Forum for Health Economics and Policy最新文献_第7页

The Value of Delaying Alzheimer's Disease Onset. 延缓阿尔茨海默病发病的价值。

Forum for Health Economics and Policy Pub Date : 2014-11-01 Epub Date: 2014-11-04 DOI: 10.1515/fhep-2014-0013

Julie Zissimopoulos, Eileen Crimmins, Patricia St Clair

{"title":"The Value of Delaying Alzheimer's Disease Onset.","authors":"Julie Zissimopoulos, Eileen Crimmins, Patricia St Clair","doi":"10.1515/fhep-2014-0013","DOIUrl":"https://doi.org/10.1515/fhep-2014-0013","url":null,"abstract":"Alzheimer's disease (AD) extracts a heavy societal toll. The value of medical advances that delay onset of AD could be significant. Using data from nationally representative samples from the Health and Retirement Study (1998-2008) and Aging Demographics and Memory Study (2001-2009), we estimate the prevalence and incidence of AD and the formal and informal health care costs associated with it. We use microsimulation to project future prevalence and costs of AD under different treatment scenarios. We find from 2010 to 2050, the number of individuals ages 70+ with AD increases 153%, from 3.6 to 9.1 million, and annual costs increase from $307 billion ($181B formal, $126B informal costs) to $1.5 trillion. 2010 annual per person costs were $71,303 and double by 2050. Medicare and Medicaid are paying 75% of formal costs. Medical advances that delay onset of AD for 5 years result in 41% lower prevalence and 40% lower cost of AD in 2050. For one cohort of older individuals, who would go on to acquire AD, a 5-year delay leads to 2.7 additional life years (about 5 AD-free), slightly higher formal care costs due to longer life but lower informal care costs for a total value of $511,208 per person. We find Medical advances delaying onset of AD generate significant economic and longevity benefits. The findings inform clinicians, policymakers, businesses and the public about the value of prevention, diagnosis, and treatment of AD.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"18 1","pages":"25-39"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fhep-2014-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34361480","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}

引用次数: 177

Retail Tobacco Display Bans 零售烟草陈列禁令

Forum for Health Economics and Policy Pub Date : 2014-09-01 DOI: 10.1515/fhep-2013-0019

I. Irvine, V. Nguyen

引用次数: 2

Can Oral Nutritional Supplements Improve Medicare Patient Outcomes in the Hospital? 口服营养补充剂能改善医院医疗保险患者的预后吗?

Forum for Health Economics and Policy Pub Date : 2014-09-01 DOI: 10.1515/fhep-2014-0011

D. Lakdawalla, J. Snider, D. Perlroth, C. LaVallee, M. Linthicum, T. Philipson, J. Partridge, P. Wischmeyer

{"title":"Can Oral Nutritional Supplements Improve Medicare Patient Outcomes in the Hospital?","authors":"D. Lakdawalla, J. Snider, D. Perlroth, C. LaVallee, M. Linthicum, T. Philipson, J. Partridge, P. Wischmeyer","doi":"10.1515/fhep-2014-0011","DOIUrl":"https://doi.org/10.1515/fhep-2014-0011","url":null,"abstract":"Abstract We analyzed the effect of oral nutritional supplement (ONS) use on 30-day readmission rates, length of stay (LOS), and episode costs in hospitalized Medicare patients (≥65), and subsets of patients diagnosed with acute myocardial infarction (AMI), congestive heart failure (CHF) or pneumonia (PNA). Propensity-score matching and instrumental variables were used to analyze ONS and non-ONS episodes from the Premier Research Database (2000–2010). ONS use was associated with reductions in probability of 30-day readmission by 12.0% in AMI and 10.1% in CHF. LOS decreases of 10.9% in AMI, 14.2% in CHF, and 8.5% in PNA were associated with ONS, as were decreases in episode costs in AMI, CHF and PNA of 5.1%, 7.8% and 10.6%, respectively. The effect on LOS and episode cost was greatest for the Any Diagnosis population, with decreases of 16.0% and 15.8%, respectively. ONS use in hospitalized Medicare patients ≥65 is associated with improved outcomes and decreased healthcare costs, and is therefore relevant to providers seeking an inexpensive, evidence-based approach for meeting Affordable Care Act quality targets.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"41 1","pages":"131 - 151"},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79479196","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}

引用次数: 9

The Effects of Smoking Cessation on Weight Gain: New Evidence Using Workplace Smoking Bans 戒烟对体重增加的影响:工作场所禁烟的新证据

Forum for Health Economics and Policy Pub Date : 2014-09-01 DOI: 10.1515/fhep-2013-0004

Jason M. Fletcher

引用次数: 4

Patient Outcomes and Cost Effects of Medicaid Formulary Restrictions on Antidepressants 医疗补助限制抗抑郁药的患者结局和成本效应

Forum for Health Economics and Policy Pub Date : 2014-09-01 DOI: 10.1515/fhep-2014-0016

S. Seabury, D. Lakdawalla, D. Walter, J. Hayes, T. Gustafson, A. Shrestha, D. Goldman

引用次数: 6

A Note on Income Effects and Health Care Cost Growth in Medicare 关于医疗保险的收入效应和医疗保健成本增长的说明

Forum for Health Economics and Policy Pub Date : 2014-02-01 DOI: 10.1515/fhep-2013-0001

T. Mcguire

引用次数: 3

A Note on Income Effects and Health Care Cost Growth in Medicare. 关于医疗保险的收入效应和医疗保健成本增长的说明。

Forum for Health Economics and Policy Pub Date : 2014-02-01 DOI: 10.1515/fhep-2013-0

Thomas G McGuire

引用次数: 0

The Crowd, the Cloud and Improving the Future of Medical Device Innovation 人群、云与改善医疗器械创新的未来

Forum for Health Economics and Policy Pub Date : 2014-01-01 DOI: 10.1515/fhep-2012-0023

Marco D. Huesch, R. Szczerba

引用次数: 1

Medicare Reimbursement Reform for Provider Visits and Health Outcomes in Patients on Hemodialysis. 医疗保险报销改革对提供者访问和血液透析患者的健康结果。

Forum for Health Economics and Policy Pub Date : 2014-01-01 DOI: 10.1515/fhep-2012-0018

Kevin F Erickson, Wolfgang C Winkelmayer, Glenn M Chertow, Jay Bhattacharya

{"title":"Medicare Reimbursement Reform for Provider Visits and Health Outcomes in Patients on Hemodialysis.","authors":"Kevin F Erickson, Wolfgang C Winkelmayer, Glenn M Chertow, Jay Bhattacharya","doi":"10.1515/fhep-2012-0018","DOIUrl":"https://doi.org/10.1515/fhep-2012-0018","url":null,"abstract":"The relation between the quantity of many healthcare services delivered and health outcomes is uncertain. In January 2004, the Centers for Medicare and Medicaid Services introduced a tiered fee-for-service system for patients on hemodialysis, creating an incentive for providers to see patients more frequently. We analyzed the effect of this change on patient mortality, transplant wait-listing, and costs. While mortality rates for Medicare beneficiaries on hemodialysis declined after reimbursement reform, mortality declined more - or was no different - among patients whose providers were not affected by the economic incentive. Similarly, improved placement of patients on the kidney transplant waitlist was no different among patients whose providers were not affected by the economic incentive; payments for dialysis visits increased 13.7% in the year following reform. The payment system designed to increase provider visits to hemodialysis patients increased Medicare costs with no evidence of a benefit on survival or kidney transplant listing.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"17 1","pages":"53-77"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fhep-2012-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34293533","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}

引用次数: 12

A Cost-Benefit Analysis of Using Evidence of Effectiveness in Terms of Progression Free Survival in Making Reimbursement Decisions on New Cancer Therapies 使用无进展生存期的有效性证据来制定新的癌症治疗报销决策的成本-收益分析

Forum for Health Economics and Policy Pub Date : 2014-01-01 DOI: 10.1515/fhep-2013-0025

Warren Stevens, T. Philipson, Yanyu Wu, Connie Chen, D. Lakdawalla

{"title":"A Cost-Benefit Analysis of Using Evidence of Effectiveness in Terms of Progression Free Survival in Making Reimbursement Decisions on New Cancer Therapies","authors":"Warren Stevens, T. Philipson, Yanyu Wu, Connie Chen, D. Lakdawalla","doi":"10.1515/fhep-2013-0025","DOIUrl":"https://doi.org/10.1515/fhep-2013-0025","url":null,"abstract":"Abstract Payers increasingly require evidence of a statistically significant difference in overall survival (OS) for reimbursement of new cancer therapies. At the same time, it becomes increasingly costly to design clinical trials that measure OS endpoints instead of progression-free survival (PFS) endpoints. While PFS is often an imperfect proxy for OS effects, it is also faster and cheaper to measure accurately. This study develops a general cost-benefit framework that quantifies the competing trade-offs of the use of PFS versus that of OS in oncology reimbursement. We then apply this general framework to the illustrative case of metastatic renal cell carcinoma (mRCC). In the particular case of mRCC, the framework demonstrates that the net benefit to society from basing reimbursement decisions on PFS endpoints could be between $271 and $1271 million in the United States, or between €171 and €1128 million in Europe. In longevity terms, waiting for OS data in this case would result in a net loss of 3549–14,557 life-years among US patients, or 6785–27,993 life-years for European patients. While more stringent standards for medical evidence improve accuracy, they also impose countervailing costs on patients in terms of foregone health gains. These costs must be weighed against the benefits of greater accuracy. The magnitudes of the costs and benefits may vary across tumor types and need to be quantified systematically.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":"4 1","pages":"21 - 52"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75709695","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}

引用次数: 5