Economic Burden of Illness of the Cervical Cancer Treatment Protocol in Bangladesh

Background: Cervical cancer is a significant health concern in Bangladesh, with high mortality rates due to limited awareness and costly treatments. The disease stages influence treatment protocols, ranging from surgery and radiotherapy for early stages to chemotherapy and radiation for advanced stages, but survival rates decrease as the cancer progresses. Objective: The objective of this study is to determine the economic impact of the disease and recommend cost-efficient strategies for prevention and treatment. Methods: A population-based, cross-sectional study was conducted with a stratified sample of cervical cancer patients from selected healthcare facilities across Bangladesh. Data collection involved structured interviews and validated questionnaires. The study measured the economic impact, treatment costs, and other related expenses. Quantitative data analysis was performed using SPSS v22, MS-Excel, and R Programming, with Multivariate regression analysis and Post Hoc tests, including the chi-square test, applied to selected indicators. Results: All respondents in the study were female, aged 34 - 75, with 72.3% aged 40 - 50. Most were illiterate (38.6%) and housewives (95.0%). Additionally, 98% were married, 85.10% married before age 18, and 46.50% experienced their first menstruation before age 12. Families typically had a monthly income of 10,000 - 30,000 Taka, spending similar amounts on treatment. Significant relationships were found between educational qualifications, occupation, personal hygiene practices, history of oral contraceptive use, and age of marriage (p Conclusion: The article emphasizes the impact of monthly family income on cervical cancer treatment costs, stressing the need for comprehensive support services to address the financial and emotional burdens faced by patients. Improving access to quality care and implementing measures can enhance outcomes for cervical cancer patients in Bangladesh.

Economic burden and influencing factor analysis of outpatients with epilepsy: A cross-sectional study in Shanghai,Shanxi and Sichuan

Objective: To better understand the economic burden of patients with epilepsy receiving outpatient services in China and to analyze potential factors influencing epileptic economic burden through a cross-sectional study. Methods: Using a self-designed questionnaire, we collected information retrospectively from 754 patients with epilepsy evaluated in neurology clinics in Shanghai Municipality, Shanxi Province and Sichuan Province. Descriptive analyses were used after cost variables were presented as logarithms, and multiple linear regressions were performed to explore influencing factors. Results: Fifty percent of the investigated patients experienced an epilepsy attack before the age of 15, and 51.3% had suffered from epilepsy for more than five years. In the past year, 87.9% of patients had visited different hospitals multiple times for evaluation(40.3%) and maintenance treatment(40.7%). The total economic burden of epilepsy was US$ 1143.2. The average direct economic burden and indirect economic burden were US$ 939.0 and US$ 110.2, respectively. Multiple linear regressions showed that patients had to bear greater economic burden if they were hospitalized,using multiple antiepileptic drugs, experiencing illness for less than 5 years, in severe seizure index or active epilepsy with drug resistance, which was statistically significant. Totally only14.3% of patients could get reimbursement in outpatient services. Conclusions: Patients with epilepsy must present to hospitals regularly for satisfactory prognosis, which results in economic burden. Patients bear greater economic burden, especially direct medical costs, if they are newly diagnosed, experience severe seizures, or undergo multiple drug treatments that require more frequent monitoring. However, current insurance policy for outpatient services do not help reduce economic burden of patients efficiently.

Estimation of economic burden throughout course of cervical squamous intraepithelial lesion and cervical cancer in China:A nationwide multicenter cross-sectional study

Objective: Cervical squamous intraepithelial lesion(SIL) and cervical cancer are major threats to females' health and life in China, and we aimed to estimate the economic burden associated with their diagnosis and treatment.Methods: A nationwide multicenter, cross-sectional, hospital-based survey was conducted in 26 qualified hospitals across seven administrative regions of China. We investigated females who had been pathologically diagnosed with SIL and cervical cancer, and included five disease courses(“diagnosis”, “initial treatment”,“chemoradiotherapy”, “follow-up” and “recurrence/progression/metastasis”) to estimate the total costs. The median and interquartile range(IQR) of total costs(including direct medical, direct non-medical, and indirect costs), reimbursement rate by medical insurance, and catastrophic health expenditures in every clinical stage were calculated.Results: A total of 3,471 patients in different clinical stages were analyzed, including low-grade SIL(LSIL)(n=549), high-grade SIL(HSIL)(n=803), cervical cancer stage ⅠA(n=226), ⅠB(n=610), ⅡA(n=487), ⅡB(n=282), Ⅲ(n=452) and Ⅳ(n=62). In urban areas, the estimated total costs of LSIL and HSIL were $1,637.7(IQR:$956.4-$2,669.2) and $2,467.1(IQR:$1,579.1-$3,762.3), while in rural areas the costs were $459.0(IQR:$167.7-$1,330.3) and $1,230.5(IQR:$560.6-$2,104.5), respectively. For patients with cervical cancer stage ⅠA,ⅠB, ⅡA, ⅡB, and Ⅲ-Ⅳ, the total costs were $15,034.9(IQR:$11,083.4-$21,632.4), $19,438.6(IQR:$14,060.0-$26,505.9), $22,968.8(IQR:$16,068.8-$34,615.9), $26,936.0(IQR:$18,176.6-$41,386.0) and $27,332.6(IQR:$17,538.7-$44,897.0), respectively. Medical insurance covered 43%-55% of direct medical costs for cervical cancer patients, while the coverage for SIL patients was 19%-43%. For most cervical cancer patients, the expense was catastrophic, and the extent of catastrophic health expenditure was about twice large for rural patients than that for urban patients in each stage.Conclusions: The economic burden of SIL and cervical cancer in China is substantial, with a significant proportion of the costs being avoidable for patients with LSIL. Even for those with medical insurance, catastrophic health expenditures are also a major concern for patients with cervical cancer, particularly for those living in rural areas.

Medical Resource Utilizations and Economic Burden in Chinese Cancer Patients with Chemotherapy-induced Anemia:A Populational Database Study

Objective： Most of published studies emphasized the medical cost of treating chemotherapy-induced anemia （CIA） by using specific agents, for example, epoetin α, epoetin β, darbepoetin α or combined with red blood cell transfusions, however, the investigation of the overall medical resources utilizations and economic burden of CIA is still limited. Besides, such studies which emphasized Chinese population still lack. The aim of this study is to investigate the medical resource utilization and the economic burden of Chinese cancer patients with CIA by using a populational representative claim database. Methods： The data for this study are from the 2000-2003 Population Health Insurance Research Database （PHIRD） in Taiwan. On the basis of issuing catastrophic illness cards in the enrollment data files, a total of 26,053 beneficiaries were identified from the PHIRD, who were newly diagnosed with these four cancers in 2001 and 2002 （2001： n=12,954; 2002： n=13099）. A generalized linear model （GLM） was employed for analyzing the differences of medical resource utilization and economic burden between the anemic and non-anemic groups. Results： Analyses showed that the anemic patients were significantly more likely to have longer length of hospital stay than non-anemic patients （P〈0.05） across all these four cancers and in two study periods （except women breast cancer in 2002/03）. As regards the health care expenditures, the average one-year total medical cost was USD$8,982 （2001/02） and USD$8,990 （2002/03） for anemic patients among these four cancers, and USD$7,769 （2001/02） and USD$7713 （2002/03） for non-anemic patients （P〈0.0001）. As for ambulatory costs, anemic patients＇ was significantly higher than non-anemic patients＇ for lung cancer （in 2001/02）, women breast cancer （in 2001/02 and 2002103） and the summarized data （in 2001/02）. As for inpatient costs, anemic patients＇ was significantly higher than non-anemic patients＇ for gastric cancer （in 2002/03）, colon and rectal cancer （in 2001/02 and 2002/03）, lung cancer （in 2001/02 and 2002/03）, women breast cancer （in 2001/02） and the summarized data （in 2001/02 and 2002/03）. Conclusion： This study is the first study to demonstrate that cancer patients who receive chemotherapy and with anemia utilize more medical resources and have heavier economic burden among Chinese cancer patients. Although the Population Health Insurance Program in Taiwan was established to provide more low-burdened medical care for all cancer patients, further effort is still needed to reduce the economic burden for cancer patients who have specific complications.

Routine Preoperative Laboratory Testing: Economic Burden on Pre-Surgical Patients

Background: Routine pre-operative test, results in significant cost to the hospital and expense for the patient. The cost of a single laboratory test may be negligible but too many tests have increased cost for many national health schemes. Most of these patients cannot afford this extra cost thereby delaying surgery and adding up to emergencies. Implementation of change is necessary to reduce economic burden on the patient and enhance patient care. The aim of this study was to determine the economic burden of preoperative laboratory tests on pre-surgical patients in Komfo Anokye Teaching Hospital with a view to making appropriate recommendations that will reduce costs for the patients. Methodology: This was a prospective, cross-sectional study of patients undergoing elective surgery at K.A.T.H from 1st to 31st March 2014. A quantitative technique was used to effectively quantify laboratory results that were contained in a patient’s folder before an elective surgical procedure. Close and open ended questionnaire was developed and answered by reviewing patient’s folders during the pre-anaesthesia assessment. Cost of various laboratory investigations was obtained on request from one private laboratory and the KATH main laboratory. Data were analyzed using Statistical Package of Social Sciences (SSPS) version 22 and Microsoft Excel 2010. Results: The total cost of preoperative laboratory investigations in the study population was GHC 15, 321.19 (GHC 92.85 per individual);and for tests that were not indicated, GHC 3, 266.83 (GHC19.80 per individual). Conclusion: Routine preoperative laboratory tests ordered by Surgeons in Komfo Anokye Teaching Hospital impose an economic burden on the patients. The development of a comprehensive guideline that will help in the ordering of preoperative laboratory investigation will reduce costs for the patients.

Healthcare utilization patterns and economic burden of animal bites:A cross-sectional study

Objective:To determine the healthcare utilization patterns and estimate the economic burden of animal bites in Golestan province,north part of Iran.Methods:This cross-sectional study was performed based on the data of 12181 animal-bite patients from Golestan province who were referred to the rabies prophylaxis centers between March 2019 and March 2020.The study was a societal perspective,and all patients were investigated by census method.The micro-costing method with a bottom-up approach as well as the human capital approach were used to estimate the economic burden.Results:In our study,the economic burden caused by animal bites was estimated at$1383639(275354672060 Rials).The largest share of costs was related to direct healthcare costs,direct non-healthcare costs,and indirect costs accouting for 91%,5%,and 4%,respectively.In addition,the average cost of a animal-bite patient was estimated at$113.5(22605260 Rials)(The average cost of a case in type 2 and 3 exposures was$45 and$412.8,respectively).The largest share of direct healthcare costs was related to immunoglobulin,vaccine,and personnel expenses accounting for 61.3%,19.8%,and 11.65%,respectively.Conclusions:Our study shows that animal bites in Golestan province,north of Iran impose a high economic burden on the communities,especially the healthcare system,which indicates the need to review management and control programs of animal bites and rabies based on animal-bite patterns of the area.

广州市某医院脑梗死患者疾病经济负担研究

目的分析脑梗死患者次均住院费用,特别是次均住院自负费用的结构以及影响因素,为缓解患者疾病经济负担提供参考依据。方法运用描述性统计分析对广州市某三甲医院2015—2022年脑梗死出院患者的次均费用及费用结构进行比较分析,并采用多重线性分析法研究影响患者次均住院自负费用的因素。结果脑梗死患者次均住院费用增长放缓,年均增长率为2.86%;费用结构逐步优化,2022年次均技术劳务费占比47.41%;脑梗死患者次均住院自负费用呈增长趋势,年均增长率5.96%,且受住院时间、病例分型、付费方式以及患者来源等因素共同影响。结论脑梗死患者的疾病经济负担仍然较重,医疗机构应不断规范诊疗行为,加强临床路径管理,政府应该不断完善社会保障体系,降低患者的疾病经济负担。

诊断相关分组耐药菌院内感染及经济负担分析

目的分析基于DRGs的MDRO医院感染情况与经济负担,为MDRO防控提供依据。方法回顾性分析本院2021年1月-2021年12月MDRO感染情况,将DRGs同组患者分为MDRO医院感染组和非MDRO感染组,分析2组患者住院时间及住院费用。结果2021年住院患者共入组DRGs病例73150例,发生MDRO医院感染188例,感染率为0.26%。MDRO医院感染DRGs组数占全院总DRGs组数的11.64%,下呼吸道感染位居第一位。MDRO医院感染组较非MDRO感染组住院时间延长14.5d,住院总费用增加47188.03元,医疗费、医技费、护理费、药品费、耗材费、抗菌药物费、输血费等MDRO医院感染组均高于非MDRO感染组差异有统计学意义(P<0.001)。结论由DRGs支付的患者医治数据可知易感染MDRO的患者及其所在科室和大幅增加的医治费用,相关部门适时关注DRGs支付情况,及时采取针对性措施,则可降低患者MDRO感染率和经济负担。

经济负担对前列腺癌患者失志情况影响的研究

目的了解经济负担对前列腺癌患者失志情况的影响,为制定干预措施提供理论依据。方法采用便利抽样法选取2020年12月至2022年12月在某院住院治疗的249例前列腺癌患者为研究对象。采用癌症患者报告结局的经济毒性量表、失志综合征量表Ⅱ进行问卷调查。结果经济负担得分为(27.05±8.14)分,失志得分为(14.93±4.87)分;不同年龄、学历、家庭人均月收入、工作状态、确诊年限、肿瘤临床分期、合并症的患者失志得分存在显著性差异(P<0.05);前列腺癌患者经济负担得分与失志总分及各维度得分均呈正相关(P<0.01);前列腺癌患者的肿瘤临床分期、经济负担、学历及合并症是患者失志的主要影响因素(P<0.05)。结论前列腺癌患者经济负担较重,失志水平较高,应针对患者的确诊年限、经济负担、学历及合并症情况采取相应的干预措施,缓解患者的失志程度。

基本医疗保险参与增强居民家庭经济韧性了吗?

基于中国家庭追踪调查(CFPS)2014—2020年共4期数据,利用贫困陷阱理论和非线性动力学理论测度居民家庭经济韧性,厘清基本医疗保险参与增强居民家庭经济韧性的机理。研究发现,基本医疗保险参与能显著增强居民家庭经济韧性,并且这一结果具有稳健性。改善家庭成员健康状况和减轻家庭医疗负担是基本医疗保险参与增强居民家庭经济韧性的重要渠道。按照基本医疗保险发挥边际效果的特征,居民家庭可划分为高效型、低效型、无效型等类型,其中无效型和低效型家庭经济韧性较强、医疗负担较低。随着居民家庭经济韧性的增强,基本医疗保险参与的边际效果逐渐下降。低收入家庭基本医疗保险参与增强居民家庭经济韧性的效果最显著,高收入家庭则无显著效果。

1981—2020年昆山市肺癌疾病负担和间接经济负担分析

目的分析昆山市1981—2020年肺癌所致的疾病负担和间接经济负担。方法1981—2020年肺癌发病和死亡病例来源于肿瘤登记和死因监测,以伤残调整生命年(DALY)为疾病负担评价指标,以人力资本法计算因肺癌所致的间接经济负担。结果1981—2020年昆山户籍居民因肺癌死亡9272例,男性和女性分别为7106例、2166例。全人群中肺癌所致的DALY在1981—1990年、1991—2000年、2001—2010年、2011—2020年四个时期分别为3.81人年/千人、4.14人年/千人、4.38人年/千人、9.46人年/千人;与之相对应肺癌所致的间接经济负担为1051.5万元、14165.7万元、81379.4万元和665914.9万元。2011—2020年,男性、女性及总人群中寿命损失年(YLL)占DALY的比例分别为92.42%、95.15%和93.60%。结论昆山市肺癌所致的DALY呈现持续上升趋势,与之对应的间接经济负担重。肺癌所致的疾病负担与间接经济负担在年龄间并不对称,提示在人群中有效预防肺癌,降低肺癌负担十分紧迫,特别是45~59岁人群。

某三甲医院细菌耐药健康及经济负担研究——以产超广谱β-内酰胺酶大肠埃希菌为例

目的 细菌耐药是全世界共同面对的公共健康难题,产生了严重的健康及经济威胁。本研究从医院视角进一步明确产超广谱β-内酰胺酶(ESBLs)大肠埃希菌感染导致的健康及经济负担,以期为细菌耐药相关政策干预的评估与优化提供实证依据。方法 选取江西省某三甲医院出院时间在2018—2019年的170,819住院人次样本为研究对象,并设置了ESBLs阳性感染组、ESBLs阴性感染组和无感染及定植组。采用倾向得分匹配(propensity score matching, PSM)对3个组进行1:1:100匹配,并采用Cox比例风险回归模型、多状态模型分别测算ESBLs阳性感染组相对于两对照组的死亡风险比(hazard ratio, HR)和额外床日数,最终基于医院视角测算额外住院成本。结果 经匹配后纳入分析的ESBLs阳性感染组、ESBLs阴性感染组和无感染及定植组的样本分别为885、885和81,245住院人次。ESBLs阳性感染组的死亡风险是无感染及定植组的2.58倍(P<0.001),同ESBLs阴性感染者相比并未显著增大患者的死亡风险(P=0.25)。ESBLs阳性感染组相较于其无感染及定植组和ESBLs阴性感染组产生的额外床日数分别为每例3.69 d和1.92 d,对应的额外住院成本为每例6,570.12元和3,418.60元。结论 产ESBLs大肠埃希菌感染会增加患者死亡风险,延长住院时间并加重患者的经济负担,应采取措施进行防控。

深圳市宝安区手足口病经济负担及影响因素

目的:了解深圳市宝安区2021年手足口病经济负担并分析其影响因素。方法:收集某三级甲等医院2021年9月1日—12月1日就诊的1 225例手足口病病人,设计调查问卷,采用电话询问及医院信息系统查询收集资料,评估手足口病造成的经济负担并分析其影响因素。结果:1 225例病人中,门诊病人1 195例(97.55%),住院病人30例(2.45%),无重症病例。1 195例手足口病门诊病人的总体经济负担为422.57(336.70,604.54)元/例,30例手足口病住院病人的总体经济负担为(4 386.88±1 624.61)元/例。年龄、报销类型以及诊疗次数是手足口病门诊病人总体经济负担的影响因素(P<0.05)。结论:手足口病住院病人经济负担高于门诊病人,年龄、报销类型以及诊疗次数是手足口病门诊病人经济负担的影响因素。早发现、早诊断、早治疗能有效降低疾病经济负担。

基于倾向性评分匹配及广义线性模型的出血性脑卒中医院感染经济负担研究

目的研究出血性脑卒中患者发生医院感染导致的经济负担。方法回顾性调查某三级甲等医院2021年1月1日—2022年12月31日的出血性脑卒中患者,收集其人口学特征、临床相关信息、住院费用等资料。根据是否发生医院感染将其分为医院感染组及对照组,采用倾向性评分匹配法和广义线性模型法研究医院感染组与对照组住院日数、住院费用增量及医院经济负担。结果共纳入688例患者,发生医院感染266例,医院感染发病率为38.66%。经过倾向性评分匹配,医院感染组199例患者成功匹配,医院感染组较对照组住院日数中位数增加16 d,增加1倍(Z=11.779,P<0.001),住院费用中位数增加34597.42元,增加85%(Z=6.299,P<0.001);广义线性模型法中归因于医院感染因素的住院日数增加1.24倍,住院费用增加76%(均P<0.001);单项医疗费用支出中,医院感染组除手术费用外,其他各项医疗支出均高于对照组(均P<0.05);因医院感染导致的医院经济负担为54.19万元。结论医院感染明显加重出血性脑卒中患者及医院的经济负担,延长住院时间,临床工作人员应加强感染防控意识,降低医院感染发病率,节约医疗资源。

我国原发性高血压病人直接经济负担及其影响因素

目的:了解我国原发性高血压病人的直接经济负担及其影响因素,为有效减轻高血压的疾病负担提供参考依据。方法:收集中国卫生行业科研专项子课题“心血管病危险因素监测和高血压规范化管理”15个省份220家基层医疗机构管理的43 769例原发性高血压病人的基线调查数据,采用直接法估算直接经济负担,直接经济负担费用经正态性检验服从偏态分布,对数转换使其呈近似正态化后应用多元线性逐步回归模型分析原发性高血压病人直接经济负担的主要影响因素。结果:我国原发性高血压病人的人均直接经济负担为5 461.50(2 812.50,10 367.50)元,人均直接医疗费用为5 413.50(2 796.40,10 300.00)元,人均直接非医疗费用为12.00(4.00,32.00)元;直接医疗费用中,人均门诊费、住院费和自购药费分别为240.00(80.00,700.00)元、4 200.00(2 300.00,8 000.00)元和200.00(80.00,500.00)元;多元线性逐步回归分析结果显示,初中以上文化程度、已婚、退休及下岗待业人员、家庭年人均收入5万~9万元、高血压病程≥5年和就诊次数≥10次的原发性高血压病人的直接经济负担均较高。结论:我国原发性高血压病人直接经济负担较高,文化程度、婚姻状况、职业、家庭年人均收入、高血压病程和就诊次数是我国原发性高血压病人直接经济负担的主要影响因素。

癫痫疾病经济负担研究进展

癫痫是一种严重的神经系统疾病,其昂贵的医疗费用给社会、家庭以及个人带来了沉重的经济负担。到目前为止,关于癫痫经济负担的研究数量有限,本研究就国内外关于癫痫的疾病经济负担现状进行综述,旨在为合理分配卫生资源和有效制定卫生医疗政策提供参考。

2022年全球癌症统计报告的窄谱总结和展望

根据国际癌症研究机构(IARC)最近更新的全球癌症统计数据,2022年共有近2000万例新发癌症病例,970万例死亡病例。肺癌是最常见的癌症,有近250万例新发病例(占全球所有癌症的12.4%),其次是女性乳腺癌(11.6%)、结直肠癌(9.6%)、前列腺癌(7.3%)和胃癌(4.9%)。肺癌也是导致癌症死亡的主要原因,估计有180万例死亡病例(18.7%),其次是结直肠癌(9.3%)、肝癌(7.8%)、女性乳腺癌(6.9%)和胃癌(6.8%)。根据基于人口统计学的预测表明,到2050年,新发癌症病例将达到3500万例。加大针对癌症关键风险因素(包括吸烟、超重肥胖和感染)的防控投入,可以拯救全球许多生命,为各国未来几十年带来巨大的经济和社会回报。

高血压患者住院费用变化及影响因素分析

目的:分析2018—2022年江西省A医院3 127例高血压患者的住院费用构成,探究住院费用的变动趋势及主要影响因素。方法:对高血压患者的次均住院费用进行描述性统计、单因素分析,并构建结构方程模型分析其影响因素及影响程度。结果:2018—2022年,高血压住院患者的直接疾病经济负担呈持续下降趋势,检查费、药品费合计占比超过70%,住院天数是住院费用的主要影响因素。结论:高血压住院患者的疾病经济负担依然沉重,应加强监管,加快按病种分值(DIP)付费和医疗服务价格改革,缩短住院天数,丰富社区健康管理模式,重视社区规范化管理。

新疆农村四类主要慢病的疾病经济负担研究

目的:测算分析新疆农村四类主要慢病的疾病经济负担。方法:采用多阶段分层整群抽样方法,对新疆6个县区11532名农村常住居民进行问卷调查,采用二步模型法和人力资本法测算四类主要慢病的疾病经济负担,采用多元线性回归分析门诊及住院费用影响因素。结果:2021年新疆农村四类主要慢病的患病率为16.29%;样本人群四类主要慢病的直接经济负担4.21亿元,间接经济负担0.34亿元,心脑血管疾病、恶性肿瘤、糖尿病、呼吸系统疾病经济负担分别为2.89亿元(63.53%)、0.88亿元(19.44%)、0.66亿元(14.47%)、0.12亿元(2.56%)。结论:新疆农村四类主要慢病的疾病经济负担比预想的低,可能受疫情防控的影响,以及与新疆农村地广人稀的特点有关。后疫情时代,应提高基层慢病早期筛查与管理水平,合理分级诊疗,缩短平均住院天数,切实减轻慢病患者的疾病经济负担。

COPD疾病经济负担测算方法的研究进展

慢性阻塞性肺疾病(COPD)是一种并发症多、预后差、需要患者长期坚持药物治疗的疾病,其开销巨大,给患者个人、社会和国家都造成了巨大的经济负担。疾病经济负担分为直接经济负担和间接经济负担,通过测算COPD疾病经济负担,能为合理配置医疗资源提供参考依据。本文将对COPD的流行情况、COPD疾病经济负担的测算方法进行综述,以期为相关研究提供参考。