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At least 19 recordsLinked to original sources
PubMed1982

Problems in measuring the cost of illness.

Cost of illness (COI) studies have grown in importance in the last decade. They are frequently used in funding decisions for selected health care programs. Cost of illness study proponents present their results as objective, unbiased analysis. Yet, there are severe conceptual and methodological difficulties with the technique. Given its methodological weaknesses, the singular use of COI analysis to reach policy decisions may be no better than the political decision process it was intended to replace.

Costs and Cost Analysis↗
PubMed2004

Economic aspects of severe sepsis: a review of intensive care unit costs, cost of illness and cost effectiveness of therapy.

Severe sepsis remains both an important clinical challenge and an economic burden in intensive care. An estimated 750,000 cases occur each year in the US alone (300 cases per 100,000 population). Lower numbers are estimated for most European countries (e.g. Germany and Austria: 54-116 cases per year per 100,000). Sepsis patients are generally treated in intensive care units (ICUs) where close supervision and intensive care treatment by a competent team with adequate equipment can be provided. Staffing costs represent from 40% to >60% of the total ICU budget. Because of the high proportion of fixed costs in ICU treatment, the total cost of ICU care is mainly dependent on the length of ICU stay (ICU-LOS). The average total cost per ICU day is estimated at approximately 1200 Euro for countries with a highly developed healthcare system (based on various studies conducted between 1989 and 2001 and converted at 2003 currency rates). Patients with infections and severe sepsis require a prolonged ICU-LOS, resulting in higher costs of treatment compared with other ICU patients. US cost-of-illness studies focusing on direct costs per sepsis patient have yielded estimates of 34,000 Euro, whereas European studies have given lower cost estimates, ranging from 23,000 Euro to 29,000 Euro. Direct costs, however, make up only about 20-30% of the cost of illness of severe sepsis. Indirect costs associated with severe sepsis account for 70-80% of costs and arise mainly from productivity losses due to mortality. Because of increasing healthcare cost pressures worldwide, economic issues have become important for the introduction of new innovations. This is evident when introducing new biotechnology products, such as drotrecogin-alpha (activated protein C), into specific therapy for severe sepsis. Data so far suggest that when drotrecogin-alpha treatment is targeted to those patients most likely to achieve the greatest benefit, the drug is cost effective by the standards of other well accepted life-saving interventions.

Anti-Bacterial Agents↗
PubMed2005

Does the Integrated Management of Childhood Illness cost more than routine care? Results from the United Republic of Tanzania.

OBJECTIVE: The Integrated Management of Childhood Illness (IMCI) strategy is designed to address the five leading causes of childhood mortality, which together account for 70% of the 10 million deaths occurring among children worldwide annually. Although IMCI is associated with improved quality of care, which is a key determinant of better health outcomes, it has not yet been widely adopted, partly because it is assumed to be more expensive than routine care. Here we report the cost of IMCI compared with routine care in four districts in the United Republic of Tanzania. METHODS: Total district costs of child care were estimated from the societal perspective as the sum of child health-care costs incurred in a district at the household level, primary health-facility level and hospital level. We also included administrative and support costs incurred by national and district administrations. The incremental cost of IMCI is the difference in costs of child health-care between districts with and without IMCI, after standardization for population size. FINDINGS: The annual cost per child of caring for children less than five years old in districts with IMCI was USD 11.19, 44% lower than the cost in the districts without IMCI (USD 16.09). Much of the difference was due to higher rates of hospitalization of children less than 5 years old in the districts without IMCI. Not all of this difference can be attributed to IMCI but even when differences in hospitalization rates are excluded, the cost per child was still 6% lower in IMCI districts. CONCLUSION: IMCI was not associated with higher costs than routine child health-care in the four study districts in the United Republic of Tanzania. Given the evidence of improved quality of care in the IMCI districts, the results suggest that cost should not be a barrier to the adoption and scaling up of IMCI.

Child Health Services↗
PubMed2000

Deinstitutionalisation for long-term mental illness: cost differences in hospital and community care.

OBJECTIVE: This project studied the cost analysis of psychiatric hospital and then community care for long-stay patients with chronic mental illness discharged during the closure of a psychiatric hospital in Sydney. METHOD: Expenditure and income data in both settings were collected. Costs were analysed on an occupied bed-day basis. RESULTS: The hospital setting cost more per patient per day compared with the various community costs which were one-third to one-half of the comparable hospital costs. CONCLUSIONS: The analysis demonstrated overall that hospital care was nearly twice as expensive as care in the community setting. The factors which may have influenced, although not necessarily altered, the substance of the findings largely related to 'organisational efficiency'. The mental hospital as an older, more rigid system was likely to be less efficient than the newer community service provision which was under intensive scrutiny both clinically and financially by all interested parties.

Australia↗
PubMed2004

Quality of life and illness costs in irritable bowel syndrome.

Quality of life is reduced in patients with irritable bowel syndrome, and the costs for this disease are substantial to society. During a meeting in London, UK, the IBiS club reviewed the literature on these subjects. Drawbacks and advantages with existing instruments to assess quality of life and costs were discussed and the clinical and scientific relevance of the current knowledge was assessed. A summary from the meeting is presented in this paper.

Clinical Trials as Topic↗
PubMed1998

[Total illness costs of schizophrenia and monetary evaluation of prevention of recurrence exemplified by a standard depot neuroleptic (flupenthixol decanoate)].

Treatment of patients suffering from schizophrenia is very expensive. However, by consistently and methodically performed medical prophylaxis the disease can be controlled sufficiently well. Regular prophylactic treatment compared to repeated treatment of acute episodes has both medical advantages and reduces cost by reducing the rate of hospitalisation. Prophylactic treatment with Flupentixoldecanoat can save up to 68% of costs.

Adult↗
PubMed1994

Costs of illness in cost-effectiveness analysis. A review of the methodology.

Costs of illness are an important input in cost-effectiveness analysis (CEA). Reviews of the literature have found that many CEAs are of low technical quality and fail to take account of costs of illness appropriately. The costs of illness and disease averted by an intervention, indirect costs, and medical care costs in added years of life are topics that present methodological issues and are not handled consistently in CEAs. Costs of illness and disease averted may be estimated by prevalence- or incidence-based methods; the correct conceptual paradigm depends on the nature of the disease. Incidence costs may be estimated by modelling the disease process, or directly from prevalence costs, the choice being determined by the extent and quality of data available. Regardless of the method, in forward-looking CEAs potential technological change must be taken into account so that incidence-based lifetime costs estimated from current treatment practices will not be biased. Whether to include indirect costs is an important issue, because indirect costs may be large and have a significant impact on the cost-effectiveness ratio. In the pure CEA model, indirect costs are excluded on ethical grounds and to prevent incursion of elements of cost-benefit analysis into CEA. The modified CEA model accepts enhanced productivity as an economic benefit made possible by, but distinct from, the health effect of an intervention. Indirect costs are included when appropriate, depending on the perspective of the analysis, the measure of effectiveness, and who bears the costs. When medical care extends life, expenditures will be incurred in the added years for illness and disease unrelated to the intervention. As with indirect costs, the pure CEA considers unrelated 'downstream' costs an indirect consequence of the health benefit of the intervention and excludes them from CEAs with the societal perspective. The modified CEA treats unrelated downstream costs as an economic effect of the change in health due to the intervention and includes them in order to have a more complete accounting of the cost of the intervention.

Cost of Illness↗