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1.
Orphanet J Rare Dis ; 16(1): 294, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215312

RESUMO

BACKGROUND: Tenosynovial Giant-Cell Tumour (TGCT) is a benign clonal neoplastic proliferation arising from the synovium, causing a variety of symptoms and often requiring repetitive surgery. This study aims to define the economic burden-from a societal perspective-associated with TGCT patients and their health-related quality of life (HRQOL) in six European countries. METHODS: This article analyses data from a multinational, multicentre, prospective observational registry, the TGCT Observational Platform Project (TOPP), involving hospitals and tertiary sarcoma centres from six European countries (Austria, France, Germany, Italy, the Netherlands, and Spain). It includes information on TGCT patients' health-related quality of life and healthcare and non-healthcare resources used at baseline (the 12-month period prior to the patients entering the registry) and after 12 months of follow-up. RESULTS: 146 TGCT patients enrolled for the study, of which 137 fulfilled the inclusion criteria. Their mean age was 44.5 years, and 62% were female. The annual average total costs associated with TGCT were €4866 at baseline and €5160 at the 12-month follow-up visit. The annual average healthcare costs associated with TGCT were €4620 at baseline, of which 67% and 18% corresponded to surgery and medical visits, respectively. At the 12-month follow-up, the mean healthcare costs amounted to €5094, with surgery representing 70% of total costs. Loss of productivity represented, on average, 5% of the total cost at baseline and 1.3% at follow-up. The most-affected HRQOL dimensions, measured with the EQ-5D-5L instrument, were pain or discomfort, mobility, and the performance of usual activities, both at baseline and at the follow-up visit. Regarding HRQOL, patients declared a mean index score of 0.75 at baseline and 0.76 at the 12-month follow-up. CONCLUSION: The results suggest that TGCT places a heavy burden on its sufferers, which increases after one year of follow-up, mainly due to the healthcare resources required-in particular, surgical procedures. As a result, this condition has a high economic impact on healthcare budgets, while the HRQOL of TGCT patients substantially deteriorates over time.


Assuntos
Efeitos Psicossociais da Doença , Qualidade de Vida , Adulto , Áustria , Cuidadores , Estudos Transversais , Europa (Continente) , Feminino , França , Alemanha , Custos de Cuidados de Saúde , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Países Baixos , Assistência ao Paciente , Sistema de Registros , Perfil de Impacto da Doença , Fatores Socioeconômicos , Espanha , Inquéritos e Questionários
3.
Eur J Health Econ ; 20(8): 1207-1236, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31342208

RESUMO

BACKGROUND: The main objective of this study was to analyse how the inclusion (exclusion) of social costs can alter the results and conclusions of economic evaluations in the field of Alzheimer's disease interventions. METHODS: We designed a systematic review that included economic evaluations in Alzheimer's disease. The search strategy was launched in 2000 and ran until November 2018. The inclusion criteria were: being an original study published in a scientific journal, being an economic evaluation of any intervention related to Alzheimer's disease, including social costs (informal care costs and/or productivity losses), being written in English, using QALYs as an outcome for the incremental cost-utility analysis, and separating the results according to the perspective applied. RESULTS: It was finally included 27 studies and 55 economic evaluations. Around 11% of economic evaluations changed their main conclusions. More precisely, three of them concluded that the new intervention became cost-effective when the societal perspective was considered, whereas when using just the health care payer perspective, the new intervention did not result in a cost-utility ratio below the threshold considered. Nevertheless, the inclusion of social cost can also influence the results, as 37% of the economic evaluations included became the dominant strategy after including social costs when they were already cost-effective in the health care perspective. CONCLUSIONS: Social costs can substantially modify the results of the economic evaluations. Therefore, taking into account social costs in diseases such as Alzheimer's can be a key element in making decisions about public financing and pricing of health interventions.


Assuntos
Doença de Alzheimer/economia , Custos de Cuidados de Saúde , Anos de Vida Ajustados por Qualidade de Vida , Cuidadores/economia , Análise Custo-Benefício , Eficiência , Humanos , Assistência de Longa Duração/economia , Assistência ao Paciente/economia
4.
Health Policy ; 123(2): 152-158, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30528244

RESUMO

OBJECTIVES: To pilot the feasibility of using a discrete choice experiment (DCE) design to investigate individual preferences from the decision-maker perspective regarding the use of public funding for orphan drugs and generate prior information for future experimental designs. METHODS: A DCE was used on a convenience sample of participants from five European countries (England, France, Germany, Italy and Spain), exploring their preferences in distinct healthcare scenarios involving orphan drugs. A preliminary review of the empirical literature on distributive preferences informed the selection of attributes and their levels in the design. An online questionnaire was used to conduct the DCE survey. RESULTS: A total of 199 questionnaires were completed. The five country model showed relative preference for some attributes over others: cost of treatment, improvement in health, value for money and availability of treatment alternatives received the greatest attention. However, disease severity, beginning of life, waiting times and side effects were also shown to be important social values that should not be ignored. CONCLUSIONS: The findings presented in this study provide insight about the preferences that can influence decisions on orphan drugs in different countries. This study also provides valuable prior information that could inform future DCE designs in this area.


Assuntos
Tomada de Decisões Gerenciais , Produção de Droga sem Interesse Comercial/economia , Doenças Raras/tratamento farmacológico , Valores Sociais , Adulto , Idoso , Comportamento de Escolha , Europa (Continente) , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
5.
J Nutr Health Aging ; 21(2): 207-214, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28112778

RESUMO

BACKGROUND: Frailty is associated with adverse health outcomes, but its association with hospital healthcare costs has not been analyzed. The main objective was to estimate the adjusted annual costs and use of hospital healthcare resources in frail older adults compared to non frail ones. DESIGN: FRADEA Study. Mean follow-up 1044 days (SD 314). SETTING: Albacete city, Spain. PARTICIPANTS: 830 adults ≥70 years. MEASUREMENTS: Age, sex, comorbidity measured with the Charlson index and Fried´s Frailty phenotype as independent variables, and use of hospital resources (hospital admissions, emergency visits, and specialist visits), and hospital healthcare costs as outcome variables. Outcome data were collected from Minimum Data Set of the Complejo Hospitalario Universitario Albacete. The cost base year was 2013. Logistic regression and two-part models were used to analyze the association between frailty and the use of healthcare resources. Generalized Linear Models were applied to estimate the impact of frailty and comorbidity on the healthcare costs. RESULTS: The average cost associated with the use of health resources was 1,922€/year. Frail participants had an average total cost of health resources of 2,476€/year, pre-frail 2,056€/year, and non-frail 1,217€/year. 67% of the total health cost was associated with hospital admission cost, 29% with specialist visits cost and 4% with emergency visits cost. Frailty and comorbidity were the most important factors associated with the use of hospital healthcare resources. Adjusted healthcare costs were 592€/year and 458€/year greater in frail and pre-frail participants respectively, compared to non-frail ones, and having a Charlson index ≥ 3, was associated with an increased costs of 2,289€/year. CONCLUSION: Frailty and comorbidity are meaningful and complementary associated with increased hospital healthcare resources use, and related costs.


Assuntos
Idoso Fragilizado , Custos de Cuidados de Saúde , Recursos em Saúde/economia , Custos Hospitalares , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Custos e Análise de Custo , Feminino , Seguimentos , Hospitalização/economia , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Espanha
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