Cost control, medical care

There is little doubt that the identification and control of hazardous chemicals is necessary to protect human health and the environment. An assessment of the occupational health benefits of REACH estimates that improved chemical risk assessment and risk management can reduce compensation for worker-related illness by between 18 and 54 billion over a 30-year period [190]. The long-term benefits of improved environmental protection resulting from the identification of hazardous chemicals under REACH (e.g., avoided costs for carrying out environmental remediation) can readily result in savings of hundreds of million Euro per substance [190]. Based on World Bank estimates that chemicals and chemical pollution causes between 0.6% and 2.5% of diseases in developed countries, the European Commission calculated a saving of 50 billion on health and medical care within the EU over 30 years could result if REACH can reduce the occurrence of disease by 0.1% [282]. 

Chiquette, E. Amato, M.G. Bussey, H.I. Comparison of an anticoagulation clinic with usual medical care Anticoagulation control, patient outcomes, and health care costs. Arch. Intern. Med. 1998, 158, 1641 1647. 

An Australian study compared medical utilization and costs in patients with panic disorder, those with social anxiety disorder, and a control group (Rees et al, 1998). Almost half of the panic disorder patients had seen a primary-care physician more than seven times over a 6-month period, compared with 7% of the social phobic patients and none of the control group. The mean costs were A 150, A 60 and A 20 respectively. The patients with panic disorder were treated with antidepressants (39%), benzodiazepines (15%), relaxants (12%), beta-blockers (7%) and other medication (7%). Twenty per cent received no medication. Patients with panic... 

The indemnity fee-for-service model protects the patient from catastrophic medical expenses but has its own set of potential problems. There is little incentive for either the provider or the patient to control costs. The patient pays less than the full cost of care, creating an incentive to use more care. The provider is paid on a fee-for-service basis and thus can generate more income by providing more services. The health care... 

Second, the book includes sections on pain control, antibiotic use in neutropenic fever, antiemetic guidelines, and supportive care medications. The book continues with a section on drugs used in commonly encountered problems in hematology, and concludes with a listing of the wholesale costs of most chemotherapy agents. The rapid growth of chemotherapeutic options will make frequent updates of this handbook essential for the future state-of-the-art care of our patients. 

Attempts have been made to calculate the societal cost of MDD in terms of health care utilization, absenteeism from work, decreased productivity, job-related injuries, and adverse effects on quality control because of impaired concentration and attention. In a prospective study of 3,000 patients, depression was related to poorer physical health and increased health care utilization ( 52). In the same study, employed individuals had a five times greater risk of using disability days. In another study, disability because of major depression was similar to or worse than chronic medical illnesses such as hypertension, diabetes mellitus, and arthritis ( 53). 

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