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PubMed2004

Out-of-Pocket expenditure for depression among patients attending private community psychiatric clinics in Pakistan.

BACKGROUND: Depression is a serious public health problem in Pakistan because of the disabilities it causes and the cost burden for the family. About 6% of the Pakistani population suffers from this illness and approximately 50% ofthose affected seek treatment. The health budget of the country is very low, average per capita income is 430 US dollars and 35% of the population falls below the poverty line. It follows that depression puts a heavy economic burden on its sufferers. AIM: The aim of this study was to estimate the economic burden on patients suffering from depression who were attending community psychiatry clinics. METHODS: This is a prevalence-based analysis of mental health care expenditure in a sample of 200 patients with an ICD-X diagnosis of depression. The patients attended four private community clinics, run on a once-a-week basis, with all care paid for by the patients out of pocket. A questionnaire was designed with a view to gathering information on out-of-pocket treatment and travel expenditures. The data was subjected to SPSS analysis. RESULTS: Among the subjects enrolled in the study (n=200), 85% were spending over Rs. 3,133 (51.40 US dollars) per month as general expenses on health. Sixty-five percent of the subjects were earning below Rs. 5,000 ( 86.00 US dollars). The majority used the public bus for transportation, costing the family Rs. 83 (1.40 US dollars) per trip. Laboratory investigation costs were negligible as there is a lesser emphasis on lab tests in psychiatry. DISCUSSION: The high cost of depression keeps a vast majority of the population away from ongoing treatment, which contributes to the misery of the illness and the associated loss of productivity. The national budget is very low, the average income for the majority is far from satisfactory, and though partial support from charitable organizations, public sector hospitals, insurance cover and medical facilities is available, the majority of needs are unmet. It is essential to increase the health budget and enhance efforts toward preventive strategies. Further research on health economics is needed along with an appropriate government database.

Adult↗
PubMed2004

The economics of integrated electronic medical record systems.

The decision to adopt electronic medical record systems in private practices is usually based on factors specific to the practice--the cost, cost and timesaving, and impact on quality of care. As evident by the low adoption rates, providers have not found these evaluations compelling. However, it is recognized that the widespread adoption of EMR systems would greatly benefit the health care system as a whole. One explanation for the lack of adoption is that there is a misalignment of the costs and benefits of EMR systems across the health care system. In this paper we present an economic model of the adoption of EMR systems that explicitly represents the distribution of costs and benefits across stakeholders (physicians, hospitals, insurers, etc.). We discuss incentive systems for balancing the costs and benefits and, thus, promoting the faster adoption of EMR systems. Finally, we describe our plan to extend the model and to use real-world data to evaluate our model.

Costs and Cost Analysis↗
PubMedDate not supplied

Political issues in internal medicine in Europe.

What will be the future of Internal Medicine in Europe? Because of rapidly growing concerns regarding the position of Internal Medicine in many European countries, the European Federation of Internal Medicine has established a working group to analyze the situation. Being well aware of the variation of working practices in the different countries, the members of the group used an "all-European" approach to answer the following questions: Are there problems for Internal Medicine, what problems and why? Why do the health care systems of the European countries need Internal Medicine? Why do the patients need Internal Medicine? What needs to be done? Internal Medicine is the modern, clinical and scientific medical discipline taking care of adult patients with one or more complex, acute or chronic illnesses. Internal Medicine is the cornerstone of integrated health care delivery service that is needed today. Decision-makers in politics and hospitals, insurers, journalists and the general public need a better understanding of what Internal Medicine can offer to the health care system and to the individual patient.

Europe↗
PubMed2006

Medicare finances: findings of the 2006 trustees report.

Medicare helps pay medical expenses for 37 million Americans age 65 and older and 6 million persons with disabilities. The benefits are financed primarily by dedicated taxes on wages and self-employment income, premiums paid by beneficiaries, and payments from general revenues. According to the 2006 report of Medicare's trustees, Medicare's Hospital Insurance (HI) program is not adequately financed. The HI trust fund is projected to start drawing down its reserves in 2010. Its reserves will be depleted in 2018, at which time scheduled income will cover 80 percent of estimated expenditures. The Supplementary Medical Insurance program is adequately financed but will require continuing increases in both premiums and general revenue contributions. Medicare spending is growing rapidly because of increases in the cost and use of medical services. Total Medicare expenditures are projected to grow from 2.7 percent of gross domestic product (GDP) in 2005 to 9.0 percent of GDP in 2050.

Costs and Cost Analysis↗
PubMed2006

The big squeeze. Insurers point to slower growth in premiums in past few years to show progress, but providers say they're paying the price.

While insurers last week were trumpeting the third straight year of slower growth in premiums, providers weren't exactly celebrating. That's because of huge mergers, which give insurers far more leverage and have led to reimbursements being cut back even more. "What's worrying us is that there's a growing segment (of insurers) that aren't going to budge an inch, no matter what," says Russ Weaver, left.

Cost Savings↗
PubMed2002

Genetic determinants of essential hypertension.

This study aimed at determining the role of genetic and environmental risk factors in the development of essential hypertension in Alexandria, Egypt. A case-control-study was conducted in the Main Health Insurance Hospital, (MHI) Alexandria, Egypt, whereby cases previously diagnosed as hypertensive were included in the study. A hospital-based control group visiting the hospital for other unrelated conditions and randomly selected in the same day as cases was also included in the study. Both cases and controls were subjected to a semi-structured questionnaire including information concerning socio-demographic data and risk factors for hypertension Only cases were subjected to segregation analysis. This study included 165 cases with history of essential hypertension, and 196 controls. Multivariate analysis of potential risk factors showed the following factors to be independently associated with an increased risk of essential hypertension: age over 40 years, elevated BMI, workers, ever smoker and stress. Education less than 6 years remained in the model as an independent protective effect. Segregation analysis proved that the disease is not inherited as single gene mode of inheritance. On the other hand, the heritability for 1st, 2nd and 3rd degree relative was 28.2%, 28.7% and 20.0%. These figures provide evidence to multifactorial mode of inheritance in essential hypertension.

Adult↗
PubMed1991

Actuarial status of the HI and SMI Trust Funds.

This article presents the "Summary of the 1991 Annual Reports of the Medicare Board of Trustees." The Board reports that the present financing schedule for the Hospital Insurance (HI) program is sufficient to ensure the payment of benefits over the next 14 years with trust fund exhaustion occurring in 2005 if the alternative II (intermediate) assumptions are realized. Although the HI Trust Fund is financially adequate based on the short-range test, the Board believes that corrective action will be needed very soon to avoid the need for potentially precipitous changes later. For the Supplementary Medical Insurance (SMI) Trust Fund, the Board concludes that funds are sufficient to cover projected benefits and administrative costs through December 1991, but notes with concern the rapid growth in the cost of the program and recommends that Congress continue to work to curtail the rapid growth in the cost of the SMI program.

Actuarial Analysis↗