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Comparing systems for costing hospital treatments. The case of stable angina pectoris.

https://arctichealth.org/en/permalink/ahliterature53378
Source
Health Policy. 2004 Mar;67(3):293-307
Publication Type
Article
Date
Mar-2004
Author
Jytte Larsen
Ulla Slothuus Skjoldborg
Author Affiliation
Department of Accounting and Finance, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark. jyt@sam.sdu.dk
Source
Health Policy. 2004 Mar;67(3):293-307
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Angina Pectoris - economics - therapy
Comparative Study
Denmark
Diagnosis-Related Groups
Health Services Research
Hospital Costs
Humans
Length of Stay
Abstract
This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed.
PubMed ID
15036817 View in PubMed
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Cost of illness for chronic stable angina patients enrolled in a self-management education trial.

https://arctichealth.org/en/permalink/ahliterature154832
Source
Can J Cardiol. 2008 Oct;24(10):759-64
Publication Type
Article
Date
Oct-2008
Author
Michael H McGillion
Ruth Croxford
Judy Watt-Watson
Sandra Lefort
Bonnie Stevens
Peter Coyte
Author Affiliation
Faculty of Nursing, University of Toronto, Toronto, Canada. michael.mcgillion@utoronto.ca
Source
Can J Cardiol. 2008 Oct;24(10):759-64
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Aged
Angina Pectoris - economics - therapy
Chronic Disease
Cost of Illness
Cost-Benefit Analysis
Female
Follow-Up Studies
Humans
Male
Ontario
Patient Education as Topic - methods
Retrospective Studies
Self Care - methods
Urban Population
Abstract
Chronic stable angina (CSA) is a major debilitating health problem in Canada. A paucity of relevant cardiovascular data sets has precluded a detailed examination of the impact of interventions on CSA-related costs and its broader economic burden.
As part of a larger clinical trial, the authors sought to determine the short-term impact of a standardized self-management training program on CSA-related costs. A secondary objective was to estimate the total annualized cost of CSA per patient from a societal perspective.
Pre- and three-month post-test cost data were collected on 117 participants using the Ambulatory Home Care Record. Mean annualized direct, indirect and system-related CSA costs (2003 to 2005) were estimated; total per-patient CSA costs from a societal perspective were calculated as the sum of these costs.
The mean (+/- SD) age of participants was 68+/-11 years; 80% were male. The program did not impact costs in the short-term. Direct annual out-of-pocket costs, including money paid for health care, travel to appointments, medication, equipment and home support totaled $3,267. Indirect costs, reflecting the value of all unpaid time spent by those engaged in angina-related care, were $12,963. System costs, including costs paid by public and private insurers, were $2,979. Total estimated annual CSA costs from a societal perspective were $19,209 per patient.
These data suggest that CSA imposes a major economic burden, comparable with other prevalent conditions such as chronic noncancer pain. Advancements in self-management training research are needed to help reduce the economic burden of CSA in Canada.
Notes
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PubMed ID
18841254 View in PubMed
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Cost of managing complications resulting from type 2 diabetes mellitus in Canada.

https://arctichealth.org/en/permalink/ahliterature186121
Source
BMC Health Serv Res. 2003 Mar 21;3(1):7
Publication Type
Article
Date
Mar-21-2003
Author
Judith A O'Brien
Amanda R Patrick
J Jaime Caro
Author Affiliation
Caro Research Institute, Concord, MA, USA. jobrien@caroresearch.com
Source
BMC Health Serv Res. 2003 Mar 21;3(1):7
Date
Mar-21-2003
Language
English
Publication Type
Article
Keywords
Amputation - economics
Angina Pectoris - economics - therapy
Canada
Cost of Illness
Diabetes Mellitus, Type 2 - complications - economics
Diabetic Angiopathies - economics - therapy
Diabetic Foot - economics - therapy
Diabetic Nephropathies - economics - therapy
Diabetic Neuropathies - economics - therapy
Diabetic Retinopathy - economics - therapy
Episode of Care
Health Care Costs - statistics & numerical data
Health Resources - economics - utilization
Hospital Costs - statistics & numerical data
Humans
Ischemic Attack, Transient - economics - etiology - therapy
Myocardial Infarction - economics - etiology - therapy
Stroke - economics - etiology - therapy
Abstract
Decision makers need to have Canadian-specific cost information in order to develop an accurate picture of diabetes management. The objective of this study is to estimate direct medical costs of managing complications of diabetes. Complication costs were estimated by applying unit costs to typical resource use profiles. For each complication, the event costs refer to those associated with the acute episode and subsequent care in the first year. State costs are the annual costs of continued management. Data were obtained from many Canadian sources, including the Ontario Case Cost Project, physician and laboratory fee schedules, formularies, reports, and literature. All costs are expressed in 2000 Canadian dollars.
Major events (e.g., acute myocardial infarction: 18,635 dollars event cost; 1,193 dollars state cost), generate a greater financial burden than early stage complications (e.g., microalbuminuria: 62 dollars event cost; 10 dollars state cost). Yet, complications that are initially relatively low in cost (e.g., microalbuminuria) can progress to more costly advanced stages (e.g., end-stage renal disease, 63,045 dollars state cost).
Macrovascular and microvascular complication costs should be included in any economic analysis of diabetes. This paper provides Canadian-based cost information needed to inform critical decisions about spending limited health care dollars on emerging new therapies and public health initiatives.
Notes
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PubMed ID
12659641 View in PubMed
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Societal costs of non-cardiac chest pain compared with ischemic heart disease--a longitudinal study.

https://arctichealth.org/en/permalink/ahliterature106796
Source
BMC Health Serv Res. 2013;13:403
Publication Type
Article
Date
2013
Author
Ghassan Mourad
Jenny Alwin
Anna Strömberg
Tiny Jaarsma
Author Affiliation
Department of Social and Welfare Studies, Division of Health, Activity and Care, Faculty of Health Sciences, Linköping University, Linköping, Kungsgatan 40, 601 74, Norrköping, Sweden. ghassan.mourad@liu.se.
Source
BMC Health Serv Res. 2013;13:403
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Angina Pectoris - economics - therapy
Chest Pain - economics - therapy
Delivery of Health Care - economics - utilization
Female
Health Care Costs - statistics & numerical data
Hospitalization - economics - statistics & numerical data
Humans
Longitudinal Studies
Male
Middle Aged
Myocardial Infarction - economics - therapy
Myocardial Ischemia - economics - therapy
Primary Health Care - economics - utilization
Sick Leave - economics - statistics & numerical data
Sweden - epidemiology
Abstract
Non-cardiac chest pain (NCCP) is a common complaint. Our aim was to present a detailed description of the costs of patients with NCCP compared to patients with acute myocardial infarction (AMI) and Angina Pectoris (AP) from a societal perspective.
Data on healthcare utilization and annual societal costs, including direct healthcare costs and indirect costs due to productivity loss, were collected from different databases. The participants consisted of 199 patients from a general hospital in Sweden (99 with NCCP, 51 with AMI, 49 with AP), mean age of 67 years, 59% men.
NCCP, AMI, and AP patients had on average 54, 50 and 65 primary care contacts and 3, 4, and 4 hospital admissions during a period of 2 years. Length of hospital stay was 6, 11 and 11 days. On average, 14%, 18%, and 25% of NCCP, AMI and AP patients were on sick-leave annually, and about 12% in each group received a disability pension. The mean annual societal costs of NCCP, AMI and AP patients were €10,068, €15,989 and €14,737.
Although the annual societal cost of NCCP patients was lower than in AMI and AP patients, the cost was still considerable (€10,068). Taken into account the high prevalence of NCCP, the cumulative annual national cost of these patients could be more than the double of AMI and AP if all patients incurred the same costs as in this study. Targeted interventions are important in order to support patients with NCCP and minimize healthcare utilization and costs.
Notes
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PubMed ID
24107009 View in PubMed
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[The cost of angina. Reduction of productivity is as expensive as medical treatment]

https://arctichealth.org/en/permalink/ahliterature54622
Source
Lakartidningen. 1996 Aug 28;93(34):2842-4
Publication Type
Article
Date
Aug-28-1996
Author
F. Andersson
B. Kartman
Author Affiliation
Health Economics & Quality of Life, Astra Hässle AB, Mölndal.
Source
Lakartidningen. 1996 Aug 28;93(34):2842-4
Date
Aug-28-1996
Language
Swedish
Publication Type
Article
Keywords
Angina Pectoris - economics - therapy
Cost of Illness
Humans
Sick Leave
Sweden
PubMed ID
8815331 View in PubMed
Less detail