RESUMO
Analyses of the medical and economic burden of chronic disorders such as systemic lupus erythematosus (SLE) are valuable for clinical and health policy decisions. We performed a chart-based review of 215 adult SLE patients with active autoantibody-positive disease at the predefined ratio of 30% severe (involvement of major organs requiring treatment) and 70% non-severe, followed at seven hospital centres in Greece. We reviewed 318 patients consecutively registered over three months (sub-study). Disease activity, organ damage, flares and healthcare resource utilization were recorded. Costs were assessed from the third-party payer perspective. Severe SLE patients had chronic active disease more frequently (22.4% vs 4.7%), higher average SLE disease activity index (SLEDAI) (10.5 vs 6.1) and systemic lupus international collaborating clinics (SLICC) damage index (1.1 vs 0.6) than non-severe patients. The mean annual direct medical cost was 3741 for severe vs 1225 for non-severe patients. Severe flares, active renal disease and organ damage were independent cost predictors. In the sub-study, 19% of unselected patients were classified as severe SLE, and 30% of them had chronic active disease. In conclusion, this is the first study to demonstrate the significant clinical and financial burden of Greek SLE patients with active major organ disease. Among them, 30% display chronic activity, in spite of standard care, which represents a significant unmet medical need.
Assuntos
Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/economia , Adulto , Autoanticorpos/imunologia , Feminino , Grécia , Custos de Cuidados de Saúde , Humanos , Lúpus Eritematoso Sistêmico/imunologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
UNLABELLED: A Greek-specific cost-effectiveness analysis determined the FRAX-based intervention thresholds. Assuming a willingness to pay of 30,000
Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Osteoporose/economia , Fraturas por Osteoporose/economia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Conservadores da Densidade Óssea/economia , Análise Custo-Benefício , Custos de Medicamentos/estatística & dados numéricos , Feminino , Grécia/epidemiologia , Custos de Cuidados de Saúde/estatística & dados numéricos , Fraturas do Quadril/economia , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Econométricos , Osteoporose/tratamento farmacológico , Osteoporose/epidemiologia , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/prevenção & controle , Medição de Risco/métodos , Fatores SexuaisRESUMO
AIMS: To estimate the annual cost of treatment for Type 2 diabetic patients in Greece and investigate the effect of blood glucose regulation on patient cost. METHODS: A multipoint data collection procedure based on the patient records of 51 geographically distributed physicians was used in order to obtain the necessary data for the analysis and the construction of the patient cost model. Patients were classified as controlled (i.e. maintaining blood glucose regulation for the 1 year retrospective time frame of the analysis) and non-controlled (the patients failing to do so in the specified time period). Cost categories included pharmaceutical expenditure, laboratory/diagnostic tests and consultation fees. Costs attributable to hospitalizations due to diabetic complications were not included. Calculations were based on 2007 fees and prices, and costs are expressed in Euros. RESULTS: The average annual cost of treatment for controlled patients was estimated at 981.72 euro (95% confidence interval, 940.66-1023.01 euro), whereas for non-controlled patients it was 1566.12 euro (95% confidence interval, 1485.42-1650.20 euro). Non-controlled patients had 29.7% higher annual pharmaceutical costs (340.50 vs. 441.96 euro), 70% higher costs for laboratory/diagnostic tests (422.54 vs. 718.49 euro) and 85.5% higher consultation costs (218.68 vs. 405.67 euro) compared with their controlled peers. The average cost for a Type 2 diabetic patient in Greece, regardless of blood glucose regulation, was 1297.30 euro (95% confidence interval, 1244.42-1349.61 euro). CONCLUSIONS: Failing to control blood glucose levels within 'glycaemic goals', apart from the clinical consequences, can also have a significant financial impact, resulting in a 59.5% increase in the mean annual patient cost.
Assuntos
Diabetes Mellitus Tipo 2/economia , Custos de Cuidados de Saúde , Hipoglicemiantes/economia , Análise Custo-Benefício/economia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Esquema de Medicação , Grécia , Humanos , Hipoglicemiantes/uso terapêutico , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To identify the determinants of dental care utilisation among Greek adults, with a particular emphasis on socio-economic determinants. METHODS: Data were collected through a national survey on health and health care services utilisation of a sample of 4,003 Greek adults stratified by geographic region, age and gender. A purpose made questionnaire was used during face-to-face interviews. A 2-stage model was developed to assess the impact of independent variables on dental utilisation likelihood and frequency. RESULTS: 39.6% (1,562) of Greek adults reported having visited a dentist within the last year. Among dental attenders, 32.6% reported prevention as the reason for visit. Statistically significant differences in dental care utilisation were observed in relation to demographic, socioeconomic and lifestyle factors. Logistic regression analysis showed that gender, age, income, education, place of residence, private insurance coverage and self-rated oral health are important determinants of dental services utilisation. Mean number of dental visits within previous year was 1.6. Results from Poisson regression analysis indicated that lower income level correlates to lower number of dental visits, while having visited for treatment (rather than for prevention) correlated to higher number of dental visits. CONCLUSIONS: Greek adults do not exhibit satisfactory dental visiting behaviour. Extent of care sought is associated with need for treatment rather than preventive reasons. The findings confirm the existence of socioeconomic inequalities in dental services utilisation among Greek adults.