372 results on '"Societal costs"'
Search Results
2. Estimating the societal cost of heroin dependence in an Australian population engaged in treatment or harm reduction services
- Author
-
Hall, Natasha, Le, Long, Abimanyi-Ochom, Julie, Marel, Christina, Mills, Katherine, Teesson, Maree, and Mihalopoulos, Cathrine
- Published
- 2024
- Full Text
- View/download PDF
Catalog
3. The Cost-Effectiveness of Seizure Dogs for Persons Living With Severe Refractory Epilepsy: Results From the EPISODE Study.
- Author
-
van Hezik-Wester, Valérie, de Groot, Saskia, Kanters, Tim, Wagner, Louis, Ardesch, Jacqueline, Brouwer, Werner, Corro-Ramos, Isaac, van Exel, Job, and Versteegh, Matthijs
- Subjects
- *
SERVICE dogs , *QUALITY of life , *CAREGIVERS , *TECHNOLOGY assessment , *ECONOMIC statistics , *MICROSIMULATION modeling (Statistics) - Abstract
The Epilepsy Support Dog Evaluation study was commissioned by the Dutch Ministry of Health, Welfare and Sports to inform a reimbursement decision on seizure dogs. The randomized trial found that seizure dogs reduce seizure frequency and improve health-related quality of life of persons with severe refractory epilepsy (PSREs). This article examined the cost-effectiveness (CE) of adding seizure dogs to usual care for PSREs in The Netherlands. A microsimulation model was developed, informed by generalized linear mixed models using patient-level trial data from the Epilepsy Support Dog Evaluation study. The model adopted a 10-year time horizon and took a societal perspective. Seizure frequency was predicted as a function of time with the seizure dog. Patient utilities, caregiver utilities, and costs were predicted as a function of seizure frequency and time with the seizure dog. Quality-adjusted life-years (QALYs) of PSREs with a seizure dog and usual care alone were estimated at 6.28 and 5.65, respectively (Δ 0.63). For caregivers, estimated QALYs were 6.94 and 6.52, respectively (Δ 0.42). Total costs were respectively €228 691 and €226 261 (Δ €2430). Intervention costs were largely offset by savings in informal care and healthcare. The incremental CE ratio was €2314/QALY. Probabilistic sensitivity analysis indicated a 91% probability of seizure dogs being cost-effective at the €50 000/QALY threshold. The incremental CE ratio fell well below this threshold in scenario analyses. Seizure dogs are likely to be a cost-effective addition to usual care for PSREs in The Netherlands. • Examining the effectiveness of seizure dogs in persons with severe refractory epilepsy, the Epilepsy Support Dog Evaluation trial found that adding a seizure dog to standard care reduced seizure frequencies and improved quality of life. Using the health economic data collected during the trial, this article is the first to evaluate the cost-effectiveness (CE) of seizure dogs. • A microsimulation model was developed to extrapolate the findings beyond the 3-year trial follow-up to cover the average duration of a seizure dog partnership. Over a 10-year time horizon, the model assessed the CE of seizure dogs relative to standard care alone from a societal perspective. Alongside healthcare costs and patient utilities, it incorporated primary caregiver utilities and costs for informal care, productivity loss, and transportation. • Although the costs of a seizure dog are high and occur upfront, a significant portion is offset by savings in healthcare and informal care. Both patients and their primary caregivers experience quality-adjusted life-year gains due to improvements in health-related quality of life. With incremental CE ratios well below the threshold of €50 000/quality-adjusted life-year, the base-case analysis, scenario analyses, and sensitivity analyses indicate that seizure dogs are a cost-effective addition to usual care for individuals with severe refractory epilepsy, with minimal decision uncertainty. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
- Full Text
- View/download PDF
4. Costs attributable to hypercholesterolemia in a single period and over the life cycle.
- Author
-
Reitzinger, Stephanie, Reiss, Miriam, and Czypionka, Thomas
- Subjects
LDL cholesterol ,MYOCARDIAL ischemia ,LIFE cycles (Biology) ,CARDIOVASCULAR diseases risk factors ,CORONARY disease - Abstract
Hypercholesterolemia is a major risk factor for atherosclerotic cardiovascular disease leading to reduced (healthy) life years. The aim of this study is to quantify the societal costs associated with hypercholesterolemia. We use epidemiologic data on the distribution of cholesterol levels as well as data on relative risks regarding ischemic heart disease, stroke, and other cardiovascular diseases. The analytical approach is based on the use of population-attributable fractions applied to direct medical, direct non-medical and indirect costs using data of Austria. Within a life-cycle analysis we sum up the costs of hypercholesterolemia for the population of 2019 and, thus, consider future morbidity and mortality effects on this population. Epidemiologic data suggest that approximately half of Austria's population have low-density lipoprotein cholesterol (LDL-C) levels above the target levels (i.e., are exposed to increased risk). We estimate that 8.2% of deaths are attributable to hypercholesterolemia. Total costs amount to about 0.33% of GDP in the single-period view. In the life-cycle perspective, total costs amount to €806.06 million, €312.1 million of which are medical costs, and about €494 million arise due to production loss associated with hypercholesterolemia. The study points out that significant shares of deaths, entries into disability pension and care allowance, full-time equivalents lost to the labor market as well as monetary costs for the health system and the society could be avoided if LDL-C-levels of the population were reduced. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
- Full Text
- View/download PDF
5. Societal costs of older adults with low back pain seeking chiropractic care: findings from the BACE-C cohort study
- Author
-
Esther T. Maas, Brenda L. van der Vossen, Johanna M. van Dongen, Alan D. Jenks, and Sidney M. Rubinstein
- Subjects
Low back pain ,Older adults ,Societal costs ,Prediction ,Chiropractic ,RZ201-275 ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background To describe the societal costs during one year of follow-up among older adults seeking chiropractic care due to a new episode of low back pain (LBP), and to determine what factors predict high societal costs in this population. Methods Prospective cohort study, within chiropractic private practices (n = 38) in the Netherlands. 223 people ≥ 55 years of age with a new episode of LBP seeking chiropractic care participated. The primary outcome was total societal costs. High societal costs were defined as patients with costs in the top 20th percentile. The final prediction models were obtained using forward selection. Results were presented for the total population and stratified for retirement status. The model’s prognostic accuracy (Hosmer–Lemeshow X2, Nagelkerke’s R2) and discriminative ability [area under the receiver operating curve (AUC)] were assessed, and the models were internally validated using bootstrapping. Results The mean total annual societal cost per patient was €5297 [95% confidence interval (CI): 4191–6403]. The biggest cost driver was presenteeism (65% of total costs), and costs were higher among non-retired participants (€7759; 95% CI 6047–9470) than retired participants (€1892; 95% CI 1088–2695). In the total population, younger age [odds ratio (OR): 0.87 for each additional year; 95% CI 0.80–0.95], being male instead of female (OR 2.96; 95% CI 1.19–7.44), less alcohol intake (OR 0.49; 95% CI 0.20–1.19), working instead of retirement (OR 9.37; 95% CI 1.83–48.04), and more disability at baseline (OR 1.08; 95% CI 1.00–1.16) were found to be predictive of high societal costs. Working was found to be the strongest predictor for high societal costs. After internal validation, the model’s fit was good, it’s explained variance was moderate (28%) and their AUCs could be interpreted as moderate (0.85). For non-pensioners, the same predictive factors were identified as for the entire population. The costs for the retired participants showed too little variation to be able to predict high costs. Conclusions This study estimated the mean total annual societal cost of older adults seeking chiropractic care due to a new episode of LBP at €5297 (95% CI 4191–6403).These costs were mainly due to high levels of presenteeism, and extensively differed based upon work status. more...
- Published
- 2024
- Full Text
- View/download PDF
6. Societal costs of older adults with low back pain seeking chiropractic care: findings from the BACE-C cohort study.
- Author
-
Maas, Esther T., van der Vossen, Brenda L., van Dongen, Johanna M., Jenks, Alan D., and Rubinstein, Sidney M.
- Subjects
PEARSON correlation (Statistics) ,SPINAL adjustment ,PREDICTION models ,DATA analysis ,RESEARCH funding ,DESCRIPTIVE statistics ,LONGITUDINAL method ,ODDS ratio ,STATISTICS ,CONFIDENCE intervals ,MEDICAL care costs ,LUMBAR pain ,ECONOMICS ,OLD age - Abstract
Background: To describe the societal costs during one year of follow-up among older adults seeking chiropractic care due to a new episode of low back pain (LBP), and to determine what factors predict high societal costs in this population. Methods: Prospective cohort study, within chiropractic private practices (n = 38) in the Netherlands. 223 people ≥ 55 years of age with a new episode of LBP seeking chiropractic care participated. The primary outcome was total societal costs. High societal costs were defined as patients with costs in the top 20th percentile. The final prediction models were obtained using forward selection. Results were presented for the total population and stratified for retirement status. The model's prognostic accuracy (Hosmer–Lemeshow X
2 , Nagelkerke's R2 ) and discriminative ability [area under the receiver operating curve (AUC)] were assessed, and the models were internally validated using bootstrapping. Results: The mean total annual societal cost per patient was €5297 [95% confidence interval (CI): 4191–6403]. The biggest cost driver was presenteeism (65% of total costs), and costs were higher among non-retired participants (€7759; 95% CI 6047–9470) than retired participants (€1892; 95% CI 1088–2695). In the total population, younger age [odds ratio (OR): 0.87 for each additional year; 95% CI 0.80–0.95], being male instead of female (OR 2.96; 95% CI 1.19–7.44), less alcohol intake (OR 0.49; 95% CI 0.20–1.19), working instead of retirement (OR 9.37; 95% CI 1.83–48.04), and more disability at baseline (OR 1.08; 95% CI 1.00–1.16) were found to be predictive of high societal costs. Working was found to be the strongest predictor for high societal costs. After internal validation, the model's fit was good, it's explained variance was moderate (28%) and their AUCs could be interpreted as moderate (0.85). For non-pensioners, the same predictive factors were identified as for the entire population. The costs for the retired participants showed too little variation to be able to predict high costs. Conclusions: This study estimated the mean total annual societal cost of older adults seeking chiropractic care due to a new episode of LBP at €5297 (95% CI 4191–6403).These costs were mainly due to high levels of presenteeism, and extensively differed based upon work status. [ABSTRACT FROM AUTHOR] more...- Published
- 2024
- Full Text
- View/download PDF
7. Societal costs before and up to 1 year after the first fracture liaison service visit in patients requiring anti-osteoporosis treatments
- Author
-
Maas, Lieke, Boonen, Annelies, Wyers, Caroline E., Bours, Sandrine, van den Bergh, Joop P., Evers, Silvia M., van Kuijk, Sander M. J., and Hiligsmann, Mickaël
- Published
- 2024
- Full Text
- View/download PDF
8. Cost effectiveness of preemptive school closures to mitigate pandemic influenza outbreaks of differing severity in the United States
- Author
-
Dauelsberg, Lori R., Maskery, Brian, Joo, Heesoo, Germann, Timothy C., Del Valle, Sara Y., and Uzicanin, Amra
- Published
- 2024
- Full Text
- View/download PDF
9. Cost of Illness of Head and Neck Cancer in Sweden.
- Author
-
Silfverschiöld, Maria, Jarl, Johan, Hafström, Anna, Greiff, Lennart, and Sjövall, Johanna
- Subjects
- *
ECONOMIC aspects of diseases , *HEAD & neck cancer , *SICK leave , *NASOPHARYNX cancer , *EARLY death , *MEDICAL care cost statistics - Abstract
Head and neck cancer (HNC) is the sixth most common cancer worldwide. The condition and its treatment often lead to marked morbidities and, for some patients, premature death. Inferentially, HNC imposes a significant economic burden on society. This study aims to provide a comprehensive and detailed estimation of the cost of illness of HNC for Sweden in 2019. This is a prevalence-based cost of illness study. Resource utilization and related costs are quantified using national registry data. A societal perspective is applied, including (1) direct costs for healthcare utilization, (2) costs for informal care from family and friends, and (3) costs for productivity loss due to morbidity and premature death. The human capital approach is used when estimating productivity losses. The societal cost of HNC for Sweden in 2019 was estimated at €92 million, of which the direct costs, costs for informal care, and costs for productivity loss represented 34%, 2%, and 64%, respectively. Oral cavity cancer was the costliest HNC, followed by oropharyngeal cancer, whereas nasopharyngeal cancer was the costliest per person. The cost of premature mortality comprised 60% of the total cost of productivity loss. Males accounted for 65% of direct costs and 67% of costs for productivity loss. The societal cost of HNC is substantial and constitutes a considerable burden to Swedish society. The results of the present study may be used by policymakers for planning and allocation of resources. Furthermore, the information may be used for future cost-effectiveness analyses. • Available cost-of-illness studies of head and neck cancer often lack in comprehensiveness, are not tumor site-specific, and do not have a societal perspective. • The cost for head and neck in Sweden for 2019 was estimated to €92 386 801: 64% was generated by productivity loss due to morbidity (sick leave) and premature death (early retirement). The data are tumor-site-specific and include costs for healthcare utilization, informal care, and productivity loss. • The results highlight the marked impact of costs for productivity loss on the total societal costs for head and neck cancer, which may have implications for decisions such as whether or not to implement standardized programs for early rehabilitation. The data provide a basis for future cost-effectiveness analyses. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
- Full Text
- View/download PDF
10. Costs of major depression covered / not covered in British Columbia, Canada
- Author
-
Sonya Cressman, Shahzad Ghanbarian, Louisa Edwards, Sandra Peterson, Mary Bunka, Alison M. Hoens, Linda Riches, Jehannine Austin, Rohit Vijh, Kimberlyn McGrail, and Stirling Bryan
- Subjects
Depression ,Financial hardship ,Financial protection ,Inequality ,Societal costs ,Expenditure proportion ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Major depressive disorder (MDD) is one of the world’s leading causes of disability. Our purpose was to characterize the total costs of MDD and evaluate the degree to which the British Columbia provincial health system meets its objective to protect people from the financial impact of illness. Methods We performed a population-based cohort study of adults newly diagnosed with MDD between 2015 and 2020 and followed their health system costs over two years. The expenditure proportion of MDD-related, patient paid costs relative to non-subsistence income was estimated, incidences of financial hardship were identified and the slope index of inequality (SII) between the highest and lowest income groups compared across regions. Results There were 250,855 individuals diagnosed with MDD in British Columbia over the observation period. Costs to the health system totalled >$1.5 billion (2020 CDN), averaging $138/week for the first 12 weeks following a new diagnosis and $65/week to week 52 and $55/week for weeks 53–104 unless MDD was refractory to treatment ($125/week between week 12–52 and $101/week over weeks 53–104). The proportion of MDD-attributable costs not covered by the health system was 2-15x greater than costs covered by the health system, exceeding $700/week for patients with severe MDD or MDD that was refractory to treatment. Population members in lower-income groups and urban homeowners had disadvantages in the distribution of financial protection received by the health system (SII reached − 8.47 and 15.25, respectively); however, financial hardship and inequities were mitigated province-wide if MDD went into remission (SII − 0.07 to 0.6). Conclusions MDD-attributable costs to health systems and patients are highest in the first 12 weeks after a new diagnosis. During this time, lower income groups and homeowners in urban areas run the risk of financial hardship. more...
- Published
- 2023
- Full Text
- View/download PDF
11. Societal costs of personality disorders among treatment-seeking patients in Norway: the relative contribution of specific DSM-5 categories.
- Author
-
Sveen, C. A., Pedersen, G., Ulvestad, D. A., Zahl, K. E., Wilberg, T., and Kvarstein, E. H.
- Subjects
- *
PERSONALITY disorders , *MENTAL health services , *MULTIPLE regression analysis , *SUBSTANCE abuse , *COST - Abstract
Personality disorders (PDs) are associated with high levels of societal costs, regardless of whether a single PD or a broad range of PDs have been studied. However, research on the relative contribution of specific PD-types on societal costs is limited. The aim of this study was to explore the possible contributions of the individual DSM-5 categories of PDs on the level of societal costs and its components (health service costs and productivity loss), while controlling for the impact of comorbid mental health and substance use disorders on these outcomes. Participants (n = 798) were retrieved from the quality register of the Norwegian Network for Personality Disorders—a collaboration of PD-treatment units within specialist mental health services. The patients were referred to treatment in the time-period 2017–2020. Costs were assessed using a structured interview covering the 6-month period prior to assessment. Diagnoses were determined by semi-structured diagnostic interviews (SCID-5-PD and M.I.N.I.). Statistics included multiple regression analyses. The main result was that no specific PD had a unique contribution to the high level of societal costs generally found among treatment-seeking patients with PDs. Borderline PD (BPD) was the only PD with significantly higher health service costs than the other PDs, while BPD, avoidant PD, and unspecified PD were independently associated with enhanced productivity loss. The differential cost-effects of specific PDs on the cost components were small. Several comorbid mental health and substance use disorders were significant contributors to costs, irrespective of PD status. The results underscore the importance of developing and implementing effective treatments for a broader range of PDs, to reduce the high levels of societal costs associated with all PDs. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
- Full Text
- View/download PDF
12. Costs of major depression covered / not covered in British Columbia, Canada.
- Author
-
Cressman, Sonya, Ghanbarian, Shahzad, Edwards, Louisa, Peterson, Sandra, Bunka, Mary, Hoens, Alison M., Riches, Linda, Austin, Jehannine, Vijh, Rohit, McGrail, Kimberlyn, and Bryan, Stirling
- Subjects
MENTAL depression ,FINANCIAL stress ,FINANCIAL risk ,COST - Abstract
Background: Major depressive disorder (MDD) is one of the world's leading causes of disability. Our purpose was to characterize the total costs of MDD and evaluate the degree to which the British Columbia provincial health system meets its objective to protect people from the financial impact of illness. Methods: We performed a population-based cohort study of adults newly diagnosed with MDD between 2015 and 2020 and followed their health system costs over two years. The expenditure proportion of MDD-related, patient paid costs relative to non-subsistence income was estimated, incidences of financial hardship were identified and the slope index of inequality (SII) between the highest and lowest income groups compared across regions. Results: There were 250,855 individuals diagnosed with MDD in British Columbia over the observation period. Costs to the health system totalled >$1.5 billion (2020 CDN), averaging $138/week for the first 12 weeks following a new diagnosis and $65/week to week 52 and $55/week for weeks 53–104 unless MDD was refractory to treatment ($125/week between week 12–52 and $101/week over weeks 53–104). The proportion of MDD-attributable costs not covered by the health system was 2-15x greater than costs covered by the health system, exceeding $700/week for patients with severe MDD or MDD that was refractory to treatment. Population members in lower-income groups and urban homeowners had disadvantages in the distribution of financial protection received by the health system (SII reached − 8.47 and 15.25, respectively); however, financial hardship and inequities were mitigated province-wide if MDD went into remission (SII − 0.07 to 0.6). Conclusions: MDD-attributable costs to health systems and patients are highest in the first 12 weeks after a new diagnosis. During this time, lower income groups and homeowners in urban areas run the risk of financial hardship. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
- Full Text
- View/download PDF
13. Cost consequences of task-shifting intravitreal injections from physicians to nurses in a tertiary hospital in Norway
- Author
-
Stine Bolme, Dordi Austeng, Tora Sund Morken, Turid Follestad, and Vidar Halsteinli
- Subjects
Task-shifting ,Physicians versus nurses ,Anti-VEGF injections ,Hospital costs ,Societal costs ,Cost projections ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Anti-vascular endothelial growth factor is a medicine administered intravitreally by an injection to maintain visual acuity in patients with a variety of retinal diseases. The demand for this treatment has grown considerably in the westernized world the last two decades and will continue to increase due to an aging population. Because of the high volume, injections seize enormous resources and represent high costs for both hospitals and society. Task-shifting of injections from physicians to nurses may be a means to reduce such costs, however the magnitude of possible savings has been poorly investigated. To this end we investigated changes in the hospital costs per injection, six-year cost projections of physician- versus nurse-administered injections for a Norwegian tertiary hospital and we compared the societal costs per patient per year. Methods Patients (n = 318) were randomized to either physician- or nurse administered injections, and data were prospectively collected. Hospital costs per injection were calculated as the sum of training costs, personnel time and running expenses. The number of injections for the years 2014 – 21 from a Norwegian tertiary hospital was combined with age group specific injection prevalence and population projections to calculate cost projections for 2022 – 27. Societal costs per patient were calculated as the sum of hospital costs, transport costs for patients, caregivers’ use of time, costs of ophthalmology consultations and community-based homecare. Results The hospital costs per injection were 5.5 € higher for physicians compared to nurses (281.6 € versus 276.1 €). Cost projections estimated an annual hospital saving of task-shifting of 48 921 € for 2022 – 27. Societal costs per patient did not differ significantly between the two groups (mean 4988 € vs 5418 €, p = 0.398). Conclusion Task-shifting of injections from physicians to nurses can reduce hospital costs and increase the flexibility of physician resources. The annual savings are modest, but increased demand for injections might increase future cost savings. To achieve future savings for society, organizing ophthalmology consultations and injections on the same day to reduce the number of visits might be a solution. Trial registration ClinicalTrials.gov NCT02359149 (09/02/2015). more...
- Published
- 2023
- Full Text
- View/download PDF
14. Societal costs of personality disorders: A cross‐sectional multicenter study of treatment‐seeking patients in mental health services in Norway.
- Author
-
Sveen, C. A., Pedersen, G., Ulvestad, D. A., Zahl, K. E., Wilberg, T., and Kvarstein, E. H.
- Subjects
- *
MENTAL health services , *PUBLIC records , *PERSONALITY disorders , *ANXIETY treatment , *PEOPLE with mental illness , *SOCIAL anxiety , *HELP-seeking behavior , *CROSS-sectional method , *COST estimates - Abstract
Objective: There is a relatively small body of research on the cost‐of‐illness of personality disorders (PDs). Most studies only include borderline PD. The aim of this study was to investigate mean societal costs, including its components, (direct) health service costs and (indirect) productivity loss, among treatment‐seeking patients with the broad range of all PDs according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5). Methods: Cross‐sectional data from 911 patients diagnosed with at least 1 PD were retrieved from the quality register of the Norwegian Network for Personality Disorders—a collaboration of PD treatment units within specialist mental health services. The patients were referred in the time period 2017–2020. Estimation of costs was based on a bottom‐up approach, using information from a structured interview covering the 6‐month period before assessment, whereas unit costs were retrieved from public reports, public records, or public agencies. The human capital approach was used to calculate productivity loss. Diagnoses were determined by semi‐structured diagnostic interviews (Structured Clinical Interview for DSM‐5‐PD [SCID‐5‐PD]). Results: The mean societal costs were €20.260 during the 6‐month period before specialized treatment. The largest cost component was productivity loss (65%), whereas health service costs constituted 35%. The main contributors to societal costs from the underlying health service cost components were inpatient treatment (20.5%) and individual outpatient treatment (10.5%). Conclusion: Societal costs were substantial among treatment‐seeking patients with the broad range of DSM‐5 PDs, comparable to the societal costs of schizophrenia, and significantly higher than the societal costs of both depression and anxiety disorders. The cost estimates converged with recent, register‐based cost‐of‐illness studies of different PDs but exceeded previous findings from other bottom‐up studies. Furthermore, the results underscore the importance of implementing effective and specialized treatment for patients with a broad range of PDs, not only to alleviate individual suffering but also to reduce the level of societal costs. The emphasis on productivity loss as a main contributor to the overall societal costs is substantiated, hence underlining the relevance of interventions focusing on improving occupational functioning. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
- Full Text
- View/download PDF
15. Environmental sustainability opportunity and socio-economic cost analyses of phosphorus recovery from sewage sludge
- Author
-
Jiawen Xie, Xingchen Zhuge, Xixi Liu, Qian Zhang, Yiwen Liu, Peizhe Sun, Yingxin Zhao, and Yindong Tong
- Subjects
Phosphorus recovery ,Sewage sludge ,Life cycle assessment ,Environmental impacts ,Societal costs ,Environmental sciences ,GE1-350 ,Environmental technology. Sanitary engineering ,TD1-1066 - Abstract
Although phosphorus (P) recovery and management from sewage sludge are practiced in North America and Europe, such practices are not yet to be implemented in China. Here, we evaluated the environmental sustainability opportunity and socio-economic costs of recovering P from sewage sludge by replacing the current-day treatments (CT; sludge treatment and landfill) and P chemical fertilizer application (CF) in China using life cycle assessment and life cycle costing methods. Three potential P recovery scenarios (PR1‒PR3: struvite, vivianite, and treated sludge) and corresponding current-day scenarios (CT1‒CT3 and CF) were considered. Results indicated that PR1 and PR2 have smaller environmental impacts than the current-day scenarios, whereas PR3 has larger impacts in most categories. PR3 has the lowest net costs (sum of internal costs and benefits, 39.1–54.7 CNY per kg P), whereas PR2 has the lowest external costs (366.8 CNY per kg P). Societal costs for production and land use of 1 kg P by P recovery from sewage sludge (e.g., ∼527 CNY for PR1) are much higher than those of P chemical fertilizers (∼20 CNY for CF). However, considering the costs in the current-day treatments (e.g., ∼524 CNY for CT1), societal costs of P recovery scenarios are close to or slightly lower than those of current-day scenarios. Among the three P recovery scenarios, we found that recovering struvite as P fertilizer has the highest societal feasibility. This study will provide valuable information for improved sewage sludge management and will help promote the sustainable supply of P in China. more...
- Published
- 2023
- Full Text
- View/download PDF
16. The societal cost of vaccine refusal: A modelling study using measles vaccination as a case study.
- Author
-
Olivera Mesa, Daniela, Winskill, Peter, Ghani, Azra C, and Hauck, Katharina
- Subjects
- *
VACCINE refusal , *MEASLES vaccines , *VACCINE hesitancy , *VACCINATION status , *ANTI-vaccination movement - Abstract
Increasing vaccine hesitancy and refusal poses a challenge to public health as even small reductions in vaccine uptake can result in large outbreaks of infectious diseases. Here we estimate the societal costs of vaccine refusal using measles as a case study. We developed a compartmental metapopulation model of measles transmission to explore how the changes in the size and level of social mixing between populations that are "pro-vaccination", and "anti-vaccination" impacts the burden of measles. Using the projected cases and deaths, we calculated the health, healthcare, direct medical costs, and productivity loss associated with vaccine refusal. Using measles in England as a case study, we quantified the societal costs that each vaccine refusal imposes on society. When there is a high level of mixing between the pro- and anti-vaccination populations, those that refuse to be vaccinated benefit from the herd immunity afforded by the pro-vaccination population. At the same time, their refusal to be vaccinated increases the burden in those that are vaccinated due to imperfect vaccines, and in those that are not able to be vaccinated due to other underlying health conditions. Using England as a case study, we estimate that this translates to a societal loss of GBP 292 million and disease burden of 17 630 quality-adjusted-life-years (sensitivity range 10 594–50 379) over a 20-year time horizon. Of these costs, 26 % are attributable to healthcare costs and 74 % to productivity losses for patients and their carers. This translates to a societal loss per vaccine refusal of GBP 162.21 and 0.01 (0.006–0.03) quality-adjusted-life-years. Our findings demonstrate that even low levels of vaccine refusal can have a substantial and measurable societal burden on the population. These estimates can support the value of investment in interventions that address vaccine hesitancy and vaccine refusal, providing not only improved public health but also potential economic benefits to society. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
- Full Text
- View/download PDF
17. Economic evaluations of mental health interventions in criminal justice.
- Author
-
Knapp, Martin and Wong, Gloria
- Subjects
- *
COMPETENCY assessment (Law) , *MEDICAL economics , *JUVENILE offenders , *CRIMINAL justice policy , *COST benefit analysis - Abstract
Background: Mental health interventions targeting crime perpetrators are available. An overview of the current scenario of their economic benefits will help policy decisions. Aim: To provide an update on economic evidence for mental health interventions in criminal justice, and to identify challenges and responses in using economic evidence to inform policy. Method: Narrative review with an analysis frame that organises evidence around four points on the criminal justice system pathway: (a) point of contact; (b) post‐arrest; (c) incarceration/punishment and (d) post‐incarceration. Results: There is a paucity of high‐quality economic evidence, especially from cost‐benefit analyses. However, there is some evidence of cost‐effectiveness in support of interventions at the point of incarceration, such as cognitive behavioural therapy, multisystemic therapy for juvenile delinquents, therapeutic communities, electronic monitoring and telepsychiatry in forensic psychiatry settings. There is also evidence that post‐incarceration interventions such as assertive community treatment can be cost‐effective. Conclusion: There remain large evidence gaps. There are also challenges in turning economic evidence on mental health interventions in criminal justice into policy changes and improved practice, such as hidden costs, silo budgeting and delayed pay‐off. Research incorporating multi‐sectoral costs and benefits recommended by health economics and health technology assessment groups should be prioritised to support difficult resource allocation decisions faced by policy makers. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
- Full Text
- View/download PDF
18. Burden of illness among intermittent catheter users with non-neurogenic urinary retention in Denmark.
- Author
-
Buchter, Marie Lynge, Kjellberg, Jakob, Ibsen, Rikke, Sternhufvud, Catarina, and Petersen, Birte
- Abstract
Urinary retention (UR) caused by non-neurogenic conditions is a frequent disorder often requiring the use of intermittent catheterization (IC). This study examines the burden of illness among subjects with an IC indication due to non-neurogenic UR. Health-care utilization and costs were extracted from Danish registers (2002–2016) related to the first year after IC training and compared to matched controls. A total of 4,758 subjects with UR due to benign prostatic hyperplasia (BPH) and 3,618 subjects with UR due to other non-neurological conditions were identified. Total health-care utilization and costs per patient-year were significantly higher compared to matched controls (BPH: 12,406 EUR vs 4,363, p < 0.000; other non-neurogenic causes: 12,497 EUR vs 3,920, p < 0.000) and driven mainly by hospitalizations. Urinary tract infections (UTIs) were the most frequent bladder complications often requiring hospitalization. The inpatient costs per patient-year for UTIs were significantly higher for cases than controls (BPH: 479 EUR vs 31, p < 0.000; other non-neurogenic causes: 434 EUR vs 25, p < 0.000). The burden of illness caused by non-neurogenic UR with need for IC was high and essentially driven by hospitalizations. Further research should clarify if additional treatment measures may reduce the burden of illness in subjects suffering from non-neurogenic UR using IC. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
- Full Text
- View/download PDF
19. Cost consequences of task-shifting intravitreal injections from physicians to nurses in a tertiary hospital in Norway.
- Author
-
Bolme, Stine, Austeng, Dordi, Morken, Tora Sund, Follestad, Turid, and Halsteinli, Vidar
- Subjects
INTRAVITREAL injections ,ENDOTHELIAL growth factors ,HOSPITAL personnel ,PHYSICIANS ,HOSPITAL costs ,TASK shifting - Abstract
Background: Anti-vascular endothelial growth factor is a medicine administered intravitreally by an injection to maintain visual acuity in patients with a variety of retinal diseases. The demand for this treatment has grown considerably in the westernized world the last two decades and will continue to increase due to an aging population. Because of the high volume, injections seize enormous resources and represent high costs for both hospitals and society. Task-shifting of injections from physicians to nurses may be a means to reduce such costs, however the magnitude of possible savings has been poorly investigated. To this end we investigated changes in the hospital costs per injection, six-year cost projections of physician- versus nurse-administered injections for a Norwegian tertiary hospital and we compared the societal costs per patient per year. Methods: Patients (n = 318) were randomized to either physician- or nurse administered injections, and data were prospectively collected. Hospital costs per injection were calculated as the sum of training costs, personnel time and running expenses. The number of injections for the years 2014 – 21 from a Norwegian tertiary hospital was combined with age group specific injection prevalence and population projections to calculate cost projections for 2022 – 27. Societal costs per patient were calculated as the sum of hospital costs, transport costs for patients, caregivers' use of time, costs of ophthalmology consultations and community-based homecare. Results: The hospital costs per injection were 5.5 € higher for physicians compared to nurses (281.6 € versus 276.1 €). Cost projections estimated an annual hospital saving of task-shifting of 48 921 € for 2022 – 27. Societal costs per patient did not differ significantly between the two groups (mean 4988 € vs 5418 €, p = 0.398). Conclusion: Task-shifting of injections from physicians to nurses can reduce hospital costs and increase the flexibility of physician resources. The annual savings are modest, but increased demand for injections might increase future cost savings. To achieve future savings for society, organizing ophthalmology consultations and injections on the same day to reduce the number of visits might be a solution. Trial registration: ClinicalTrials.gov NCT02359149 (09/02/2015). [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
- Full Text
- View/download PDF
20. Health-related quality of life, direct medical and societal costs among children with moderate or severe haemophilia in Europe: multivariable models of the CHESS-PAEDs study
- Author
-
Idaira Rodriguez-Santana, Pronabesh DasMahapatra, Tom Burke, Zalmai Hakimi, José Bartelt-Hofer, Jameel Nazir, and Jamie O’Hara
- Subjects
Haemophilia A ,Haemophilia B ,Direct medical costs ,Societal costs ,Productivity ,Quality of life ,Medicine - Abstract
Abstract Background Haemophilia bears substantial humanistic and economic burden on children and their caregivers. Characterising the differential impact of severe versus moderate paediatric haemophilia is important for clinical and health policy decisions. We analysed health-related quality of life (HRQoL), annual direct medical (excluding factor treatment costs), non-medical and societal costs among children and adolescents with moderate and severe haemophilia A or B without inhibitors from the European CHESS-PAEDs study. Information was reported by physicians and caregivers; patients aged ≥ 8 years self-reported their HRQoL. Descriptive statistics summarised demographic and clinical characteristics, costs, and HRQoL scores (EQ-5D-Y). Regression models estimated differences in HRQoL and costs for moderate versus severe haemophilia adjusting for age, body mass index z-score, country, number of comorbidities, and weight-adjusted annual clotting factor consumption. Results The analytic sample comprised 794 patients with a mean age of 10.5 years; most had haemophilia A (79%) and 58% had severe haemophilia. Mean predicted direct medical costs in moderate patients were two-thirds of the predicted costs for severe disease (€3065 vs. €2047; p more...
- Published
- 2022
- Full Text
- View/download PDF
21. Differential humanistic and economic burden of mild, moderate and severe haemophilia in european adults: a regression analysis of the CHESS II study
- Author
-
Idaira Rodriguez-Santana, Pronabesh DasMahapatra, Tom Burke, Zalmai Hakimi, José Bartelt-Hofer, Jameel Nazir, and Jamie O’Hara
- Subjects
Haemophilia A ,Haemophilia B ,Direct medical costs ,Societal costs ,Productivity ,Quality of life ,Medicine - Abstract
Abstract Background The lifelong nature of haemophilia makes patient-centred and societal assessments of its impact important to clinical and policy decisions. Quantifying the humanistic and economic burden by severity is key to assessing the impact on healthcare systems. We analysed the annual direct medical (excluding factor replacement therapy costs) and non-medical costs as well as societal costs and health-related quality of life (HRQoL) of mild, moderate and severe disease among adults with haemophilia A or B without inhibitors in Europe. Participants in the CHESS II study reported their HRQoL, non-medical costs, and work impairment; physicians provided costs and consultation history from the medical chart. Descriptive statistics summarized patient characteristics, costs, and HRQoL scores. Regression models estimated differences in outcomes for moderate and severe versus mild disease, adjusting for age, body mass index, country, comorbidities, weight-adjusted factor consumption and education. Results The analytic sample included 707 patients with a mean age of 38 years; the majority of patients had haemophilia A (81%), and 47% had severe disease, followed by moderate (37%) and mild disease (16%). Patients with severe or moderate disease had on average higher direct costs, €3105 and €2469 respectively, versus mild disease. Societal costs were higher for patients with severe and moderate disease by €11,115 and €2825, respectively (all P more...
- Published
- 2022
- Full Text
- View/download PDF
22. Production loss and sick leave caused by antibiotic resistance: a register-based cohort study
- Author
-
Sofie Larsson, Mikael Svensson, and Anders Ternhag
- Subjects
Societal costs ,Production loss ,Antibiotic resistance ,Days of sick leave ,Two-part model ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Adverse economic consequences of antibiotic resistance, both in health care systems and in society at large, have been estimated to emerge and significantly affect the global economy. To date, most studies of the societal costs of antibiotic resistance have had a macroeconomic perspective, using the number of attributable deaths as a quantifier for production loss. In contrast, there have been few studies of the consequences of antibiotic resistance in terms of the length of sick leave and hence the impact of morbidity on production loss. The aim of our study was to estimate the production loss from ill health caused by antibiotic resistance. Method To estimate additional production loss due to antibiotic resistance, we used Swedish register-based cohort data to determine days of long-term sick leave (LTSL) for episodes of infection caused by resistant and susceptible bacteria respectively. We collected patient data for four common infection types (bloodstream infection, urinary tract infection, skin and soft tissue infection, and pneumonia), as well as, antibiotic susceptibility test data, and total days of LTSL. We used a two-part model to estimate the number of LTSL days attributable to resistance, and controlled for comorbidities and demographic variables such as age and gender. Results The results show that antibiotic resistance adds an additional 8.19 days of LTSL compared with a similar infection caused by susceptible bacteria, independent of infection type and resistance type. Furthermore, the results suggest that production loss due to temporary sick leave caused by antibiotic resistance in a working-age population amounts to about 7% of total health care costs attributable to antibiotic resistance in Sweden. Conclusion Estimating the effect of antibiotic resistance in terms of temporary production loss is important to gain a better understanding of the economic consequences of antibiotic resistance in society and, by extension, enable more effective resource allocation to combat further emergence of resistance. Society’s economic costs of antibiotic resistance are, however, probably much greater than those of sick leave due to disease alone. more...
- Published
- 2022
- Full Text
- View/download PDF
23. Misbehaving Drinking Water Systems: Risk and the Complex Nature of Failure
- Author
-
Karney, Bryan, Gibson, John, Shrivastava, Paul, Series Editor, Zsolnai, László, Series Editor, Walker, Thomas, editor, Gramlich, Dieter, editor, Vico, Kalima, editor, and Dumont-Bergeron, Adele, editor more...
- Published
- 2021
- Full Text
- View/download PDF
24. Societal costs of decreased visual acuity: A Finnish cohort study with 15 years of registry data follow-up.
- Author
-
Taipale J, Purola PKM, Väätäinen S, Nättinen JE, Koskinen SVP, and Uusitalo HMT
- Abstract
Purpose: To examine what direct and indirect societal costs are associated with decreased visual acuity (VA)., Methods: Nationally representative sample of 8028 Finnish adults aged 30 years or older with survey data and clinical examination including VA assessment was evaluated. These data were linked with multiple national registers to capture health care services utilization during 1999-2013. All direct and indirect costs were calculated using prevalence-based bottom-up approach and adjusted for age, sex, and comorbidities with generalized linear models. The results in 2019 cost level are presented according to VA groups at baseline per person, and with population estimates., Results: Total direct health care costs ranged from 1996 €/year/person for those with VA ≥1.0 to 3277 €/year/person for those with weak (0.32-0.5) VA. The increase in direct costs was notable even before the onset of visual impairment. Indirect costs showed monotonously increasing trend with decreasing VA. At the population level, the additional annual direct costs associated with decreased VA were estimated at 1.9 billion €. Only 2% or less of the additional costs are due to increased direct eye-related secondary health care usage. Estimated additional annual national indirect costs were 1.2 billion €., Conclusions: In addition to those with visual impairment or blindness, health care need, and societal costs are elevated even among those with adequate VA. We conclude, that focusing on prevention of VA decrease would not only help sustain the patients' quality of life but could also reduce the future societal costs., (© 2025 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.) more...
- Published
- 2025
- Full Text
- View/download PDF
25. Societal costs and quality of life analysis in patients undergoing resective epilepsy surgery: A one-year follow-up
- Author
-
L. Maas, J. Kellenaers, G. van Mastrigt, S.M.J van Kuijk, M.C.G. Vlooswijk, M. Hiligsmann, S. Klinkenberg, L. Wagner, J. Nelissen, O.E.M.G. Schijns, H.J.M. Majoie, and K. Rijkers
- Subjects
Resective epilepsy surgery ,Societal costs ,Cost-effectiveness ,Epilepsy ,Drug-resistant epilepsy patients ,Quality of life ,Neurology. Diseases of the nervous system ,RC346-429 ,Neurophysiology and neuropsychology ,QP351-495 - Abstract
Although effectiveness of Resective Epilepsy Surgery (RES) for patients with drug-resistant epilepsy (DRE) is widely proven, research on the impact of societal costs (SC) is lacking. The aim of this study is to provide both clinical and economic outcomes of RES by offering an overview of treatment effectiveness as well as SC of RES in a cohort of 30 Dutch DRE patients. This project serves as a pilot project to offer an up-to-date model for larger cost-effectiveness studies. Medical consumption, productivity losses, disease-specific and generic health-related quality of life (QoL), and seizure frequency were assessed before and 3-, 6-, and 12-months post-surgery with validated questionnaires. Linear mixed models, ANOVAs, and logistic regressions were performed. SC for the first year after RES entailed €54,376 and decreased over time. Moreover, 50% of patients experienced a clinically important increase in disease-specific QoL and 53% of patients in generic health-related QoL. Lastly, 73% of patients reached seizure freedom 12 months postoperative. Seizure reduction was correlated with increase in disease-specific QoL. Within one year after surgery, RES leads to reduction in SC and improvements in QoL over time. Future research should encompass longer follow-up periods, larger sample size, and a cost-effectiveness analysis with a comparator. more...
- Published
- 2023
- Full Text
- View/download PDF
26. Personality disorders: the impact of severity on societal costs
- Author
-
Sveen, Carl-Aksel, Pedersen, Geir, Hummelen, Benjamin, and Kvarstein, Elfrida Hartveit
- Published
- 2023
- Full Text
- View/download PDF
27. The burden of colorectal cancer survivors in the Netherlands: costs, utilities, and associated patient characteristics.
- Author
-
Mulder, Frederike E. C. M., van Roekel, Eline H., Bours, Martijn J. L., Weijenberg, Matty P., and Evers, Silvia M. A. A.
- Abstract
Purpose: The aim of this study is to assess the societal burden of colorectal cancer (CRC) survivorship 2–10 years post-diagnosis in terms of (1) societal costs, and (2) quality of life/utilities, and to analyze associated patient characteristics. Methods: This is a cross-sectional, bottom-up prevalence-based burden of disease study, conducted from a societal perspective in the Netherlands. In total, 155 CRC survivors were included. Utilities were measured by the EQ-5D-5L, using the Dutch tariffs. A cost questionnaire was developed to obtain cost information. Subgroup analyses were performed, based on patient characteristics and sensitivity analyses. Results: Of all CRC survivors, 81(54%) reported no problems for mobility, 133(88%) for self-care, 98(65%) for daily activities, 59(39%) for pain/discomfort, and 112(74%) for anxiety/depression on the EQ-5D-5L. The average EQ-5D-5L utility score was 0.82 (SD = 0.2) on a scale from 0 (death) to 1 (perfect health). Significant differences in utility score were found for gender, tumor stage, number of comorbidities, and lifestyle score. The average societal costs per CRC survivor per 6 months were estimated at €971 (min = €0, max = €32,425). Significant differences in costs were found for the number of comorbidities. Conclusions: This study shows a considerable burden of CRC survivors 2–10 years after diagnosis, in comparison with survivors sooner after diagnosis and with healthy individuals in the Netherlands. Implications for Cancer Survivors: Long-term care of CRC survivors should focus on improving the societal burden by identifying modifiable factors, as summarized in the WCRF/AICR lifestyle score, including body composition, physical activity, and diet. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
- Full Text
- View/download PDF
28. Burden of illness the first year after diagnosed bladder dysfunction among people with spinal cord injury or multiple sclerosis – a Danish register study.
- Author
-
Buchter, Marie Lynge, Kjellberg, Jakob, Ibsen, Rikke, Sternhufvud, Catarina, and Petersen, Birte
- Abstract
People with spinal cord injury (SCI) or multiple sclerosis (MS) are often living with some degree of bladder and/or bowel dysfunction due to acquired neurogenic damage. The objective was to estimate the burden of illness of SCI and MS the first year after diagnosed bladder dysfunction. Data were extracted from registers covering all Danish citizens. People with SCI or MS were indexed at diagnosis of bladder dysfunction. Inclusion period was 2002–2015 and cases and matched controls were followed for one year. A total of 2,132 subjects with SCI and 1,887 subjects with MS were identified. Healthcare utilization and societal costs per patient-year were significantly higher for cases compared to controls driven primarily by inpatient care. Cases with urinary tract infection had significantly higher inpatient costs per patient-year compared to controls (SCI: 544 EUR vs 23, p < 0.05; MS: 497 EUR vs 6, p< 0.05) and medication for constipation was significantly more costly per patient-year (SCI: 178 EUR vs 3, p < 0.05; MS: 78 vs 1, p < 0.05). The study demonstrates heavy societal and personal costs in the first year after bladder dysfunction in people with SCI or MS. This emphasizes the need for medical and social interventions to reduce the burden of illness. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
- Full Text
- View/download PDF
29. Annual dementia incidence and monetary burden attributable to fine particulate matter (PM2.5) exposure in Sweden
- Author
-
Hedi Katre Kriit, Bertil Forsberg, Daniel Oudin Åström, and Anna Oudin
- Subjects
Dementia ,Incidence ,Particulate matter ,Air pollution ,PM2.5 ,Societal costs ,Industrial medicine. Industrial hygiene ,RC963-969 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Alzheimer’s disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM2.5) air pollution and resulting monetary estimates are lacking. Methods We used data on average population-weighted exposure to ambient PM2.5 for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM2.5 exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives. Results The annual number of dementia cases attributable to PM2.5 exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM2.5 by 1 μg/m3 was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019. Conclusion This study estimated that 5% of annual dementia cases could be attributed to PM2.5 exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions. more...
- Published
- 2021
- Full Text
- View/download PDF
30. Assessing the Effect of Including Social Costs in Economic Evaluations of Diabetes-Related Interventions: A Systematic Review
- Author
-
Rodriguez-Sanchez B, Aranda-Reneo I, Oliva-Moreno J, and Lopez-Bastida J
- Subjects
diabetes ,societal costs ,informal care ,productivity losses ,economic evaluation ,health technology assessment ,Medicine (General) ,R5-920 ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Beatriz Rodriguez-Sanchez,1 Isaac Aranda-Reneo,2 Juan Oliva-Moreno,3 Julio Lopez-Bastida4 1University Camilo José Cela, Faculty of Communication and Humanities, Madrid, Spain; 2University of Castilla-La Mancha, Faculty of Social Science, Economics and Finance Department, Toledo, Spain; 3University of Castilla-La Mancha, Faculty of Law and Social Science, Economics and Finance Department, Toledo, Spain; 4University of Castilla-La Mancha, Faculty of Health Sciences, Talavera de la Reina, Toledo, SpainCorrespondence: Beatriz Rodriguez-SanchezUniversity Camilo José Cela, Faculty of Communication and Humanities, Urb. Villafranca del Castillo, Calle Castillo de Alarcón, 49, Villanueva de la Cañada, Madrid, 28692, SpainEmail brodriguez@ucjc.eduBackground: The economic burden of diabetes from a societal perspective is well documented in the cost-of-illness literature. However, the effect of considering social costs in the results and conclusions of economic evaluations of diabetes-related interventions remains unknown.Objective: To investigate whether the inclusion of social costs (productivity losses and/or informal care) might change the results and conclusions of economic evaluations of diabetes-related interventions.Methods: A systematic review was designed and launched on Medline and the Cost-Effectiveness Analysis Registry from the University of Tufts, from the year 2000 until 2018. Included studies had to fulfil the following criteria: i) being an original study published in a scientific journal, ii) being an economic evaluation of an intervention on diabetes, iii) including social costs, iv) being written in English, v) using quality-adjusted life years as outcome, and vi) separating the results according to the perspective applied.Results: From the 691 records identified, 47 studies (6.8%) were selected. Productivity losses were included in 45 of the selected articles (73% used the human capital approach) whereas informal care costs in only 13 (when stated, the opportunity cost method was used in seven studies and the replacement cost in one). The 47 studies resulted in 110 economic evaluation estimations. The inclusion of social costs changed the conclusions in 8 estimations (17%), 6 of them switching from not cost-effective from the healthcare perspective to cost-effective or dominant from the societal perspective. Considering social costs altered the results from cost-effective to dominant in 9 estimations (19%).Conclusion: When social costs are considered, the results and conclusions of economic evaluations performed in diabetes-related interventions can alter. Wide methodological variations have been observed, which limit the comparability of studies and advocate for the inclusion of a wider perspective via the consideration of social costs in economic evaluations and methodological guidelines relating to their estimation and valuation.Keywords: diabetes, social costs, informal care, productivity losses, economic evaluation, health technology assessment more...
- Published
- 2021
31. Societal costs of illegal drug use in Sweden
- Author
-
Hofmarcher, Thomas, Leppänen, Anne, Månsdotter, Anna, Strandberg, Joakim, Håkansson, Anders, Hofmarcher, Thomas, Leppänen, Anne, Månsdotter, Anna, Strandberg, Joakim, and Håkansson, Anders
- Abstract
Background: Illegal drug use is a public health concern with far-reaching consequences for people who use them and for society. In Sweden, the reported use of illegal drugs has been growing and the number of drug-induced deaths is among the highest in Europe. The aim of this study was to provide a comprehensive and up-to-date estimation of the societal costs of illegal drug use in Sweden, relying as much as possible on registry and administrative data. Methods: A prevalence-based cost-of-illness study of illegal drug use in Sweden in 2020 was conducted. A societal approach was chosen and included direct costs (such as costs of health care, social services, and the criminal justice system), indirect costs (such as lost productivity due to unemployment and drug-induced death), and intangible costs (such as reduced quality of life among people who use drugs and their family members). Costs were estimated by combining registry, administrative, and survey data with unit cost data. Results: The estimated societal costs of illegal drug use were 3.7 billion euros in 2020. This corresponded to 355 euros per capita and 0.78 % of the gross domestic product. The direct and intangible costs were of similar sizes, each contributing to approximately 40 % of total costs, whereas indirect costs contributed to approximately 20 %. The largest individual cost components were reduced quality of life among people who use drugs and costs of the criminal justice system. Conclusion: Illegal drug use has a negative impact on the societal aim to create good and equitable health in Sweden. The findings call for evidence-based prevention of drug use and treatment for those addicted. It is important to address the co-morbidity of mental ill-health and drug dependence, to develop low-threshold services and measures for early prevention among children and young adults, as well as to evaluate laws and regulations connected to illegal drug use. more...
- Published
- 2024
- Full Text
- View/download PDF
32. Health-related quality of life, direct medical and societal costs among children with moderate or severe haemophilia in Europe: multivariable models of the CHESS-PAEDs study.
- Author
-
Rodriguez-Santana, Idaira, DasMahapatra, Pronabesh, Burke, Tom, Hakimi, Zalmai, Bartelt-Hofer, José, Nazir, Jameel, and O'Hara, Jamie
- Subjects
HEMOPHILIA ,CROSS-sectional method ,QUALITY of life ,ECONOMIC aspects of diseases - Abstract
Background: Haemophilia bears substantial humanistic and economic burden on children and their caregivers. Characterising the differential impact of severe versus moderate paediatric haemophilia is important for clinical and health policy decisions. We analysed health-related quality of life (HRQoL), annual direct medical (excluding factor treatment costs), non-medical and societal costs among children and adolescents with moderate and severe haemophilia A or B without inhibitors from the European CHESS-PAEDs study. Information was reported by physicians and caregivers; patients aged ≥ 8 years self-reported their HRQoL. Descriptive statistics summarised demographic and clinical characteristics, costs, and HRQoL scores (EQ-5D-Y). Regression models estimated differences in HRQoL and costs for moderate versus severe haemophilia adjusting for age, body mass index z-score, country, number of comorbidities, and weight-adjusted annual clotting factor consumption.Results: The analytic sample comprised 794 patients with a mean age of 10.5 years; most had haemophilia A (79%) and 58% had severe haemophilia. Mean predicted direct medical costs in moderate patients were two-thirds of the predicted costs for severe disease (€3065 vs. €2047; p < 0.001; N = 794), while societal costs were more than half of the predicted costs for children with severe haemophilia (€6950 vs. €3666; p < 0.001; N = 220). Mean predicted HRQoL scores were 0.74 and 0.69 for moderate and severe disease, respectively (p < 0.05; N = 185).Conclusion: Children with haemophilia and their caregivers displayed a significant economic and humanistic burden. While severe patients showed the highest direct medical and societal costs, and worse HRQoL, the burden of moderate haemophilia on its own was substantial and far from negligible. [ABSTRACT FROM AUTHOR] more...- Published
- 2022
- Full Text
- View/download PDF
33. Differential humanistic and economic burden of mild, moderate and severe haemophilia in european adults: a regression analysis of the CHESS II study.
- Author
-
Rodriguez-Santana, Idaira, DasMahapatra, Pronabesh, Burke, Tom, Hakimi, Zalmai, Bartelt-Hofer, José, Nazir, Jameel, and O'Hara, Jamie
- Abstract
Background: The lifelong nature of haemophilia makes patient-centred and societal assessments of its impact important to clinical and policy decisions. Quantifying the humanistic and economic burden by severity is key to assessing the impact on healthcare systems. We analysed the annual direct medical (excluding factor replacement therapy costs) and non-medical costs as well as societal costs and health-related quality of life (HRQoL) of mild, moderate and severe disease among adults with haemophilia A or B without inhibitors in Europe. Participants in the CHESS II study reported their HRQoL, non-medical costs, and work impairment; physicians provided costs and consultation history from the medical chart. Descriptive statistics summarized patient characteristics, costs, and HRQoL scores. Regression models estimated differences in outcomes for moderate and severe versus mild disease, adjusting for age, body mass index, country, comorbidities, weight-adjusted factor consumption and education.Results: The analytic sample included 707 patients with a mean age of 38 years; the majority of patients had haemophilia A (81%), and 47% had severe disease, followed by moderate (37%) and mild disease (16%). Patients with severe or moderate disease had on average higher direct costs, €3105 and €2469 respectively, versus mild disease. Societal costs were higher for patients with severe and moderate disease by €11,115 and €2825, respectively (all P < 0.01). HRQoL scores were also significantly worse for severe and moderate patients versus those with mild disease.Conclusion: Severity of haemophilia is predictive of increasing economic and humanistic burden. The burden of moderate disease, as measured by direct costs and HRQoL, did not appear to be substantially different than that observed among patients with severe haemophilia. [ABSTRACT FROM AUTHOR] more...- Published
- 2022
- Full Text
- View/download PDF
34. Comparing the long-term clinical and economic impact of ofatumumab versus dimethyl fumarate and glatiramer acetate in patients with relapsing multiple sclerosis: A cost-consequence analysis from a societal perspective in Germany.
- Author
-
Koeditz, Dominik, Frensch, Juergen, Bierbaum, Martin, Ness, Nils-Henning, Ettle, Benjamin, Vudumula, Umakanth, Gudala, Kapil, Adlard, Nicholas, Tiwari, Santosh, and Ziemssen, Tjalf
- Subjects
GLATIRAMER acetate ,DIMETHYL fumarate ,MULTIPLE sclerosis ,ECONOMIC impact ,DISEASE relapse - Abstract
Background: Evidence suggests that early highly efficacious therapy in relapsing multiple sclerosis is superior to escalation strategies. Objective: A cost-consequence analysis simulated different treatment scenarios with ofatumumab (OMB), dimethyl fumarate (DMF) and glatiramer acetate (GA): immediate OMB initiation as first treatment, early switch to OMB after 1 year on DMF/GA, late switch after 5 years or no switch. Methods: An EDSS-based Markov model with a 10-year time horizon was applied. Cycle transitions included EDSS progression, improvement or stabilization, treatment discontinuation, relapse or death. Input data were extracted from OMB trials, a network meta-analysis, published literature, and publicly available sources. Results: The late switch compared to the immediate OMB scenario resulted in a lower proportion of patients with EDSS 0–3 (Δ − 7.5% DMF; Δ − 10.3% GA), more relapses (Δ + 0.72 DMF; Δ + 1.23 GA) and lower employment rates (Δ − 4.0% DMF; Δ − 5.6% GA). The same applies to late versus early switches. No switch scenarios resulted in worse outcomes. Higher drug acquisition costs in the immediate OMB and early switch scenarios were almost compensated by lower costs for patient care and productivity loss. Conclusion: Immediate OMB treatment and an early switch improves clinical and productivity outcomes while remaining almost cost neutral compared to late or no switches. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
- Full Text
- View/download PDF
35. Production loss and sick leave caused by antibiotic resistance: a register-based cohort study.
- Author
-
Larsson, Sofie, Svensson, Mikael, and Ternhag, Anders
- Subjects
PRODUCTION (Economic theory) ,SICK leave ,ANTIBIOTICS ,DRUG resistance ,MEDICAL care ,MEDICAL care costs ,EMPLOYMENT ,IMPACT of Event Scale ,DRUG resistance in microorganisms ,LONGITUDINAL method - Abstract
Background: Adverse economic consequences of antibiotic resistance, both in health care systems and in society at large, have been estimated to emerge and significantly affect the global economy. To date, most studies of the societal costs of antibiotic resistance have had a macroeconomic perspective, using the number of attributable deaths as a quantifier for production loss. In contrast, there have been few studies of the consequences of antibiotic resistance in terms of the length of sick leave and hence the impact of morbidity on production loss. The aim of our study was to estimate the production loss from ill health caused by antibiotic resistance.Method: To estimate additional production loss due to antibiotic resistance, we used Swedish register-based cohort data to determine days of long-term sick leave (LTSL) for episodes of infection caused by resistant and susceptible bacteria respectively. We collected patient data for four common infection types (bloodstream infection, urinary tract infection, skin and soft tissue infection, and pneumonia), as well as, antibiotic susceptibility test data, and total days of LTSL. We used a two-part model to estimate the number of LTSL days attributable to resistance, and controlled for comorbidities and demographic variables such as age and gender.Results: The results show that antibiotic resistance adds an additional 8.19 days of LTSL compared with a similar infection caused by susceptible bacteria, independent of infection type and resistance type. Furthermore, the results suggest that production loss due to temporary sick leave caused by antibiotic resistance in a working-age population amounts to about 7% of total health care costs attributable to antibiotic resistance in Sweden.Conclusion: Estimating the effect of antibiotic resistance in terms of temporary production loss is important to gain a better understanding of the economic consequences of antibiotic resistance in society and, by extension, enable more effective resource allocation to combat further emergence of resistance. Society's economic costs of antibiotic resistance are, however, probably much greater than those of sick leave due to disease alone. [ABSTRACT FROM AUTHOR] more...- Published
- 2022
- Full Text
- View/download PDF
36. The societal costs of problem gambling in Sweden
- Author
-
T. Hofmarcher, U. Romild, J. Spångberg, U. Persson, and A. Håkansson
- Subjects
Gambling ,Societal costs ,Cost-of-illness ,Economic burden ,Sweden ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Problem gambling is a public health issue affecting both the gamblers, their families, their employers, and society as a whole. Recent law changes in Sweden oblige local and regional health authorities to invest more in prevention and treatment of problem gambling. The economic consequences of gambling, and thereby the potential economic consequences of policy changes in the area, are unknown, as the cost of problem gambling to society has remained largely unexplored in Sweden and similar settings. Methods A prevalence-based cost-of-illness study for Sweden for the year 2018 was conducted. A societal approach was chosen in order to include direct costs (such as health care and legal costs), indirect costs (such as lost productivity due to unemployment), and intangible costs (such as reduced quality of life due to emotional distress). Costs were estimated by combining epidemiological and unit cost data. Results The societal costs of problem gambling amounted to 1.42 billion euros in 2018, corresponding to 0.30% of the gross domestic product. Direct costs accounted only for 13% of the total costs. Indirect costs accounted for more than half (59%) of the total costs, while intangible costs accounted for 28%. The societal costs were more than twice as high as the tax revenue from gambling in 2018. Direct and indirect costs of problem gambling combined amounted to one third of the equivalent costs of smoking and one sixth of the costs of alcohol consumption in Sweden. Conclusions Problem gambling is increasingly recognized as a public health issue. The societal costs of it are not negligible, also in relation to major public health issues of an addictive nature such as smoking and alcohol consumption. Direct costs for prevention and treatment are very low. A stronger focus on prevention and treatment might help to reduce many of the very high indirect and intangible costs in the future. more...
- Published
- 2020
- Full Text
- View/download PDF
37. Socio-Economic Burden of Myasthenia Gravis: A Cost-of-Illness Study in Bulgaria
- Author
-
Valentina Ignatova, Kostadin Kostadinov, Evguenia Vassileva, Naira Muradyan, Georgi Stefanov, Georgi Iskrov, and Rumen Stefanov
- Subjects
myasthenia gravis ,cost-of-illness ,socio-economic burden ,burden of disease ,societal costs ,Bulgaria ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundMyasthenia gravis (MG) is a chronic autoimmune disorder, which is characterized by fatigable muscle weakness with frequent ocular signs and/or generalized muscle fatigue, and occasionally associated with thymoma. MG patients and their families face a significant socio-economic burden. This population is often experiencing unemployment, unwilling job transfers and decreased income.ObjectiveThis study aimed to estimate the annual costs from a societal perspective in a triple dimension of direct health care costs, direct non-health care costs (formal and informal care) and labor productivity losses in MG patients from Bulgaria, as well as to identify the main clinical and demographical cost drivers.MethodsA bottom-up, cross-sectional, cost-of-illness analysis of 54 adult MG patients was carried out in 2020. To collect data on demographic characteristics, health resource utilization, informal care and productivity losses, questionnaires were administered to and completed by patients.Results and ConclusionMedian annual costs of MG in Bulgaria were 4,047 EUR per patient. Direct costs slightly outweighed indirect costs, with drugs cost item having the biggest monetary impact. Despite the zero-inflated median, hospitalizations also influenced the direct costs by an estimated amount of 1,512 EUR in the 3rd quartile. Social services and professional caregiver costs were found to be almost missing, with the vast majority of patients reporting reliance on informal caregivers. Severe generalized disease, disease crises, and recurrent infections were confirmed as statistically significant cost driving factors. There were no severe generalized MG patients in the bottom quartile of the total costs distribution. It should be noted that in both cases of crises or infections, the overall increase in the total costs was mainly due to higher indirect costs observed. Reliance on family members as informal caregivers is routine among Bulgarian MG patients. This phenomenon is likely due to the lack of access to appropriate social services. Moreover, it is directly related with higher disease burden and significant inequalities. There is a need for further research on MG in Bulgaria in order to design targeted health policies that meet the needs and expectations of these patients. more...
- Published
- 2022
- Full Text
- View/download PDF
38. On the relationships between the size of agricultural machinery, soil quality and net revenues for farmers and society
- Author
-
Nargish Parvin, Elsa Coucheney, Ing-Marie Gren, Hans Andersson, Katarina Elofsson, Nicholas Jarvis, and Thomas Keller
- Subjects
Soil quality ,Soil ecosystem services ,Societal costs ,Flooding ,Profitability ,Nitrate leaching ,Geology ,QE1-996.5 - Abstract
Mechanization in agriculture has greatly improved the efficiency of field operations, but also resulted in heavier agricultural vehicles, which has led to increased risks of soil compaction. Hence, farmers benefit from machinery with higher capacity but may suffer from decreased yields caused by compaction. Compaction may result in further environmental costs to society. We present a framework that relates the machinery capacity to soil compaction and its impacts on crop yields and environmental disservices, and associated revenues and costs for farmers and society. We combined simulations using a soil compaction model and a soil-crop model with simple economic analyses. We applied the framework to a case study of cereal production in Sweden, to derive the optimal combine harvester size that maximizes the farmer's private profit and the societal net benefit, respectively. Increased machinery size decreased harvesting costs, but also reduced simulated crop yields and thus crop revenue as a result of soil compaction. Furthermore, in the model simulations, compaction also increased surface run-off, nitrogen leaching and greenhouse gas emissions. Intermediate machinery size maximized the farmer's net revenue. Net benefits for society were highest for the lowest possible compaction level, due to the considerable external costs from soil compaction. We show that the optimal machinery size and thus compaction level for maximum farmer revenue would decrease if either producer prices were higher, harvesting costs savings from larger machinery were smaller, or if farmers were charged for (part of the) environmental costs. more...
- Published
- 2022
- Full Text
- View/download PDF
39. Loss of quality of life and increased societal costs in patients with hypertrophic cardiomyopathy: the AFFECT-HCM study.
- Author
-
Schoonvelde SAC, Wiethoff I, Zwetsloot PP, Hirsch A, Knackstedt C, Germans T, Sikking M, Schinkel AFL, van Slegtenhorst MA, Verhagen JMA, de Boer RA, Evers SMAA, Hiligsmann M, and Michels M
- Abstract
Introduction: Hypertrophic cardiomyopathy (HCM) is the most prevalent inherited cardiac disease. The impact of HCM on quality of life (QoL) and societal costs remains poorly understood. This prospective multi-centre burden of disease study estimated QoL and societal costs of genotyped HCM patients and genotype-positive phenotype-negative (G+/P-) subjects., Methods: Participants were categorized into three groups based on genotype and phenotype: 1) G+/P- (left ventricular (LV) wall thickness <13 mm), 2) non-obstructive HCM (nHCM, LV outflow tract (LVOT) gradient <30 mmHg), and 3) obstructive HCM (oHCM, LVOT gradient ≥30 mmHg). We assessed QoL with EQ-5D-5L and Kansas City Cardiomyopathy Questionnaires (KCCQ). Societal costs were measured using medical consumption (iMCQ) and productivity cost (iPCQ) questionnaires. We performed subanalyses within three age groups: <40, 40-59, and ≥60 years., Results: From three Dutch hospitals, 506 subjects were enrolled (84 G+/P-, 313 nHCM, 109 oHCM; median age 59 years, 39% female). HCM (both nHCM and oHCM) patients reported reduced QoL vs G+/P- subjects (KCCQ: 88 vs 98, EQ-5D-5L: 0.88 vs 0.96; both p<0.001). oHCM patients reported lower KCCQ scores than nHCM patients (83 vs 89, p=0.036). Societal costs were significantly higher in HCM patients (€19,035/year vs €7,385/year) compared to G+/P- controls, mainly explained by higher healthcare costs and productivity losses. Being symptomatic and of younger age (<60 years) particularly led to decreased QoL and increased costs., Conclusion: HCM is associated with decreased QoL and increased societal costs, especially in younger and symptomatic patients. oHCM patients were more frequently symptomatic than nHCM patients. This study highlights the substantial disease burden of HCM and can aid in assessing new therapy cost-effectiveness for HCM in the future., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.) more...
- Published
- 2024
- Full Text
- View/download PDF
40. Parkinson's disease in Sweden—resource use and costs by severity.
- Author
-
Hjalte, Frida, Norlin, Jenny M., Kellerborg, Klas, and Odin, Per
- Subjects
- *
PARKINSON'S disease , *MEDICAL registries , *COST , *MEDICAL care costs - Abstract
Objectives: To estimate resource use and costs, including direct and indirect costs, in relation to levels of severity in individuals with Parkinson's disease (PD) in a Swedish setting. Materials and methods: Patients with idiopathic PD registered in the National Parkinson's Disease Patient Registry (PARKreg), with registrations of Hoehn and Yahr (H&Y) and "off time" in the Skåne Region, were included. Annual costs of healthcare contacts, drugs, formal and informal care, and productivity loss associated with PD were estimated using data from PARKreg linked with regional and national healthcare registers between 2013 and 2019. Results: In total, 960 patients and 1324 observations (patient‐years) were included. Total average cost per patient‐year was SEK 168,982 (EUR 15,958) and ranged from SEK 62,404 (EUR 5893) for H&Y stage I to SEK 1,056,324 (EUR 99,755) in H&Y stage V. The dominating part of total costs for early stages were indirect costs accounting for 50–60% while formal care made up for 55% and 81% of total costs in H&Y IV and V, respectively. Total mean costs for formal care, informal care, and productivity loss also increased with increasing off‐time. Conclusion: Advanced and late stages of PD are associated with significant societal costs as patients in those stages often require resource‐intensive and costly formal care. Thus, there are potential savings to be made, by optimizing the pharmacological and surgical symptomatic treatment of patients with advanced disease. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
- Full Text
- View/download PDF
41. Annual dementia incidence and monetary burden attributable to fine particulate matter (PM2.5) exposure in Sweden.
- Author
-
Kriit, Hedi Katre, Forsberg, Bertil, Åström, Daniel Oudin, and Oudin, Anna
- Subjects
DEMENTIA ,PARTICULATE matter ,AIR pollutants ,QUALITY-adjusted life years ,ALZHEIMER'S disease ,COVID-19 - Abstract
Background: Alzheimer's disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM
2.5 ) air pollution and resulting monetary estimates are lacking. Methods: We used data on average population-weighted exposure to ambient PM2.5 for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM2.5 exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives. Results: The annual number of dementia cases attributable to PM2.5 exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM2.5 by 1 μg/m3 was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019. Conclusion: This study estimated that 5% of annual dementia cases could be attributed to PM2.5 exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions. [ABSTRACT FROM AUTHOR] more...- Published
- 2021
- Full Text
- View/download PDF
42. Cost of out-of-hospital cardiac arrest survivors compared with matched control groups.
- Author
-
Qvist Kristensen, Lola, van Tulder, Maurits W., Eiskjær, Hans, Sørensen, Lotte, Wulff Risør, Bettina, and Gregersen Oestergaard, Lisa
- Subjects
- *
MYOCARDIAL infarction , *CARDIAC arrest , *SICK leave , *MEDICAL care use , *HOSPITAL admission & discharge , *VOCATIONAL rehabilitation - Abstract
• Societal costs of OHCA survivors were extensive and considerably higher than costs for people with myocardial infarction and people with no cardiac diseases. • Costs were highest in the first year after event, especially within health care. • Throughout the second to fifth year, costs of work inability, with sick leave and later disability pension, accounted for the main economic burden of working aged OHCA survivors. • Allocating resources for tailored interventions may support the management of OHCA survivors after discharge from hospital, and sensibly distribute resources at the same time. Societal costs of out-of-hospital cardiac arrest (OHCA) survivors may be extensive due to high health care utilization and sick leave. Knowledge of the costs of OHCA survivors may guide decision-makers to prioritize health resources. The aims of the study were to evaluate the costs of OHCA survivors from a societal perspective, and to compare these costs to the costs of individuals with non-cardiac arrest myocardial infarction (MI) and individuals with no cardiac disease (non-CD). From the Danish OHCA Registers, survivors, with a cardiac arrest between 2005–2018 were identified. Each case was assigned one MI control and one non-CD control, matched on gender and age. Based on register data, costs of healthcare utilization, sick leave, vocational rehabilitation, disability pension and other social benefits one year before event and five years after, were estimated. In total 5,646 OHCA survivors were identified with associated control groups. The mean costs for OHCA survivors during the 6-year period were €119,106 (95%CI: 116,297–121,916), with €83,472 (95%CI: 81,392–85,552) being healthcare costs. Mean costs of OHCA survivors were €49,132 higher than the MI-control group and €100,583 higher than the non-CD control group. Total costs of OHCA survivors were considerably higher than costs of MI- and non-CD controls. Hospital costs were highest during the first year after event, and work inability during the second to fifth year with sick leave and later disability pension as main burdens. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
- Full Text
- View/download PDF
43. Attributable societal costs of first-incident obesity-related cardiovascular comorbidities in Denmark.
- Author
-
Kjellberg, Jakob and Tikkanen, Christian K
- Abstract
Background: Obesity is associated with increased societal costs, primarily due to its comorbidities. The objective of this study was to estimate the 3-year attributable societal costs of the first event of cardiovascular comorbidities among people with obesity. Methods: We used an incidence-based cohort study based on Danish national registries. Attributable costs of each event were calculated as the difference between costs of individuals with an event and costs incurred by matched controls. Results: We identified 58,597 individuals with a diagnosis of obesity. On average, 2,038 individuals were diagnosed annually with one or more than ten cardiovascular comorbidities between 2007 and 2013. The 3-year attributable societal costs (health-care costs plus productivity loss) for patients of working age ranged from 8,164 EUR for other ischemic heart disease to 32,203 EUR for hemorrhagic stroke. In the incidence year, costs were mainly driven by health-care costs, while productivity loss and income transfer payments were the primary drivers in subsequent years. Conclusion: The onset of obesity-related cardiovascular comorbidities affected health-care costs and work ability to an extent where sick pay and disability pension were required. Our study demonstrates the need to intensify obesity and cardiovascular disease risk factor management to prevent costly and debilitating obesity-related comorbidities. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
- Full Text
- View/download PDF
44. Benchmarking European Home Care Models for Older Persons on Societal Costs: The IBenC Study.
- Author
-
van Lier, Lisanne I, van der Roest, Henriëtte G, Garms-Homolová, Vjenka, Onder, Graziano, Jónsson, Pálmi V, Declercq, Anja, Hertogh, Cees MPM, van Hout, Hein PJ, and Bosmans, Judith E
- Abstract
This study aims to benchmark mean societal costs per client in different home care models and to describe characteristics of home care models with the lowest societal costs. In this prospective longitudinal study in 6 European countries, 6-month societal costs of resource utilization of 2060 older home care clients were estimated. Three care models were identified and compared based on level of patient-centered care (PCC), availability of specialized professionals (ASP) and level of monitoring of care performance (MCP). Differences in costs between care models were analyzed using linear regression while adjusting for case mix differences. Societal costs incurred in care model 2 (low ASP; high PCC & MCP) were significantly higher than in care model 1 (high ASP, PCC & MCP, mean difference €2230 (10%)) and in care model 3 (low ASP & PCC; high MCP, mean difference €2552 (12%)). Organizations within both models with the lowest societal costs, systematically monitor their care performance. However, organizations within one model arranged their care with a low focus on patient-centered care, and employed mainly generalist care professionals, while organizations in the other model arranged their care delivery with a strong focus on patient-centered care combined with a high availability of specialized care professionals. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
- Full Text
- View/download PDF
45. Healthcare and Societal Costs in Patients with COPD and Breathlessness after Completion of a Comprehensive Rehabilitation Program.
- Author
-
Verberkt, Cornelia A., van den Beuken-van Everdingen, Marieke H. J., Dirksen, Carmen D., Schols, Jos M. G. A., Vanfleteren, Lowie E. G. W., Franssen, Frits M. E., Groenen, Miriam T. J., Wouters, Emiel F. M., and Janssen, Daisy J. A. more...
- Subjects
- *
MEDICAL care costs , *DYSPNEA , *TREATMENT programs , *MEDICAL personnel , *OBSTRUCTIVE lung diseases - Abstract
Breathlessness is one of the most frequent symptoms in chronic obstructive pulmonary disease (COPD). COPD may result in disability, decreased productivity and increased healthcare costs. The presence of comorbidities increases healthcare utilization. However, the impact of breathlessness burden on healthcare utilization and daily activities is unclear. This study's goal was to analyze the impact of breathlessness burden on healthcare and societal costs. In this observational single-center study, patients with COPD were followed-up for 24 months after completion of a comprehensive pulmonary rehabilitation program. Every three months participants completed a cost questionnaire, covering healthcare utilization and impact on daily activities. The results were compared between participants with low (modified Medical Research Council (mMRC) grade <2; LBB) and high baseline breathlessness burden (mMRC grade ≥2; HBB). Healthcare costs in year 1 were €7302 (95% confidence interval €6476–€8258) for participants with LBB and €10,738 (€9141–€12,708) for participants with HBB. In year 2, costs were €8830 (€7372-€10,562) and €14,933 (€12,041–€18,520), respectively. Main cost drivers were hospitalizations, contact with other healthcare professionals and rehabilitation. Costs outside the healthcare sector in year 1 were €682 (€520–€900) for participants with LBB and €1520 (€1210–€1947) for participants with HBB. In year 2, costs were €829 (€662–€1046) and €1457 (€1126–€1821) respectively. HBB in patients with COPD is associated with higher healthcare and societal costs, which increases over time. This study highlights the relevance of reducing costs with adequate breathlessness relief. When conventional approaches fail to improve breathlessness, a personalized holistic approach is warranted. [ABSTRACT FROM AUTHOR] more...
- Published
- 2021
- Full Text
- View/download PDF
46. Can the Consideration of Societal Costs Change the Recommendation of Economic Evaluations in the Field of Rare Diseases? An Empirical Analysis.
- Author
-
Aranda-Reneo, Isaac, Rodríguez-Sánchez, Beatriz, Peña-Longobardo, Luz María, Oliva-Moreno, Juan, and López-Bastida, Julio
- Subjects
- *
ECONOMIC change , *RARE diseases , *QUALITY-adjusted life years , *COST , *ORPHAN drugs , *RESEARCH , *LABOR productivity , *RESEARCH methodology , *MEDICAL cooperation , *EVALUATION research , *COMPARATIVE studies , *COST effectiveness , *SYMPTOMS , *ECONOMIC aspects of diseases , *STATISTICAL models - Abstract
Objectives: To analyze whether the adoption of a societal perspective would alter the results and conclusions of economic evaluations for rare disease-related healthcare technologies.old>Methods: A search strategy involving all the active substances considered as orphan drugs by the European Medicines Agency plus a list of 76 rare diseases combined with economic-related terms was conducted on Medline and the Cost-Effectiveness Registry from the beginning of 2000 until November 2018. We included studies that considered quality-adjusted life years as an outcome, were published in a scientific journal, were written in English, included informal care costs or productivity losses, and separated the results according to the applied perspective.Results: We found 14 articles that fulfilled the inclusion criteria. Productivity losses were considered in 12 studies, the human capital approach being the method most frequently used. Exclusively, informal care was considered in 2 articles, being valued through the opportunity cost method. The 14 articles selected resulted in 26 economic evaluation estimations, from which incremental cost-utility ratio values changed from cost-effective to dominant in 3 estimates, but the consideration of societal costs only modified the authors' conclusion in 1 study.Conclusions: The presence of societal costs in the economic evaluation of rare diseases did not affect the conclusions of the studies except in a single specific case. In those studies where the societal perspective was considered, we did not find significant changes in the economic evaluation results due to the higher costs of treatments and the low quality-adjusted life-years gained. [ABSTRACT FROM AUTHOR] more...- Published
- 2021
- Full Text
- View/download PDF
47. Quality of life and societal costs in patients with dilated cardiomyopathy.
- Author
-
Wiethoff I, Sikking M, Evers S, Gabrio A, Henkens M, Michels M, Verdonschot J, Heymans S, and Hiligsmann M
- Subjects
- Humans, Female, Male, Middle Aged, Cross-Sectional Studies, Netherlands epidemiology, Surveys and Questionnaires, Health Care Costs, Registries, Aged, Cardiomyopathy, Dilated economics, Cardiomyopathy, Dilated psychology, Quality of Life, Cost of Illness
- Abstract
Aims: Dilated cardiomyopathy (DCM) is a major cause of heart failure impairing patient wellbeing and imposing a substantial economic burden on society, but respective data are missing. This study aims to measure the quality of life (QoL) and societal costs of DCM patients., Methods and Results: A cross-sectional evaluation of QoL and societal costs of DCM patients was performed through the 5-level EuroQol and the Medical Consumption Questionnaire and Productivity Cost Questionnaire, respectively. QoL was translated into numerical values (i.e. utilities). Costs were measured from a Dutch societal perspective. Final costs were extrapolated to 1 year, reported in 2022 Euros, and compared between DCM severity according to NYHA classes. A total of 550 DCM patients from the Maastricht cardiomyopathy registry were included. Mean age was 61 years, and 34% were women. Overall utility was slightly lower for DCM patients than the population mean (0.840 vs. 0.869, P = 0.225). Among EQ-5D dimensions, DCM patients scored lowest in 'usual activities'. Total societal DCM costs were €14 843 per patient per year. Cost drivers were productivity losses (€7037) and medical costs (€4621). Patients with more symptomatic DCM (i.e. NYHA class III or IV) had significantly higher average DCM costs per year compared to less symptomatic DCM (€31 099 vs. €11 446, P < 0.001) and significantly lower utilities (0.631 vs. 0.883, P < 0.001)., Conclusion: DCM is associated with high societal costs and reduced QoL, in particular with high DCM severity., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.) more...
- Published
- 2024
- Full Text
- View/download PDF
48. Economic burden of maternal depression among women with a low income in Cape Town, South Africa
- Author
-
Susan Cleary, Stacey Orangi, Emily Garman, Hanani Tabani, Marguerite Schneider, and Crick Lund
- Subjects
Low and middle income countries ,economic burden ,maternal depression ,societal costs ,Psychiatry ,RC435-571 - Abstract
BackgroundMaternal depression is a notable concern, yet little evidence exists on its economic burden in low- and middle-income countries.AimsThis study assessed societal costs and economic outcomes across pregnancy to 12 months postpartum comparing women with depression with those without depression. Trial registration: ClinicalTrials.gov: NCT01977326 (registered on 24 October 2013); Pan African Clinical Trials Registry (www.pactr.org): PACTR201403000676264 (registered on 11 October 2013).MethodParticipants were recruited during the first antenatal visit to primary care clinics in Khayelitsha, Cape Town. In total, 2187 women were screened, and 419 women who were psychologically distressed were retained in the study. Women were interviewed at baseline, 8 months gestation and at 3 and 12 months postpartum; the Hamilton Rating Scale for Depression was used to categorise women as having depression or not having depression at each interview. Collected data included sociodemographics; health service costs; user fees; opportunity costs of accessing care; and travelling expenses for the women and their child(ren). Using Markov modelling, the incremental economic burden of maternal depression was estimated across the period.ResultsAt 12 months postpartum, women with depression were significantly more likely to be unemployed, to have lower per capita household income, to incur catastrophic costs and to be in a poorer socioeconomic group than those women without depression. Costs were higher for women with depression and their child(ren) at all time points. Modelled provider costs were US$805 among women without depression versus US$1303 in women with depression.ConclusionsEconomic costs and outcomes were worse in perinatal women with depression. The development of interventions to reduce this burden is therefore of significant policy importance. more...
- Published
- 2020
- Full Text
- View/download PDF
49. The Economical Impact of Pain
- Author
-
Gaskin, Darrell J., Richard, Patrick, Walburn, Joseph, and Saba, Luca, editor
- Published
- 2017
- Full Text
- View/download PDF
50. Burden of Providing Informal Care for Patients with Atrial Fibrillation.
- Author
-
Kanters, Tim A., Brugts, Jasper J., Manintveld, Olivier C., and Versteegh, Matthijs M.
- Subjects
- *
ATRIAL fibrillation , *SERVICES for caregivers , *BURDEN of care , *JOB absenteeism , *PATIENT care , *RESEARCH , *CAREGIVERS , *LABOR productivity , *AGE distribution , *ACTIVITIES of daily living , *MENTAL health , *HEALTH status indicators , *MEDICAL cooperation , *SOCIOECONOMIC factors , *SEX distribution , *COMPARATIVE studies , *QUALITY of life , *PSYCHOLOGY of caregivers , *INTERPERSONAL relations , *QUESTIONNAIRES , *ECONOMIC aspects of diseases , *COMORBIDITY - Abstract
Objectives: Patients with atrial fibrillation (AF) have rapid and irregular heart rates, increasing the risk of comorbidities and mortality. Next to formal medical care, many patients receive informal care from their social environment. The objective of this study was to examine the well-being and economic burden of providing informal care to patients with AF in the UK, Italy, and Germany.Methods: Caregivers of patients with AF completed an online survey based on the iMTA Valuation of Informal Care Questionnaire, with questions about their caregiving situation, perceived burden of caregiving, and absence from work due to health problems resulting from caregiving. Care-related quality-of-life utilities were calculated using the Care-related Quality of Life instrument and associated tariffs. Societal costs of caregiving were calculated based on the proxy good method.Results: A total of 585 caregivers participated in this study. On average, caregivers provided 33 hours of informal care per week to patients (SD 29 hours). On a scale from 0 to 10, their self-rated burden was 5.4. The average Care-related Quality of Life utility was 72. Caregivers primarily indicated problems with daily activities, mental health, and physical health. Still, the vast majority of caregivers (87%) derived fulfillment from providing care. Weekly societal costs of caregiving were on average €636. Comorbidities contributed substantially to the caregiver time and burden.Conclusions: Caring for a patient with AF is associated with substantial objective and subjective burden, but also provides fulfillment from being able to care for a loved one. [ABSTRACT FROM AUTHOR] more...- Published
- 2021
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.