1University of Maryland School of Pharmacy Graduate School, Baltimore, MD, ... health care centers and the University Hospital were screened for eligibility by.
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of hospital Utilization for the outbreak was 17,085.38 USD. The total cost saving to the Osu Klottey Health system was 69,052.91 USD. Conclusions: The study underscored the economic burden cholera posed to patients and the health system in low resourced settings. Government needs to engage stakeholders to reassess challenges impeding the implementation of the free cholera treatment policy. PHS35 Out-Of-Pocket Health Expenditures In Patients With Uncontrolled Asthma From Colombia Zakzuk J1, Parra D2, Salcedo Mejía F3, Alvis-Zakzuk JS4, Buendia E1, Caraballo L5, AlvisGuzmán N2 1University of Cartagena. Institute for Immunological Research., Cartagena, Colombia, 2University of Cartagena. Health Economics Research Group., Cartagena, Colombia, 3University of Cartagena., CARTAGENA DE INDIAS, Colombia, 4Universidad de Cartagena. Centro de Investigación y Docencia. Hospital Infantil Napoleón Franco Pareja, Cartagena de Indias, Colombia, 5University of Cartagena. Institute for Immunological Research. Fundemeb., Cartagena, Colombia
Objectives: To estimate out-of-pocket health expenditures and loss of productivity in patients with asthma. Methods: Subjects attending to five public primary health care centers and the University Hospital were screened for eligibility by physicians of the research staff between June 2010 and March 2011 in Cartagena, Colombia (WAO Journal 2015;8:8). Individuals diagnosed with asthma were included in the study. A sample of 194 patients resulted from the screening. A previously standardized and validated instrument was used to collect information regarding asthma symptoms, sociodemographic characteristics and out of pocket health (OOP) expenditures. Cost were converted to American dollars using mean exchange rate 2011. Results: In this sample of asthmatic patients, 70.3% attended the emergency room (ER) service due to asthma symptoms in the last year; most of them (62.6%) with a frequency of 1 - 4 times/year. Frequency rate of hospitalization was 10.9%, wherein 90.5% spent less than 5 bed-days. The use of health care service for asthma attention was 98.8% (median outpatient visit in the last year: 4, IQR: 4) and only few cases (1.2%) chose alternative management options (hierbatero or homeopaths). Fifty nine percent (59.0%) reported monthly OOP expenditures due to asthma (median: $US 16.2, IQR: 46.0; 1.7 daily minimum wage). Those attending ER in the last year had greater OOP (mean: US$ 45.9, 95% CI 34.8 – 57.2) than those who did not (mean: US$ 23.4, 95% CI: 15.5 – 31.3, p = 0.02). Almost half of patients (47.9%) reported to have missed work/school days due to asthma (median: 5 days in the last 6 months, IQR: 8). Conclusions: As observed in most low- and middle-income countries, poor control of asthma was frequent in this study. This is associated with important epidemiologic and economic burden for patients as well as the health system. Colciencias Grant 590-2013.
number 998823/2015. Results: Predominated female (55%), 54.8 years as mean age and hypertension was the most prevalent disease (75%). Although 55% of the sample refer to nephrologist prior monitoring, the making of arteriovenous fistula occurred in 27%, favoring the emergency dialysis. 40 catheters implants were performed. For 11 patients were performed 20 device replacements. Infection was the main cause of access substitute, which costs R$ 6,695.41/ treatment. The total cost related to catheter use was R$ 51,808.59. The mortality rate was 5%. Conclusions: The use of temporary catheter in HD patients bring benefits, though their frequent manipulations and permanency are directly related to complications. The catheter maintenance and management facilitates infections, improving morbidity, mortality and hospital costs, that could be avoid. It is necessary to adapt catheter choices to patient’s needs. Cost management provides adequate resources allocation, considering patient safety and quality care. PHS38 Severe Hypoglycemias Treatment Costs (Inpatient) At Institutional Level In Mexico Camacho-Cordero LM1, Baez-Revueltas FB2, Herran S2, Huicochea-Bartelt JL3, Yamamoto JV2 1Health Consoultings, Distrito Federal, Mexico, 2Boehringer Ingelheim, Distrito Federal, Mexico, 3UMIT, Tirol, Austria
Objectives: Estimate the direct medical cost related to diabetes-patient hospitalization suffering severe hypoglycemia from the Instituto Mexicano del Seguro Social (IMSS) perspective. Methods: A retrospective analysis was performed in order to estimate the annual costs due to DM patients suffering SH and requiring hospital care at the IMSS between January 1st and December 31st, 2014. The unitary costs reported in public tabulators (IMSS 2015) were considered. Results: During 2014 the IMSS reported close to 71,800 hospitalized diabetes patients. Among these, around 3,500 are hypoglycemia related. Besides this, with the diagnostic “Other types of hypoglycemia” (CIE-10: E16), there were 3,600 cases, among which 53% are of patients aged 60 to 79 years old. We estimate a per cápita average cost, for inpatients with SH, of MNX$83,447.78 per year; 95% of the total costs are due to the hospitalization and ER, with average costs of de MNX$66,348.40 & MNX$12,218.50, respectively. Conclusions: The risk of a SH case increases as the patient requires higher insulin dosage. It was observed that the hypoglycemic events may result in severe economic complications. The findings of the present study coincide with international studies, where the higher costs belong to hospitalization and ER. This further stresses the importance of considering better treatment strategies for diabetic patients which allow for proper care without economically debasing healthcare institutions.
PHS36 Outcomes, Health Care Resources Use, And Costs In Patients With Post-Myocardial Infarction: The Horus Cohort Study In The Egb French Claims And Hospital Database
PHS39 Costs Of End-Of-Life Treatments Among Elderly Metastatic Colon Cancer Patients
Blin P1, Dureau-Pournin C1, Lassalle R1, Jové J1, Thomas-Delecourt F2, Droz-Perroteau C1, Danchin N3, Moore N4 1Bordeaux PharmacoEpi, INSERM CIC1401, ADERA, Bordeaux University, Bordeaux, France, 2AstraZeneca, Rueil-Malmaison, France, 3European Georges Pompidou Hospital, Paris, France, 4Bordeaux PharmacoEpi, INSERM CIC1401, Bordeaux University, Bordeaux CHU, Bordeaux, France
1University
Objectives: To estimate real-life outcomes, healthcare resources use and costs in patients with post-myocardial infarction (MI), and in a subpopulation similar to the PEGASUS-TIMI 54 trial (PEG), performed to assess long-term use of ticagrelor in patients with prior MI. Methods: Cohort study in the EGB, a 1/97 representative sample of the French nationwide claims and hospital database. Post-MI patients had MI between 2005 and 2010 and 1-year event-free period after MI (index date). PEG patients were those with at least one of these risk factors: ≥ 50 years, diabetes, history of MI, or renal disease, but without history of stroke, dialysis, and current use of oral anticoagulant. Patients were followed for 3 years after index date with censure in December 2012. The primary outcome was a composite of death, hospitalization for MI or stroke. Healthcare resources use and their costs were estimated from the societal perspective. Results: 1764 post-MI and 951 PEG patients were identified, representing 4348 and 2314 person-years (PY), with 68% and 61% of men, and a mean age of 66 and 74 years, respectively. Patients were mainly followed by GPs with a high rate of use of cardiovascular secondary prevention drugs. Primary outcome incidence rate [95%CI] was 6.5 [5.7;7.2], and 7.9 [6.8;9.0] per 100 PY, respectively, and deaths represented about 80% of this composite outcome. The mean healthcare cost per patient followed for three years was about 20,000€ for the post-MI population, 21% were for non-cardiovascular hospitalizations, 16% for cardiovascular plus antidiabetic drugs, and 13% for cardiovascular hospitalizations. The cost structure was similar for the PEG population. Conclusions: For patients who survived one year after a MI, death represented the main event of the composite criterion. The cost of cardiovascular hospitalizations and cardiovascular plus antidiabetic drugs represented about a quarter of the mean healthcare cost per patient. PHS37 Cost Assessment Of Sojourn Catheter Use In Chronic Renal Patients CM1, Souza
RC2, Silva
FV1, Mosegui
GB3, Peregrino AA1
Vianna do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, 2Universidade do Estado do Rio de Janeiro, RIO DE JANEIRO, Brazil, 3Universidade Federal Fluminense, Niterói, Brazil
1Universidade
Objectives: Hemodialysis (HD) is a modality of renal replacement therapy that depends on a viable vascular access. The temporary double-lumen catheter (TBLC) provides immediate management; however, its use implies complications. This research aimed to calculate the average cost of TBLC use in chronic renal failure patients undergoing HD. Methods: It was an observational cost assessment study, with quantitative approach, performed in the HD unit of a University Hospital in Rio de Janeiro, Brazil in the period from April to September 2015. The sample consisted of 20 patients using TBLC who started dialysis. Data were analyzed using the statistical program Epi Info and Excel® 2010. Ethics Committee approved the study with
Sieluk J1, Hanna N2, Goto D3, Seal B4, Mullins CD3 of Maryland School of Pharmacy Graduate School, Baltimore, MD, USA, 2University of Maryland Department of Surgery, Division of General and Oncologic Surgery, Baltimore, MD, USA, 3University of Maryland School of Pharmacy, Baltimore, MD, USA, 4Takeda Pharmaceutical Company, Cambridge, MA, USA
Objectives: Metastatic colon cancer (mCC) poses a significant burden on the U.S. healthcare system due to its high treatment costs. In this study, we analyzed differences in costs of end-of-life care between patients who withdrawn from active treatment and moved to hospice, and those who did not receive hospice care. Methods: Retrospective analysis of cost trajectories of mCC decedents using SEER-Medicare dataset for years 2003-2010. Hospice and non-hospice patients were defined as those who had a claim within the end-of-life period defined as 7, 14, and 30 days before death. Results: The study population consisted of 3,669 patients diagnosed with metastatic colon cancer between 2003 and 2009, who received at least one line of chemotherapy/biologics. On average, non-hospice and hospice patients incurred $1670.11 and $184.60, respectively, of direct medical costs on the last day of life. Thirty days before death, the cost difference between hospice and non-hospice patients was equal to $40.11 (p-value = 0.0032). On the 14th, 7th and on the last day of life, cost differences were equal to $179.21, $374.35 and $1485.51, respectively (p-value = 0.0001). The major cost contributors for non-hospice patients were inpatient costs, accounting for 47.87%, 55.37%, 67.46% and 86.98% of total costs on the 30th, 14th, 7th and the last day of life, respectively; the major cost contributor for hospice patients were hospice costs, accounting for 6%, 10.95%, 16.96% and 51.72% on the 30th, 14th, 7th and on the last day of life, respectively. Conclusions: Assuming that hospice has been providing equally high quality care compared with non-hospice providers, hospice has been successful in reducing the use of health care resources among metastatic colon cancer patients. PHS40 Opportunity Cost And Health Impact Of Prenatal Care In Pregnant Women With Public Health Insurance In Colombia Gomez de la rosa F1, Marrugo Arnedo C2, Florez tanuz A1, Lopez pajaro K3, Mazenett granados E3, Orozco Africano J1, Alvis Guzman N1 1Grupo de investigación en economía de la salud - GIES, Cartagena, Colombia, 2Universidad de Cartagena. Centro de Investigación y Docencia. Hospital Infantil Napoleón Franco Pareja, Cartagena de Indias, Colombia, 3Centro de investigación e Innovación en Salud - CiiSA, Cartagena de Indias, Colombia
Objectives: To estimate health care costs of live births and the impact on maternal mortality rate (MMR) in women who attend or not prenatal cares visits (PCV) and have public health insurance in 2014. Methods: A randomized sample of 9.244 pregnant women (out of total ≈ 25.000) was extracted from the database of a public health insurance company. MMR was estimated for women who attend or not outpatient prenatal care visits. Direct medical costs were estimated from the Individual Records of Health Care Services (IRHCS) and from the billing database. Mean differences and proportions were calculated to compare results in both groups of women.
