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Cost-analysis of different management policies for patients with mild hepatitis A virus infection in Kazakhstan.

Yassin AS, Favorov M, Maes E, Sadek R, Jumagulova A, Merker V, Surdina T, Chorba T - Cost Eff Resour Alloc (2005)

Bottom Line: For patients with mild hepatitis A virus (HAV) infection, this study compared estimates of total costs associated with managing cases under a policy of mandatory hospitalization in the Republic of Kazakhstan and estimates of total costs associated with managing cases in outpatient settings.Costs were estimated both from the perspective of the Ministry of Health and from a broader societal perspective.The survey results showed that a relatively minor change in the current policy of mandatory hospitalization could result in an estimated total annual savings of 4.62 million US dollars (2001 US dollars) in Kazakhstan.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of International Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. yassin.abdiaziz@dol.gov

ABSTRACT

Objective: For patients with mild hepatitis A virus (HAV) infection, this study compared estimates of total costs associated with managing cases under a policy of mandatory hospitalization in the Republic of Kazakhstan and estimates of total costs associated with managing cases in outpatient settings. Costs were estimated both from the perspective of the Ministry of Health and from a broader societal perspective.

Methods: Data were collected by using a standardized structured questionnaire. For cases of mild HAV infection, medical records were obtained from 200 patients managed by hospitalization and from 251 patients managed in an outpatient setting. Personal interviews were also conducted to collect information on productivity losses and out-of-pocket expenses.

Results: Nationally, we estimated about 21,600 cases of mild HAV infection annually. The mean annual treatment costs in hospital for mild HAV infection was estimated at 3.39 million US dollars (2001 US dollars) (95% confidence interval [CI] = [3.26 million US dollars-3.52 million US dollars]). The total annual mild HAV infection cost to the society, including direct medical and nonmedical costs and productivity losses due to 721,440 lost work days, was estimated at 6.26 million US dollars (95% CI [6.05 million US dollars-6.47 million US dollars]). In sensitivity analyses, the total annual cost of mild HAV infection ranged from 4.37 million US dollars to 24.66 million US dollars. The survey results showed that a relatively minor change in the current policy of mandatory hospitalization could result in an estimated total annual savings of 4.62 million US dollars (2001 US dollars) in Kazakhstan.

Conclusion: Adoption of an outpatient management policy for cases of mild HAV infection would generate substantial cost savings to the Ministry of Health and society.

No MeSH data available.


Related in: MedlinePlus

Mean treatment costs per mild HAV inpatient by age group
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Figure 1: Mean treatment costs per mild HAV inpatient by age group

Mentions: Results from the PROC TTEST indicated that the difference between the mean treatment costs for management of mild HAV infection among the inpatient and outpatient groups was US$134.6 (2001 US$), 95% CI = (US$ 128.0 – 140.0) and statistically significant at (p ≤ 0.0001). When we controlled for the effect of age on medical cost by stratifying the samples by age group, we found that the mean treatment costs in the outpatient setting was still considerably lower than those in the inpatient setting. For example, the mean treatment costs of managing cases of mild HAV infection for outpatients aged 19 to 26 years was estimated at 13.9% of that for the inpatients of the same age. The one-way ANOVA analysis indicated that the mean treatment costs per inpatient decreased as age increased (Figure 1). The mean treatment cost per inpatient for the age group ≥ 35 years was estimated at US$144 compared with US$163 for the age group ≤ 18 years (F-value = 1.40; p = 0.25). Results from this analysis indicated that although there were differences in population means among different age groups, these differences were not statistically significant. We also noted that the mean treatment cost per outpatient in the age group ≥ 35 years was estimated at US$28 versus US$22 for the age group ≤ 18 years (F-value = 2.05; p = 0.10). Again, results from this analysis indicated that although there were differences in population means, these differences were not statistically significant. Mean treatment costs as well as productivity losses per outpatient increase slightly as age increases (Table 3).


Cost-analysis of different management policies for patients with mild hepatitis A virus infection in Kazakhstan.

Yassin AS, Favorov M, Maes E, Sadek R, Jumagulova A, Merker V, Surdina T, Chorba T - Cost Eff Resour Alloc (2005)

Mean treatment costs per mild HAV inpatient by age group
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1173129&req=5

Figure 1: Mean treatment costs per mild HAV inpatient by age group
Mentions: Results from the PROC TTEST indicated that the difference between the mean treatment costs for management of mild HAV infection among the inpatient and outpatient groups was US$134.6 (2001 US$), 95% CI = (US$ 128.0 – 140.0) and statistically significant at (p ≤ 0.0001). When we controlled for the effect of age on medical cost by stratifying the samples by age group, we found that the mean treatment costs in the outpatient setting was still considerably lower than those in the inpatient setting. For example, the mean treatment costs of managing cases of mild HAV infection for outpatients aged 19 to 26 years was estimated at 13.9% of that for the inpatients of the same age. The one-way ANOVA analysis indicated that the mean treatment costs per inpatient decreased as age increased (Figure 1). The mean treatment cost per inpatient for the age group ≥ 35 years was estimated at US$144 compared with US$163 for the age group ≤ 18 years (F-value = 1.40; p = 0.25). Results from this analysis indicated that although there were differences in population means among different age groups, these differences were not statistically significant. We also noted that the mean treatment cost per outpatient in the age group ≥ 35 years was estimated at US$28 versus US$22 for the age group ≤ 18 years (F-value = 2.05; p = 0.10). Again, results from this analysis indicated that although there were differences in population means, these differences were not statistically significant. Mean treatment costs as well as productivity losses per outpatient increase slightly as age increases (Table 3).

Bottom Line: For patients with mild hepatitis A virus (HAV) infection, this study compared estimates of total costs associated with managing cases under a policy of mandatory hospitalization in the Republic of Kazakhstan and estimates of total costs associated with managing cases in outpatient settings.Costs were estimated both from the perspective of the Ministry of Health and from a broader societal perspective.The survey results showed that a relatively minor change in the current policy of mandatory hospitalization could result in an estimated total annual savings of 4.62 million US dollars (2001 US dollars) in Kazakhstan.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of International Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. yassin.abdiaziz@dol.gov

ABSTRACT

Objective: For patients with mild hepatitis A virus (HAV) infection, this study compared estimates of total costs associated with managing cases under a policy of mandatory hospitalization in the Republic of Kazakhstan and estimates of total costs associated with managing cases in outpatient settings. Costs were estimated both from the perspective of the Ministry of Health and from a broader societal perspective.

Methods: Data were collected by using a standardized structured questionnaire. For cases of mild HAV infection, medical records were obtained from 200 patients managed by hospitalization and from 251 patients managed in an outpatient setting. Personal interviews were also conducted to collect information on productivity losses and out-of-pocket expenses.

Results: Nationally, we estimated about 21,600 cases of mild HAV infection annually. The mean annual treatment costs in hospital for mild HAV infection was estimated at 3.39 million US dollars (2001 US dollars) (95% confidence interval [CI] = [3.26 million US dollars-3.52 million US dollars]). The total annual mild HAV infection cost to the society, including direct medical and nonmedical costs and productivity losses due to 721,440 lost work days, was estimated at 6.26 million US dollars (95% CI [6.05 million US dollars-6.47 million US dollars]). In sensitivity analyses, the total annual cost of mild HAV infection ranged from 4.37 million US dollars to 24.66 million US dollars. The survey results showed that a relatively minor change in the current policy of mandatory hospitalization could result in an estimated total annual savings of 4.62 million US dollars (2001 US dollars) in Kazakhstan.

Conclusion: Adoption of an outpatient management policy for cases of mild HAV infection would generate substantial cost savings to the Ministry of Health and society.

No MeSH data available.


Related in: MedlinePlus