Healthcare resource utilisation for chronic kidney disease and other major non-communicable chronic diseases in China: a cross-sectional study

ObjectiveTo evaluate the healthcare resource utilisation for chronic kidney disease (CKD) and other major non-communicable chronic diseases (NCDs) in China.DesignA cross-sectional study.SettingA national inpatient database of tertiary hospitals in China.ParticipantsThe study included a total of 19.5 million hospitalisations of adult patients from July 2013 to June 2014. Information on CKD and other major NCDs, including coronary heart disease (CHD), stroke, hypertension, diabetes, chronic obstructive pulmonary disease (COPD) and cancer, was extracted from the unified discharge summary form.Outcome measuresCost, length of hospital stay and in-hospital mortality.ResultsThe percentages of hospitalisations with CKD, CHD, stroke, hypertension, diabetes, COPD and cancer were 4.5%, 9.2%, 8.2%, 18.8%, 7.9%, 2.3% and 19.4%, respectively. For each major NCD, the presence of CKD was independently associated with longer hospital stay, with increased percentages ranging from 7.69% (95% CI 7.11% to 8.28%) for stroke to 21.60% (95% CI 21.09% to 22.10%) for CHD. Hospital mortality for other NCDs was also higher in the presence of CKD, with fully adjusted relative risk ranging from 1.91 (95% CI 1.82 to 1.99) for stroke to 2.65 (95% CI 2.55 to 2.75) for cancer. Compared with other NCDs, CKD was associated with the longest hospital stay (22.1% increase) and resulted in the second highest in-hospital mortality, only lower than that of cancer (relative risk, 2.23 vs 2.87, respectively).ConclusionsThe presence of diagnosed CKD alongside each major NCD was associated with an additional burden on the healthcare system. Healthcare resource utilisation and prognosis of CKD were comparable with those of other major NCDs, which highlights the importance of CKD as a major public health burden.

Healthcare resource utilisation pattern and costs associated with herpes simplex virus diagnosis and management: a systematic review

ObjectivesLittle is known about the economic burden of herpes simplex virus (HSV) across countries. This article aims to summarise existing evidence on estimates of costs and healthcare resource utilisation associated with genital and neonatal HSV infection.DesignSystematic literature review.Data sourcesSeven databases were searched from inception to 31 August 2020. A focused search was performed to supplement the results.Eligibility criteriaStudies which reported either healthcare resource utilisation or costs associated with HSV-related healthcare, including screening, diagnosis and treatment of genital HSV infection and neonatal herpes prevention and treatment.Data extraction and synthesisTwo independent reviewers extracted data and assessed the risk of bias using the Larg and Moss’s checklist. All data were summarised narratively.ResultsOut of 11 443 articles, 38 were included. Most studies (35/38, 94.6%) were conducted in high-income countries, primarily the United States, and were more often related to the prevention or management of neonatal herpes (n=21) than HSV genital ulcer disease (n=17). Most analyses were conducted before 2010. There was substantial heterogeneity in the reporting of HSV-related healthcare resource utilisation, with 74%–93% individuals who sought care for HSV, 11.6%–68.4% individuals who received care, while neonates with herpes required a median of 6–34 hospitalisation days. The costs reported were similarly heterogeneous, with wide variation in methodology, assumptions and outcome measures between studies. Cost for screening ranged from US$7–100, treatment ranged from US$0.53–35 for an episodic therapy, US$240–2580 yearly for suppressive therapy, while hospitalisation for neonatal care ranged from US$5321–32 683.ConclusionsA paucity of evidence exists on healthcare resource utilisation and costs associated with HSV infection, especially among low-income and middle-income countries. Future research is needed on costs and healthcare utilisation patterns to improve overall understanding of the global economic burden of HSV.

Study of the impact of available healthcare resources on the population’s mortality rate using the hierarchical linear modelling

Introduction. The uneven development of the medical material and technical base and resources is observed worldwide. At the same time, healthcare resource availability is associated with the territorial characteristics of the population’s mortality rate. In order to reduce mortality, a better understanding of this relationship is needed. The purpose of the study is to assess the impact of healthcare resource availability on mortality, taking into account the hierarchical nesting of municipalities in subjects of the Russian Federation with further funding for health care and demographic indicators. Material and methods. For these purposes, hierarchical linear modelling is used. The assessment was carried out on the data of 265 municipalities attributed to 6 constituent entities of the Russian Federation. The data sources are the Territorial Bodies of the Federal State Statistics Service and the Unified Interdepartmental Information and Statistical System (www.fedstat.ru). Results. As a result of modelling, the health care resources (doctors, medical personnel, beds) at the municipal level were determined to reduce the population mortality rate positively. At the same time, an ambiguous influence of the actual cost of the territorial compulsory medical insurance program was revealed at the regional level. Conclusion. The results obtained correspond to studies devoted to the regional diversity of the population mortality rate and the available healthcare resources. However, they make it possible to determine the influence of factors taking into account the level of their formation (regional, municipal). The proposed models make it possible to improve the quality of managerial decision-making in the health care system since, taking into account the hierarchical nesting, they share the influence of regional and local factors on the variation of municipalities in terms of the mortality rate of the population.

Healthcare Resource Utilization and Healthcare Costs of COVID-19 Patients in A Tertiary Care Public Hospital: A Retrospective Cohort Study in Thailand

Objective: Health care costs (HCCs) are a significant concern in developing countries. The authors investigated the healthcare resource utilization (HCRU) and HCCs for patients with COVID-19 based on disease severity and infection site. Materials and Methods: The authors reviewed data from the electronic medical records of COVID-19 patients admitted to the present study hospital between January 2020 and April 2020. The authors used comorbidities and patient characteristics as covariates. Analyses were conducted using simple linear regression and generalized linear regression models with a log-link and gamma distribution. Results: Two hundred two patients had confirmed SARS-CoV-2 infection. Total costs per patient were 6,626 USD (756 to 45,586). Personal protection equipment costs were the most significant cost for COVID-19 patients with a mean of 3,778 USD. The mean treatment cost per patient was 326 USD. Patients with severe symptoms and lower respiratory tract infection (LRI) had a higher cost and resource utilization value before and after adjusting for covariates. Conclusion: COVID-19 patients with severe symptoms and LRI had higher HCRU. Length of stay, severity of symptoms, and LRI were associated with higher cost of treatment. Keywords: SARS-CoV-2; COVID-19; Healthcare resource utilization; Healthcare costs; Thailand