Economic burden of cirrhosis in Catalonia: a population-based analysis.
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ABSTRACT:
SUBMITTER: Miquel M
PROVIDER: S-EPMC5855312 | biostudies-literature | 2018 Mar
REPOSITORIES: biostudies-literature
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Project description:IntroductionIn 2017, 1.5 million people were diagnosed with stroke, 9 million were living with stroke and 0.4 million died because of stroke in 32 European countries. We estimate the economic burden of stroke across these countries in 2017.Patients and methodsIn a population-based cost analysis, we evaluated the cost of stroke. We estimated overall health and social care costs from expenditure on care in the primary, outpatient, emergency, inpatient and nursing/residential care settings, and pharmaceuticals. Additionally, we estimated the costs of unpaid care provided by relatives or friends of patients, lost earnings due to premature death and costs associated with individuals who temporarily or permanently left employment because of illness.ResultsIn 2017 stroke cost the 32 European countries under analysis €60 billion, with health care accounting for €27 billion (45%), representing 1.7% of health expenditure. Adding the costs of social care (€5 billion), annual stroke-related care costs were equivalent to €59 per citizen, varying from €11 in Bulgaria to €140 in Finland. Productivity losses cost €12 billion, equally split between early death and lost working days. A total of €1.3 billion hours of informal care were provided to stroke survivors, costing Europe €16 billion.ConclusionOur study provides a snapshot of the economic consequences posed by stroke to 32 European countries in 2017. It also strengthens and updates the evidence we have gathered over the last 15?years, indicating that the costs of stroke are rising, partly due to an ageing population.
| S-EPMC7092742 | biostudies-literature
Project description:BACKGROUND: Knowledge on the epidemiology of non-hip fractures in Spain is limited and somewhat outdated. Using computerized primary care records from the SIDIAP database, we derived age and sex-specific fracture incidence rates for the region of Catalonia during the year 2009. METHODS: The SIDIAP database contains quality-checked clinical information from computerized medical records of a representative sample of >5,800,000 patients (80% of the population of Catalonia). We conducted a retrospective cohort study including all patients aged ?50?years, and followed them from January 1 to December 31, 2009. Major osteoporotic fractures registered in SIDIAP were ascertained using ICD-10 codes and validated by comparing data to hospital admission and patient-reported fractures records. Incidence rates and 95% confidence intervals were calculated. RESULTS: In total, 2,011,430 subjects were studied (54.6% women). Overall fracture rates were 10.91/1,000 person-years (py) [95%CI 10.89-10.92]: 15.18/1,000 py [15.15-15.21] in women and 5.78/1,000 py [5.76-5.79] in men. The most common fracture among women was wrist/forearm (3.86/1,000 py [3.74-3.98]), while among men it was clinical spine (1.25/1,000 py [1.18-1.33]). All fracture rates increased with age, but varying patterns were observed: while most of the fractures (hip, proximal humerus, clinical spine and pelvis) increased continuously with age, wrist and multiple rib fractures peaked at age 75-80 and then reached a plateau. CONCLUSIONS: Our study provides local estimates of age, sex and site-specific fracture burden in primary health care, which will be helpful for health-care planning and delivery. A proportion of fractures are not reported in primary care records, leading to underestimation of fracture incidence rates in these data.
| S-EPMC3489545 | biostudies-other
Project description:IntroductionThe prevalence of cirrhosis is increasing despite advances in therapeutics, and it remains an expensive medical condition. Studies examining the healthcare burden of inpatient cirrhosis-related care regardless of etiology, stage, or severity are lacking. This study aims to describe the current drivers of cost, length of stay (LOS), and mortality in hospitalized patients with cirrhosis.MethodsUsing the National Inpatient Sample (NIS) data from 2008 to 2014, we categorized admissions into decompensated cirrhosis (DC), compensated cirrhosis (CC), and NIS without cirrhosis. Descriptive statistics and regression analysis were used to analyze the association between patient characteristics, comorbidities, complications, and procedures with costs, LOS, and mortality in each group.ResultsThe hospitalization costs for patients with cirrhosis increased 30.2% from 2008 to 2014 to $7.37 billion. Cirrhosis admissions increased by 36% and 24% in the DC and CC groups, respectively, compared with 7.7% decrease in the NIS without cirrhosis group. DC admissions contributed to 58.6% of total cirrhotic admissions by 2014. Procedures increased costs in both DC and CC groups by 15%-152%, with mechanical ventilation being associated with high cost increase and mortality increase. Complications are also key drivers of costs and LOS, with renal and infectious complications being associated with the highest increases in the DC group and infections and nonportal hypertensive gastrointestinal bleeding for the CC group.DiscussionEconomic burden of hospitalized patients with cirrhosis is increasing with more admissions and longer LOS in DC and CC groups. Important drivers include procedures and portal hypertensive and nonportal hypertensive complications.
| S-EPMC6708673 | biostudies-literature
Project description:BACKGROUND:Economic burden of HBV and HCV infection are trending upwards. AIMS:Compare hepatitis B virus (HBV) and hepatitis C virus (HCV) related hospital admission rates, charges, mortality rates, causes of death in a US population-based study. METHODS:Retrospective cohort analysis of HBV and HCV patients from the California Office of Statewide Health Planning and Development (2006-2013) database. RESULTS:A total of 23,891 HBV and 148,229 HCV patients were identified. Across the 8-year period, the mean increase for all-cause ($1,863 vs $1,388) and liver-related hospitalization charges ($1,175 vs $675) were significantly higher for the HBV cohort compared to the HCV cohort. HBV patients had significantly higher liver-related hospital charges per person per year than HCV patients after controlling for covariates ($123,239 vs $111,837; p = 0.002). Compared to HCV patients, adjusted mortality hazard ratio was slightly lower in HBV patients (relative risk = 0.96; 95% CI 0.94-0.99). The major causes and places of death were different. The three major causes of death for HBV were: other malignant neoplasms (35%), cardiovascular disease/other circulatory disorders (17%), and liver-related disease (15%) whereas for HCV patients were: liver-related disease (22%), other malignant neoplasms (20%), and cardiovascular disease (16%). Regarding the place of death, 53% of HBV patients and 44% of HCV patients died in hospital inpatient, respectively. CONCLUSIONS:HBV patients incurred higher liver-related hospital charges and higher mean increase for all-cause and liver-related hospitalization charges over the 8-year period compared to HCV patients. HBV patients had slightly lower mortality rate and their major causes and places of death were noticeably different from HCV patients.
| S-EPMC5927421 | biostudies-literature
Project description:BACKGROUND:The prevalence of heart failure (HF) and its economic burden are increasing with age of the South Korean population. This study aimed to assess the economic impact of HF from the societal perspective. METHODS:A prevalence-based, incremental cost-of-patient study was performed to estimate the cost ratio between patients with HF and those without HF based on the claims database of the national health insurance in South Korea. We defined adult HF patients as those aged ?19 years who had at least one insurance claim record with a primary or secondary diagnosis of HF. Age- and gender-matched controls were defined using a 1:4 greedy matching method. Costs were estimated by including medical costs for insurance-covered and non-covered services, transportation costs, caregiver's cost, and time costs of patients. The ratio of costs between patients with HF and those without HF was adjusted for age, gender, and type of universal health security program in the multivariate regression model. RESULTS:The average annual per-capita cost was estimated to be $6,601 for patients with HF (n = 14,252), which is about 3.38 (95% confidence interval [CI]: 3.31-3.46) times higher than that for patients without HF (n = 1,116,882) and 1.64 (95% CI: 1.59-1.70) times higher than that for the age- and gender-matched patients without HF (n = 57,008). In the multivariate regression model, the annual per-capita total costs were 1.98-fold (95% CI: 1.94-2.02) statistically higher for patients with HF than for patients without HF after adjustment for age, gender, and type of universal health security program. CONCLUSIONS:This study demonstrates a significant incremental burden of HF. Given that the prevalence of HF is expected to increase with an increase in the aging population, the national economic burden is expected to be substantial in the future. Thus, greater emphasis on the prevention and treatment of HF is warranted.
| S-EPMC6303080 | biostudies-other
Project description:BackgroundResource and cost issues are a growing concern in health care. Thus, it is important to have an accurate estimate of the economic burden of care. Previous work has estimated the economic burden of cancer care for Canada; however, there is some concern this estimate is too low. The objective of this analysis was to provide a comprehensive revised estimate of this burden.MethodsWe used a case-control prevalence-based approach to estimate direct annual cancer costs from 2005 to 2012. We used patient-level administrative health care data from Ontario to correctly attribute health care costs to cancer. We employed the net cost method (cost difference between patients with cancer and control subjects without cancer) to account for costs directly and indirectly related to cancer and its sequelae. Using average patient-level cost estimates from Ontario, we applied proportions from national health expenditures data to obtain the economic burden of cancer care for Canada. All costs were adjusted to 2015 Canadian dollars.ResultsCosts of cancer care rose steadily over our analysis period, from $2.9 billion in 2005 to $7.5 billion in 2012, mostly owing to the increase in costs of hospital-based care. Most expenditures for health care services increased over time, with chemotherapy and radiation therapy expenditures accounting for the largest increases over the study period. Our cost estimates were larger than those in the Economic Burden of Illness in Canada 2005-2008 report for every year except 2005 and 2006.InterpretationThe economic burden of cancer care in Canada is substantial. Further research is needed to understand how the economic burden of cancer compares to that of other diseases.
| S-EPMC5878959 | biostudies-literature
Project description:BACKGROUND: According to importance of cirrhosis of the liver and the lack of information about the economic burden of the disease, we performed this study to estimate the economic burden of liver Cirrhosis in Iran in 2011. METHODS: The cost-of-illness method, based on the human capital theory, has been used. Both direct and indirect costs have been estimated using a prevalence approach and bottom-up method. The inpatient and outpatient records were investigated for obtaining the medical costs. Also, a questionnaire was used for collection the other data such as transportation costs, out of pocket payment and times of inpatients, etc. Costs consisted of expenditures which happened during March 2011 to February 2012 and the perspective of the study was Iranian society. RESULTS: The total cost of the disease was 2014.5 billion Rials (USD164.32 million). Direct and indirect costs were 1384.16 and 630.4 billion Rials (86.7% and 11.3% of the total cost), respectively. Cost due to premature death was USD 38.66 million, included 23.52% of the total cost and 75% of indirect cost. CONCLUSION: Liver Cirrhosis impose enormous economic burden on Iranian society. Policymakers should therefore take this into consideration and according to available health resources provide services and facilities for the prevention and treatment of the disease.
| S-EPMC4441964 | biostudies-literature
Project description:BACKGROUND:The exudative age-related macular degeneration (AMD) causes considerable healthcare costs for patients and healthcare system, which are expected to grow as the population ages. The objective of this study was to assess the incremental economic burden of exudative AMD by comparing total healthcare costs between the exudative AMD group and non-AMD group to understand economic burden related to exudative AMD. METHODS:This retrospective cohort study used the National Health Insurance Service database including the entire Korean population. Exudative AMD group included individuals with at least one claim for ranibizumab and one claim using the registration code for exudative AMD (V201). Non-AMD group was defined as individuals without any claims regarding the diagnostic code of H35.3 or ranibizumab. The exudative AMD group and non-AMD group were matched using a propensity-score model. Incremental healthcare resource utilization and healthcare costs were measured during a one-year follow-up by employing econometric models: ordinary least squares (OLS) with log transformation and heteroscedastic retransformation; and generalized linear model (GLM) with a log link function and gamma distribution. RESULTS:A total of 7119 exudative AMD patients were matched to 7119 non-AMD patients. The number of outpatient visits was higher in the exudative AMD group (P-value <?0.0001), while the length of hospitalization was shorter in exudative AMD group (P-value <?0.0001). Exudative AMD patients had total costs 2.13 times (95%CI, 2.08-2.17) greater than non-AMD group using OLS, and total costs 4.06 times (95%CI, 3.82-4.31) greater than non-AMD group using GLM. Annual incremental total costs were estimated as $5519 (OLS) and $3699 (GLM). CONCLUSIONS:Exudative AMD was associated with significantly increased healthcare costs compared to the non-AMD group. Attention is needed to manage the socioeconomic burden of exudative AMD.
| S-EPMC6852978 | biostudies-literature
Project description:IntroductionInfluenza disease burden and economic impact data are needed to assess the potential value of interventions. Such information is limited from resource-limited settings. We therefore studied the cost of influenza in Peru.MethodsWe used data collected during June 2009-December 2010 from laboratory-confirmed influenza cases identified through a household cohort in Peru. We determined the self-reported direct and indirect costs of self-treatment, outpatient care, emergency ward care, and hospitalizations through standardized questionnaires. We recorded costs accrued 15-day from illness onset. Direct costs represented medication, consultation, diagnostic fees, and health-related expenses such as transportation and phone calls. Indirect costs represented lost productivity during days of illness by both cases and caregivers. We estimated the annual economic cost and the impact of a case of influenza on a household.ResultsThere were 1321 confirmed influenza cases, of which 47% sought health care. Participants with confirmed influenza illness paid a median of $13 [interquartile range (IQR) 5-26] for self-treatment, $19 (IQR 9-34) for ambulatory non-medical attended illness, $29 (IQR 14-51) for ambulatory medical attended illness, and $171 (IQR 113-258) for hospitalizations. Overall, the projected national cost of an influenza illness was $83-$85 millions. Costs per influenza illness represented 14% of the monthly household income of the lowest income quartile (compared to 3% of the highest quartile).ConclusionInfluenza virus infection causes an important economic burden, particularly among the poorest families and those hospitalized. Prevention strategies such as annual influenza vaccination program targeting SAGE population at risk could reduce the overall economic impact of seasonal influenza.
| S-EPMC4910177 | biostudies-literature
Project description:BACKGROUND:Understanding the impact of prevention programs on Clostridioides difficile infection rates is important, and decisions on future program changes, including how to use vaccines currently in development, requires a detailed understanding of the epidemiologic features of C. difficile infection. We analyzed Ontario health administrative data to determine incidence rates and medical costs of C. difficile infection, based on whether acquisition and onset occurred in acute care hospitals (ACHs), long-term care facilities or the community. METHODS:We performed a retrospective analysis using individual-level data from Ontario health databases from Apr. 1, 2005, to Mar. 31, 2015, identifying rates of C. difficile infection requiring hospital admission per 100 000 person-years in adults aged 18 years or more for categories of acquisition and onset. We estimated health care system costs of infection 180 and 365 days after admission by matching patients with C. difficile infection with control patients with similar characteristics. RESULTS:Over the study period, 33 909 people in Ontario were admitted to hospital with C. difficile infection; 17 272 cases (50.9%) were associated with ACHs. The number of cases per 100 000 person-years ranged from 27.7 in 2009/10 to 37.0 in 2012/13. Annually, the highest incidence of infection was for ACH-associated/ACH-onset. Community-associated infection became more prevalent over time, rising from 19.4% of cases in 2005/06 to 29.2% in 2014/15. Infection costs were mostly due to hospital admission within 180 days after hospital discharge. Infection associated with ACHs had the highest total costs and the largest cost attributable to C. difficile infection (median $38 953 for infected patients v. $13 542 for control patients). Median costs attributable to C. difficile infection were $1051 for that associated with long-term care facilities, $13 249 for community-associated infection and $11 917 for ACH-associated/community-onset infection. INTERPRETATION:Community-associated C. difficile infection had similar health care cost implications as hospital-associated infection. With rates of community-associated C. difficile infection on the rise, family physicians should be supported to prevent this infection in their patients.
| S-EPMC7004222 | biostudies-literature