COST ANALYSIS OF DISEASE DIAGNOSES
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Abstract
Background: A variety of methods exist to show the estimated costs of disease analysis or perhaps a new intervention method. All the same, the decision to choose a particular model remains unclear. Thus in this research, we shall compare the cost analysis of a diagnosis-related group in determining whether using a particular approach can have a huge impact on the results of economic variations.
Methods: A cost-utility model was initiated to compare the prevention methods for hip fractured patients while using data from the CDC and CMS. All the same, I adopted a health care perspective and utilities using Microsoft Excel and a meta-regression model. Nevertheless, I also used hospital resources using the DRG- unit costs and a regression model developed using data from patients to pass the information regarding health in the states.
Results: In my results, I discovered that the finished consultant episode was the highest admission cost, costing about ($5600). However, spell-level tariffs were the lowest in terms of total hospital costs. When using a nursing fracture liaison method, the model of health care was the better alternative.
Conclusion: My results show that, when the national unit costs are adopted, the cost of hip fracture may vary considerably; thus, different diagnosis and intervention methods have to be put in place in reaching better intervention strategies.
Introduction
A medical facility comprises of hospital spells or perhaps medical admission of patients at the same hospital. In the hospital spell, a patient is likely to receive medical attention from one or many medical practitioners. Since 1980, data has always been collected in all public health facilities (Orces, 2016). Unlike the other studies, mine is different as it entails cost analysis of a particular diagnosis that is a hip fracture and its correlation to its prevention strategies. .All the same reference cost has also been used to determine the cost of providing a unit of medical care in a given institution while compared to other institutions (Basu, 2016). Therefore in this analysis, the sources of unit costs include data sources from the CDC and CMS. This paper aims to address the cost analysis of disease diagnoses using hip fractures as a case example. Similarly, other studies have also shown that Hip fractures are a major health problem in our society today as a trivial number of patients are affected, causing the health industry an estimated $2 billion annually.
Methods
I developed a transition model using the Markov model to calculate the cost-effectiveness of the three models care for patients with hip fracture problems, an estimate of lifetime costs, and even the quality-adjusted life years for patients admitted to a hospital in the US. The three prevention methods put into the trial were: a) A prologue of nurse-led fracture liaison service, which is a secondary prevention strategy, b) Orthogeriatrician service, which is very vital for recovery after hip fracture, and c) standard post hip care services without using the above means. I also developed a model using Microsoft Excel (Microsoft Corp., Redmond, WA, USA) to examine the patient history with hip problems, costs of patients with index hip problems, home-based care delivery system after hip surgery, or living in a care home and even death within 20 days after the hip fracture. I applied an iterative model in a definition of the model in practice. This entailed subject information from clinical experts and epidemiologists. The hospital costs were also updated after using the re-analysis of the data.
Data
Medical costs of hip fractures
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681302/
Characteristics of patients with hip fractures
| Total N | 758 |
| Gender, % | |
| Female | 73 |
| Age, y, mean ± SD | |
| Overall | 85.6 |
| Race, % | |
| White | 95.8 |
| Hispanic | 1.2 |
| Black | 1.3 |
| Asian | 1.9 |
| American Indian | 0.1 |
| Other | 0.5 |
| Prefecture residence, % | |
| Community | 48.1 |
| Assisted living | 16.8 |
| Nursing home | 33.3 |
| Unknown | 1.8 |
| Charlson score, mean ± SD | |
| Overall | 2.9 ± 2.2 |
| Female | 2.8 ± 2.2 |
| Male | 3.4 ± 2.3 |
| Dementia, % | 45.8 |
| Length of stay, mean ± SD | 20.1 ± 3.3 |
| Readmission rate, % | 15.4 |
| Reoperation rate, % | 0.85 |
| Admit average Parker mobility, mean ± SD | 4.4 ± 2.7 |
| Inpatient mortality, % | 2.8 |
| Admission activities of daily living, mean ± SD | 3.94 ± 2.4 |
| Total N | 758 |
Markov-model medical costs of hip fractures
| Costs | Mean costs (£) (95% confidence interval)a | ||
| FCE-level reference costs | Spell-level reference costs | Spell-level tariffs | |
| Initial inpatient care costs (index admission to discharge) | 9075 | 8145 | 6689 |
| Inpatient care costs within 1 year of fracture | 13,866 | 11,759 | 10,263 |
| A&E and outpatient care costs within 1 year of fracture | 575 | 575 | 86 |
| Total hospital care costs within 1 year of fracture | 14,440 | 12,334 | 10,749 |
Retrieved from: https://link.springer.com/article/10.1007/s40273-018-0673-y
Analysis
Results
Patient sample results
In my results, I discovered that the mean age of those identified with hip fracture was 80 years old. About 77% of the patients were also females. All the same, a lot of the patients belonged to the white ethnic society. The average follow-up of the cohort was also 1.4 years, and the mean length of stay was given as 20 days.
Costs of Hip Fractures
In using the three sets of national unit costs, The FCE- level reference was the highest at the admission level at ($9075). It was relatively high also in the year of the fracture at ($14440). All the same, the use of spell- level tariffs was at its slowest within one year, with a difference of about $ 3780 and a 95% confidence interval when compared to spell- level reference costs, which had a difference of about $ 2226(Clair, 2016). More than 90% of the costs were due to patients getting admitted to the hospitals in all the health care resource groups.
Analysis of the hospital costs
About 750 patients were used in the analysis of this study. Regression models for hospitalization rates: The admitted patients and patients in critical conditions and rates of non-hospitalization, including outpatient, were analyzed. In summation, the coefficients were all constant in the three sets of data (Imam, 2019). Nevertheless, the significance was seen in regards to the units of costs used in the experiment. For instance, costs of hospitalization were associated with death within the 2o days of hip fracture.
Discussion
In my research, I found out that the hospital cost of hip fracture was largely based on data’s three-unit costs. The hospital costs also varied between $ 10000 and $14500 per fracture in correlation to the specific costs of units used (Sbikicki, 2019). These differences did impact an individual and the total costs a hospital can spend on hip fractures. All the same, reference costs were being collected to have a quick comparison between various facilities. All the same, there are still some local interventions, and further academic research carried forward to have interventions of the hip fractures.
Conclusion
The availability of health care medical records has made it possible for data to be analyzed in full measure. Moreover, the research is also documented in full. According to my results, the condition of national unit costs being adopted by the government may vary considerably about the policies being adopted to have an intervention regarding a certain disease. In the end, these costs may impair our health industry and may lead to a reduction of a healthy population if the government does not put up measures to provide good health care at a cheap cost.
Reference
Basu N, Nat our M, Mounasamy V, Kates SL. Geriatric hip fracture management: keys to providing a successful program. European Journal of Trauma and Emergency Surgery. 2016 Oct 1;42(5):565-9.
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681302/
Clair AJ, Evangelista PJ, Lajam CM, Slover JD, Bosco JA, Iorio R. Cost analysis of total joint arthroplasty readmissions in a bundled payment care improvement initiative. The Journal of arthroplasty. 2016 Sep 1;31(9):1862-5.
Retrieved from: https://link.springer.com/article/10.1007/s40273-018-0673-y
Imam MA, Shehata MS, Elsehili A, Morsi M, Martin A, Shawqi M, Grubhofer F, Chirodian N, Narvani A, Ernstbrunner L.
Contemporary cemented versus uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures: A meta-analysis of forty-two thousand forty-six hips. International orthopedics. 2019 Jul 4;43(7):1715-23.
Orces CH. Hip fracture-related mortality among older adults in the United States: analysis of the CDC WONDER multiple causes of death data, 1999–2013. Epidemiology Research International. 2016;2016.
Skibicki H, Yayac M, Krueger CA, Courtney PM. Target Price Adjustment for Hip Fractures Is Not Sufficient in the Bundled Payments for Care Improvement Initiative. The Journal of arthroplasty. 2020 Jul 31.