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Cost-of-Illness Study

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 7742

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Prof. Dr. Ulf Gerdtham

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Guest Editor

Department of Economics and Department of Medicine, Lund University, Lund 22814, Sweden
Interests: public health; health economics; health policy; applied econometrics; economic evaluation
Special Issues, Collections and Topics in MDPI journals

Dr. Saha Sanjib

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Guest Editor

Health Economics Unit, Lund University, 22362 Lund, Sweden
Interests: cost-effectiveness analysis; cost utility analysis; cost benefit analysis; decision analytic model; cost-of-illness

Special Issue Information

Dear Colleagues,

Cost of illness (COI) studies deal with different aspects of a disease on the health economic consequences which can apply to a country, regions or even individuals from different perspectives, i.e., healthcare, societal, third party pare, patient, etc. The health economic consequences are, for example, cost, quality of life for not only the patient but also for the caregivers due to injury, disability, or premature death related to the diseases and associated comorbidities.

COI studies are helpful in many aspects. First, it provides an estimation of how much a society is spending on a particular disease that would be saved if the disease can be prevented. Second, COI studies are beneficial while performing an economic evaluation, especially decision-analytic model-based economic evaluation. Third, COI studies can identify the different components of cost and the size of its contribution to each sector of society. For example, around 40% to 75% of the total cost of dementia is due to cost related to informal care. Thus, knowledge regarding COI is also important to prioritize policies and interventions in healthcare so that scarce healthcare resources can be allocated considering the budget and needs of society.

Prof. Dr. Ulf Gerdtham
Dr. Saha Sanjib
Guest Editors

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Keywords

cost of illness
economic burden
disease burden
financial impact
cost studies

Published Papers (5 papers)

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Research

14 pages, 666 KiB

Open AccessArticle

The Healthcare and Societal Costs of Familial Intellectual Disability

by Deborah Schofield, Rupendra Shrestha, Owen Tan, Katherine Lim, Radhika Rajkumar, Sarah West, Jackie Boyle, Lucinda Murray, Melanie Leffler, Louise Christie, Morgan Rice, Natalie Hart, Jinjing Li, Robert Tanton, Tony Roscioli and Mike Field

Int. J. Environ. Res. Public Health 2024, 21(3), 299; https://doi.org/10.3390/ijerph21030299 - 04 Mar 2024

Viewed by 1014

Abstract

Most of the studies on the cost of intellectual disability are limited to a healthcare perspective or cohorts composed of individuals where the etiology of the condition is a mixture of genetic and non-genetic factors. When used in policy development, these can impact the decisions made on the optimal allocation of resources. In our study, we have developed a static microsimulation model to estimate the healthcare, societal, and lifetime cost of individuals with familial intellectual disability, an inheritable form of the condition, to families and government. The results from our modeling show that the societal costs outweighed the health costs (approximately 89.2% and 10.8%, respectively). The lifetime cost of familial intellectual disability is approximately AUD 7 million per person and AUD 10.8 million per household. The lifetime costs to families are second to those of the Australian Commonwealth government (AUD 4.2 million and AUD 9.3 million per household, respectively). These findings suggest that familial intellectual disability is a very expensive condition, representing a significant cost to families and government. Understanding the drivers of familial intellectual disability, especially societal, can assist us in the development of policies aimed at improving health outcomes and greater access to social care for affected individuals and their families. Full article

(This article belongs to the Special Issue Cost-of-Illness Study)

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13 pages, 1579 KiB

Open AccessArticle

Annual Direct Cost and Cost-Drivers of Systemic Lupus Erythematosus: A Multi-Center Cross-Sectional Study from CSTAR Registry

by Haiyan Wang, Mengtao Li, Kaiwen Zou, Yilin Wang, Qiaoling Jia, Li Wang, Jiuliang Zhao, Chanyuan Wu, Qian Wang, Xinping Tian, Yanhong Wang and Xiaofeng Zeng

Int. J. Environ. Res. Public Health 2023, 20(4), 3522; https://doi.org/10.3390/ijerph20043522 - 16 Feb 2023

Cited by 3 | Viewed by 1529

Abstract

Background: To estimate the annual direct costs and cost-drivers associated with systemic lupus erythematosus (SLE) patients in China. Methods: A multi-center, cross-sectional study was conducted based on the CSTAR registry. The information on demography and expenditures for outpatient and inpatient visits due to SLE were collected using online questionnaires. These patients’ medical records were from the database of the Chinese Rheumatology Information System (CRIS). The average direct costs and 95% confidence interval were estimated using the bootstrap method with 1000 bootstrap samples by resampling with replacement. The cost-drivers were identified using multivariate regression models. Results: A total of 1778 SLE patients from 101 hospitals participated in our study, with 92.58% as females, a mean age of 33.8 years old, a median duration of SLE of 4.9 years, 63.8% in an active disease state, 77.3% with two organs or more damaged, and 8.3% using biologics as treatment. The average annual direct cost per patient was estimated at CNY 29,727, which approximates to 86% for direct medical costs. For moderate to severe disease activities, the use of biologics, hospitalization, treatment of moderate or high dose glucocorticoids, and peripheral vascular, cardiovascular, and/or renal system involvements were found to substantially increase the direct costs, while health insurance slightly decreased the direct costs of SLE. Conclusions: This study provided reliable insight into financial pressures on individual SLE patients in China. The efforts focusing on preventing flare occurrences and limiting disease progression were recommended to further reduce the direct cost of SLE. Full article

(This article belongs to the Special Issue Cost-of-Illness Study)

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10 pages, 874 KiB

Open AccessArticle

Analysis of Hospitalization Costs in Patients Suffering from Cerebral Infarction along with Varied Comorbidities

by Yongmei He, Sixuan Chen and Yongcong Chen

Int. J. Environ. Res. Public Health 2022, 19(22), 15053; https://doi.org/10.3390/ijerph192215053 - 16 Nov 2022

Cited by 1 | Viewed by 1145

Abstract

Objective: This study aimed to study the influence of comorbidities on hospitalization costs for inpatients with cerebral infarction. Methods: The data from the medical records pertaining to 76,563 inpatients diagnosed with cerebral infarction were collected from public hospital records for the period between 1 January 2020 and 30 December 2020 in Gansu Province. EpiData 3.1 software was used for data collation, and SPSS 25.0 was used for data analysis. Numbers and percentages were calculated for categorical variables, the chi-squared test was used to compare differences between groups, and multiple independent-sample tests (Kruskal–Wallis H test, test level α = 0.05) and multiple linear regression were used to analyze the influence of different types of comorbidity on hospitalization costs. Results: Among the 76,563 cerebral infarction inpatients, 41,400 were male (54.07%); the average age of the inpatients was 67.68 ± 10.75 years (the 60~80-year-old group accounted for 65.69%). Regarding the incidence of varied chronic disease comorbidities concomitant with cerebral infarction, hypertension was reported as the most frequent, followed by heart disease and chronic pulmonary disease. The average hospitalization cost of cerebral infarction inpatients is US $1219.66; the hospitalization cost increases according to the number of comorbidities with which a patient suffers (H = 404.506, p < 0.001); Regarding the types of comorbidities, the hospitalization cost of cancer was the highest, at US $1934.02, followed by chronic pulmonary disease (US $1533.02). Regarding the cost of hospitalization for combinations of comorbidities, cerebral infarction + chronic pulmonary disease was the most costly (US $1718.90), followed by cerebral infarction + hypertension + chronic pulmonary disease (US $1530.60). In the results of multiple linear regression analysis, cerebral infarction with chronic pulmonary disease had significant effects on hospitalization costs (β = 0.181, p < 0.001), drug costs (β = 0.144, p < 0.001) and diagnosis costs (β = 0.171, p < 0.001). Conclusions: Comorbidities are significantly associated with high hospitalization costs for cerebral infarction patients. Furthermore, relevant health departments should build preventative and control systems to reduce the risk of comorbidities, as well as to improve hospital clinical pathway management and to strengthen and refine the cost-control management of cerebral infarction from the perspective of comorbidities. Full article

(This article belongs to the Special Issue Cost-of-Illness Study)

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20 pages, 4186 KiB

Open AccessArticle

Cost and Quality Comparison of Hernia Surgery in Stationary, Day-Patient and Outpatient Care

by Bassey Enodien, Dominik Moser, Florian Kessler, Stephanie Taha-Mehlitz, Daniel M. Frey and Anas Taha

Int. J. Environ. Res. Public Health 2022, 19(19), 12410; https://doi.org/10.3390/ijerph191912410 - 29 Sep 2022

Cited by 2 | Viewed by 1797

Abstract

Background: Medical progress is increasingly enabling more and more stationary treatment to be provided in the outpatient sector. This development should be welcomed, as healthcare costs have been rising for years. The design of efficient processes and a needs-based infrastructure enable further savings. According to international recommendations (EHS/IEHS), outpatient treatment of unilateral inguinal hernias is recommended. Method: Data from patients in GZO Hospital Wetzikon/Zurich between 2019 and 2021 for unilateral inguinal hernia repair was included in this study (n = 234). Any over- or under-coverage correlated with one of the three treatment groups: stationary, partially stationary and patients treated in outpatients clinic. Complications and 30-day readmissions were also monitored. Results: Final revenue for all patients is −95.36 CHF. For stationary treatments, the mean shifts down to −575.01 CHF, for partially stationary treatments the mean shifts up to −24.73 CHF, and for patients in outpatient clinic final revenue is 793.12 CHF. This result is also consistent with the operation times, which are lowest in the outpatient clinic with a mean of 36 min, significantly longer in the partially stationary setting with 58 min, and longest in the stationary setting with 76 min. The same applies to the anesthesia times and the relevant care times by the nurses as the most important cost factors in addition to the supply and allocation costs. Conclusions: We show that cost-effective elective unilateral inguinal hernia care in the outpatient clinic with profit (mean 793.12 CHF) is possible. Stationary unilateral hernia care (mean −575.01 CHF) is loss-making. Crucial factors for cost efficiency are optimized processes in the operating room (anesthesia, surgical technique and quality, operating time), as well as optimized care processes with minimal preoperative services and care times for the patient. However, at the same time, these optimizations pose a challenge to surgical and anesthesiology training and structures with high levels of preoperative and Postoperative services and pay-as-you-go costs. The complication rate is 0.91% lower than in a comparable study. The readmission within 30 days post-operation results with a positive deviation of −3.53% (stationary) and with a negative deviation of +2.29% (outpatient clinic) compared to a comparative study. Full article

(This article belongs to the Special Issue Cost-of-Illness Study)

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11 pages, 1871 KiB

Open AccessArticle

The Effects of Anastomotic Leaks on the Net Revenue from Colon Surgery

by Bassey Enodien, Andreas Maurer, Vincent Ochs, Marta Bachmann, Maike Gripp, Daniel M. Frey and Anas Taha

Int. J. Environ. Res. Public Health 2022, 19(15), 9426; https://doi.org/10.3390/ijerph19159426 - 01 Aug 2022

Viewed by 1234

Abstract

Background: Complications in colon surgery can have severe health consequences, while at the same time, they are associated with increased costs. An anastomotic leak (AL) is associated with significantly increased costs compared to cases without. The aim of our analysis was to evaluate, which individual processes and patient-unrelated factors influencing the treatment process of colon surgery are responsible for the financial burden in patients with AL. Methods: Data from 263 patients who underwent colon surgery in Wetzikon hospital between January 2018 and December 2020 and was analyzed. In these 263 cases, 12 anastomotic leaks occurred and were compared with 36 cases without AL using a Propensity Score Matching (PSM). The covariates for the PSM have been Age, Sex, and Type of Surgery (t value: −3.26, p-value: 0.001). Results: A total of 48 surgeries were broken down in terms of costs and profitability. This reflected a mean deficit of −37,527 CHF per case (range from −130.05 to +755 CHF) for patients with AL, whereas a mean profit of 1590 CHF per case (range from −24.37 to +12.65 CHF) for those without AL (p < 0.001). Thus, the difference in profit showed a factor of 24.6 with an overall significant negative outcome for the occurrence of AL. The main cost contributing factors were the length of hospital stay (~p < 0.05) and length of intensive care (p < 0.05), whereas neither surgical operation time and anesthesia time nor surgical access, insurance status, indication or type of operation had a significant influence on the net revenue. Conclusion: AL after colon surgery leads to a significant deficit regarding the net revenue. Regarding process optimization, our analysis identified several sectors of non-patient-related, yet cost-influencing variables that should be addressed in future evaluations and optimization of the colon surgery treatment processes. Full article

(This article belongs to the Special Issue Cost-of-Illness Study)

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