Author : Wendy Joan Ungar
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (133 download)
Book Synopsis An Assessment of a Prospective Measure of Health Services Utilization and the Cost of Asthma by : Wendy Joan Ungar
Download or read book An Assessment of a Prospective Measure of Health Services Utilization and the Cost of Asthma written by Wendy Joan Ungar and published by . This book was released on 1997 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction. There is increasing concern with rising health care costs. Assessing cost-of-illness reveals the major determinants of costs to society. Weaknesses in current methodology include a lack of comprehensiveness, insufficient precision, the absence of information on reliability and validity and the omission of key stakeholders' perspectives. The objectives of this thesis were to assess the reliability of patient self-reports of health services utilization and to utilize a prospective model to generate a comprehensive and precise estimate of the cost of asthma per patient from multiple perspectives. Methods. The Pharmacy Medication Monitoring Program (PMMP) collects longitudinal data from patients recruited in community pharmacies. Respiratory patients reported medication consumption, health services use, out-of-pocket costs, quality-of-life and other information during 3 telephone interviews conducted at 1, 3 and 6 months after enrollment. Self-reports of health services utilization were compared to Ontario Health Insurance Plan (OHIP) records in 83 subjects and the cost of asthma was assessed in 1,279 patients. Results. A gradient agreement between self-reports and OHIP records was observed, ranging from substantial for admissions to slight for emergency room visits. Age, disease severity and occupation were significant determinants of total costs. The annual cost to society among adults ranged from $1,633 per mildly ill patient (95\% CI \$1,282, $1,984) to \$4,223 per severely ill patient (95% CI $3,849, \$4,598). The costs in children under 4 years were higher than older children but lower than adults. Indirect costs were responsible for 43% of total costs. The largest components of direct costs were hospitalizations, 47%, and medications, 40%. Conclusions. Interventions aimed at reducing productivity losses and admissions may result in savings to society, the health care system and the patient. Estimates stratified by age, severity and occupation can serve as benchmarks and prove useful for case mix and capitation planning. The quality of clinical and health policy decision-making may be enhanced by cost-of-illness estimates that are comprehensive, precise and expressed from multiple perspectives. The PMMP is a potentially useful model for outcomes research and health economic assessments.
