Hospitalization costs

From the early beginning of treating HIV/AIDS, most health economic studies focussed on the calculation of provider costs. During the first years there had been a clear dominance of research on hospital costs for patients with AIDS, in particular,... 

The introduction of protease inhibitor-based regimens seemed to be responsible for a change within the structure of provider costs. There is some evidence that the share of drugs increased, whereas the importance of hospitalization declined. For instance, Hellinger (1993) estimated that drug costs to account for about 10% of the total provider costs, whereas the inpatient hospitals costs were responsible for some... 

Flori and le Vaillant (2004) studied the temporal relationship between the uptake of the more aggressive antiretroviral therapy and the use and cost of hospital treatment for HIV-infected patients in France from 1995 to 2000 from a hospital perspective. The authors found that during this period the proportion of patients on ARV treatment increased from 69.5% to 97%, with a large rise in the use of polytherapy. This increase was most notable for patients with CD4 cell counts above 500. ART expenditures per patient increased between the study years by 220%, reaching US 1,886 in 2000. Unlike that, inpatient hospitalization fell by 60% and average length of stay declined. Thus hospital costs (excluding ART) decreased to US 2,137 in 2000. 

Bozette et al. (2001) examined expenditures for the care of adult HIV-infected patients since the introduction of highly active antiretroviral therapy. They interviewed a representative random sample of 2,864 patients in early 1996 and followed them for up to 36 months. They estimated the average expenditure per patient per month on the basis of self-reported information. According to their calculations, the mean expenditure was US 1,792 per patient per month at base hne in early 1996, but it decbned to US 1,359 for survivors in 1997, since the increases in pharmaceutical expenditures were smaller than the reductions in hospital costs. After adjustments for the interview date, clinical status, and deaths, the estimated annual expenditure declined from US 20,300 per patient (1996) to US 18,300 (1998). 

In the main, economic analysis was rudimentary and only hospital costs were included, although some reports also noted work status (but without calculating costs of productivity) and in one (Hamilton et al,... 

Although atypical antipsychotic agents may cost several times as much as traditional antipsychotics, drug costs in schizophrenia account for only 1-4% of the total treatment cost (Knapp, 1997). The argument then is that a small increase in drug costs— say to 10% of total cost—may result in disproportionate savings in the highly expensive direct hospital costs, if clinical trial... 

A recent report by the Inshtute of Medicine (lOM), To Err is Human, Building a Safer Health System, claims that an3rwhere from 44,000 to 98,000 people die each year as a result of preventable medical errors. Many of these adverse events are associated with the use of pharmaceuhcals and are potenhally preventable. The lOM estimates that in the United States more than 7000 deaths occur annually as a result of preventable medication errors. In addihon, preventable medicahon errors are estimated to increase hospital costs by about 2 billion nationwide. ... 

Medication errors are costly to both the patient (direct costs such as additional treatment and increased hospital stay) and to society (indirect costs such as decreased employment, costs of litigation) [1,5]. The cost of medication errors in a 700-bed teaching hospital based on a study in eleven medical and surgical units in two hospitals over a six-month period, was estimated to be 2.8 million dollars annually [2]. The increased length of stay associated with a medication error was estimated to be 4.6 days [2]. In a four-year study of the eosts of adverse drug events (ADEs) in a tertiary care center, 1% of these events were elassified as medication errors. The excess hospital costs for ADEs over the study period were almost 4,500,000 with almost 4,000 days of increased hospital stay [12]. 

Table 3 shows the results of the univariate analysis of hospital costs measured among men receiving vehicle and an investigational medication for the... 

Table 3. Hospital costs of tirilazad mesylate for subarachnoid hemorrhage in men...

Table 4 shows selected results of an ordinary least-squares regression predicting hospital costs... 

Granneman TW, Brown RS, Pauly MV. Estimating hospital costs. J Health Econ 1986 5 107-27. 

Reed SD, Friedman JY, Gnanasakthy A, Schuhnan KA. Comparison of hospital costing methods in an economic evaluation of a multinational chnical trial. Int J Technol Assess Health Care 2003 19 396-406. 

Insomnia can have a serious impact on a person s quality of life. Acute insomnia can lead to daytime sleepiness and reduced ability to concentrate, remember things, use logical reasoning, and even impair your ability to drive a car. Chronic insomnia can have major health consequences, such as an increased susceptibility to depression and some forms of heart disease and a reduced ability to fight off colds or infections. There is also a tremendous cost to society caused by insomnia—billions of dollars are spent each year on treatment, healthcare services, and hospital costs. An equal cost can be attributed to lost productivity at work and property and personal damage from accidents caused by sleepy insomniacs. 

Costs are often separated into direct and indirect costs. Direct costs typically consist of hospitalization costs, physician fees, laboratory fees, and costs of medical treatments/medications. Direct nonmedical costs can include costs of using transportation to and from the medical facility. Thus far, only direct costs have been estimated. Indirect/opportunity costs incurred with the death of a patient or while the individual is undergoing treatment are often expressed as days lost from work and reduced productivity. The so-called intangible costs are the monetary values of the results of pain and suffering. 

Economic outcomes Costs associated with sleep loss and fatigue (e.g., fatigue related medical errors) Cost-benefit analyses of fatigue management programs Hospital costs Patient care costs Direct and indirect costs... 

A good example of the recent and future evolution of viral vaccines and their concomitant issues of technology, complexity and competition, is the rotavirus vaccine. This is of great relevance for the prevention of diarrhea, which is often deadly in developing countries (half a million deaths per year) and has high hospitalization costs in rich countries. After successive failures of monovalent vaccines, multivalent vaccines based on the reshuffling of rotavirus strains comprising the attenuation properties of animal strains with the external capsid of human serotypes were developed. 

A generation of pregnant women has been without access to this highly effective drug. As a result, hospital admissions for excessive vomiting in pregnancy per thousand live births rose by 50 percent in 1984. An estimate of excess hospital costs attendant to these admissions over the years 1983-1987 in the United States was 73 million. 

Traffic accidents, Incl. rescue hospital costs 31 200= 31 200= 31200= 31200= euro 1... 

The frequency of ADRs in the general population is unknown. However, the reported rates of new occurrences for ADRs are noted for selected patient populations. A meta-analysis of 39 prospective studies reported an overall incidence of serious ADRs in hospitalized patients of 6.7% and of fatal ADRs of 0.32% . The fatality rate makes ADRs the fourth to sixth leading cause of death in the United States. Another meta-analysis of 36 studies indicated that approximately 5% of hospital admissions are due to ADRs. The costs of ADRs are estimated to be 1.56- 4 billion in direct hospital costs per year in the United States. ... 

The cost issue has probably been best explored by Cagnoni et al [214] in a randomized, double-blind, comparative, multicenter trial in persistently febrile neutropenic patients treated as first-line empirical therapy with either liposomal versus conventional AmB. By using itemized hospital billing data on 414 patients, hospital costs from the time of first dose to discharge were significantly higher for all patients who received liposomal AmB ( 48, 962 vs. 43, 183 p=0.022) without any difference in clinical outcome... 

Nearly 50% of the annual hospital charges ( 29.3 billion) in the United States for delivery and neonatal care are associated with prematurity. Hospitalization costs for a normal delivery average 1300 where costs where for premature infants average 75 000. These initial charges do not include the public and private health care costs for the 25% of these infants who survive with blindness, cerebral palsy, and other chronic conditions. 

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