Objectives To estimate medical expenditures attributable to older adult falls using a methodology that can be updated annually to track these expenditures over time. Design Population data from the National Vital Statistics System (NVSS) and cost estimates from the Web‐based Injury Statistics Query and Reporting System (WISQARS) for fatal falls, quasi‐experimental regression analysis of data from the Medicare Current Beneficiaries Survey (MCBS) for nonfatal falls. Setting U.S. population aged 65 and older during 2015. Participants Fatal falls from the 2015 NVSS (N=28,486); respondents to the 2011 MCBS (N=3,460). Measurements Total spending attributable to older adult falls in the United States in 2015, in dollars. Results In 2015, the estimated medical costs attributable to fatal and nonfatal falls was approximately $50.0 billion. For nonfatal falls, Medicare paid approximately $28.9 billion, Medicaid $8.7 billion, and private and other payers $12.0 billion. Overall medical spending for fatal falls was estimated to be $754 million. Conclusion Older adult falls result in substantial medical costs. Measuring medical costs attributable to falls will provide vital information about the magnitude of the problem and the potential financial effect of effective prevention strategies.
Importance It is important to understand the magnitude and distribution of the economic burden of prescription opioid overdose, abuse and dependence to inform clinical practice, research and other decision makers. Decision makers choosing approaches to address this epidemic need cost information to evaluate the cost effectiveness of their choices. Objective To estimate the economic burden of prescription opioid overdose, abuse, and dependence from a societal perspective Design, Setting and Participants Incidence of fatal prescription opioid overdose from the National Vital Statistics System, prevalence of abuse and dependence from the National Survey of Drug Use and Health. Fatal data are for the U.S population, nonfatal data are is a nationally representative sample of the U.S. civilian noninstitutionalized population ages 12 and older. Cost data are from various sources including health care claims data from the Truven Health MarketScan® Research Databases, and cost of fatal cases from the WISQARS™ (Web-based Injury Statistics Query and Reporting System) cost module. Criminal justice costs were derived from the Justice Expenditure and Employment Extracts published by the Department of Justice. Estimates of lost productivity were based on a previously published study. Exposure Calendar year 2013 Main Outcomes and Measures Monetized burden of fatal overdose and abuse and dependence of prescription opioids. Results The total economic burden is estimated to be $78.5 billion. Over one third of this amount (is due to increased health care and substance abuse treatment costs ($28.9 billion). Approximately one quarter of the cost is borne by the public sector in health care, substance abuse treatment, and criminal justice costs. Conclusions and Relevance These estimates can assist decision makers in understanding the magnitude of adverse health outcomes associated with prescription opioid use such as overdose, abuse, and dependence.
Objectives To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. Methods This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used attributable costs whenever possible. For those categories that attributable cost data were not available, costs were estimated as the product of incremental effect of child maltreatment on a specific outcome multiplied by the estimated cost associated with that outcome. The estimate of the aggregate lifetime cost of child maltreatment in 2008 was obtained by multiplying per-victim lifetime cost estimates by the estimated cases of new child maltreatment in 2008. Results The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion. Conclusions Compared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment.
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