Health care costs, increased

In the analysis of health care the price of care is often confused with the level of expenditure, particularly so in the analysis of the cost of pharmaceuticals. Pharmaceutical cost containment should never be the exclusive goal of public policies emphasis on costs without paying attention to the value of the products may lead to inefficient policies. The value of a new pharmaceutical resides in its ability to improve health, not just in its contribution to the decrease or increase of health care costs. Increased spending on health care and pharmaceuticals is therefore compatible with a reduction in their price, if the resulting value increases more than the expenditure. 

Insomnia can lead to increased risk of depression problems with memory, family/social relationships, and mood poorer quality of life increased health care costs increased absenteeism and increased risk for coronary disease. 

Osteoporosis is a common and often silent disorder associated with significant morbidity and mortality and reduced quality of life. It is associated with increased risk and rates of bone fracture and is responsible for over 1.5 million fractures in the United States annually, resulting in direct health care costs of over 17 billion.1 As the population ages, these numbers are expected to increase. It is estimated that postmenopausal Caucasian women have a 50% lifetime chance of developing an osteoporosis-related fracture.1 Common sites of fracture include the spine, hip, and wrist, although almost all sites can be affected. Only a fraction of patients with osteoporosis receive optimal treatment. 

O Osteomyelitis is an infection of the bone that is associated with high morbidity and increased health care costs. The inflammatory response associated with acute osteomyelitis can lead to bone necrosis and subsequently chronic infections. Bacterial pathogens, particularly Staphylococcus aureus, are the most common microorganisms implicated in these infections. Diagnosis and treatment are often difficult due to the heterogeneous... 

SSIs negatively affect patient outcomes and increase health care costs. Patients who develop SSIs are five times more likely to be readmitted to the hospital and have twice the mortality of patients who do not develop an SSI.1 A patient infected with an SSI is also 60% more likely to be admitted to an intensive care unit.1 Clinical studies have shown that SSIs increase lengths of hospital stay and costs.1,3,4 The type of SSI can also affect outcome. Deep SSIs, involving organs or spaces, result in longer durations of hospital stay and higher costs compared to SSIs that are limited to the incision.5... 

As noted by Goldsmith, medical technologies do not inherently increase health care costs. Their effects are broad-based and complex. Advances in medical technology may influence (1) the population at risk, (2) the cost of each treatment, (3) the risk of complications, (4) clinical incomes or hospital revenue, (5) the need for additional treatment, and/or (6) patients quality of life (Goldsmith, 1994). The pharmacoeconomics of an intervention are particularly important when the intervention is a therapeutic breakthrough (leads to better patient outcomes), is relatively expensive compared... 

A few studies have examined the impacts of Medicaid and non-Medicaid copayments on drug utilization and health care costs. In a 1993 study, Reeder et al. noted an 11% decrease in prescription use after South Carolina established a 50-cent per prescription copayment. This increase was significantly greater than in Tennessee, a comparison state with no copayments (Reeder et al., 1993). Another study using survey data from the 1992 Medicare Beneficiary Survey found that elderly and disabled Medicaid beneficiaries who live in states with prescription drug copayments have lower prescription drug utilization than their counterparts in states without copayment, and three-fourths of the difference was directly attributed to copayment policies. The study predicted that Medicaid copayments... 

Based on these principles the priorities could be made at different levels. This should be started at the highest level among politicians and others, with mutual, transparent, long lasting decisions. Of course this is problematic. With the three ethical principles in mind we must all think of what we can do with limited resources and make our own priorities. EBM principles and methods as described above should be used. Some factors that increase the health-care costs are presented in Box 3.8, and should be considered. Several of the solutions presented in this and other chapters can be used. 

The U.S. 1994 economic burden impact of STDs and associated sequelae has been estimated to be approximately 10 billion for the major STDs and increases to 17 billion when sexually transmitted HIV infections are included [4], Greater than 10% of new AIDS cases reported to the CDC in 1990 were from heterosexual transmission [5], with double of such heterosexual transmission between 1990 and 1995 [6]. Clearly, effective STD prevention can dramatically reduce death, morbidity, and health care costs. 

There are major consequences of alcoholism, from child abuse to domestic or public violence to traffic accidents and from cirrhosis to hypertension. Mean life expectancy of alcohol abusers is around 55 years. Alcohol seems involved in several hundred thousand deaths each year in Europe, with considerable added social and health care costs. This is in clear contrast with the little attention paid to the treatment of alcohol dependence and abuse. It is important to note that there is an increasing knowledge of similar effects on driving etc. from other psychoactive substances, particularly from the seda-tive/tranquillizer drugs and antihistamines. 

Intersubject variation in drug response is thought to cost lives and dramatically increase health care costs [1,2]. While... 

The net profit is 0.83% of total costs. Conclusion reducing profits on drugs has a negligible effect on reducing total health care costs and could increase long-term cost by reducing the number of new drugs developed. 

Many food industry innovations are now slowly being adopted by pharmaceutical manufacturers as they also come under increasing pressure to help reduce health care costs. 

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