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1.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(4): 414-418, 2020 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-32935520

RESUMO

OBJECTIVE: To analyze the advantages, disadvantages, opportunities and challenges for schistosomiasis elimination in Laos, so as to propose the corresponding healthy policies and suggestions. METHODS: A SWOT analysis was performed to analyze the strength, weakness, opportunity and threat for the schistosomiasis elimination program in Laos, and the corresponding policy suggestions were proposed. RESULTS: The national schistosomiasis elimination program of Laos receives governmental emphases and great supports. A strategy based on mass drug administration was proposed and a sentinel site-bases surveillance system has been built for schistosomiasis elimination in Laos; however, there are several challenges for the national schistosomiasis elimination program in Laos, including insufficient financial supports, inadequate professional capability, weak schistosomiasis control awareness in community populations and difficulty in vector control. CONCLUSIONS: Persistent governmental leadership, increasing financial supports, strengthening professional team building and improving schistosomiasis control awareness in community populations are required to facilitate the progress towards schistosomiasis elimination in Laos.


Assuntos
Erradicação de Doenças , Programas Nacionais de Saúde , Esquistossomose , Erradicação de Doenças/normas , Humanos , Laos , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/normas , Controle de Pragas , Esquistossomose/prevenção & controle
3.
Artigo em Inglês | MEDLINE | ID: mdl-32872616

RESUMO

This study used the Korean National Health Insurance (NHI) claims database from 2011 to 2017 to estimate the incidence and the incidence-based cost of cervical cancer and carcinoma in situ of cervix uteri (CIS) in Korea. The primary outcome was the direct medical cost per patient not diagnosed with cervical cancer (C53) or CIS (D06) 2 years prior to the index date in the first year after diagnosis. A regression analysis was conducted to adjust for relevant covariates. The incidence of cervical cancer tended to decrease from 2013 to 2016, while that of CIS increased. In particular, the incidence rate of CIS in women in their 20 s and 30 s increased by 56.8% and 28.4%, respectively, from 2013 to 2016. The incidence-based cost of cervical cancer and CIS was USD 13,058 and USD 2695 in 2016, respectively, which increased from 2013. Multivariate regression analysis suggested that age was the most influential variable of the cost in both patient groups, and the cost was highest in those aged over 60, i.e., the medical cost was significantly lower in younger women than their older counterparts. These findings suggest that targeting younger women in cervical cancer prevention is a reasonable option from both economic and public health perspectives.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Neoplasias do Colo do Útero , Adulto , Fatores Etários , Carcinoma in Situ/economia , Carcinoma in Situ/epidemiologia , Efeitos Psicossociais da Doença , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/estatística & dados numéricos , Lesões Pré-Cancerosas/economia , Lesões Pré-Cancerosas/epidemiologia , República da Coreia/epidemiologia , Projetos de Pesquisa , Neoplasias do Colo do Útero/economia , Neoplasias do Colo do Útero/epidemiologia , Adulto Jovem
4.
Int J Behav Nutr Phys Act ; 17(1): 101, 2020 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778110

RESUMO

BACKGROUND: Few studies have examined relationships between physical activity (PA) during mid-age and health costs in women. The aim of this study was to investigate associations between PA levels and trajectories over 12 years with medical and pharmaceutical costs in mid-age Australian women. METHODS: Data from 6953 participants in the Australian Longitudinal Study on Women's Health (born in 1946-1951) were analysed in 2019. PA was self-reported in 2001 (50-55y), 2007 (56-61y) and 2013 (62-67y). PA data were linked with 2013-2015 data from the Medicare (MBS) and Pharmaceutical (PBS) Benefits Schemes. Quantile regression was used to examine associations between PA patterns [always active, increasers, decreasers, fluctuaters or always inactive (reference)] with these medical and pharmaceutical costs. RESULTS: Among women who were consistently inactive (< 500 MET.minutes/week) in 2001, 2007 and 2013, median MBS and PBS costs (2013 to 2015) were AUD4261 and AUD1850, respectively. Those costs were AUD1728 (95%CI: 443-3013) and AUD578 (95%CI: 426-729) lower among women who were consistently active in 2001, 2007 and 2013 than among those who were always inactive. PBS costs were also lower in women who were active at only one survey (AUD205; 95%CI: 49-360), and in those whose PA increased between 2001 and 2013 (AUD388; 95%CI: 232-545). CONCLUSION: Maintaining 'active' PA status was associated with 40% lower MBS and 30% lower PBS costs over three years in Australian women. Helping women to remain active in mid-life could result in considerable savings for both women and the Australian government.


Assuntos
Exercício Físico , Custos de Cuidados de Saúde/estatística & dados numéricos , Custos de Cuidados de Saúde/tendências , Programas Nacionais de Saúde/economia , Saúde da Mulher/economia , Idoso , Austrália/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade
5.
Infect Dis Poverty ; 9(1): 78, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600426

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is now a global public threat. Given the pandemic of COVID-19, the economic impact of COVID-19 is essential to add value to the policy-making process. We retrospectively conducted a cost and affordability analysis to determine the medical costs of COVID-19 patients in China, and also assess the factors affecting their costs. METHODS: This analysis was retrospectively conducted in Shandong Provincial Chest Hospital between 24 January and 16 March 2020. The total direct medical expenditures were analyzed by cost factors. We also assessed affordability by comparing the simulated out-of-pocket expenditure of COVID-19 cases relative to the per capita disposable income. Differences between groups were tested by student t test and Mann-Whitney test when appropriate. A multiple logistic regression model was built to determine the risk factors associated with high cost. RESULTS: A total of 70 COVID-19 patients were included in the analysis. The overall mean cost was USD 6827 per treated episode. The highest mean cost was observed in drug acquisition, accounting for 45.1% of the overall cost. Total mean cost was significantly higher in patients with pre-existing diseases compared to those without pre-existing diseases. Pre-existing diseases and the advanced disease severity were strongly associated with higher cost. Around USD 0.49 billion were expected for clinical manage of COVID-19 in China. Among rural households, the proportions of health insurance coverage should be increased to 70% for severe cases, and 80% for critically ill cases to avoid catastrophic health expenditure. CONCLUSIONS: Our data demonstrate that clinical management of COVID-19 patients incurs a great financial burden to national health insurance. The cost for drug acquisition is the major contributor to the medical cost, whereas the risk factors for higher cost are pre-existing diseases and severity of COVID-19. Improvement of insurance coverage will need to address the barriers of rural patients to avoid the occurrence of catastrophic health expenditure.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Pandemias , Pneumonia Viral , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Modelos Econômicos , Programas Nacionais de Saúde/economia , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Estudos Retrospectivos , População Rural , Adulto Jovem
6.
S Afr Med J ; 110(3): 188-191, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32657694

RESUMO

Health promotion - keeping people healthy - is critical to ensuring that South Africa (SA)'s National Health Insurance (NHI) services and funding will not be overwhelmed by having to service and pay for large numbers of people with avoidable disease. Although the 2019 NHI Bill mentions health promotion, its lack of emphasis and the narrow approach proposed in the Bill make it unlikely that health promotion will have significant impact on population health or reducing healthcare need. Health promotion experts submit that there is in fact huge potential for carefully planned and researched health promotion to impact on population health. The establishment of a multisectoral National Health Commission or an independent Health Promotion and Development Foundation linked directly to the NHI Fund that includes several relevant government departments and civil society and researchers is proposed. Of the NHI Fund, 2% should be dedicated specifically to promoting health and preventing illness, which must support comprehensive, multisectoral health promotion interventions that go beyond awareness raising and health education. SA's specific realities and needs, including poverty and its related behavioural impacts and health consequences, must be taken into account.


Assuntos
Promoção da Saúde , Programas Nacionais de Saúde/economia , Administração Financeira , Governo , Educação em Saúde , Humanos , Doenças não Transmissíveis/mortalidade , Doenças não Transmissíveis/prevenção & controle , África do Sul
7.
PLoS One ; 15(7): e0235176, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614846

RESUMO

The maternal mortality rate in Indonesia is still high, at 305 per 100,000 live births. Several studies indicated maternal financial burden as one of the dimensions of access that influence a pregnant woman's ability to receive adequate, high-quality medical care. This study aims to identify the association between the use of Indonesia's national health insurance (JKN) and out-of-pocket (OOP) expenditures in accessing delivery services, using data from the Indonesian Family Life Survey 5. In addition, this study also investigated the relationship of JKN and the potential reduction of catastrophic delivery expenditures (CDEs) for delivery services. The results show that JKN was associated with reduced OOP expenditures for delivery as well as reduced risk of incurring CDE. However, some OOP expenditure for cost of delivery services still exists among mothers who used JKN during delivery, potentially due to factors such as medicine stock availability and inpatient care shortages.


Assuntos
Parto Obstétrico/economia , Adolescente , Adulto , Feminino , Gastos em Saúde , Humanos , Indonésia , Pessoa de Meia-Idade , Programas Nacionais de Saúde/economia , Gravidez , Qualidade da Assistência à Saúde/economia , Adulto Jovem
8.
PLoS One ; 15(7): e0235736, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32673350

RESUMO

Globally, about one in four people develop a psychiatric disorder during their lifetime. Specifically, the lifetime prevalence of schizophrenia is about 0.48%, and schizophrenia can have detrimental effects on a patient's life. Therefore, estimating the economic burden of schizophrenia is important. We investigated the cost-of-illness trend of schizophrenia in South Korea from 2006 to 2016. The cost-of-illness trend was estimated from a societal perspective using a prevalence-based approach for direct costs and a human capital approach for indirect costs. We utilized information from the following sources: 1) National Health Insurance Service, 2) Korean Statistical Information Service, Statistics Korea, 3) the National Survey of Persons with Disabilities, 4) Budget and Fund Operation Plan, Ministry of Justice, 5) Budget and Fund Operation Plan, Ministry of Health and Welfare, and 6) annual reports from the National Mental Health Welfare Commission. Direct healthcare costs, direct non-healthcare costs, and indirect costs by sex and age group were calculated along with sensitivity analyses of the estimates. The cost-of-illness of schizophrenia in Korea steadily increased from 2006 to 2016, with most costs being indirect costs. Individuals in their 40s and 50s accounted for most of the direct and indirect costs. Among indirect costs, the costs due to unemployment were most prevalent. Our estimation implies that schizophrenia is associated with a vast cost-of-illness in Korea. Policymakers, researchers, and physicians need to put effort into shortening the duration of untreated psychosis, guide patients to receive community-care-based services rather than hospital-based services and empower lay people to learn about schizophrenia.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Programas Nacionais de Saúde/economia , Esquizofrenia/economia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , República da Coreia/epidemiologia , Esquizofrenia/epidemiologia , Esquizofrenia/terapia , Adulto Jovem
9.
Washington; Organización Panamericana de la Salud; jul. 30, 2020. 4 p.
Não convencional em Espanhol | LILACS | ID: biblio-1116084

RESUMO

Varios países de América Latina son el epicentro de la pandemia de COVID-19. La región, la más desigual del mundo, es especialmente vulnerable a la COVID-19 por sus altos niveles de informalidad laboral, urbanización y débiles sistemas de salud y protección social.


Assuntos
Pneumonia Viral/economia , Sistemas de Saúde/economia , Infecções por Coronavirus/economia , Economia , Pandemias/economia , Betacoronavirus , Desenvolvimento Sustentável/economia , Programas Nacionais de Saúde/economia , Região do Caribe , Políticas Públicas de Saúde , América Latina
10.
Am J Trop Med Hyg ; 103(3): 1057-1064, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32618253

RESUMO

Costs related to tuberculosis (TB) can impose a significant burden on patients and their families and create barriers to diagnosis and treatment. Our study aimed to quantify out-of-pocket costs expended by TB patients in Bandung, Indonesia. This cross-sectional study recruited adults with TB from community health centers (CHCs), public and private hospitals, and private practitioners (PPs). An interview was completed at the time of diagnosis or at their return for 2- or 6-month treatment. Costs were converted to U.S. dollars (US$)-presented as median and interquartile range (IQR). Of 469 TB patients recruited, the mean age was 38 years and 57% were male. The median pretreatment direct cost per person was $37.51 (IQR 20.79-71.24). Hospitalization, diagnostic tests, and travel costs were predominant. Higher pretreatment costs were associated with no health insurance ($41.88 versus $27.41, P < 0.001), ≥ 6 visits to a healthcare provider ($39.91 versus $24.32, P < 0.001), ≥ 60 days pretreatment ($36.35 versus $26.25, P = 0.02), and presenting first to a PP ($40.71) or informal provider ($32.72) compared with private hospital ($21.26), public hospital ($19.63), or CHC ($13.52) (P = 0.01). For a subsample of 106 patients with total pre- and posttreatment costs available, the median total cost was $243.66 (IQR 128.46-550.71). For 26.5% of these patients, total costs were ≥ 20% of their annual household income. Despite having a good network of free TB diagnostic and treatment services throughout Bandung, patients experienced significant out-of-pocket costs. Increased uptake of the National Health Insurance, and systems for early recognition and diagnosis of TB, will contribute toward reducing costs.


Assuntos
Assistência à Saúde/economia , Programas Nacionais de Saúde/economia , Tuberculose/diagnóstico , Adolescente , Adulto , Estudos Transversais , Feminino , Gastos em Saúde , Humanos , Indonésia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
11.
G Ital Nefrol ; 37(3)2020 Jun 10.
Artigo em Italiano | MEDLINE | ID: covidwho-595676

RESUMO

The aim of this editorial is to illustrate the new public funding framework of the Italian National Health System following the Covid-19 pandemic. The document reviews the measures put in place by the Italian Government and European Institutions such as the European Commission (EC), the European Central Bank (ECB) and the European Stability Mechanism (ESM) to deal with this health crisis and subsequent severe economic recession, with particular reference to sources and uses of resources. The use of new budgetary financial spaces in deficit entails greater attention to the assessment of interventions and makes it necessary to keep expenditure under strict control. At the same time, the remodeling of expenditure within its aggregates, public investment in innovation, and the removal of administrative obstacles can strengthen the capacity of the healthcare system to meet the extraordinary needs deriving from the spread of Covid-19 and its resilience to future health shocks.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/economia , Financiamento Governamental/economia , Programas Nacionais de Saúde/economia , Pandemias/economia , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/economia , Recessão Econômica , Europa (Continente) , Gastos em Saúde , Recursos em Saúde , Humanos , Itália/epidemiologia , Pneumonia Viral/economia , Saúde Pública
12.
G Ital Nefrol ; 37(3)2020 Jun 10.
Artigo em Italiano | MEDLINE | ID: mdl-32530146

RESUMO

The aim of this editorial is to illustrate the new public funding framework of the Italian National Health System following the Covid-19 pandemic. The document reviews the measures put in place by the Italian Government and European Institutions such as the European Commission (EC), the European Central Bank (ECB) and the European Stability Mechanism (ESM) to deal with this health crisis and subsequent severe economic recession, with particular reference to sources and uses of resources. The use of new budgetary financial spaces in deficit entails greater attention to the assessment of interventions and makes it necessary to keep expenditure under strict control. At the same time, the remodeling of expenditure within its aggregates, public investment in innovation, and the removal of administrative obstacles can strengthen the capacity of the healthcare system to meet the extraordinary needs deriving from the spread of Covid-19 and its resilience to future health shocks.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/economia , Financiamento Governamental/economia , Programas Nacionais de Saúde/economia , Pandemias/economia , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/economia , Recessão Econômica , Europa (Continente) , Gastos em Saúde , Recursos em Saúde , Humanos , Itália/epidemiologia , Pneumonia Viral/economia , Saúde Pública
14.
J Korean Med Sci ; 35(24): e224, 2020 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-32567260

RESUMO

Coronavirus disease 2019 (COVID-19) has resulted in an ongoing pandemic; however, the socioeconomic burden of COVID-19 treatment in the pediatric population remains unclear. Thus, the aim of this study was to determine the hospitalization periods and medical costs among children with COVID-19. In total, 145 billing statements for pediatric patients receiving healthcare services because of COVID-19 from February 1, 2020 to March 31, 2020 were used. The study showed that individual treatment costs for children with COVID-19 are approximately USD 2,192 under the Korean National Health Insurance Service System. This study revealed the differences in cost among age groups, determined by the type of hospital wherein admission occurred, as a trend of increasing age, increasing hospitalization time, and increasing cost was observed. Tailored COVID-19 treatment strategies by age group may lower costs and increase the effectiveness of resource allocation.


Assuntos
Infecções por Coronavirus/economia , Hospitalização/economia , Pandemias/economia , Pneumonia Viral/economia , Adolescente , Betacoronavirus , Criança , Pré-Escolar , Infecções por Coronavirus/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Tempo de Internação/economia , Programas Nacionais de Saúde/economia , Pneumonia Viral/tratamento farmacológico , República da Coreia/epidemiologia , Adulto Jovem
15.
BMC Public Health ; 20(1): 949, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32546221

RESUMO

BACKGROUND: A national Publicly Funded Health Insurance (PFHI) scheme called Pradhan Mantri Jan Arogaya Yojana (PMJAY) was launched by government of India in 2018. PMJAY seeks to cover 500 million persons with an annual cover of around 7000 USD per household. PMJAY claims to be the largest government funded health scheme globally and has attracted an international debate as a policy for Universal Health Coverage. India's decade-long experience of the earlier national and state-specific PFHI schemes had shown poor effectiveness in financial protection. Most states in India have completed a year of implementation of PMJAY but no evaluations are available of this important scheme. METHODS: The study was designed to find out the effect of enrolment under PMJAY in improving utilisation of hospital services and financial protection in Chhattisgarh which has been a leading state in implementing PFHI in terms of enrolment and claims. The study analyses three repeated cross-sections. Two of the cross-sections are from National Sample Survey (NSS) health rounds - year 2004 when there was no PFHI and 2014 when the older PFHI scheme was in operation. Primary data was collected in 2019-end to cover the first year of PMJAY implementation and it formed the third cross-section. Multivariate analysis was carried out. In addition, Propensity Score Matching and Instrumental Variable method were applied to address the selection problem in insurance. RESULTS: Enrollment under PMJAY or other PFHI schemes did not increase utilisation of hospital-care in Chhattisgarh. Out of Pocket Expenditure (OOPE) and incidence of Catastrophic Health Expenditure did not decrease with enrollment under PMJAY or other PFHI schemes. The size of OOPE was significantly greater for utilisation in private sector, irrespective of enrollment under PMJAY. CONCLUSION: PMJAY provided substantially larger vertical cover than earlier PFHI schemes in India but it has not been able to improve access or financial protection so far in the state. Though PMJAY is a relatively new scheme, the persistent failure of PFHI schemes over a decade raises doubts about suitability of publicly funded purchasing from private providers in the Indian context. Further research is recommended on such policies in LMIC contexts.


Assuntos
Gastos em Saúde , Acesso aos Serviços de Saúde/economia , Hospitais , Seguro Saúde , Programas Nacionais de Saúde/economia , Estudos Transversais , Características da Família , Feminino , Humanos , Índia , Setor Privado , Inquéritos e Questionários , Cobertura Universal do Seguro de Saúde
16.
Rev Bras Epidemiol ; 23: e200042, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32428191

RESUMO

INTRODUCTION: The acquisition of medicines accounts for a significant proportion of private health expenditures. The objective of this study was to analyse the private spending with the purchase of medicines and the commitment of the family income, by the elderly. METHODS: Population survey conducted in Praia Grande, São Paulo, Brazil. The monthly expenditure and the per capita family income commitment with the purchase of medicines were calculated from the information obtained in the interviews. The variables were described in absolute and relative frequencies and the hypothesis test was Pearson's χ2, Student's t and Anova, with a significance level of 5%. RESULTS: The prevalence of drug use was 61.2%. The average monthly expenditure per capita was R$ 34.59, with significantly higher income impairment for individuals with higher levels of education, without chronic diseases and health plan beneficiaries. CONCLUSION: The prevalence of drug use was low. The cost generated by the purchase of medicines is one of the ways in which inequality can manifest in society. The expansion of free drug provision would be necessary to expand access and avoid spending, especially those who have private health plans but cannot afford drug treatment.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Renda/estatística & dados numéricos , Preparações Farmacêuticas/economia , Idoso , Idoso de 80 Anos ou mais , Brasil , Cidades , Custos de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/estatística & dados numéricos , Preparações Farmacêuticas/provisão & distribução , Fatores Socioeconômicos , Estatísticas não Paramétricas
19.
PLoS One ; 15(5): e0233334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32437376

RESUMO

To update the landscape analysis of vaccine injuries no-fault compensation programmes, we conducted a scoping review and a survey of World Health Organization Member States. We describe the characteristics of existing no-fault compensation systems during 2018 based on six common programme elements. No-fault compensation systems for vaccine injuries have been developed in a few high-income countries for more than 50 years. Twenty-five jurisdictions were identified with no-fault compensation programmes, of which two were recently implemented in a low- and a lower-middle-income country. The no-fault compensation programmes in most jurisdictions are implemented at the central or federal government level and are government funded. Eligibility criteria for vaccine injury compensation vary considerably across the evaluated programmes. Notably, most programmes cover injuries arising from vaccines that are registered in the country and are recommended by authorities for routine use in children, pregnant women, adults (e.g. influenza vaccines) and for special indications. A claim process is initiated once the injured party or their legal representative files for compensation with a special administrative body in most programmes. All no-fault compensation programmes reviewed require standard of proof showing a causal association between vaccination and injury. Once a final decision has been reached, claimants are compensated with either: lump-sums; amounts calculated based on medical care costs and expenses, loss of earnings or earning capacity; or monetary compensation calculated based on pain and suffering, emotional distress, permanent impairment or loss of function; or combination of those. In most jurisdictions, vaccine injury claimants have the right to seek damages either through civil litigation or from a compensation scheme but not both simultaneously. Data from this report provide an empirical basis on which global guidance for implementing such schemes could be developed.


Assuntos
Seguro de Responsabilidade Civil , Vacinas/efeitos adversos , Adulto , Criança , Compensação e Reparação , Feminino , Saúde Global , Política de Saúde/economia , Política de Saúde/legislação & jurisprudência , Humanos , Responsabilidade Legal/economia , Masculino , Imperícia/economia , Imperícia/legislação & jurisprudência , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/legislação & jurisprudência , Gravidez , Inquéritos e Questionários , Vacinação/efeitos adversos , Vacinação/economia , Vacinação/legislação & jurisprudência , Vacinas/economia , Organização Mundial da Saúde
20.
J Headache Pain ; 21(1): 44, 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32366217

RESUMO

BACKGROUND: Cluster headache (CH) is the most frequent trigemino-autonomic cephalgia. CH can manifest as episodic (ECH) or chronic cluster headache (CCH) causing significant burden of disease and requiring attack therapy and prophylactic treatment. The few data available on the economic burden of CH come from retrospective studies based on questionnaires, population surveys and medical insurance claims database. Although all these studies showed an important economic burden, they provided different estimates depending on variability of CH awareness and management, healthcare systems, available therapies and use of treatments according to different guidelines. METHODS: This prospective study aimed to quantify the total direct and indirect cost of ECH and CCH over a cluster period, both for the patient and for the National Health System (NHS), using data from subjects who consecutively attended an Italian tertiary headache centre between January 1, 2018 and December 31, 2018. RESULTS: A total 108 patients (89 ECH, 19 CCH) were included. Mean attack frequency was 2.3 ± 1.4 per day. Mean total cost of a CH bout was €4398 per patient and total cost of CCH was 5.4 times higher than ECH (€13,350 vs. €2487, p <  0.001). Direct costs represented the 72.1% of total cost and were covered for the 94.8% by the NHS. The costs for any item of expense were higher for CCH than for ECH (p <  0.001). Mean indirect costs for a CH bout were €1226 per patient and were higher for CCH compared to ECH (€3.538 vs. €732), but the difference was not significant. Days with reduced productive capacity impacted for the 64.6% of the total indirect costs. The analysis of the impact CH on work showed that 27%% of patients felt that CH had limited their career, 40% had changed their work pattern, 20% had changed their place of employment and 10% had lost a job due to the disease. CONCLUSION: Our results provide a valuable estimate of the direct and indirect costs of ECH and CCH in the specific setting of a tertiary headache centre and confirm the high economic impact of CH on both the NHS and patients.


Assuntos
Cefaleia Histamínica/economia , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Programas Nacionais de Saúde/economia , Centros de Atenção Terciária/economia , Adulto , Cefaleia Histamínica/epidemiologia , Cefaleia Histamínica/terapia , Estudos Transversais , Bases de Dados Factuais/tendências , Feminino , Custos de Cuidados de Saúde/tendências , Gastos em Saúde/tendências , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/tendências , Estudos Prospectivos , Estudos Retrospectivos , Inquéritos e Questionários , Centros de Atenção Terciária/tendências , Adulto Jovem
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