Financial burden
Dotaz
Zobrazit nápovědu
BACKGROUND AND OBJECTIVE: Bladder cancer (BCa) imposes a substantial economic burden on health care systems and patients. Understanding these financial implications is crucial for effective resource allocation and optimization of treatment cost effectiveness. Here, we aim to systematically review and analyze the financial burden of BCa from the health care and patient perspectives. METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant systematic review was conducted, searching PubMed/Medline, Embase, and public sources for studies evaluating the financial impact of BCa, encompassing costs, cost effectiveness, and financial toxicity (FT). KEY FINDINGS AND LIMITATIONS: Non-muscle-invasive BCa (NMIBC) incurs significant costs for surveillance and treatment, with costs exceeding $200 000 after 5 yr for high-risk NMIBC patients progressing after bacillus Calmette-Guerin (BCG) treatment (including inpatient, outpatient, and physician service expenses). Muscle-invasive BCa generates substantial costs from radical cystectomy (RC) and neoadjuvant chemotherapy, averaging $30 000-40 000 from surgical costs of RC, with additional expenses in case of complications. Trimodal therapy has higher costs (1-yr management cost >$200 000) than RC because of higher outpatient, radiology, and medication costs. Metastatic BCa incurs the highest financial burden, with systemic therapy costs ranging from $40 000 to over $100 000 per five-cycle course, increasing further with combination therapies (ie, enfortumab vedotin and pembrolizumab), treatment-related toxicity, and supportive care. FT is particularly prevalent among younger, less educated, and minority populations. CONCLUSIONS AND CLINICAL IMPLICATIONS: BCa treatment, particularly in advanced stages, imposes a substantial economic burden. Innovations in care, while improving oncologic outcomes, necessitate detailed cost-effectiveness assessments. Addressing these economic challenges is essential for optimizing BCa management, targeting patients at a higher risk of FT, and improving patient quality of life.
- MeSH
- analýza nákladů a výnosů MeSH
- cystektomie ekonomika škodlivé účinky MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nádory močového měchýře * ekonomika terapie patologie MeSH
- náklady na zdravotní péči * MeSH
- osobní újma zaviněná nemocí * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
OBJECTIVE: To provide an assessment of the cost burden of obesity across a spectrum of obesity-related comorbidities (ORCs) for four countries in South-Eastern Europe (SEE). METHODS: A micro-costing analysis from the public payer perspective was conducted to estimate direct healthcare costs associated with ten obesity-related comorbidities (ORCs) in Czech Republic, Greece, Hungary, and Romania. A survey was administered to obtain healthcare resource use and unit cost data. Cost estimates were validated by local steering committees which comprised at least one public sector clinician and a panel of independent industry experts. RESULTS: Chronic kidney disease and cardiovascular diseases were the costliest ORCs across all 4 countries, where annual cost burden per ORC exceeded 1,500 USD per patient per year. In general, costs were driven by the tertiary care resources allocated to address treatment-related adverse events, disease complications, and associated inpatient procedures. CONCLUSIONS: Our findings confirm that the high prevalence of obesity and its comorbidities result in substantial financial burden to all 4 SEE public payers. By quantifying the burden of obesity from a public healthcare perspective, our study aims to support policy efforts that promote health education and promotion in combating obesity in the region.
- MeSH
- finanční stres * MeSH
- lidé MeSH
- náklady na zdravotní péči MeSH
- obezita epidemiologie MeSH
- osobní újma zaviněná nemocí MeSH
- podpora zdraví * MeSH
- prevalence MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran. PATIENTS AND METHODS: In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD. Post-surgical HRQOL (obtained from EORTC QLQ-C30 and QLQBLM-30), financial burden, surgical complications, and survival were compared. Kruskal-Wallis H test, One-way ANOVA, and Kaplan-Meier analyses were utilized; accordingly. RESULTS AND LIMITATIONS: In total 187 patients were identified-orthotopic neobladder (ONB) (N = 75), ileal conduit (IC) (N = 57), and cutaneous ureterostomy (CU) (N = 55)-and were followed for a median 17.5 (Interquartile range: 7.0, 47.0) months. ONB was associated with better HRQOL, especially in the domains addressing physical, role and social functioning (p = 0.003, 0.011, 0.045) as well as better body image (p < 0.001), lower short- and long-term financial burden (p = 0.034 and <0.001, respectively), marginally lower complication rate (p = 0.049), and better 5-year overall survival (p < 0.001), in comparison with other UDs. Patients who underwent CU had the lowest HRQOL and worst survival. Limitations were retrospective design and possibility of selection bias. CONCLUSIONS: In this first study that assesses a Middle Eastern collective; ONB seems to be the UD of choice with regard to HRQOL and economic burden when there is no contraindication.
- MeSH
- cystektomie * metody MeSH
- diverze moči * MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- nádory močového měchýře * chirurgie MeSH
- osobní újma zaviněná nemocí * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Írán MeSH
OBJECTIVES: This article aimed to count and compare treatment's direct (only biological drugs) and indirect (loss of productivity) costs in patients with rheumatoid arthritis from 2019 to 2021. METHODS: The friction cost approach was used to establish indirect costs. Elasticity factor values and friction period for the Slovak Republic from 2019 to 2021 were determined. Direct drug costs were calculated based on average prices from 2019 to 2021 and the number of dispensed medication packages. RESULTS: The average productivity loss reached €2984.54 in 2019, €3338.46 in 2020, and €3154.01 in 2021. Total indirect costs include productivity loss and sick pay, and from 2019 to 2021 came the values of €8.4 million, €10.1 million, and €8.1 million, respectively. CONCLUSIONS: Indirect costs were almost 2.5 to 3 times lower than the biological and targeted treatment costs.
Cíl: Cílem studie bylo identifikovat a analyzovat faktory, které souvisí se zátěží a stresem rodičů handicapovaných dětí. Metody: Do systematického přehledu byly zahrnuty plnotextové přehledy primárních výzkumů, které byly publikovány v anglickém jazyce v období 2005-2021. K vyhledávání byly použity volně přístupné i licencované databáze CINAHL EBSCO, SCOPUS, Wiley Library Online, ProQuest a Web of Science. Výsledky: Z literárního přehledu vyplynulo, že během patnácti let byla publikována řada studií, které se zabývaly faktory způsobujícími stres a zátěž rodičů, kteří pečují o děti s handicapem. Bylo nalezeno celkem 325 studií. Ve čtyřech studiích byl potvrzen pozitivní vliv na snížení zátěže a stresu. V osmi studiích bylo identifikováno patnáct faktorů zvyšujících stres a zátěž rodičů dětí s handicapem. Mezi pozitivní faktory patřilo využívání respitní péče, pořízení psa, vládní finanční podpora a náboženství. Mezi negativní faktory patřila inkontinence dítěte, neúplná rodina, dětská deprese, poruchy učení, neobvyklé chování dítěte na veřejnosti, zhoršená kognitivní schopnost dítěte, Aspergerův syndrom, ženské pohlaví, prestižnější a lukrativnější povolání rodičů, nízká úroveň podpory příbuzných při péči o dítě, noční pomočování, obtížné chování dítěte a vysoké nároky na péči o dítě, pandemie covidu-19, obezita u dítěte. Závěr: Faktory působící na rodiče mohou mít pozitivní i negativní vliv na vývoj a výchovu dítěte. Velmi důležitá je včasná identifikace negativních faktorů, které mohou způsobit zátěž a stres rodičům handicapovaných dětí. Dětská sestra tvoří mezičlánek mezi rodiči, lékařem a dítětem. Proto by se měla podílet nejen na ošetřovatelské péči, ale také na včasném záchytu a identifikaci rizikových faktorů. Zdravotníci by měli poskytovat rodičům pomoc ve všech aspektech péče o děti.
Aim: The aim of the study was to identify and analyse factors which are related to burden and stress of parents with disabled children. Methods: The systematic review includes full-text primary research papers, published in English, in the period 2005-2021. Freely accessible as well as licensed databases CINAHL EBSCO, SCOPUS, Wiley Library Online, ProQuest a Web of Science have been used for the search. Results: The literature review shows that over a period of fifteen years, numerous studies have been published that address the factors causing stress and burden n parents taking care for children with disabilities. A total of 325 studies have been found. In four studies, a positive effect on the reduction of burden and stress was confirmed. In eight studies, fifteen factors increasing the stress and burden of parents of children with disabilities were identified. Positive factors included using respite care, acquiring a dog, governmental financial support and religion. Negative factors included the child incontinence, single-parent family, child depression, learning disorders, unusual behaviour of the child in public, impaired cognitive ability of the child, Asperger syndrome, female gender, more prestigious and lucrative occupation of parents, low level of support from relatives in taking care of the child, night enuresis, difficult behaviour of the child and high demands on child care, the COVID-19 pandemic, obese child. Conclusion: Factors affecting parents can have positive as well as negative influence on the education of the child. Early identification of negative factors that can cause burden and stress on parents of disabled children is very important. The paediatric nurse acts as a link between the parents, the doctor and the child. Therefore, it should be involved not only in nursing care, but also in the early detection and identification of risk factors. Healthcare professionals should help parents in all areas of childcare.
OBJECTIVE: The need to align investments in health research and development (R&D) with public health needs is one of the most important public health challenges in Japan. We examined the alignment of disease-specific publicly competitive R&D funding to the disease burden in the country. METHODS: We analyzed publicly available data on competitive public funding for health in 2015 and 2016 and compared it to disability-adjusted life year (DALYs) in 2016, which were obtained from the Global Burden of Disease (GBD) 2017 study. Their alignment was assessed as a percentage distribution among 22 GBD disease groups. Funding was allocated to the 22 disease groups based on natural language processing, using textual information such as project title and abstract for each research project, while considering for the frequency of information. RESULTS: Total publicly competitive funding in health R&D in 2015 and 2016 reached 344.1 billion JPY (about 3.0 billion USD) for 32,204 awarded projects. About 49.5% of the funding was classifiable for disease-specific projects. Five GDB disease groups were significantly and relatively well-funded compared to their contributions to Japan's DALY, including neglected tropical diseases and malaria (funding vs DALY = 1.7% vs 0.0%, p<0.01) and neoplasms (28.5% vs 19.2%, p<0.001). In contrast, four GDB disease groups were significantly under-funded, including cardiovascular diseases (8.0% vs 14.8%, p<0.001) and musculoskeletal disorders (1.0% vs 11.9%, p<0.001). These percentages do not include unclassifiable funding. CONCLUSIONS: While caution is necessary as this study was not able to consider public in-house funding and the methodological uncertainties could not be ruled out, the analysis may provide a snapshot of the limited alignment between publicly competitive disease-specific funding and the disease burden in the country. The results call for greater management over the allocation of scarce resources on health R&D. DALYs will serve as a crucial, but not the only, consideration in aligning Japan's research priorities with the public health needs. In addition, the algorithms for natural language processing used in this study require continued efforts to improve accuracy.
- MeSH
- biomedicínský výzkum ekonomika statistika a číselné údaje MeSH
- ekonomické soutěžení * MeSH
- finanční podpora * MeSH
- financování vládou klasifikace organizace a řízení normy MeSH
- globální zátěž nemocemi * ekonomika organizace a řízení normy statistika a číselné údaje MeSH
- investice ekonomika statistika a číselné údaje MeSH
- kvalitativně upravené roky života MeSH
- lidé MeSH
- mezinárodní klasifikace nemocí MeSH
- náklady na zdravotní péči statistika a číselné údaje MeSH
- nemoc klasifikace ekonomika MeSH
- veřejné zdravotnictví ekonomika MeSH
- výzkum ekonomika statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Japonsko MeSH
OBJECTIVE: Diabetic foot (DF), especially DF ulcers (DFUs) are a relatively frequent and financially burdensome late-stage complication of diabetes. However, data on the costs of podiatric care in the Czech Republic are scarce. The aim of this prospective multicenter study was to determine the total costs associated with long-term podiatric care in selected foot clinics across the Czech Republic. RESEARCH DESIGN AND METHODS: A total of 119 patients with DFUs (mean age of 68 ± 11 years, diabetes duration of 19 ± 11 years, HbA1c level of 62 ± 14 mmol/mol, composite WIfI score of 3 ± 2, 33 % had new DFUs, 37 % previous amputations, and 50 % had peripheral artery disease (PAD)) from 10 podiatric foot clinics in the Czech Republic were enrolled in our financial analysis. Direct and indirect costs associated with podiatric care - diagnostic and treatment methods - including angiological, radiological, and microbiological examinations, blood sampling, prescribed materials for local therapy, antibiotics, surgical procedures, offloading devices, hospital services and additional expenses such as patient transportation, doctors' visits, home care assistance, and work incapacity - were monitored over a 6-month period using an electronic database. RESULTS: The average cost of podiatric care per patient over a 6-month period was €2,506 with median €1,320. The largest expenses were spent on therapeutic procedures (51.4 %). Costs for patients hospitalized during the study period were significantly higher than for outpatients (€7,923 vs. €1,304 on average; P < 0.001). Among hospitalized patients, the main costs were hospital services (32 %), therapeutic procedures (26 %), and antibiotic and local therapies (20 %). Among outpatients, therapeutic procedures accounted for 74 % of the total costs. Newly developed DFUs or PAD were not linked to significantly increased costs. The composite WIfI score, primarily the wound component, was the only parameter that significantly positively correlated with the total podiatric costs (r = 0.434; 95 % CI 0.279-0.559; P < 0.0001). Other patient characteristics such as age, diabetes duration, DFU duration, and HbA1c level did not show significant cost correlations. CONCLUSIONS: On average, podiatric care for patients with DFUs in the Czech Republic is 3 to 9 times more expensive than standard diabetes healthcare. The expenses for hospitalized patients are almost 6 times higher than for outpatients. The composite WIfI score was the most significant indicator of podiatric financial burden.
- MeSH
- diabetická noha * ekonomika terapie epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- náklady na zdravotní péči * MeSH
- osobní újma zaviněná nemocí * MeSH
- podiatrie * ekonomika MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Obstructive sleep apnea (OSA) is a risk factor for several diseases and is correlated with other non-medical consequences that increase the disease's clinical and economic burden. However, OSA's impact is highly underestimated, also due to substantial diagnosis gaps. OBJECTIVE: This study aims at assessing the economic burden of OSA in the adult population in Italy by performing a cost-of-illness analysis with a societal perspective. In particular, we aimed at estimating the magnitude of the burden caused by conditions for which OSA is a proven risk factor. METHODS: A systematic literature review on systematic reviews and meta-analyses, integrated by expert opinion, was performed to identify all clinical and non-clinical conditions significantly influenced by OSA. Using the Population Attributable Fraction methodology, a portion of their prevalence and costs was attributed to OSA. The total economic burden of OSA for the society was estimated by summing the costs of each condition influenced by the disease, the costs due to OSA's diagnosis and treatment and the economic value of quality of life lost due to OSA's undertreatment. RESULTS: Twenty-six clinical (e.g., diabetes) and non-clinical (e.g., car accidents) conditions were found to be significantly influenced by OSA, contributing to an economic burden ranging from €10.7 to €32.0 billion/year in Italy. The cost of impaired quality of life due to OSA undertreatment is between €2.8 and €9.0 billion/year. These costs are substantially higher than those currently borne to diagnose and treat OSA (€234 million/year). CONCLUSIONS: This study demonstrates that the economic burden due to OSA is substantial, also due to low diagnosis and treatment rates. Providing reliable estimates of the economic impact of OSA at a societal level may increase awareness of the disease burden and help to guide evidence-based policies and prioritisation for healthcare, ultimately ensuring appropriate diagnostic and therapeutic pathways for patients.
- MeSH
- dospělí MeSH
- finanční stres MeSH
- kvalita života * MeSH
- lidé MeSH
- náklady na zdravotní péči MeSH
- obstrukční spánková apnoe * epidemiologie terapie MeSH
- osobní újma zaviněná nemocí MeSH
- poskytování zdravotní péče MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- systematický přehled MeSH
Autoři asociovali data Národního onkologického registru s administrativními daty tří nemocnic (Nemocnice Na Bulovce – NNB, Všeobecné fakultní nemocnice – VFN a Thomayerovy nemocnice – TN), které jsou sdruženy v jednom Komplexním onkologickém centru (KOC). Na takto získaných číslech prokazují vysokou migrační zátěž onkologicky nemocnými nejen ze Středočeského kraje, kde není ustaveno žádné KOC, ale i z jiných krajů, kde příslušná KOC jsou a kde je incidence zhoubných novotvarů podstatně nižší než v hl. m. Praze. S tím kontrastuje nerovnost přístupu k finančním zdrojům (zejména zdroje EU), kdy mimopražská KOC tento přístup mají relativně velmi jednoduchý. Pacienti mají právo na výběr zdravotnického zařízení a na výběr lékaře a pojednávané KOC toto právo ctí. Je potěšující, že je toto KOC nemocnými tak vyhledáváno. Je to nepochybně i známkou vysoké úrovně. Na druhé straně je třeba počítat s limitací finančních budgetů. Situaci by napomohlo, kdyby finance od plátců skutečně směřovaly za pacientem.
The authors associated the National Cancer Registry data with administrative data of three hospitals (University Hospital Bulovka – NNB, General Faculty Hospital – General University Hospital and Thomayer Hospital – TN), which are grouped in a Comprehensive Cancer Center (CCC). On thus obtained figures showing high migration burden of oncological patients not only from the Central Bohemia region, where there is no established CCC, but also from other regions with relevant CCC and where the incidence of malignant tumors is substantially lower than in the capital Praha. This contrasts with the inequality of access to financial resources (mainly EU sources) when for CCC outside Prague this approach is relatively simple. Patients have the right to choose health care facility and to choose a doctor and discussed CCC is respecting this right. It is gratifying that patients seek after this CCC. It’s undoubtedly a sign of a high level. On the other hand, we must reckon with the limitations of financial budgets. The situation could be helped if funding from health insurancies would follow the patient.
