The Personal Financial Burden of Chronic Rhinosinusitis: A Canadian Perspective
28
Citation
31
Reference
10
Related Paper
Citation Trend
Abstract:
Previous studies describe the financial burden of chronic rhinosinusitis (CRS) from the perspective of third-party payers, but, to our knowledge, none analyze the costs borne by patients (i.e., out-of-pocket expenses [OOPE]). Furthermore, this burden has not been previously investigated in the context of a publicly funded health care system.The purpose of this study was to characterize the financial impact of CRS on patients, specifically by evaluating its associated OOPEs and the perceived financial burden. The secondary aim was to determine the factors predictive of OOPEs and perceived burden.Patients with CRS at a tertiary care sinus center completed a self-administered questionnaire that assessed their socioeconomic characteristics, disease-specific quality of life (22-item Sino-Nasal Outcome Test [SNOT-22]), workdays missed due to CRS, perceived financial burden, and direct medical and nonmedical OOPEs over a 12-month period. Total OOPEs were calculated from the sum of direct medical and nonmedical OOPEs. Regression analyses determined factors predictive of OOPEs and the perceived burden.A total of 84 patients completed the questionnaires. After accounting for health insurance coverage and the median direct medical, direct nonmedical, and total OOPEs per patient over a 12-month period were Canadian dollars (CAD) $336.00 (2011) [U.S. $339.85], CAD $129.87 [U.S. $131.86], and CAD $607.10 [U.S. $614.06], respectively. CRS resulted in an average of 20.6 workdays missed over a 12-month period. Factors predictive of a higher financial burden included younger age, a greater number of previous sinus surgeries, <80% health insurance coverage, residing out of town, and higher SNOT-22 scores.Total OOPEs incurred from the treatment of CRS may amount to CAD $607.10 [U.S. $614.06] per patient per year, within the context of a single-payer health care system. Managing clinicians should be aware of patient groups with a greater perceived financial burden and consider counseling them on strategies to offset expenses, including obtaining travel grants, using telemedicine for follow-up assessments, providing drug samples, and streamlining diagnostic testing with medical visits.Keywords:
Chronic Rhinosinusitis
This paper reviews the evidence on the well-known positive association between socioeconomic status and health. We focus on four dimensions of socioeconomic status -- education, financial resources, rank, and race and ethnicity -- paying particular attention to how the mechanisms linking health to each of these dimensions diverge and coincide. The extent to which socioeconomic advantage causes good health varies, both across these four dimensions and across the phases of the lifecycle. Circumstances in early life play a crucial role in determining the co-evolution of socioeconomic status and health throughout adulthood. In adulthood, a considerable part of the association runs from health to socioeconomic status, at least in the case of wealth. The diversity of pathways casts doubt upon theories that treat socioeconomic status as a unified concept.
Association (psychology)
Cite
Citations (1)
ObjectiveTo assess the disease burden and health economics of inpatients with multiple sclerosis (MS) in China by evaluating the direct, indirect, and intangible costs.MethodsA total of 863 patients were included for a cross-sectional retrospective study in 50 centers. The direct economic burden was measured by the cost of hospitalization and out-of-hospital application drugs, and the indirect economic burden was measured by the human capital method. The disability-adjusted life year (DALY) was used to express the intangible economic burden. Cost-utility analysis (CUA) using DALYs as indicators of health benefits was performed by calculating the incremental cost-utility ratio.ResultsThe mean direct economic burden/year, daily medication expenses/year, DALY, indirect economic burden, and indirect economic burden/year were 27,655.57 Yuan, 17,944.97 Yuan, 10.89 Yuan, 512,041.7 Yuan, and 11,299.85 Yuan, respectively. For the study period of two years, the direct economic burden, daily medication expense, and indirect economic burden were 48.6%, 31.5%, and 19.85% of the total economic burden, respectively. Disease burden and the number of episodes of remission were not statistically significant (p>0.001). The direct economic burden and total economic burden of the disease-modifying therapy (DMT) group were higher than those of the non-DMT group, but DALYs had no statistical significance (p>0.001). CUA showed that inpatients with MS in the DMT group received a DALY every time compared with the non-DMT group.ConclusionThe DALY losses are concentrated in young and middle-aged Chinese people. In this two-year study, CUA prompted the application of DMT drugs to increase the economic burden and DALYs. However, follow-up time is still short, and further follow-up observation is required.
Disability-adjusted life year
Economic Evaluation
Economic cost
Health Economics
Cite
Citations (6)
Aim: The purpose of this study was to analyze the impact of socioeconomic characteristics on oral health-related quality of life (OHRQoL) in patients with oral submucous fibrosis (OSF). Methods: A total of 300 OSF patients' quality of life (QoL) data were obtained using OHRQoL-OSF and global self ratings of oral health and overall wellbeing. The socioeconomic status (SES) of participants was analyzed by using modified Kuppuswamy scale. Results: OSF patients with lower SES had worse OHRQoL as compared with those with middle and upper SES (p < 0.001). The household income of the family was found to be strongly associated with poor OHRQoL. Conclusion: Socioeconomic characteristics should be considered in the holistic management of OSF as it has been strongly associated with the OHRQoL of these patients.
Oral submucous fibrosis
Cite
Citations (16)
This study aimed to estimate the socioeconomic burden of asthma in South Korea. The data were obtained from the National Patient Sample of 2014. The direct costs included health care and non-health care costs, and the indirect costs included loss of productivity. To estimate the prevalence of asthma, this study used both primary diagnoses and treatment-based criteria. The prevalence of asthma was 3.7% using primary diagnosis-based criteria. The total costs of asthma were $645.8 million. The direct and indirect costs were $553.9 million and $92.0 million, respectively. When the treatment-based criteria were applied, the prevalence decreased to 1.8% and the total costs decreased to $465.1 million. The direct and indirect costs were $394.9 million and $70.2 million, respectively. In the future, the cost of asthma, derived from various perspectives, should be regularly estimated and used as a basis for lowering the burden of disease due to asthma.
Economic cost
Cite
Citations (12)
The study is aimed at examining changes in economic burden in comparison with figures cited in previous studies. Data from South Korea’s National Health Insurance claims database are used to measure the economic burden of chronic disease. Both direct and indirect costs are considered. Direct costs are those associated directly with treatment, medication, and transportation, and indirect costs are assessed in terms of the loss of productivity and their caregivers and consist of morbidity and mortality costs. We also undertake sensitivity analysis, wherein we extract incidence cases and categorize them in terms of their frequency of hospital visits (from one time to five times). The total economic burden posed by chronic disease in South Korea in 2010 was found to be approximately 3.7 million USD; indirect costs and direct medical costs accounted for most of the economic burden, although the rates of these varied from disease to disease. In a comparison of disability-adjusted life years values and the economic burden of diseases, diseases varied widely in terms of their burden. The findings of this study can be used to inform policymakers as they establish public health policies that address various disease burden indexes. Key words: Chronic illness, economic analysis, measurement.
Economic cost
Economic data
Economic Analysis
Medical costs
Cite
Citations (0)
Social status
Cite
Citations (1)
Euros
Disability-adjusted life year
Cumulative incidence
Medical costs
Cite
Citations (1)
Our goal in treating chronic rhinosinusitis (CRS) is to reduce sinonasal symptoms and improve quality of life (QoL). In patients with CRS, sinonasal symptoms have a significant impact on QoL. Various validated measures exist to quantify QoL such as the 22-item Sinonasal Outcomes Test (SNOT- 22) and MSNOT-20 Young Persons Questionnaire (MSYPQ) specific to CRS, while others measure general QoL, such as the EuroQol 5-Dimensional general health-related QoL survey (EQ5D).
Chronic Rhinosinusitis
Cite
Citations (8)
Utilized two psychologists as actors in making four videotapes to depict background information and verbal modes of communication for alcoholics according to black-white race differences and high-low socioeconomic status. Forty graduate psychology students (10 per group) then were shown randomly one of the four recordings and asked to make a diagnosis. A significant difference was found for the effects of race, socioeconomic status, and race X socioeconomic status interaction on the correct diagnosis of alcoholism. Results were interpreted as suggesting that a clinician's personal biases and/or prejudices might extend into the clinical diagnosis and treatment of clients.
Cite
Citations (12)
Objective To evaluate the effect of functional endoscopic sinus surgery and the modus operandi on symptoms and quality of life of patients with chronic rhinosinusitis.Methods Sixty patients with chronic rhinosinusitis and nasal polyps were enrolled by random and their QOL scores were assessed by using QOL instruments including existing SF-36 questionnaires(Chinese version) and SNOT-20 questionnaires,and of them patients of different groups were given different scope surgeries to appraise the impact of the modus operandi on patient′s symptoms and the quality of life.Results In the 1 month follow-up settings, such domains as role physical,mental health,role emotional and general health of SF-36,scores of the total 20 items and the most important 5-item scores of SNOT-20 were markedly improved(P0.05);in the 2-6 month follow-up settings,the above indexes stayed fixed(P0.05);and in the 6-month follow-up settings,indexes of symptoms and QOL status entirely improved from the baseline,and different scope surgeries had no statistical significance on symptoms and QO L.Conclusions On the whole patients undergoing endoscopic sinus surgery have their symptoms relieved and QOL status will be normal on postoperative 6 months.Improved and traditional endoscopic sinus surgery are basically identical on the improvement of the symptoms and QOL.
Chronic Rhinosinusitis
Endoscopic sinus surgery
Nasal Polyps
Sinus (botany)
Cite
Citations (0)