Cost Of Medical Treatment Research Articles

Challenges in improving the quality of medical examination and treatment and the goal of universal health insurance

An abstract is a summary of entire paper should be written in Cambria with font size- 10. Author can select Normal According to the Health Sector Overview Report of the Ministry of Health, 3.9% of households (equivalent to 3.5 million people) face financial difficulties due to the cost of medical examination and treatment. The report also found that direct out-of-pocket household spending accounts for 50 percent of total health expenditures, while on average worldwide, this cost is only about 30 percent. In addition, due to the advancement of science and technology in the medical industry, methods are also born more and more, drugs and medical supplies are increasingly modern, prices tend to increase. Therefore, the increasing cost of medical examination and treatment is an inevitable trend. That will become a burden on the budget of each family, especially families with people with serious and chronic diseases that require long-term treatment. According to Vietnam Social Insurance data, by the end of December 2022, the coverage rate of Health Insurance reached over 92.06% (equivalent to nearly 91.1 million people). However, one thing worth. However, one thing worth note that easily exploited objects such as those participating in health insurance under labor contracts or groups paid by social insurance organizations and the State budget have almost absolute coverage. The remaining target groups have not high coverage and exploiting these groups is not easy because the health insurance participation fee is mainly paid by the beneficiaries. Therefore, achieving 100% coverage is not easy.

Medical service utilization by children with physical or brain disabilities in South Korea

BackgroundChildren with physical or brain disabilities experience several functional impairments and declining health complications that must be considered for adequate medical support. This study investigated the current medical service utilization of children expressing physical or brain disabilities in South Korea by analyzing medical visits, expenses, and comorbidities.MethodsWe used a database linked to the National Rehabilitation Center of South Korea to extract information on medical services utilized by children with physical or brain disabilities, the number of children with a disability, medical visits for each child, medical expenses per visit, total medical treatment cost, copayments by age group, condition severity, and disability type.ResultsBrain disorder comorbidities significantly differed between those with mild and severe disabilities. Visits per child, total medical treatment cost, and copayments were higher in children with severe physical disabilities; however, medical expenses per visit were lower than those with mild disabilities. These parameters were higher in children with severe brain disabilities than in mild cases. Total medical expenses incurred by newborns to three-year-old children with physical disorders were highest due to increased visits per child. However, medical expenses per visit were highest for children aged 13–18.ConclusionMedical service utilization varied by age, condition severity, and disability type. Severe cases and older children with potentially fatal comorbidities required additional economic support. Therefore, a healthcare delivery system for children with disabilities should be established to set affordable medical costs and provide comprehensive medical services based on disability type and severity.

Enabling Remote Elderly Care: Design and Implementation of a Smart Energy Data System with Activity Recognition.

Seniors face many challenges as they age, such as dementia, cognitive and memory disorders, vision and hearing impairment, among others. Although most of them would like to stay in their own homes, as they feel comfortable and safe, in some cases, older people are taken to special institutions, such as nursing homes. In order to provide serious and quality care to elderly people at home, continuous remote monitoring is perceived as a solution to keep them connected to healthcare service providers. The new trend in medical health services, in general, is to move from 'hospital-centric' services to 'home-centric' services with the aim of reducing the costs of medical treatments and improving the recovery experience of patients, among other benefits for both patients and medical centers. Smart energy data captured from electrical home appliance sensors open a new opportunity for remote healthcare monitoring, linking the patient's health-state/health-condition with routine behaviors and activities over time. It is known that deviation from the normal routine can indicate abnormal conditions such as sleep disturbance, confusion, or memory problems. This work proposes the development and deployment of a smart energy data with activity recognition (SEDAR) system that uses machine learning (ML) techniques to identify appliance usage and behavior patterns oriented to older people living alone. The proposed system opens the door to a range of applications that go beyond healthcare, such as energy management strategies, load balancing techniques, and appliance-specific optimizations. This solution impacts on the massive adoption of telehealth in third-world economies where access to smart meters is still limited.

Operative vs. conservative treatment of AC-Joint Dislocations Rockwood grade ≥ III -An economical and clinical evaluation-

IntroductionAcromioclavicular joint dislocations (ACD) are one of the most common shoulder injuries. There is no consensus in how to treat higher graded ACD ≥ Rockwood grade III. This study compares operative versus conservative treatment regarding costs and clinical outcome parameters.Materials and MethodsThis retrospective, consecutive case-control-study includes 14 patients. Seven operatively treated patients were matched, by Rockwood grade, with seven conservatively treated patients. The cost was extracted out of the clinical- and insurance-based cost sheets and furthermore these include the loss of earnings. Clinical examination, demographic data as well as different outcome-questionnaires were recorded.ResultsThere were no significant differences between operative and conservative treated patients for outcome Questionnaires. Of note, there was a significantly higher incidence of tenderness over the AC-joint (p = 0.0038) postoperatively. As expected, economical evaluation showed various findings in favor of the conservative treatment. The costs for medical services (11012.39vs.1163.81USD; p = 0.0061), days of hospitalization (3.3vs.0days; p < 0.0001); total cost for medical treatment (30262.17 vs. 7833.82 USD; p = 0.0358) were significantly higher in the operative group.ConclusionEven with a limited case number and a retrospective study design almost all clinical results were equal in both groups. Operative therapy of higher graded ACDs (Rockwood > III) compared to conservative is economically inefficient. Under consideration of clinical comparable results, indications for operative treatment should be set very carefully.

Overview of the Ayushman Bharat (PMJAY) in the Mathura Region

Plenty of people lives in the Uttar Pradesh state's Mathura region, where obtaining economical and high-quality healthcare services can be difficult. By giving access to healthcare facilities and health insurance, Ayushman Bharat seeks to alleviate these problems. For up to INR 5 lakh (about USD 6,700) per household per year in the Mathura region, eligible beneficiaries of Ayushman Bharat have access to cashless healthcare services. This insurance plan covers a variety of medical procedures, hospital stays, and treatment costs. In order to guarantee that they receive high-quality medical care, beneficiaries can seek treatment in hospitals that have been accredited, both public and private. The economically challenged groups of society in the Mathura region have benefited greatly from the implementation of Ayushman Bharat. It has boosted families' financial security by protecting them from the burden of high medical costs. The programme has lessened the financial burden on families and made sure they can obtain vital medical care without financial restrictions by offering cashless benefits. In the Mathura region, Ayushman Bharat has significantly improved the state of healthcare. The programme has improved access to high-quality healthcare services for the economically needy population by offering health insurance coverage, creating Wellness Centres, and guaranteeing mobility of benefits. In the Mathura region, it has reduced financial pressures and enhanced the general well-being of people and families.

Global incidence, risk factors and trends of vulvar cancer: A country-based analysis of cancer registries.

Vulvar cancer is an uncommon malignancy. Vulvar cancer alarmed the public health problem in terms of the cost of diagnostic and medical treatments and psychical health of females. Our study aims to provide a thorough analysis of the global disease burden, related risk factors and temporal incidence trends of vulvar cancer in population subgroups. Data from Global Cancer Observatory and the Cancer Incidence in Five Continents Plus were used for the vulvar cancer incidence. Age-standardized rates (ASR) were used to depict the incidence of vulvar cancer. The 10-year trend of incidence was assessed using joinpoint regression with average annual percentage change and 95% confidence intervals in various age groups, while its correlations with risk factors were investigated using linear regression. Higher ASR were found in Western Europe (2.4), Northern America (1.9), Northern Europe (1.9), Australia and New Zealand (1.8) and Eastern Africa (1.4). The associated risk factors of higher vulvar cancer incidence were gross domestic product per capita, Human Development Index, higher prevalence of smoking, alcohol drinking, unsafe sex and human immunodeficiency virus infection. The overall trend of vulvar cancer incidence was increasing. An increasing trend was found in older females while a mixed trend was observed in younger females. The disease burden of vulvar cancer follows a bimodal pattern according to its two histologic pathways, affecting women in both developed and developing regions. Smoking cessation, sex education and human papillomavirus vaccination programs should be promoted among the general population. Subsequent studies can be done to explore the reasons behind the increasing trend of vulvar cancer.

Application Of Activity-Based Costing Method in The Eestimate of Cataract Surgery Cost

Objective: Hospital managers need to have accurate information about actual costs to make efficient and effective decisions. Activity-based costing (ABC) is put forward as an alternative, more accurate costing method to calculate the cost of medical treatment. The objective of this paper is the application of an activity-based method to estimate the cost of cataract surgery in an ophthalmic hospital. Methods: The present descriptive-analytical study was carried out at an ophthalmic hospital, in February and March of 2021, in Iran. Surgical operations for cataracts were considered. The required data were collected through conducting interviews with experts and relevant units, direct observation of activities, analysis of documents in the financial department, and the hospital information system (HIS) and financial software system of the hospital. The cost of surgical operations was estimated by activity-based costing (ABC). Results: According to the findings, the amount and the share of the total costs of the activities identified in the main centers were as follows: human resources 54.24% of the total cost of cataract surgery which is the highest share of surgery costs; the cost of consumables was 32.57% of the total cost of cataract surgery is the second share of surgery costs. Conclusions: The research results showed that in this regard administrators should design and implement a comprehensive operational planning system in the hospital.

APAP Treatment Acceptance Rate and Cost-Effectiveness of Telemedicine in Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial.

This study evaluated the treatment acceptance rate and cost-effectiveness of the telemedicine model in clinical practice for adult patients with obstructive sleep apnea (OSA). Patients admitted to the sleep center for snoring were randomly divided into telemedicine and control groups. Patients diagnosed with moderate-to-severe OSA using the Home Sleep Apnea Test (HSAT) were voluntarily treated with auto-adjusted positive airway pressure (APAP) therapy. The acceptance rate of the APAP treatment, cost of patient visits, time cost, and labor cost of doctors in the two groups were observed. A total of 57 subjects were included, with an average age of 40.12±11.73 years, including 47 males (82.5%); 26 patients were in the telemedicine group, and 31 were in the control group. Follow-up results showed that the acceptance rate of APAP treatment was 57.7% and 54.8% in the telemedicine and control groups, respectively, with no significant difference between the two groups (p=0.829). The cost-benefit analysis showed that the telemedicine group reduced the cost of patients' medical treatment [-457.84(-551.19,1466.87)] but increased the extra intervention frequency and time outside the doctor's office. Further analysis showed that male subjects of older age, higher education level, distant residence, no fatty liver, poor sleep quality, severe insomnia, and higher OSA severity were more likely to receive telemedicine diagnosis and treatment. The APAP treatment acceptance rate and compliance of OSA patients in the telemedicine group were similar to those in the control group, and the cost of patients' medical treatment was reduced. However, telemedicine increases the frequency and duration of additional out-of-hospital interventions.

What matters most? A qualitative study exploring priorities for supportive interventions for people with tuberculosis in urban Viet Nam

IntroductionThe health and economic burden of tuberculosis (TB) in urban Viet Nam is high. Social protection and support interventions can improve treatment outcomes and reduce costs. However, evidence regarding optimal...

Psychiatric comorbidity in emergency general surgery patients: a prospective observational study

ObjectivesAnnually, approximately 27 million individuals in the United States are admitted to hospitals for emergency general surgery (EGS). Approximately 50% develop postoperative complications and 22% require unplanned readmission within 90...

Standard diagnostics with and without urine-based lipoarabinomannan testing for tuberculosis disease in HIV-infected patients in a high-burden setting-A cost-effectiveness analysis.

Recent clinical findings reported the reduced mortality associated with treatment guided by sputum-based molecular test with urine-based lipoarabinomannan (LAM) assay for tuberculosis (TB) disease in HIV-infected individuals. We aimed to evaluate the cost-effectiveness of sputum-based Xpert tests with and without urine-based LAM assays among HIV-infected individuals with signs and symptoms of TB disease (TBD) from the perspective of South African healthcare providers. A one-year decision-analytic model was constructed to simulate TB-related outcomes of 7 strategies: Sputum smear microscope (SSM), Xpert, Xpert Ultra, Xpert with AlereLAM, Xpert Ultra with AlereLAM, Xpert with FujiLAM, and Xpert Ultra with FujiLAM, in a hypothetical cohort of adult HIV-infected individuals with signs and symptoms of TB. The model outcomes were TB-related direct medical cost, mortality, early treatment, disability-adjusted life-years (DALYs) and incremental cost per DALY averted (ICER). The model inputs were retrieved from literature and public data. Base-case analysis and sensitivity analysis were conducted. In the base-case analysis, the Xpert Ultra with FujiLAM strategy showed the highest incidence of early treatment (267.7 per 1000 tested) and lowest mortality (29.0 per 1000 tested), with ICER = 676.9 USD/DALY averted. Probabilistic sensitivity analysis of 10,000 Monte Carlo simulations showed the cost-effective probability of Xpert Ultra with FujiLAM was the highest of all 7 strategies at the willingness-to-pay (WTP) threshold >202USD/DALY averted. Standard sputum-based TB diagnostic Xpert Ultra with urine-based FujiLAM for TBD testing in HIV-infected individuals appears to be the preferred cost-effective strategy from the perspective of the health service provider of South Africa.

A Review on Skin Disease Classification and Detection Using Deep Learning Techniques

Skin cancer ranks among the most dangerous cancers. Skin cancers are commonly referred to as Melanoma. Melanoma is brought on by genetic faults or mutations on the skin, which are caused by Unrepaired Deoxyribonucleic Acid (DNA) in skin cells. It is essential to detect skin cancer in its infancy phase since it is more curable in its initial phases. Skin cancer typically progresses to other regions of the body. Owing to the disease's increased frequency, high mortality rate, and prohibitively high cost of medical treatments, early diagnosis of skin cancer signs is crucial. Due to the fact that how hazardous these disorders are, scholars have developed a number of early-detection techniques for melanoma. Lesion characteristics such as symmetry, colour, size, shape, and others are often utilised to detect skin cancer and distinguish benign skin cancer from melanoma. An in-depth investigation of deep learning techniques for melanoma's early detection is provided in this study. This study discusses the traditional feature extraction-based machine learning approaches for the segmentation and classification of skin lesions. Comparison-oriented research has been conducted to demonstrate the significance of various deep learning-based segmentation and classification approaches.

Evaluation of Antibacterial Activity of Sunflower Seed Extract on Listeria monocytogenes and Shigella sonnei Associated with Food-Borne- Infections

Introduction: The emerging upsurge in the rate of resistance of bacteria to conventional antibiotics and the high cost of orthodox medical treatment underpinned the need for medicinal plant as potential alternative therapy. This study aimed at evaluating the antibacterial activity of sunflower seed extract in the treatment of diarrhea. Ethanol and aqueous seed crude extract were screened for antibacterial activity in-vitro against Listeria monocytogenes and Shigella sonnei. Prior to the screening, plant phytochemical screening was conducted using standard methods. The antibacterial activity was carried out using agar well diffusion method and compared to the standard antibiotic ciprofloxacin. The minimum bactericidal concentration was determined by plating out from microtiter plates with no visible growth. The results of phytochemical screening reveal the presence of alkaloids, flavonoids, saponins, cardiac glycoside, anthraquinones and resins from prepared crude extract of sunflower. The ethanolic extract had antibacterial activity against the tests organisms with diameter zone of inhibition range from 31mm at 15.63mg/ml. This provides evidence for its usage as an alternative remedy for the treatment of diarrhea caused by Listeria monocytogenes and Shigella sonnei.

Trend of fetal echocardiography use and comparison of medical costs for congenital heart disease treatment based on fetal echocardiography use in a Korean single center.

The rate of the prenatal diagnosis of congenital heart disease is increasing along with advances in fetal echocardiography techniques. Here, we aimed to investigate the trend of the use of fetal echocardiography over time and to compare the medical costs of congenital heart disease treatment according to whether fetal echocardiography was performed. We reviewed our hospital's database, and patients who underwent the first surgery for congenital heart disease within 30 days of birth during 2005-2007, 2011-2013, and 2017-2019 were included. The severity of congenital heart disease diagnosed in each case was evaluated according to The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Mortality Scores (STS-EACTS Mortality Scores) and Mortality Categories (STAT Mortality Categories). In total, 375 patients were analyzed, and fetal echocardiography use increased significantly after the 2010s compared with in 2005-2007 (19.1% vs. 39%, p = 0.032 in Mortality Category 1-3; 15.5% vs. 69.5%, p = 0.000 in Mortality Category 4-5). Additionally, the mean STS-EACTS Mortality Score was higher in prenatally diagnosed patients than in postnatally diagnosed patients (2.287 vs. 1.787, p = 0.001). In the recent period, there was no significant difference in hospitalization durations and medical costs according to whether or not fetal echocardiography was performed. This single center study showed the use of fetal echocardiography is increasing. Further, prenatal diagnosis with fetal echocardiography causing no differences in medical costs in recent years. Therefore, we suggest that fetal echocardiography can be applied more widely without increasing the economic burden.

A Review of Skin Cancer Detection: Traditional and Deep Learning-Based Techniques

One of the most serious types of cancer is skin cancer. The rising number of skin cancer cases, high mortality rate, and high cost of medical treatment necessitate early detection of its symptoms. Skin cancer is detected and differentiated from melanoma using lesion criteria such as symmetry, color, size, and shape.&#x0D; Given the significance of these challenges, researchers have developed a variety of early-detection approaches for skin cancer.&#x0D; This paper comprehensively reviews classical and deep-learning techniques for detecting early skin cancer. The performance of these techniques is evaluated based on various metrics, and the datasets used for training and testing are analyzed. Studies using techniques such as clinical examination, dermoscopy, and histopathology are identified, and the architecture of the deep neural networks used for skin cancer detection is analyzed. A comprehensive comparison of classical and deep-learning techniques for skin cancer detection is provided in this review paper.

Topic Modeling Analysis of Diabetes-Related Health Information during the Coronavirus Disease Pandemic.

This study aimed to provide diabetes-related health information by analyzing queries posted in the diabetes-related online community required during the COVID-19 pandemic. A total of 9156 queries from the diabetes-related online community, dated between 1 December 2019 and 3 May 2022, were used in the study. The collected data were preprocessed for bidirectional encoder representation from transformer topic modeling analysis. Topics were extracted using the class-based term frequency-inverse document frequency for nouns and verbs. From the extracted verbs, words with common definitions were subject to substitution and unification processes, which enabled the identification of multifrequent verb categories by noun topics. The following nine noun topics were extracted, in this order: dietary management, drug management, gestational and childhood diabetes, management of diabetic complications, use and cost of medical treatment, blood glucose management, exercise treatment, COVID-19 vaccine and complications, and diabetes in older adults. The top three verb categories by noun topics were permission, method, and possibility. This study provided baseline data that can be used by clinical nurses to deliver diabetes-related education and management based on information sought by patients.

Medical care costs at the end of life among older adults with cancer: a national health insurance data-based cohort study

ObjectiveAlong with aging, the elderly population with cancers is increasing. The costs of end-of-life (EOL) care are particularly high among cancer patients. The purpose of this study was to investigate the trends in medical costs in the last year of life among older adults with cancer.Design, setting, and participantsUsing the Health Insurance Review and Assessment Services (HIRA) database for the period 2016–2019, we identified older adults aged ≥ 65 years who had a primary diagnosis of cancers and high-intensity treatment at least once in the intensive care unit (ICU) of tertiary hospitals.Main outcomes and measuresHigh-intensity treatment was defined as receiving at least one of the following treatments: cardiopulmonary resuscitation, mechanical ventilation, extracorporeal membrane oxygenation, hemodialysis, and transfusion. The EOL medical treatment costs were calculated by dividing periods 1, 2, 3, 6, and 12 months from the time of death, respectively.ResultsThe mean total EOL medical expense per older adult during the year before death was $33,712. The cost of EOL medical expenses for three months and one month before subjects’ death accounted for 62.6% ($21,117) and 33.8% ($11,389) of total EOL costs, respectively. Among subjects who died while receiving high-intensity treatment in the ICU, the costs associated with medical treatments that occurred during the last month before death were 42.4% ($13,841) of the total EOL expenses during the year.ConclusionThe findings indicate that EOL care expenditures for the older population with cancer are highly concentrated until the last month. The intensity of medical care is an important and challenging issue in terms of care quality and cost suitability. Efforts are needed to properly use medical resources and provide optimal EOL care for older adults with cancer.

Policy on Work Accident, Occupational Disease Insurance in Vietnam

During the process of production activities, there are factors or incidents that affect the health of workers, such as hazardous working environments, prolonged fixed working postures, accidents caused by machinery, etc., resulting in a decrease or even permanent loss of work ability. Accidents occurring during labor or illnesses arising from work conditions incur costs for medical treatment, functional recovery, purchase of assistive devices for daily living, costs of caregivers in case of disability or severe illness, reduction or loss of income due to the inability to perform previous works, or the need to find a new job suitable for the health condition. Economic and social development has impacted the occupational risks of workers and changed the protection needs of workers against these risks. Therefore, countries, including Vietnam, have promulgated policies for workers involved in work related accidents and occupational diseases, with the cornerstone being the social insurance regime for work related accidents and occupational diseases. This writing analyzes the achieved results and limitations of the policy for workers involved in work related accidents and occupational diseases in Vietnam, and proposes solutions to improve this policy.

Analysis of the direct economic burden of measles cases and its influencing factors in Shanghai from 2017 to 2019

Objective: To analyze the direct economic burden caused by measles cases in Shanghai from 2017 to 2019 and its influencing factors. Methods: A total of 161 laboratory-confirmed measles cases reported from January 1, 2017, to December 31, 2019, in Shanghai were included in the study through the "Measles Surveillance Information Reporting and Management System" of the "China Disease Surveillance Information Reporting and Management System". Through telephone follow-up and consulting hospital data, the basic information of population, medical treatment situation, medical treatment costs and other information were collected, and the direct economic burden of cases was calculated, including registration fees, examination fees, hospitalization fees, medical fees and other disease treatment expenses, as well as transportation and other expenses of cases. The multiple linear regression model was used to analyze the main influencing factors of the direct economic burden. Results: The age of 161 measles cases M (Q1, Q3) was 28.21 (13.33, 37.00) years. Male cases (56.52%) were more than female cases (43.48%). The largest number of cases was≥18 years old (70.81%). The total direct economic burden of 161 measles cases was 540 851.14 yuan, and the per capita direct economic burden was 3 359.32 yuan. The direct economic burden M (Q1, Q3) was 873.00 (245.01, 4 014.79) yuan per person. The results of multiple linear regression model analysis showed that compared with other and unknown occupations, central areas and non-hospitalized cases, the direct economic burden of measles cases was higher in scattered children, childcare children, students, and cadre staff in the occupational distribution, suburban areas and hospitalized, with the coefficient of β (95%CI) values of 0.388 (0.150-0.627), 0.297 (0.025-0.569), 0.327 (0.148-0.506) and 1.031 (0.853-1.209), respectively (all P values<0.05). Conclusion: The direct economic burden of some measles cases in Shanghai is relatively high. Occupation, area of residence and hospitalization are the main factors influencing the direct economic burden of measles cases.

Cost-effectiveness analysis of COVID-19 treatment for hospitalized patients: a healthcare provider perspective in Batam, Indonesia

The COVID-19 pandemic is a global crisis that has continued to impact health, population, and the economy. Therefore, this study aims to evaluate the cost-effectiveness of COVID-19 treatment for hospitalized patients from the perspective of healthcare providers. An observational study was conducted retrospectively by collecting data from medical records of hospitalized COVID-19 patients between April 1 and June 30, 2021. The effectiveness of the therapy was evaluated based on COVID-19 treatment guidelines in Indonesia, by calculating the number of recovered patients within 14 days. The study only considered the direct medical costs of treatment, while the cost-effectiveness was analyzed using Average Cost-Effectiveness Ratio (ACER) and Incremental Cost-Effectiveness Ratio (ICER). The results showed that the average direct cost of COVID-19 treatment per patient was approximately IDR 28,114,775.52 ± IDR 16,352,597.11. The most effective treatment was Favipiravir + Levofloxacin + N-acetylcysteine, followed by Favipiravir + Levofloxacin + Azithromycin + N-acetylcysteine, with 97% and 91% effectiveness, respectively. The ACER of COVID-19 treatments ranged from Rp 15,596,973 to 58,140,864, while the ICER was mainly located in the South East Quadrant, with Favipiravir + Levofloxacin + N-acetylcysteine being dominant compared to other treatments, saving IDR 161,653.97 to 33,870,916.17 per recovered patient. Effective COVID-19 treatments for hospitalized patients provide good value for the health system. However, this study was limited by the unavailability of the most recent information on the rapidly evolving pandemic.