A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective

Pyykönen, Mikko; Leminen, A; Tynkkynen, Juho; Tykkyläinen, Markku; Laatikainen, Tiina

doi:10.4081/gh.2019.809

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…Campanella et al [ 40 ] observed that digital healthcare not only partially lead to a higher level of customer satisfaction, but also to better organisational performance of public health companies. Such technology can also enhance care protocols and decrease the number of visits to healthcare facilities, as the part of visits can be replaced by self-monitoring and remote follow-up care [ 41 ] and using algorithms to select drugs that require fewer follow-up visits to laboratories from fringe areas [ 42 , 43 ]. In pre- and postoperative telemedicine consultations services given by Korean physicians to Vietnamese patients, a robot-based system for telemedicine decreased in-person contact, travel and cost [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Service quality and accessibility of healthcare facilities: digital healthcare potential in Ho Chi Minh City

La²,

Tykkyläinen

2022

BMC Health Serv Res

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Background Effective delivery of health services requires adequate quality in healthcare facilities and easy accessibility to health services physically or virtually. The purpose of this study was to reveal how the quality of healthcare facilities varies across the different parts of Ho Chi Minh City and how well residents (N = 9 million) can reach healthcare facilities. By demarcating the deficiently served areas of low accessibility, the study shows where urban planning and digital healthcare could improve accessibility to health services and the quality of services efficiently. Methods The analysis utilised geocoded information on hospitals, clinics, roads and population and the data of the quality scores of healthcare facilities. Quality scores were analysed by hot spot analysis and inverse distance weighting. Accessibility and formation of travel time-based service areas by travel time distances were calculated using road network, driving speed and population data. Results The results unveiled a centripetal spatial pattern of healthcare facilities and a similar pattern in their quality. Outside the travel time of 30 min for hospitals and 15 min for clinics, the deficiently served areas have a population of 1.1 to 1.2 million. Based on the results and the evidence of digital healthcare, this paper highlights how to develop and plan spatially effective service provision. Especially, it gives grounds to discuss how cost-effective digital healthcare could be applied to improve the accessibility and quality of health services in an urban structure of extensively varying accessibility to health services. Conclusions The results bring up the need and the means for improving the quality of health services and their cost-efficient availability by location optimisation, road improvements and implementing digital healthcare provided by hospitals and clinics in the city. At the same, this study provides a multidisciplinary approach for planning more equal and efficient health service provision geographically.

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Section: Discussionmentioning

confidence: 99%

Service quality and accessibility of healthcare facilities: digital healthcare potential in Ho Chi Minh City

La²,

Tykkyläinen

2022

BMC Health Serv Res

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Patient-specific and healthcare real-world costs of atrial fibrillation in individuals treated with direct oral anticoagulant agents or warfarin

Pyykönen

Linna

Tykkyläinen

et al. 2021

BMC Health Serv Res

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Background Anticoagulant therapies are used to prevent atrial fibrillation-related strokes, with warfarin and direct oral anticoagulant (DOAC) the most common. In this study, we incorporate direct health care costs, drug costs, travel costs, and lost working and leisure time costs to estimate the total costs of the two therapies. Methods This retrospective study used individual-level patient data from 4000 atrial fibrillation (AF) patients from North Karelia, Finland. Real-world data on healthcare use was obtained from the regional patient information system and data on reimbursed travel costs from the database of the Social Insurance Institution of Finland. The costs of the therapies were estimated between June 2017 and May 2018. Using a Geographical Information System (GIS), we estimated travel time and costs for each journey related to anticoagulant therapies. We ultimately applied therapy and travel costs to a cost model to reflect real-world expenditures. Results The costs of anticoagulant therapies were calculated from the standpoint of patient and the healthcare service when considering all costs from AF-related healthcare visits, including major complications arising from atrial fibrillation. On average, the annual cost per patient for healthcare in the form of public expenditure was higher when using DOAC therapy than warfarin therapy (average cost = € 927 vs. € 805). Additionally, the average annual cost for patients was also higher with DOAC therapy (average cost = € 406.5 vs. € 296.7). In warfarin therapy, patients had considerable more travel and time costs due the different implementation practices of therapies. Conclusion The results indicated that DOAC therapy had higher costs over warfarin from the perspectives of the patient and healthcare service in the study area on average. Currently, the cost of the DOAC drug is the largest determinator of total therapy costs from both perspectives. Despite slightly higher costs, the patients on DOAC therapy experienced less AF-related complications during the study period.

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A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective

Cited by 2 publications

References 25 publications

Service quality and accessibility of healthcare facilities: digital healthcare potential in Ho Chi Minh City

Service quality and accessibility of healthcare facilities: digital healthcare potential in Ho Chi Minh City

Patient-specific and healthcare real-world costs of atrial fibrillation in individuals treated with direct oral anticoagulant agents or warfarin

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