Value in health regional issues最新文献

{"title":"The Reform Dynamics of State Management Practices in the Healthcare Sector of the Republic of Kazakhstan: A Global and Local Perspective","authors":"Talgat Zharlygassinov ,&nbsp;Rashid Ruzanov PhD ,&nbsp;Manshuk Dosmanbetova PhD","doi":"10.1016/j.vhri.2024.101047","DOIUrl":"10.1016/j.vhri.2024.101047","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to analyze the changes in public administration practices in this area in the Republic of Kazakhstan and to assess the general state of healthcare in the country.</div></div><div><h3>Methods</h3><div>The study used various methods, including analysis, historical research, deduction, and forecasting, to assess the current state and prospects for healthcare development in the Republic of Kazakhstan and some post-Soviet countries in Eastern Europe.</div></div><div><h3>Results</h3><div>The findings indicate that although these countries have lower qualitative and quantitative healthcare characteristics than more developed nations, they still outperform Kazakhstan. This suggests that Kazakhstan should take a more proactive approach toward developing its healthcare system and prioritizing the well-being of its citizens, their standard of living, and their ability to combat diseases, including financially.</div></div><div><h3>Conclusions</h3><div>The article contributes new insights into the healthcare systems of developing countries, including post-Soviet nations.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101047"},"PeriodicalIF":1.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of a Specialized Oral Nutritional Supplement in the Management of Chronic Wounds in Patients With and Without Diabetes Mellitus: Cost-Effectiveness Analysis","authors":"Adriano Antonio Mehl MD, MSc, PhD ,&nbsp;Victoria Marzagão Ribeiro Pagliosa BSc ,&nbsp;Débora Auad Tauil BSc ,&nbsp;Valéria Abrahão Schilling Rosenfeld MD","doi":"10.1016/j.vhri.2024.101049","DOIUrl":"10.1016/j.vhri.2024.101049","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the cost-effectiveness of the use of a specialized oral nutritional supplement (ONS) with proline, arginine, vitamins, and micronutrients to stimulate the healing of chronic wounds in patients with and without diabetes mellitus.</div></div><div><h3>Methods</h3><div>This is a quantitative study on cost-effectiveness. This model used a decision-tree model followed by a budget impact analysis from the Brazilian public healthcare system’s perspective. For this analysis, the population and data from a randomized trial of an oral specialized-ONS-containing supplement were considered. For budget impact analysis, an epidemiologic approach was used to estimate the eligible population. The eligible population comprised 3 different groups: patients with pressure ulcers, patients with vascular ulcers, and patients with diabetic feet. The budget impact analysis used the results of the cost-effectiveness analysis.</div></div><div><h3>Results</h3><div>The results demonstrate that the use of specialized ONS, when compared with control ONS, proved to be cost saving (cheaper and more effective), considering the presence of predictive scar factor. The aggregated budget impact analysis results shows that the total reduction of costs after 5 years is USD 332 628 437.00.</div></div><div><h3>Conclusions</h3><div>The use of a specialized ONS was cost-effective in the healing of chronic wounds, when compared with control. The budget impact analysis showed a significant decrease in costs in a 5-year time horizon for the management of pressure ulcers, vascular ulcers, and diabetic feet.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101049"},"PeriodicalIF":1.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The High Cost of the Legal Route in Public Health: The Impact of the Judicialization of Medicines in the Municipal Unified Health System in Campinas.","authors":"Stefane Cristina Paixão Oliveira, Dyego Carlos Souza Anacleto de Araújo, Patricia Moriel, Marília Berlofa Visacri","doi":"10.1016/j.vhri.2024.101050","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101050","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the costs and factors associated with the judicialization of medicines for the municipal Unified Health System in Campinas, São Paulo, Brazil, from 2017 to 2021.</p><p><strong>Methods: </strong>This cross-sectional study used data provided by the Municipal Health Department of Campinas and the Court of Justice of the State of São Paulo.</p><p><strong>Results: </strong>The sample comprised 506 medicines (322 active substances) and 493 legal cases. Of the US$9.270 million disbursed, 67.3% were allocated to purchase medicines. On average, 28.8% of the pharmaceuticals were listed on the National List of Essential Medicines (Rename), of which 52.3% were listed in the specialized component. Expenditures on nonincorporated and oncological medicines accounted for 76% of the total value. Acquisition of brand-specific medicines was predominant (53.7%), of which 75.5% had therapeutic equivalents. ABC curve shows that only 28 active substances corresponded to 79.8% of the expenses incurred to serve 573 plaintiffs. Four factors, when present in legal actions, prevented the rational use of public resources: assumption of responsibilities of other federative entities, acquisition of medicines not incorporated in Rename and oncological drugs, trademark determination, and the requirement to supply the medicine for an indefinite period. Costs associated with these factors caused an increase in expenditure, even with a decrease in legal demands filed against the municipality.</p><p><strong>Conclusions: </strong>Judicialization of medicines in Campinas from 2017 to 2021 required an allocation of US$6.2 million, aimed at treating only 0.068% of the population. Associated factors include legal requirements and internal management challenges that have increased costs.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101050"},"PeriodicalIF":1.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to 'Cost-effectiveness Analysis of Prostate Specific Antigen Screening among Chinese Men': [Value in Health Regional Issues Volume 21, May 2020, Pages 272-279].","authors":"Guoqiang Zhao, Yuchen Shao, Nan Zhang, Jialin Wang, Linlin Yuan, Xiaojie Sun, Lizheng Shi","doi":"10.1016/j.vhri.2024.101053","DOIUrl":"https://doi.org/10.1016/j.vhri.2024.101053","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101053"},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Savings Through Telemedicine: Initial Data From a Hospital-at-Home Program","authors":"Chong Yau Ong MMed(FM) ,&nbsp;Angus Jun Jie Ng BSc ,&nbsp;Sarah Yu Juan Ang BSc ,&nbsp;Jean Mui Hua Lee MBBS","doi":"10.1016/j.vhri.2024.101046","DOIUrl":"10.1016/j.vhri.2024.101046","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to estimate travel-related time and cost savings from the use of telemedicine for an inpatient hospital-at-home program.</div></div><div><h3>Methods</h3><div>This was a retrospective study on the initial data obtained from a newly implemented hospital-at-home program from June 26, 2023, to March 31, 2024. Time cost savings were calculated based on difference between time spent on teleconsultation versus time needed to travel a round trip to patients’ homes to conduct physical consultation via home visit. Travel distances were calculated based on the distance of patient’s homes from the hospital.</div></div><div><h3>Results</h3><div>There were 505 teleconsultations (497 scheduled, 8 unscheduled) delivered throughout 132 enrollments. Total travel distance saved was 4022 km. Total time savings was 18 707 minutes or 13.0 days. Total trip cost savings were Singapore dollars 4618.70.</div></div><div><h3>Conclusions</h3><div>Despite being a newly introduced program, utilization of telemedicine in delivery of hospital-at-home showed time savings for the clinicians, cost savings from the distance needed to travel otherwise. Incorporation of telemedicine in hospital-at-home delivery demonstrated time and distance savings even at the pilot phase of program.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101046"},"PeriodicalIF":1.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Custo-Efetividade de Diferentes Tratamentos Minimamente Invasivos Para Disfunção Temporomandibular de Origem Articular sob a Perspectiva do Sistema Público de Saúde Brasileiro","authors":"George A. Lemos PhD ,&nbsp;Pâmela L.P. da Silva PhD ,&nbsp;Eduarda C. Moretti PhD ,&nbsp;Antônio C. Pereira PhD","doi":"10.1016/j.vhri.2024.101014","DOIUrl":"10.1016/j.vhri.2024.101014","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the cost-effectiveness (CE) of minimally invasive interventions for pain associated with articular temporomandibular dysfunction from the Brazilian Public Health System (SUS) perspective.</div></div><div><h3>Methods</h3><div>This is a CE study with a 1-year time horizon. Effectiveness data were extracted from a network meta-analysis, and 2 treatments with moderate levels of evidence certainty were evaluated: arthrocentesis (ARTRO) plus intra-articular corticosteroid (CO) injection and ARTRO plus intra-articular injection of sodium hyaluronate (SH). For CE analysis, the costs of 2 types of SH (low and high molecular weight) and 4 COs (betamethasone [B], dexamethasone acetate [D], methylprednisolone sodium succinate [M], or triamcinolone hexacetonide [T]) were considered. Modeling was conducted using TreeAge Pro Healthcare software, with the construction of a decision tree representing a hypothetical cohort of adults with articular temporomandibular dysfunction. Deterministic and probabilistic sensitivity analyses were performed. In addition, an acceptability curve was developed.</div></div><div><h3>Results</h3><div>The total costs per joint for ARTRO plus low- and high-molecular-weight SH and ARTRO plus COs B, D, M, and T were, respectively, R$583.32, R$763.85, R$164.39, R$133.93, R$138.57, and R$159.86. ARTRO plus dexamethasone acetate was considered cost-effective, with lower cost and higher net monetary benefit than other technologies. In all sensitivity analysis scenarios, it remained cost-effective. It also showed greater acceptability.</div></div><div><h3>Conclusion</h3><div>ARTRO plus dexamethasone acetate was considered the cost-effective technology, exhibiting higher net monetary benefit and higher acceptability from the SUS perspective.</div></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"44 ","pages":"Article 101014"},"PeriodicalIF":1.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Main Predictors of Decreasing in Quality of Life in Patients With Post-COVID-19: A Cross-Sectional Study","authors":"Jonnathan O. Cázares-Lara MD ,&nbsp;Alberto Ordinola-Navarro MD ,&nbsp;Zully Carmona-Aguilera MD ,&nbsp;Gustavo M. Benitez-Altamirano MD ,&nbsp;Luis D. Beltran-Ontiveros MD ,&nbsp;Juan P. Ramirez-Hinojosa MD ,&nbsp;Cesar Lopez-Vejar MD ,&nbsp;Bruno A. Lopez-Luis MD","doi":"10.1016/j.vhri.2024.101039","DOIUrl":"10.1016/j.vhri.2024.101039","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to assess physical and psychosomatic manifestations of patients with long COVID and their association with a decreased patient’s quality of life (QOL) or different times elapsed since the COVID-19 diagnosis.</p></div><div><h3>Methods</h3><p>This is a cross-sectional study. We retrospectively collected the clinical characteristics of adult patients who had tested positive for SARS-CoV-2 and had symptoms at least as early as 4 weeks after COVID-19 in México City between April 2020 and February 2021. A total of 179 were included. They answered questions to define chronic symptoms. The Sniffin’ Sticks Screening 12 test olfactory evaluation was performed. The diminish of QOL was defined by ≥10 points in the EuroQol visual analog scale between pre- and post-COVID-19, and each dimension of EQ-5D-5L test was evaluated. Chi-square test, Fisher’s exact test, Student <em>t</em> test, Wilcoxon rank-sum, and signed-rank test were used as required. A backward stepwise logistic regression analysis determined the factors associated with a decrease in QOL. All analyses were performed using R software version 3.6.3 (R Foundation).</p></div><div><h3>Results</h3><p>In the multivariable analysis, post-COVID-19 pain/discomfort (adjusted odds ratio [aOR] 2.5 [1.66-9.68]; <em>P</em> = .01), anxiety/depression (aOR 13 [1.44-17.23]; <em>P</em> = .03), and persistence of ≥3 symptoms (aOR 2.6 [0.96-7.47]; <em>P</em> = .05) remained statistically significant associated with decreased QOL.</p></div><div><h3>Conclusions</h3><p>Patients with long COVID-19 have decreased QOL mainly associated with pain/discomfort, anxiety/depression, and ≥3 persistent symptoms. Our findings enhanced the notion of a strong psychosomatic factors involved with long COVID-19. Therefore, these patients might benefit from neuropsychological rehabilitation, although the effect of such interventions should be evaluated.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101039"},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000724/pdfft?md5=9b46d1178d49c8b47b72cfafda364c75&pid=1-s2.0-S2212109924000724-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An EQ-5D-5L Value Set for Ghana Using an Adapted EuroQol Valuation Technology Protocol","authors":"Rebecca Addo PhD ,&nbsp;Brendan Mulhern PhD ,&nbsp;Richard Norman PhD ,&nbsp;Richmond Owusu PhD ,&nbsp;Rosalie Viney PhD ,&nbsp;Justice Nonvignon PhD","doi":"10.1016/j.vhri.2024.101045","DOIUrl":"10.1016/j.vhri.2024.101045","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;p&gt;Ghana’s economic evaluation reference case recommends quality-adjusted life-years as an outcome measure for the conduct of cost-utility analysis. There is no Ghanaian value set available to be used in estimating quality-adjusted life-years. This study aimed to develop a value set for Ghana using the EQ-5D-5L instrument.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Face-to-face preference data were collected from 300 adults across 3 regions of Ghana using the adapted version of the EuroQol valuation technology (EQ-VT) standardized valuation protocol; with composite time-trade-off (cTTO) and discrete-choice experiments (DCEs) elicitation techniques. The cTTO and DCE data were modeled individually or together to provide complementary results on respondents’ utility preferences. Models explored were generalized least squares, Tobit, heteroskedastic, logit, and hybrid. The best-fitting model for the value set was selected based on its logical consistency, accounting for left-censored and heteroscedasticity data, and the statistical significance of parameters.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The 300 interviews provided 4500 cTTO responses and 4200 DCE responses. The preferred model chosen for the Ghana value set was the Hybrid Tobit random effect heteroscedastic-constrained model. The predicted value for the worst attainable health state (55555) was −0.493 and the best health state (11112) was 0.969. The largest decrement was registered for level 5 mobility (0.369) followed by pain/discomfort (0.312), self-care (0.273), anxiety/depression (0.271), and usual activities (0.268).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;This is the first Ghanaian EQ-5D-5L value set based on social preference derived from a nationally representative sample. The value set will play a key role in the use of economic evaluation studies to inform priority setting in Ghana where different health technologies can be compared.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Introducción&lt;/h3&gt;&lt;p&gt;El caso de referencia de la evaluación económica de Ghana recomienda los años de vida ajustados por calidad (AVAC) como medida de resultado para la realización de análisis de costo-utilidad. No existe ningún conjunto de valores ghaneses disponible para utilizar en la estimación de los AVAC. Este estudio tuvo como objetivo desarrollar un conjunto de valores para Ghana utilizando el instrumento EQ-5D-5L.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Método&lt;/h3&gt;&lt;p&gt;Se recopilaron datos de preferencia cara a cara de 300 adultos en tres regiones de Ghana utilizando la versión adaptada del protocolo de valoración estandarizado de la tecnología de valoración EuroQol (EQ-VT); con técnicas de obtención de experimentos de elección discreta (DCE) y compensación de tiempo compuesto (cTTO). Los datos de cTTO y DCE se modelaron individualmente o en conjunto para proporcionar resultados complementarios sobre las preferencias de servicios públicos de los encuestados. Los modelos explorados fueron mínimos cuadrados generalizados, Tobit, heterocedástico,","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101045"},"PeriodicalIF":1.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000785/pdfft?md5=37c377aa82fe62b47be3780d62f60f13&pid=1-s2.0-S2212109924000785-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experience of Herpes Zoster Disease in Argentina: Validation of a Health-Related Quality of Life Conceptual Model","authors":"Maria Belizan MSc ,&nbsp;Federico Augustovski MD, PhD ,&nbsp;Ariel Bardach MD, PhD ,&nbsp;Thatiana Pinto PhD ,&nbsp;Agustina Villarejo MSc ,&nbsp;Elena Lazo MD, MSc ,&nbsp;Maria V. Cordo MD ,&nbsp;Desirée A.M. van Oorschot MSc","doi":"10.1016/j.vhri.2024.101044","DOIUrl":"10.1016/j.vhri.2024.101044","url":null,"abstract":"<div><h3>Objectives</h3><p>Herpes zoster (HZ) substantially affects patients’ health-related quality of life (HRQoL), both in the acute phase and also in those developing postherpetic neuralgia (PHN). Building upon a previous qualitative concept elicitation study in Canada, we adopted a similar approach to further understand the patient experience of HZ/PHN in Argentina and impact on quality of life and qualitatively validate the previously published conceptual model for Argentina.</p></div><div><h3>Methods</h3><p>(1) Comprehensive literature review of HZ impact on HRQoL in Latin America. (2) Qualitative concept elicitation interviews with participants aged ≥50 years with acute HZ or PHN. Verbatim interview transcripts underwent thematic and content analysis related to symptoms and impacts.</p></div><div><h3>Results</h3><p>Studies from the literature (n = 6) identified 5 dimensions of HZ impact on HRQoL: pain management, disease management, family life, work, and emotional impact. A total of 10 participants were interviewed (5 acute HZ and 5 with PHN) with a mean age of 68.5 years (range 50-77 years) and 60% female. All participants reported rash and pain (some reporting a migratory element), fatigue (7 of 10), and itchiness (4 of 10). HRQoL domains most commonly affected were activities of daily living (9 of 10), emotional functioning (8 of 10), physical functioning (8 of 10), and sleep (7 of 10). Emergent themes on disease management included the need for greater public disease awareness/education, participants with PHN seeking alternative/traditional medical therapies.</p></div><div><h3>Conclusions</h3><p>This study qualitatively validates the previously reported HRQoL conceptual framework. HZ symptoms, especially acute and chronic pain, substantially impair various aspects of HRQoL, prompting some participants to seek out alternative medical treatments.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"44 ","pages":"Article 101044"},"PeriodicalIF":1.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000773/pdfft?md5=7c713428d4d8079151c5c2bdf37adad4&pid=1-s2.0-S2212109924000773-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142128708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Services Costs of Clinical Heart Failure With Reduced Ejection Fraction in Singapore","authors":"Sameera Senanayake PhD ,&nbsp;Sanjeewa Kularatna PhD ,&nbsp;Audry Shan Yin Lee MBBChir ,&nbsp;Annie Lee PhD ,&nbsp;Yee How Lau BSc ,&nbsp;Derek J. Hausenloy PhD ,&nbsp;Khung-Keong Yeo MBBS ,&nbsp;Mark Yan-Yee Chan PhD ,&nbsp;Raymond Ching Chiew Wong MBBS ,&nbsp;Seet Yoong Loh MBBS ,&nbsp;Kheng Leng David Sim MBBS ,&nbsp;Chow Weien MMed ,&nbsp;Nicholas Graves PhD","doi":"10.1016/j.vhri.2024.101037","DOIUrl":"10.1016/j.vhri.2024.101037","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to estimate the annual healthcare burden of heart failure (HF) with reduced ejection fraction (&lt;40%) in Singapore.</p></div><div><h3>Methods</h3><p>Retrospective longitudinal descriptive cohort study was conducted using a linked national administrative data set (Singapore Cardiovascular Longitudinal Outcomes Database). In Singapore, during 2011, there were a total of 3267 HF-related hospital admissions. Among these, 1631 patients (49.9%), who had an ejection fraction of less than 40%, were followed up for 9 years. The primary outcomes were annual healthcare costs related to hospital admissions and outpatient visits.</p></div><div><h3>Results</h3><p>There was a consistent decline in HF-related hospital admissions over the years, and the average per-hospital admission cost and average cost per day for HF varied over the 9 years. The average all-cause per-patient admission cost remained stable annually, ranging between S$16 000 and S$18 800. In the final year of life, there was a significant increase in both all-cause and HF-related hospital admission costs (by 24% and 54% from the previous year, respectively), and this rise in costs reflected increased frequency of admissions and longer hospital stays. There was an upward trend in the cost of outpatient visits as the patients neared death.</p></div><div><h3>Conclusions</h3><p>Hospital-based HF care imposes a significant financial impact on Singapore’s healthcare system. This suggests a need for cost-efficient management strategies to reduce the reliance on hospital-based treatment, thus mitigating economic pressures on the healthcare system.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101037"},"PeriodicalIF":1.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000700/pdfft?md5=b1185b2623e5889927950369567b36da&pid=1-s2.0-S2212109924000700-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}