scholarly journals Unbalanced Treatment Costs of Breast Cancer in China: Implications From the Direct Costs of Inpatient and Outpatient Care in Liaoning Province

2021 ◽  
Author(s):  
Zihua Ma ◽  
Gongman Deng ◽  
Zhaolin Meng ◽  
Yanan Ma ◽  
Huazhang Wu
Keyword(s):  
Breast Cancer ◽  
Cost Containment ◽  
Outpatient Care ◽  
Direct Costs ◽  
Treatment Costs ◽  
Cost Driver ◽  
Liaoning Province ◽  
Inpatient Cost ◽  
Health Institutions ◽  
Inpatient And Outpatient Care

Background: The increasing incidence of breast cancer and its financial burden highlights the need for controlling treatment costs. This study aimed to assess the direct costs of inpatient and outpatient care for breast cancer patients in Liaoning Province to provide a policy reference for cost containment. Methods: Based on the System of Health Accounts 2011 (SHA 2011), systematic data collection was conducted via multistage stratified cluster random sampling. A total of 1160 health institutions, including 83 hospitals, 16 public health institutions, 120 primary health institutions, and 941 outpatient institutions were enrolled in 2017. A database was established containing 20 035 patient-level medical records from the information system of these institutions. Curative care expenditure (CCE)was calculated, and generalized linear modeling was performed to determine cost-related factors. Results: In 2017, the CCE for breast cancer was approximately CNY 830.19 million (US$122.96 million) in Liaoning province (0.7% of the total health expenditure and 9.9% of cancer-related healthcare costs). Inpatient care costs were estimated to be CNY 617.27 million (US$91.42 million), accounting for 74.4% of the CCE for breast cancer, almost three times as large as outpatient costs (25.6%). The average inpatient and outpatient costs for breast cancer were estimated to be CNY 12 108 (US$1793) and CNY 829 (US$123) per visit. Medication cost was the main cost driver, which comprised 84.0% of the average outpatient cost and 37.2% of the mean inpatient cost. Conclusion: Breast cancer imposes a large economic burden on patients and the social health insurance system. Results show an irrational cost pattern of inpatient and outpatient services, with patients relying excessively on inpatient services for treatment. Promoting outpatient care whenever relevant is conducive to cost containment and rational utilization of resources.

scholarly journals Direct costs of both inpatient and outpatient care for all type cancers: The evidence from Beijing, China

2019 ◽  
Vol 8 (6) ◽  
pp. 3250-3260 ◽  
Author(s):  
Xuejun Yin ◽  
Yue Xu ◽  
Xiaowei Man ◽  
Liming Liu ◽  
Yan Jiang ◽  
...  
Keyword(s):  
Outpatient Care ◽  
Direct Costs ◽  
Inpatient And Outpatient Care ◽  
Beijing China

scholarly journals Costs for Schizopsychotic Patients in Sweden

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
L. Helldin ◽  
F. Hjärthag ◽  
M. Lothgren ◽  
C. Hjortsberg
Keyword(s):  
Patient Care ◽  
Indirect Costs ◽  
Premature Death ◽  
Direct Costs ◽  
Cost Driver ◽  
Local Municipality ◽  
Cost Item ◽  
Cost Variability ◽  
Inpatient And Outpatient Care ◽  
At Home

As part of the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS), 200 patients diagnosed with schizophrenia, schizoaffective disorder or delusional disorder, are studied. the aim is to provide up-to-date costs for a defined patient population with schizopsychotic disorders in Sweden.We identify the actual clinical management of illness and explain cost variability. Costs are combined with information on outcomes and severity of the disorder.Total costs per patient-year amount to 62.320 Euro. Direct costs correspond to 41% and indirect costs to 59% of total costs. Inpatient and outpatient care corresponds to 7% each of total costs, while costs for special housing and assistance at home is estimated to 22% of total costs. Medication only corresponds to 3% of total costs.We conclude that costs differ between patients depending on illness severity. Also a reallocation has taken place during the last 15 years between different cost items, from direct costs to indirect costs and from in-patient care at hospitals to out-patient care and assistance at home. the main cost driver is indirect costs due to decreased working ability and premature death. Special housing and home-assistance is the second largest cost item. In-patient care corresponds to 7% of total costs, which 15 years ago amounted to 50% of total costs. This reflects the change in care of schizopsychotic patients. Instead of treating patients at institutions, patients are now to a large extent living in their own housing but often receiving some kind of assistance at home provided by the local municipality.

scholarly journals Long-term improvement of quality of life in patients with breast cancer: supporting patient-physician communication by an electronic tool for inpatient and outpatient care

2021 ◽  
Author(s):  
Patricia Lindberg-Scharf ◽  
Brunhilde Steinger ◽  
Michael Koller ◽  
Andrea Hofstädter ◽  
Olaf Ortmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Outpatient Care ◽  
Physician Communication ◽  
Electronic Tool ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
The Right ◽  
Inpatient And Outpatient Care

Abstract Purpose The effectiveness of a pathway with quality of life (QoL) diagnosis and therapy has been already demonstrated in an earlier randomized trial (RCT) in patients with breast cancer. We refined the pathway by developing and evaluating an electronic tool for QoL assessment in routine inpatient and outpatient care. Methods In a single-arm study, patients with breast cancer with surgical treatment in two German hospitals were enrolled. QoL (EORTC QLQ-C30, QLQ-BR23) was measured with an electronic tool after surgery and during aftercare in outpatient medical practices (3, 6, 9, 12, 18, and 24 months) so that results (QoL-profile) were available immediately. Feedback by patients and physicians was analyzed to evaluate feasibility and impact on patient-physician communication. Results Between May 2016 and July 2018, 56 patients were enrolled. Physicians evaluated the QoL pathway as feasible. Patients whose physician regularly discussed QoL-profiles with them reported significantly more often that their specific needs were cared for (p < .001) and that their physician had found the right treatment strategy for these needs (p < .001) compared with patients whose doctor never/rarely discussed QoL-profiles. The latter significantly more often had no benefit from QoL assessments (p < .001). Conclusion The QoL pathway with electronic QoL assessments is feasible for inpatient and outpatient care. QoL results should be discussed directly with the patient. Clinical trial information NCT04334096, date of registration 06.04.2020

scholarly journals Direct costs of common osteoporotic fractures (Hip, Vertebral and Forearm) in Iran

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marziyeh Rajabi ◽  
Afshin Ostovar ◽  
Ali Akbari Sari ◽  
Sayed Mahmoud Sajjadi-Jazi ◽  
Noushin Fahimfar ◽  
...  
Keyword(s):  
Direct Cost ◽  
Osteoporotic Fractures ◽  
Direct Costs ◽  
Fracture Incidence ◽  
Inpatient Cost ◽  
First Year ◽  
Forearm Fractures ◽  
Medical Sciences ◽  
The Us ◽  
The Mean

Abstract Background Osteoporotic fractures impose significant costs on society. The objective of this study was to estimate the direct costs of the hip, vertebral, and forearm fractures in the first year after fracture incidence in Iran. Methods We surveyed a sample of 300 patients aged over 50 years with osteoporotic fractures (hip, vertebral, and forearm) admitted to four hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2017 and were alive six months after the fracture. Inpatient cost data were obtained from the hospital patient records. Using a questionnaire, the data regarding outpatient costs were collected through a phone interview with patients at least six months after the fracture incidence. Direct medical and non-medical costs were estimated from a societal perspective. All costs were converted to the US dollar using the average exchange rate in 2017 (1USD = IRR 34,214) Results The mean ± standard deviation (SD) age of the patient was 69.83 ± 11.25 years, and 68% were female. One hundred and seventeen (39%) patients had hip fractures, 56 (18.67%) patients had vertebral fractures, and 127 (42.33%) ones had forearm fractures. The mean direct cost (medical and non-medical) during the year after hip, vertebral and forearm fractures were estimated at USD5,381, USD2,981, and USD1,209, respectively. Conclusion The direct cost of osteoporotic fracture in Iran is high. Our findings might be useful for the economic evaluation of preventive and treatment interventions for osteoporotic fractures as well as estimating the economic burden of osteoporotic fractures in Iran.

Hepatitis C prevalence in HIV-infected individuals: a comparison of inpatient and outpatient care

2014 ◽  
Vol 25 (11) ◽  
pp. 806-811
Author(s):  
Ziqiang Zhu ◽  
Teena Dhir ◽  
Myat Soe ◽  
Linda Green ◽  
Ning Jiang
Keyword(s):  
Hepatitis C ◽  
Outpatient Care ◽  
Inpatient And Outpatient Care

Impact of TAILORx on chemotherapy prescribing and 21‐gene recurrence score–guided treatment costs in a population‐based cohort of patients with breast cancer

Cancer ◽  
2021 ◽  
Author(s):  
Megan E. Tesch ◽  
Caroline Speers ◽  
Rekha M. Diocee ◽  
Lovedeep Gondara ◽  
Stuart J. Peacock ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Recurrence Score ◽  
Population Based ◽  
Treatment Costs

scholarly journals Cost of schizophrenia: direct costs and use of resources in the State of São Paulo

2006 ◽  
Vol 40 (2) ◽  
pp. 304-309 ◽  
Author(s):  
Raquel Jales Leitão ◽  
Marcos Bosi Ferraz ◽  
Ana Cristina Chaves ◽  
Jair J Mari
Keyword(s):  
Public Sector ◽  
Outpatient Care ◽  
Direct Costs ◽  
Sao Paulo ◽  
The State ◽  
Public Hospitals ◽  
Total Direct Cost ◽  
São Paulo ◽  
Regular Treatment ◽  
The Public

OBJECTIVE: To estimate the direct costs of schizophrenia for the public sector. METHODS: A study was carried out in the state of São Paulo, Brazil, during 1998. Data from the medical literature and governmental research bodies were gathered for estimating the total number of schizophrenia patients covered by the Brazilian Unified Health System. A decision tree was built based on an estimated distribution of patients under different types of psychiatric care. Medical charts from public hospitals and outpatient services were used to estimate the resources used over a one-year period. Direct costs were calculated by attributing monetary values for each resource used. RESULTS: Of all patients, 81.5% were covered by the public sector and distributed as follows: 6.0% in psychiatric hospital admissions, 23.0% in outpatient care, and 71.0% without regular treatment. The total direct cost of schizophrenia was US$191,781,327 (2.2% of the total health care expenditure in the state). Of this total, 11.0% was spent on outpatient care and 79.2% went for inpatient care. CONCLUSIONS: Most schizophrenia patients in the state of São Paulo receive no regular treatment. The study findings point out to the importance of investing in research aimed at improving the resource allocation for the treatment of mental disorders in Brazil.

scholarly journals A review of the applications for involuntary admissions made to the Mental Health Review Boards by institutions in Gauteng in 2008

2010 ◽  
Vol 16 (4) ◽  
pp. 6
Author(s):  
M Y H Moosa ◽  
F Y Jeenah
Keyword(s):  
Mental Health ◽  
Health Care Professionals ◽  
Outpatient Care ◽  
Inpatient Care ◽  
Psychiatric Hospitals ◽  
Department Of Health ◽  
Massive Scale ◽  
Inpatient And Outpatient Care ◽  
Health Review ◽  
Review Boards

<p><strong>Aim.</strong> To review applications for involuntary admissions made to the Mental Health Review Boards (MHRBs) by institutions in Gauteng.</p><p><strong>Method.</strong> A retrospective review of the register/database of the two review boards in Gauteng for the period January - December 2008. All applications for admissions (involuntary and assisted inpatient) and outpatient care (involuntary and assisted), and periodic reports for continued care (inpatient or outpatient care) were included.</p><p><strong>Results.</strong> During the study period the two MHRBs received a total of 3 803 applications for inpatient care, of which 2 526 were for assisted inpatient care (48.1% regional hospitals, 29.6% specialised psychiatric hospitals, 22.2% tertiary academic hospitals). Of the applications for involuntary inpatient care, 73.1% were from the specialised psychiatric hospitals (65.2% from Sterkfontein Hospital). Applications for outpatient care, treatment and rehabilitation (CTR) numbered 1 226 (92% assisted outpatient CTR). Although the health establishments in northern Gauteng applied for more outpatient CTR compared with those in southern Gauteng (879 v. 347, respectively), the ratios of assisted to involuntary outpatient applications for CTR for each region were similar (approximately 12:1 and 9:1, respectively). The boards received 3 805 periodic reports for prolonged CTR (93.5% inpatient, 6.5% outpatient), in the majority of cases for assisted CTR.</p><p><strong>Conclusion.</strong> The study suggests that in the 4 years since the promulgation of the MHCA in 2004 , there have been significant strides towards implementation of the procedures relating to involuntary admission and CTR by all stakeholders. Differences in levels of implementation by the various stakeholders may result from differences in knowledge, perceptions, attitudes and understanding of their roles and therefore indicate the need for education of mental health care professionals and the public on a massive scale. The Department of Health also needs to invest more funds to improve mental health human resources and infrastructure at all health establishments.</p>

Sign in / Sign up

Export Citation Format

Share Document