ClinicoEconomics and Outcomes Research最新文献

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Development of the Cesarean Section Clinical Pathway Model: Not Examining Cesarean Section Comprehensively [Response to Letter]. 剖宫产临床路径模型的开发:未对剖腹产进行全面检查[回信]。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S485709
Aladin Aladin, Werry Darta Taifur, Syed Mohamed Aljunid, Dwiana Ocviyanti
{"title":"Development of the Cesarean Section Clinical Pathway Model: Not Examining Cesarean Section Comprehensively [Response to Letter].","authors":"Aladin Aladin, Werry Darta Taifur, Syed Mohamed Aljunid, Dwiana Ocviyanti","doi":"10.2147/CEOR.S485709","DOIUrl":"10.2147/CEOR.S485709","url":null,"abstract":"","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113374","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: 0
Evaluating Service Satisfaction and Sustainability of the Afya Insurance Scheme in Kuwait: An Exploratory Analysis. 评估科威特 Afya 保险计划的服务满意度和可持续性:探索性分析。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-08-23 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S469810
Maha Alnashmi, Nuzhat Masud Bhuiyan, Nour AlFaham, Ahmad Salman, Hanadi AlHumaidi, Nabeel Akhtar
{"title":"Evaluating Service Satisfaction and Sustainability of the Afya Insurance Scheme in Kuwait: An Exploratory Analysis.","authors":"Maha Alnashmi, Nuzhat Masud Bhuiyan, Nour AlFaham, Ahmad Salman, Hanadi AlHumaidi, Nabeel Akhtar","doi":"10.2147/CEOR.S469810","DOIUrl":"10.2147/CEOR.S469810","url":null,"abstract":"<p><strong>Purpose: </strong>In 2014, the Kuwaiti parliament enacted the private health insurance law for Kuwaiti retirees ie, Afya to enhance service quality for retirees through the involvement of the private sector. The study aimed to comprehensively analyze Afya across three crucial dimensions: efficiency, inclusiveness, effectiveness, and service quality; delivery of services throughout the revenue management cycle; and its long-term sustainability in Kuwait.</p><p><strong>Methods: </strong>Conducted between June 2021 and August 2022, the study employed both web-based and hardcopy questionnaires, reaching a response rate of 78.79% from a random sample of 514 Kuwaiti beneficiaries holding Afya insurance cards. Exclusions were made for those who did not receive cards or declined participation, resulting in analysis of 405 completed surveys.</p><p><strong>Results: </strong>The findings revealed that 95% of participants frequently utilized services from private hospitals, with a corresponding 78.79% satisfaction rate. However, when seeking medical services from government hospitals, respondents often opted to repeat procedures to ensure accurate results and diagnoses. Despite a strong endorsement for enhancing Afya's coverage plan (94%), over half of the respondents suggested a temporary suspension of the scheme to conduct thorough research and alleviate potential financial burdens on the government. Notably, a significant positive correlation (0.578, p < 0.01) was observed between beneficiary satisfaction and their experience with Afya coverage, underscoring the importance of aligning scheme operations with beneficiary needs.</p><p><strong>Conclusion: </strong>Addressing these disparities and improving access to healthcare services for retirees necessitate a thorough reformation of the Afya scheme. To address these challenges, the study recommends comprehensive reform through evidence-based research, enhanced information exchange mechanisms between public and private sectors, and broader coverage targeting younger demographics. These measures are crucial for ensuring the scheme's efficacy, sustainability, and alignment with the evolving healthcare landscape in Kuwait.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082134","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: 0
Health Equity Considerations in Cost-Effectiveness Analysis: Insights from an Umbrella Review. 成本效益分析中的健康公平考虑因素:从总体审查中获得的启示》。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-08-20 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S471827
Jeffrey M Muir, Amruta Radhakrishnan, Ipek Ozer Stillman, Grammati Sarri
{"title":"Health Equity Considerations in Cost-Effectiveness Analysis: Insights from an Umbrella Review.","authors":"Jeffrey M Muir, Amruta Radhakrishnan, Ipek Ozer Stillman, Grammati Sarri","doi":"10.2147/CEOR.S471827","DOIUrl":"10.2147/CEOR.S471827","url":null,"abstract":"<p><p>Cost-effectiveness analyses (CEA) are important in healthcare decision-making and resource allocation; however, expanding the scope of CEAs beyond the traditional clinicoeconomic concepts to also include value elements such as health equity has attracted much interest in recent years. This umbrella review aimed to synthesize evidence on how equity concepts have been considered in modified types of CEAs. Publicly available articles in MEDLINE were searched on January 25, 2024, to identify systematic reviews (SLRs) published in English since 2013 that incorporate health equity considerations in CEAs. Title/abstract, full-text article screening and data extraction were conducted by a single reviewer and validated by a second reviewer. Results were qualitatively synthesized to identify common themes. Eight SLRs were included. Distributional CEAs (DCEA), equity-based weighting, extended CEA (ECEA), mathematical programming and multi-criteria decision analysis (MCDA) were the most discussed approaches. A lack of consensus on the best approach for incorporating health equity into CEAs was highlighted, as these approaches are not currently consistently used in decision-making. Important limitations included scarcity of robust data to inform health equity indices, bias associated with commonly used health outcome metrics and the challenge of accounting for additional contextual factors such as fairness and opportunity costs. Proposals to expand CEAs to address equity issues come with challenges due to data unavailability, methods complexity, and decision-makers unfamiliarity with these approaches. Our review indicates that extended and distributional CEAs can support decision-making by capturing the impact of inequity on the clinical and cost-effectiveness assessment of treatments, although future modeling should account for additional contextual factors such as fairness and opportunity costs. Recommendations for actions moving forward include standardization of data collection for outcomes related to equity and familiarity with methodologies to account for the complexities of integrating health equity considerations in CEAs.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056834","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: 0
Real-World Adherence and Discontinuation of Oral Antipsychotics and Associated Factors in a National Sample of US Medicare Beneficiaries with Schizophrenia. 美国精神分裂症医保受益人全国样本中口服抗精神病药物的实际依从性和停药情况及相关因素。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-08-14 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S469001
Christopher Zacker, Justin T Puckett, Sachin Kamal-Bahl
{"title":"Real-World Adherence and Discontinuation of Oral Antipsychotics and Associated Factors in a National Sample of US Medicare Beneficiaries with Schizophrenia.","authors":"Christopher Zacker, Justin T Puckett, Sachin Kamal-Bahl","doi":"10.2147/CEOR.S469001","DOIUrl":"10.2147/CEOR.S469001","url":null,"abstract":"<p><strong>Purpose: </strong>Little is known about adherence to and discontinuation of newly initiated oral antipsychotics (OAPs) as well as associated factors among Medicare beneficiaries with schizophrenia. This study aimed to examine rates of OAP adherence and discontinuation and associated factors in a national sample of fee-for-service Medicare beneficiaries with schizophrenia.</p><p><strong>Patients and methods: </strong>This retrospective study used 100% fee-for-service Medicare claims data to identify adult beneficiaries with schizophrenia, initiating a new OAP between 01/01/2017 and 12/31/2019 (index date = date of new OAP prescription). Outcomes included adherence and discontinuation. Factors associated with adherence were assessed using logistic and linear regressions; Cox regressions were used to assess factors associated with discontinuation.</p><p><strong>Results: </strong>In our final sample of 46,452 Medicare beneficiaries with schizophrenia, 35.4% were adherent to their newly initiated OAP (mean [SD] PDC: 0.52 [0.37]) over 12 months after initiation. Most patients (79.4%) discontinued their new OAP (median [IQR] time to discontinuation: 3.6 (1.0, 9.9) months). Factors associated with lower odds of adherence included younger age (OR: 0.43; 95% CI: 0.40-0.47, p <0.001 for patients aged 18-35 relative to patients aged ≥65 years); non-White race (OR: 0.72; 95% CI: 0.69-0.75, p <0.001 relative to White patients); and evidence of prior schizophrenia-related hospitalization (OR: 0.80; 95% CI: 0.77-0.83, p <0.001 relative to patients without evidence of prior schizophrenia-related hospitalization). Similar associations were observed for discontinuation outcomes. Twice-daily dosing frequency was also associated with lower odds of adherence (odds ratio [OR]: 0.93; 95% CI: 0.89-0.97, p = 0.0014) and higher hazard of discontinuation (hazard ratio [HR]: 1.03; 95% CI: 1.00-1.05, p = 0.0244) relative to once-daily dosing frequency.</p><p><strong>Conclusion: </strong>We found high rates of non-adherence and discontinuation among Medicare beneficiaries initiated on currently available OAPs. We also identified risk factors that contribute to increased odds of medication non-adherence. By identifying at-risk patient populations, targeted interventions can be initiated to facilitate treatment continuity.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005531","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: 0
Healthcare Resource Use and Costs Among Individuals with Vitiligo and Psychosocial Comorbidities: Retrospective Analysis of an Insured US Population. 患有白癜风和社会心理并发症的患者的医疗资源使用情况和成本:对美国参保人群的回顾性分析。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-08-08 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S463987
Jennifer H Lofland, Samyuktha Darbha, Ahmad B Naim, David Rosmarin
{"title":"Healthcare Resource Use and Costs Among Individuals with Vitiligo and Psychosocial Comorbidities: Retrospective Analysis of an Insured US Population.","authors":"Jennifer H Lofland, Samyuktha Darbha, Ahmad B Naim, David Rosmarin","doi":"10.2147/CEOR.S463987","DOIUrl":"10.2147/CEOR.S463987","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to describe healthcare resource utilization and costs among individuals with vitiligo who were diagnosed with ≥1 psychosocial comorbidity, using data from US claims databases.</p><p><strong>Patients and methods: </strong>A retrospective, observational cohort analysis of the IBM MarketScan Commercial and Medicare supplemental claims databases for US individuals with vitiligo aged ≥12 years and a first vitiligo claim between January 1 and December 31, 2018, was undertaken to assess psychosocial burden, including mental and behavioral health comorbidities.</p><p><strong>Results: </strong>Of the 12,427 individuals included in the analysis, nearly 1 in 4 (23.5%) who had vitiligo were also diagnosed with ≥1 psychosocial comorbidity. A greater percentage of these individuals versus those who were not diagnosed with a psychosocial comorbidity had a vitiligo-related prescription claim (50.2% vs 45.4%; <i>P</i><0.0001), especially for oral corticosteroids (25.4% vs 16.6%; <i>P</i><0.0001) and low-potency topical corticosteroids (9.0% vs 7.6%; <i>P</i><0.05). Total vitiligo-related healthcare resource utilization and costs were consistent among individuals with and without psychosocial comorbidity despite significantly (<i>P</i><0.05) higher vitiligo-related ER visit utilization and expenditure among those with psychosocial comorbidity. Furthermore, individuals diagnosed with vitiligo and ≥1 psychosocial comorbidity had significantly (<i>P</i><0.0001) greater utilization of all-cause mean prescription claims (25.0 vs 12.8), outpatient services (other than physician and ER visits: 19.5 vs 11.3), outpatient physician visits (10.1 vs 6.4), inpatient stays (0.6 vs 0.1), and ER visits (0.4 vs 0.2) and incurred significantly higher mean (SD) direct medical expenditures ($18,804 [$46,621] vs $9833 [$29,094] per patient per year; <i>P</i><0.0001).</p><p><strong>Conclusion: </strong>Individuals with vitiligo who were diagnosed with ≥1 psychosocial comorbidity incurred greater total all-cause but not vitiligo-related healthcare resource utilization and expenditures than those without diagnosis of psychosocial comorbidities. Identification of psychosocial comorbidities in individuals with vitiligo may be important for multidisciplinary management of vitiligo to reduce overall burden for individuals with vitiligo.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972098","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: 0
Health Technology Assessment for Fast-Track Elective Knee and Hip Arthroplasty in a High-Volume Orthopaedic Hospital in Italy. 意大利骨科大医院快速通道选择性膝关节和髋关节置换术的健康技术评估。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-08-05 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S464775
Umberto Restelli, Jacopo Vitale, Edoardo Croce, Susan Bernareggi, Stefania Guida, Sofia Silvola, Giuseppe Banfi, Luigi Zagra
{"title":"Health Technology Assessment for Fast-Track Elective Knee and Hip Arthroplasty in a High-Volume Orthopaedic Hospital in Italy.","authors":"Umberto Restelli, Jacopo Vitale, Edoardo Croce, Susan Bernareggi, Stefania Guida, Sofia Silvola, Giuseppe Banfi, Luigi Zagra","doi":"10.2147/CEOR.S464775","DOIUrl":"10.2147/CEOR.S464775","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the analysis presented is to assess the efficacy of a fast-track pathway for elective hip and knee arthroplasty, compared to the traditional approach, adopted within a research hospital located in Milan (Italy), in terms of length of stay reduction and related direct medical costs.</p><p><strong>Methods: </strong>A monocentric observational retrospective study was implemented considering adult subjects who underwent elective primary total hip or knee replacement, with a diagnosis of primary or secondary osteoarthritis. Exclusion criteria were subjects admitted via emergency department, subjects undergoing knee or hip replacement because of fractures or prosthesis revision. The analysis compared the length of stay and the direct medical costs, assuming the hospital perspective, of subjects admitted in the pre-fast-track period (years 2016/2017) and during the fast-track period (years 2018/2019).</p><p><strong>Results: </strong>Knee replacement mean costs are 5,599 € (±1,158.3 €) in the pre-fast-track period and 4,487 € (±978.4 €) in the fast-track period (-1,112 €; -19.9%). Hip replacement mean costs in the pre-fast-track period are 5,364 € (±1,037.2 €) and 4,450 € (±843.7 €) in the fast-track period (-914 €; -17.0%). The adoption of fast-track pathway led to a statistically significant decrease of days of hospitalization of -2.8 (-37.6%) in knee replacement and of -2.9 (-39.2%) in hip replacement.</p><p><strong>Conclusion: </strong>The fast-track pathway adopted proved to be effective, reducing patients' length of stay, and sustainable and efficient, reducing direct medical costs, for both elective hip and knee replacement surgeries.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11314516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917757","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: 0
Clinical and Economic Impact of Early Diagnosis of Chronic Kidney Disease in General Practice: The Endorse Study. 全科慢性肾病早期诊断的临床和经济影响:Endorse 研究
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-08-05 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S470728
Francesco Pesce, Giacomo Matteo Bruno, Giorgio Lorenzo Colombo, Sergio Di Matteo, Anna Rita Maurizi, Valentina Mongelli, Silvia Mele, Lavinia Narici, Stefano Bianchi, Mario Bonomini, Giuseppe Castellano, Luca De Nicola, Giovanni Gambaro, Giuseppe Grandaliano, Gaetano La Manna, Antonello Pani, Andrea Ranghino, Loreto Gesualdo
{"title":"Clinical and Economic Impact of Early Diagnosis of Chronic Kidney Disease in General Practice: The Endorse Study.","authors":"Francesco Pesce, Giacomo Matteo Bruno, Giorgio Lorenzo Colombo, Sergio Di Matteo, Anna Rita Maurizi, Valentina Mongelli, Silvia Mele, Lavinia Narici, Stefano Bianchi, Mario Bonomini, Giuseppe Castellano, Luca De Nicola, Giovanni Gambaro, Giuseppe Grandaliano, Gaetano La Manna, Antonello Pani, Andrea Ranghino, Loreto Gesualdo","doi":"10.2147/CEOR.S470728","DOIUrl":"10.2147/CEOR.S470728","url":null,"abstract":"<p><strong>Introduction: </strong>The underdiagnosis of chronic kidney disease (CKD) remains a significant public health concern. The Early chroNic kiDney disease pOint of caRe Screening (ENDORSE) project aimed to evaluate the clinical and economic implications of a targeted training intervention for general practitioners (GPs) to enhance CKD awareness and early diagnosis.</p><p><strong>Methods: </strong>Data on estimated Glomerular Filtration Rate (eGFR) and Urinary Albumin-Creatinine Ratio (uACR) were collected by 53 Italian GPs from 112,178 patients at baseline and after six months. The intervention involved six months of hybrid training provided by 11 nephrologists, which included formal lectures, instant messaging support, and joint visits for complex cases.</p><p><strong>Results: </strong>The results demonstrated a substantial increase in the use of eGFR (+44.7%) and uACR (+95.2%) tests. This led to a 128.9% rise in the number of individuals screened for CKD using the KDIGO classification, resulting in a 62% increase in CKD diagnoses. The intervention's impact was particularly notable in high-risk groups, including patients with type 2 diabetes, hypertension, and heart failure.</p><p><strong>Discussion: </strong>A budget impact analysis projected cumulative five-year savings of €1.7 million for the study cohort. When these findings were extrapolated to the entire Italian CKD population, potential savings were estimated at €106.6 million, highlighting significant cost savings for the national health service. The clinical simulation assumed that early diagnosed CKD patients would be treated according to current indications for dapagliflozin, which slows disease progression.</p><p><strong>Conclusion: </strong>The ENDORSE model demonstrated that targeted training for GPs can significantly improve early CKD detection, leading to better patient outcomes and considerable economic benefits. This approach shows promise for broader implementation to address the underdiagnosis of CKD on a national and potentially international scale.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11313497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917756","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: 0
Comparison of Costs, Re-Intervention Rates, and Length of Hospital Stay for Three Uterus Sparing Interventions for Uterine Fibroids: A 2-Year Retrospective Claims Analysis. 三种子宫肌瘤疏通术的成本、再介入率和住院时间比较:两年回顾性索赔分析》。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S437353
David Eisenstein, Ghadear H Shukr, John J Carlow, Laura Kemp, Steve Yu
{"title":"Comparison of Costs, Re-Intervention Rates, and Length of Hospital Stay for Three Uterus Sparing Interventions for Uterine Fibroids: A 2-Year Retrospective Claims Analysis.","authors":"David Eisenstein, Ghadear H Shukr, John J Carlow, Laura Kemp, Steve Yu","doi":"10.2147/CEOR.S437353","DOIUrl":"10.2147/CEOR.S437353","url":null,"abstract":"<p><strong>Purpose: </strong>To describe two-year post-operative outcomes, and healthcare utilization of three uterus-sparing interventions used to treat women with intramural and/or subserosal uterine fibroids.</p><p><strong>Subjects and methods: </strong>This was a post-market, randomized, prospective, multi-center, longitudinal, interventional, and comparative clinical study to evaluate the costs and health outcomes of LAP-RFA vs the standard uterine conserving technologies (myomectomy and UAE) for the treatment of symptomatic uterine fibroids in women who desire uterine conservation. For this RCT study, 54 subjects were randomized on a 1:1 ratio across the three procedures and followed out to two years. Their results were compared to retrospective US insurance claims from the IBM MarketScan<sup>®</sup> Commercial Database from 2017-2020 for 96,854 women who underwent a uterus-sparing procedure for fibroids.</p><p><strong>Results: </strong>Mean ambulatory surgical center costs and the mean out-patient hospital costs were lowest for LAP-RFA ($13,134 and $14,428) and highest for UAE ($28,214 and $19,131). The total two-year re-intervention rate of any subsequent procedure (AM, LM, LAP-RFA, or UAE) was lowest in AM group (0%) followed by LM (4.2%), LAP-RFA (11%), and UAE (33%). Mean peri-operative reintervention costs and the mean reintervention total costs were $2429 and $5939 for LAP-RFA, $2122 and $8368 for LM, $4410 and $11,942 for AM, and $8113 and $46,692 for UAE subjects. In the RCT study, the average length of hospital stay was significantly less for the LAP-RFA group subjects (8.2 hours) in contrast to both the laparoscopic myomectomy group subjects (16.0 hours) and the abdominal myomectomy group subjects (33.6 hours). Despite the small numbers, two-year reintervention rates followed a similar pattern as the IBM MarketScan data.</p><p><strong>Conclusion: </strong>In comparing these three non-invasive approaches, LAP-RFA was associated with the lowest peri-operative cost, and UAE was associated with the highest peri-operative cost. Further studies are needed to assess the cost, effectiveness, and subject satisfaction with each procedure.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890409","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: 0
Assessment of Direct Medical Cost of Hospitalized COVID-19 Adult Patients in Kuwait During the First Wave of the Pandemic. 科威特第一波大流行期间 COVID-19 住院成人患者的直接医疗费用评估。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-07-24 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S467543
Sarah A AlManie, Mai S AlHazami, Alyah Ebrahim, Muhammad S Attique
{"title":"Assessment of Direct Medical Cost of Hospitalized COVID-19 Adult Patients in Kuwait During the First Wave of the Pandemic.","authors":"Sarah A AlManie, Mai S AlHazami, Alyah Ebrahim, Muhammad S Attique","doi":"10.2147/CEOR.S467543","DOIUrl":"10.2147/CEOR.S467543","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to estimate the direct medical cost of COVID-19 hospitalizations and to utilize prevalence estimates from Jaber Al-Ahmad Hospital to estimate the direct medical cost of all hospitalized adult patients in Kuwait using a decision tree analysis.</p><p><strong>Methods: </strong>A cost-of-illness model was developed. The Ministry of Health perspective was considered, direct medical costs were estimated from July 1st to September 30th, using a bottom-up approach. The mean cost per hospitalized patient was estimated using a decision analysis model. Prevalence estimates of ambulance use, use of ER, ICU admission, and mortality were considered in the current study. Patients aged 18 years and above with a confirmed diagnosis of COVID-19 were included. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were performed.</p><p><strong>Results: </strong>Data for 2986 patients were analyzed. The mean age was 61 (SD= 11) years old. Most of the patients were Kuwaiti (2864, 95.91%), and more than half were females (1677, 56.16%). Of the total hospital admissions, 417 patients (14%) were admitted to the ICU. The average length of the hospital stay was 11 (SD= 9) days, and among all hospital admissions, 270 (9.04%) patients died. The total estimated direct medical cost of hospitalized patients at Jaber Al-Ahmad Hospital was $47,213,768 (14,283,203.6 KD). The average cost of hospital stay per patient was estimated at $15,498 (4,688.60 KD). The weighted average cost per hospitalized patient in Kuwait was estimated at $16,373 (4,953.08 KD). The total direct medical cost of hospitalized COVID-19 patients in Kuwait during the study period was estimated at $174,372,450 (52,751,502 KD).</p><p><strong>Conclusion: </strong>The COVID-19 pandemic constituted a significant burden on the Kuwaiti healthcare system. The findings of this study urge the need for preventive care strategies to reduce adverse health outcomes and the economic impact of the pandemic.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789390","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: 0
Contextual Blindness: Indonesian Cesarean Section Research Trapped in Narrow Perspectives [Letter]. 语境盲区:印度尼西亚剖腹产研究受困于狭隘的视角[信]。
IF 2.1
ClinicoEconomics and Outcomes Research Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI: 10.2147/CEOR.S483874
M Zaenul Muttaqin, Yansen Alberth Reba, Yovian Yustiko Prasetya
{"title":"Contextual Blindness: Indonesian Cesarean Section Research Trapped in Narrow Perspectives [Letter].","authors":"M Zaenul Muttaqin, Yansen Alberth Reba, Yovian Yustiko Prasetya","doi":"10.2147/CEOR.S483874","DOIUrl":"10.2147/CEOR.S483874","url":null,"abstract":"","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555697","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: 0
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