BACKGROUND:: Inflammatory bowel diseases are costly chronic gastrointestinal diseases. We aimed to determine whether immediate colectomy with ileal pouch-anal anastamosis (IPAA) after diagnosis of severe ulcerative colitis (UC) was cost-effective compared to the standard medical therapy. METHODS:: We created a Markov model simulating 2 cohorts of 21-year-old patients with severe ...

OBJECTIVE.: Although the knee joint is one the most affected joints by osteoarthritis (OA), research on economic implications focussed merely on OA in general. The goal of this study was to identify and quantify knee related productivity and medical costs in knee OA patients in paid employment. Furthermore, we evaluated ...

Electronic medical record (EMR) systems have been proposed as technology to improve the quality of patient care, decrease medical errors, control and reduce medical expenditure, however the financial effects have not yet been as well documented in China. We presented a net financial cost-benefit analysis of implementing electronic medical record ...

To assess the cost of hemodialysis (HD) delivered at our center according to the treatment protocols based on the current Kidney Disease Outcome Quality Initiative (K/DOQI) guidelines, we analyzed our cost data during the period from 1st of January 2007 to 30th of June 2010. The methods were used to ...

BACKGROUND: Cardiovascular disease (CVD) is a major source of mortality and morbidity in dialysis patients. Population-level descriptions of CVD medication use are lacking in this population. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Adult dialysis patients in the United States, alive on December 31, 2006, with Medicare Parts A ...

OBJECTIVE: To determine the cost-effectiveness of medical and surgical management of early pregnancy loss. DESIGN: Analyses of cost, effectiveness, and incremental cost-effectiveness ratios and utilities of a multicenter trial with 652 women with first-trimester pregnancy failure randomized to medical or surgical management. SETTING: Analysis of data from a multicenter trial. ...

Objectives: Medication noncompliance is a recognized problem worldwide. This study evaluated the factors associated with compliance, discontinuation and switching of finasteride among Chinese benign prostatic hyperplasia patients. Materials and Methods: A retrospective cohort study was conducted with 682 outpatients newly diagnosed with benign prostatic hyperplasia and prescribed with finasteride from ...

BACKGROUND: Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena. QUESTIONS/PURPOSES: (1) Why is ADR needed? (2) Is ...

Child maltreatment is a serious and prevalent public health problem, which has been shown to be associated with numerous short- and long-term effects on mental and physical health. Few estimates of the medical costs of these effects have been published to date. To determine the range and quality of currently ...

Objectives: To evaluate the cost impact of an integrative medicine intervention on an inpatient oncology service. Study Design: This study used nonrandomized, nonequivalent groups. A baseline sample of inpatient oncology patients at Beth Israel Medical Center admitted to the medical oncology unit before implementation of the Urban Zen Initiative were ...

Objectives: To propose a model in which insurers work with hospitals to provide a discharge supply of antiplatelet medication to patients receiving stents and to examine the cost implications of this strategy. Study Design: A decision tree was modeled using data from previously published research. The study adopts an insurer's ...

Abstract Objectives. There have been no reported data on the medical care cost of idiopathic peptic ulcer disease (PUD) compared with H. pylori (+) and/or NSAID (+) cases although H. pylori-negative idiopathic ulcers are increasing. The aim of this study was to investigate the direct medical care costs of PUD ...

OBJECTIVE: To assess the costs of a housing and case management program in a novel sample-homeless adults with chronic medical illnesses. DATA SOURCE: The study used data from multiple sources: (1) electronic medical records for hospital, emergency room, and ambulatory medical and mental health visits; (2) institutional and regional databases ...

Interventions that both improve outcomes and save costs are unusual, but the provision of lifesaving medications to survivors of myocardial infarction is one such example.(1) In the past, physicians' poor compliance with evidence-based guidelines was a major reason for suboptimal use of such medications. Now, with help from the dissemination ...

BACKGROUND: An earlier study showed that from a societal perspective it was less expensive to encourage patients to self-regulate their medication for GERD (gastro-esophageal reflux disease) by treating patients on-demand. OBJECTIVE: The objective was to investigate whether physician involvement in a clinical trial financed by the pharmaceutical industry subsequently results ...

Abstract The teleoncology practice based at the University of Kansas Medical Center (KUMC) in Kansas City, Kansas, is one of the longest running practices of its kind worldwide. The practice began in 1995 and connected an oncologist at KUMC with a rural medical center in Hays, Kansas. Fifteen years later, ...

Purpose: This study aimed to capture direct costs of outpatient rehabilitative stroke care and medications for a 1-year period after discharge from inpatient rehabilitation. Methods: Outpatient rehabilitative services and medication costs for 1 year, during the time period of 2001 to 2005, were calculated for 54 first-time stroke survivors. Costs ...

This paper is the first to use the method of instrumental variables (IV) to estimate the impact of obesity on medical costs in order to address the endogeneity of weight and to reduce the bias from reporting error in weight. Models are estimated using restricted-use data from the Medical Expenditure ...

Abstract Objectives: This study examines the evolutionary impact of valsartan initiation on medical costs. Methods: A retrospective time series study design was used with a large, US national commercial claims database for the period of 2004–2008. Hypertensive patients who initiated valsartan between the ages of 18 and 63, and had ...

Abstract Background. Ambulance transport of injured patients to the most appropriate medical care facility is an important decision. Trauma centers are designed and staffed to treat severely injured patients and are increasingly burdened by cases involving less-serious injury. Yet, a cost evaluation of the Field Triage national guideline has never ...

Objective:We examined key factors that affect out-of-pocket medical expenditures per $1000 of household income for children with special health care needs (CSHCN) with a broad range of conditions, controlling for insurance type and concentrating on the potentially moderating role of the medical home.Methods:A Heckman selection model was used to estimate ...

Background: Both medical and surgical abortions are popular in developing countries. However, the monetary costs of these two methods have not been compared. Methods: 430 women seeking abortions were recruited in 2008. Either a medical or surgical method was used for the abortion. We adopted the perspective of a third-party ...

Abstract Objective: In addition to negative impacts on clinical effectiveness in treating secondary hyperparathyroidism, low adherence to cinacalcet may have negative impacts on healthcare costs. This study assessed the relationship between medication adherence and healthcare costs among US patients on dialysis given cinacalcet to manage secondary hyperparathyroidism. Methods: Retrospective cohort ...

BACKGROUND: The affordability of prescription medications continues to be a major public health issue in the United States. Estimates of cost-related medication underuse come largely from surveys of ambulatory patients. Hospitalized patients may be vulnerable to cost-related underuse and its consequences, but have been subject to little investigation. OBJECTIVE: To ...

Since the implementation of managed care, clinicians have struggled with ways to provide optimal treatment in a cost-effective manner. With the rising cost of medications, generic substitutes appear to be an answer. Some medications have proven to be less effective in generic form. Consumers may be wary of generics. However, ...

To estimate the rate and costs of hypoglycemia in patients with type 2 diabetes. We used a retrospective cohort design to assess the rate and costs of hypoglycemia among working-age patients with type 2 diabetes in the 2004 to 2008 MarketScan database. We followed patients from cohort entry to the ...

BACKGROUND: Little information is available on the analysis of medical costs of acute pancreatitis hospitalizations. AIM: This study aimed to determine the factors affecting medical costs of patients with acute pancreatitis during hospitalization using a Japanese administrative database. METHODS: A total of 7193 patients with acute pancreatitis were referred to ...

Dexamethasone, one of the key medications for the prevention of chemotherapy-induced nausea and vomiting (CINV), may cause hiccups as an adverse effect. In this case series, we present five patients who developed hiccups after receiving dexamethasone for CINV. We successfully switched dexamethasone to an equipotent dosage of either methylprednisolone or ...

The purposes of this study are to investigate medical resource utilization and medical costs of Korean rheumatoid arthritis (RA) patients and to analyze predictors in relation to medical costs. National claims data on medical treatment were analyzed for the 151,472 RA patients in 2009. For outpatients, the mean annual number ...

The high cost of medical liability increases healthcare expenditure and decreases healthcare services. To understand the public perception of medical liability issues in Puerto Rico, a survey was made with the assistance of Gaither International. Five hundred interviews were made in a representative sample of all six US Census demographic ...

BACKGROUND: Several studies have examined adherence when switching from loose-dose combination therapy (LDCT) to fixed-dose combination therapy (FDCT) among oral antidiabetic agents. However, little is known regarding combination therapies, including pioglitazone and metformin. OBJECTIVES: The objectives of this study were (1) to describe adherence to monotherapy (MT), LDCT, and FDCT ...

By using 140 sets of automated discharge instructions, Department of Veterans Affairs Medical Center at Portland, Ore., cut its 14-day readmission rate to 1.5 for every 1,000 outpatient procedures. Providers are prompted to document: Dosage directions for any medications to be taken upon discharge The date when it is safe ...

ABSTRACT: BACKGROUND: Beta-blocker drugs are commonly used in family practice and studies showed that they were the most popularly prescribed medications among all antihypertensive agents. This study aimed to identify the factors associated with medication switching from a beta-blocker to another antihypertensive drug among Chinese patients. METHODS: We used a ...

Adherence to osteoporosis treatment is low. Although new therapies and behavioral interventions may improve medication adherence, questions are likely to arise regarding their cost-effectiveness. Our objectives were to develop and validate a model to simulate the clinical outcomes and costs arising from various osteoporosis medication adherence patterns among women initiating ...

In this article we highlight the important role that medication therapy can play in preventing disease and controlling costs. Focusing on coronary artery disease, we demonstrate that prevention, with the appropriate use of generic medications, appears far more cost-effective than previously documented, and it may even save on costs. For ...

Objective: To identify determinants of direct medical costs among patients with osteoporosis, osteoarthritis, back pain or fibromyalgia. Design: Cross-sectional study. Participants: Convenience sample of 410 patients undergoing outpatient rehabilitation. Methods: Resource use was assessed with a self-report retro-spective questionnaire, and direct medical costs were calculated considering outpatient physician services, non-physician ...

(Headache 2011;51:1058-1077) Objective.- To evaluate and compare healthcare resource use and related costs in chronic migraine and episodic migraine in the USA and Canada. Background.- Migraine is a common neurological disorder that produces substantial disability for sufferers around the world. Several studies have quantified overall costs associated with migraine in ...

The average costs of Musculoskeletal Disorder (MSD) and odds ratios for filing medical claims related to MSD were examined. The medical claims were identified by ICD 9 codes for four US Census regions within retail trade. Large private firms' medical claims data from Thomson Reuters Inc. MarketScan databases for the ...

Medicare Part D has expanded medication access; however, there is some evidence that dually eligible psychiatric patients have experienced medication access problems. The aim of this study was to characterize medication switches and access problems for dually eligible psychiatric patients and associations with adverse events, including emergency department visits, hospitalizations, ...

BACKGROUND:: Inflammatory bowel diseases (IBD) are costly chronic gastrointestinal diseases, with pediatric IBD representing increased costs per patient compared to adult disease. Healthcare expenditures for ulcerative colitis (UC) are more than 2 billion dollars annually. It is not clear whether the addition of VSL#3 to standard medical therapy in UC ...

PURPOSE: The objective was to assess the long-term economic consequences of the medical management of glaucoma in the UK. METHODS: The economic evaluation was conducted using the results from a 10-year Markov model based around 3 key triggers for a switch in medical therapy for glaucoma, namely: lack of tolerance ...

ABSTRACT: Study Design. A retrospective-cohort investigation (N = 245) utilizing a review of patient medical records and costs accrued through the Workers' Compensation Fund of Utah.Objective. To replicate a previous study of compensation and medical costs in compensated lumbar fusion patients, to identify changes in costs across time, and to ...

BACKGROUND: Survival for childhood acute lymphoblastic leukemia (ALL) has reached 80-90%. Future improvement in treatment success will involve new technologies and medication, adding to the pressure on limited financial resources. Therefore a retrospective cost-effectiveness analysis of ALL treatment with chemotherapy only according to the two most recent Dutch Childhood Oncology ...

Parasites can mediate profound negative effects on host fitness. Colour polymorphism has been suggested to covary genetically with intrinsic physiological properties. Tawny owl colour polymorphism is highly heritable with two main morphs, grey and brown. We show that experimental medication acts to reduce blood parasites and that medicated grey females ...

ABSTRACT: BACKGROUND: The prevalence of physician-diagnosed-asthma has risen over the past three decades and misdiagnosis of asthma is potentially common. Objective: to determine whether a secondary-screening-program to establish a correct diagnosis of asthma in those who report a physician diagnosis of asthma is cost effective. METHOD: Randomly selected physician-diagnosed-asthmatic subjects ...

Adverse drug reactions (ADRs) may cause prolonged hospital admissions with high treatment costs. The burden of ADRs in children has never been evaluated in Nigeria. The incidence of pediatric ADRs and the estimated cost of treatment over an 18-month period were determined in this study. Prospective observational study on children ...

The adoption of electronic medical records technology in medical practices is helping to improve quality and decrease costs. While electronic records can increase practice efficiencies, this stored digital information is also playing an increasingly central role in the discovery phase of lawsuits. The sheer volume of electronic files that may ...

Actinomyces israelii are gram-positive filamentous bacteria forming yellow sulfur granules. They are the most well known complication of intrauterine contraceptive devices (IUCD). Healthcare staff dealing with reporting cervical smears should be aware of pseudoactinomyces entity in a cervical smears and biopsies as it may raise a false alarm to the ...

The health hazards of exposure to secondhand smoke (SHS) are well-defined. Less is known about the economic costs. We performed an analysis of the medical costs of SHS in North Carolina that was based on a similar study conducted in Minnesota. We used 2006 Blue Cross and Blue Shield of ...

Time trajectories of medical costs-associated with onset of twelve aging-related cancer and chronic noncancer diseases were analyzed using the National Long-Term Care Survey data linked to Medicare Service Use files. A special procedure for selecting individuals with onset of each disease was developed and used for identification of the date ...