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Excess Costs (excess + cost)
Selected AbstractsHealthcare Costs of Acute and Chronic Pain Associated with a Diagnosis of Herpes ZosterJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2007Robert H. Dworkin PhD OBJECTIVES: To determine the healthcare costs of acute and chronic pain associated with herpes zoster. DESIGN: Retrospective cohort analysis. SETTING: Inpatient and outpatient care. PARTICIPANTS: Patients were selected from Medicare, commercial insurance, and Medicaid claims databases if they had a diagnosis of herpes zoster or postherpetic neuralgia (PHN) or were prescribed analgesics after a diagnosis of herpes zoster (possible PHN) and were matched to controls for demographic and clinical factors using propensity scores. MEASUREMENTS: One-year excess healthcare expenditures attributable to herpes zoster pain or PHN were calculated for inpatient, outpatient, and prescription drug services. RESULTS: For the Medicare cohort, the average excess cost per patient was $1,300 in the year after a diagnosis of herpes zoster with 30 days or fewer of analgesic use and ranged from $2,200 to $2,300 per patient with PHN or possible PHN. Patients with possible PHN were 53% more prevalent than patients with PHN in the Medicare cohort and accounted for half of all excess expenditures. Findings were similar in the younger cohorts with commercial insurance and Medicaid except that costs attributable to PHN and possible PHN were higher, and patients with possible PHN were three to five times as prevalent as patients with PHN. CONCLUSION: Healthcare costs associated with PHN were substantially greater than those associated with herpes zoster pain that resolved within 30 days. The data suggest that as many as 80% of patients with PHN may not be diagnosed with PHN and that these patients account for at least half of PHN expenditures. [source] Do PPPs in Social Infrastructure Enhance the Public Interest?AUSTRALIAN JOURNAL OF PUBLIC ADMINISTRATION, Issue 2010Evidence from England's National Health Service This article outlines and critiques the main fiscal and economic rationales for the Private Finance Initiative , by far the dominant form of public-private partnership in the United Kingdom (UK) , and examines the impact of the policy on the long term financial viability of the National Health Service. It shows that the interest rate on private finance contains a significant element of ,excess return' to investors, and there is no evidence that this ,excess cost' to the public sector is offset by greater efficiency through the contracting process. It concludes that the private financing of public capital investment is highly problematic , and can have a serious impact on the finances and capacity of public authorities. [source] Evolution of single-chick broods in the Swallow-tailed Gull Creagrus furcatusIBIS, Issue 2 2003ANA Agreda Swallow-tailed Gulls lay single-egg clutches, and so raise single-chick broods. As they are pelagic seabirds, this small brood size is expected to relate to proximate food limitation owing to infrequent food deliveries. However, a previous brood doubling experiment detected an 82% increase in fledging success from experimentally doubled broods compared to controls. We repeated the brood doubling experiment, and found that none of 50 enlarged broods produced more than one independent offspring. Control and experimental parents produced fledglings of similar body size, which also had indistinguishable rates of fledging and subsequent survival and reproduction. A variety of parameters estimating survival and breeding costs of reproduction showed no treatment effect. Since two-chick broods yield dramatically higher fledging rates at some times, apparently without excess costs of reproduction, selection on brood size appears to favour a two-chick brood. However, selection may not favour a two-egg clutch if egg production is very costly. Additionally, our estimates of reproductive success do not incorporate the performance of experimental and control offspring as adults, which could differ, since growth of chicks differed slightly by treatment. [source] The socio-economical burden of hypersomniaACTA NEUROLOGICA SCANDINAVICA, Issue 4 2010P. Jennum Jennum P, Kjellberg J. The socio-economical burden of hypersomnia. Acta Neurol Scand: 2010: 121: 265,270. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, In the absence of socio-economical consequences of hypersomnia this study addresses the factual indirect and direct costs. Methods,,, Two thousand two hundred and eight patients with a hypersomnia diagnosis from 1998 to 2005 were identified in the Danish national patient registry (NPR), each compared with 4 age and gender adjusted, randomly chosen citizens selected from the Civil Registration System Statistics. The health cost was decomposed in direct and indirect yearly costs, including labor supply and social transfer payments. Direct costs included frequencies and costs of discharges and outpatient use by cost weights according to diagnosis related groups and specific outpatient prices based on data from The Danish Ministry of Health. The use of and costs of drugs was based on data from the Danish Medicines Agency. The frequencies and costs from primary sectors were based on data from The National Health Security. Indirect costs were based on income data from the coherent social statistics (CSS). Results,,, Patients with hypersomnia presented significant higher health related contact rate, expenses and medication use. No differences were identified in employment and income. The yearly sum of direct and indirect costs were yearly ,3402 vs. ,1212 in controls (P < 0.001), corresponding to a yearly excess costs ,2190. The patients presented higher transfer income, total ,889. Conclusion,,, Hypersomnia patient present higher health and medication uses, and social transfer income and thus represent a significant socio-economical burden. [source] | ||||||||||