Public healthcare expenditure in Spain: Measuring the impact of driving factors

Blanco-Moreno, Ángela; Urbanos-Garrido, Rosa M.; Thuissard-Vasallo, I.J.

doi:10.1016/j.healthpol.2013.03.012

Cited by 29 publications

(22 citation statements)

References 7 publications

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“…In line with these findings and despite HDSFs being more expensive than standard formulas, a net global saving in hospitalization costs was found in the present analysis. These savings in hospitalization costs can be considered paramount given the exponential increment on health-care costs observed after the age of 50 years [ 26 ] and to the extra costs associated with malnutrition (up to €5,829 ($8,134.85) per patient) [ 27 ]. Moreover, the indirect cost savings associated with the decrease in hospitalizations, the economic benefits related to avoiding insulinizations or the possible improvement in patients’ and carers’ Health-Related Quality of Life (HRQoL) have not been considered, which could translate into additional benefits.…”

Section: Discussionmentioning

confidence: 99%

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

et al. 2016

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Diabetes-specific formulas are an effective alternative for providing nutrients and maintaining glycemic control. This study assesses the effect of treatment with an oral enteral nutrition with a hypercaloric diabetes-specific formula (HDSF) for one year, on health-care resources use, health-care costs, glucose control and nutritional status, in 93 type-2 diabetes mellitus (T2DM) malnourished patients. Changes in health-care resources use and health-care costs were collected the year before and during the year of intervention. Glucose status and nutritional laboratory parameters were analyzed at baseline and one-year after the administration of HDSF. The administration of HDSF was significantly associated with a reduced use of health-care resources, fewer hospital admissions (54.7%; p < 0.001), days spent at hospital (64.1%; p < 0.001) and emergency visits (57.7%; p < 0.001). Health-care costs were reduced by 65.6% (p < 0.001) during the intervention. Glycemic control (short- and long-term) and the need of pharmacological treatment did not change, while some nutritional parameters were improved at one year (albumin: +10.6%, p < 0.001; hemoglobin: +6.4%, p = 0.026). In conclusion, using HDSF in malnourished older type-2 diabetic patients may allow increasing energy intake while maintaining glucose control and improving nutritional parameters. The use of health-care resources and costs were significantly reduced during the nutritional intervention.

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Section: Discussionmentioning

confidence: 99%

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

et al. 2016

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“…Considering that depressive mood develops more frequently in fall/winter [23][24][25] and that light therapy is effective in patients with fall/winter depression [26], external light is expected to be the strongest contributing factor [27]. Most studies that investigated climatic factors considered external light, and reported a significant effect of hours of sunshine ( [17]; Mersch et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Prevalence, behavioral manifestations and associated individual and climatic factors of seasonality in the Korean general population

Baek

Kim

Huh

et al. 2015

Comprehensive Psychiatry

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“…These findings are consistent with a Dutch investigation of individual HCE drivers [10], which revealed a move away from inpatient care coupled with a higher rate of day case admissions, shorter inpatient stays and greater use of outpatient clinics. A Spanish study [29] found per capita outpatient expenditure rose by 50% in real terms from 1998 to 2008, with the largest rise in people of working age. Evidence regarding the effect of age and TTD on outpatient utilisation and expenditure is mixed [13,30].…”

Section: Outpatient Carementioning

confidence: 99%

“…For community prescribing, proximity to death might be a more important driver than age as there is evidence that the effects of age on prescribing expenditure are smaller when models control for TTD [13,43,44]. Gender also seems to be a driver of pharmaceutical expenditure: there is evidence that females in all age groups incur higher expenditure [29] and receive more prescriptions [13].…”

Section: Community Care (Cc)mentioning

confidence: 99%

Trends in and drivers of healthcare expenditure in the English NHS: a retrospective analysis

Santana¹,

Aragon

Rice

et al. 2020

Health Econ Rev

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Background: In England, rises in healthcare expenditure consistently outpace growth in both GDP and total public expenditure. To ensure the National Health Service (NHS) remains financially sustainable, relevant data on healthcare expenditure are needed to inform decisions about which services should be delivered, by whom and in which settings. Methods: We analyse routine data on NHS expenditure in England over 9 years (2008/09 to 2016/17). To quantify the relative contribution of the different care settings to overall healthcare expenditure, we analyse trends in 14 healthcare settings under three broad categories: Hospital Based Care (HBC), Diagnostics and Therapeutics (D&T) and Community Care (CC). We exclude primary care and community mental health services settings due to a lack of consistent data. We employ a set of indices to aggregate diverse outputs and to disentangle growth in healthcare expenditure that is driven by activity from that due to cost pressures. We identify potential drivers of the observed trends from published studies. Results: Over the 9-year study period, combined NHS expenditure on HBC, D&T and CC rose by 50.2%. Expenditure on HBC rose by 54.1%, corresponding to increases in both activity (29.2%) and cost (15.7%). Rises in expenditure in inpatient (38.5%), outpatient (57.2%), and A&E (59.5%) settings were driven predominately by higher activity. Emergency admissions rose for both short-stay (45.6%) and long-stay cases (26.2%). There was a switch away from inpatient elective care (which fell by 5.1%) and towards day case care (34.8% rise), likely reflecting financial incentives for same-day discharges. Growth in expenditure on D&T (155.2%) was driven by rises in the volume of high cost drugs (270.5%) and chemotherapy (110.2%). Community prescribing grew by 45.2%, with costs falling by 24.4%. Evidence on the relationship between new technologies and healthcare expenditure is mixed, but the fall in drug costs could reflect low generic prices, and the use of health technology assessment or commercial arrangements to inform pricing of new medicines. Conclusions: Aggregate trends in HCE mask enormous variation across healthcare settings. Understanding variation in activity and cost across settings is an important initial step towards ensuring the long-term sustainability of the NHS.

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Public healthcare expenditure in Spain: Measuring the impact of driving factors

Cited by 29 publications

References 7 publications

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

Prevalence, behavioral manifestations and associated individual and climatic factors of seasonality in the Korean general population

Trends in and drivers of healthcare expenditure in the English NHS: a retrospective analysis

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