Value in health regional issues最新文献

{"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}

{"title":"Economic Burden of Sickle Cell Disease in Saudi Arabia","authors":"Emad Shdaifat PhD ,&nbsp;Firas Abu-Sneineh MSN ,&nbsp;Nagla Alsaleh PhD ,&nbsp;Abdallah Ibrahim MSN","doi":"10.1016/j.vhri.2024.101038","DOIUrl":"10.1016/j.vhri.2024.101038","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to determine the direct and indirect costs of sickle cell disease (SCD) in Saudi Arabia.</p></div><div><h3>Methods</h3><p>Data were collected from 217 participants aged ≥18 years in the eastern region of Saudi Arabia, using a prevalence-based cost-of-illness approach. The Institute for Medical Technology Assessment Medical Consumption Questionnaire and Institute for Medical Technology Assessment Productivity Cost Questionnaire were used to assess costs. A multistage process was used, encompassing patient data collection over 3 months, cost calculation from clinic visits and drug prices, and extrapolation for annual estimates.</p></div><div><h3>Results</h3><p>The study revealed substantial societal costs of SCD, with an average per-patient cost of SAR181 899 (US$48 506), covering healthcare and productivity losses. Healthcare costs, including hospitalization, informal care, and medication, averaged SAR80 306 (US$21 415). In addition, productivity costs, including unpaid work and presenteeism, averaged SAR101 594 (US$27 092). Obtaining higher levels of education, such as a diploma and BSc degree or higher, has been found to significantly decrease the costs associated with SCD (<em>P</em> = .016, <em>P</em> = .001). Furthermore, when comparing different employment statuses, students (B = −0.301, <em>P</em> = .058) were found to have marginally lower SCD costs, suggesting that their expenses were lower than those of individuals in other employment categories. The predictive model used in this study explained 11.2% of the variation in costs.</p></div><div><h3>Conclusion</h3><p>Our study highlights a significant economic burden of SCD in Saudi Arabia and highlights the need for targeted strategies to alleviate financial challenges and improve patient well-being.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101038"},"PeriodicalIF":1.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000712/pdfft?md5=74332115991fbbd530bf777fa149d6c4&pid=1-s2.0-S2212109924000712-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096254","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 and Caregiver Preferences for Hemophilia A Treatment in Taiwan: A Discrete Choice Experiment","authors":"Shyh-Shin Chiou MD, PhD ,&nbsp;Te-Fu Weng MD ,&nbsp;Jiaan-Der Wang MD, PhD","doi":"10.1016/j.vhri.2024.101035","DOIUrl":"10.1016/j.vhri.2024.101035","url":null,"abstract":"<div><h3>Objectives</h3><p>This study evaluated the treatment preferences among patients and caregivers for moderate or severe hemophilia A in Taiwan.</p></div><div><h3>Methods</h3><p>This cross-sectional study used a discrete choice experiment approach to assess treatment preferences among patients with hemophilia A and their caregivers. Respondents chose between 2 hypothetical treatments defined by 7 attributes including no bleeding episode, treated events of joint bleeding, long-term safety, type of treatment and risk of thromboembolic events, administration frequency, consumption route, and monitoring dosing options. Preference weights and relative importance (RI) of attributes were estimated using a hierarchical Bayesian logistic regression model.</p></div><div><h3>Results</h3><p>A total of 51 eligible respondents completed the discrete choice experiment (patients, 76.5%; caregivers, 23.5%). Most patients (70.6%) had severe hemophilia and 43.1% received prophylactic treatment for &gt;10 years. Respondents valued “type of treatment and risk of thromboembolic events” as the most important factor (RI 26.2%; 95% CI 20.9-31.5) followed by “consumption route” (RI 25.8%; 95% CI 20.7-30.9) and “administration frequency” (RI 15.2%; 95% CI 12.0-18.4). “Monitoring dosing options” was the least important attribute (RI 6.3%; 95% CI 5.2-7.4). Respondents had 63% possibility to choose a treatment profile that has factor VIII product compared with nonfactor product.</p></div><div><h3>Conclusions</h3><p>Patients and caregivers valued “type of treatment and risk of thromboembolic events” as the most important driver in choosing a treatment for moderate or severe hemophilia A. This study provides important insights into patients’ preferences and informs clinicians to consider patients’ choices when prescribing a treatment.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101035"},"PeriodicalIF":1.4,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000682/pdfft?md5=eece8a4c30e36a203836a47cc0ac3c96&pid=1-s2.0-S2212109924000682-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083196","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":"Population Norms and Disutility Catalog for Chronic Conditions in Sri Lanka","authors":"Nilmini Wijemunige MPH ,&nbsp;Anuji Gamage MD (Community Medicine) ,&nbsp;Ravindra P. Rannan-Eliya DPH ,&nbsp;Sanjeewa Kularatna PhD","doi":"10.1016/j.vhri.2024.101033","DOIUrl":"10.1016/j.vhri.2024.101033","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to produce Sri Lankan population norms of utility values, EuroQol visual analog scale scores, and reported problems in each domain of the EQ-5D-5L, as well as a disutility catalog, based on a representative set of Sri Lankan preferences.</p></div><div><h3>Methods</h3><p>Data from a nationally representative sample of 6415 adults from the Sri Lanka Health and Ageing Study in 2018 to 2019 were used. Sri Lankan preferences were applied to EQ-5D-5L scores to produce utility values. Descriptive statistics were produced for responses by EQ-5D-5L dimension, mean utility values, and EuroQol visual analog scale scores, disaggregated by demographic and disease group. Multivariable logistic regression assessed associations with problems in each dimension, and demographic and chronic diseases. Robust ordinary least squares and tobit regressions were performed to estimate the marginal disutility of demographic covariates and disease conditions.</p></div><div><h3>Results</h3><p>The mean utility value for the overall population was 0.867. Utility values decreased with age and increased with increasing education and richer socioeconomic quintiles. Males had higher utility values than females (0.89 vs 0.84; <em>P &lt;</em> .001). Utility values declined by 0.007 with each year increase in age (<em>P &lt;</em> .001) and statistically significant differences (<em>P &lt;</em> .05) in utility were found by ethnicity, socioeconomic quintile, and disease conditions such as stroke, diabetes, cancer, depression, and musculoskeletal conditions, using a tobit regression.</p></div><div><h3>Conclusions</h3><p>This study provides the first nationally representative set of population norms based on a local value set for key demographic groups and selected chronic disease conditions for Sri Lanka. It also provides a catalog that can be easily used to calculate quality-adjusted life-years for cost-utility analysis when modeling public health interventions.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101033"},"PeriodicalIF":1.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000669/pdfft?md5=d722ea825505d1ca571165169318b1ec&pid=1-s2.0-S2212109924000669-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142075795","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":"Psychometric Evaluation of the Bengali Short Form 12 Version 2 Health Survey in Patients With Inflammatory Bowel Disease","authors":"SM Ali Hasan MD ,&nbsp;Chanchal K. Ghosh MD ,&nbsp;Abdur R. Miah MD ,&nbsp;Md Anwarul Kabir MD","doi":"10.1016/j.vhri.2024.101036","DOIUrl":"10.1016/j.vhri.2024.101036","url":null,"abstract":"<div><h3>Objectives</h3><p>Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, significantly affects health-related quality of life (HRQOL). Despite the widespread use of the Short Form 12 version 2 (SF-12v2) questionnaire to assess HRQOL, its validity and reliability in Bengali IBD populations remain unclear. Our study aimed to evaluate the ability of the Bengali SF-12v2 to predict HRQOL in individuals with IBD.</p></div><div><h3>Methods</h3><p>Through a cross-sectional survey, we evaluated the Bengali SF-12v2’s reliability and validity in 150 patients with IBD, with a mean age of 34 years, including 67 with Crohn’s disease and 83 with ulcerative colitis.</p></div><div><h3>Results</h3><p>A 2-factor model comprising physical and mental aspects was supported by confirmatory factor analysis. The 2-factor model demonstrated adequate goodness-of-fit indices (chi-square 96.49 [df 51]; goodness-of-fit index 0.903; adjusted goodness-of-fit index 0.851; normed fit index 0.929; comparative fit index 0.965; Tucker-Lewis index 0.954; root mean square error of approximation 0.077 [90% CI 0.053-0.101]; and standard root mean square residual 0.04). All standardized estimates were statistically significant. Item-scale correlations ranged considerably from 0.87 to 1.00, surpassing alternative item-scale correlations. Bengali SF-12v2 scores effectively identified subgroups of IBD based on disease severity. Internal consistency reliability was deemed acceptable, with Cronbach’s alpha values of 0.889 for the physical component summary and 0.904 for the mental component summary. Intraclass correlation coefficients exceeded 0.8 in all domains. A ceiling effect was observed only for bodily pain (41.3%).</p></div><div><h3>Conclusions</h3><p>The Bengali SF-12v2 was shown to have adequate psychometric validity in patients with IBD. The findings support the Bengali SF-12v2’s future usage among individuals with IBD.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"45 ","pages":"Article 101036"},"PeriodicalIF":1.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109924000694/pdfft?md5=8ece7fe941871d5d2090c783607d4886&pid=1-s2.0-S2212109924000694-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142075948","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":"Changes in Health Spending During the COVID-19 Pandemic by Expenditure Type and Household Profiles in Mexican Households","authors":"María I. Lara Msc ,&nbsp;Monserrat Serio PhD","doi":"10.1016/j.vhri.2024.101032","DOIUrl":"10.1016/j.vhri.2024.101032","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to analyze the changes in the health expenditure of households in Mexico during the COVID-19 pandemic to approximate changes in healthcare that can lead to difficulties in detecting noncommunicable diseases, among others.</p></div><div><h3>Methods</h3><p>We compare health spending before and after the pandemic through various estimators using multivariate linear regression models at the household level. We also explore heterogeneous effects by zone, sex, and household composition by age. We explore potential mechanisms of change estimating probit models of healthcare. We use microdata from the National Health and Nutrition Survey 2018 and COVID-19.</p></div><div><h3>Results</h3><p>The results suggest a significant reduction in health spending, mainly referring to oral health, clinical analysis, and medical studies. Moreover, differences arise by type of area and household age profile. Changes are more significant among families with children younger than 12 years and households situated in urban areas. Regarding the mechanisms, the results suggest that the lower spending is not due to fewer health needs but rather due to less healthcare attention.</p></div><div><h3>Conclusion</h3><p>The COVID-19 pandemic had a significant and heterogeneous impact on household health spending. This lower spending could lead to less detection of noncommunicable diseases, translating into more pressure on the health system in the medium and long term.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"44 ","pages":"Article 101032"},"PeriodicalIF":1.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142075968","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":"Assessing the Impact of a Designated Pharmacist Intervention on Drug Treatment Costs and Technical Efficiency in the Hemato-Oncology Outpatient Clinic","authors":"Areen Khateeb Alabbasi BPharm, MHA ,&nbsp;Shai Cohen MD ,&nbsp;Manfred S. Green MD, PhD ,&nbsp;Meir Preis MD ,&nbsp;Shmuel Klang PhD ,&nbsp;Shuli Brammli-Greenberg PhD","doi":"10.1016/j.vhri.2024.101034","DOIUrl":"10.1016/j.vhri.2024.101034","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to investigate the impact of a designated pharmacist (DPha) intervention in a hemato-oncology unit, focusing on reducing drug treatment costs and improving technical efficiency (TE).</p></div><div><h3>Methods</h3><p>Data from an 8-month intervention in the Israeli Clalit Health Services hemato-oncology outpatient unit were analyzed. During the study, the DPha reviewed the drug therapies being administered. After the review, a recommendation letter was sent, if relevant, to the treating physician. Data on drug treatment costs and interventions were meticulously collected and analyzed from the perspective of the insurer. A simple design was used to assess the DPha intervention’s contribution to TE and cost reduction, which was used to generate credible and transparent estimates. Sensitivity analyses were conducted to assess the robustness of 2 major variables: drug prices and pharmacist salaries.</p></div><div><h3>Results</h3><p>Over 8 months, DPha interventions led to a $279 191 cost reduction for 91 patients, resulting in net savings of $269 420 ($2960 per patient). Noteworthy is the $411 savings for each hour worked by the pharmacist, with a major impact on medications not insurer approved for the patient’s condition ($101 151) and discontinuing inappropriate medications ($52 681). Biological drug optimization accounted for 81% of total savings. Sensitivity analyses demonstrated significant cost savings across various drug prices and pharmacist salary scenarios.</p></div><div><h3>Conclusions</h3><p>The study proposes a practical framework for optimizing pharmacist services and reducing the inappropriate use of costly oncology medications. Incorporating a DPha enhances TE and yields significant cost reductions, offering valuable insights for insurers, policy makers, and healthcare professionals.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"44 ","pages":"Article 101034"},"PeriodicalIF":1.4,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049253","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":"Psychometric Measurements of the Adherence to Refills and Medication Scales Among Patients With HIV/AIDS in Indonesia","authors":"Ika Ratna Hidayati MSc, Apt ,&nbsp;Lia Amalia Dr, Apt ,&nbsp;Meddy Setiawan Dr dr, SpPD, FINASIM ,&nbsp;T.I. Armina Padmasawitri Dr, Apt ,&nbsp;M. Rifqi Rokhman MSc, Apt","doi":"10.1016/j.vhri.2024.101027","DOIUrl":"10.1016/j.vhri.2024.101027","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to conduct a psychometric evaluation of the Adherence to Refills and Medications Scale (ARMS) among patients with HIV/AIDS in Indonesia.</p></div><div><h3>Methods</h3><p>Psychometric analysis was conducted at 2 hospitals and 7 public health centers at the voluntary counseling and testing clinic. Content validity was measured by assessing the relevance and clarity of each ARMS item. Construct validity was also assessed. Reliability was evaluated using internal consistency and test-retest reliability.</p></div><div><h3>Results</h3><p>This study involved 11 experts in the assessment of the content validity and 240 participants in the estimation of the construct validity. All ARMS items were generally considered easy to understand and relevant, with scale-level content validity index based on the average method (S-CVI/Ave) of 0.9 (&gt;0.78) and item-level content validity index (I-CVI) in the range from 0.5 to 1 for the relevance level and S-CVI/Ave of 0.95 (&gt;0.78) and I-CVI in the range from 0.8 to 1 for the clarity level. Two items (numbers 2 and 3) were revised based on experts’ suggestions to enhance comprehension. Confirmatory factor analysis supported 2 subscales: adherence to taking medications and adherence to refilling prescriptions. Good reliability was supported by internal consistency (Cronbach’s α 0.793) and test-retest reliability (intraclass correlation coefficient 0.722) for the overall adherence score.</p></div><div><h3>Conclusions</h3><p>The Indonesian version of ARMS is a valid and reliable medication adherence scale when used in Indonesian patients with HIV/AIDS.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"44 ","pages":"Article 101027"},"PeriodicalIF":1.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141985701","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":"Analysis of Factors Influencing Hospitalization Expenses of Patients with Gastric Cancer in Shanghai, 2014-2021: Based on Grey Relational Analysis and Structural Equation Modeling","authors":"Yichun Gu MD, MPH ,&nbsp;Mengying Liu MD ,&nbsp;Anqi Wang PhD ,&nbsp;Da He PhD ,&nbsp;Hui Sun PhD ,&nbsp;Xin Cui PhD ,&nbsp;Wenqi Tian MD ,&nbsp;Yulin Zhang MD ,&nbsp;Chunlin Jin PhD ,&nbsp;Haiyin Wang PhD","doi":"10.1016/j.vhri.2024.101029","DOIUrl":"10.1016/j.vhri.2024.101029","url":null,"abstract":"<div><h3>Objectives</h3><p>This study analyzed the basic condition and the influencing factors of hospitalization costs of patients with gastric cancer in Shanghai from 2014 to 2021, so as to provide a scientific reference for promoting the reform of the medical and healthcare system.</p></div><div><h3>Methods</h3><p>The study data were obtained from the electronic medical record system of Shanghai Hospital. The grey relational analysis was applied to analyze the correlation strength of various expenses with hospitalization costs. The structural equation modeling was constructed to analyze the influences of factors on the hospitalization expenses, as well as the relationship between each factor.</p></div><div><h3>Results</h3><p>A total of 23 335 study subjects were included. The results of grey relational analysis showed that the total cost of drugs had the strongest correlation with hospitalization expenses, followed by material expenses and surgery cost, whereas those of others were lower. The results of the structural equation modeling showed that age had the greatest influence on hospitalization expenses with a path coefficient of 0.618. Other influencing factors included surgery history, length of stay, hospital level, gender, and medical insurance.</p></div><div><h3>Conclusions</h3><p>The total cost of drugs had the strongest correlation with hospitalization expenses. Factors such as gender, age, and hospital level all affect the hospitalization expenses. In the future, it is necessary to take further measures to control the cost of drugs and constantly optimize the structure of hospitalization costs. Meanwhile, the reform of the medical and healthcare system should be deepened to reasonably regulate the medical behaviors and reduce the financial burden of patients.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"44 ","pages":"Article 101029"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879476","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":"Health Utility Values Among Patients With Diabetic Retinopathy, Wet Age-Related Macular Degeneration, and Cataract in Thailand: A Multicenter Survey Using Time Trade-Off, EQ-5D-5L, and Health Utility Index 3","authors":"Pear Ferreira Pongsachareonnont MD, MPH ,&nbsp;Phantipa Sakthong PhD ,&nbsp;Voraporn Chaikitmongkol MD ,&nbsp;Wantanee Dangboon Tsutsumi MD ,&nbsp;Chavakij Bhoomibunchoo MD ,&nbsp;Cameron P. Hurst PhD ,&nbsp;Yot Teerawattananon MD, PhD ,&nbsp;Kittisak Kulvichit MD","doi":"10.1016/j.vhri.2024.101030","DOIUrl":"10.1016/j.vhri.2024.101030","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to establish normative health utility data in Thai patients with diabetic retinopathy, wet age-related macular degeneration, and cataract; evaluate the sensitivity of different utility instruments to visual impairment; explore the relationship among these health utility values with the vision-specific quality of life (QoL); and assess the association of baseline characteristics and visual acuity level with health utility values and vision-specific QoL.</p></div><div><h3>Methods</h3><p>This multicenter cross-sectional survey included 309 patients from tertiary eye centers. We used health utility instruments (time trade-off [TTO], EuroQol five-dimension [EQ-5D-5L], and Health Utility Index 3 [HUI3]) and vision-specific QoL instrument (National Eye Institute Visual Function Questionnaire) for face-to-face interviews. Demographic data and Early Treatment Diabetic Retinopathy Study visual acuity were recorded during the participants ophthalmic visits. Univariable and multivariable mixed-effect models were used to evaluate factors associated with the utility scores. Health utility scores among each type of eye disease were compared.</p></div><div><h3>Results</h3><p>The overall mean utility values from the TTO, EQ-5D-5L, and HUI3 were 0.84 ± 0.25, 0.70 ± 0.19, and 0.68 ± 0.26, respectively. The health utility scores obtained from TTO and HUI3 showed a significant response to severe visual impairment or worse. Health utility scores from HUI3 (r = 0.54; <em>P</em> &lt; .01) and EQ-5D-5L (r = 0.43; <em>P</em> &lt; .01) displayed a moderate correlation with the National Eye Institute Visual Function Questionnaire score. There were no significant differences in health utility value among the 3 diseases upon adjusting for the visual acuity level and demographics.</p></div><div><h3>Conclusions</h3><p>Visual acuity level has a greater impact on a patient’s QoL than the type of eye disease. HUI3 and EQ-5D-5L and TTO are suitable for measuring health utility in leading causes of blindness.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":"44 ","pages":"Article 101030"},"PeriodicalIF":1.4,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876089","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}