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2 "Costs and cost analysis"
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Brief Report
Determinants of Hospital Inpatient Costs in the Iranian Elderly: A Micro-costing Analysis
Ebrahim Hazrati, zahra Meshkani, Saeed Husseini Barghazan, Sanaz Zargar Balaye Jame, Nader Markazi-Moghaddam
J Prev Med Public Health. 2020;53(3):205-210.   Published online May 16, 2020
DOI: https://doi.org/10.3961/jpmph.19.250
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AbstractAbstract PDF
Objectives
Aging is assumed to be accompanied by greater health care expenditures. The objective of this retrospective, bottom-up micro-costing study was to identify and analyze the variables related to increased health care costs for the elderly from the provider’s perspective.
Methods
The analysis included all elderly inpatients who were admitted in 2017 to a hospital in Tehran, Iran. In total, 1288 patients were included. The Mann-Whitney and Kruskal-Wallis tests were used.
Results
Slightly more than half (51.1%) of patients were males, and 81.9% had a partial recovery. The 60-64 age group had the highest costs. Cancer and joint/orthopedic diseases accounted for the highest proportion of costs, while joint/orthopedic diseases had the highest total costs. The surgery ward had the highest overall cost among the hospital departments, while the intensive care unit had the highest mean cost. No statistically significant relationships were found between inpatient costs and sex or age group, while significant associations (p<0.05) were observed between inpatient costs and the type of ward, length of stay, type of disease, and final status. Regarding final status, costs for patients who died were 3.9 times higher than costs for patients who experienced a partial recovery.
Conclusions
Sex and age group did not affect hospital costs. Instead, the most important factors associated with costs were type of disease (especially chronic diseases, such as joint and orthopedic conditions), length of stay, final status, and type of ward. Surgical services and medicine were the most important cost items.
Summary
Original Article
Use of Drug-eluting Stents Versus Bare-metal Stents in Korea: A Cost-minimization Analysis Using Population Data
Hae Sun Suh, Hyun Jin Song, Eun Jin Jang, Jung-Sun Kim, Donghoon Choi, Sang Moo Lee
J Prev Med Public Health. 2013;46(4):201-209.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.201
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  • 82 Download
  • 1 Crossref
AbstractAbstract PDF
Objectives

The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data.

Methods

We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses.

Results

Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization.

Conclusions

Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

Summary

Citations

Citations to this article as recorded by  
  • A cost analysis comparing telepsychiatry to in-person psychiatric outreach and patient travel reimbursement in Northern Ontario communities
    Eva Serhal, Tanya Lazor, Paul Kurdyak, Allison Crawford, Claire de Oliveira, Rebecca Hancock-Howard, Peter C Coyte
    Journal of Telemedicine and Telecare.2020; 26(10): 607.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health