Econometric estimation of WHO-CHOICE country-specific costs for inpatient and outpatient health service delivery

Stenberg, Karin; Lauer, Jeremy A.; Gkountouras, Georgios; Fitzpatrick, Christopher; Stanciole, Anderson

doi:10.1186/s12962-018-0095-x

Cited by 95 publications

(107 citation statements)

References 20 publications

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“…The total number of in-patient days of patients with ICs but without an SSI diagnosis were the same as for those who had an SSI. If one considers total in-patient time as an indicator of in-patient cost [14], an obligatory overly fine distinction between SSI and other IC might seem less relevant. Furthermore, a significant financial impact of noninfection-related IC on healthcare cost can be assumed.…”

Section: Discussionmentioning

confidence: 99%

Proposed Classification of Incision Complications: Analysis of a Prospective Study on Elective Open Lower-Limb Revascularization

Hasselmann

Björk

Svensson‐Björk

et al. 2020

Surgical Infections

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Background: Incision complications (IC) have a significant impact on procedure-related morbidity after lowerlimb revascularization. One of the most studied IC is surgical site infection (SSI). Reporting these complications in a uniform way is crucial to evaluate treatment approaches. The aim of this study was to propose a comprehensive classification of IC and apply it to compare SSI with other IC in a trial on elective open lowerlimb revascularization procedures. Methods: Two hundred twenty-three eligible patients undergoing elective unilateral inguinal and infra-inguinal arterial vascular surgery were extracted from a randomized controlled trial on incisional negative-pressure wound therapy (NPWT) on inguinal vascular surgical incisions. The IC were classified by grades of severity (grade 0-6) that focused on IC-related consequences such as out-patient treatment (grade 1), prolonged inpatient treatment (grade 2), re-admission (grade 3), and re-operation (grade ‡4). An SSI was defined by the ASEPSIS score criteria. Results: An SSI was diagnosed in 63 patients (28.3%). Thirty-five of 160 patients (21.8%) not suffering from SSI underwent IC treatment. Treatment for IC was recorded for 25/144 patients (17.4%) with satisfactory site healing as judged by the ASEPSIS score. The median incision-related in-hospital stay in those with SSI (n = 79) and disturbed healing (n = 16) according to the ASEPSIS score was 13 days in both groups (p = 0.53). Five patients had peri-vascular SSI (IC grade 4 n = 4; grade 5 n = 1). The proposed classification of IC and the ASEPSIS score correlated highly (r = 0.77; p < 0.001). Inter-rater reliability for IC grading was substantial for three investigators with different levels of experience (k = 0.81, 0.71, and 0.70). Conclusions: The proposed incision classification suggests a comparable clinical significance of vascular IC in terms of IC-related in-patient stay, whether there was a surgical site infection or not. This classification system requires external validation.

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Section: Discussionmentioning

confidence: 99%

Proposed Classification of Incision Complications: Analysis of a Prospective Study on Elective Open Lower-Limb Revascularization

Hasselmann

Björk

Svensson‐Björk

et al. 2020

Surgical Infections

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“…However, nondiabetic SARI admissions may have different characteristics (e.g., fewer co-morbidities, younger in age) that could lead to bias and limit comparisons. Another limitation is that the WHO-CHOICE estimates may underestimate indirect hospital costs [34]. A further limitation is that some of the results relied on patient or caregiver recollection, so they may not have accurately remembered or accounted for costs.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and costs of severe acute respiratory infection and influenza hospitalizations in adults with diabetes in India

Koul

Bhavsar

Mir

et al. 2019

J Infect Dev Ctries

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Introduction: The incidence of diabetes mellitus is increasing rapidly in India. In addition to well-known complications, diabetes increases the risk for hospitalization and death from severe acute respiratory infection (SARI) and influenza. Here we examined the impact of SARI and influenza in Indian adults with diabetes. Methodology: This was a single-center, active surveillance study conducted in Jammu and Kashmir State, India, during the 2015–2016 and 2016–2017 influenza seasons. Adults hospitalized for SARI and receiving at least one diabetes medication were included. Demographics, health care use, and direct costs were collected from medical records and interviews of patients or caregivers. Indirect costs were estimated based on lost earnings and WHO-CHOICE estimates for hospital costs. Results: The study included 192 patients with type 2 diabetes. Median age was 66 years, median body mass index was 26.6 kg/m2, and most patients had comorbidities, especially hypertension and cardiovascular disease (83.9%). Only 32.2% regularly monitored blood glucose or hemoglobin A1C, and median values at admission indicated poor glycemic control for most. Influenza was detected in 8.9% of cases. The median hospital stay for SARI was 8 days, and 22 patients (11.4%) died. Median total costs associated with hospitalization were US$710 (interquartile range, $539–$1067) for SARI patients and US$716 ($556–$1078) for influenza patients, mostly (~75%) from indirect costs. Conclusions: Adults with diabetes in India hospitalized with SARI or influenza are generally older, in poor health, and suffer from poor glycemic control. The costs for their hospitalization and care are substantial.

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“…[18] The assumptions on materials used and personnel time to administer each contraceptive method were based on similar analyses in the OneHealth tool [19] and WHO-CHOICE. [20] An average cost for provision of modern contraception was calculated by applying the weighted totals from Table 1 for each contraceptive method to the associated annual cost, giving a figure of ZAR228.35 ( Table 2). The total cost of current contraceptive use was calculated as the product of the number currently using contraceptives (Table 1) and the weighted total cost (ZAR228, Table 2).…”

Section: Methodsmentioning

confidence: 99%

Projecting the fiscal impact of South Africa’s contraceptive needs: Scaling up family planning post 2020

et al. 2019

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Background. Evidence-informed priority setting is vital to improved investment in public health interventions. This is particularly important as South Africa (SA) makes the shift to universal health coverage and institution of National Health Insurance. Objectives. To measure the financial impact of increasing the demand for modern contraceptive methods in the SA public health sector. We estimated the total cost of providing contraceptives, and specifically the budgetary impact of premature removals of long-acting reversible contraceptives. Methods. We created a deterministic model in Microsoft Excel to estimate the costs of contraception provision over a 5-year time horizon (2018-2023) from a healthcare provider perspective. Only direct costs of service provision were considered, including drugs, supplies and personnel time. Costs were not discounted owing to the short time horizon. Scenario analyses were conducted to test uncertainty. Results. The base-case cost of current contraceptive use in 2018 was estimated to be ZAR1.64 billion (ZAR29 per capita). Injectable contraceptives accounted for ~47% of total costs. To meet the total demand for family planning, SA would have to spend ~30% more than the estimate for current contraceptive use. In the year 2023, the 'current use' of modern contraceptives would increase to ZAR2.2 billion, and fulfilling the total demand for family planning would require ZAR2.9 billion. The base-case cost of implantable contraceptives was estimated at ZAR54 million. Assuming a normal removal rate, the use of implants is projected to increase by 20% during the 5-year period between 2019 and 2023, with an estimated 46% increase in costs. The cost of early removal of Implanon NXT is estimated at ZAR75 million, with total contraception costs estimated at ZAR102 million in 2019, compared with ZAR56 million when a normal removal rate is applied. Conclusions. The costs of scaling up modern contraceptives in SA are substantial. Early and premature removals of implantable contraceptives are costly to the nation and must be minimised. The government should consider conducting appropriate health technology assessments to inform the introduction of new public health interventions as SA makes the shift to universal health coverage by means of National Health Insurance.

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Econometric estimation of WHO-CHOICE country-specific costs for inpatient and outpatient health service delivery

Cited by 95 publications

References 20 publications

Proposed Classification of Incision Complications: Analysis of a Prospective Study on Elective Open Lower-Limb Revascularization

Proposed Classification of Incision Complications: Analysis of a Prospective Study on Elective Open Lower-Limb Revascularization

Epidemiology and costs of severe acute respiratory infection and influenza hospitalizations in adults with diabetes in India

Projecting the fiscal impact of South Africa’s contraceptive needs: Scaling up family planning post 2020

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