scholarly journals The Power Of Annual Cost-Of-Illness In Predicting COPD Survival At 3 Years

2020 ◽  
Vol 6 (2) ◽  
pp. 1-5
Author(s):  
Negro RWD ◽  
Keyword(s):  
Lung Function ◽  
Cost Of Illness ◽  
Annual Cost ◽  
Predictive Power ◽  
Clinical Signs ◽  
Total Annual Cost ◽  
High Predictive Power ◽  
Data Support

Clinical signs and lung function are variably sensitive in predicting survival in COPD. 1) Specific and appropriate lung function indices contribute to predicting mortality in COPD effectively. 2) Total annual cost confirms the most sensitive predictor of mortality at three years. 3) Present data support the high predictive power of the careful functional and economic phenotyping in COPD.

Cost of illness in Charcot-Marie-Tooth neuropathy

Neurology ◽  
2019 ◽  
Vol 92 (17) ◽  
pp. e2027-e2037 ◽  
Author(s):  
Elisabeth Schorling ◽  
Simone Thiele ◽  
Laura Gumbert ◽  
Sabine Krause ◽  
Constanze Klug ◽  
...  
Keyword(s):  
Disease Severity ◽  
Informal Care ◽  
Cost Of Illness ◽  
Annual Cost ◽  
Multivariate Regression Analysis ◽  
Health Care Use ◽  
Total Annual Cost ◽  
Total Cost ◽  
Charcot Marie Tooth ◽  
Patient Reported

ObjectiveTo assess cost associated with the disease-specific need of patients diagnosed with Charcot-Marie-Tooth neuropathies (CMT) in Germany.MethodsPatients with CMT were identified through the national patient registry and invited to complete a standardized questionnaire. The data collected include information about health care use, informal care, and other disease-related expenses as well as the working situation. Based on this information, we estimated the annual cost of CMT from the perspective of society.ResultsThis study included 397 patients with a genetically confirmed CMT diagnosis. We estimated total annual cost of illness (COI) of $22,362 (95% CI $19,464–$25,723) per patient, of which 67.3% were direct costs. The highest single cost factor was informal care cost. For Germany, we extrapolated total cost of CMT of $735.0 million ($639.8 million–$845.5 million). Multivariate regression analysis showed that total annual cost increased with disease severity (Charcot-Marie-Tooth Neuropathy Score). Age, CMT subtype, comorbidities, body mass index, and employment status were also predictors of a change in cost (p < 0.05). Moreover, we found differences in total cost depending on marital status, subjectively evaluated impairments, dependence on other persons, care level, educational level, and disease duration.ConclusionsCMT is associated with a substantial economic burden. For the first time, the COI of CMT has been assessed and will serve as important input to decision-making in health policy, especially regarding research and development of therapies. Moreover, our results indicate the importance of the patient-reported perception of disease severity related to the consumption of resources.

Study of mixed materials heat exchanger using optimization techniques

2019 ◽  
Vol 17 (2) ◽  
pp. 414-433 ◽  
Author(s):  
Habib Karimi ◽  
Hossein Ahmadi Danesh Ashtiani ◽  
Cyrus Aghanajafi
Keyword(s):  
Heat Exchanger ◽  
Annual Cost ◽  
Optimization Techniques ◽  
Total Annual Cost ◽  
Shuffled Frog Leaping Algorithm ◽  
Content Type ◽  
Economic View ◽  
Shuffled Frog Leaping ◽  
Mixed Material ◽  
Shell And Tube

Purpose This paper aims to examine total annual cost from economic view mixed materials heat exchangers based on three optimization algorithms. This study compares the use of three optimization algorithms in the design of economic optimization shell and tube mixed material heat exchangers. Design/methodology/approach A shell and tube mixed materials heat exchanger optimization design approach is expanded based on the total annual cost measured by dividing the costs of the heat exchanger to area of surface and power consumption. In this study, optimization and minimization of the total annual cost is considered as the objective function. There are three types of exchangers: cheap, expensive and mixed. Mixed materials are used in corrosive flows in the heat exchanger network. The present study explores the use of three optimization techniques, namely, hybrid genetic-particle swarm optimization, shuffled frog leaping algorithm techniques and ant colony optimization. Findings There are three parameters as decision variables such as tube outer diameter, shell diameter and central baffle spacing considered for optimization. Results have been compared with the findings of previous studies to demonstrate the accuracy of algorithms. Originality/value The present study explores the use of three optimization techniques, namely, hybrid genetic-particle swarm optimization, shuffled frog leaping algorithm techniques and ant colony optimization. This study has demonstrated successful application of each technique for the optimal design of a mixed material shell and tube heat exchanger from the economic view point.

scholarly journals P167 Pulmonary hypertension in patients with systemic sclerosis: an audit of screening practices, incidence and cost over 10 years

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Luke Spray ◽  
Josephine Vila ◽  
Bridget Griffiths
Keyword(s):  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
Annual Cost ◽  
Screening Programme ◽  
Total Annual Cost ◽  
Electronic Patient Records ◽  
Right Heart Catheterisation ◽  
Annual Screening ◽  
Pulmonary Arterial ◽  
Low Incidence

Abstract Background Patients with systemic sclerosis (SSc) are at risk of developing pulmonary arterial hypertension (PAH), a subtype of pulmonary hypertension (PH) which is not due to left-heart disease, chronic hypoxia or pulmonary arterial thrombus. The European Society of Cardiology recommends annual screening of patients with SSc due to the insidious presentation of PAH, poor outcomes, and the availability of effective treatments. Transthoracic echocardiography is the standard screening investigation, but NT pro-BNP, a biochemical marker of ventricular stretch, may be a cost-effective initial test with echocardiography reserved for patients with new or worsening symptoms or increasing NT pro-BNP. Our centre introduced NT pro-BNP as an adjunct to echocardiography in 2014. Methods We audited our SSc-PAH screening programme from 2009-2018 against the standard that every SSc patient should be screened annually with echocardiography or NT pro-BNP. Patients seen by the regional PH service prior to the first rheumatology clinic were excluded. We used our centre’s database of SSc patients and electronic patient records to determine if a patient had undergone PH screening. We calculated cost estimates from our hospital’s biochemistry and echocardiography departments. Results From 2009 to 2018, the number of SSc patients requiring annual screening rose from 81 to 215. In 2009, 65% of patients were screened - all with echocardiography. In 2018, 88% of patients were screened - 25% had an echocardiogram and 83% had a NT pro-BNP. 63% of patients were screened only through NT pro-BNP. Across the 1476 patient-years studied, only 6 new cases of PH were identified. PH was secondary to ILD in two cases, and true PAH in three cases (one patient refused diagnostic right-heart catheterisation). All three PAH diagnoses came from echocardiograms requested for worsening dyspnoea, so are not attributable to the screening programme. On 31 December 2018, 55% of these patients were taking phosphodiesterase 5 inhibitors (PDE-5i) for severe Raynaud’s phenomenon (50% on sildenafil and 5% on tadalafil). 4% of patients were prescribed bosentan and 3% of patients were prescribed dual therapy with a PDE5i and bosentan. This may explain our centre’s low incidence of PAH. The annual cost of screening per patient has dropped from £82 in 2014 to £59 in 2018, and the total annual cost has plateaued since 2014, despite rising patient numbers and improved screening rates. Conclusion Since introducing NT pro-BNP alongside echocardiography as a screening tool for PAH in SSc patients, we spend less on our screening programme per patient and achieve higher screening rates. However, in 10 years, our screening programme has not detected any asymptomatic cases of PAH, raising questions about the necessity of screening asymptomatic SSc patients. Widespread PDE-5i use may contribute to the low incidence of PAH in our cohort. Disclosures L. Spray None. J. Vila None. B. Griffiths None.

scholarly journals Predicting Liver Disease Risk Using a Combination of Common Clinical Markers: A Screening Model from Routine Health Check-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Yi Wang ◽  
Yanni Li ◽  
Xiaoyi Wang ◽  
Ranko Gacesa ◽  
Jie Zhang ◽  
...  
Keyword(s):  
Liver Disease ◽  
Early Detection ◽  
Predictive Power ◽  
Disease Screening ◽  
Health Check ◽  
Initial Presentation ◽  
Screening Tools ◽  
Clinical Markers ◽  
Liver Disorders ◽  
High Predictive Power

Background. Early detection is crucial for the prognosis of patients with autoimmune liver disease (AILD). Due to the relatively low incidence, developing screening tools for AILD remain a challenge. Aims. To analyze clinical characteristics of AILD patients at initial presentation and identify clinical markers, which could be useful for disease screening and early detection. Methods. We performed observational retrospective study and analyzed 581 AILD patients who were hospitalized in the gastroenterology department and 1000 healthy controls who were collected from health management center. Baseline characteristics at initial presentation were used to build regression models. The model was validated on an independent cohort of 56 patients with AILD and 100 patients with other liver disorders. Results. Asymptomatic AILD individuals identified by the health check-up are increased yearly (from 31.6% to 68.0%, p<0.001). The cirrhotic rates at an initial presentation are decreased in the past 18 years (from 52.6% to 20.0%, p<0.001). Eight indicators, which are common in the health check-up, are independent risk factors of AILD. Among them, abdominal lymph node enlargement (LN) positive is the most significant different (OR 8.85, 95% CI 2.73-28.69, p<0.001). The combination of these indicators shows high predictive power (AUC=0.98, sensitivity 89.0% and specificity 96.4%) for disease screening. Except two liver or cholangetic injury makers, the combination of AGE, GENDER, GLB, LN, concomitant extrahepatic autoimmune diseases, and familial history also shows a high predictive power for AILD in other liver disorders (AUC=0.91). Conclusion. Screening for AILD with described parameters can detect AILD in routine health check-up early, effectively and economically. Eight variables in routine health check-up are associated with AILD and the combination of them shows good ability of identifying high-risk individuals.

Direct Financial Cost of Diabetes Mellitus among Adult Sudanese Patients in Khartoum State 2016-2017

2019 ◽  
pp. 1-8
Author(s):  
Mahmoud Elnil ◽  
Zeinab Swaraldahab ◽  
Sulaf Ibrahim Abdelaziz
Keyword(s):  
Diabetes Mellitus ◽  
Annual Cost ◽  
Health Care Services ◽  
Sampling Technique ◽  
Tight Glycemic Control ◽  
Cross Sectional Study ◽  
Total Annual Cost ◽  
Diabetic Patients ◽  
Cross Sectional

Background: Diabetes mellitus is a chronic disease with devastating short and long-term complications that affect productivity. The corner stone for diabetes care is tight glycemic control with regular follow up. To achieve this care, medications and other health care services must be available and affordable. Objective: To estimate the direct cost of diabetes mellitus care among adult patients in Khartoum state. Methods: Cross-sectional study using multi-stage sampling technique to select the facilities proportional to population size. Patients were interviewed using questionnaire. Results: The total annual cost of Diabetes was estimated to be 3820 Sudanese pound (SDG) per person. Hospitalizations fees accounted for the major portion of the cost. Forty-seven percent of the patients were admitted with diabetes related problems during the previous year. One in four of the diabetic patients had no sufficient supply of medications. Conclusion: The total annual cost was significantly lower among those with regular follow up visits than those with irregular visits (P < 0.03). Emphasis should be put on providing affordable and available health services and medication especially at PHC level.

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