A Specialized Home Care Team Does Make a Difference

Results of a study done in a large teaching and research facility in Alberta reveal that a specialized home care team can substantially lower the cost of caring for people who are ventilator dependent. With the assistance of a pulmonary physician, the Respiratory Home Care program has shown excellent results. Patients report that they “feel as safe at home as in the hospital”, and the savings to the health care system are estimated to be about $2,000,000 per year.

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Hospital based Home Care Program, for technology depended children. Its benefit for the Health Care System

10.1183/13993003.congress-2019.pa3974 ◽

2019 ◽

Author(s):

Elisavet-Anna Chrysochoou ◽

Fotios Kirvassilis ◽

Elpis Hatziagorou ◽

John Tsanakas

Keyword(s):

Health Care ◽

Home Care ◽

Health Care System ◽

Care Program ◽

Care System

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Reoperation costs in attempted breast-conserving surgery: a decision analysis

Current Oncology ◽

10.3747/co.23.2989 ◽

2016 ◽

Vol 23 (5) ◽

pp. 314 ◽

Cited By ~ 15

Author(s):

R. Pataky ◽

C.R. Baliski

Keyword(s):

Health Care ◽

Breast Reconstruction ◽

Patient Care ◽

Health Care System ◽

Early Stage ◽

Treatment Options ◽

Breast Conserving Surgery ◽

Reoperation Rate ◽

The Cost ◽

Care System

Background Breast-conserving surgery (bcs) is the preferred surgical approach for most patients with early-stage breast cancer. Frequently, concerns arise about the pathologic margin status, resulting in an average reoperation rate of 23% in Canada. No consensus has been reached about the ideal reoperation rate, although 10% has been suggested as a target. Upon undergoing reoperation, many patients choose mastectomy and breast reconstruction, which add to the morbidity and cost of patient care. We attempted to identify the cost of reoperation after bcs, and the effect that a reduction in the reoperation rate could have on the B.C. health care system.Methods A decision tree was constructed to estimate the average cost per patient undergoing initial bcs with two reoperation frequency scenarios: 23% and 10%. The model included the direct medical costs from the perspective of the B.C. health care system for the most common surgical treatment options, including breast reconstruction and postoperative radiation therapy.Results Costs ranged from a low of $8,225 per patient with definitive bcs [95% confidence interval (ci): $8,061 to $8,383] to a high of $26,026 for reoperation with mastectomy and delayed reconstruction (95% ci: $23,991 to $28,122). If the reoperation rate could be reduced to 10%, the average saving would be $1,055 per patient undergoing attempted bcs (95% ci: $959 to $1,156). If the lower rate were to be achieved in British Columbia, it would translate into a savings of $1.9 million annually.Summary The implementation of initiatives to reduce reoperation after bcs could result in significant savings to the health care system, while potentially improving the quality of patient care.

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P1546UK ANNUAL THERAPY COST OF DIALYSIS WITH THE QUANTA SC+ PERSONAL HAEMODIALYSIS SYSTEM

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1546 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Thomas Ferguson ◽

Paul Komenda ◽

Gerard Harper ◽

John Milad

Keyword(s):

Health Care ◽

Emergency Department ◽

Health Care System ◽

Self Care ◽

Emergency Department Visits ◽

Weekend Effect ◽

Care At Home ◽

The Uk ◽

Care System ◽

At Home

Abstract Background and Aims The number of patients receiving dialysis is increasing in the United Kingdom, costing the National Health Service (NHS) over 500 million GBP annually. New personal haemodialysis systems are being developed, such as the Quanta SC+, that are smaller and simpler to use by patients while providing the clearances of conventional systems. Increasing uptake of lower intensity assistance and full self-care dialysis may provide economic benefits to the public health payer. In addition, promotion of every other day dialysis (3.5x weekly) may improve costs to the health system by helping to close the “post-weekend effect” with increased emergency department use and hospitalisations following the long interdialytic gap. As such, we aimed to describe the annual therapy costs of using SC+ in the UK for 3x weekly and 3.5x weekly dialysis regimens, both for self-care haemodialysis provided in-centre and at home in comparison to dialysis provided with conventional machines from the perspective of the health care system. Method Cost minimisation approach. Costs for human resources, equipment, and consumables were sourced from the dialysis machine developer (Quanta Dialysis Technologies). Other costs, such as facility expenses, dialysis-related drugs, avoided emergency department and hospitalisation events, and utilities were taken from a review of the literature. Costs are provided in 2018 GBP. Results Therapy provided as self-care in-centre or full self-care at home were found to have similar costs (£33,721 in-centre versus £33,836 at home for the 3x weekly regimen). Costs increased to £37,238 for self-care in-centre and £35,557 at home for the 3.5x weekly regimen. A comparator cost of £39,416 was established for dialysis provided with conventional machines in-hospital 3x weekly. For each dialysis patient, the health care system is anticipated to save £3,666 in costs associated with excess hospital stays and £2,176 in costs associated with excess emergency department visits. Conclusion In the UK, SC+ offers cost savings when used both for self-care in-centre and full self-care at home in comparison to dialysis provided in the clinic using conventional machines.

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PCV54 THE COST-UTILITY OF ALISKIREN IN THE TREATMENT OF MILD TO MODERATE HYPERTENSION. A CANADIAN HEALTH CARE SYSTEM PERSPECTIVE

Value in Health ◽

10.1016/s1098-3015(10)70642-2 ◽

2008 ◽

Vol 11 (3) ◽

pp. A202-A203 ◽

Cited By ~ 1

Author(s):

A Lee ◽

SJ Barry ◽

L Leiter ◽

A Nanji ◽

L Annemans ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Moderate Hypertension ◽

Cost Utility ◽

System Perspective ◽

Canadian Health Care System ◽

Canadian Health ◽

Canadian Health Care ◽

The Cost ◽

Care System

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The cost burden of trastuzumab and bevacizumab monoclonal antibody therapy in solid tumors: Can we afford it?

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.6044 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 6044-6044 ◽

Cited By ~ 3

Author(s):

A. Drucker ◽

K. Virik ◽

C. Skedgel ◽

D. Rayson ◽

M. Sellon ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Drug Costs ◽

Cost Burden ◽

Care Providers ◽

Treatment Standard ◽

Pharmacy Data ◽

The Cost ◽

The Impact ◽

Care System

6044 Background: Monoclonal antibodies (MAb), such as trastuzumab (TZ) and bevacizumab (BZ), have become an important yet expensive component of cancer treatment. The potential cost impact on health care budgets needs to be assessed in the context of its potential utilization. An estimate of the additional costs incurred by adopting TZ and BZ therapy in breast (BRC), lung (LUC) and colorectal (CRC) cancers was undertaken. Methods: The MAb costs per patient were estimated based on treatment indications, length of treatment, standard doses / schedules and local pharmacy data. Supportive medications, diagnostics and health resources utilization only required for the MAb therapy were also examined. This analysis was performed in Canadian dollars ($), and assumes complete drug delivery and uncomplicated cycles. Drug costs were based on average 2005 wholesale prices in Canada. The analysis took a direct payer perspective. We subsequently estimated the cost of MAb therapy per patient relative to the total costs of conventional cancer management without MAb therapy. Budget impact estimates on Canada’s health care system were then derived according to constructed schema, which accounts for absolute numbers of target patients and systemic therapy utilization. Results: The average costs of TZ per treated patient were $47,278 and $26,648 for adjuvant and metastatic BRC, respectively. For BZ, these were $47,250 and $38,500 for metastatic LUC and CRC, respectively. Other costs associated with MAb therapy were in the range of 3–6%. The predicted TZ drug costs in metastatic breast cancer were within 10% of the actual costs derived from pharmacy data. The potential life-time absolute costs to Canada’s health care system were approximately $118 million for TZ, and $262 million for BZ. This corresponds to an average of approximately 21% increase in the health care expenditure for BRC, LUC, and CRC. Conclusions: MAb therapy, such as TZ and BZ, may add a significant cost burden to Canada’s publicly funded health care system. The developed schema in this analysis may be of potential use to health care providers and policy makers in assessing the impact of MAb therapy on health care budgets. No significant financial relationships to disclose.

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E. Thumé, L.A. Facchini, G. Wyshak and P. Campbell. The utilization of home care by the elderly in Brazil’s primary health care system. American Journal of Public Health 2011, 101(5)ThuméE.FacchiniL.A.WyshakG.CampbellP.The utilization of home care by the elderly in Brazil’s primary health care system. American Journal of Public Health2011, 101(5), 868–74.

Journal of Health Management ◽

10.1177/0972063412457523 ◽

2012 ◽

Vol 14 (3) ◽

pp. 378-378

Author(s):

Priyanka Bakshi

Keyword(s):

Public Health ◽

Health Care ◽

Primary Health Care ◽

Home Care ◽

Health Care System ◽

The Elderly ◽

Primary Health Care System ◽

Primary Health ◽

Care System

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Administrative Waste in the U.S. Health Care System in 2003: The Cost to the Nation, the States, and the District of Columbia, with State-Specific Estimates of Potential Savings

International Journal of Health Services ◽

10.2190/d2bl-huxy-rlf8-ulxa ◽

2004 ◽

Vol 34 (1) ◽

pp. 79-86 ◽

Cited By ~ 14

Author(s):

David U. Himmelstein ◽

Steffie Woolhandler ◽

Sidney M. Wolfe

Keyword(s):

Health Care ◽

Health Care System ◽

District Of Columbia ◽

The Cost ◽

The U.S ◽

Care System

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Management of complex chronic disease: facing the challenges in the Canadian health-care system

Health Services Management Research ◽

10.1258/hsmr.2008.008001 ◽

2008 ◽

Vol 21 (4) ◽

pp. 228-235 ◽

Cited By ~ 16

Author(s):

Peter Tsasis ◽

Jatinder Bains

Keyword(s):

Health Care ◽

Chronic Disease ◽

Home Care ◽

Health Care System ◽

Care Delivery ◽

Canadian Health Care System ◽

Canadian Health ◽

Canadian Health Care ◽

Complex Chronic Disease ◽

Care System

This paper discusses the challenges that those living with complex chronic disease present to the Canadian health-care system. The literature suggests home care and the management of complex chronic disease can together ease many of the present and future pressures facing the health-care system in dealing with this new health-care phenomenon. A review of current literature and dialogue with key informants reveals that the current level of investment and the present policy environment are not sustainable to support the health-care system. In this paper, changes to policy and resource allocation to the home care sector are suggested to help manage complex chronic disease and thus improve the effectiveness of the Canadian health-care system. A case is made for a reorganization and increased commitment to the home care sector for a more efficient and patient-centred health-care delivery system.

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