A study on smoking-attributable health economic costs in China was conducted from 1988-1992, in which three major categories of chronic diseases, diseases of cancer, diseases of circulatory system, and diseases of res...A study on smoking-attributable health economic costs in China was conducted from 1988-1992, in which three major categories of chronic diseases, diseases of cancer, diseases of circulatory system, and diseases of respiratory system were included. A prevalence-based method which estimated the cumulative effect of cigarette smoking during the past 20-30years was used. The results show that in 1989, the total smoking-attributable economic costs to health sectors in China were about 27.1 billion of Chinese Yuan, including about 7 billion Yuan in direct medical costs and 20 billion Yuan in indirect costs, which include indirect morbidity costs and indirect mortality costs. The relatively low direct costs reflected the low medical costs at hospitals in China at that time. And the high proportion of indirect costs relative to the total costs shows the high potential years of life lost due to clgarette smoking. The results also show the heavier health burden in urban areas than in rural areas, reflecting the worse situation in urban China at nowadays. But if considering that almost 80% of the Chinese are rural farmers with the higher smoking prevalence and relatively shorter history of manufactured cigarette smoking than their urban counterparts,the very frightful situation due to cigarette smoking would be for China in the next century展开更多
Globally, air pollution is a significant cause of death, illness and social discomfort. The problem is particularly severe in Nigeria, the country with the highest number of premature deaths due to ambient particulate...Globally, air pollution is a significant cause of death, illness and social discomfort. The problem is particularly severe in Nigeria, the country with the highest number of premature deaths due to ambient particulate matter pollution in Sub Saharan region. It is especially worrying in Lagos, the country’s commercial capital and one of the world’s fastest growing megacities. Despite growing concerns about its deadly impacts, there is currently no reliable monetary estimate of the effects of ambient air pollution, nor a comprehensive control plan in Lagos. Using available ground-level monitored data and the most recent valuation techniques, this paper estimates that in 2018 alone, ambient fine particulate matter (PM2.5) caused about 11,200 premature deaths, and generated a health cost of US$2.1 billion in Lagos. This is equivalent to about 2.1 percent of Lagos’ GDP in the same year. These results call for an urgent plan of action to improve air quality in the city, with primary focus on the main pollution sources: road transport, industrial emissions, and power generation.展开更多
Ambient fine particulate matter(PM_(2.5))pollution causes the largest environmental health risk globally,yet ex-posure levels and the resulting health risks vary across countries with different income levels.Global we...Ambient fine particulate matter(PM_(2.5))pollution causes the largest environmental health risk globally,yet ex-posure levels and the resulting health risks vary across countries with different income levels.Global wealth inequality has intensified in recent years,yet the relationship between wealth inequality and health risks related to PM_(2.5) pollution remains poorly understood.In this study,we evaluated the global mortality and health cost at-tributable to PM_(2.5) exposure from 2017 to 2021,and analyzed the relationship between wealth inequality,PM_(2.5) pollution,and the associated health risks across regions with varying economic levels.We found a consistent decline in mortalities and health costs attributable to PM_(2.5) exposure from 2017 to 2020,followed by a rebound after 2020,driven primarily by the resurgence of PM_(2.5) concentrations and a deceleration in the reduction of baseline mortality rates.We also found that the average PM_(2.5) concentration and associated risks decrease as domestic wealth inequality decreases and national income level increases.However,regions with extremely high levels of wealth inequality consistently show lower national average PM_(2.5) concentrations and health risks.These findings highlight the need to consider healthcare security during emergencies,as well as policy fairness across economic regions,in the formulation of global PM_(2.5) pollution control measures to promote sustainable,more equitable economic growth and coordinated air pollution management.展开更多
Background In response to environmental degradation and the associated health challenges,the Chinese government has implemented a comprehensive array of environmental protection measures.Given the health enhancement o...Background In response to environmental degradation and the associated health challenges,the Chinese government has implemented a comprehensive array of environmental protection measures.Given the health enhancement objective of environmental protection measures and the considerable costs involved in the implementation process,evaluating whether environmental regulation is benefcial to reducing the health costs of the population is of great signifcance for enhancing environmental governance efciency and social welfare.The data from the Chinese Family Panel Survey(CFPS)is applied to examine the efect of environmental regulation on the reduction of residents’health costs from a microscopic perspective.Results The results indicate that for a 1%increase in total investment in environmental governance,residents’health costs will decrease by 0.189%.The examination of the causal pathway suggests that implementing environmental regulation can diminish residents’health costs through improving air quality and residents’health status.Concurrently,there exist signifcant heterogeneities in the role of environmental regulation in reducing residents’health costs.The efect of environmental regulation is more pronounced for the young,males,and individuals with better self-perceived health.Furthermore,the outcome of environmental regulation exhibits greater efcacy in urban areas compared to rural areas.Lastly,market-incentive environmental regulation in reducing health costs is more efective than command-controlled regulation.Conclusions Enhancing the intensity of environmental regulation contributes to decreasing residents’health costs.The fndings can provide policy reference for implementing environmental governance and achieving tangible enhancements in individuals’life quality.展开更多
Similar to most developed countries, obesity rates inRussiahave been steadily increasing. This has led to a high burden of obesity related diseases and associated healthcare costs. The micro-simulation model has been ...Similar to most developed countries, obesity rates inRussiahave been steadily increasing. This has led to a high burden of obesity related diseases and associated healthcare costs. The micro-simulation model has been utilized to project body mass index (BMI) and BMI related disease burden and healthcare costs. Incidence, mortality, survival and healthcare costs were collected for thirteen diseases. The results have been simulated for 3 hypothetical scenarios to project a potential impact of policy interventions: 1) assuming no reduction in BMI;2) 1% reduction in mean BMI across the population;3) 5% reduction in mean BMI across the population. Nearly 58% of the female population was obese (BMI ≥30 kg/m2) or overweight (BMI 25 -29.9 kg/m2) in 2010, and the prevalence is projected to decrease to 54% in 2050. The rates are predicted to increase for men from 51% in 2010 to 76% in 2050. The prevalence rates will triple for some obesity-related diseases. A one percent decrease in BMI across the population will save more than two billion US Dollars in 2030 and 2050. Despite female obesity prevalence starting at a higher point than the men, obesity is predicted to increase in males but not females. Disease and economic burden attributed to these obesity rates are still severe and the country should implement strong policies to tackle the obesity epidemic.展开更多
The financial crisis has caused a severe limitation of resources for the public health service and rehabilitation. The proposal of integrated diagnosis and treatment in rehabilitation, involving the introduction of ne...The financial crisis has caused a severe limitation of resources for the public health service and rehabilitation. The proposal of integrated diagnosis and treatment in rehabilitation, involving the introduction of new therapeutic models alongside orthodox models, could lead to a reduction in health care costs through better patient compliance. In rehabilitative assistance in health care, the limiting of financial resources can be simplified, given its multifaceted nature and the need to integrate clinical experience with research. In addition, the phases of rehabilitative recovery do not focus on organ damage, but improved participation and the reduction of disability. For this reason, we have considered incorporating narrative based medicine (NBM) and Psycho-Neuro-Immuno-Endocrinology (PNEI) in the rehabilitation process through an empathetic approach, taking evidence based medicine (EBM) into account, thus creating a “framework” of reference. Managing patients through this “framework” would be a move towards an integrated model of care that could lead to a reduction in health care costs, given the aging population and the rise in patients with chronic pain. The decision to modify health care in rehabilitative assistance through a new “framework” will require time, organizational capacity and experimentation, but may represent the appropriate response for an improved quality of life for patients and a better allocation of resources.展开更多
With the advancement of technology and health sciences,health care delivery costs are steadily increasing.This affects both households and governments.Unfortunately,the present truth is that health has become an essen...With the advancement of technology and health sciences,health care delivery costs are steadily increasing.This affects both households and governments.Unfortunately,the present truth is that health has become an essential but unaffordable commodity.This is very concerning.Quality,up-to-date,costeffective health care delivery is one of the prime objectives,and focuses on administration and health care authority.As the per capita spent on health from public/government funds is very poor in developing countries,the responsibility of cost-effective health care delivery falls primarily on the shoulder of the treating physicians.Anesthesiologists are becoming an indispensable part of health care delivery,having a diverse role in the emergency,critical care,pain,and perioperative care of patients.As the population ages,the need for surgical care is also increasing.Therefore,the anesthesiologist can also play a more significant role in delivering cost-effective health care,and minimize the cost without affecting the quality.This brief narrative review analyzes the current practice of anesthesiologists in two prime areas in the context of cost-savings:Preoperative investigation and low/minimal flow anesthesia.展开更多
One of the most significant annual expenses that a person has is their health insurance coverage. Health insurance accounts for one-third of GDP, and everyone needs medical treatment to varying degrees. Changes in med...One of the most significant annual expenses that a person has is their health insurance coverage. Health insurance accounts for one-third of GDP, and everyone needs medical treatment to varying degrees. Changes in medicine, pharmaceutical trends, and political factors are only a few of the many factors that cause annual fluctuations in healthcare costs. This paper describes how a system may analyse a person’s medical history to display their insurance plans and make predictions about their health insurance premiums. The performance of four ML models—XGBoost, Lasso, KNN, and Ridge—is evaluated using R2-score and RMSE. The analysis of medical health insurance cost prediction using Lasso regression, Ridge regression, and K-Nearest Neighbours (KNN), and XGBoost (XGB) highlights notable differences in performance. KNN has the lowest R2-score of 55.21 and an RMSE of 4431.1, indicating limited predictive ability. Ridge Regression improves on this by an R2-score of 78.38 but has a higher RMSE of 4652.06. Lasso Regression slightly edges out Ridge with an R2-score of 79.78, yet it suffers from an advanced RMSE of 5671.6. In contrast, XGBoost excels with the highest R2-score of 86.81 and the lowermost RMSE of 4450.4, demonstrating superior predictive accuracy and making it the most effective model for this task. The best method for accurately predicting health insurance premiums was XGBoost Regression. The findings beneficial for policymakers, insurers, and healthcare providers as they can use this information to allocate resources more efficiently and enhance cost-effectiveness in the healthcare industry.展开更多
Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases...Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.展开更多
Introduction:Direct-to-consumer(DTC)telemedicine has emerged as an option for transgender patients seeking gender affirming hormone therapy(GAHT).We aimed to characterize the healthcare services provided by DTC teleme...Introduction:Direct-to-consumer(DTC)telemedicine has emerged as an option for transgender patients seeking gender affirming hormone therapy(GAHT).We aimed to characterize the healthcare services provided by DTC telemedicine companies offering GAHT and to compare their costs to a tertiary care center.Methods:We identified DTC telemedicine platforms offering GAHT via internet searches and extracted information from their websites related to evaluation,treatment,monitoring,and cost.Cost of theDTC GAHT was compared to cost for comparable services at a tertiary care center.Results:Six DTC companies were identified.All platforms utilized an informed consent model without prerequisite mental health evaluation for GAHT.Platforms did not provide comprehensive mental health services.All platforms endorsed the use of regular follow up visits throughout the treatment period although interval of laboratory assessment varied.Cost estimates were comparable for uninsured patients and higher compared to those for insured patients.Cost estimates were lowest with private and public insurance at the tertiary center.Conclusions:DTC telemedicine platforms offering GAHT appear to be in line with the recently released World Professional Association for Transgender Health standards of care regarding the laboratory evaluation and monitoring,but it is unclear whether they are compliant with other recommendations.These platforms offer competitive costs for TGD patients without insurance.展开更多
Accountable care organizations (ACOs) and hospitals are facing additional requirements and financial rewards for improving population health. Therefore, ACOs and hospitals will need tools to understand the relationshi...Accountable care organizations (ACOs) and hospitals are facing additional requirements and financial rewards for improving population health. Therefore, ACOs and hospitals will need tools to understand the relationship between their patients and social determinants and health. We demonstrate the use of hot spotting for identifying geographical sources of high hospital costs and examining links between social determinants of health and these high-cost areas, known as hot spots. In 2012, using hospital data, we generated maps of inpatient costs from 2011 throughout New Haven and within an example neighborhood, Dixwell. We defined hot spots as addresses where costs were in the top 25%. We also overlaid data on concerns and assets in the community. Finally, we calculated the number of concerns and assets that fall within the 250 and 500 ft radii of the defined hot spots. We found that 34 addresses in Dixwell accounted for 70% of total costs for Dixwell. Hot spotting is a straightforward, approachable, and easily understood method for ACOs and hospitals to begin to address population health.展开更多
Background: Considering the importance of getting the right patient at the right location to maintain and optimize quality of life of inflammatory arthritis patients, appropriate referral by general practitioners is e...Background: Considering the importance of getting the right patient at the right location to maintain and optimize quality of life of inflammatory arthritis patients, appropriate referral by general practitioners is essential. This study aims to assess the effect and cost effectiveness of different referral strategies for inflammatory arthritis in primary care patients. Methods: This study follows a cluster randomized controlled trial design. General practitioners from primary care centers in Southwest-The Netherlands are randomly assigned to either one of the two strategic interventions for referring adult patients who are in the opinion of the general practitioner suspected of inflammatory arthritis: 1) Standardized digital referral algorithm based on existing referral models PEST, CaFaSpA and CARE;2) Triage by a rheumatologist in the local primary care center. These interventions will be compared to a control group, e.g. usual care. The primary outcome is the percentage of patients diagnosed with inflammatory arthritis by the rheumatologist. Secondary outcomes are quality of life as a patient reported outcome, work participation and healthcare costs. These data, including demographic and clinical parameters, are prospectively collected at baseline, three, six, and twelve months. Discussion: If this study can demonstrate improvements in appropriate referrals to the rheumatologist, thereby improving cost-effectiveness, there is sufficient supporting evidence to implement one of the referral strategies as a standard of care. Finally, with these optimization strategies a higher quality of care can be achieved, that might be of value for all patients with arthralgia. Trial Registration: NCT03454438, date of registration: March 5, 2018. Retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT03454438?term=NCT03454438&draw=1&rank=1.展开更多
Coal has been dominating the electricity supply in Indonesia,especially in long-term power generation from fossil energy.This dominance is due to lower production costs in coal-fired power plant generation.However,thi...Coal has been dominating the electricity supply in Indonesia,especially in long-term power generation from fossil energy.This dominance is due to lower production costs in coal-fired power plant generation.However,this low price is only based on monetary costs and ignores the social costs.Therefore,this study aims to quantify the social costs of coal-fired generation.Using QUERI-AirPacts modeling,the present study quantifies the social costs resulting from the Tenayan Raya coal-fired generation in Riau,Indonesia.It includes the levelized cost of electricity and health costs into the generation costs.After that,this study calculates the net present value,internal rate return,and project payback period.The study found that as much as$50.22/MWh was the levelized cost of electricity.While$15.978/MWh or$0.015978/kWh was the social cost that was not included in the generating cost.At the electricity production level of 1,380,171.69 MWh per year,there is an expected extra cost of$22,052,383.30 uncounted when externalities are included.For instance,the net present value(NPV)is lower and even negative when external costs are included(-$24,062,274.19)compared to$176,108,091.52 when externalities are not considered.The internal rate of return(IRR)is much higher when the social costs are not considered.The payback period is also shorter when the social costs are excluded than when the externalities are included.This global number indicates that the inclusion of external costs would impact NPV,IRR,and the payback period.This result implies that the government should internalize the external cost to stimulate the electricity producers to conduct cost-benefit analyses.The cost-benefit analysis mechanism would lead the producers to be more efficient.展开更多
文摘A study on smoking-attributable health economic costs in China was conducted from 1988-1992, in which three major categories of chronic diseases, diseases of cancer, diseases of circulatory system, and diseases of respiratory system were included. A prevalence-based method which estimated the cumulative effect of cigarette smoking during the past 20-30years was used. The results show that in 1989, the total smoking-attributable economic costs to health sectors in China were about 27.1 billion of Chinese Yuan, including about 7 billion Yuan in direct medical costs and 20 billion Yuan in indirect costs, which include indirect morbidity costs and indirect mortality costs. The relatively low direct costs reflected the low medical costs at hospitals in China at that time. And the high proportion of indirect costs relative to the total costs shows the high potential years of life lost due to clgarette smoking. The results also show the heavier health burden in urban areas than in rural areas, reflecting the worse situation in urban China at nowadays. But if considering that almost 80% of the Chinese are rural farmers with the higher smoking prevalence and relatively shorter history of manufactured cigarette smoking than their urban counterparts,the very frightful situation due to cigarette smoking would be for China in the next century
文摘Globally, air pollution is a significant cause of death, illness and social discomfort. The problem is particularly severe in Nigeria, the country with the highest number of premature deaths due to ambient particulate matter pollution in Sub Saharan region. It is especially worrying in Lagos, the country’s commercial capital and one of the world’s fastest growing megacities. Despite growing concerns about its deadly impacts, there is currently no reliable monetary estimate of the effects of ambient air pollution, nor a comprehensive control plan in Lagos. Using available ground-level monitored data and the most recent valuation techniques, this paper estimates that in 2018 alone, ambient fine particulate matter (PM2.5) caused about 11,200 premature deaths, and generated a health cost of US$2.1 billion in Lagos. This is equivalent to about 2.1 percent of Lagos’ GDP in the same year. These results call for an urgent plan of action to improve air quality in the city, with primary focus on the main pollution sources: road transport, industrial emissions, and power generation.
基金supported by the National Natural Science Foundation of China(Nos.42305089 and 42175106)the Self-supporting Program of Guangzhou Laboratory(No.SRPG22-007)+1 种基金the Youth Science and Technology Fund Project of Gansu(No.22JR5RA512)the Fundamental Research Funds for the Central Universities(No.lzujbky-2022-pd05).
文摘Ambient fine particulate matter(PM_(2.5))pollution causes the largest environmental health risk globally,yet ex-posure levels and the resulting health risks vary across countries with different income levels.Global wealth inequality has intensified in recent years,yet the relationship between wealth inequality and health risks related to PM_(2.5) pollution remains poorly understood.In this study,we evaluated the global mortality and health cost at-tributable to PM_(2.5) exposure from 2017 to 2021,and analyzed the relationship between wealth inequality,PM_(2.5) pollution,and the associated health risks across regions with varying economic levels.We found a consistent decline in mortalities and health costs attributable to PM_(2.5) exposure from 2017 to 2020,followed by a rebound after 2020,driven primarily by the resurgence of PM_(2.5) concentrations and a deceleration in the reduction of baseline mortality rates.We also found that the average PM_(2.5) concentration and associated risks decrease as domestic wealth inequality decreases and national income level increases.However,regions with extremely high levels of wealth inequality consistently show lower national average PM_(2.5) concentrations and health risks.These findings highlight the need to consider healthcare security during emergencies,as well as policy fairness across economic regions,in the formulation of global PM_(2.5) pollution control measures to promote sustainable,more equitable economic growth and coordinated air pollution management.
基金supported by the Youth Project of the National Social Science Foundation of China(NSSFC):Research on the Mechanism and Countermeasures of Property Rights Incentive to Promote Social Capital Participation in Marine Ecological Restoration in China(Fund No.22CJY028).
文摘Background In response to environmental degradation and the associated health challenges,the Chinese government has implemented a comprehensive array of environmental protection measures.Given the health enhancement objective of environmental protection measures and the considerable costs involved in the implementation process,evaluating whether environmental regulation is benefcial to reducing the health costs of the population is of great signifcance for enhancing environmental governance efciency and social welfare.The data from the Chinese Family Panel Survey(CFPS)is applied to examine the efect of environmental regulation on the reduction of residents’health costs from a microscopic perspective.Results The results indicate that for a 1%increase in total investment in environmental governance,residents’health costs will decrease by 0.189%.The examination of the causal pathway suggests that implementing environmental regulation can diminish residents’health costs through improving air quality and residents’health status.Concurrently,there exist signifcant heterogeneities in the role of environmental regulation in reducing residents’health costs.The efect of environmental regulation is more pronounced for the young,males,and individuals with better self-perceived health.Furthermore,the outcome of environmental regulation exhibits greater efcacy in urban areas compared to rural areas.Lastly,market-incentive environmental regulation in reducing health costs is more efective than command-controlled regulation.Conclusions Enhancing the intensity of environmental regulation contributes to decreasing residents’health costs.The fndings can provide policy reference for implementing environmental governance and achieving tangible enhancements in individuals’life quality.
文摘Similar to most developed countries, obesity rates inRussiahave been steadily increasing. This has led to a high burden of obesity related diseases and associated healthcare costs. The micro-simulation model has been utilized to project body mass index (BMI) and BMI related disease burden and healthcare costs. Incidence, mortality, survival and healthcare costs were collected for thirteen diseases. The results have been simulated for 3 hypothetical scenarios to project a potential impact of policy interventions: 1) assuming no reduction in BMI;2) 1% reduction in mean BMI across the population;3) 5% reduction in mean BMI across the population. Nearly 58% of the female population was obese (BMI ≥30 kg/m2) or overweight (BMI 25 -29.9 kg/m2) in 2010, and the prevalence is projected to decrease to 54% in 2050. The rates are predicted to increase for men from 51% in 2010 to 76% in 2050. The prevalence rates will triple for some obesity-related diseases. A one percent decrease in BMI across the population will save more than two billion US Dollars in 2030 and 2050. Despite female obesity prevalence starting at a higher point than the men, obesity is predicted to increase in males but not females. Disease and economic burden attributed to these obesity rates are still severe and the country should implement strong policies to tackle the obesity epidemic.
文摘The financial crisis has caused a severe limitation of resources for the public health service and rehabilitation. The proposal of integrated diagnosis and treatment in rehabilitation, involving the introduction of new therapeutic models alongside orthodox models, could lead to a reduction in health care costs through better patient compliance. In rehabilitative assistance in health care, the limiting of financial resources can be simplified, given its multifaceted nature and the need to integrate clinical experience with research. In addition, the phases of rehabilitative recovery do not focus on organ damage, but improved participation and the reduction of disability. For this reason, we have considered incorporating narrative based medicine (NBM) and Psycho-Neuro-Immuno-Endocrinology (PNEI) in the rehabilitation process through an empathetic approach, taking evidence based medicine (EBM) into account, thus creating a “framework” of reference. Managing patients through this “framework” would be a move towards an integrated model of care that could lead to a reduction in health care costs, given the aging population and the rise in patients with chronic pain. The decision to modify health care in rehabilitative assistance through a new “framework” will require time, organizational capacity and experimentation, but may represent the appropriate response for an improved quality of life for patients and a better allocation of resources.
文摘With the advancement of technology and health sciences,health care delivery costs are steadily increasing.This affects both households and governments.Unfortunately,the present truth is that health has become an essential but unaffordable commodity.This is very concerning.Quality,up-to-date,costeffective health care delivery is one of the prime objectives,and focuses on administration and health care authority.As the per capita spent on health from public/government funds is very poor in developing countries,the responsibility of cost-effective health care delivery falls primarily on the shoulder of the treating physicians.Anesthesiologists are becoming an indispensable part of health care delivery,having a diverse role in the emergency,critical care,pain,and perioperative care of patients.As the population ages,the need for surgical care is also increasing.Therefore,the anesthesiologist can also play a more significant role in delivering cost-effective health care,and minimize the cost without affecting the quality.This brief narrative review analyzes the current practice of anesthesiologists in two prime areas in the context of cost-savings:Preoperative investigation and low/minimal flow anesthesia.
文摘One of the most significant annual expenses that a person has is their health insurance coverage. Health insurance accounts for one-third of GDP, and everyone needs medical treatment to varying degrees. Changes in medicine, pharmaceutical trends, and political factors are only a few of the many factors that cause annual fluctuations in healthcare costs. This paper describes how a system may analyse a person’s medical history to display their insurance plans and make predictions about their health insurance premiums. The performance of four ML models—XGBoost, Lasso, KNN, and Ridge—is evaluated using R2-score and RMSE. The analysis of medical health insurance cost prediction using Lasso regression, Ridge regression, and K-Nearest Neighbours (KNN), and XGBoost (XGB) highlights notable differences in performance. KNN has the lowest R2-score of 55.21 and an RMSE of 4431.1, indicating limited predictive ability. Ridge Regression improves on this by an R2-score of 78.38 but has a higher RMSE of 4652.06. Lasso Regression slightly edges out Ridge with an R2-score of 79.78, yet it suffers from an advanced RMSE of 5671.6. In contrast, XGBoost excels with the highest R2-score of 86.81 and the lowermost RMSE of 4450.4, demonstrating superior predictive accuracy and making it the most effective model for this task. The best method for accurately predicting health insurance premiums was XGBoost Regression. The findings beneficial for policymakers, insurers, and healthcare providers as they can use this information to allocate resources more efficiently and enhance cost-effectiveness in the healthcare industry.
文摘Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.
文摘Introduction:Direct-to-consumer(DTC)telemedicine has emerged as an option for transgender patients seeking gender affirming hormone therapy(GAHT).We aimed to characterize the healthcare services provided by DTC telemedicine companies offering GAHT and to compare their costs to a tertiary care center.Methods:We identified DTC telemedicine platforms offering GAHT via internet searches and extracted information from their websites related to evaluation,treatment,monitoring,and cost.Cost of theDTC GAHT was compared to cost for comparable services at a tertiary care center.Results:Six DTC companies were identified.All platforms utilized an informed consent model without prerequisite mental health evaluation for GAHT.Platforms did not provide comprehensive mental health services.All platforms endorsed the use of regular follow up visits throughout the treatment period although interval of laboratory assessment varied.Cost estimates were comparable for uninsured patients and higher compared to those for insured patients.Cost estimates were lowest with private and public insurance at the tertiary center.Conclusions:DTC telemedicine platforms offering GAHT appear to be in line with the recently released World Professional Association for Transgender Health standards of care regarding the laboratory evaluation and monitoring,but it is unclear whether they are compliant with other recommendations.These platforms offer competitive costs for TGD patients without insurance.
文摘Accountable care organizations (ACOs) and hospitals are facing additional requirements and financial rewards for improving population health. Therefore, ACOs and hospitals will need tools to understand the relationship between their patients and social determinants and health. We demonstrate the use of hot spotting for identifying geographical sources of high hospital costs and examining links between social determinants of health and these high-cost areas, known as hot spots. In 2012, using hospital data, we generated maps of inpatient costs from 2011 throughout New Haven and within an example neighborhood, Dixwell. We defined hot spots as addresses where costs were in the top 25%. We also overlaid data on concerns and assets in the community. Finally, we calculated the number of concerns and assets that fall within the 250 and 500 ft radii of the defined hot spots. We found that 34 addresses in Dixwell accounted for 70% of total costs for Dixwell. Hot spotting is a straightforward, approachable, and easily understood method for ACOs and hospitals to begin to address population health.
文摘Background: Considering the importance of getting the right patient at the right location to maintain and optimize quality of life of inflammatory arthritis patients, appropriate referral by general practitioners is essential. This study aims to assess the effect and cost effectiveness of different referral strategies for inflammatory arthritis in primary care patients. Methods: This study follows a cluster randomized controlled trial design. General practitioners from primary care centers in Southwest-The Netherlands are randomly assigned to either one of the two strategic interventions for referring adult patients who are in the opinion of the general practitioner suspected of inflammatory arthritis: 1) Standardized digital referral algorithm based on existing referral models PEST, CaFaSpA and CARE;2) Triage by a rheumatologist in the local primary care center. These interventions will be compared to a control group, e.g. usual care. The primary outcome is the percentage of patients diagnosed with inflammatory arthritis by the rheumatologist. Secondary outcomes are quality of life as a patient reported outcome, work participation and healthcare costs. These data, including demographic and clinical parameters, are prospectively collected at baseline, three, six, and twelve months. Discussion: If this study can demonstrate improvements in appropriate referrals to the rheumatologist, thereby improving cost-effectiveness, there is sufficient supporting evidence to implement one of the referral strategies as a standard of care. Finally, with these optimization strategies a higher quality of care can be achieved, that might be of value for all patients with arthralgia. Trial Registration: NCT03454438, date of registration: March 5, 2018. Retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT03454438?term=NCT03454438&draw=1&rank=1.
文摘Coal has been dominating the electricity supply in Indonesia,especially in long-term power generation from fossil energy.This dominance is due to lower production costs in coal-fired power plant generation.However,this low price is only based on monetary costs and ignores the social costs.Therefore,this study aims to quantify the social costs of coal-fired generation.Using QUERI-AirPacts modeling,the present study quantifies the social costs resulting from the Tenayan Raya coal-fired generation in Riau,Indonesia.It includes the levelized cost of electricity and health costs into the generation costs.After that,this study calculates the net present value,internal rate return,and project payback period.The study found that as much as$50.22/MWh was the levelized cost of electricity.While$15.978/MWh or$0.015978/kWh was the social cost that was not included in the generating cost.At the electricity production level of 1,380,171.69 MWh per year,there is an expected extra cost of$22,052,383.30 uncounted when externalities are included.For instance,the net present value(NPV)is lower and even negative when external costs are included(-$24,062,274.19)compared to$176,108,091.52 when externalities are not considered.The internal rate of return(IRR)is much higher when the social costs are not considered.The payback period is also shorter when the social costs are excluded than when the externalities are included.This global number indicates that the inclusion of external costs would impact NPV,IRR,and the payback period.This result implies that the government should internalize the external cost to stimulate the electricity producers to conduct cost-benefit analyses.The cost-benefit analysis mechanism would lead the producers to be more efficient.
