Cost-sharing Research Articles

Mississippi USA'S timber severance tax apportionments and their economic contributions

Eighty percent of Mississippi's timber severance tax collections were authorized by the state legislature in 1984 to fund the Forest Resource Development Program (FRDP), which is a cost share program through which landowners can receive up to 75% reimbursement for their forest management expenses. The remaining 20% is apportioned on shares to counties where timber was harvested. The regional economic contributions of the Mississippi timber severance tax funding spending for FRDP and county governments were determined. Social accounting matrixes (SAMs) were constructed and customized using 2019 data collected by Mississippi State University, IMPLAN, and Lightcast. The modified SAMs were rebalanced to ultimately obtain the total requirements matrix. Funds expended for FRDP and counties in 2019 were run as exogenous final demands. The total possible impact was estimated to be $6.00 million in industrial output and 222 full-time and part-time employment. Because actual expenses were only 72.8% of FRDP funds available that year, this lessened the actual contribution by $1.80 million in output, $1.39 million in value added, and 80 jobs. Regional output contributions correlated moderately with tax collections and forest inventory statistics. Evidence pointed to an inequality of economic flows regarding what South Mississippi paid in tax and the contributions it received in return via industrial activities.

Association of arbitrary prescribing behavior to costly drug expenditures: a pharmacoeconomic study in primary care.

We aimed to examine the cost-related prescribing performance of primary care physicians who had a higher versus lower tendency of arbitrary prescribing. In this cross-sectional study, we evaluated the prescriptions of primary care physicians in Istanbul, collected with 3:1 systematic sampling. We determined higher versus lower arbitrary prescribing by the physician's degree of writing the solo diagnosis of "Z00- General examination without diagnosis/complaint": those for whom such prescriptions constituted >5% were classified as Group A and those with them at <0.5% as Group B. We compared these two groups by the total and disease-specific drug costs per prescription they produced for 10 frequently encountered indications. The median cost of disease-specific medication for all diagnoses in Group A and Group B, except anemia, was equal. In upper respiratory tract infections (URTIs), hypertension, anemia, diabetes, and conjunctivitis, the mean prescription costs of Group A were significantly higher than those of Group B (P < .001, P < .001, P = .009, P = .007, and P < .001, respectively), whereas disease-specific drug costs per prescription were similar (P > .05 in all diagnoses). In myalgia, Group A had lower cost per prescription (P < .001) and higher analgesic costs per prescription (P < .001) compared to those in Group B. We found significantly higher disease-specific drug cost share in Group B for URTIs (antibiotic), gastroesophageal reflux disease (gastric acid-suppressant), hypertension (antihypertensive), anemia (iron preparations), diabetes (antidiabetic), depression (antidepressant), and conjunctivitis (corticosteroid) than those in Group A (P < .001 for each). Our study showed that physicians who had a higher tendency of prescribing for no clear indication are also more likely to produce costly prescriptions.

Impact of the Russia–Ukraine war on grain and fertilizer supply: Evidence from Kenya

AbstractThis paper examines the impact of the Russia–Ukraine war on grain and fertilizer supply to Kenya as the sixth largest economy in Africa using the Regression Discontinuity estimator on monthly data spanning from January 2017 to August 2022. The share of the quantity and value of cereals and fertilizer imports by Kenya from Russia and Ukraine in the total quantity and value of cereals and fertilizer imports by Kenya from world are utilized. The share of freight and insurance costs on grain and fertilizer imports by Kenya from Russia and Ukraine in total freight and insurance costs on grain and fertilizer from world have also been used. After controlling for sensitivity and incorporating depreciation of the exchange rate and a dummy on drought as covariates, the results indicate the war has had insignificant impact on imports of grain and fertilizer by Kenya though the impact is negative for grain but positive for fertilizer. The findings have policy implications touching on need for African countries to diversify import sources for grain and fertilizer, enhance productive capacities through investment on irrigation, strengthen diplomatic ties with existing import sources for grain and fertilizer, and invest in climate action to tackle drought incidences.

Meeting User Needs through Building Automation and Control Systems: A Review of Impacts and Benefits in Office Environments

Smart building technologies and building automation and control systems (BACS) can offer a range of additional benefits beyond energy savings, in particular by improving building responsiveness to user needs. Although in recent years these technologies have gained popularity as a means of reducing energy consumption and improving building performance, a clear picture of the role of BACS in providing a wider range of benefits is still missing. This review identifies and collects BACS impacts in office buildings with a special emphasis on improving indoor environmental quality by adapting building operation to changing conditions and guaranteeing feedback and real-time interaction with occupants. The resulting benefits, such as increased employee productivity, fewer occurrences of sick leave, and lower rates of absenteeism are highlighted. Offices represent an interesting field of application, as small improvements in the built environment can have a significant impact on labour costs which are the predominant share of the total operating costs. Furthermore, quantitative relationships between physical factors of the indoor environment and benefits have been displayed where available. This literature review aims at establishing an approach that comprehensively evaluates BACS across their entire spectrum, leading to the promotion of novel business cases.

An Economic Analysis of Wheat Cultivation in North-Karnataka, India

Wheat is an important cereal crop in India as half of the population depends on wheat for food. The average wheat sown area of the country is 30.38 ha in the last five years from 2017-2022. The present paper was designed to study the cost of cultivation and return structure of wheat cultivation in Karnataka which comes under the peninsular zone where the total wheat cultivating area is 1.60 million ha. The study was undertaken in three major wheat-growing districts of Karnataka i.e., Belagavi, Vijayapura and Dharwad. The multistage random sampling method was followed for the selection of districts and farmers. The primary data was collected from 90 farmers (30 farmers from each district) and analyzed using tabular analysis. The results of the study revealed that per hectare total cost of cultivation of wheat at an aggregate level was ₹ 35,076.37 in which the share of the variable cost was 59.86 per cent and the fixed cost was 40.14 per cent. Among the variable costs, human labour cost was highest (21.95%) per hectare and in fixed cost, the rental value of land (34.63%) was highest. The gross return and net return obtained by the farmer were ₹ 54,786.56 and ₹ 19,710.18 and the return per rupee of expenditure was found to be 1.55 indicating that wheat is a profitable crop enterprise. However, the cost of production per quintal was found ₹ 1,869.60 and the profits obtained were ₹1,008.27 per quintal. Lack of labour and high cost of labour was the major problem in wheat cultivation. Hence, boosting up the mechanization may help to reduce the cost of cultivation. Using custom hiring centres and farmer producer organization approaches would better augment the mechanization in the wheat economy.

Key drivers of 90-day costs in primary total elbow arthroplasty

BackgroundA comprehensive understanding of both surgical care costs and the factors influencing these costs is critical to make progress toward value-based care in orthopedics. Therefore, the purpose of this study was to assess 90-day health system costs in primary total elbow arthroplasty (TEA), the proportion of contribution from each cost group to total hospital cost, and to determine key drivers of 90-day costs in primary TEA. MethodsConsecutive patients who underwent primary TEA between 2014 and 2021 at a tertiary care academic medical center were included. An institutional accounting database was queried to determine direct costs to the health system attributed to TEA. All costs within 90 days of the surgical encounter were included for analysis to reflect the global postoperative period. Descriptive statistics were used to summarize patient and surgical characteristics, as well as cost data. Subcategories were determined to assess the key cost groups that contribute to total hospital fees for the entire cohort, and subanalysis was performed to evaluate only readmitted patients. Furthermore, a linear regression analysis was used to determine key drivers of 90-day costs in the setting of primary TEA. ResultsThirty-five patients who underwent primary TEA were identified from 2014 to 2021; 28 patients with 90-day cost data were included in this study. The mean surgical encounter cost was $18,075 (+/− $9772) and mean 90-day cost was $19,875 (+/− $9885). The largest proportion of health system costs in primary TEA was surgical implants (48%), followed by operating room fees (18%), surgical supplies (9%), and anesthesia (7%). Among readmitted patients, the most significant share of health system costs was attributed to surgical implants (30%) followed by operating room fees (22%). However, hospital fees (19%) experienced a substantial increase. In assessing the key drivers of 90-day health system costs, length of stay (B = 1304.30, 95% confidence interval [CI] 674.54 to 1934.05; P < .001), readmission (B = 16,148.55, 95% CI 7055.01 to 25,240.08; P = .001∗), and Charlson comorbidity index (B = 2247.43, 95% CI 68.64 to 4426.22; P = .044) were statistically significant predictors of increased 90-day costs. ConclusionImplant costs comprise nearly half of total 90-day costs in primary TEA, with operating room costs making the second largest contribution. Additionally, length of stay, readmission, and patient comorbidity burden were significantly associated with increased 90-day costs.

Design and optimization of a multi-level wasted heat recovery system for a natural gas-based gas turbine cycle; comprehensive exergy and economic analyses

The increasing demand for power and the imperative of harnessing wasted heat to optimize power systems have motivated this current study. The main goal is conceptualizing an innovative multi-generation plant fueled by natural gas, which ingeniously integrates four distinct cycles: steam Rankine, absorption power, ejector refrigeration, and proton exchange membrane electrolyzer. This integration is synergistically coupled with a gas turbine to elevate overall system performance significantly. The investigation extends to the thorough examination, including the system's energy, exergy, and economic attributes, facilitating an all-encompassing assessment of the newly conceived plant's efficiency. Through a meticulous parametric inquiry, the study scrutinizes the influence of various parameters on the operational prowess of the system. Moreover, the quest for optimum performance unfolds through a multi-objective optimization process conducted across three distinct scenarios. Regarding the outcomes, at the base operating conditions, the novel system exhibits the capacity to yield 3,896.6 kW of net power, additionally generating a cooling load of 77.7 kW and producing 0.22 kg/h of hydrogen. Notably, it attains an exergy efficiency of 47.1 %, with the combined unit cost of products and a commendable payback period measuring at 9.16 $/GJ and 1.4 years, respectively, under baseline conditions. The preeminent role in exergy destruction is attributed to the gas turbine cycle, accounting for 88.59 % of the total, while the highest share of the total investment cost is allocated to the turbines. The pinnacle of optimal performance is realized in a state wherein the system achieves its zenith in terms of efficiency and output, reflecting the culmination of meticulous design and analysis.

Analysis of the state of the electric power industry of the Ural Federal District

The article studies importance of marketing analysis of electric power industry on the example the Ural Federal District. A brief characteristic of the region under consideration has been given and prevailing branches of specialization and territories of their location reflected. Electricity consumption indicators in dynamics for the decade (2012–2022) for all groups of consumers in the region (industrial consumers, population, non-industrial consumers, budgetary consumers, and agricultural producers) have been analyzed, and electricity consumption structure considered, i.e. electricity shares that fall on each group of consumers have been revealed. Forecasts of electricity consumption have been made and dynamics of such an important indicator as electricity intensity of gross regional product analyzed. Dynamics of electricity tariffs for urban and rural population, non-industrial consumers, as well as for large and small industrial enterprises, has been analyzed. Consumers’ ability to pay for electricity has been studied by identifying the share of electricity costs in expenditures of households and enterprises of different energy intensity structure. The indebtedness of consumers to guaranteeing suppliers and power grid companies has been given. Effective measures to combat the indebtedness of some large guaranteeing suppliers from the district under consideration have been analyzed.

Characterization of the Mechanical Properties of Low Stiffness Marine Power Cables through Tension, Bending, Torsion, and Fatigue Testing

The exploitation and harnessing of offshore marine renewable energy have led to an increased demand for reliable marine power cables with long service lives. These cables constitute a considerable share of the total installation cost of offshore renewable energy facilities and have high maintenance and repair costs. The critical characteristics of these power cables must be determined to reduce the risk of exceeding their ultimate strength or fatigue life, which can result in unwanted and unexpected failures. This study investigates dynamic marine power cables that are suitable for application in devices that harness energy from ocean currents, waves, and tides. Tension, bending, torsion, and fatigue tests were conducted on three dynamic power cables (1 kV, 3.6 kV, and 24 kV) that have high flexibility, i.e., low mechanical stiffness. The specimen lengths and axial pretension force were varied during the tests. The results are discussed in terms of the mechanical fatigue degradation and ultimate design load, and the key observations and lessons learned from the tests are clarified. The study’s main contribution is the results from physical component testing of the dynamic marine power cables without metallic armors, which can be used to calibrate numerical models of this type of dynamic marine power cable in the initial design of, e.g., inter-array cables between floating wave energy converters. The benefits offered by this type of cable and the importance of the results for creating reliable numerical simulation models in the future are highlighted.

The Impact of Energy Consumption Costs on the Profitability of Production Companies in Poland in the Context of the Energy Crisis

The paper presents the results of the authors’ research on the share of energy costs in revenues and their impact on the profitability of companies. This research was inspired by a large increase in energy prices in 2022. The authors analyzed the shares of energy consumption costs in production companies from various industries, using various sources: scientific literature, expert studies, and statistical data. Based on the results of these analyses, the authors simulated the impact of changes in energy prices on the profitability of companies. The research results are as follows: according to the authors, the share of these costs in the value of sales is much lower (several percent) than presented in various literature sources (a dozen or so, and even up to 30% in some cases). Despite this, however, the change in energy prices should significantly reduce profitability according to the simulations conducted by the authors. However, the financial reports analyzed by the authors show that profitability in many cases not only did not deteriorate, but revenues and profits increased in a large number of companies. In many cases, this can be explained by the actions taken by companies to reduce energy consumption costs and by increases in product prices. The authors’ research also shows that if factors such as the specificity of the industry or the size of the company have an impact on energy efficiency, it is only to a small extent. The share of energy costs in sales and financial results, even within a given industry and in companies of similar size, varies greatly. The authors therefore believe that the effectiveness of the management of a given company has the greatest impact. Therefore, the results of the analysis differ significantly from the results of studies presented in the literature. Energy consumption data were analyzed using various literature sources from different countries. However, the main analyses conducted by the authors focused on Poland.

Characterization of combined endoscopies and aerodigestive care: An analysis of utilization and financial feasibility.

Aerodigestive care is one model of multi-disciplinary care, which is a valuable tool for both providers and patients. Aerodigestive care models are associated with improved outcomes, reduced anesthesia exposure, reduction in hospital admissions, and fewer days of missed work or school. This is the first study to explore national usage and cost trends in combined endoscopy utilization to identify gaps in care and the potential for financial resource optimization. Data from the Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Sample (KID) was used from 2016 and 2019. Diagnoses and procedures were identified using ICD-10 codes, for patients with hospital length of stay less than 1 day. Demographic data were identified, and survey-weighted means and proportions were computed. Bivariate comparisons were made using Rao Scott Chi-Square tests. National estimates of charges were computed with discharge weights, developed using the American Hospital Association (AHA) universe. White, high-income patients, and those at urban teaching hospitals received the greatest proportion of combined endoscopic procedures. The cost/charges associated with combined endoscopies are less than for separate gastrointestinal (GI) or airway only endoscopies combined. However, combined procedures comprise a smaller share of national aggregate cost. National utilization trends highlight racial and socioeconomic disparities and suggest differences in access based on hospital characteristics, despite the reduced cost/charges of the combined procedure. For patients with a need for combined aerodigestive procedures, there appears to be a cost-savings opportunity to increase efforts for combined procedures at the level of the clinician or hospital.

Integrating evidence-based interventions in cardiac and pulmonary rehabilitation guidelines

Cardiac rehabilitation (CR) and pulmonary rehabilitation (PR) programs play a crucial role in optimizing the functional capacity and quality of life of individuals with cardiac and respiratory conditions. These programs are guided by evidence-based interventions that have shown effectiveness in improving clinical outcomes and reducing the burden of disease. Patients with chronic diseases like chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) suffer a disproportionate share of healthcare costs, and many see a decline in their physical and mental abilities as a result. Breathlessness is the first sign of both COPD and cardiovascular disease. Rehabilitation programs (RP) symptoms and improving overall health are two of rehabilitation's demonstrated benefits. Management recommendations for COPD and CVD include participation in a PR and CR program. This study looks at similar evidence-based strategies in rehabilitation guidelines that aim to help patients with COPD and CVD feel less short of breath and better able to function physically and mentally. The results of the show that there was agreement in terms of program structure, setting, healthcare provider teams, pre- and post-program patient assessments, and educational content (with some exceptions related to disease-specific content). Evidence-based recommendations for CR and PR differ from rehabilitation guidelines most noticeably in their emphasis on nutritional screening, inspiratory muscle exercise, and psychological evaluations.

Holistic Life-cycle Cost-benefit Analysis of Green Buildings: A China Case Study

Green buildings, compared with conventional ones, can mitigate the rapid growth of China's carbon emissions. They offer many advantages, such as saving resources and reducing negative environmental impacts. However, few studies have assessed their incremental costs and social benefits. This study comprehensively analyzed the incremental costs and benefits of green buildings in China through the life cycle stages of preparation, design, construction, and operation-management. The Analytic Hierarchy Process and Matter Element Analysis were jointly applied to establish a comprehensive green-building cost-benefit evaluation system. Based on expert judgment, an embracive two-level index scheme and a three-step grading strategy were developed. A residential case study tested the applicability of the model. It yielded the largest share of incremental cost in the construction phase at 90.5%. The economic benefits accounted for the largest proportion of incremental benefits at 72.22%, meeting the green building criteria and achieving the highest 3-star rating. The study has developed a full life-cycle costing methodology for green building design and quantified the benefits at each stage. The findings offer the theoretical and practical basis to refine the assessment of green building projects and improve green building performance to meet sustainable development goals.

The Role of the Intellectual Potential of Employees in Creating the Goodwill of a Teaching Hospital

Hospitals are medical entities providing health services to patients. The dominant share of labour costs in the cost structure of the healthcare entity is evidence of the critical role of employees in a hospital's activities. Specialized medical staff provide medical services and educate future medical staff, while also conducting clinical trials and supporting the development of medical technologies. The article aims to recognize the impact of the intellectual potential of employees on creating goodwill in a teaching hospital. The inference was made based on the financial data available on hospital employees' income and labour costs as factors in the development of the goodwill of a teaching hospital. The following research questions were posed: whether the existing legal regulations regarding the financing of the activities of teaching hospitals in Poland, including the costs of medical staff, are conducive to the creation and development of goodwill of teaching hospitals; whether the ratio of the value of operating revenues to labour costs can be considered as a determinant of the increase in the goodwill of a teaching hospital. The research was conducted based on reporting data for 2018 - 2019 involving selected teaching hospitals as the basic units associating high-class medical specialists. The research was empirical and based on quantitative and qualitative data. The analyses were of an expert nature, from the perspective of a statutory auditor and a long-term researcher of the problems of the functioning of medical entities - hospitals. The preliminary findings indicate that the intellectual capital of teaching hospitals is crucial in creating and developing the goodwill measured by the ratio of the value of operating revenues to labour costs. The considerations undertaken in the article are an essential voice in recognizing the conditions for developing hospitals as entities with intellectual capital that is helpful in solving health problems on an international scale. The article is a continuation of the author's research on the development of intellectual capital of employees of teaching hospitals in Poland.

Growth In Patient Cost Sharing For Hospitalizations With And Without Intensive Care Among Commercially Insured Patients.

Intensive care units (ICUs) are increasingly used for hospital care, yet out-of-pocket spending for ICU hospitalizations remains poorly understood, particularly among the nearly half of the US population with commercial health insurance. Using 2008-19 MarketScan data, we compared 1,441,810 hospitalizations involving ICU services with 13,011,208 hospitalizations that did not involve ICU services. Average cost sharing, adjusted for patient and admission factors, increased from $1,137 per hospitalization in 2008 to $1,539 in 2019, or a 34percent increase. This was driven by increasing deductibles, which rose by 163percent. Across twenty clinical conditions whose hospitalizations commonly occurred in both ICU and non-ICU settings, ICU admission was associated with $155 higher cost sharing (13.0percent higher) relative to cost sharing in non-ICU hospitalizations. Patients with high-deductible plans faced the highest cost sharing relative to those with other plan types. Patients who received out-of-network hospital care encountered higher cost sharing relative to those admitted to in-network hospitals with in-network clinicians.

MODELLING FOR FUEL POLICY IN LOW VISIBILITY OPERATIONS IN AIRLINE OPERATIONS MANAGEMENT

Purpose- It can be said that fuel costs have the highest share in airline operation costs. Therefore, fuel efficiency is important for cost optimization in airline operation management. Fuel efficiency has been studied in many ways in airline operation management in the literature. It can be reported that the cost optimization due to additional fuel transportation caused by meteorological conditions is also an important field. This study aims to provide data for making a decision to form a fuel policy for a flight schedule by determining the divert risk rate by analyzing previous meteorology reports when there is a risk of divert due to low visibility in meteorology reports. Methodology- Thus, by providing data for airline operation managers to make decisions that will provide fuel optimization, cost-effectiveness will also be contributed. Data for the study were taken from OGIMET (the Spanish meteorology website). A simulated flight was created for the study, and the past period forecast efficiency was calculated from previous meteorological data to determine the divert risk rate. Then, it was revealed how much the divert risk rate was reduced if additional fuel was carried for the flight according to the past period meteorological data to ensure that the aircraft waited for suitable conditions in the air at the landing aerodrome. Findings- The above results reveal the divert risk rate for the airline39 flights when additional fuel is loaded and without loading additional fuel in low visibility forecast operations for the three months of the year when low visibility is more common, based on past meteorological data. Conclusion- As a result of the study, it can be reported that a model has been created relating to how to determine the divert risk rate to make a fuel policy decision for a flight schedule when there is a risk of diverting due to low visibility in airline operation management. Keywords: Airline operation management, low visibility, fuel policy, airline fuel efficieny, divert risk ratio, JEL Codes: L93, M21, C44

Economic burden of breast cancer: a case of Southern Iran

BackgroundBreast cancer is one of the main causes of death from cancer around the world, imposing a significant economic burden on the families and healthcare system. The present study aimed at determining the economic burden of breast cancer in the patients referred to the medical centers in Fars province in southern Iran in 2021.MethodsThis cross-sectional study is a partial economic evaluation and a cost-of-illness study with a bottom-up and prevalence-based approach, conducted in Fars province in southern Iran in 2021 from the societal perspective. A total of 230 patients were randomly included in the study, and a researcher-made data collection form was used to collect the required data. The data on direct medical costs were collected using the information on patients’ medical and financial records. On the other hand, the data on direct non-medical and indirect costs were obtained using self-reports by the patients or their companions. The Excel 2016 software was used to analyze the collected data.ResultsThe results showed that the annual cost of each breast cancer patient in the studied sample was 11,979.09 USD in 2021. Direct medical costs accounted for the largest share of costs (70.69%, among which the cost of radiotherapy was the highest one. The economic burden of the disease in the country was estimated at 193,090,952 USD.ConclusionsIn general, due to the high prevalence of breast cancer and the chronicity of this disease, its medical costs can impose a heavy economic burden on society, the health system, the insurance system, and patients. Thus, in order to reduce the costs, the following suggestions can be offered: the use of advanced radiotherapy techniques, increasing the insurance coverage of required services, establishing low-cost accommodation centers near medical centers for the patients and their companions, providing specialized medical services for the patients in towns, using the Internet and virtual space to follow up the treatment of the patients, and carrying out free screening programs and tests for faster diagnosis of the infected patients and susceptible or exposed people.

Data-Driven Approach to Analyze Interdependencies between Electrode Manufacturing Parameters and Electrochemical Performance of the Lithium-Ion Battery Cell

The lithium-ion battery cell production is a complex process chain with a high number of process steps and manifold interdependencies. The majority of the properties determining the electrochemical performance of the battery cell are established during electrode manufacturing. An in-depth understanding of electrode manufacturing and its influence on cell performance can pave the way toward high-quality, cost-efficient cell production. Considering the complexity of the process chain and the high share of material costs in battery production, the classic one-factor-at-a-time experimentation is deemed inadequate and expensive.Machine learning (ML) approaches have been proven suitable for analyzing complex process chains. Design of experiment (DoE) methods can be used to generate a sufficient informative database for ML techniques. This study was based on the joint application of DoE and ML methods in electrode manufacturing. For this purpose, in the first step, the response surface methodology (RSM) was used to conduct experiments and analyze the effect of mass loading, drying temperature, and porosity on cell performance. The study was focused on graphite anodes produced at a pilot scale. The electrochemical performance of electrodes was assessed on coin cells at discharge C-rates from C/10 to 5C. Additionally, symmetric coin cells were used to analyze the electrochemical impedance spectra. Supervised machine learning models were adopted to predict the cell characteristics based on the electrode properties. Additionally, a factor analysis reflecting the contribution and importance of each factor on the final cell properties was conducted. The efficient experiment-based data generation using RSM combined with the applied ML techniques can support practitioners towards smart quality-oriented battery cell production.

P83. Patient preferences and willingness to cost share in spine surgery

P83. Patient preferences and willingness to cost share in spine surgery

Share of and Absolute Costs of Informal Care in Five Subpopulations of Outpatients with Dementia in Croatia: A Latent Profile Analysis.

High heterogeneity exists in estimates of the share of and absolute costs of informal care (IC) for individuals diagnosed with dementia. To assess the differences in the share of and absolute costs of IC between subpopulations defined by latent profiles of activities of daily living (ADLs), neuropsychiatric symptoms, and global cognitive functioning. We performed a nested cross-sectional analysis of data collected from 2019-2021 at the Zagreb-Zapad Health Center, Zagreb, Croatia, from a sample of patients and their caregivers. The outcome was the share of costs of IC in the total costs of care estimated using the Resource Utilization in Dementia questionnaire. We used latent profile analysis of six principal components of the Alzheimer's Disease Cooperative Study ADLs inventory, Neuropsychiatric Inventory and Mini-Mental State Examination, and conducted the analysis using beta and quantile regression. We enrolled 240 patients with a median age of 74 years; 78% were women. The annual cost for treatment and care for one patient was 11,462 (95% confidence interval 9,947; 12,976) EUR. After the adjustment for covariates, five latent profiles were significantly associated with the share of costs and absolute cost of IC. The adjusted annual costs of IC ranged from 2,157 EUR, with a share of 53% in the first latent profile, to 18,119 EUR, with a share of 78% in the fifth latent profile. The population of patients with dementia was heterogeneous, and there were relatively large differences in the share and absolute costs of IC between particular subpopulations.