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Effects of Adalimumab Entering National Reimbursement on medical costs for Patients With Psoriasis:A 4-Year Single-Center Retrospective Study in China

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International Journal of Dermatology and Venereology 2024年第2期7卷 84-88页

作者： Yu Li Bo-Kun Zhu Qing-Sheng Min Mei Ju Min Li Department of medical Affairs Hospital for Skin Diseases(Institute of Dermatology)Chinese Academy of Medical Sciences and Peking Union Medical CollegeNanjingJiangsu 210042China Hospital Network Information Center Hospital for Skin Diseases(Institute of Dermatology)Chinese Academy of Medical Sciences and Peking Union Medical CollegeNanjingJiangsu 210042China Department of Physiotherapy Hospital for Skin Diseases(Institute of Dermatology)Chinese Academy of Medical Sciences and Peking Union Medical CollegeNanjingJiangsu 210042China Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs Hospital for Skin Diseases(Institute of Dermatology)Chinese Academy of Medical Sciences and Peking Union Medical CollegeNanjingJiangsu 210042China

Objective:Adalimumab(ADA)is expensive and rarely used among ***,its cost for moderate to severe chronic plaque psoriasis can now be reimbursed since its addition to the National Reimbursement Drug List(NRDL)in January ***,we conducted this study to estimate the medical cost of ADA and its influencing factors in patients with psoriasis using ADA and thus gain a better understanding of the effect of the NRDL adjustment in ***:This retrospective study evaluated the medical cost of ADA before and after the addition of ADA to the NRDL(2018—2022)among 320 patients in a large professional dermatology specialty *** analysis,Welch’s analysis of variance,and multiple regression analysis were used to evaluate the medical cost and influencing ***:Before ADA was added to the NRDL,patients’mean total cost and ADA cost were¥24,243.56±16,346.53 and¥20,391.11±14,440.69,*** ADA became covered by the NRDL,the above 2 expenses decreased to¥10,461.19±7,554.66 and¥8,775.27±7,092.16,*** significant decrease in the cost of ADA resulted in a significant 110.5-times increase in ADA *** significant differences were found in the total cost,patient type(outpatient/inpatient),insurance status(yes/no),reimbursement status(before/after),and *** insurance reimbursement(Pmedical insurance reimbursement is the most important factor affecting patients’total cost of ADA by reducing the economic burden,enhancing the availability of ADA,and stimulating the need for treatment.

关键词： adalimumab biological agent psoriasis medical cost medical insurance

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Minimally invasive surgery alone compared with intensity-modulated radiotherapy for primary stage I nasopharyngeal carcinoma

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Cancer Communications 2019年第1期39卷 634-644页

作者： You-Ping Liu Xing Lv Xiong Zou Yi-Jun Hua Rui You Qi Yang Le Xia Shao-Yan Guo Wen Hu Meng-Xia Zhang Si-Yuan Chen Mei Lin Yu-Long Xie Li-Zhi Liu Rui Sun Pei-Yu Huang Wei Fan Xiang Guo Ming-Huang Hong Ming-Yuan Chen Department of Nasopharyngeal Carcinoma Sun Yat-sen University Cancer Center651 Dongfeng East RoadGuangzhou 510060GuangdongP.R.China State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of medical Imaging and Interventional Radiology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Nuclear Medicine Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Clinical Trials Center Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China

Background:The National Comprehensive Cancer Network guidelines recommend intensity-modulated radiotherapy(IMRT)as the primary curative treatment for newly diagnosed nasopharyngeal carcinoma(NPC),but the radiation-related complications and relatively high medical costs remain a consequential burden for the *** nasopharyngectomy(ENPG)was successfully applied in recurrent NPC with radiation free and relatively low medical *** this study,we examined whether ENPG could be an effective treatment for localized stage I ***:Ten newly diagnosed localized stage I NPC patients voluntarily received ENPG alone from June 2007 to September 2017 in Sun Yat-sen University Cancer ***,the data of 329 stage I NPC patients treated with IMRT were collected and used as a reference *** survival outcomes,quality of life(QOL),and medical costs between two groups were ***:After a median follow-up of 59.0 months(95%CI 53.4-64.6),no death,locoregional recurrence,or distant metastasis was observed in the 10 patients treated with *** 5-year overall survival,local relapse-free survival,regional relapse-free survival,and distant metastasis-free survival among the ENPG-treated patients was similar to that among the IMRT-treated patients(100%vs.99.1%,100%vs.97.7%,100%vs.99.0%,100%vs.97.4%,respectively,P>0.05).In addition,compared with IMRT,ENPG was associated with decreased total medical costs($4090.42±1502.65 vs.$12620.88±4242.65,Pmedical costs,and satisfactory QOL and might therefore be an alternative strategy for treating newly diagnosed localized stage I NPC patients who refused ***,the application of ENPG should be prudent,and prospective clinical tri-als were needed to further verify the results.

关键词： Nasopharyngeal carcinoma Localized Early stage Endoscopic nasopharyngectomy Intensity-modulated radiotherapy Survival medical cost Quality of life

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Research on 2041 Cases of High Inpatient Expenditure and Influence Factors during 3 Years in a Single Center

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Chinese medical Journal 2016年第19期129卷 2325-2330页

作者： Suo-Wei Wu Qi Pan Chao Li Qin Wang Jing-Chen Song Tong Chen Department of medical Administration Beijing Hospital Beijing 100730 China

Background：The study was to explore the causes of high inpatient expenditure through analyzing the distribution characteristics as well as the influence factors of high inpatient expenditure cases during 3 years within a Grade-A tertiary hospital through various aspects and multiple angles,thus identifying the major influence factors for high medical expenditure to develop further ***：We retrospectively studied 204l inpatient cases which cost more than RMB 100,000 Yuan per case in a Grade-A tertiary hospital from 2013 to *** analyzed the compositions of the medical cost to evaluate the major factors that cause the high inpatient *** the data and materials were collected from medical record system,and the statistical methods included t-test,variance of analysis,and multivariate linear ***：The average cost of the 2,041 cases was RMB 152,173 Yuan for medicines and materials of medical costs,which respectively accounted for 33.03% and 32.32% of the total cost;and the average length of hospital stay was 28.39 days/*** of skeletal and muscular system,circulatory system,and tumor were the top three disease categories of high inpatient expenditure,which accounted for 39.00%,33.46%,and 18.03%,***,criticality of the disease,gender of the patients,the occurrence of death,and the excessive length of hospital stay all had great impacts on average medical expenditure,while age,hospital infection,and surgery showed no significant impact on average medical ***：The main factors for high inpatient expenditure included the inadequate use of high-value medicines and materials,lacking cost control measures within the hospital,the excessive length of hospital stay for inpatients,and the unnecessary treatment for the patients.

关键词： High Inpatient Expenditure Influence Factors medical cost

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medical Resource Utilizations and Economic Burden in Chinese Cancer Patients with Chemotherapy-induced Anemia:A Populational Database Study

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Chinese Journal of Cancer Research 2008年第4期20卷 307-315页

作者：刘介宇刘沧梧刘季鑫萧金福陈立宗 Department of Nursing Taipei College of Nursing Division of Biostatistics and Bioinformatics Taiwan Health Research Institutes Institute of Cancer Research Taiwan Health Research Institutes

Objective： Most of published studies emphasized the medical cost of treating chemotherapy-induced anemia （CIA） by using specific agents, for example, epoetin α, epoetin β, darbepoetin α or combined with red blood cell transfusions, however, the investigation of the overall medical resources utilizations and economic burden of CIA is still limited. Besides, such studies which emphasized Chinese population still lack. The aim of this study is to investigate the medical resource utilization and the economic burden of Chinese cancer patients with CIA by using a populational representative claim database. Methods： The data for this study are from the 2000-2003 Population Health Insurance Research Database （PHIRD） in Taiwan. On the basis of issuing catastrophic illness cards in the enrollment data files, a total of 26,053 beneficiaries were identified from the PHIRD, who were newly diagnosed with these four cancers in 2001 and 2002 （2001： n=12,954; 2002： n=13099）. A generalized linear model （GLM） was employed for analyzing the differences of medical resource utilization and economic burden between the anemic and non-anemic groups. Results： Analyses showed that the anemic patients were significantly more likely to have longer length of hospital stay than non-anemic patients （P〈0.05） across all these four cancers and in two study periods （except women breast cancer in 2002/03）. As regards the health care expenditures, the average one-year total medical cost was USD$8,982 （2001/02） and USD$8,990 （2002/03） for anemic patients among these four cancers, and USD$7,769 （2001/02） and USD$7713 （2002/03） for non-anemic patients （P〈0.0001）. As for ambulatory costs, anemic patients＇ was significantly higher than non-anemic patients＇ for lung cancer （in 2001/02）, women breast cancer （in 2001/02 and 2002103） and the summarized data （in 2001/02）. As for inpatient costs, anemic patients＇ was significantly higher than non-anemic patients＇ for gastric cancer （in 2002/03）, colon and rectal c

关键词： Economic burden medical cost Cancer Chemotherapy Anemia

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Multi-source financing for tuberculosis treatment in China: key issues and challenges

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Infectious Diseases of Poverty 2021年第2期10卷 44-49页

作者： Qian Long Wei-Xi Jiang Hui Zhang Jun Cheng Sheng-LanTang Wei-Bing Wang Global Health Research Center Duke Kunshan UniversityJiangsuChina National Center for Tuberculosis Control and Prevention China CDCBeijingChina Duke Global Health Institute Duke UniversityDurhamNCUSA. Department of Epidemiology School of Public Health&Key Laboratory of Public Health Safety(Ministry of Education)Fudan University138 Vi Xue Yuan RoadShanghai 200032China.

Background:The End Tuberculosis(TB)Strategy of the World Health Organization highlights the need for patientcentered care and social protection measures that alleviate the financial hardships faced by many TB *** China,TB treatments are paid for by earmarked government funds,social health insurance,medical assistance for the poor,and out-of-pocket payments from *** part of Phase III of the China-Gates TB project,this paper introduces multi-source financing ofTB treatment in the three provinces of China and analyzes the challenges of moving towards universal coverage and its implications of multi-sectoral engagement for TB *** text:The new financing policies forTB treatment in the three provinces include increased reimbursement forTB outpatient care,linkage ofTB treatment with local poverty alleviation programs,and use of local government funds to cover some costs to reduce out-of-pocket ***,there are several challenges in reducing the financial burdens faced byTB ***,medical costs must be contained by reducing the profit-maximizing behaviors of ***,treatment forTB and multi-drug resistant TB(MDR-TB)is only available at county hospitals and city or provincial hospitals,respectively,and these hospitals have low reimbursement rates and high ***,many patients with TB and MDR-TB are at the edge of poverty,and therefore ineligible for medical assistance,which targets extremely poor *** addition,the local governments of less developed provinces often face fiscal difficulties,making it challenging to use of local government funds to provide financial support for TB *** suggest that stakeholders at multiple sectors should engage in transparent and responsive communications,coordinate policy developments,and integrate resources to improve the integration of social protection ***:The Chinese government is examining the establishment of multi-source financing forTB treatm

关键词： Tuberculosis medical cost Financial protection Universal health coverage Multi-sector engagement China

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An Analysis and Prediction of Health Insurance costs Using Machine Learning-Based Regressor Techniques

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Journal of Data Analysis and Information Processing 2024年第4期12卷 581-596页

作者： Gagan Kumar Patra Chandrababu Kuraku Siddharth Konkimalla Venkata Nagesh Boddapati Manikanth Sarisa Mohit Surender Reddy Tata Consultancy Services Charlotte NC USA Mitaja Corportaion Woodlawn MD USA Adobe Seattle WA USA Microsoft Charlotte NC USA Ally Financial Inc Charlotte NC USA

One of the most significant annual expenses that a person has is their health insurance coverage. Health insurance accounts for one-third of GDP, and everyone needs medical treatment to varying degrees. Changes in medicine, pharmaceutical trends, and political factors are only a few of the many factors that cause annual fluctuations in healthcare costs. This paper describes how a system may analyse a person’s medical history to display their insurance plans and make predictions about their health insurance premiums. The performance of four ML models—XGBoost, Lasso, KNN, and Ridge—is evaluated using R2-score and RMSE. The analysis of medical health insurance cost prediction using Lasso regression, Ridge regression, and K-Nearest Neighbours (KNN), and XGBoost (XGB) highlights notable differences in performance. KNN has the lowest R2-score of 55.21 and an RMSE of 4431.1, indicating limited predictive ability. Ridge Regression improves on this by an R2-score of 78.38 but has a higher RMSE of 4652.06. Lasso Regression slightly edges out Ridge with an R2-score of 79.78, yet it suffers from an advanced RMSE of 5671.6. In contrast, XGBoost excels with the highest R2-score of 86.81 and the lowermost RMSE of 4450.4, demonstrating superior predictive accuracy and making it the most effective model for this task. The best method for accurately predicting health insurance premiums was XGBoost Regression. The findings beneficial for policymakers, insurers, and healthcare providers as they can use this information to allocate resources more efficiently and enhance cost-effectiveness in the healthcare industry.

关键词： medical cost Health Insurance cost Prediction medical cost Personal Datasets Machine Learning

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医疗保障对老年人家庭医疗负担的效应分析

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社会保障制度 2014年第2期

作者：杨清红

根据2008年全国老年人口健康状况调查数据(CLHLS)，实证分析医疗保障对老年人家庭医疗负担产生的经济影响，结果发现，医疗保障从整体上对老年人家庭医疗负担存在挤出效应，减轻了老年人的家庭医疗负担；医疗保障对老年人家庭医疗负担... 详细信息

根据2008年全国老年人口健康状况调查数据(CLHLS)，实证分析医疗保障对老年人家庭医疗负担产生的经济影响，结果发现，医疗保障从整体上对老年人家庭医疗负担存在挤出效应，减轻了老年人的家庭医疗负担；医疗保障对老年人家庭医疗负担具有显著的城乡差异；医疗保障对老年人家庭医疗负担体现出群体性差异和非均衡性。出现这些情况，其根源在于医疗保障自身的运作机制以及医疗卫生制度存在各种弊病，建立公平、按需分配的医疗保障制度是根本出路。

关键词：医疗保障医疗负担老年人 medical insurance medical cost elders

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城乡失能老人照料成本研究

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社会保障制度 2018年第1期

作者：沙莎周蕾

基于多状态生命表方式，使用中国老年健康长寿2008-2012年纵向调查数据，将我国失能老人照料成本分为直接成本、机会成本和医疗成本，重点关注机会成本，设计出高、中、低三种机会成本方案，对我国城乡失能老人余生照料成本做出估算。... 详细信息

基于多状态生命表方式，使用中国老年健康长寿2008-2012年纵向调查数据，将我国失能老人照料成本分为直接成本、机会成本和医疗成本，重点关注机会成本，设计出高、中、低三种机会成本方案，对我国城乡失能老人余生照料成本做出估算。根据城乡失能老人照料成本特征与规律，建立和完善老年长期护理保险制度、开展针对老年照料提供者的帮助计划是解决城乡失能老人照料的根本路径。

关键词：失能老人直接成本机会成本医疗成本 disabled elderly direct cost opportunity cost medical cost

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