Economic Burden Research Articles

Economic Burden of Treatment-Resistant Depression: Insights from Real-World Data

Background: Treatment-resistant depression (TRD) is a highly prevalent condition. It is generally referred to as the failure of at least two or more prior treatments with antidepressants or augmentation therapy with adequate dose and duration. TRD affects the individual's overall health and social life, in addition to the economic impact associated with the illness. Therefore, this review is focused on examining the financial burden of illness among patients with TRD across different countries and identifying the key drivers for the incremental costs and healthcare resource utilization (HRU). Methods: A literature search was carried out in the PubMed database using relevant MeSH terms. This review included relevant studies published between 2019 & 2024. Results: Overall, 22 studies were included in this review, with the majority based in the United States (n=15). The majority of the patients were females, ranging from 53.1% to 77%, and the mean age of patients with TRD ranged from 37.7±14.4 to 73.1±6.5 years. The mean annual all-cause healthcare cost per patient ranged from $3,190 to $40,040. The mean annual all-cause indirect costs per patient ranged from $4,199 to $6,342. Outpatient visits were the frequently utilized healthcare services, especially psychiatric visits and visits to general practitioners or family physicians. The incremental costs were primarily driven by worsening symptom severity, the presence of comorbidities, advancing age, and frequent visits to specialists. Conclusion: Regardless of the factors influencing the cost burden, TRD generally accounts for higher healthcare use and costs compared to individuals with major depressive disorder or without any mental illness. This underscores the need for fostering newer interventions and implementation of multidisciplinary approaches to lessen the cost burden of this condition, in addition to managing it effectively.

Lumpy Skin Disease: A review of epidemiological study and preventive measures

Background: Lumpy skin disease (LSD) is a highly infectious and economically important transboundary disease that is rapidly spreading to the globe. The disease causes high morbidity and a low mortality rate of infection. The animals show acute or chronic illnesses depending on the immune responses of the hosts. The economic burden of LSD manifested the poor-quality hides, a drop in milk and meat production, abortion, and death. Methods: This systematic literature review was accomplished according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature on lumpy skin disease has been explored over the last two decades and searched keywords on online databases such as Google Scholar, PubMed, and Scopus. Both automated and manual searching tools were used to screen the articles. The literature published other than English was rejected during the screening process. Conference papers were excluded during the screening. Results: LSD is transmitted by blood-sucking arthropods and is most prevalent in summer and rainy seasons. Exotic-bred cattle and calves are highly susceptible. Although the disease has low mortality, the high mortality of the disease prevails in endemic regions in complicated cases. Calves from unvaccinated cows should be vaccinated at any age, on the other hand, the calves from vaccinated cows should be immunized at 3 months of age. Animals should be vaccinated before the risk period. Strict biosecurity, quarantine, and immunoprophylaxis can reduce the prevalence of the disease. Conclusions: Lumpy skin disease (LSD) is an acute infectious and contagious disease affecting cattle and water buffaloes. The disease causes serious economic loss due to decreased production, skin problems, and mortality in complicated cases. Further details on genetic characterization, transmission dynamics, and host-pathogen interaction should be performed to prevent the prevalence of the disease in emerging or re-emerging countries.

The Annual Economic Burden of Uterine Fibroids in the United States (2010 Versus 2022): A Comparative Cost-Analysis.

In 2010, the estimated annual cost of uterine fibroids in the United States ranged from 5.9 to 34.4billion USD. In the past decade, more uterine-sparing and fertility preserving interventions have become available to treat symptomatic fibroids. This comparative cost-analysis aims to evaluate change in societal costs of uterine fibroids in the US between 2010 and 2022 given changing fibroid and obstetric management, population growth, and inflation. A systematic review was conducted to update uterine fibroid, treatment, and obstetric complication prevalence, direct costs of medical and surgical interventions, indirect productivity costs, and obstetric costs attributable to fibroids in 2022. A comparative cost-analysis with paired t-tests was performed using baseline data published in 2010. Percent (%) changes between 2010 and 2022 were reported. NIH research funding for fibroids and other common diseases was compared. All costs were converted to 2023 USD. The number of US women with uterine fibroids increased by 10.6% from 2010 to 2022. Over this period, the economic burden of uterine fibroids increased up to 41.4billion USD compared to 34.4billion USD in 2010. Overall costs increased to 42.2billion USD after incorporating new costs associated with MRgFUS and infertility. Direct costs of medical management decreased while costs of surgical interventions increased as a result of evolving treatment-seeking behavior. Lost work costs continue to account for the largest proportion of the economic burden for fibroids. Cesarean section delivery remains the largest contributor (average 80.0%) to indirect obstetrical costs. Despite the rise in the number of individuals affected by uterine fibroids and its sizable annual cost to society, uterine fibroids research continues to be underfunded.

Efficacy of hypertonic dextrose (prolotherapy) in early knee osteoarthritis: a short term outcome

Background: Knee osteoarthritis (OA) is a prevalent, painful, and progressive condition significantly affecting patients' quality of life and imposing a social and economic burden. Traditionally managed through symptom relief and joint function improvement, research is increasingly focusing on disease-modifying treatments. Dextrose prolotherapy, a low-cost alternative involving the injection of a hypertonic solution, has shown promise despite limited acceptance in current guidelines. Methods: This prospective cohort study, approved by the Institutional Ethical Board of Jamia Hamdard University, assessed the effects of 12.5% hypertonic dextrose prolotherapy in 92 patients with knee OA. Patients received injections at multiple sites over a 6-week period. Outcomes were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores at baseline, 4, 8, 16, and 24 weeks. Results: Significant improvements were observed in both WOMAC and VAS scores. WOMAC scores decreased from 53.83 to 26.70 (p<0.0001), and VAS scores dropped from 7.12 to 3.06 (p<0.0001) at the 24-week follow-up. No major complications were noted, with minimal adverse effects reported. Improvement was consistent across all OA grades. Conclusions: Dextrose prolotherapy demonstrated substantial, sustained improvements in pain and function in knee OA patients. Given its safety, low cost, and efficacy, it represents a viable therapeutic option, especially in resource-constrained settings. Further high-quality randomized controlled trials are needed to confirm these findings and optimize treatment protocols.

A Narrative Review of the Clinical, Humanistic, and Economic Value of Pembrolizumab-Based Immunotherapy for the Treatment of Breast and Gynecologic Cancers.

Breast and gynecologic cancers are common across the world and are associated with substantial societal and economic burden. Pembrolizumab was among the first immune checkpoint inhibitors targeting programmed cell death protein1 to be approved for the treatment of patients with triple-negative breast cancer, cervical cancer, and endometrial cancer. Recent clinical trials have established pembrolizumab regimens as a standard of care treatment for these tumor types. Clinical data are further supported by patient-reported outcome, cost-effectiveness, and real-world evidence. Pembrolizumab monotherapy and combination regimens do not negatively influence health-related quality of life and are cost-effective relative to comparators. Ongoing phase3 studies with pembrolizumab will expand the current understanding of its use in breast and gynecologic cancers. Several of these studies are in patients with early-stage disease with the hope of curing patients. The main objective of this review is to summarize the clinical, humanistic, and economic value of pembrolizumab in these settings and to describe the future challenges for patients, caregivers, clinicians, and payers.

Impact of ayurvedic panchakarma therapy on osteoarthritis

Osteoarthritis is the leading cause of chronic pain and disability in adults, imparting a substantial economic burden on both society and individuals. This case series explored the impact of Ayurvedic Panchakarma therapy on knee osteoarthritis. Data from procedures conducted between March 2022 and January 2024 at a clinic in Maharashtra, India was collected. Patients of either gender who were clinically diagnosed with osteoarthritis grade 2 and underwent Knee Rejuvenation Therapy were included in this analysis. Follow-up was conducted after 1 month and at 90 days. Baseline data was compared with follow-up data. A total of 16 patients with mean age of 57.63 ± 10.20 years were included in the study. The Knee Injury and Osteoarthritis Outcome Score (KOOS) score (day 1: 20.31±11.18, after 1 month: 49.94±10.85, day 90: 71.31±5.89, p=0.00), pain (day 1: 25.44±14.03, after 1 month: 57.81±10.66, day 90: 80.63±5.78, p=0.00), symptoms (day 1: 30.69±14.59, after 1 month: 55.75±12.94, day 90: 83.00±6.04, p=0.00), sports (day 1: 2.81±6.84, after 1 month: 25.31±15.05, day 90: 39.69±15.76, p=0.00), function (day 1: 31.25±16.69, after 1 month: 58.94±12.34, day 90: 78.81±7.98, p=0.00), and quality of life (day 1: 14.13±14.83, after 1 month: 52.00±10.78, after 1 month: 73.50±4.50, p=0.00) increased from baseline to the 90-day follow-up. Ayurvedic treatment is effective in improving the KOOS score and reducing the severity of arthritis in diagnosed osteoarthritis patients.

Microscopic Varicocelectomy under Local Anesthesia as the Treatment of Varicocele.

Varicocele, characterized by the dilation of veins within the spermatic cord, is a prevalent disease in males, accounting for 35%-40% of infertility cases among men of reproductive age. This condition may disrupt normal neuroregulation, blood supply, and temperature regulation in the testicles, thereby impacting sperm count, quality (morphology, fragmentation rate), and functionality (motility). It may even induce symptoms such as pain and testicular atrophy. The international standard treatment method is microscopic varicocelectomy, typically performed under general anesthesia. This requires patients to fast before surgery and necessitates recovery and fasting care postoperatively. The arterial blood pressure drop caused by anesthesia may obscure the fluctuation of the spermatic artery, making the precise intraoperative isolation and protection of the spermatic artery more challenging. Therefore, this study proposes and implements microscopic varicocelectomy under local anesthesia. This method facilitates rapid and precise identification of the fluctuating spermatic artery, reducing the risk of spermatic artery damage. It also provides more humane care for patients, reduces economic burden, and offers a new perspective on the treatment of varicocele.

Evaluating the Economic Impact of the PedAMINES App in Reducing Medication Errors in Pediatric Emergency Care: Cost-Effectiveness Analysis.

The administration of drugs in pediatric emergency care is a time-consuming process and is associated with a higher occurrence of medication errors compared with adult care. This is attributed to the intricacies of administration, which involve calculating doses based on the child's weight or age. To mitigate the occurrence of adverse drug events (ADEs), the PedAMINES (Pediatric Accurate Medication in Emergency Situations; Geneva University Hospitals) mobile app has been developed. This app offers a step-by-step guide for preparing and administering pediatric drugs during emergency interventions by automating the dose calculation process. Although previous simulation-based randomized controlled trials conducted in emergency care have demonstrated the efficacy of the PedAMINES app in reducing drug administration errors, there is a lack of evidence regarding its economic implications. This study aims to evaluate the cost-effectiveness of implementing the PedAMINES app for 4 emergency drugs: epinephrine, norepinephrine, dopamine, and midazolam. The economic evaluation was conducted by combining hospital data from 2019, previous trial outcomes, information extracted from existing literature, and PedAMINES maintenance costs. The cost per avoided medication error was calculated, along with the number of administrations needed to achieve a positive return on investment. Subsequently, Monte Carlo simulations were used to identify the key parameters contributing to result uncertainty. The study revealed the number of preventable errors per administration for the 4 examined drugs: 0.513 for epinephrine, 0.484 for norepinephrine, 0.500 for dopamine, and 0.671 for midazolam. The cost-effectiveness ratios per ADE prevented were computed as follows: US $4808 for epinephrine, US $9705 for norepinephrine, US $6957 for dopamine, and US $2074 for midazolam. Accounting for the economic impact of ADEs, the analysis estimated that 16 administrations of epinephrine, 17 of norepinephrine and dopamine, and 13 of midazolam would be required to attain a positive return on investment. This corresponds to roughly one-third of the annual administrations at a major university hospital in Switzerland. The primary factors influencing the uncertainty in the estimated cost per ADE include the cost of maintenance of the app, the likelihood of an ADE resulting from an administration error, and the frequency of underdosing in the trial's control group. A dedicated mobile app presents an economically viable solution to alleviate the health and economic burden of drug administration errors in in-hospital pediatric emergency care. The widespread adoption of this app is advocated to pool costs and extend the benefits on a national scale in Switzerland.

Economic burden of sarcopenia-related disability in the elderly population: a study in Iran

ObjectiveSarcopenia is linked to escalating health costs, heightened risk of physical disability, diminished quality of life and an increased demand for care services. This study aimed to assess the economic impact of sarcopenia-related disability in Iran. A prevalence-based economic burden study was conducted utilizing the Population Attributable Risk (PAR) method, based on 2022 price index. Prevalence data for sarcopenia, categorized by gender and disease severity, were extracted from recent comprehensive studies. The relative risk of sarcopenia disability was determined from the most robust available evidence. Subsequently, direct medical costs, direct non-medical costs, and indirect costs for each individual with sarcopenia were computed and adjusted to 2022 values to estimate disability costs.ResultsTaking into account the prevalence of sarcopenia and the Iranian population across various age groups, 2,192,168 adults aged ≥ 60 years with sarcopenia in Iran were included. The total PAR of sarcopenia for men and women was estimated at 49% and 28%, respectively. The cumulative direct medical costs, direct non-medical costs, and indirect costs amounted to $215.1 million, $7.76 million, and $34.1 million, respectively. Additionally, the average total economic burden of sarcopenia-related disability in Iranian population aged ≥ 60 years was estimated at $257.1 million.

Bibliometric Analysis of Traditional Chinese Medicine in the Treatment of Asthma from 2005 to 2024

Asthma is a complex chronic respiratory disease that affects most people worldwide and imposes a heavy economic and health burden. Traditional Chinese medicine (TCM) is one of the common treatments for asthma; however, there is a lack of bibliometric analysis data on the relationship between bronchial asthma and traditional Chinese medicine. This study analyzes and visualizes current research status and future trends. Relevant English publications on traditional Chinese medicine treatment for bronchial asthma were collected from the Web of Science core collection, and bibliometric analysis was conducted using software like Histcite. A total of 406 articles meeting the criteria were included after manual screening. China (including Taiwan) emerged as the leading contributor, with the Beijing University of Chinese Medicine being the institution with the highest number of publications. 'Journal of Ethnopharmacology' was a significant publication in this domain. The most frequently occurring keyword on the main display platform was 'airway inflammation.' Future research hotspots are expected to focus on intestinal flora and metabolism. This research offers a fresh perspective for understanding developments in this field.

Transforming public health and economic outcomes by reducing risky behaviors: the potential for South Korea

South Korea faces a diminishing workforce driven by the world's lowest fertility rate, restrictive immigration, and low female labor participation. This paper explores reducing non-communicable diseases from risky behaviors as a solution. We investigate how many cases could be prevented if South Koreans changed risky consumption patterns, and the associated economic healthcare burden impact. Utilizing the Preventable Risk Integrated Model (PRIME), we model hypothetical 2022 reductions in tobacco, alcohol, and unhealthy diet risks to estimate disease case and economic cost impacts. We contrast actual 2022 consumption against a moderate harm reduction scenario. Findings reveal potentially preventing approximately 73,400 new non-communicable disease cases, 69% among working-age Koreans, benefiting the workforce. This reduction could save $13 billion from avoided treatment costs, absenteeism, and premature deaths, including $3.7 billion in 2022 and $9.3 billion in future economic losses. The study emphasizes needing a harm reduction regulatory approach balancing public health and societal realities. We advocate risk-proportionate taxation policies incentivizing consumers toward less harmful alternatives. Given government responsibilities preserving both public health and productivity, smart regulation of risky consumption is critical. This timely research quantifies the significant potential gains from strategic interventions on key risk factors, informing policymakers navigating health promotion and economic objectives.

Research Progress of Pulsed Radiofrequency in the Treatment of Shoulder Pain

The shoulder is one of the most complex anatomical structures in the body, consisting of bones, muscles, tendons, bursae, joint capsules, nerves, and blood vessels. Shoulder pain is one of the most common musculoskeletal syndromes clinically, according to statistics, the prevalence of shoulder pain in the adult population is 11% to 27%, lifetime prevalence as high as 67%. There are also significant differences in the prevalence of shoulder pain across age and gender. Typically, shoulder pain stems from trauma, degeneration, inflammation, vascular disease, and referred pain from other parts of the head, neck, and hands. Studies have shown that in addition to personal risk factors such as age, arthritis, obesity, diabetes, and thyroid disease, external factors such as living and working environments can lead to varying degrees of pain, limited mobility, and dysfunction in the shoulder, It imposes a huge economic burden on social development and healthcare services.

Non-invasive prediction of human embryonic ploidy using artificial intelligence: a systematic review and meta-analysis

Embryonic ploidy is critical for the success of embryo transfer. Currently, preimplantation genetic testing for aneuploidy (PGT-A) is the gold standard for detecting ploidy abnormalities. However, PGT-A has several inherent limitations, including invasive biopsy, high economic burden, and ethical constraints. This paper provides the first comprehensive systematic review and meta-analysis of the performance of artificial intelligence (AI) algorithms using embryonic images for non-invasive prediction of embryonic ploidy. Comprehensive searches of studies that developed or utilized AI algorithms to predict embryonic ploidy from embryonic imaging, published up until August 10, 2024, across PubMed, MEDLINE, Embase, IEEE, SCOPUS, Web of Science, and the Cochrane Central Register of Controlled Trials were performed. Studies with prospective or retrospective designs were included without language restrictions. The summary receiver operating characteristic curve, along with pooled sensitivity and specificity, was estimated using a bivariate random-effects model. The risk of bias and study quality were evaluated using the QUADAS-AI tool. Heterogeneity was quantified using the inconsistency index (I 2 ), derived from Cochran's Q test. Predefined subgroup analyses and bivariate meta-regression were conducted to explore potential sources of heterogeneity. This study was registered with PROSPERO (CRD42024500409). Twenty eligible studies were identified, with twelve studies included in the meta-analysis. The pooled sensitivity, specificity, and area under the curve of AI for predicting embryonic euploidy were 0.71 (95% CI: 0.59-0.81), 0.75 (95% CI: 0.69-0.80), and 0.80 (95% CI: 0.76-0.83), respectively, based on a total of 6879 embryos (3110 euploid and 3769 aneuploid). Meta-regression and subgroup analyses identified the type of AI-driven decision support system, external validation, risk of bias, and year of publication as the primary contributors to the observed heterogeneity. There was no evidence of publication bias. Our findings indicate that AI algorithms exhibit promising performance in predicting embryonic euploidy based on embryonic imaging. Although the current AI models developed cannot entirely replace invasive methods for determining embryo ploidy, AI demonstrates promise as an auxiliary decision-making tool for embryo selection, particularly for individuals who are unable to undergo PGT-A. To enhance the quality of future research, it is essential to overcome the specific challenges and limitations associated with AI studies in reproductive medicine. This work was supported by the National Key R&D Program of China (2022YFC2702905), the Shengjing Freelance Researcher Plan of Shengjing Hospital and the 345 talent project of Shengjing Hospital.

Cardiodiabesity: Epidemiology, resource and economic impact

ObjectiveTo assess i) the epidemiology of cardiodiabesity, ii) its association with healthcare resource utilization and cost of care, as well as iii) provide recommendations for its management. MethodsA cohort study of insured adults with early-stage and/or active cardiodiabesity from January 2019 to December 2021 identified through a longitudinal, and de-identified medical and pharmacy claims database was conducted. All patients were followed for one year through December 2022. Conditions include cardiovascular disease, prediabetes, Type 2 diabetes (T2D), chronic kidney disease (CKD), overweight and/or obesity. Rates of progression from early-stage cardiodiabesity to active cardiodiabesity and/or advanced cardiodiabesity with complications; frequency of emergency department, inpatient and outpatient visits; as well as total cost of care over one year were analyzed. ResultsA total of 3,273,813 and 1,628,407 patients had at least one of the comorbid conditions for early-stage and active cardiodiabesity, respectively. Among those with all early-stage cardiodiabesity conditions, 27.4 % progressed to active cardiodiabesity, while 88.4 % of those with all active cardiodiabesity conditions progressed to complications within one year. Predictors of progression from early-stage to active cardiodiabesity were hypertension (OR: 2.31, 95 % CI: 2.29–2.33, p < 0.001), hyperlipidemia (OR: 1.77, 95 % CI: 1.76–1.79, p < 0.001), CKD stages 1 and 2 (OR: 1.74, 95 % CI: 1.69–1.79, p < 0.001), prediabetes (OR: 1.64, 95 % CI: 1.63–1.66, p < 0.001) and living in areas with very high social needs (OR: 1.25, 95 % CI: 1.23–1.26, p < 0.001). Significant predictors of progression from active cardiodiabesity to complications were T2D (OR: 1.88, 95 % CI: 1.81–1.96, p < 0.001), CVD (OR: 1.47, 95 % CI: 1.44–1.51, p < 0.001), CKD stages 3 and 4 (OR: 1.37, 95 % CI: 1.34–1.41, p < 0.001) and obesity (OR: 1.29, 95 % CI: 1.26–1.32, p < 0.001). Average total cost of care increased significantly among those who progressed from one disease phase to the next (p < 0.05). ConclusionsCardiodiabesity is deadly and rapidly progressive with substantial economic burden on the healthcare system. However, it is preventable. Innovative approaches to better understand the holistic impact of cardiodiabesity on total cost of care, early intervention or management to halt disease progression and promote equity, as well as decrease resource utilization are needed.

Novel Approaches in HIV-1 Cure: Genetic Editing and Gene Repression Techniques. Topic Review

Introduction: The worldwide challenge presented by human immunodeficiency virus type 1, affecting 39 million individuals, endures despite the highly active antiretroviral therapy. Limitations of it, including insufficiently addressing viral reservoirs leading to prolonged drug toxicity, resistance concerns, and economic burdens, have fueled exploration into alternative approaches. Gene editing and gene repression techniques have emerged as potential solutions. Objective: Conduct a comprehensive analysis of recent research following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, focusing on genetic modification and gene repression in HIV-1-infected samples. Methods: A meticulous search identified 413 articles, of which 76 met strict criteria. Inclusion criteria involved studies on gene editing and HIV-1 expression (2019–2023), emphasizing CCR5 repression. Exclusions targeted weak evidence, lacking practical efficacy, and non-relevance to HIV-1 or genetic tools. Duplicates and non-open-access articles were also excluded. Results: The identified strategies show promise in their ability to mitigate the chronicity of the infection. However, challenges such as off-target effects, ethical considerations surrounding in vivo, ex vivo, and germline editing, and variable efficacy across studies are evident. The imperative for continued evaluation, refinement of techniques, and the development of effective administration methods is underscored. Conclusions: This topic review provides a nuanced exploration of recent advancements in gene editing and gene repression techniques for managing HIV-1. While the findings suggest promising avenues, the identified challenges necessitate ongoing research and innovation in order to harness the full potential of these strategies in the quest for an effective HIV-1 solution.

Analysis of Alzheimer's Disease-Related Mortality Rates Among the Elderly Populations Across the United States: An Analysis of Demographic and Regional Disparities from 1999 to 2020.

Alzheimer's Disease (AD) is the leading cause of dementia and a significant public health concern, characterized by high incidence, mortality, and economic burden. This study analyzes the mortality patterns and demographic disparities in Alzheimer's disease-related deaths among the elderly population in the United States from 1999 through 2020. Alzheimer's disease mortality data for individuals 65 and older were obtained from the CDC WONDER database, utilizing ICD-10 codes G30.0, G30.1, G30.8, and G30.9 for identification. Demographic and regional variables included age, gender, race/ethnicity, place of death, urban- rural status, and geographic region. Crude death rates (CR) and age-adjusted mortality rates (AAMR) per 100,000 individuals were calculated. Joinpoint Regression Program 5.0.2 was used to analyze trends, calculating Annual Percentage Changes (APCs) and Average Annual Percentage Changes (AAPCs). From 1999 to 2020, 1,852,432 deaths were attributed to AD among individuals aged 65 and older. The AAMR increased from 128.8 in 1999 to 254.3 in 2020, with an AAPC of 2.99% (95% CI = 2.61-3.48). The age-adjusted mortality rate (AAMR) was higher in females (218.5) than in males (163.5). Among racial and ethnic groups, non-Hispanic whites had the highest AAMR, followed by Non-Hispanic Blacks and Hispanics. Regionally, the West reported the highest AAMR, while the Northeast recorded the lowest. Most deaths occurred in nursing homes (57.3%), with a significant portion also occurring at decedents' homes (22.4%). AD mortality rates in the U.S. have risen significantly, with notable disparities across age, gender, race, and geographic regions. These findings highlight the need for targeted interventions and research to address the growing burden of AD, particularly among the most affected demographic groups.

Urinary tract infection among pregnant Jordanian women: role of hygiene and sexual practices

PurposeThe purpose of this study was to examine the association between hygiene and sexual practices and the incidence of urinary tract infection (UTI) among Jordanian pregnant women.MethodsThe cross-sectional data were collected using self- administered survey from October 2018 to January 2019 in central Jordan. A total of 200 pregnant women completed the survey. All of them were married and aged between 18 and 45 years (M = 27.45; SD = 6.06). The measures used were demographics, social, hygiene and sexual practices.ResultsA significant association was found between the incidence of UTI and the educational level of husbands (p = 0.05), history of UTI in previous pregnancies (p = 0.02) and being in the second trimester of pregnancy (p = 0.02). Their sexual and hygiene practices also were significantly associated with the incidence of UTI.ConclusionHistory of UTI in previous pregnancies, hygiene and sexual practices are associated with increased incidence of UTI among Jordanian pregnant women. Appropriate strategies and techniques to promote health and preventive behaviors for pregnant women with UTI should be provided to improve the quality of life among pregnant women and reduces economic burdens on health care system.

National Costs for Cardiovascular-Related Hospitalizations and Inpatient Procedures in the United States, 2016 to 2021

The current economic burden of cardiovascular-related hospitalizations grouped by diagnoses and procedures in the U.S. has not been well characterized. The objective was to identify current trends in cardiovascular-related hospitalizations, procedural utilization, and health care costs, using the most recent 6 years of hospitalization data. A retrospective analysis of discharge data from the National Inpatient Sample (NIS) database was conducted to determine trends in cardiovascular-related hospitalizations, costs, and procedures for each year from 2016 to the most recent available dataset, 2021. Total cardiovascular-related costs were adjusted to and reported in 2023 dollars. In 2021, there were 4,687,370 cardiovascular-related hospitalizations at a cost of $108 billion. Heart failure hospitalizations accounted for the highest costs at $18.5 billion, followed by Non-ST-Elevation Myocardial Infarction at $11.2 billion, and stroke at $10.9 billion. Significant upward trends in costs from 2016 to 2021 were observed for heart failure, stroke, atrial fibrillation, ST-elevation myocardial infarction, chest pain, hypertensive emergency, ventricular tachycardia, aortic dissection, sudden cardiac death, pericarditis, supraventricular tachycardia, and pulmonary heart disease. Over the 6 observational years, total costs increased by over $10 billion, representing a 10 percent increase. However, the increases were not linear, as there was a significant increase of 6.5% from 2018 to 2019, then a dip of over 7% from 2019 to 2020, followed by a rise of about 6% from 2020 to 2021. By 2030, total CV-related costs are projected to reach $131.3 billion. For all years, coronary procedures were the most performed, followed by ECMO, non-bypass peripheral vascular surgery, pacemaker placement, and CABG. Both TAVR and MitraClip procedures demonstrated significant upward trends from 2016 to 2021. Overall, from the years 2016 to 2021, cardiovascular-related hospitalizations, costs, and procedures demonstrated upward trends. In conclusion, cardiovascular disease remains a high burden in the hospital setting with tremendous health care costs.

Economic burden of knee joint replacement in Iran

BackgroundThe knee is the most commonly afflicted weight-bearing joint. Osteoarthritis of the knee is regarded as one of the most commonly diagnosed causes of disability in the elderly. Knee joint replacement can be regarded as a final solution for Osteoarthritis of the knee in which the joint is worn out, accompanied by clinical symptoms such as pain, deformity, and limited movement.Aimthis study sought to estimate the economic burden of knee joint replacement procedures carried out in Iran.MethodThis cross-sectional descriptive study utilized the Incidence-based approach to assess the economic burden of knee joint replacement surgeries conducted in Iran during 2022, estimating the costs of the disease from a societal perspective. The sampling method employed was random sampling, and the sample size consisted of 300 patients. Direct costs were calculated employing the top-down approach, while indirect costs were estimated using the human capital approach. Microsoft Excel was employed for data analysis.ResultThe average direct medical costs of the knee replacement procedure per patient were $10,076.87 and $13,099.93 in the public and private sectors, respectively. The average direct non-medical costs of knee joint replacement surgery are $1123.64, with companion costs constituting most of the direct non-medical costs. Finally, the economic burden of the knee joint replacement surgery was estimated at $67340417.28.ConclusionDespite insurance coverage, knee joint replacement surgery in Iran incurs substantial costs. With the anticipated rise in the elderly population, the frequency of these procedures is expected to increase, amplifying the economic burden on the Iranian public.

Assessment of the sentiments expressed by traumatic brain injury patients and caregivers: A qualitative study based on in-depth interviews

IntroductionTraumatic Brain Injury (TBI) is a significant public health concern that causes death, disability, and economic burden. Its repercussions affect physical, cognitive, emotional, and behavioral aspects of long-term care needs. Despite improvements in communication among multidisciplinary teams, the management of TBI remains fragmented. ObjectiveThis study aimed to assess patients and caregivers’ experiences through sentiment analysis. Materials and methodsA qualitative cross-sectional study utilized structured topic modeling (STM) to analyze in-depth interview data. The study involved 29 patients with TBI and 27 caregivers in Madrid (Spain), using a survey design. The interviews were conducted, transcribed, and coded independently over 5 months. Sentiments such as anticipation, fear, and emotional concerns were analyzed using three dictionaries. The STM analysis identified four key concepts: desire for independence, potential improvement, need for injury information, and psychological consequences. STM diagnostic graphs were used to determine the number of topics relevant to the evaluation of patient and caregiver concerns. Furthermore, an analysis was conducted across four topics. ResultsThe average age of the patients was 44.2 ± 14.9 years (69 % males). Regarding TBI severity, 59 % of patients had severe TBI, whereas the remaining 41 % had experienced moderate TBI. Among the caregivers, the majority were parents (30 %), partners (24 %), or siblings (24 % each). Among the 51 participants, sentiments were analyzed using three dictionaries. While there were no significant age differences (Z = 0.24, p = 0.815), the STM model was adjusted for significant sex differences (p = 0.017) between patients and relatives. Anticipation and fear prevailed in both groups, highlighting the shared emotional patterns. DiscussionThe analysis of diagnostic graphs indicated the optimal number of topics for evaluation, emphasizing key concerns across different phases of TBI. Patients' main worries shifted from physical symptoms to limitations in daily life and independence. Caregivers highlighted the importance of staff interactions, misinformation challenges, and the need for psychological care. ConclusionKey patient concerns, including dependency on daily activities, limitations in autonomy, and caregiver burden, emphasize crucial areas for enhancement in multidisciplinary treatment. Moreover, the lack of long-term psychological support is a significant barrier to optimal patient and caregiver well-being.