Health Economics Review最新文献

{"title":"Economic costing methodologies for drug-resistant bacterial infections in humans in low-and middle-income countries: a systematic review.","authors":"Edward Masoambeta, Charity Mkwanda, Edna Ibrahim, Kenneth Chizani, Chikondi Chapuma, Priscilla Dzanja, Edson Mwinjiwa, Raphael Chanda, Mirfin Mpundu, Luigia Scudeller, Tomislav Kostyanev, Finola Leonard, Surbhi Malhotra-Kumar, Fiammetta Bozzani, Eric Umar, Rajab Mkakosya, Chantal Morel, Chisomo Msefula, Jobiba Chinkhumba","doi":"10.1186/s13561-025-00644-5","DOIUrl":"10.1186/s13561-025-00644-5","url":null,"abstract":"<p><strong>Background: </strong>This review examined methodologies used to cost the impact of antimicrobial resistance (AMR) infections in humans from household and health system perspectives. Although extensive research has been conducted on the clinical AMR burden in low- and middle-income countries (LMICs) in terms of prevalence and other drivers of antimicrobial resistance, there is increased misuse and overuse of antibiotics which increases the risk of AMR infections compared to high-income countries. Lack of comprehensive estimates on economic costs of AMR in LMICs due to lack of standard methodologies that incorporate time biases and inference for instance, may negatively affect accuracy and robustness of results needed for reliable and actionable policies.</p><p><strong>Methods: </strong>We conducted a systematic review of studies searched in PubMed and other electronic databases. Only studies from LMICs were included. Data were extracted via a modified Covidence template and a Joanna Briggs Institute (JBI) assessment tool for economic evaluations to assess the quality of the papers.</p><p><strong>Results: </strong>Using PRISMA, 2542 papers were screened at the title and abstract levels, of which 148 were retrieved for full-text review. Of these, 62 articles met the inclusion criteria. The articles had a quality assessment score averaging 85%, ranging from 63 to 100%. Most studies, 13, were from China (21%), followed by 8 from South Africa (13%). Tuberculosis (TB), general bacterial, and nosocomial infection costs are the most studied, accounting for 40%, 39%, and 6%, respectively with TB common in South Africa than the rest of the countries. The majority of the papers used a microcosting approach (71%), followed by gross costing (27%), while the remainder used both. Most studies analyzed costs descriptively (61%), followed by studies using regression-based techniques (17%) and propensity score matching (5%), among others.</p><p><strong>Conclusion: </strong>Overall, the use of descriptive statistics without justification, limited consideration for potential data challenges, including confounders, and short-term horizons suggest that the full AMR cost burden in humans in LMICs has not been well accounted for. Given the limited data available for these studies, the use of a combination of methodologies may help triangulate more accurate and policy-relevant estimates. While the resources to conduct such cost studies are limited, the use of modeling costs via regression techniques while adjusting for cofounding could help maximize robustness and better estimate the vast and varied burden derived directly and indirectly from AMR.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"47"},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applications of artificial intelligence and the challenges in health technology assessment: a scoping review and framework with a focus on economic dimensions.","authors":"Maryam Ramezani, Ahad Bakhtiari, Rajabali Daroudi, Mohammadreza Mobinizadeh, Ali Akbar Fazaeli, Alireza Olyaeemanesh, Hamid R Rabiee, Maryam Ramezani, Hakimeh Mostafavi, Saharnaz Sazgarnejad, Sanaz Bordbar, Amirhossein Takian","doi":"10.1186/s13561-025-00645-4","DOIUrl":"10.1186/s13561-025-00645-4","url":null,"abstract":"<p><strong>Background: </strong>Health Technology Assessment (HTA) is a crucial tool for evaluating the worth and roles of health technologies, and providing evidence-based guidance for their adoption and use. Artificial intelligence (AI) can enhance HTA processes by improving data collection, analysis, and decision-making. This study aims to explore the opportunities and challenges of utilizing artificial intelligence (AI) in health technology assessment (HTA), with a specific focus on economic dimensions. By leveraging AI's capabilities, this research examines how innovative tools and methods can optimize economic evaluation frameworks and enhance decision-making processes within the HTA context.</p><p><strong>Methods: </strong>This study adopted Arksey and O'Malley's scoping review framework and conducted a systematic search in PubMed, Scopus, and Web of Science databases. It examined the benefits and challenges of AI integration into HTA, with a focus on economic dimensions.</p><p><strong>Findings: </strong>AI significantly enhances HTA outcomes by driving methodological advancements, improving utility, and fostering healthcare innovation. It enables comprehensive assessments through robust data systems and databases. However, ethical considerations such as biases, transparency, and accountability emphasize the need for deliberate planning and policymaking to ensure responsible integration within the HTA framework.</p><p><strong>Conclusion: </strong>AI applications in HTA have significant potential to enhance health outcomes and decision-making processes. However, the development of robust data management strategies and regulatory frameworks is essential to ensure effective and ethical implementation. Future research should prioritize the establishment of comprehensive frameworks for AI integration, fostering collaboration among stakeholders, and improving data quality and accessibility on an ongoing basis.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"46"},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Tobacco Use and Prevention Laws on Regional Cigarette Sales: An Analysis of Provincial Disparities and Convergence Patterns in Spain.","authors":"Aida Galiano, Josep Blasco, Juan Manuel Martín-Álvarez, Miguel Angel Del Arco Osuna","doi":"10.1186/s13561-025-00641-8","DOIUrl":"10.1186/s13561-025-00641-8","url":null,"abstract":"<p><p>This paper aims to examine regional disparities in cigarette sales that occurred after the implementation of two laws regulating the sale and use of tobacco products in Spain. These laws became effective in December 2005 (Act 28/2005) and December 2010 (Act 42/2010). Furthermore, it provides a framework for studying spill-over effects pertaining to cross-border strategies that may alter how frontier regions react to the implementation of the laws. Provincial official data from January 2005 to December 2010 for legal cigarette sales has been divided into two distinct periods based on these regulatory changes. We apply Phillips and Sul's club convergence test for absolute and withing-group convergence. Our findings indicate that although the 2010 law helped to reduce disparities across provinces, there was no complete convergence, meaning that the impact of the law was not uniform across all regions, especially in frontier regions with France and Gibraltar. However, we observe evidence of convergence within groups of similar entities, and the number of these groups decreased over time. This outcome highlights several interesting insights. Firstly, it supports what previous studies have established, indicating that the 2010 law was more restrictive than the one in 2005. Secondly, the effectiveness of these regulations can vary in border regions due to different laws in neighboring countries, resulting in unintended consequences that can reduce the impact of tobacco control policies, a result that is also in line with the literature. Finally, it is important to have harmonized regulations to ensure greater effectiveness in controlling tobacco use.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"44"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valuation of informal care for the old-aged with disabilities in China-a discrete choice experiment approach.","authors":"Zhan Zhao, Shuaizhen Chen, Fengyi Sun, Wenjing Cheng, Chen Chen, Elizabeth Maitland, Stephen Nicholas, Jian Wang, Lei Si, Jialong Tan","doi":"10.1186/s13561-025-00642-7","DOIUrl":"10.1186/s13561-025-00642-7","url":null,"abstract":"<p><strong>Background: </strong>The rapidly aging population will lead to a surge in demand for long-term care services in China. Reinforced by the cultural norms, and with inadequate nursing resources and social care facilities, long-term care in China is primary the responsibility of the immediate family. Despite the central role of family caregivers, little is known about their preferences and how they value different types of caregiving tasks. This study provides new evidence on the economic valuation of informal care in the Chinese context.</p><p><strong>Methods: </strong>Discrete choice experiment (DCE) and mixed logit models (MXL) were employed to measure the preferences for an economic value of different types of informal care (daily care, medical care and companion care) among old-aged adults in China. 466 participants from nationwide were recruited and interviewed.</p><p><strong>Results: </strong>Among the respondents, 19.5% always chose to receive the free care package and 15.2% always chose to obtain cash compensation for informal caregiving. Of the three care tasks, participants placed the highest value on daily care (RMB48.202 ($13.26 PPP) per hour) and the lowest value on companion care (RMB18.608 ($5.12 PPP) per hour). The probability of choosing cash compensation rose when compensation increased and fells when the care time increased. The preferences for assistance varied significantly by individual's demographic and health-related characteristics. Female respondents preferred for care packages relative to males; farmers and current caregivers preferred cash compensation; married participants had low preferences for companion care; participants from western region had low preferences for medical care.</p><p><strong>Discussion: </strong>Our findings confirm the importance of cash compensation in retaining caregivers to provide informal care. The heterogeneity of preferences among different groups is significantly influenced by their sex, occupation, caregiving, marital status and region. Our study supports the promotion of cash compensation to informal caregivers and different levels of incentives for different groups of informal caregivers.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"45"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health economic evaluations of diagnostic tests for tuberculosis: a narrative review.","authors":"Cemre Arpa, Ahmed Abd El Wahed, Serap Aydin, Prakash Ghosh, Dinesh Mondal, Lydia Nakiyingi, Julius Boniface Okuni, Sophie Schneitler, Manfred Weidmann, Martin Siegel","doi":"10.1186/s13561-025-00639-2","DOIUrl":"10.1186/s13561-025-00639-2","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis is the leading cause of death from infectious diseases globally. Non-specific symptoms and limitations of existing diagnostics involve challenges for informed policymaking and clinical practice. This paper reviews common practices in reporting the selection and definition of cost and effect parameters, and in reporting the translation of effect parameters into utility and disability weights, in health economic evaluations of TB diagnostic tests.</p><p><strong>Methods: </strong>A targeted literature search in PubMed, Cochrane Library, Web of Science, and Google Scholar identified health economic evaluations of diagnosis and population screening strategies for TB.</p><p><strong>Results: </strong>We found 28 studies comprising 11 cost-effectiveness and 17 cost-utility analyses. Observed patient data were used in 6 studies, 22 relied solely on model-based evaluations. Variations in prevalence, accuracy, and utility parameters were common, the Consolidated Health Economic Evaluation Reporting Standards terminology for costing was only used in 8 out of 28 studies.</p><p><strong>Discussion: </strong>Future studies should state the exact type of TB studied, as it can manifest in multiple organs, remain inactive for long periods of time, and since different diagnostics can perform differently depending on the site involved it may influence test accuracies. Additionally, potential impacts of sequential diagnostics on test accuracy and the cost of inaction should receive more attention.</p><p><strong>Conclusion: </strong>Precise terminology and transparent definitions of parameters and methodology in health economics evaluations are necessary to generate evidence that guides policymakers and supports clinical decision-making in the context of TB.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"43"},"PeriodicalIF":2.7,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cost-effectiveness analysis comparing single-inhaler extrafine beclomethasone/formoterol/glycopyrronium bromide against other SITTs in adult patients with uncontrolled asthma in England.","authors":"Ioanna Vlachaki, Simon Donhauser, Alessandra Madoni, Marielle van der Deijl, Yuvraj Sharma, Dimitrios Tzelis, Ines Guerra","doi":"10.1186/s13561-025-00640-9","DOIUrl":"10.1186/s13561-025-00640-9","url":null,"abstract":"<p><strong>Background: </strong>In patients with asthma uncontrolled by a medium or high-strength (MS/HS) inhaled corticosteroid (ICS) plus long-acting β2-agonist (LABA), according to Global Initiative for Asthma (GINA) guidelines, a maintenance therapy option is the addition of a long-acting muscarinic antagonist (LAMA) via single-inhaler triple therapy (SITT). Evidence has previously been published on the cost-effectiveness of a SITT extra fine formulation of beclomethasone, formoterol and glycopyrronium bromide (BDP/FOR/GLY) vs. dual ICS/LABA combination, using data from two 52-week clinical trials (TRIMARAN and TRIGGER). However, there is limited evidence on the comparative cost-effectiveness of SITTs. The current analysis evaluated the cost-effectiveness of BDP/FOR/GLY versus other SITTs, in the UK setting.</p><p><strong>Methods: </strong>Markov cohort state-transition model was developed to investigate the cost-effectiveness of BDP/FOR/GLY Medium Strength (MS) vs. fluticasone, umeclidinium, and vilanterol (FF/UMEC/VI) MS and, BDP/FOR/GLY High Strength vs. FF/UMEC/VI HS and vs. indacaterol acetate, glycopyrronium bromide, and mometasone (IND/GLY/MF) HS. A network meta-analysis was performed to estimate comparative efficacy of BDP/FOR/GLY against other SITTs. The model analyzed cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER), net monetary benefit (NMB), and was developed from the perspective of England National Health Service (NHS) and Prescribed Specialized Services expenditure (2022 costs). Uncertainty of the inputs was estimated using one-way and probabilistic sensitivity analyses.</p><p><strong>Results: </strong>BDP/FOR/GLY MS was projected to be a dominant treatment alternative against FF/UMEC/VI MS (£5,121 less costly, gained 0.065 additional QALYs). Similarly, BDP/FOR/GLY HS was a dominant treatment alternative against FF/UMEC/VI HS (£143, 0.003 additional QALYs) and IND/GLY/MF HS (£692 less costly, gained 0.023 additional QALYs). BDP/FOR/GLY MS and HS had 77.1%, 51.3%, and 61.2% likelihoods to be cost-effective vs. FF/UMEC/VI MS, FF/UMEC/VI HS, and IND/GLY/MF HS at the defined willingness-to-pay (WTP) threshold of £20,000 per QALY gained, respectively.</p><p><strong>Conclusions: </strong>BDP/FOR/GLY MS and HS were a dominant treatment alternative compared with FF/UMEC/VI, both MS and HS, and IND/GLY/MF HS in patients with asthma uncontrolled by ICS/LABA.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"42"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost effectiveness of imaging strategies in the emergency department for the diagnostic workup of community-acquired pneumonia: a real-life retrospective study.","authors":"Sabrina Kepka, Kevin Zarca, Mickaël Ohana, Louise Hoffbeck, Charlène Heimann, Pierrick Le Borgne, François Severac, Joris Muller, Erik-André Sauleau, Pascal Bilbault, Isabelle Durand Zaleski","doi":"10.1186/s13561-025-00625-8","DOIUrl":"10.1186/s13561-025-00625-8","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare the length of stay (LOS) and costs of diagnostic workup by Ultra Low Dose (ULD) chest computed tomography and radiography for patients treated for a community-acquired pneumonia (CAP) in the emergency department (ED).</p><p><strong>Methods: </strong>We conducted a real-life retrospective study of patients treated for a CAP in two ED between March 1, 2019 and February 29, 2020. We estimated length of stay (LOS) as the difference between ED discharge and entry times, total hospital costs at 60 days including ED, initial admissions and readmissions. Patients with initial radiography were compared with patients with initial ULD CT using inverse probability weighing of the propensity score calculated from demographic variables, vital parameters and clinical presentation. We calculated the incremental cost effectiveness ratio as the difference between costs and the difference between LOS. Variability of the results was assessed using non-parametric bootstrapping.</p><p><strong>Results: </strong>We included 1609 consecutive patients, 1476 patients with radiography and 133 patients with ULD CT. The average costs were respectively €4317 [3483; 5067] and €4223 [4034; 4612] with 11.9 [10.1; 13.2] and 11.7 [11.5; 12.2] hours of LOS in the ED for chest radiography and ULD chest CT respectively, resulting in lower costs of € -94 [-870; 819] and a decreased LOS of 12 [-108; 76.9] minutes in favor of ULD chest CT.</p><p><strong>Conclusions: </strong>In this real-life study, the management of CAP in ED by ULD chest CT compared with chest radiography resulted in lower costs without increasing LOS.</p><p><strong>Trial registration: </strong>This study was registered with the Clinical Trials Registry (NCT05140408).</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"41"},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI integration in energy management: enhancing efficiency in Italian hospitals.","authors":"Paolo Pariso, Michele Picariello, Alfonso Marino","doi":"10.1186/s13561-025-00638-3","DOIUrl":"10.1186/s13561-025-00638-3","url":null,"abstract":"<p><strong>Background: </strong>In the rapidly evolving healthcare landscape, artificial intelligence (AI) is revolutionizing hospital operations by enhancing operational efficiency and patient care. This study focuses on the integration of AI in energy management within Italian hospitals and the role of energy managers.</p><p><strong>Methods: </strong>A comprehensive questionnaire was developed to understand current practices, challenges, and opportunities in AI adoption within hospital energy management. The study targeted regions in Italy with the highest concentration of hospital energy managers. A quantitative approach was employed, and the collected data were statistically analysed for reliability and validity using SPSS.</p><p><strong>Results: </strong>The analysis revealed significant benefits of integrating AI in energy management, including optimized energy consumption, predictive maintenance, and greater sustainability. Energy managers' roles are evolving to leverage AI technologies effectively, ensuring compliance with energy regulations and promoting eco-friendly practices.</p><p><strong>Conclusions: </strong>This research underscores AI's transformative potential in creating smarter, greener, and more efficient hospital environments. The findings highlight the importance of adopting AI-driven energy management solutions to enhance hospital efficiency. Future trends indicate further advancements in AI applications, necessitating ongoing adaptation and training for energy managers to exploit these technologies fully.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"40"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Budgetary impact of increasing use of peritoneal dialysis over haemodialysis in Spain.","authors":"Gemma Barbado, Carla Garí, Asís Ariznavarreta, Neus Vidal-Vilar, Carlos Alvarez","doi":"10.1186/s13561-025-00633-8","DOIUrl":"https://doi.org/10.1186/s13561-025-00633-8","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) represents a significant public health concern, due to its high prevalence and incidence, as well as its substantial socio-economic costs. In Spain, estimates suggest that the direct healthcare costs of CKD will increase by 13.8% from 2022, which is why the cost of kidney replacement treatment (KRT) programs efficiency and sustainability is under constant analysis. Our analysis aimed to estimate the cost associated with peritoneal dialysis (PD) compared to hemodialysis (HD) from the Spanish National Health System (NHS) perspective and to evaluate the budgetary impact of an increase in the use of PD in our healthcare system environment.</p><p><strong>Methods: </strong>The number of patients eligible for KRT was calculated based on the total Spanish population and the incidence and prevalence of patients with end-stage renal disease (ESRD). Patients receiving each modality, type of dialysis, and location of dialysis were estimated. The annual costs of each dialysis modality were calculated and included the cost of dialysis sessions and additional costs (including the cost of peritoneal and vascular access, hospitalisation costs due to potential complications of dialysis, cost of health care personnel, and cost of health care transport used by patients). Population data and costs (€, 2024) were obtained from the Spanish databases and a nephrologist validated the assumptions. Budget impact analysis assessed the incremental budget impact between the current scenario and the alternative scenario, where 30% of incident patients on scheduled HD would receive PD.</p><p><strong>Results: </strong>We estimated that in Spain, there are 27,281 prevalent dialysis patients (3,141 receiving PD and 24,140 receiving HD/HDF) and 6,052 incident dialysis patients (1,173 receiving PD and 4,879 HD/HDF). The cost of dialysis amount to €1,555,573,771 (€141,361,374 PD and €1,414,212,397 to HD) in the current scenarios and to €1,540,584,011 (€167,593,157 PD and €1,372,990,854 HD) in the alternative scenario, resulting in a saving of €14,989,760 when 30% of the patients scheduled to receive HD would instead receive PD during the first year.</p><p><strong>Conclusions: </strong>The increased use of PD in Spain improves the system's efficiency, generating significant savings in the treatment of ESRD patients from the NHS perspective.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"39"},"PeriodicalIF":2.7,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and hospitalization costs of chronic kidney disease in Romania.","authors":"Ildiko Aliz Bradacs, László-István Bába, László Lorenzovici, Andreea Mihaela Precup, Szabolcs Farkas- Ráduly, Gyongyi Tar, Vasile Nastase, Lucia Georgeta Daina, Raul Bozu, Gyula Jozsef Nagy, Dimitrie Cristian Siriopol, Dorel Sandesc, Ovidiu Horea Bedreag, Florin Buicu, Gabriel Mircescu, Gener Ismail","doi":"10.1186/s13561-025-00614-x","DOIUrl":"https://doi.org/10.1186/s13561-025-00614-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease or chronic renal failure is a progressive condition defined as abnormalities of kidney structure or function, present for longer than 3 months. It is estimated to affect more than 10% of the general population worldwide. Management of CKD represents an especially large burden for the health systems of low- and middle-income countries, and it has been recognized as a leading public health problem. Previous research articles reported an age-adjusted prevalence of 7.6% for Romania, but the hospital costs generated by CKD are unknown. The present research article aimed to measure the hospital costs and one-year national healthcare budget impact of CKD, excepting the chronic care costs of RRTs.</p><p><strong>Methods: </strong>In this retrospective study we reviewed the electronic health records of 4 University, 3 County and 5 City hospitals from 1^st of January 2019 to 31^st of December 2019 in order to calculate costs related to hospitalization due to chronic kidney disease. Inclusion criteria were defined as: CKD-related diagnostic codes or dialysis-related procedures in medical cases (without surgical interventions). KDIGO severity grades 1-5 were considered, including dialysis costs. The costs generated by the chronic care of RRTs were not considered here. Hospitalization cost calculation was based on hospital controlling methodology including direct, indirect and overhead costs. For the national-level burden study, we analyzed the health claim records of all public and private hospitals for 2019.</p><p><strong>Results: </strong>In 2019 a total number of 229 276 cases reported chronic kidney disease in Romania. The average hospital costs per patient episode was €917.1, with significantly higher costs in cases with complications or higher severity grades. The total hospitalization cost-related budget impact in 2019 was €210 million.</p><p><strong>Conclusions: </strong>The high hospitalization costs of CKD (representing 2.6% of the NHIH budget, not considering the funds for sick leave) cause major impact on the national health payer`s budget. Preventive strategies, early diagnosis and management as well as health education measures could act as means of mitigation. Our results should warn the public health policy decision makers about the importance of this disease.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"38"},"PeriodicalIF":2.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}