Economic and medical benefits of ultrasound screenings for gallstone disease

Shen, Hung-Ju; Hsu, Chung‐Te; Tung, Tao‐Hsin

doi:10.3748/wjg.v21.i11.3337

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…In addition, educational campaigns on food safety and general hygiene standards should be established and directed toward people from rural, less developed, and remote areas to ensure the risk of GSD caused by unsafe dietary and eating habit being properly addressed. Routine screening programs for GSD in Vietnam can also be conducted, as such screening regime was found to be both medically and economically valuable in some countries 35…”

Section: Discussionmentioning

confidence: 99%

<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases – a case for health insurance policy revaluation</p>

Tran

Nathan

et al. 2019

CEOR

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PurposeDespite gallstone diseases (GSDs) being a major public health concern with both acute and chronic episodes, none of the studies in Vietnam has been conducted to investigate the household expenditure for the GSD treatment. The objective of this study was to estimate the costs of managing GSD and to explore the prevalence and determinants of catastrophic health expenditure (CHE) among Vietnamese patients.Materials and methodsA cross-sectional study was conducted from June 2016 to March 2017 in the Department of Hepatobiliary and Pancreatic Surgery, Viet Duc Hospital in Hanoi, Vietnam. A total of 206 patients were enrolled. Demographic and socioeconomic data, household income, and direct and indirect medical costs of patients seeking treatment for GSD were collected through face-to-face interview. Multivariate logistic regression was used to explore factors associated with CHE.ResultsThe prevalence of CHE in patients suffering from GSD was 35%. The percentage of patients who were covered by health insurance and at risk for CHE was 41.2%, significantly higher than that of those noninsured (15.8%). Proportions of patients with and without health insurance who sought outpatient treatment were 30.6% and 81.6%, respectively. Patients who were divorced or widowed and had intrahepatic gallstones were significantly more likely to experience CHE. Those who were outpatients, were women, had history of pharmacological treatment to parasitic infection, and belong to middle and highest monthly household income quantile were significantly less likely to experience CHE.ConclusionThe findings suggested that efforts to re-evaluate health insurance reimbursement capacity, especially for acute diseases and taking into account the varying preferences of people with different disease severity, should be conducted by health authority. Further studies concerning CHE of GSD in the context of ongoing health policy reform should consider utilizing WHO-recommended measures like the fairness in financial contribution index, as well as taking into consideration the behavioral aspects of health care spending.

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Section: Discussionmentioning

confidence: 99%

<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases – a case for health insurance policy revaluation</p>

Tran

Nathan

et al. 2019

CEOR

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show abstract

Section: Discussionmentioning

confidence: 99%

“…Notably, we should acknowledge that some gallstones could not be clearly observed on abdominal CT images, and transabdominal ultrasonography should be the first-line approach for diagnosing gallstones. [40] Our study had several features. First, the study population was from our prospectively established database of liver cirrhosis and was regularly followed.…”

Section: Journal Of Translational Internal Medicine / Aopmentioning

confidence: 99%

Associations of gallbladder and gallstone parameters with clinical outcomes in patients with cirrhosis

Ding

Yin

Zhu

et al. 2023

Journal of Translational Internal Medicine

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Background Morphologic changes in the gallbladder and gallstones are common in cirrhotic patients, but their associations with outcomes of cirrhotic patients are unclear. Methods We retrospectively enrolled 206 cirrhotic patients and measured their gallbladder length and width, gallbladder wall thickness, presence of gallstones, and gallstones’ length and width in axial contrast-enhanced computed tomography (CT) images. X-tile software was utilized to calculate the optimal cutoff values of these parameters for evaluating survival and hepatic decompensation events in the cirrhosis group. Their associations with survival were explored by Cox regression analyses and Kaplan–Meier curve analyses. Their associations with hepatic decompensation events were evaluated by competing risk analyses and Nelson-Aalen cumulative risk curve analyses where death was a competing event. Results Cirrhotic patients with gallbladder length < 72 mm had a significantly higher cumulative survival rate than those with a length of ≥ 72 mm (P = 0.049 by log-rank test), but gallbladder width, gallbladder wall thickness, presence of gallstones, and gallstones’ length and width were not significantly associated with survival (P = 0.10, P = 0.14, P = 0.97, P = 0.73, and P = 0.73 by log-rank tests, respectively). Cirrhotic patients with gallbladder wall thickness < 3.4 mm had a significantly lower cumulative rate of hepatic decompensation events than those with a wall thickness of ≥ 3.4 mm (P = 0.02 by Gray’s test), but gallbladder length and width, presence of gallstones, and gallstones’ length and width were not significantly associated with hepatic decompensation events (P = 0.15, P = 0.15, P = 0.54, P = 0.76, and P = 0.54 by Gray’s tests, respectively). Conclusion Changes in gallbladder length and gallbladder wall thickness, rather than gallstone parameters, may be in parallel with the long-term outcomes of cirrhotic patients.

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“…Puschel K et al publicaron un estudio de costo-efectividad (11) que demostraba que un programa de tamizaje ecográfico podía reducir la mortalidad asociada enfermedad vesicular en un 80% a un costo incremental bajo para el sistema de salud chileno. Un estudio posterior con similar metodología publicado por Shen J et al (12) arrojó a similares conclusiones promoviendo la detección precoz de enfermedad vesicular en poblaciones de alto riesgo de complicaciones de enfermedad vesicular, como es la población chilena. Sreen A et al (13) publicaron un estudio con la experiencia clínica piloto de un programa de detección precoz de enfermedad vesicular observando un gran impacto en la sobrevida de pacientes de alto riesgo que recibieron el tamizaje ecográfico.…”

Section: Diagnóstico Precoz: Enfermedad Vesicular Y Cáncer De Vesículaunclassified

Clinical Effectiveness of Primary Health Care in Chile: Innovations and Challenges

PÜSCHEL ILLANES

2024

BACM

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Chile presents a dissociation between the high level of human development indexes and public health indicators achieved versus the existent relatively low clinical effectiveness level, especially at the primary health care (PHC) system. PHC in Chile has developed a number of pilot innovations that could be replicated and escalated at a national level, to improve clinical effectiveness and the health care level of the population. The development of new models in clinical effectiveness in Chile, has been associated with significant reductions in inappropriate referrals, hospitalizations, emergency care visits and even general mortality. The Chilean PHC system has implemented pilot and innovative interventions in cancer prevention, early detection of gallbladder disease, peptic ulcer disease and gastric cancer, as well as innovative clinical management initiatives on COVID-19 infections and cardiovascular disease. Specific instruments and strategies have been tested and validated to implement the person-centered family systems approach. New initiatives on rapid tests and clinical ultrasound for cardiovascular and respiratory disease should be integrated soon in PHC in Chile given the existent evidence on their effectiveness and relative low cost. It is recommended to assess locally clinical new practices at the primary care level before escalating them to the entire network given that in many cases, available clinical information comes from clinical scenarios that are not necessarily equivalent to primary care. The primary care system in Chile has the challenge to implement strategies of proven effectiveness at local level that should be escalated to a national level.

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Economic and medical benefits of ultrasound screenings for gallstone disease

Abstract: AIM:To investigate whether screening for gallstone disease was economically feasible and clinically effective.

Cited by 4 publications

References 23 publications

<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases – a case for health insurance policy revaluation</p>

<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases – a case for health insurance policy revaluation</p>

Associations of gallbladder and gallstone parameters with clinical outcomes in patients with cirrhosis

Clinical Effectiveness of Primary Health Care in Chile: Innovations and Challenges

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Economic and medical benefits of ultrasound screenings for gallstone disease

Abstract: AIM:To investigate whether screening for gallstone disease was economically feasible and clinically effective.

Cited by 4 publications

References 23 publications

<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases &ndash; a case for health insurance policy revaluation</p>

<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases &ndash; a case for health insurance policy revaluation</p>

Associations of gallbladder and gallstone parameters with clinical outcomes in patients with cirrhosis

Clinical Effectiveness of Primary Health Care in Chile: Innovations and Challenges

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Product

Resources

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<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases – a case for health insurance policy revaluation</p>

<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases – a case for health insurance policy revaluation</p>