scholarly journals Cost Assessment of Inpatient Care Episodes of Stroke in Romania

2020 ◽  
Vol 8 ◽  
Author(s):  
László Lorenzovici ◽  
Andrea Székely ◽  
Marcell Csanádi ◽  
Péter Gaál
Keyword(s):  
Economic Burden ◽  
Inpatient Care ◽  
Management Control ◽  
Stroke Patients ◽  
Healthcare Budget ◽  
Management Control System ◽  
Number Of Patients ◽  
Level Of Economic Development ◽  
The Cost ◽  
Gross Costing

Introduction: Stroke is the second leading cause of death worldwide and Romania is no exception. There is a high economic burden associated with the treatment of stroke patients, which puts pressure on the healthcare budget. This study aims to measure the inpatient treatment costs of stroke patients in Romania.Methods: Our retrospective analysis follows stroke patients in six Romanian hospitals at different progressivity level from different regions. Patients are identified from the official hospital databases, reported for reimbursement purposes. Mean inpatient costs incurred with the treatment of these stroke patient episodes are calculated using the gross costing method. The cost data are derived from the management control system of the study hospitals.Results: 3,155 patient episodes of stroke were identified in the study hospitals. The average cost per stroke inpatient care episode sums up to EUR 995.57 (95% CI: EUR 963.74—EUR 1 027.39) in 2017, while the overall yearly healthcare burden adds up to EUR 140 million, representing 2.18% of the total national health insurance budget and a cost of EUR 7.15 per capita.Conclusion: The hospital cost of stroke inpatient care episode in Romania is high and it represents a sizable part of the healthcare budget, but it is among the lowest in Europe, which can mainly be explained by the level of economic development of the country. As both the number of patients and the cost of acute care are expected to increase in the future, the economic burden of stroke is also expected to increase.

P0464HEALTH ADN ECONOMIC BURDEN OF THROMBOTIC MICROANGIOPATHY. A NEED FOR A MULTIDISCIPLINARY TEAM

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
MIGUEL URIOL ◽  
Aina Obrador Mulet ◽  
Ana Escriva ◽  
Ana Tugores ◽  
Albert Perez ◽  
...  
Keyword(s):  
Thrombotic Microangiopathy ◽  
Economic Burden ◽  
Multidisciplinary Team ◽  
Incidence Density ◽  
Risk Of Death ◽  
Number Of Patients ◽  
The Mean ◽  
System Sustainability ◽  
The Cost ◽  
The Impact

Abstract Background and Aims Thrombotic microangiopathy (TMA) is a life-threatening and rare disease associated with a higher risk of dead and chronic renal replacement therapy (CRRT). Eculizumab is highly effective but also expensive. We evaluate the direct economic burden of the TMA, the cost of CRRT, Eculizumab, and the impact of a multidisciplinary team (MDT) after two years of its implementation. Method It is a retrospective study, conducted in a 3rd level hospital. We evaluate the risk of i) dead and ii) CRRT need. The number of patients no treated under futility consideration. The cost (euros) for hospitalization at the floor and intensive care unit admission, CRRT and Eculizumab at the pre-MDT implementation (from January 2008 to May 2016) in comparison with the post-MDT period (from May 2018 to Dec 2018). Clinical outcomes: i) risk of death and ii) risk of CRRT need. To determine the cost per patient-year, we calculated the total number of days of hospitalization, the entire months on dialysis or in kidney transplant program (KTx) and the milligrams of Eculizumab used at any period. The total amount divided by the whole years of observation and finally and by the mean number of patients per year diagnosed at any period. The number of patients-year we determined considering the incidence density (ID: cases/1,000,000 person-year). Patients with ADAMTS-13 deficiency were excluded. Results Forty-two patients were included. ID increased from 2.3 cases/1,000,000 person-years (n=20) to 11.7 cases/1,000,000 person-year (n=22). Comparing with the pre-MDT period, the number of patients who died increased from 3(15%) to 7(32%), P=0.20; while the risk for CRRT decreased from 9(45%) to 0, P<0.01 [relative risk (95%CI) for no CRRT requirements: 0.55 (0.37 to 0.81)]. One (5%) and three (14%) patients died under futility consideration at the pre- and post-MDT period, respectively (P=0.60). From all the patients who died, only one was in acute dialysis program while 7 showed neurologic damage. The mean cost per patient-year changed from 319,931 to 150,878 euros from the pre- to post-MDT period. Conclusion The implementation of an MDT shows a change in the natural history of the disease, where neurological damage emerges as a risk factor associated with mortality instead of CRRT needs. TMA patients represent a remarkable economic burden, representing an essential challenge for the health system sustainability that could be improved by an MDT.

scholarly journals The economic burden of constipation therapy

2019 ◽  
Author(s):  
Anamaria Albu ◽  
Andreea Farcas ◽  
Liliana David ◽  
Dan L. Dumitrascu
Keyword(s):  
Economic Burden ◽  
Over The Counter ◽  
Healthcare Budget ◽  
Total Cost ◽  
Adequate Therapy ◽  
The Cost

Background and aim. Constipation is a widespread condition that requires adequate therapy. Given the large use of laxatives, it is important to know the burden of the treatment of this condition on the healthcare budget. Methods. We collected information on the number of therapeutic units (boxes) of five frequently used laxatives delivered by prescription or over the counter in 30 pharmacies randomly selected in two adjacent counties from Romania for two consecutive years. We calculated also the cost value of the laxatives delivered. Results. The total cost of laxatives in the group of pharmacies investigated was on average 62,500 euros per year. We extrapolated that the laxative consumption in Romania should be over 15 million Euro. Conclusions. To our knowledge this is the first study on the burden of constipation in this country. Although therapeutic units of laxatives are not expensive, the wide use of these drugs represents an economic burden for the patient.

scholarly journals Costs of Stroke and Incidence of First Diagnosis of Atrial Fibrillation at Time of Stroke. Neurology Ward Hospital Poznań, Poland 2018

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 999
Author(s):  
Tomasz Zaprutko ◽  
Jolanta Florczak-Wyspiańska ◽  
Dorota Kopciuch ◽  
Anna Paczkowska ◽  
Piotr Ratajczak ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Inpatient Care ◽  
Oral Anticoagulants ◽  
Industrialized Countries ◽  
Hospital Records ◽  
Number Of Patients ◽  
The Cost ◽  
Time Of Admission ◽  
First Diagnosis

Stroke is a major cause of morbidity in industrialized countries, representing 8% of total deaths across Europe in 2017. It is also a very costly disorder, frequently caused by atrial fibrillation. We aimed to calculate the cost of stroke hospitalization in 2018 in Poznań (Poland). We also intended to present patients with the first AF diagnosis at the time of stroke. The study was conducted from January 2019 to July 2020. Data were obtained from hospital records and from the hospital accounting department. Out of 164 patients included in the study, 41 had AF and in 18 cases AF was first diagnosed at the time of stroke. The cost of hospitalization in Poznań was EUR 139,257.21 (x¯= EUR 849.13). Among those with concomitant AF, the general cost of inpatient care was EUR 33,859.18 (x¯= EUR 825.83). Considering those who had AF first diagnosed during hospitalization the cost was EUR 16,248.97 (x¯= EUR 906.24). Stroke is associated with high costs of inpatient care, which turned out to be higher among those with AF first diagnosed at the time of stroke. The number of patients who used oral anticoagulants at the time of admission was relatively low. The most frequently used NOAC was dabigatran.

scholarly journals Comorbidity index for predicting mortality at 6 months after reperfusion therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hyo Suk Nam ◽  
Young Dae Kim ◽  
Joonsang Yoo ◽  
Hyungjong Park ◽  
Byung Moon Kim ◽  
...  
Keyword(s):  
Prospective Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Area Under The Curve ◽  
Reperfusion Therapy ◽  
Good Prediction ◽  
Multivariate Logistic Regression ◽  
Stroke Patients ◽  
Number Of Patients ◽  
Comorbidity Index ◽  
Using Data

AbstractThe eligibility of reperfusion therapy has been expanded to increase the number of patients. However, it remains unclear the reperfusion therapy will be beneficial in stroke patients with various comorbidities. We developed a reperfusion comorbidity index for predicting 6-month mortality in patients with acute stroke receiving reperfusion therapy. The 19 comorbidities included in the Charlson comorbidity index were adopted and modified. We developed a statistical model and it was validated using data from a prospective cohort. Among 1026 patients in the retrospective nationwide reperfusion therapy registry, 845 (82.3%) had at least one comorbidity. As the number of comorbidities increased, the likelihood of mortality within 6 months also increased (p < 0.001). Six out of the 19 comorbidities were included for developing the reperfusion comorbidity index on the basis of the odds ratios in the multivariate logistic regression analysis. This index showed good prediction of 6-month mortality in the retrospective cohort (area under the curve [AUC], 0.747; 95% CI, 0.704–0.790) and in 333 patients in the prospective cohort (AUC, 0.784; 95% CI, 0.709–0.859). Consideration of comorbidities might be helpful for the prediction of the 6-month mortality in patients with acute ischemic stroke who receive reperfusion therapy.

scholarly journals Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching

2021 ◽  
Vol 11 (2) ◽  
pp. 161
Author(s):  
Chong-Chi Chiu ◽  
Jhi-Joung Wang ◽  
Chao-Ming Hung ◽  
Hsiu-Fen Lin ◽  
Hong-Hsi Hsien ◽  
...  
Keyword(s):  
Propensity Score ◽  
Functional Status ◽  
Propensity Score Matching ◽  
Acute Care ◽  
Medical Cost ◽  
Economic Burden ◽  
Stroke Rehabilitation ◽  
Stroke Patients ◽  
The Impact ◽  
Post Acute Care

Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost–illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (p < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (p < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status.

scholarly journals Healthcare Expenditures Associated with Heart Failure in Saudi Arabia: A Cost of Illness Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 988
Author(s):  
Ahmed Alghamdi ◽  
Eman Algarni ◽  
Bander Balkhi ◽  
Abdulaziz Altowaijri ◽  
Abdulaziz Alhossan
Keyword(s):  
Heart Failure ◽  
Saudi Arabia ◽  
Cost Of Illness ◽  
Economic Burden ◽  
Indirect Costs ◽  
Health Care Expenditures ◽  
Decision Makers ◽  
Hospitalization Costs ◽  
Illness Study ◽  
The Cost

Heart failure (HF) is considered to be a global health problem that generates a significant economic burden. Despite the growing prevalence in Saudi Arabia, the economic burden of HF is not well studied. The aim of this study was to estimate the health care expenditures associated with HF in Saudi Arabia from a social perspective. We conducted a multicenter cost of illness (COI) study in two large governmental centers in Riyadh, Saudi Arabia using 369 HF patients. A COI model was developed in order to estimate the direct medical costs associated with HF. The indirect costs of HF were estimated based on a human capital approach. Descriptive and inferential statistics were analyzed. The direct medical cost per HF patient was $9563. Hospitalization costs were the major driver in total spending, followed by medication and diagnostics costs. The cost significantly increased in line with the disease progression, ranging from $3671 in class I to $16,447 in class IV. The indirect costs per working HF patient were $4628 due to absenteeism, and $6388 due to presenteeism. The economic burden of HF is significantly high in Saudi Arabia. Decision makers need to focus on allocating resources towards strategies that prevent frequent hospitalizations and improve HF management and patient outcomes in order to lower the growing economic burden.

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