Analysis on disease burden and direct medical cost of Xueshuan Xinmaining Tablets in patients with cerebral infarction and coronary heart disease / 中国中药杂志

The increasing burden of cardiovascular disease in China has become a major public health problem, and the prevention and treatment of cardiovascular disease is in urgent need. For the reality of integrated Chinese and Western medicine in the Chinese health care system, we can consider the service ability of traditional Chinese medicine. Xueshuan Xinmaining Tablet is a kind of Chinese patent medicine commonly used in the treatment of recovery stage of ischemic stroke and angina pectoris of coronary heart disease. Based on the data of hospitalized patients covered by national urban basic medical insurance of China Medical Insurance Research Association in 2013, this study evaluated the treatment cost and detailed composition of the cost for the patients with cerebral infarction and coronary heart disease treated by Xueshuan Xinmaining Tablets. At the same time, the differences in disease burden and direct medical expenses among Xueshuan Xinmaining Tablets group, Western medicine group and another commonly used Chinese patent medicine group were analyzed. Among the three groups of patients with cerebral infarction and coronary heart disease, the hospitalization rates caused by various causes(44.4% and 29.6%) and diseases(20.8% and 5.2%) in Xueshuan Xinmaining Tablets group were the lowest(all P<0.01), and the number of hospitalization times in half a year was highest in the common Chinese patent medicine group(all P<0.01). In patients with cerebral infarction, the median annual total outpatient expenses were 7 476.8, 7 601.8, 15 650.1 yuan respectively in Western medicine group, Xueshuan Xinmaining Tablets group and the common Chinese patent medicine group(P<0.01), and the median hospitalization expenses were 11 620.2, 14 988.9, 13 325.6 yuan respectively(P=0.058). In patients with coronary heart disease, the total outpatient expenses of the three groups were 6 831.4, 10 228.6, 13 132.4 yuan respectively(P<0.01), and the total hospitalization expenses were 13 354.7, 14 911.5, 15 725.3 yuan respectively(P=0.134). The results showed that in patients with cerebral infarction and coronary heart disease, the hospitalization rate was lowest in Xueshuan Xinmaining Tablets group, beneficial to the turnover of hospital beds and full use of hospital medical resources. The total annual outpatient cost of Xueshuan Xinmaining Tablets group was lower than that of common Chinese patent medicine group, beneficial to reduce the burden of disease.

Direct Medical Costs for Patients with Type 2 Diabetes and Related Complications: A Prospective Cohort Study Based on the Korean National Diabetes Program

We analyzed the direct medical costs for Korean patients with type 2 diabetes according to the type of complications and the number of microvascular complications. We analyzed costs for type 2 diabetes and associated complications in 3,125 patients. These data were obtained from the Korean National Diabetes Program (KNDP), a large, ongoing, prospective cohort study that began in 2005. The cost data were prospectively collected, using an electronic database, for the KNDP cohort at six hospitals. The costs were analyzed according to complications for 1 yr from enrollment in the study. Among 3,125 patients, 918 patients had no vascular complications; 1,883 had microvascular complications only; 51 had macrovascular complications only; and 273 had both complications. The annual direct medical costs for a patient with only macrovascular, only microvascular, or both macrovascular and microvascular complications were 2.7, 1.5, and 2.0 times higher than the medical costs of patients without complications. Annual direct medical costs per patient increased with the number of microvascular complications in patients without macrovascular complications. The economic costs for type 2 diabetes are attributable largely to the management of microvascular and macrovascular complications. Proper management of diabetes and prevention of related complications are important for reducing medical costs.

Direct Medical Costs of Type 2 Diabetic Patients in the Tertiary Hospital / 당뇨병

BACKGROUND: Type 2 diabetes mellitus is a common, chronic and costly disease. Its prevalence is rapidly increasing worldwide. Diabetes has big economic burden mainly because of its chronic complications. We analyzed the annual direct medical costs of type 2 diabetic patients, including the costs associated with its complications in Korea retrospectively. METHODS: We enrolled 531 type 2 diabetic patients who had been treated in the 3 Tertiary Hospital in 2005. Clinical characteristics, duration of diabetes, modality of glycemic control, and presence of microvascular and macrovascular complications were assessed by the review of medical records. The annual direct medical costs were assessed using the hospital electronic database and included insurance covered and uncovered medical costs. RESULTS: The annual direct medical costs of type 2 diabetic patients without any complications was 1,184,563 won (95% CI for mean: 973,006~1,396,121 won). Compared to diabetic patients without complications, annual total medical costs increased 4.7-fold, 10.7-fold, and 8.8-fold in patients with microvascular complications, macrovascular complications and both complications, respectively. Hospitalization costs largely increased by 78.7-fold and 61.0-fold in patients with macrovascular complications and both complications, respectively. Major complications to increase medical costs were kidney transplantation (23.1-fold), dialysis (21.0-fold), PTCA or CABG (12.4-fold), and leg amputation (11.8-fold). The total medical costs dramatically increased according to the stage of diabetic retinopathy and nephropathy. CONCLUSION: Diabetic complications have a substantial impact on the direct medical costs of type 2 diabetic patients. The prevention of diabetic complications will benefit the patients as well as the overall healthcare expenditures.

Clinical Characteristics and Direct Medical Costs of Type 2 Diabetic Patients / 당뇨병

BACKGROUND: Type 2 diabetes mellitus is an expensive chronic metabolic disorder and its prevalence has been increasing rapidly in South Korea, owing to a westernized lifestyle. We analyzed the annual direct medical costs attributable to type 2 diabetes and its chronic complications in Korea retrospectively. METHODS: We randomly selected 1,051 patients with type 2 diabetes who visited Ajou University Hospital as an outpatient in 2005. Clinical characteristics, duration of diabetes, and microvascular and macrovascular complications were assessed from a medical chart review. The annual direct medical costs included insurance covered and uncovered medical costs. RESULTS: Of the 1,051 patients with type 2 diabetes, 48.2% had at least one microvascular complication, 5.6% had at least one macrovascular complication, and 12.4% of the patients had both microvascular and macrovascular complications. The average annual direct medical cost was found to be 3,348,488won per patient. In patients with microvascular complications, the total cost of management was increased 1.4 times compared to those without complications. Direct medical costs for patients with macrovascular complications were 2.1-fold as high as patients with no complications. Those patients with both microvascular and macrovascular complications, increased costs by 3.1-fold over those without complications. CONCLUSION: Chronic complications have a substantial impact on the direct medical costs of type 2 diabetes. The prevention of chronic diabetic complications will not only influence the mortality and morbidity of patients with type 2 diabetes, but also potentially reduce medical costs.

One-year Follow-up of the Hospitalized Schizophrenic Patients Treated with Risperidone or Olanzapine: Aspects in Cost Economy / 신경정신의학

OBJECTIVES: This study was conducted to access the cost-effectiveness of risperidone or olanzapine in a subset of patients with schizophrenia. METHODS: Two schizophrenia patient groups who were with risperidone(n=17) or olanzapine(n=20) were compared with each other in total medical cost, average daily cost of antipsychotics, discharge rate, drop-out rate, readmission rate and extropyramidal side effect(EPS). RESULTS: The average daily costs of risperidone and olanzapine treated groups were \9,778 and \9,536 in admission, and \2,219 and \5,118 in patients one year after discharge respectively. Risperidone group showed higher rate of EPS than olanzapine group. There was no significant difference in discharge or drop-out rate. CONCLUSIONS: Olanzapine group had higher total daily medical cost and daily medication cost, while risperidone group showed higher readmission and EPS rate.