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Custo do tratamento do diabetes mellitus tipo 1: dificuldades das famílias; Cost of diabetes mellitus type 1 treatment: difficulties of the families; Custo do tratamento do diabetes mellitus tipo 1: dificuldades das famílias

CASTRO, Amparito del Rocio Vintimilla; GROSSI, Sonia Aurora Alves
Fonte: Escola Paulista de Enfermagem, Universidade Federal de São Paulo Publicador: Escola Paulista de Enfermagem, Universidade Federal de São Paulo
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
75.56%
OBJETIVOS: Conhecer a renda familiar dos pacientes diabéticos e os locais de aquisição das seringas e analisar o custo do tratamento da doença no domicílio e as conseqüências desses custos. MÉTODOS: Estudo descritivo, analítico, transversal. Entrevistados 199 pacientes atendidos em ambulatório de hospital escola, pediátrico de grande porte em São Paulo durante o ano 2004. RESULTADOS: A renda familiar predominante foi de um a dois salários mínimos (48,8%). A aquisição dos materiais para aplicar insulina era feita na farmácia (65,3%) e nas Unidades Básicas de Saúde (25,1%). A população gastava de R$ 20,00 a R$ 79,00 mensais com a compra de seringas (US$ 8 a US$ 27). CONCLUSÃO: Para minimizar os gastos com a doença, pacientes e responsáveis eram obrigados a reutilizar as seringas em (76,8%), constituindo uma prática comum no tratamento do diabetes.; OBJECTIVES: To know the family income of diabetic patients and the places where they acquire/purchase the syringes, and to analyze the cost of treating the disease at home and the consequences of such costs. METHODS: Descriptive, analytical, cross-section study, which interviewed 199 patients cared for at a large pediatric school hospital in São Paulo in 2004. RESULTS: The predominant family income varied between one and two times the minimum wage (48.8%). Materials to apply insulin were acquired/purchased at the pharmacy (56.3%) and the Basic Healthcare Units (25.1%). The population would spend from R$ 20.00 to R$ 79.00 (US$ 8 to US$ 27) in syringes every month. CONCLUSION: Patients and guardians were forced to reuse the syringes in 76.8% of the cases to decrease their expenditure with the disease...

ENCOMS: Argentinian survey in cost of illness and unmet needs in multiple sclerosis

Ysrraelit,Celica; Caceres,Fernando; Villa,Andres; Marcilla,Marcela Parada; Blanche,Jorge; Burgos,Marcos; Parera,Ignacio Casas; Colombo,Oscar; Crespo,Ernesto; Deri,Norma; Labal,Patricio; Maluendez,Monica; Martinez,Alejandra; Melcon,Mario; Nofal,Pedro; Reic
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/2014 EN
Relevância na Pesquisa
85.69%
The objective of the study was to assess the cost of multiple sclerosis (MS) patients in Argentina categorized by disease severity using a societal perspective. Method: Cross-sectional study including MS patients from 21 MS centers in 12 cities of Argentina. Patients were stratified by disease severity using the expanded disability status scale (EDSS) (group 1 with EDSS score between 0 and 3; group 2 with EDSS >3 and <7; group 3 with EDSS ≥7). Direct and indirect costs were analyzed for the second quarter of 2012 from public sources and converted to US Dollars. Results: 266 patients were included. Mean annual cost per MS patient was USD 36,025 (95%CI 31,985-38,068) for patients with an EDSS between 0-3; USD 40,705 (95%CI 37,199-46,300) for patients with EDSS >3 and <7, and USD 50,712 (95%CI 47,825-62,104) for patients with EDSS ≥7. Conclusions: This is the first Argentine study evaluating the costs of MS considering disease severity.

Cost of the treatment of myelodisplastic syndrome in Brazil

Clark,Otávio; Faleiros,Enéas José de Matos
Fonte: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Publicador: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2011 EN
Relevância na Pesquisa
75.63%
INTRODUCTION: Myelodysplastic syndrome is an incurable and rare hematological disease that affects the production of blood cells. One aim of treatment is to maintain the blood-cell count to near-normal levels. This is mainly achieved with hematopoietic- growth factors and transfusions. Our objective was to determine the cost of supportive treatment/care for patients with low and intermediate I risk myelodysplastic syndrome in respect to private healthcare plans in Brazil. METHOD: We adapted the National Comprehensive Cancer Network treatment guidelines for intermediate risk myelodysplastic syndrome patients to the Brazilian reality, adopting a decision tree to explore treatment combinations. Then, we calculated the costs for each branch of the tree, according to national prices. We also estimated total costs for a cohort of 100 patients, distributed across treatment combinations according to the expected epidemiology. We assumed a horizon of one year of treatment. RESULTS: The mean cost of treatment for low and intermediate I risk myelodysplastic syndrome is US$ 42,758/patient/year. This cost can vary from US$ 24,282 to US$ 121,952, according to patient characteristics and the treatment used. Overall, patients that require immunotherapy with antithymocyte globulins are associated with the highest cost. Those that achieve disease stability solely with the use of erythropoietin were associated with the lowest cost. CONCLUSION: In Brazil...

Societal Burden of Clinically Anxious Youth Referred for Treatment: A Cost-of-illness Study

Bodden, Denise H. M.; Dirksen, Carmen D.; Bögels, Susan M.
Fonte: Springer US Publicador: Springer US
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
65.83%
A prevalence-based cost-of-illness study using a societal perspective was conducted to investigate the cost-of-illness in clinically anxious youth aged 8–18 in The Netherlands. Discriminant validity of the cost diary used was obtained by comparing costs of families with an anxious child (n = 118) to costs of families from the general population (n = 41). To examine the convergent validity, bottom-up acquired costs derived from cost diaries were compared to top-down acquired costs obtained from national registrations. Bottom-up acquired costs measured by means of cost diaries amounted to €2,748 per family of a clinically referred anxious child per annum. Societal costs of families with clinically anxious children were almost 21 times as high compared to families from the general population. With respect to convergent validity, total health care costs using the bottom-up approach from clinically anxious children were quite comparable to those of top-down data of anxious children, although costs within the subcategories differed considerably. Clinical anxiety disorders in childhood cost the Dutch society more than 20 million euros a year. Based on results of discriminate and convergent validity, the cost diary seems a valid method in establishing cost-of-illness in childhood anxiety disorders.

The Chikungunya Epidemic on La Réunion Island in 2005–2006: A Cost-of-Illness Study

Soumahoro, Man-Koumba; Boelle, Pierre-Yves; Gaüzere, Bernard-Alex; Atsou, Kokuvi; Pelat, Camille; Lambert, Bruno; La Ruche, Guy; Gastellu-Etchegorry, Marc; Renault, Philippe; Sarazin, Marianne; Yazdanpanah, Yazdan; Flahault, Antoine; Malvy, Denis; Hansli
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 14/06/2011 EN
Relevância na Pesquisa
75.76%
For a long time, studies of chikungunya virus infection have been neglected, but since its resurgence in the south-western Indian Ocean and on La Réunion Island, this disease has been paid greater amounts of attention. The economic and social impacts of chikungunya epidemics are poorly documented, including in developed countries. This study estimated the cost-of-illness associated with the 2005–2006 chikungunya epidemics on La Réunion Island, a French overseas department with an economy and health care system of a developed country. “Cost-of-illness” studies measure the amount that would have been saved in the absence of a disease. We found that the epidemic incurred substantial medical expenses estimated at €43.9 million, of which 60% were attributable to direct medical costs related, in particular, to expenditure on medical consultations (47%), hospitalization (32%) and drugs (19%). The costs related to care in ambulatory and hospitalized cases were €90 and €2000 per case, respectively. This study provides the basic inputs for conducting cost-effectiveness and cost-benefit evaluations of chikungunya prevention strategies.

Methodological considerations in cost of illness studies on Alzheimer disease

Costa, Nagede; Derumeaux, Helene; Rapp, Thomas; Garnault, Valérie; Ferlicoq, Laura; Gillette, Sophie; Andrieu, Sandrine; Vellas, Bruno; Lamure, Michel; Grand, Alain; Molinier, Laurent
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em 11/09/2012 EN
Relevância na Pesquisa
65.8%
Cost-of-illness studies (COI) can identify and measure all the costs of a particular disease, including the direct, indirect and intangible dimensions. They are intended to provide estimates about the economic impact of costly disease. Alzheimer disease (AD) is a relevant example to review cost of illness studies because of its costliness.The aim of this study was to review relevant published cost studies of AD to analyze the method used and to identify which dimension had to be improved from a methodological perspective. First, we described the key points of cost study methodology. Secondly, cost studies relating to AD were systematically reviewed, focussing on an analysis of the different methods used. The methodological choices of the studies were analysed using an analytical grid which contains the main methodological items of COI studies. Seventeen articles were retained. Depending on the studies, annual total costs per patient vary from $2,935 to $52, 954. The methods, data sources, and estimated cost categories in each study varied widely. The review showed that cost studies adopted different approaches to estimate costs of AD, reflecting a lack of consensus on the methodology of cost studies. To increase its credibility, closer agreement among researchers on the methodological principles of cost studies would be desirable.

The Cost of Illness Associated with Stepped Care for Obsessive-Compulsive Disorder

Diefenbach, Gretchen J.; Tolin, David F.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
65.82%
Stepped care for obsessive-compulsive disorders (OCD) is a promising approach for improving the accessibility and cost-effectiveness of exposure and response prevention (ERP). Previous research has shown that stepped care is less costly compared with standard, therapist-directed ERP, owing largely to the roughly one-third of patients who respond to lower intensity guided self-help (GSH). The aim of this study was to recalculate the costs of treatment in stepped versus standard care when also including the cost of illness; defined as costs related to functional disability in work, school, and home functioning attributed to OCD symptoms. It was found that the cost savings of stepped care was reduced to a moderate effect (d = 0.66) when the cost of illness was included. Data also indicated substantial potential cost savings if patient-to-treatment matching variables are identified. Exploratory analyses suggested that problems with attention may be an important variable to investigate as a potential treatment moderator in future GSH treatment outcome research. These data highlight the importance of including the cost of illness in cost-effectiveness analyses, and of identifying predictors that will facilitate matched care and prevent unnecessary treatment delay for the roughly two-thirds of patients who will not respond to GSH for OCD.

Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

Steinke, Sabine I. B.; Peitsch, Wiebke K.; Ludwig, Alexander; Goebeler, Matthias
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 23/10/2013 EN
Relevância na Pesquisa
75.7%
Treatment modalities of chronic plaque psoriasis have dramatically changed over the past ten years with a still continuing shift from inpatient to outpatient treatment. This development is mainly caused by outpatient availability of highly efficient and relatively well-tolerated systemic treatments, in particular BioLogicals. In addition, inpatient treatment is time- and cost-intense, conflicting with the actual burst of health expenses and with patient preferences. Nevertheless, inpatient treatment with dithranol and UV light still is a major mainstay of psoriasis treatment in Germany. The current study aims at comparing the total costs of inpatient treatment and outpatient follow-up to mere outpatient therapy with different modalities (topical treatment, phototherapy, classic systemic therapy or BioLogicals) over a period of 12 months. To this end, a retrospective cost-of-illness study was conducted on 120 patients treated at the University Medical Centre Mannheim between 2005 and 2006. Inpatient therapy caused significantly higher direct medical, indirect and total annual costs than outpatient treatment (13,042 € versus 2,984 €). Its strong influence on cost levels was confirmed by regression analysis, with total costs rising by 104.3% in case of inpatient treatment. Patients receiving BioLogicals produced the overall highest costs...

Cost-of-Illness and Quality of Life in Patients with Ankylosing Spondylitis at a Tertiary Hospital in Korea

Lee, Tae-Jin; Park, Bo-Hyun; Kim, Joon Wan; Shin, Kichul; Lee, Eun Bong; Song, Yeong-Wook
Fonte: The Korean Academy of Medical Sciences Publicador: The Korean Academy of Medical Sciences
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
75.62%
The objectives of this study were to estimate the cost-of-illness (COI) and health-related quality of life (HRQOL) in patients with ankylosing spondylitis (AS) in Korea and to evaluate the effects of socio-demographic and clinical factors on the COI and the HRQOL. Face-to-face interview surveys were taken from patients with AS at the Rheumatology Clinic of Seoul National University Hospital. Direct medical and non-medical costs, indirect costs (productivity loss due to job loss and sick leave), and deterioration of HRQOL in patients with AS were measured. Factors associated with COI and HRQOL were analyzed with multiple regression and multivariate logistic regression. A total of 191 patients with AS was enrolled in the study. The COI in patients with AS amounted to 11,646,180 Korean Won (KRW) per patient, and their HRQOL was 0.62. As functional severity worsened, the total costs increased (class I, KRW 7.7 million; class II, KRW 12.9 million; classes III & IV, KRW 25.2 million) and the HRQOL scores decreased (class I, 0.72; class II, 0.61; classes III & IV, 0.24). Functional severity is the major determinant of the COI and HRQOL in patients with AS.

Cost-of-illness studies: concepts, scopes, and methods

Jo, Changik
Fonte: The Korean Association for the Study of the Liver Publicador: The Korean Association for the Study of the Liver
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
75.82%
Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level...

Effectiveness of Community Health Financing in Meeting the Cost of Illness

Preker, Alexander S.; Carrin, Guy; Dror, David; Jakab, Melitta; Hsiao, William; Arhin-Tenkorang, Dyna
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
75.61%
How to finance and provide health care for the more than 1.3 billion rural poor and informal sector workers in low- and middle-income countries is one of the greatest challenges facing the international development community. This article presents the main findings from an extensive survey of the literature of community financing arrangements, and selected experiences from the Asia and Africa regions. Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Micro-level household data analysis indicates that community financing improves access by rural and informal sector workers to needed heath care and provides them with some financial protection against the cost of illness. Macro-level cross-country analysis gives empirical support to the hypothesis that risk-sharing in health financing matters in terms of its impact on both the level and distribution of health, financial fairness and responsiveness indicators. The background research done for this article points to five key policies available to governments to improve the effectiveness and sustainability of existing community financing schemes. This includes: (a) increased and well-targeted subsidies to pay for the premiums of low-income populations; (b) insurance to protect against expenditure fluctuations and re-insurance to enlarge the effective size of small risk pools; (c) effective prevention and case management techniques to limit expenditure fluctuations; (d) technical support to strengthen the management capacity of local schemes; and (e) establishment and strengthening of links with the formal financing and provider networks.

Incidence, impact on the family and cost of gastroenteritis among 4 to 6-year-old children in South Australia

Heyworth, J.; Jardine, A.; Glonek, G.; Maynard, E.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
75.58%
Background: Gastroenteritis is an important cause of morbidity in both adults and children worldwide. Although the burden of morbidity and mortality is highest in developing countries, gastroenteritis is still a significant cause of morbidity in Australia, particularly in young children. The aims of the present study were to determine the incidence of gastroenteritis among 4–6-year-old children in South Australia, to describe the impact on daily activities of the child and caregiver and estimate the cost of gastroenteritis in this population. Methods: A diary study of drinking water consumption and gastrointestinal and respiratory symptoms was undertaken among 965 rural children in South Australia over a 6-week period during February–May 1999. Data on the response to gastrointestinal episodes were collected by telephone surveys midway and at the end of the 6-week period. Costing was based on the methods of Hellard et al . Results: The incidence of community gastroenteritis among 4–6-year-old children was 5.53 episodes per child-year (95% confidence interval: 4.87–5.80). The costs associated with childhood gastroenteritis were estimated to be between $AU16 858 360 and $AU22 477 814 per annum. Conclusions: The incidence of community gastroenteritis among the 4–6-year-olds in the South Australian population is high and it costs the community a significant amount of money in terms of direct medical costs and time lost by parents and carers looking after their ill children.; Jane S Heyworth...

Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK

Stewart, S.; Murphy, N.; Walker, A.; McGuire, A.; McMurray, J.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
Relevância na Pesquisa
75.64%
Objective: To evaluate the cost of atrial fibrillation (AF) to health and social services in the UK in 1995 and, based on epidemiological trends, to project this estimate to 2000. Design, setting, and main outcome measures: Contemporary estimates of health care activity related to AF were applied to the whole population of the UK on an age and sex specific basis for the year 1995. The activities considered (and costs calculated) were hospital admissions, outpatient consultations, general practice consultations, and drug treatment (including the cost of monitoring anticoagulant treatment). By adjusting for the progressive aging of the British population and related increases in hospital admissions, the cost of AF was also projected to the year 2000. Results: There were 534 000 people with AF in the UK during 1995. The “direct” cost of health care for these patients was £244 million (~€350 million) or 0.62% of total National Health Service (NHS) expenditure. Hospitalisations and drug prescriptions accounted for 50% and 20% of this expenditure, respectively. Long term nursing home care after hospital admission cost an additional £46.4 million (~€66 million). The direct cost of AF rose to £459 million (~€655 million) in 2000...

Cost-of-illness studies: A guide to critical evaluation

Larg, A.; Moss, J.
Fonte: Adis International Ltd Publicador: Adis International Ltd
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
95.74%
Cost-of-illness (COI) studies aim to assess the economic burden of health problems on the population overall, and they are conducted for an ever widening range of health conditions and geographical settings. While they attract much interest from public health advocates and healthcare policy makers, inconsistencies in the way in which they are conducted and a lack of transparency in reporting have made interpretation difficult, and have ostensibly limited their usefulness. Yet there is surprisingly little in the literature to assist the non-expert in critically evaluating these studies. This article aims to provide non-expert readers with a straightforward guide to understanding and evaluating traditional COI studies. The intention is to equip a general audience with an understanding of the most important issues that influence the validity of a COI study, and the ability to recognize the most common limitations in such work.; Allison Larg and John R. Moss

The health and cost implications of high body mass index in Australian defence force personnel

Peake, J.; Gargett, S.; Waller, M.; McLaughlin, R.; Cosgrove, T.; Wittert, G.; Nasveld, P.; Warfe, P.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
65.82%
Background: Frequent illness and injury among workers with high body mass index (BMI) can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI. Methods: Personnel were grouped into cohorts according to the following ranges for (BMI): normal (18.5 − 24.9 kg/m2; n = 197), overweight (25–29.9 kg/m2; n = 154) and obese (≥30 kg/m2) with restricted body fat (≤28% for females, ≤24% for males) (n = 148) and with no restriction on body fat (n = 180). Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions) and administrative outcomes (e.g., discharge from service) over one year. These data were then grouped and compared between the cohorts. Results: The prevalence of injury and illness...

Epidemiologia da Demência e da Doença de Alzheimer em Portugal: Estimativas da Prevalência e dos Encargos Financeiros com a Medicação; The Epidemiology of Dementia and Alzheimer Disease in Portugal: Estimations of Prevalence and Treatment-Costs

Santana, Isabel; Centro de Neurociências e Biologia Celular. Universidade de Coimbra. Coimbra. Portugal. Departamento de Neurologia. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal. Consulta de Demência. Serviço de Neurologia. Centro
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf; application/pdf
Publicado em 29/05/2015 POR; ENG
Relevância na Pesquisa
75.67%
Introdução: A incidência e prevalência de demência e de Doença de Alzheimer aumentam com a idade, duplicando a cada cinco anos após a sexta década de vida. Portugal é um país envelhecido, previsivelmente com um número crescente de casos de demência. No entanto, os dados epidemiológicos são escassos e os estudos sobre os custos da doença praticamente inexistentes. Propomo-nos apresentar uma estimativa actualizada da prevalência de demência/ Doença de Alzheimer em Portugal e inferir, a partir da prescrição específica para demência, o número de diagnósticos efectivos e os encargos financeiros com esses medicamentos.Material e Métodos: À população residente em Portugal (2013), aplicámos os valores de prevalência de demência para a Europa Ocidental (estudo da Alzheimer’s Disease International). A estimativa dos diagnósticos efectivos de Doença de Alzheimer e dos encargos financeiros com medicação específica baseou-se nas informações do Intercontinental Marketing Services Health (IMSH) – 2013.Resultados: O número estimado de Portugueses com mais de 60 anos e com demência foi 160287, o que corresponde a 5,91% deste universo populacional. Sabendo que a Doença de Alzheimer representa 50-70% dos casos...

Cost-of-illness study in a retrospective cohort of patients with dementia in Lima, Peru

Custodio,Nilton; Lira,David; Herrera-Perez,Eder; Prado,Liza Nuñez del; Parodi,José; Guevara-Silva,Erik; Castro-Suarez,Sheila; Montesinos,Rosa
Fonte: Associação de Neurologia Cognitiva e do Comportamento Publicador: Associação de Neurologia Cognitiva e do Comportamento
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2015 EN
Relevância na Pesquisa
95.76%
Dementia is a major cause of dependency and disability among older persons, and imposes huge economic burdens. Only a few cost-of-illness studies for dementia have been carried out in middle and low-income countries. OBJECTIVE: The aim of this study was to analyze costs of dementia in demented patients of a private clinic in Lima, Peru. Methods. We performed a retrospective, cohort, 3-month study by extracting information from medical records of demented patients to assess the use of both healthcare and non-healthcare resources. The total costs of the disease were broken down into direct (medical and social care costs) and indirect costs (informal care costs). Results. In 136 outpatients, we observed that while half of non-demented patients had total care costs of less than US$ 23 over three months, demented patients had costs of US$ 1500 or over (and more than US$ 1860 for frontotemporal dementia). In our study, the monthly cost of a demented patient (US$ 570) was 2.5 times higher than the minimum wage (legal minimum monthly wage in Peru for 2011: US$ 222.22). Conclusion. Dementia constitutes a socioeconomic problem even in developing countries, since patients involve high healthcare and non-healthcare costs, with the costs being especially high for the patient's family.

Transtorno afetivo bipolar: carga da doença e custos relacionados; Bipolar disorder: burden of disease and related costs

Costa, Anna Maria Niccolai
Fonte: Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria Publicador: Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 01/01/2008 POR
Relevância na Pesquisa
75.81%
CONTEXTO: O transtorno afetivo bipolar (TAB) é uma doença recorrente, crônica e grave. Comorbidades psiquiátricas e físicas, aumento do risco de suicídio, maior utilização de serviços de saúde e prejuízo na esfera social/profissional aumentam significativamente a carga e custos relacionados à doença. OBJETIVOS: Revisar aspectos clínicos, de carga da doença e conseqüentes desfechos financeiros do TAB. MÉTODOS: Pesquisa de base de dados MEDLINE/PubMed utilizando os termos bipolar disorder, epidemiology, burden of disease, comorbidity, cost of illness, outcomes e financial consequences, publicados entre 1980 e 2006. RESULTADOS: O TAB apresenta alta comorbidade com outros transtornos, o que agrava seu prognóstico e eleva os custos com os serviços de saúde. Os indivíduos com TAB apresentam mais fatores de risco cardiovascular e, conseqüentemente, maior risco de morte por evento cardíaco. O atraso e o erro diagnóstico no TAB elevam consideravelmente a carga e os custos da doença. CONCLUSÕES: As comorbidades, o risco de suicídio, o prejuízo social/profissional e a baixa adesão ao tratamento contribuem para a alta carga e os custos associados à doença. A pesquisa de comorbidades pode ajudar os médicos a ajustarem suas estratégias de tratamento...

Effectiveness of community health financing in meeting the cost of illness

Preker,Alexander S.; Carrin,Guy; Dror,David; Jakab,Melitta; Hsiao,William; Arhin-Tenkorang,Dyna
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2002 EN
Relevância na Pesquisa
95.71%
How to finance and provide health care for the more than 1.3 billion rural poor and informal sector workers in low- and middle-income countries is one of the greatest challenges facing the international development community. This article presents the main findings from an extensive survey of the literature of community financing arrangements, and selected experiences from the Asia and Africa regions. Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Micro-level household data analysis indicates that community financing improves access by rural and informal sector workers to needed heath care and provides them with some financial protection against the cost of illness. Macro-level cross-country analysis gives empirical support to the hypothesis that risk-sharing in health financing matters in terms of its impact on both the level and distribution of health, financial fairness and responsiveness indicators. The background research done for this article points to five key policies available to governments to improve the effectiveness and sustainability of existing community financing schemes. This includes: (a) increased and well-targeted subsidies to pay for the premiums of low-income populations; (b) insurance to protect against expenditure fluctuations and re-insurance to enlarge the effective size of small risk pools; (c) effective prevention and case management techniques to limit expenditure fluctuations; (d) technical support to strengthen the management capacity of local schemes; and (e) establishment and strengthening of links with the formal financing and provider networks.

Cost-of-illness study of type 2 diabetes mellitus in Colombia

González,Juan Camilo; Walker,John H.; Einarson,Thomas R.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2009 EN
Relevância na Pesquisa
95.83%
OBJECTIVE: To determine the per patient and overall cost of illness of type 2 diabetes mellitus (T2DM) in Colombia from Ministry of Health and societal perspectives. METHODS: A published Markov transition model was adapted for Colombia, using the clinical expertise of a Colombian endocrinologist. Transition probabilities for the model were derived from an international literature review. A model was run for a time horizon of 42 years. Direct resources (drugs, laboratory, medical, hospital, other health care) were identified and cost was ascertained by using national price lists, international health care guidelines, and other Colombian studies or data from other countries. Indirect costs (work time lost) were calculated by using the human capital approach. Annual and lifetime direct and indirect costs, in 2007 U.S. dollars with a 5% discount rate, were determined on a per patient basis and projected to the overall Colombian population. Costs were clustered according to treatments and outcomes. RESULTS: The estimated annual cost was $2.7 billion from the societal perspective and $921 million from the Ministry of Health perspective. The annual direct cost per patient was $288, and the indirect cost was $559 (total = $847). This cost was distributed across disease outcomes as follows: diabetes treatment (drugs)...