Dietary supplements lead to reduced medical costs: Fact or wishful thinking?

Does increasing primary care team panel size affect health care costs: Findings from a VHA pilot program.

Disease burden of carbapenem-resistant Enterobacterales infections in Korea.

Pharmacopuncture, which combines traditional acupuncture with herbal medicine, may offer synergic therapeutic effects for insomnia management; however, evidence on its economic value remains limited. This study evaluates the cost-effectiveness of pharmacopuncture for insomnia disorder compared with other acupuncture modalities in South Korea. Two Markov models were developed from a healthcare system perspective to assess the short- and long-term cost-effectiveness of pharmacopuncture. The models included four levels of insomnia severity based on the Insomnia Severity Index (ISI). Transition probabilities, medical costs, and utility weights were derived from a pragmatic randomized controlled trial (KCT0006803). A 4-week cycle length was applied to stimulate 100 participants with moderate-to-severe insomnia. The short- and long-term models employed 8- and 24-week time horizons, respectively. Effective outcomes included the proportion of remission (ISI < 8) and quality-adjusted life-years (QALYs). Pharmacopuncture incurred an incremental cost of KRW 368,000 (USD 270) per additional remission achieved over 8 weeks. Long-term analysis showed an incremental cost-effectiveness ratio of KRW 16,940,000 (USD 12,600) per QALY. Sensitivity analyses revealed that cost-effectiveness was sensitive to pharmacopuncture pricing. Pharmacopuncture can be considered cost-effective if decision-makers accept an additional cost of KRW 400,000 (approximately USD 280) per responder over 2months. At a willingness-to-pay threshold of KRW 27,660,000 (approximately USD 21,740), pharmacopuncture is a cost-effective option for managing insomnia compared with other acupuncture modalities.

The Economic Impact and Clinical Benefits of Intraosseous Injections in Total Knee Arthroplasty.

Strengthening the health workforce is a central policy challenge in fragile and low-income settings, yet governments often lack basic information on what it costs to train health professionals. This study provides the first institutional level evidence on the structure and magnitude of medical education costs in Afghanistan using detailed administrative and financial records from Kabul Medical University. A retrospective costing approach combined with a step-down cost accounting framework is used to allocate all direct and shared expenditures across faculties and across years of study. The results reveal large differences in per student costs across programs, with Curative Medicine requiring substantially more resources than Stomatology, Nursing, and Public Health. Support services account for a large share of total expenditure, and resource use rises sharply in clinically intensive years. A sensitivity analysis that varies personnel costs, allocation rules, and price adjustments shows that these patterns remain stable. The findings indicate that fiscal pressures, gender imbalances in enrollment, and inefficient allocation of support costs limit the effectiveness of current training investments. The study provides a quantitative foundation for policies that seek to improve the financial sustainability of medical universities, align training capacity with national health needs, and strengthen resource tracking systems in fragile and low-income contexts.

Economic benefit of expanding mammography screening for breast cancer in Colombia: A cost modelling analysis.

SMDRnet: Saliency multiscale dense residual network for multimodal medical image fusion.

Healthcare systems often fail to meet the needs of low-income populations, reinforcing disparities in access, affordability, and quality of care. These inequities are not incidental but the result of design choices that prioritise efficiency and standardisation over inclusivity. Even in high-income countries with publicly funded healthcare systems, hidden costs, transport, parking, lost income, childcare, and the financial burden of following medical advice, can prevent people from accessing care. These financial barriers drive delays in treatment, missed appointments, and poorer health outcomes, entrenching health inequities. This brief synthesises evidence from systematic and realist reviews, randomised controlled trials, qualitative studies, and programme evaluations, prioritising the most robust and policy-relevant findings of the structural barriers that low-income populations face in high-income healthcare systems. It identifies three challenges: (1) the cost of time and travel, (2) the lack of financial hardship awareness in healthcare settings, and (3) the affordability of care beyond direct medical costs. Solutions exist. Flexible appointment models, including evening and remote consultations, can mitigate financial strain. Community outreach services, such as mobile health units and pop-up clinics, improve engagement with preventive care. Social needs screening, widely used in North America, has been shown to improve health outcomes by identifying financial hardship and linking patients to support services. Food prescription programs offer an emerging model for addressing health and nutrition insecurity. While healthcare alone cannot eliminate poverty, it can ensure that low-income populations are not left behind. Policymakers should embed equity into healthcare design, integrating financial support programs, expanding outreach initiatives and removing hidden costs that act as barriers to care.

Soft bandage vs rigid immobilisation in pediatric distal radius torus fractures: A cost and patient burden analysis - A retrospective cohort study.

Counting costs and carbon: A decision model for greener healthcare policy.

Prevalence of Veteran-reported treatment barriers from the breast and gynecologic oncology system of excellence.

Despite receiving triple therapy (i.e., long-acting β2-agonist + long-acting muscarinic antagonist + inhaled corticosteroid), patients with chronic obstructive pulmonary disease (COPD) continue to experience exacerbations. This study aimed to investigate the moderate and severe annualized exacerbation rate (AER) and healthcare resource utilization of patients with COPD on triple therapy in China, addressing a significant evidence gap regarding the clinical and economic disease burden in this population. This retrospective cohort study was conducted using the Chongqing Regional Electronic Health Record Database (2018-2022). Patients with COPD aged ≥ 40years who had received ≥ 3months of triple therapy during the 12-month baseline period were included. AER, COPD-related hospital visits, length of hospital stay and readmissions, and direct medical costs during the 12-month observation period were analyzed. A total of 6393 patients with COPD on triple therapy were included in the study. Among patients with available data, 17.3% had blood eosinophil count of ≥ 300 cell/μL at baseline. The percentage of patients having at least one moderate and severe exacerbation during the observation period was 53.7%, with the moderate and severe AER (95% confidence interval) being 1.37 (1.32-1.42). The mean (standard deviation (SD)) numbers of outpatient, emergency room, and inpatient visit due to COPD were 6.1 (5.56), 0.4 (1.58), and 1.0 (1.64), respectively. The direct medical costs per patient per year were ¥14,208.7. Our findings reveal a high disease burden among patients with COPD in China despite stable triple therapy, reflecting the high-risk clinical profile of these patients and supporting an ongoing need for improved management strategies.

Obstetric fistula is a distressing condition affecting mothers in Ghana and elsewhere. Most obstetric fistulas are caused by long-term obstructed labor. The majority of women suffering from this condition and their families go through challenging experiences with medical treatment and social integration. This study explored the lived experiences of women with obstetric fistula regarding the socio-medical consequences of the condition in terms of treatment-seeking challenges and socio-cultural integration in the Tamale Metropolis of the Northern Region of Ghana. The study adopted a qualitative phenomenology design. In-depth and key-informant interviews were conducted among eleven women with obstetric fistula and three healthcare professionals, respectively, in two sampled health facilities in the Tamale Metropolis. Purposive sampling was used to select the respondents. The data was collected from January to March 2024. Thematic analysis was employed to analyze the data. The results revealed the challenges to seeking treatment for obstetric fistula as financial barriers, repeated/unsuccessful repairs, negative attitude of health professionals, and difficulty coping with postoperative instructions. The socio-economic consequences faced by the women were problems with social integration, stigma and psychological trauma, reduced self-esteem, and loss of sources of income. Some of these difficulties were short-lived, especially following corrective surgery, while new ones emerged in some cases even after surgery. The lived experiences of women with obstetric fistula suggest that financial assistance and psychosocial counseling are necessary to empower victims of obstetric fistula and improve their living conditions. The study recommends that the National Health Insurance Scheme should provide effective coverage for both medical and non-medical financial costs associated with the treatment of obstetric fistula. Trust between healthcare providers and their clients should be established through strong interpersonal relationships and effective training of healthcare professionals. Societal tolerance of women living with obstetric fistula should be enhanced through public sensitization.

Economic burden of leukemia diagnosis and treatment in South Africa: A retrospective cost of illness analysis.

An adverse drug reaction (ADR) is a harmful, unwanted patient response to a drug that happens at doses normally used for prevention, diagnosis, or treatment. Despite limited and inconsistent primary evidence on the cost of ADRs in Africa, this systematic review aims to synthesize the magnitude of ADR-related costs and assess the reporting quality of existing studies. The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Three databases (PubMed, Scopus, and ScienceDirect) and a hand search were employed. All empirical African cost-of-illness studies on ADRs were included regardless of publication year, disease type, or population, while letters to the editor, case reports, conference proceedings, and abstracts were excluded. Two independent authors conducted screening, data extraction, and quality assessment. A consensus-based cost-of-illness checklist was used to assess reporting quality. The primary outcome was the cost of adverse drug reactions, reported in 2024 international dollars (I$); the secondary outcome was the reporting quality of studies. A total of 324 studies were identified, of which eight were included in the final analysis. Nearly all studies reported only direct medical costs, excluding direct non-medical and indirect costs. ADR-related hospitalization costs per patient ranged from I$54.75 in Nigeria to I$7438.47 in South Africa. Costs were mainly driven by hospitalization, medications, and investigations, and influenced by patient, disease, and health system-related factors. While all studies described their population, objectives, time horizon, and data collection methods, many failed to report important methodological details. Adverse drug reactions impose a substantial economic burden through direct medical costs influenced by multiple factors; however, many studies lacked key reported details. Future research should adopt recommended methodologies and comprehensive cost reporting to improve the reliability of cost estimates.

IntroductionTo evaluate the cost-utility of minimal invasive extracorporeal circulation (MiECC) versus conventional cardiopulmonary bypass (cCPB) in coronary artery bypass grafting (CABG) over a 7-years horizon.MethodA cohort-based, deterministic cost-utility model was constructed from the Greek NHS perspective over a 7-year period. Clinical inputs were derived from a meta-analysis including 4849 patients. Direct medical costs for intensive care unit (ICU) and ward stay, blood transfusions, intra-aortic balloon pump (IABP) use, and perfusion circuits were applied to estimate the cost of care. Quality of life was quantified in terms of quality-adjusted life years (QALYs) by mapping SF-36 data to EQ-5D utilities. Deterministic sensitivity analyses were used to test key assumptions and a probabilistic sensitivity analysis assessed overall result robustness.ResultsMiECC was associated with improved clinical outcomes, including lower perioperative mortality and complication rates, shorter mechanical ventilation duration, and reduced lengths of ICU and ward stay. Over 7 years, patients operated on MiECC accrued 2.21 QALYs versus 2.18 QALYs for cCPB. MiECC dominated cCPB, yielding both cost savings (ΔCost = -1369€) and a QALY gain (ΔQALY = +0.03). Sensitivity analysis confirmed the robustness of the default results under all tested scenarios.ConclusionsIn an era focused on value-based care, cardiac centers and healthcare authorities should consider the integration of MiECC as a standard perfusion strategy in coronary surgery, given the supportive evidence of improved morbidity and mortality outcomes without financial impact concerns.

Financial Toxicity and Cost-Related Imaging Nonadherence in Pediatric Outpatient Imaging.

To discuss the direct economic burden of Healthcare-associated Infection (HAI) in a hospital in Chengdu. All patients enrolled in the Diagnosis Related Groups (DRGs) comprehensive evaluation and management system between January 1 and December 31, 2023, were categorized into two groups: those with a Healthcare-associated Infection (HAI) and those without. A 1:1 case matching was performed based on DRG classification, sex, and age (± 5 years). Differences in direct medical costs and length of stay (LOS) between the two groups were compared, followed by a subgroup analysis of infection-related economic burden across diagnostic categories. The HAI incidence rate was 0.92%, and the HAI rate per 1,000 patient days was 1.23‰ in 2023. 726 pairs of HAI cases and non-HAI cases were successfully matched. The direct cost of the HAI group was CNY 16,251.63(13244.10 ~ 19259.16) higher than the non-HAI group (1.91 times higher, P < 0.001). The length of hospital stay in the HAI group was 10(8.58 ~ 11.42) days longer (1.71 times higher, P < 0.001), with significant cost increases in treatment fees and Western medicine (P < 0.001). Among all Major Diagnostic Categories (MDCs), the infection and parasitic diseases group incurred the largest economic burden. For HAI patients with sepsis or severe sepsis requiring ≥ 96h of mechanical ventilation, the total cost was CNY 80,162.31(27439.11 ~ 132885.51) higher than non-HAI patients (P = 0.003), and hospitalization duration increased by 17.5(5.99 ~ 29.01) days (P = 0.003). In conclusion, implementing scientifically classified DRGs in HAI management provides a strategic framework for advancing precision-oriented healthcare administration.

ABSTRACT Background Schizophrenia (SCZ) is a major public health concern that places a significant economic burden on healthcare systems. This study assessed the direct medical costs of SCZ and examined cost drivers at Hospital Pulau Pinang (HPP), Malaysia. Objective To estimate and compare direct medical costs for SCZ patients across various healthcare services, including medications, diagnostics, hospitalizations, and outpatient care. Methods A retrospective, bottom-up costing analysis was conducted using medical records of all adult SCZ patients treated at HPP from 1 January 2019, to 27 April 2021. Data included demographic and clinical features, with costs categorized by service type. Results Among 120 patients (20 inpatients), 54.2% were female with a mean age of 39.5 ± 10.3 years. The mean annual inpatient cost per patient was MYR 8,483.4, with hospitalization alone contributing 62%. Outpatient costs averaged MYR 2,222 ± 2,571.9. Conclusions SCZ treatment imposes a high financial burden, particularly due to hospitalization. These findings provide essential cost estimates to support healthcare planning and policy-making in Malaysia.