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Gender-adjusted and age-adjusted economic inpatient burden of congestive heart failure: cost and disability-adjusted life-year analysis.

ABSTRACT: The two components of disability-adjusted life year (DALY), years of life lost (YLL) and years lived with disability (YLD), are underutilized in evaluating heart failure with reduced ejection fraction (HFrEF) and in assessing the global burden of disease. We aim to describe both the direct (medical) and the indirect (morbidity and mortality) inpatient cost of congestive heart failure in a high-income non-Organization for Economic Cooperation and Development Middle Eastern country in relation to YLL and YLD.We used the World Health Organization's global burden of disease methodology to calculate DALY, YLL, and YLD in 174 consecutive prospectively enrolled New York Heart Association Classes II-IV patients in a single-centre heart failure registry using a 0.4 disability weight and a 3% future age discount. We reported the cost of hospitalization, re-hospitalization, and non-invasive and invasive procedures per 1000 HFrEF patients in US dollars (USD). Expressing results as per 1000 HFrEF capita revealed a DALY of 1480 ± 1909 vs. 2177 ± 2547 in women and men, respectively. The costs per HFrEF capita in USD were $909.00 ± 676.1 for a single-day hospital stay, $7999 per single hospitalization, $12 311 ± 13 840 for annual hospitalizations, $20 486 ± 22 068 for all-cause hospitalizations, and $37 355 ± 49 336 from the time of diagnosis until death or recovery.In this study, HFrEF imposed a substantial economic and disability burden on one non-Organization for Economic Cooperation and Development Middle Eastern country. However, men represented a higher economic burden than women.

SUBMITTER: Salem K

PROVIDER: S-EPMC5542727 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other

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Economic burden of heart failure: investigating outpatient and inpatient costs in Abeokuta, Southwest Nigeria.

Project description:BackgroundHeart failure (HF) is a deadly, disabling and often costly syndrome world-wide. Unfortunately, there is a paucity of data describing its economic impact in sub Saharan Africa; a region in which the number of relatively younger cases will inevitably rise.MethodsHeath economic data were extracted from a prospective HF registry in a tertiary hospital situated in Abeokuta, southwest Nigeria. Outpatient and inpatient costs were computed from a representative cohort of 239 HF cases including personnel, diagnostic and treatment resources used for their management over a 12-month period. Indirect costs were also calculated. The annual cost per person was then calculated.ResultsMean age of the cohort was 58.0 ± 15.1 years and 53.1% were men. The total computed cost of care of HF in Abeokuta was 76, 288,845 Nigerian Naira (US$508, 595) translating to 319,200 Naira (US$2,128 US Dollars) per patient per year. The total cost of in-patient care (46% of total health care expenditure) was estimated as 34,996,477 Naira (about 301,230 US dollars). This comprised of 17,899,977 Naira- 50.9% ($US114,600) and 17,806,500 naira -49.1%($US118,710) for direct and in-direct costs respectively. Out-patient cost was estimated as 41,292,368 Naira ($US 275,282). The relatively high cost of outpatient care was largely due to cost of transportation for monthly follow up visits. Payments were mostly made through out-of-pocket spending.ConclusionThe economic burden of HF in Nigeria is particularly high considering, the relatively young age of affected cases, a minimum wage of 18,000 Naira ($US120) per month and considerable component of out-of-pocket spending for those affected. Health reforms designed to mitigate the individual to societal burden imposed by the syndrome are required.

| S-EPMC4240551 | biostudies-literature

Trajectories of middle-aged and elderly people's chronic diseases Disability Adjusted Life Years (DALYs): cohort, socio-economic status and gender disparities.

Project description:BackgroundThe accelerated aging trend brought great chronic diseases burdens. Disabled Adjusted Life Years (DALYs) is a novel way to measure the chronic diseases burden. This study aimed to explore the cohort, socioeconomic status (SES), and gender disparities of the DALYs trajectories.MethodsA total of 15,062 participants (55,740 observations) comes from China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. Mixed growth curve model was adopted to predict the DALYS trajectories in 45-90 years old people influenced by different birth cohorts and SES.ResultsWe find significant cohort, SES (resident place, education level and income) disparities differences in the chronic diseases DALYs. For individuals of earlier cohort, DALYs are developed in a late age but grow fast with age but reversed for most recent cohorts. Living in urban, having higher SES level will decrease the growth rate with age, but converges for most recent cohorts. Meanwhile, DALYs disparities of resident place and education level show gender differentials that those for female are narrowed across cohort but for male are not.ConclusionsThe cohort effects on chronic diseases DALYs are accumulated with China's unique social, and political settings. There are large inequalities in early experiences, SES and DALYs. Efforts of reducing these inequalities must focus on the lower SES individuals and those living in rural areas, which greatly benefit individuals from recent cohorts.

| S-EPMC8335861 | biostudies-literature

Burden of epilepsy in rural Kenya measured in disability-adjusted life years.

Project description:The burden of epilepsy, in terms of both morbidity and mortality, is likely to vary depending on the etiology (primary [genetic/unknown] vs. secondary [structural/metabolic]) and with the use of antiepileptic drugs (AEDs). We estimated the disability-adjusted life years (DALYs) and modeled the remission rates of active convulsive epilepsy (ACE) using epidemiologic data collected over the last decade in rural Kilifi, Kenya.We used measures of prevalence, incidence, and mortality to model the remission of epilepsy using disease-modeling software (DisMod II). DALYs were calculated as the sum of Years Lost to Disability (YLD) and Years of Life Lost (YLL) due to premature death using the prevalence approach, with disability weights (DWs) from the 2010 Global Burden of Disease (GBD) study. DALYs were calculated with R statistical software with the associated uncertainty intervals (UIs) computed by bootstrapping.A total of 1,005 (95% UI 797-1,213) DALYs were lost to ACE, which is 433 (95% UI 393-469) DALYs lost per 100,000 people. Twenty-six percent (113/100,000/year, 95% UI 106-117) of the DALYs were due to YLD and 74% (320/100,000/year, 95% UI 248-416) to YLL. Primary epilepsy accounted for fewer DALYs than secondary epilepsy (98 vs. 334 DALYs per 100,000 people). Those taking AEDs contributed fewer DALYs than those not taking AEDs (167 vs. 266 DALYs per 100,000 people). The proportion of people with ACE in remission per year was estimated at 11.0% in males and 12.0% in females, with highest rates in the 0-5 year age group.The DALYs for ACE are high in rural Kenya, but less than the estimates of 2010 GBD study. Three-fourths of DALYs resulted from secondary epilepsy. Use of AEDs was associated with 40% reduction of DALYs. Improving adherence to AEDs may reduce the burden of epilepsy in this area.

| S-EPMC4238788 | biostudies-other

Economic cost and burden of dengue in the Philippines.

Project description:Dengue, the world's most important mosquito-borne viral disease, is endemic in the Philippines. During 2008-2012, the country's Department of Health reported an annual average of 117,065 dengue cases, placing the country fourth in dengue burden in southeast Asia. This study estimates the country's annual number of dengue episodes and their economic cost. Our comparison of cases between active and passive surveillance in Punta Princesa, Cebu City yielded an expansion factor of 7.2, close to the predicted value (7.0) based on the country's health system. We estimated an annual average of 842,867 clinically diagnosed dengue cases, with direct medical costs (in 2012 US dollars) of $345 million ($3.26 per capita). This is 54% higher than an earlier estimate without Philippines-specific costs. Ambulatory settings treated 35% of cases (representing 10% of direct costs), whereas inpatient hospitals served 65% of cases (representing 90% of direct costs). The economic burden of dengue in the Philippines is substantial.

| S-EPMC4347342 | biostudies-other

Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years.

Project description:BACKGROUND:Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis can cause life-threatening disease, there is no global burden of disease estimate in terms of Disability Adjusted Life Years (DALYs) available. METHODOLOGY/PRINCIPAL FINDINGS:We utilised the results of a parallel publication that reported global estimates of morbidity and mortality due to leptospirosis. We estimated Years of Life Lost (YLLs) from age and gender stratified mortality rates. Years of Life with Disability (YLDs) were developed from a simple disease model indicating likely sequelae. DALYs were estimated from the sum of YLLs and YLDs. The study suggested that globally approximately 2.90 million DALYs are lost per annum (UIs 1.25-4.54 million) from the approximately annual 1.03 million cases reported previously. Males are predominantly affected with an estimated 2.33 million DALYs (UIs 0.98-3.69) or approximately 80% of the total burden. For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010. Tropical regions of South and South-east Asia, Western Pacific, Central and South America, and Africa had the highest estimated leptospirosis disease burden. CONCLUSIONS/SIGNIFICANCE:Leptospirosis imparts a significant health burden worldwide, which approach or exceed those encountered for a number of other zoonotic and neglected tropical diseases. The study findings indicate that highest burden estimates occur in resource-poor tropical countries, which include regions of Africa where the burden of leptospirosis has been under-appreciated and possibly misallocated to other febrile illnesses such as malaria.

| S-EPMC4591975 | biostudies-literature

Disease burden of the most commonly detected respiratory viruses in hospitalized patients calculated using the disability adjusted life year (DALY) model.

Project description:BackgroundThe most common acute infections occur in the respiratory tract. Recent discoveries of several novel viruses have markedly increased the repertoire of agents understood to cause presentations of acute respiratory disease.ObjectivesFurther understanding is needed of the relative importance of newly discovered pathogens in the clinical setting to provide clinicians with an indication of appropriate diagnostic and therapeutic targets. To address this, quantification of the disease burden of respiratory viruses in hospitalized patients was undertaken.Study designDisease burden caused by respiratory viruses in hospitalized patients was quantified using the World Health Organization endorsed DALY model. Diagnostic testing results from samples collected over three years for adenovirus (AdV), influenzas A and B, parainfluenza viruses 1, 2 and 3 (PIV-1, -2 and -3), respiratory syncytial virus (HRSV), and previously published retrospective screening for human metapneumovirus, rhinoviruses, and four respiratory coronaviruses were applied to the DALY model. Disability weights were calculated per 1000 hospitalized patients in age banded groups.ResultsStrikingly different disease burden profiles were observed in children and adults. Adenoviruses were among the leading cause of respiratory presentations in children but not adults. HRSV and influenza A were consistently one of the greatest causes of disease regardless of sampled population. Rhinoviruses and PIV-3 were significant pathogens in all groups except those aged 16-64 years. In immunocompromised patients rhinoviruses were the leading viral cause of disease.ConclusionsThese analyses provide a framework which can be used to identify where finite resources should be directed in respiratory therapeutics and vaccine development.

| S-EPMC7108352 | biostudies-literature

Gender Differences in Disability and Economic Hardship in Older Europeans.

Project description:European women live longer, but they experience more old age-related disability than men. Disability is related to social factors, among which is poverty, through various pathways. While women's poverty has been pointed up as a challenge for Europe, our study investigates to what extent and in which countries a greater exposure to economic hardship is associated with older women's disability disadvantage. We used the 2014 EU-SILC data in 30 European countries for men and women aged 50-79 years (N = [1179-17,474]). Disability was measured by self-reported activity limitation and economic hardship by difficulties in "making both ends meet" and "facing unexpected expenses". Country-specific nested logistic regressions measured the women's disability disadvantage and its association with economic hardship. We found that activity limitations and economic hardship varied substantially across Europe, being the lowest in Sweden and Norway. We found gender gaps in activity limitations in 23 countries, always to women's disadvantage. After adjusting for age, this disadvantage was significant in 19 countries. In 11 of these countries, women's excess disability is associated with excess economic hardship in women, especially in Iceland, France, Sweden, and Austria. Women's excess disability and social factors such as economic hardship are linked, even in protective countries. These situations of double disadvantage for women deserve attention when designing policies to reduce health inequalities and to promote healthy ageing.

| S-EPMC6797682 | biostudies-literature

Congestive heart failure in dog

Project description:Canine tachycardia-induced cardiomyopathy caused by several weeks of rapid ventricular pacing is a well-established animal model of congestive heart failure. However, little is known about the underlying changes in gene expression that occur in the canine myocardium after the induction of heart failure. This project aims to compare expression profiles in left ventricular free wall samples from control dogs and dogs with pacing-induced heart failure on the custom MuscleChip. Keywords: other

2003-07-16 | GSE472 | GEO

Control and Congestive Heart Failure

Project description:Congestive heart failure was done by artificial myocardial infarction. After extracting total RNA from control and infarcted ventricles with Triazol, messenger RNA was isolated with Qiagen mRNA isolation kit. About 1.5ug poly A+ RNA was taken for probe preparation. Probe was labeled with Alexa Fluor 546 and 657. Labeled probes were hybridized with Qiagen rat unigene oligo library. After 2 low and 1 high stringency washes Prolong Antifade was added to the slides to prevent bleaching effect. The data ratio was normalized using a location and intensity dependent Lowess formula. Keywords: other

2003-09-08 | GSE632 | GEO

The Economic Burden of Brain Disability in Korea, 2008-2011.

Project description:This study estimated the economic burden of people with brain disability in Korea during 2008-2011 using nationally representative data and was conducted to use the results as an evidence for determining the resources allocation of people with brain disability. We used a prevalence-based approach to estimate the economic burden, classified by direct costs (medical costs and nonmedical costs) and indirect costs (productivity loss of morbidity and premature death). Data from the National Health Insurance Service, the National Disability Registry, the National survey on persons with disabilities, the Korea National Statistical Office's records of causes of death, and the Labor Statistics were used to calculate direct and indirect costs. The treated prevalence of brain disability increased from 0.26% (2008) to 0.35% (2011). Total economic burden of brain-related diseases was US$1.88 billion in 2008 and increased to US$2.90 billion in 2011, with a 54% rate of increase. The economic burden of all diseases, which was 1.2 to 1.4 times higher than that of brain-related diseases, accounted for US$2.61 billion in 2008 and US$3.62 billion in 2011, increasing by 39%. Owing to the growing occurrence of brain disability, the annual prevalence and related costs are increasing. Health management programs are necessary to reduce the economic burden of brain disability in Korea.

| S-EPMC7333489 | biostudies-literature

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