more in health care expenditures over 10 years.</p>

scholarly journals Direct Health Care Costs Associated with Asthma in British Columbia

2010 ◽  
Vol 17 (2) ◽  
pp. 74-80 ◽  
Author(s):  
Mohsen Sadatsafavi ◽  
Larry Lynd ◽  
Carlo Marra ◽  
Bruce Carleton ◽  
Wan C Tan ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Asthma Control ◽  
Health Care Costs ◽  
Economic Burden ◽  
Emergency Department Visits ◽  
Common Disease ◽  
Physician Visits ◽  
Hospitalization Costs ◽  
Care Costs

BACKGROUND: A better understanding of health care costs associated with asthma would enable the estimation of the economic burden of this increasingly common disease.OBJECTIVE: To determine the direct medical costs of asthma-related health care in British Columbia (BC).METHODS: Administrative health care data from the BC Linked Health Database and PharmaNet database from 1996 to 2000 were analyzed for BC residents five to 55 years of age, including the billing information for physician visits, drug dispensations and hospital discharge records. A unit cost was assigned to physician/emergency department visits, and government reimbursement fees for prescribed medications were applied. The case mix method was used to calculate hospitalization costs. All costs were reported in inflation-adjusted 2006 Canadian dollars.RESULTS: Asthma resulted in $41,858,610 in annual health care-related costs during the study period ($331 per patient-year). The major cost component was medications, which accounted for 63.9% of total costs, followed by physician visits (18.3%) and hospitalization (17.8%). When broader definitions of asthma-related hospitalizations and physician visits were used, total costs increased to $56,114,574 annually ($444 per patient-year). There was a statistically significant decrease in the annual per patient cost of hospitalizations (P<0.01) over the study period. Asthma was poorly controlled in 63.5% of patients, with this group being responsible for 94% of asthma-related resource use.CONCLUSION: The economic burden of asthma is significant in BC, with the majority of the cost attributed to poor asthma control. Policy makers should investigate the reason for lack of proper asthma control and adjust their policies accordingly to improve asthma management.

Longitudinal association between panic disorder and health care costs in older adults

2019 ◽  
Vol 36 (12) ◽  
pp. 1135-1142
Author(s):  
Johanna Katharina Hohls ◽  
Hans‐Helmut König ◽  
Dirk Heider ◽  
Hermann Brenner ◽  
Friederike Böhlen ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Panic Disorder ◽  
Health Care Costs ◽  
Longitudinal Association ◽  
Care Costs

Why health care costs more in the US: Comparing health care expenditures between systemic lupus erythematosus patients in Stanford and Montreal

1996 ◽  
Vol 39 (6) ◽  
pp. 979-987 ◽  
Author(s):  
Gail Gironimi ◽  
Ann E. Clarke ◽  
Vivian H. Hamilton ◽  
Deborah S. Danoff ◽  
Daniel A. Bloch ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Health Care ◽  
Health Care Costs ◽  
Lupus Erythematosus ◽  
Health Care Expenditures ◽  
Systemic Lupus ◽  
The Us ◽  
Care Costs

scholarly journals Prediction of health care expenditure increase: how does pharmacotherapy contribute?

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Annika M. Jödicke ◽  
Urs Zellweger ◽  
Ivan T. Tomka ◽  
Thomas Neuer ◽  
Ivanka Curkovic ◽  
...  
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Decision Tree ◽  
Health Care Costs ◽  
Decision Tree Model ◽  
Tree Model ◽  
Physician Visits ◽  
Drug Classes ◽  
Swiss Health ◽  
Care Costs

Abstract Background Rising health care costs are a major public health issue. Thus, accurately predicting future costs and understanding which factors contribute to increases in health care expenditures are important. The objective of this project was to predict patients healthcare costs development in the subsequent year and to identify factors contributing to this prediction, with a particular focus on the role of pharmacotherapy. Methods We used 2014–2015 Swiss health insurance claims data on 373′264 adult patients to classify individuals’ changes in health care costs. We performed extensive feature generation and developed predictive models using logistic regression, boosted decision trees and neural networks. Based on the decision tree model, we performed a detailed feature importance analysis and subgroup analysis, with an emphasis on drug classes. Results The boosted decision tree model achieved an overall accuracy of 67.6% and an area under the curve-score of 0.74; the neural network and logistic regression models performed 0.4 and 1.9% worse, respectively. Feature engineering played a key role in capturing temporal patterns in the data. The number of features was reduced from 747 to 36 with only a 0.5% loss in the accuracy. In addition to hospitalisation and outpatient physician visits, 6 drug classes and the mode of drug administration were among the most important features. Patient subgroups with a high probability of increase (up to 88%) and decrease (up to 92%) were identified. Conclusions Pharmacotherapy provides important information for predicting cost increases in the total population. Moreover, its relative importance increases in combination with other features, including health care utilisation.

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