Care Expenses (care + expense)

Distribution by Scientific Domains

Kinds of Care Expenses

  • health care expense

  • Selected Abstracts

    Health insurance and savings over the life cycle,a semiparametric smooth coefficient estimation

    Prof. Shin-Yi Chou
    Individuals save for future uncertain health care expenses. This is less efficient than pooling health risk through insurance. The provision of comprehensive health insurance may raise welfare by providing the missing market to smooth out consumption through the life cycle. We employ a semiparametric smooth coefficient model to examine the effects of the introduction of the National Health Insurance in Taiwan in 1995 on savings and consumption over the life cycle. The idea is to estimate the coefficients of health insurance which vary with age. Our results suggest that younger households are more sensitive to the risk reductions, and that they demonstrate a greater response in the reduction of their precautionary saving. Copyright 2004 John Wiley & Sons, Ltd. [source]

    We should work less at night

    There is growing amount of evidence that doctors' performance is poorer if they work for over-prolonged duties or at night. These working patterns decrease the standard of care and increase the health care expenses. Furthermore, night workers have serious health risks due to their non-physiological work shifts. Effective ways to reduce the overall consequences of fatigue and night work include minimising the amount of work carried out at nighttime and setting up rules for maximal hours for each work shift. [source]

    Surveillance and risk factors of norovirus gastroenteritis among children in a southern city of China in the fall,winter seasons of 2003,2006

    Ying-Chun Dai
    Aim: Noroviruses (NoVs) are an important cause of acute gastroenteritis but knowledge on the disease burden and epidemiology in children in the developing countries remains limited. In this study, we performed a surveillance of NoV gastroenteritis in children of China to address some of the questions. Methods: Faecal specimens from children (<5 years of age) at outpatient clinics of the Nan Fang Hospital in Guangzhou, China during the fall,winter seasons in 2003,2006 were tested for rotaviruses (RVs) and NoVs. A questionnaire on clinical records and hygiene habits was collected from each patient. Results: Among 957 stool specimens tested, 488 (51%) specimens were positive for RVs. NoVs were detected in 112 (24%) of the 469 RV negative specimens. The Genogroup II (GII), particularly GII-4, viruses were predominant. No significant difference of clinical symptoms, hospitalisation and patient care expenses were found between children infected with NoVs and RVs. Consumption of uncooked food is a risk for NoV infection. Contact with diarrhoea patients is a suspected risk factor. Cutting nails frequently is a protective factor against NoV infection. Conclusions: NoVs are an important cause of acute gastroenteritis in children which need special attention of patient care at the clinics in addition to RVs. The awareness of those risk factors may help future disease control and prevention. [source]

    The Private Market for Long-Term Care Insurance in the United States: A Review of the Evidence

    Jeffrey R. Brown
    This article reviews the growing literature on the market for private long-term care insurance, a market notable for its small size despite the fact that long-term care expenses are potentially large and highly uncertain. After summarizing long-term care utilization and insurance coverage in the United States, the article reviews research on the supply of and the demand for private long-term care insurance. It concludes that demand-side factors impose important limits on the size of the private market and that we currently have a limited understanding of how public policies could be designed to encourage the growth of this market. [source]

    Economic burden associated with Parkinson's disease on elderly Medicare beneficiaries

    MOVEMENT DISORDERS, Issue 3 2006
    Katia Noyes PhD
    Abstract We evaluated medical utilization and economic burden of self-reported Parkinson's disease (PD) on patients and society. Using the 1992,2000 Medicare Current Beneficiary Survey, we compared health care utilization and expenditures (in 2002 U.S. dollars) of Medicare subscribers with and without PD, adjusting for sociodemographic characteristics and comorbidities. PD patients used significantly more health care services of all categories and paid significantly more out of pocket for their medical services than other elderly (mean SE, $5,532 $329 vs. $2,187 $38; P < 0.001). After adjusting for other factors, PD patients had higher annual health care expenses than beneficiaries without PD ($18,528 vs. $10,818; P < 0.001). PD patients were more likely to use medical care (OR = 3.77; 95% CI = 1.44,9.88), in particular for long-term care (OR = 3.80; 95% CI = 3.02,4.79) and home health care (OR = 2.08; 95% CI = 1.76,2.46). PD is associated with a significant economic burden to patients and society. Although more research is needed to understand the relationship between PD and medical expenditures and utilization, these findings have important implications for health care providers and payers that serve PD populations. 2005 Movement Disorder Society [source]

    Management of Pain in Addicted/Illicit and Legal Substance Abusing Patients

    PAIN PRACTICE, Issue 1 2005
    Aaron B. Rosenblatt MD
    Abstract: Approximately one-third of the American population experiences chronic pain. This varies in origin and severity. It also has been documented that billions of dollars are lost yearly because of health care expenses and missed workdays for chronic pain. Addiction is a primary, chronic, neurobiological disease with genetic, psychological and environmental factors influencing its development and manifestations. Addictive disorders occur in 3% to 26% of the general population, 19% to 255 of hospitalized patients and 40% to 60% in patients who sustained major trauma. More specifically 13.9 million of people living in USA over the age of 12 years are currently using illicit drugs. Although patients with chronic pain may be at an increased risk for addiction, the general population has demonstrated similar addiction rates. Unfortunately, patients who have chronic pain and addition will only have one of these aspects addressed. The purpose of this article is to clarify specific definition of substance use, abuse and addiction. As well as examining the role of pain physicians in evaluating and treating the chronic pain patients who have a history of substance abuse, and lastly outline strategy for assessing patients at risks and evaluating the most practical way of dealing with their chronic pain issues. [source]

    The course and correlates of high hospital utilization in sickle cell disease: Evidence from a large, urban Medicaid managed care organization,

    C. Patrick Carroll
    Although most patients with sickle cell disease (SCD) are hospitalized infrequently and manage painful crises at home, a small subpopulation is frequently admitted to emergency departments and inpatient units. This small group accounts for the majority of health care expenses for patients with SCD. Using inpatient claims data from a large, urban Medicaid MCO for 5 consecutive years, this study sought to describe the course of high inpatient utilization (averaging four or more admissions enrolled per year for at least 1 year) in members with a diagnosis of SCD and a history of hospitalizations for vaso-occlusive crisis. High utilizers were compared with the other members with SCD on demographics, medical and psychiatric comorbidity, and use of other health care resources. Members who were high utilizers had more diagnostic mentions of sickle cell complications than low utilizers. However, the pattern of high inpatient utilization was likely to moderate over successive years, and return to the pattern after moderation was uncommon. Despite this, a small subpopulation engaged in exceptional levels of inpatient utilization over multiple years. Am. J. Hematol., 2009. 2009 Wiley-Liss, Inc. [source]

    Pathways to care for patients with bipolar disorder

    BIPOLAR DISORDERS, Issue 3 2005
    Dinesh Bhugra
    Bipolar disorder is a chronic, debilitating psychiatric illness with serious ramifications for patients, their families, and society. Despite the availability of effective treatments, this disease often goes untreated due to medical, financial, legal/governmental, and cultural barriers. In this review we explore possible reasons for this problem. Misdiagnosis of bipolar disorders is a common medical barrier. One pathway to care for individuals with bipolar disorder is through referral from primary care, but primary care physicians generally have not received special training in the recognition and management of bipolar disorder. This often leads to diagnostic delays or errors, which prevents timely ,filtering' of patients into specialized care. Using data bases we explored these pathways. Legislation in the USA, such as the Emergency Medical Treatment and Active Labor Act (EMTALA), designed to ensure access to inpatient mental health care, has instead given hospitals financial incentives to limit inpatient mental health care capacities. Reimbursement of mental health care expenses is a significant issue impacting a patient's ability to gain access to care, as bipolar disorder is a costly disease to treat. Improving access to care among the bipolar community will require multilateral strategies to influence the actions and attitudes of patients, communities, providers, health care systems, and state/national governments. In other cultures, barriers to care differ according to a number of factors such as type of services, explanatory models of illness, misdiagnosis and perceptions of care givers. It is essential that clinicians are aware of pathways and barriers so that appropriate and accessible care can be provided. [source]