direct costs

直接费用
  • 文章类型: Journal Article
    慢性鼻窦炎伴鼻息肉(CRSwNP)仍然是一种常见且具有挑战性的临床实体,到目前为止,中国还没有很好地描述其经济负担。
    共纳入101例接受内窥镜鼻窦手术的CRSwNP患者,以调查术后第一年的直接费用。门诊费用,药物使用,检查费用是从医院信息系统获得的,并比较亚组之间的差异。采用多元线性回归分析CRSwNP患者年度总直接费用的主要影响因素。
    92名受试者完成了研究。CRSwNP患者术后1年的个人平均总直接成本为$742.4。最大的贡献者是药房费用(580.2美元),其次是检查费用(108.1美元)和门诊量(54.1美元)。在临床状态不受控制的患者亚组中,总直接费用较高,哮喘共病,和嗜酸性粒细胞CRSwNP与它们的对应物相比。主要影响因素为临床控制状况(P=0.016)和哮喘共病(P=0.035)。
    CRSwNP手术后1年的个人平均总直接费用为742.4美元。临床控制状况和哮喘共病影响这些成本,因此在指导CRSwNP管理的卫生资源分配方面很重要。
    UNASSIGNED: Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a common and challenging clinical entity, and its economic burden has not been well described in China thus far.
    UNASSIGNED: A total of 101 CRSwNP patients who underwent endoscopic sinus surgery were included to investigate direct costs in the first year post-surgery. Costs for outpatient visits, medication use, and examination costs were obtained from the Hospital Information System, and differences were compared between subgroups. Multiple linear regression analysis was adopted to investigate the main influencing factors on annual total direct costs for CRSwNP patients.
    UNASSIGNED: Ninety-two subjects completed the study. The individual mean total direct cost for a CRSwNP patient 1 year post-surgery was $742.4. The largest contributors were pharmacy costs ($580.2), followed by examination costs ($108.1) and outpatient visits ($54.1). Total direct costs were higher in subgroups of patients with uncontrolled clinical status, asthma comorbidity, and eosinophilic CRSwNP compared to their counterparts. The main influencing factors were clinical control status (P = 0.016) and asthma comorbidity (P = 0.035).
    UNASSIGNED: The individual mean total direct cost of CRSwNP in 1-year post-surgery was $742.4. Clinical control status and asthma comorbidity influence these costs and are therefore important in guiding health resources allocation for CRSwNP management.
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  • 文章类型: Journal Article
    UASSIGNED:这是第一个全面的全国性研究,旨在探讨中国自闭症谱系障碍儿童家庭的直接和间接成本。自闭症谱系障碍患病率的增加凸显了对为自闭症谱系障碍儿童家庭提供护理的资源需求的增长。医疗和非医疗费用以及父母的生产力损失给他们的家庭造成了严重的负担。我们的目标是估计中国自闭症谱系障碍儿童家庭的直接和间接成本。目标人群是自闭症谱系障碍儿童的父母。我们使用来自中国国家家庭调查的横断面数据对临床诊断为自闭症谱系障碍的2-6岁儿童(N=3236)进行了分析。获得了中国30个省份的家庭数据。成本项目包括直接医疗成本,直接非医疗费用,和间接成本。在这项研究中,我们发现,自闭症谱系障碍的家庭成本中最大的部分是非医疗成本和生产力损失。自闭症谱系障碍给中国有自闭症谱系障碍儿童的父母带来了巨大的经济负担,他们需要比目前的医疗保健系统提供更多的支持。
    UNASSIGNED: This is the first comprehensive national study to explore the direct and indirect costs for families of children with autism spectrum disorder in China. The increasing prevalence of autism spectrum disorder highlights a growing need for resources to provide care for families of children with autism spectrum disorder. The medical and nonmedical costs and parents\' productivity loss have caused a serious burden on their families. Our objective is to estimate the direct and indirect costs for the families of children with autism spectrum disorder in China. The target population was parents of children with autism spectrum disorder. We analyzed the costs using cross-sectional data from a Chinese national family survey with children aged 2-6 years (N = 3236) who were clinically diagnosed with autism spectrum disorder. Family data from 30 provinces in China were obtained. Cost items included direct medical costs, direct nonmedical costs, and indirect costs. In this study, we found that the largest part of family costs for autism spectrum disorder are nonmedical costs and productivity loss. Autism spectrum disorder has imposed a huge economic burden on parents having children with autism spectrum disorder in China, who need more support than the current health care system provides.
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  • 文章类型: Multicenter Study
    背景:评估与中国系统性红斑狼疮(SLE)患者相关的年度直接费用和费用驱动因素。
    方法:多中心,横断面研究基于CSTAR注册进行.使用在线问卷收集了由于SLE引起的门诊和住院就诊的人口统计学和支出信息。这些患者的病历来自中国风湿病信息系统(CRIS)的数据库。平均直接成本和95%置信区间是使用Bootstrap方法对1000个Bootstrap样本进行重新采样并替换估算的。使用多元回归模型确定了成本驱动因素。
    结果:共有来自101家医院的1778名SLE患者参与了我们的研究,92.58%为女性,平均年龄33.8岁,SLE的中位持续时间为4.9年,63.8%处于活跃的疾病状态,77.3%有两个器官或以上受损,8.3%使用生物制剂作为治疗。每位患者的平均年直接费用估计为29,727元,直接医疗费用约为86%。对于中度至重度疾病活动,生物制剂的使用,住院治疗,中等或高剂量糖皮质激素的治疗,和外周血管,心血管,和/或肾脏系统受累被发现大大增加了直接成本,而医疗保险略微降低了SLE的直接成本。
    结论:这项研究为中国SLE患者个体的经济压力提供了可靠的见解。建议将重点放在预防发作和限制疾病进展上,以进一步降低SLE的直接成本。
    To estimate the annual direct costs and cost-drivers associated with systemic lupus erythematosus (SLE) patients in China.
    A multi-center, cross-sectional study was conducted based on the CSTAR registry. The information on demography and expenditures for outpatient and inpatient visits due to SLE were collected using online questionnaires. These patients\' medical records were from the database of the Chinese Rheumatology Information System (CRIS). The average direct costs and 95% confidence interval were estimated using the bootstrap method with 1000 bootstrap samples by resampling with replacement. The cost-drivers were identified using multivariate regression models.
    A total of 1778 SLE patients from 101 hospitals participated in our study, with 92.58% as females, a mean age of 33.8 years old, a median duration of SLE of 4.9 years, 63.8% in an active disease state, 77.3% with two organs or more damaged, and 8.3% using biologics as treatment. The average annual direct cost per patient was estimated at CNY 29,727, which approximates to 86% for direct medical costs. For moderate to severe disease activities, the use of biologics, hospitalization, treatment of moderate or high dose glucocorticoids, and peripheral vascular, cardiovascular, and/or renal system involvements were found to substantially increase the direct costs, while health insurance slightly decreased the direct costs of SLE.
    This study provided reliable insight into financial pressures on individual SLE patients in China. The efforts focusing on preventing flare occurrences and limiting disease progression were recommended to further reduce the direct cost of SLE.
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  • 文章类型: Journal Article
    未经证实:慢性鼻炎通常分为过敏性鼻炎(AR)或非过敏性鼻炎(NAR)。目前北京没有关于AR和NAR经济负担的报告,中国。
    UNASSIGNED:连续收集了来自居住在北京的448名AR患者和565名NAR患者的1013份有效问卷,以进行直接调查(例如,毒品,2020年8月至2021年4月的医疗就诊)和间接成本(旷工和出勤)。
    未经评估:AR和NAR的总费用分别为195.6欧元患者/年和185.3欧元患者/年。就疾病的标准化患病率而言,北京成年AR和NAR患者的社会总成本约为每年440.9欧元和6.719亿欧元。患者的教育水平,疾病持续时间,疾病的好发时间,症状的严重程度和与其他过敏性疾病的共病是影响鼻炎患者经济负担的因素。
    UNASSIGNED: Chronic rhinitis is generally classified as either allergic rhinitis (AR) or non-allergic rhinitis (NAR). There is currently no report on the economic burden of AR and NAR in Beijing, China.
    UNASSIGNED: A total of 1013 valid questionnaires from 448 AR patients and 565 NAR patients living in Beijing were continuously collected for investigation of the direct (e.g., drugs, medical visits) and indirect costs (absenteeism and presenteeism) from August 2020 to April 2021.
    UNASSIGNED: The total cost of AR and NAR was € 195.6 patient/year and € 185.3 patient/year respectively. The total societal cost for adult AR and NAR patients in Beijing is around € 440.9 and € 671.9 million per year in terms of the standardized prevalence of the diseases. The patient\'s level of education, disease duration, predilection time of disease, severity of symptoms and comorbidity with other allergic disease were factors that affected the economic burden on patients with rhinitis.
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  • 文章类型: Journal Article
    2013年,精神分裂症是导致社会和经济负担的全球25个主要残疾原因之一。通过观察精神分裂症患者从口服抗精神病药(OAP)转换为每月一次的帕潘立酮棕榈酸酯(PP1M)之前和之后一年,我们可以更好地了解精神分裂症患者总费用的变化,包括直接成本和间接成本,切换治疗模式后。收集2016年12月至2019年6月山东省精神卫生中心住院的100例精神分裂症(ICD-10)患者。治疗方式,比较了从口服抗精神病药直接转换为PP1M前后的医疗保健资源利用率和成本.在主要分析的82名患者中,用PP1M治疗导致直接成本增加31.92%(P<0.01),药品费用增加约142%(P<0.01),医院费用降低68.15%(P>0.05)。总成本没有显著增加(P=0.25),而直接成本增加31.92%(P<0.01),转换为PP1M后,间接成本降低35.62%(P<0.01)。与PP1M给药前相比,在使用OAP的Pre-PP1M治疗中住院时间≥1年的患者(n=32)的直接费用降低了20.16%(P<0.01),药品费用增加144%(P<0.01),住院费用显著下降72.02%(P<0.01)。观察到的住院次数(t=2.56,P≤0.01)和住院时间(t=1.73,P<0.05)的减少以及过渡到PP1M后的住院费用的减少(P<0.01)。从OAP切换到PP1M减少了家庭劳动力负担,而不增加临床医疗保健成本。转换后,在PP1M治疗前1年内,住院时间≥1的患者的直接费用显着降低,通过提高对治疗的依从性和减少住院次数和住院时间,表明这些患者在改用PP1M后可能会受益。
    Schizophrenia is ranked among the top 25 leading causes of disability worldwide in 2013 which resulting in social and economic burden. By observing patients with schizophrenia one year before and after switching from oral antipsychotics (OAPs) to once-monthly paliperidone palmitate (PP1M), we can better understand the change of total costs in schizophrenic patients, including direct costs and indirect costs, after switching treatment patterns.A total of 100 schizophrenic (ICD-10) patients from Shandong Mental Health Center were collected from December 2016 to June 2019. Treatment modalities, health care resource utilization and costs were compared before and after switching directly from oral antipsychotics to PP1M.Of the 82 patients included in the main analyses, treatment with PP1M resulted in an increase in direct costs of 31.92% (P < 0.01), an increase in medicine costs of approximately 142% (P < 0.01), and a reduction in hospital costs of 68.15% (P > 0.05). There was no significant increase in total costs (P = 0.25), while 31.92% increase in direct costs (P < 0.01), and 35.62% decrease in indirect costs (P < 0.01) after conversion to PP1M. Compared with before administration of PP1M, patients with ≥ 1 inpatient stay in 1 year Pre-PP1M treatment with OAPs (n = 32) had a 20.16% decrease in direct costs (P < 0.01), a 144% increase in medicine costs (P < 0.01), and a significant 72.02% decrease in hospital costs (P < 0.01). The observed reduction in the number of hospitalizations (t = 2.56, P ≤ 0.01) and inpatient stays (t = 1.73, P < 0.05) and after transition to PP1M resulted in a reduction in hospitalization costs (P < 0.01).Switching from OAPs to PP1M decreased the household workforce burden without increasing clinical healthcare costs. Direct costs were significantly reduced in patients with ≥ 1 inpatient stay in 1 year pre-PP1M treatment with OAPs after the switch, which decreased by improving adherence to therapy and reducing the number and length of hospital stays, suggesting that those patients may benefit after switching to PP1M.
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  • 文章类型: Journal Article
    UNASSIGNED: This study aims to update the statistics on the economic burden of T2DM and to identify the factors affecting the economic costs of T2DM in China.
    UNASSIGNED: This study conducts a systematic review of the existing literature that has reported on the direct economic costs (mainly the direct medical resource consumption) and indirect economic costs (mainly non-medical costs and intangible costs) of T2DM as of 31 May 2019.
    UNASSIGNED: The total expenditure on diabetes in China\'s western region is still relatively low. Additionally, the mean direct costs of T2DM are high in China\'s northern urban areas. However, compared to urban areas, in rural areas, the largest proportion of the total economic costs of T2DM is the mean indirect costs. Furthermore, age, sex, type and number of complications, type of medical insurance, diabetes duration, level of education, and income are the primary factors that influence the economic burden of T2DM.
    UNASSIGNED: There is a considerable economic burden associated with T2DM in China. Therefore, to address the economic burden of T2DM, it is vital to take measures to reduce the prevalence rate of diabetes.
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  • 文章类型: Journal Article
    The incidence of type 2 diabetes is increasing, creating a huge burden for China\'s social healthcare system. This study aimed to evaluate hospital length of stay (LOS) based on admission characteristics and direct costs correlated with various types of complications for type 2 diabetic inpatients in Hubei Province, China.
    A total of 1528 inpatients diagnosed with type 2 diabetes discharged between April 1, 2013, and March 31, 2014, were included in this study. Information regarding patients\' admission and hospitalization were obtained from the hospital information system. The relationship between admission characteristics and LOS, distribution of total costs, and types of complications were described and analysed.
    (1) The mean LOS was 11.65 days (median: 10 days). Multiple linear regression analysis demonstrated that inpatients with New Cooperative Medical Scheme (NCMS), aged 80 and above, had longer LOS than the reference group, and inpatients with chronic or acute + chronic complications had shorter LOS than those without. (2) Mean total costs per patient were US$159.72 ± 130.83 (median: US$135.33), US$240.60 ± 166.58 (median: US$192.09), and US$247.98 ± 166.22 (median: US$200.99) for inpatients with no complications, chronic complications, and acute + chronic complications, respectively. Total and individual costs were significantly less for patients without complications than for those with the two types of complications (p < 0.001). (3) Mean total costs per patient were US$225.40 ± 115.32 (median: US$200.34), US$221.25 ± 177.64 (median: US$170.05), and US$275.18 ± 193.14 (median: US$217.91) for inpatients with microvascular complications, macrovascular complications, and microvascular + macrovascular complications, respectively. Total costs were significantly higher for patients with microvascular + macrovascular complications than for those with other types of chronic complications (p < 0.001). (4) Drugs were the greatest expense for patients, and the least expensive treatment was nursing care.
    Medical insurance status, age, and type of complication may help to predict LOS for patients with type 2 diabetes in Hubei Province, China. The total and individual costs for patients with complications were higher than for those without, and hospitalization expenses posed a heavy burden. Efforts should be made to reduce the financial impact on patients by integrating the medical insurance system of urban and rural areas, and by reducing the risk of complications, especially microvascular complications.
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  • 文章类型: Journal Article
    BACKGROUND: In China, malaria has been posing a significant economic burden on households. To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China.
    METHODS: A number of study sites (eight counties in five provinces) were selected from the malaria endemic area in China, representing the different levels of malaria incidence, risk classification, economic development. A number of households with malaria cases (n = 923) were surveyed during the May to December in 2012 to collect information on malaria economic burden. Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender, age group, occupation and malaria type. The malaria economic costs were evaluated by direct and indirect costs. Comparisons were carried out by using the chi-square test (or Z-test) and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients, hospitalized/out patients, and treatment hospitals.
    RESULTS: The average cost of malaria per case was 1 691.23 CNY (direct cost was 735.41 CNY and indirect cost was 955.82 CNY), which accounted for 11.1 % of a household\'s total income. The average costs per case for local and imported malaria were 1 087.58 CNY and 4271.93 CNY, respectively. The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above (3 975.43 CNY) was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital (938.80 CNY).
    CONCLUSIONS: This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs. There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria, especially of imported infections, in order to eliminate the disease in China.
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