Cost Effectiveness and Resource Allocation最新文献

{"title":"Inequalities in health care use among patients with arthritis in China: using Andersen's Behavioral Model.","authors":"Jinyao Liu, Yi Tang, Peiyao Zheng, Mingsheng Chen, Lei Si","doi":"10.1186/s12962-024-00572-x","DOIUrl":"10.1186/s12962-024-00572-x","url":null,"abstract":"<p><strong>Background: </strong>This study sought to assess socioeconomic-related inequalities in health care use among arthritis patients in China and to analyze factors associated with this disparity.</p><p><strong>Methods: </strong>This study used data from the 2018 China Health and Retirement Longitudinal Study. 3255 arthritis patients were included. The annual per capita household expenditure was used to divide individuals into five categories. We calculated actual, need-predicted, and need-standardized distributions of health care use by socioeconomic groups among people with arthritis. The concentration index (Cl) was used to assess inequalities in health service use. Influencing factors of inequalities were measured with the decomposition method.</p><p><strong>Results: </strong>The outpatient and inpatient service use rates among 3255 arthritis patients were 23.13% and 21.41%, respectively. The CIs for actual outpatient and inpatient services use were 0.0449 and 0.0985, respectively. The standardized CIs for both outpatient and inpatient services use increase (CI for outpatient services use = 0.0537; CI for inpatient services use = 0.1260), indicating the emergence of a significant pro-rich inequity. Annual per capita household expenditure was the chief positive contributor to inequity for both outpatient (104.45%) and inpatient services use (105.74%), followed by infrequently social interaction (22.60% for outpatient services use) and Urban Employee Basic Medical Insurance (UEBMI) (11.90% for inpatient services use). By contrast, UEBMI also provided a high negative contribution to outpatient services use (-15.99%).</p><p><strong>Conclusions: </strong>There are significant pro-rich inequalities in outpatient and inpatient services use among patients with arthritis, which are exacerbated by widening economic gaps. Interventions to address inequalities should start by improving the economic situation of lower socioeconomic households.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"61"},"PeriodicalIF":1.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Willingness to pay for cataract surgery and its associated factors in selected medical centers in Urmia, Iran.","authors":"Fatemeh Rahmanzadeh, Cyrus Alinia, Behrouz Fathi, Hasan Yusefzadeh","doi":"10.1186/s12962-024-00570-z","DOIUrl":"https://doi.org/10.1186/s12962-024-00570-z","url":null,"abstract":"<p><strong>Introduction: </strong>Cataracts represent a significant public health issue and are the most prevalent vision disorder following refractive errors. They can restrict the economic, social, and psychological activities of those affected, thereby diminishing their quality of life. This study was undertaken to examine the willingness to pay for cataract surgery and the factors influencing this decision in selected medical centers in Urmia. The two-stage Heckman model was utilized to aid decision-making in financing this service.</p><p><strong>Methods: </strong>This research was a descriptive-analytical study evaluating the economic aspects of health interventions, conducted from the patient's perspective. In this cross-sectional study, a sample size of 217 patients with cataract issues was selected using Michel Carson's table. These patients were from Imam Khomeini Hospital and Aftab Urmia Surgery Center in 2023. Data was collected using a conditional valuation approach to determine the maximum amount patients were willing to pay, as gathered through a questionnaire. The factors influencing the willingness to pay for cataract surgery were estimated using the two-stage Heckman regression model. The final effect value of each variable was calculated using Stata version 14 software.</p><p><strong>Results: </strong>In this study, 81.11% of participants (176 individuals) expressed a willingness to pay for cataract surgery, with the average amount they were willing to pay being $206.3. However, out of the 217 respondents, 41 rejected the proposed amounts and were not willing to pay anything. The results of the Hemken model indicated that the income of patients and the size of their households significantly influenced their willingness to pay for cataract surgery. However, other variables investigated did not have a significant impact.</p><p><strong>Conclusion: </strong>The study results revealed a significant influence of both income and household size on the likelihood of willingness to pay, as well as the extent of willingness to pay for cataract surgery. Consequently, it is crucial to formulate policies and provisions that guarantee access to cataract services, particularly for individuals from large households with low income and high costs.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"60"},"PeriodicalIF":1.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic aspects of prolonged home video-EEG monitoring: a simulation study.","authors":"Tatiana Vander, Rozaliya Bikmullina, Naomi Froimovich, Tatiana Stroganova, Andreea Nissenkorn, Tal Gilboa, Dawn Eliashiv, Dana Ekstein, Mordekhay Medvedovsky","doi":"10.1186/s12962-024-00568-7","DOIUrl":"10.1186/s12962-024-00568-7","url":null,"abstract":"<p><strong>Introduction: </strong>Video EEG monitoring (VEM) is an important tool for characterizing clinical events suspected as seizures. It is also used for pre-surgical workups in patients with drug-resistant epilepsy (DRE). In-hospital VEM high cost, long admission waiting periods and some other inconveniences led to an interest in home VEM (HVEM). However, because antiseizure medications cannot be reduced at home, HVEM may require longer monitoring. While the economic aspect is one of the main motivations for HVEM, the cost of HVEM lasting several weeks has not been assessed.</p><p><strong>Methods: </strong>We modeled the cost of HVEM for 8 weeks and compared it to the cost of 1-week in-hospital VEM. Additionally, we modeled the per-patient cost for a combination of HVEM and in-hospital VEM, considering that if in a proportion of patients HVEM fails to achieve its goal, they should undergo in-hospital VEM with drug reduction.</p><p><strong>Results: </strong>The average cost of HVEM up to 4-6 weeks of monitoring was lower than that for the 1-week in-hospital VEM. Combining the 3-week HVEM with 1-week in-hospital VEM (if needed) reduced the per-patient cost by 6.6-28.6% as compared to the situation when all the patients with DRE were referred to the in-hospital VEM.</p><p><strong>Conclusions: </strong>A prolonged intermittent HVEM can be cost-effective, especially if the minimal seizure frequency is about one seizure per week. The study findings support directing efforts into clinical trials and technology development.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"59"},"PeriodicalIF":1.7,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficiency of clinical laboratories: the case of Kerman province.","authors":"Zohreh Shaker, Zainab Shaker, Mohsen Barouni, Asma Sabermahani","doi":"10.1186/s12962-024-00564-x","DOIUrl":"10.1186/s12962-024-00564-x","url":null,"abstract":"<p><strong>Background: </strong>Medical diagnostic laboratories are an essential work environment that plays an important role in diagnosing, treating, and being sensitive to diseases. One way to evaluate laboratories' performance is to calculate their efficiency. This study investigates the efficiency of laboratories that are related to health centers in the south of Iran.</p><p><strong>Methods: </strong>This study was conducted in 2021. The input numbers include: the number of technical personnel and the number of cell counters, and the output data includes: the scores obtained from the level 2 health laboratory evaluation list. And efficiency was calculated with DEAP software. The analysis is accomplished by the assumption of input-oriented.</p><p><strong>Findings: </strong>The efficiency of laboratories of Orzueeyeh and Ravar Cities had the highest efficiency with the assumption of variable returns to scale efficiency 1, and the model of all laboratories is the laboratory of Ravar City. The laboratories of Kuhbanan and Rabor cities had the lowest efficiency with the assumption of variable returns to scale efficiency of 0.859 and 0.899, respectively. The average scale efficiency, Variable returns to scale, and constant returns to scale for laboratories in the cities of Kerman province are 0.842, 0.943, and 0.895, respectively.</p><p><strong>Conclusions: </strong>To increase the efficiency of laboratories, significant resources and funds should be used, as well as few studies have been done on the efficiency of laboratories, which requires more attention.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"58"},"PeriodicalIF":1.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impacts of basic medical insurance for urban-rural residents on the perception of social equity in China.","authors":"Xin Wang, Xiangyu Chen, Lele Li, Deshui Zhou","doi":"10.1186/s12962-024-00565-w","DOIUrl":"10.1186/s12962-024-00565-w","url":null,"abstract":"<p><strong>Background: </strong>Based on CSS 2019 data, this article analyzes the impact of Basic Medical Insurance for Urban and Rural Residents (BMIUR) on perceived social equity of residents.</p><p><strong>Method: </strong>Using the CSS data of 2019, this article analyzes the influence of BMIUR on the perception of social equity of residents, on the basis of 2SLS model and mediating effect model.</p><p><strong>Results: </strong>We find that BMIUR has a significantly positive impact on the perception of social equity. That is to say, BMIUR can improve residents' evaluation of social equity and further promote the level of social equity, which makes residents more happiness. The conclusion remains valid after using robustness test and propensity score matching to conduct counterfactual reasoning. The discussion of mechanism indicates that the influence of BMIUR is mediated by enhancing social capital, improving satisfaction of income distribution and reducing self-paid medical expenses. This study also finds that the influence of BMIUR is more obvious in the low-income, low-skilled and mid-west groups.</p><p><strong>Conclusion: </strong>The reform of the medical security system should be regarded as a foothold for improving people's well-being and promoting social equity; Expanding people's social capital through multiple channels and improving income distribution mechanisms; Strengthen vocational skills training, especially to provide more public services and social security for low-income groups, low-skilled groups, and groups in the western region of China, in order to improve the welfare and policy effectiveness of China's social security reform.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"57"},"PeriodicalIF":1.7,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11298076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost and efficiency analysis in Iranian primary health centers: a micro costing and data envelopment analysis.","authors":"Alireza Mahboub-Ahar, Somayeh Khanlari, Hasan Yusefzadeh, Alireza Ghorbani","doi":"10.1186/s12962-024-00567-8","DOIUrl":"10.1186/s12962-024-00567-8","url":null,"abstract":"<p><strong>Background: </strong>Health Complex Model was implemented to provide primary health care services in urban, especially in slum areas. As a pilot at a provincial level, Chamran Health Complex offers healthcare for more than 57,000 residents of Tabriz. Despite the necessity of cost information in healthcare decision-making, there was limited knowledge about the unit cost of services. This study aims to analyze the cost and efficiency of health centers.</p><p><strong>Methods: </strong>Activity-Based Costing method with direct and step-down allocation methods was adopted. We estimated unit costs in a hypothetical scenario according to national standards to quantify the gap between current and standard practice. Input-oriented Data Envelopment Analysis was administered to measure the efficiency of health centers.</p><p><strong>Results: </strong>The total cost of the complex was $2,841,897, of which 67% ($1910373) and 33% ($931523) were accounted for direct and indirect costs, respectively. The vaccination center had the lowest ($9), and the occupational health center had the highest average unit cost ($76). The average technical efficiency of the health centers was 0.519, where the HC1 and HC3 showed the best performance.</p><p><strong>Conclusion: </strong>There is remarkable variability in service costs across health centers, which must be addressed in performance management and contracting practices. Although we found a gap between current and standard practice in terms of staff and facilities according to national standards, Chamran Health Complex has an untouched capacity that can be utilized with better planning and without incurring additional costs. It raises the need for revising national standards by the Iran Ministry of Health.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"56"},"PeriodicalIF":1.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The economic burden of bipolar disorder: a case study in Southern Iran.","authors":"Zohreh Shaker, Zahra Goudarzi, Ramin Ravangard, Zinab Shaker, Arvin Hedayati, Khosro Keshavarz","doi":"10.1186/s12962-024-00560-1","DOIUrl":"10.1186/s12962-024-00560-1","url":null,"abstract":"<p><strong>Background: </strong>Bipolar Disorder (BD) imposes considerable economic and social burdens on the community. Therefore, the present study aimed to determine the economic burden of bipolar disorder in patients referred to single-specialty psychiatric hospitals at the secondary and tertiary care level in 2022.</p><p><strong>Methods: </strong>This partial economic evaluation was conducted as a cross-sectional study in the south of Iran in 2022, and 916 patients were selected through the census method. The prevalence-based and bottom-up approaches were used to collect cost information and calculate the costs, respectively. The data on Direct Medical Costs (DMC), Direct Non-Medical Costs (DNMC), and Indirect costs (IC) were obtained using the information from the patients' medical records and bills as well as the self-reports by the patients or their companions. The human capital approach was also used to calculate IC.</p><p><strong>Findings: </strong>The results showed that in 2022, the annual cost of bipolar disorder was $4,227 per patient. The largest share of the costs was that of DMC (77.66%), with hoteling and ordinary beds accounting for the highest expenses (55.40%). The shares of DNMC and IC were 6.37% and 15.97%, respectively, and the economic burden of the disease in the country was estimated at $2,799,787,266 as well.</p><p><strong>Conclusion: </strong>In general, the costs of bipolar disorder treatment could impose a heavy economic burden on the community, the health system, the insurance system, and the patients themselves. Considering the high costs of hoteling and ordinary beds, it is suggested that hospitalization of BD patients be reduced by managing treatment solutions along with prevention methods to reduce the economic burden of this disease. Furthermore, in order to reduce the costs, proper and fair distribution of psychiatrists and psychiatric beds as well as expansion of home care services and use of the Internet and virtual technologies to follow up the treatment of these patients are recommended.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"55"},"PeriodicalIF":1.7,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Net costs of breast cancer in Colombia: a cost-of-illness study based on administrative claims databases.","authors":"Gabriel Fernando Torres, Brigitte Alejandra Alarcón, Juan Manuel Reyes-Sanchez, Natalia Castaño-Gamboa, Giancarlo Buitrago","doi":"10.1186/s12962-024-00562-z","DOIUrl":"10.1186/s12962-024-00562-z","url":null,"abstract":"<p><strong>Background: </strong>Breast Cancer (BC) is associated with substantial costs of healthcare; however, real-world data regarding these costs in Colombia is scarce. The contributory regime provides healthcare services to formal workers and their dependents and covers almost half of the population in Colombia. This study aims to describe the net costs of healthcare in women with BC covered by the contributory regime in Colombia in 2019 from the perspective of the Colombian Health System.</p><p><strong>Methods: </strong>The main data source was the Capitation Sufficiency Database, an administrative database that contains patient-level data on consumption of services included in the National Formulary (PBS, in Spanish Plan de Beneficios en Salud). Data on consumption of services not included in the PBS (non-PBS) were calculated using aggregated data from MIPRES database. All direct costs incurred by prevalent cases of BC, from January 1 to December 31, 2019, were included in the analysis. The net costs of the disease were estimated by multiplying the marginal cost and the expected number of cases with BC by region and age group. Marginal costs were defined as the costs of services delivered to patients with BC after subtracting the expected costs of health services due to age, comorbidity burden or region of residence. To calculate these costs, we used Propensity Score Matching in the main analysis. All costs were expressed in 2019 international dollars. Productivity losses, transportation expenses, and caregiving costs were not included.</p><p><strong>Results: </strong>A total of 46,148 patients with BC were identified. Total net costs were $387 million (95% CI $377 to $396 million), 60% associated with non-PBS services. Marginal costs were $8,366 (95% Confidence Interval $8,170 to $8,573), with substantial variations between regions age groups (from $3,919 for older patients in the Amazonia region to $10,070 for younger patients in the Pacific region). The costs for PBS services were higher for ambulatory services and for patients who died during 2020.</p><p><strong>Conclusions: </strong>BC imposes a substantial economic burden for the Colombian Health System with important variations in net costs between regions and age groups. Patients near death and ambulatory services were associated with higher costs of healthcare.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"54"},"PeriodicalIF":1.7,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valuating the efficiency of social security and healthcare in OECD countries from a sustainable development.","authors":"Li-Wen Lee, Yung-Ho Chiu, Fan-Peng Liu, Tai-Yu Lin, Tzu-Han Chang","doi":"10.1186/s12962-024-00555-y","DOIUrl":"10.1186/s12962-024-00555-y","url":null,"abstract":"<p><p>Under the goal of sustainable development, coping with the increase in social security and healthcare expenses caused by population aging is becoming increasingly important, but it is rare in the literature to evaluate the impact of social security efficiency on healthcare efficiency. This research uses the dynamic SBM two-stage model to observe the efficiencies of social security and healthcare in OECD countries. There are two findings as follows. First, the higher social security efficiency is, the better is the healthcare efficiency of countries with lower per capita GDP. Second, higher social security efficiency of National Health Service (NHS) countries denote better healthcare efficiency. When the financial source of the social security system is taxation, then it is more likely to bring higher efficiency to healthcare.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"53"},"PeriodicalIF":1.7,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Medical expenses and its determinants in female patients with urological disorder : Sewon Park.","authors":"Sewon Park, Seokmin Ji, Hyunseo Lee, Hangseok Choi, Mankyu Choi, Munjae Lee, Mihajlo Jakovljevic","doi":"10.1186/s12962-024-00561-0","DOIUrl":"10.1186/s12962-024-00561-0","url":null,"abstract":"","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"52"},"PeriodicalIF":1.7,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11186129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}