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Technology and healthcare costs  [cached]
Kumar R
Annals of Pediatric Cardiology , 2011,
Abstract: Medicine in the 21 st century is increasingly dependent on technology. Unlike in many other areas, the cost of medical technology is not declining and its increasing use contributes to the spiraling healthcare costs. Many medical professionals equate progress in medicine to increasing use of sophisticated technology that is often expensive and beyond the reach of the average citizen. Pediatric heart care is very technology-intensive and therefore very expensive and beyond the reach of the vast majority of children in the developing world. There is an urgent need to address this situation through development and use of appropriate technology in accordance with the needs and priorities of the society. A number of simple and inexpensive quality measures that have the potential of improving outcomes substantially without the need for expensive equipment should be instituted before embracing high-end technology. Innovations to reduce costs that are commonly used in limited resource environments should be tested systematically.
Do Randomized Controlled Trials Discuss Healthcare Costs?  [PDF]
G. Michael Allan,Christina Korownyk,Kate LaSalle,Ben Vandermeer,Victoria Ma,Douglas Klein,Donna Manca
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0012318
Abstract: Healthcare costs, particularly pharmaceutical costs, are a dominant issue for most healthcare organizations, but it is unclear if randomized controlled trials (RCTs) routinely discuss costs. Our objective was to assess the frequency and factors associated with the inclusion of costs in RCTs.
How palliative care can reduce healthcare costs & improve quality of care  [PDF]
Kwadwo Kyeremanteng
Health (Health) , 2013, DOI: 10.4236/health.2013.512283

The sustainability of the healthcare system has been in question for several years. With rising healthcare costs, limited resources and an aging population, society needs to come up with innovative ideas to reduce healthcare spending. This paper attempts to illustrate how addressing goals of care can have a significant impact on healthcare costs.


Why technology matters as much as science in improving healthcare  [cached]
Szczerba Robert J,Huesch Marco D
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-103
Abstract: Background More than half a million new items of biomedical research are generated every year and added to Medline. How successful are we at applying this steady accumulation of scientific knowledge and so improving the practice of medicine in the USA? Discussion The conventional wisdom is that the US healthcare system is plagued by serious cost, access, safety and quality weaknesses. A comprehensive solution must involve the better translation of an abundance of clinical research into improved clinical practice. Yet the application of knowledge (i.e. technology) remains far less well funded and less visible than the generation, synthesis and accumulation of knowledge (i.e. science), and the two are only weakly integrated. Worse, technology is often seen merely as an adjunct to practice, e.g. electronic health records. Several key changes are in order. A helpful first step lies in better understanding the distinction between science and technology, and their complementary strengths and limitations. The absolute level of funding for technology development must be increased as well as being more integrated with traditional science-based clinical research. In such a mission-oriented federal funding strategy, the ties between basic science research and applied research would be better emphasized and strengthened. Summary It bears repeating that only by applying the wealth of existing and future scientific knowledge can healthcare delivery and patient care ever show significant improvement.
Obesity trends in Russia. The impact on health and healthcare costs  [PDF]
Ketevan Rtveladze, Tim Marsh, Laura Webber, Fanny Kilpi, Yevgeniy Goryakin, Anna Kontsevaya, Antonina Starodubova, Klim McPherson, Martin Brown
Health (Health) , 2012, DOI: 10.4236/health.2012.412A212

Similar to most developed countries, obesity rates inRussiahave been steadily increasing. This has led to a high burden of obesity related diseases and associated healthcare costs. The micro-simulation model has been utilized to project body mass index (BMI) and BMI related disease burden and healthcare costs. Incidence, mortality, survival and healthcare costs were collected for thirteen diseases. The results have been simulated for 3 hypothetical scenarios to project a potential impact of policy interventions: 1) assuming no reduction in BMI; 2) 1% reduction in mean BMI across the population; 3) 5% reduction in mean BMI across the population. Nearly 58% of the female population was obese (BMI ≥30 kg/m2) or overweight (BMI 25 -29.9 kg/m2) in 2010, and the prevalence is projected to decrease to 54% in 2050. The rates are predicted to increase for men from 51% in 2010 to 76% in 2050. The prevalence rates will triple for some obesity-related diseases. A one percent decrease in BMI across the population will save more than two billion US Dollars in 2030 and 2050. Despite female obesity prevalence starting at a higher point than the men, obesity is predicted to increase in males but not females. Disease and economic burden attributed to these obesity rates are still severe and the country should implement strong policies to tackle the obesity epidemic.

Healthcare costs and utilization for Medicare beneficiaries with Alzheimer's
Yang Zhao, Tzu-Chun Kuo, Sharada Weir, Marilyn S Kramer, Arlene S Ash
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-108
Abstract: Demographically matched cohorts age 65 and over with comprehensive medical and pharmacy claims from the 2003–2004 MEDSTAT MarketScan? Medicare Supplemental and Coordination of Benefits (COB) Database were examined: 1) 25,109 individuals with an AD diagnosis or a filled prescription for an exclusively AD treatment; and 2) 75,327 matched controls. Illness burden for each person was measured using Diagnostic Cost Groups (DCGs), a comprehensive morbidity assessment system. Cost distributions and reasons for ER visits and inpatient admissions in 2004 were compared for both cohorts. Regression was used to quantify the marginal contribution of AD to health care costs and utilization, and the most common reasons for ER and inpatient admissions, using DCGs to control for overall illness burden.Compared with controls, the AD cohort had more co-morbid medical conditions, higher overall illness burden, and higher but less variable costs ($13,936 s. $10,369; Coefficient of variation = 181 vs. 324). Significant excess utilization was attributed to AD for inpatient services, pharmacy, ER visits, and home health care (all p < 0.05). In particular, AD patients were far more likely to be hospitalized for infections, pneumonia and falls (hip fracture, syncope, collapse).Patients with AD have significantly more co-morbid medical conditions and higher healthcare costs and utilization than demographically-matched Medicare beneficiaries. Even after adjusting for differences in co-morbidity, AD patients incur excess ER visits and inpatient admissions.Alzheimer's disease (AD) is a progressive, irreversible neurodegenerative disorder with high social and economic costs. Currently, an estimated 5.1 million Americans have AD, 4.9 million of them over the age of 65 [1]. Alzheimer's disease affects 13% of people over age 65 and nearly half of those over age 85, accounting for 50 to 70% of all dementia cases [1]. By 2050, 11.6 to 16 million Americans may have AD [2]. With the expected increase in
The impact of HIV-associated lipodystrophy on healthcare utilization and costs
Jeannie S Huang, Karen Becerra, Susan Fernandez, Daniel Lee, WC Mathews
AIDS Research and Therapy , 2008, DOI: 10.1186/1742-6405-5-14
Abstract: To examine utilization of healthcare services and associated costs with respect to presence of lipodystrophy among HIV-infected patients.Healthcare utilization and cost of healthcare services were collected from computerized accounting records for participants in a body image study among HIV-infected patients treated at a tertiary care medical center. Lipodystrophy was assessed by physical examination, and effects of lipodystrophy were assessed via body image surveys. Demographic and clinical characteristics were also ascertained. Analysis of healthcare utilization and cost outcomes was performed via between-group analyses. Multivariate modeling was used to determine predictors of healthcare utilization and associated costs.Of the 181 HIV-infected participants evaluated in the study, 92 (51%) had clinical evidence of HIV-associated lipodystrophy according to physician examination. Total healthcare utilization, as measured by the number of medical center visits over the study period, was notably increased among HIV-infected subjects with lipodystrophy as compared to HIV-infected subjects without lipodystrophy. Similarly, total healthcare expenditures over the study period were $1,718 more for HIV-infected subjects with lipodystrophy than for HIV-infected subjects without lipodystrophy. Multivariate modeling demonstrated strong associations between healthcare utilization and associated costs, and lipodystrophy score as assessed by a clinician. Healthcare utilization and associated costs were not related to body image survey scores among HIV-infected patients with lipodystrophy.Patients with HIV-associated lipodystrophy demonstrate an increased utilization of healthcare services with associated increased healthcare costs as compared to HIV-infected patients without lipodystrophy. The economic and healthcare service burdens of HIV-associated lipodystrophy are significant and yet remain inadequately addressed by the medical community.The HIV-associated lipodystrophy synd
Health-related quality of life as a predictor of pediatric healthcare costs: A two-year prospective cohort analysis
Michael Seid, James W Varni, Darron Segall, Paul S Kurtin
Health and Quality of Life Outcomes , 2004, DOI: 10.1186/1477-7525-2-48
Abstract: 317 children (157 girls) ages 2 to 18 years, members of a managed care health plan with prospective payment participated in a two-year prospective longitudinal study. At Time 1, parents reported child HRQL using the Pediatric Quality of Life Inventory? (PedsQL? 4.0) Generic Core Scales, and chronic health condition status. Costs, based on health plan utilization claims and encounters, were derived for 6, 12, and 24 months.In multiple linear regression equations, Time 1 parent proxy-reported HRQL prospectively accounted for significant variance in healthcare costs at 6, 12, and 24 months. Adjusted regression models that included both HRQL scores and chronic health condition status accounted for 10.1%, 14.4%, and 21.2% of the variance in healthcare costs at 6, 12, and 24 months. Parent proxy-reported HRQL and chronic health condition status together defined a 'high risk' group, constituting 8.7% of the sample and accounting for 37.4%, 59.2%, and 62% of healthcare costs at 6, 12, and 24 months. The high risk group's per member per month healthcare costs were, on average, 12 times that of other enrollees' at 24 months.While these findings should be further tested in a larger sample, our data suggest that parent proxy-reported HRQL can be used to prospectively predict healthcare costs. When combined with chronic health condition status, parent proxy-reported HRQL can identify an at risk group of children as candidates for proactive care coordination.Predicting healthcare costs for pediatric populations has been challenging [1]. Although population-based risk prediction and case-mix adjustment can be used to inform policy, set rates, and compare outcomes across providers [2], a more immediate concern for healthcare providers is to clinically manage their enrolled population. In a prospective payment system with predetermined funding limits, providers must be able to proactively case-manage those enrollees at greatest risk of poor health while remaining within designated b
A Method to Assess the Potential Effects of Air Pollution Mitigation on Healthcare Costs  [PDF]
Bj rn S tterstr m,Marie Kruse,Henrik Br nnum-Hansen,Jakob Hjort B nl kke,Esben Meulengracht Flachs,Jan S rensen
Journal of Environmental and Public Health , 2012, DOI: 10.1155/2012/935825
Abstract: Objective. The aim of this study was to develop a method to assess the potential effects of air pollution mitigation on healthcare costs and to apply this method to assess the potential savings related to a reduction in fine particle matter in Denmark. Methods. The effects of air pollution on health were used to identify “exposed” individuals (i.e., cases). Coronary heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer were considered to be associated with air pollution. We used propensity score matching, two-part estimation, and Lin’s method to estimate healthcare costs. Subsequently, we multiplied the number of saved cases due to mitigation with the healthcare costs to arrive to an expression for healthcare cost savings. Results. The potential cost saving in the healthcare system arising from a modelled reduction in air pollution was estimated at €0.1–2.6 million per 100,000 inhabitants for the four diseases. Conclusion. We have illustrated an application of a method to assess the potential changes in healthcare costs due to a reduction in air pollution. The method relies on a large volume of administrative data and combines a number of established methods for epidemiological analysis.
Costs and usage of healthcare services before and after open bariatric surgery
Kelles, Silvana Marcia Bruschi;Barreto, Sandhi Maria;Guerra, Henrique Leonardo;
Sao Paulo Medical Journal , 2011, DOI: 10.1590/S1516-31802011000500003
Abstract: context and objective: morbidly obese individuals are major consumers of healthcare services, with high associated costs. bariatric surgery is an alternative for improving these individuals' comorbidities. there are no studies comparing costs before and after bariatric surgery in brazil. the aim here was to analyze results relating to healthcare usage and direct costs among morbidly obese patients undergoing bariatric surgery. design and setting: historical cohort study on patients receiving healthcare through a private health plan in belo horizonte, minas gerais. methods: all healthcare services and their associated costs were included in the analysis: hospitalization, hospital stay, elective outpatient consultations, emergency service usage and examinations. the analyses were treated as total when including the whole years before and after surgery, or partial when excluding the three-month periods adjacent to the operation. results: for 382 obese patients who underwent open bariatric operations, there were 53 hospitalizations one year before and 95 one year after surgery (p = 0.013). gastrointestinal complications were the main indications for post-procedure hospitalizations. the partial average cost almost doubled after the operation (us$ 391.96 versus us$ 678.31). in subgroup analysis, the costs from patients with gastrointestinal complications were almost four times greater after bariatric surgery. even in the subgroup without complications, the partial average cost remained significantly higher. conclusion: although bariatric surgery is the only path towards sustained weight loss for morbidly obese patients, the direct costs over the first year after the procedure are greater. further studies, with longer follow-up, might elucidate whether long-term reversal of this trend would occur
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