Ermittlung standardisierter Bewertungssätze aus gesellschaftlicher Perspektive für die gesundheitsökonomische Evaluation

Bock, Jens‐Oliver; Brettschneider, Christian; Seidl, Hildegard; Bowles, David S.; Holle, R.; Greiner, Wolfgang; König, HH

doi:10.1055/s-0034-1374621

Cited by 155 publications

(158 citation statements)

References 8 publications

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“…For outpatient care visits at general practitioners ( N = 194) and or medical specialists ( N = 1829), standardized unit costs from Bock et al [2014] [17] were applied, representing costs from a societal perspective. For scheduled ( N = 39) and unscheduled ( N = 68) episodes of hospitalization, actual amounts of reimbursement were collected from the respective hospitals.…”

Section: Methodsmentioning

confidence: 99%

Results of a randomized controlled trial analyzing telemedically supported case management in the first year after living donor kidney transplantation - a budget impact analysis from the healthcare perspective

et al. 2017

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ᅟWe analyze one-year costs and savings of a telemedically supported case management program after kidney transplantation from the perspective of the German Healthcare System. Recipients of living donor kidney transplantation (N = 46) were randomly allocated to either (1) standard aftercare or (2) standard aftercare plus additional telemedically supported case management. A range of cost figures of each patient’s medical service utilization were calculated at month 3, 6 and 12 and analyzed using two-part regression models.In comparison to standard aftercare, patients receiving telemedically supported case management are associated with substantial lower costs related to unscheduled hospitalizations (mean difference: €3,417.46 per patient for the entire one-year period, p = 0.003). Taking all cost figures into account, patients receiving standard aftercare are associated, on average, with one-year medical service utilization costs of €10,449.28, while patients receiving telemedically supported case management are associated with €5,504.21 of costs (mean difference: € 4,945.07 per patient, p < 0.001). With estimated expenditures of €3,001.5 for telemedically supported case management of a single patient, we determined a mean difference of €1,943.57, but this result is not statistically significant (p = 0.128). Sensitivity analyses show that the program becomes cost-neutral at around ten participating patients, and was beneficial starting at 15 patients. Routine implementation of telemedically supported case management in German medium and high-volume transplant centers would result in annual cost savings of €791,033 for the German healthcare system.Patients with telemedically supported case management showed a lower utilization of medical services as well as better medical outcomes. Therefore, such programs should be implemented in medium and high-volume transplant centers.Trial registrationDRKS00007634 (http://www.drks.de/DRKS00007634).

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Section: Methodsmentioning

confidence: 99%

Results of a randomized controlled trial analyzing telemedically supported case management in the first year after living donor kidney transplantation - a budget impact analysis from the healthcare perspective

et al. 2017

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“…We extrapolated all measures to 12 months, under the assumption that the data were representative of the entire year. Medical services, including contact with outpatient physicians, as well as inpatient and outpatient rehabilitation and hospital stays were valued by unit costs as provided by Bock et al 28 Unit costs for a specialist visit ranged between €18.89 for a dermatologist and €78.08 for a psychotherapist visit. An overview of the different unit costs is given in online supplementary appendix 1.…”

Section: Usage Of Medical Services and Cost Analysis Direct Costsmentioning

confidence: 99%

“…Inpatient and outpatient rehabilitation was priced at €121.85 and €46.68 per day, respectively. 28 Pharmaceutical expenditures were calculated from information on name, pharmaceutical identification number and dosage of drug intake during the previous 7 days. If pharmaceuticals were taken irregularly, the intake per week was assumed by using the defined daily dose (DDD).…”

Section: Usage Of Medical Services and Cost Analysis Direct Costsmentioning

confidence: 99%

Cost burden of type 2 diabetes in Germany: results from the population-based KORA studies

et al. 2016

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ObjectiveTo examine the impact of type 2 diabetes on direct and indirect costs and to describe the effect of relevant diabetes-related factors, such as type of treatment or glycaemic control on direct costs.DesignBottom-up excess cost analysis from a societal perspective based on population-based survey data.Participants9160 observations from 6803 individuals aged 31–96 years (9.6% with type 2 diabetes) from the population-based KORA (Cooperative Health Research in the Region of Augsburg) studies in Southern Germany.Outcome measuresHealthcare usage, productivity losses, and resulting direct and indirect costs.MethodsInformation on diabetes status, biomedical/sociodemographic variables, medical history and on healthcare usage and productivity losses was assessed in standardised interviews and examinations. Healthcare usage and productivity losses were costed with reference to unit prices and excess costs of type 2 diabetes were calculated using generalised linear models.ResultsIndividuals with type 2 diabetes had 1.81 (95% CI 1.56 to 2.11) times higher direct (€3352 vs €1849) and 2.07 (1.51 to 2.84) times higher indirect (€4103 vs €1981) annual costs than those without diabetes. Cardiovascular complications, a long diabetes duration and treatment with insulin were significantly associated with increased direct costs; however, glycaemic control was only weakly insignificantly associated with costs.ConclusionsThis study illustrates the substantial direct and indirect societal cost burden of type 2 diabetes in Germany. Strong effort is needed to optimise care to avoid progression of the disease and costly complications.

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“…Resource use and productivity losses were monetarily valued using German unit costs (online supplementary table S1). 25 26 If unit costs were not available for 2014, they were adapted to the year 2014 by using the German consumer price index 27…”

Section: Methodsmentioning

confidence: 99%

Excess costs of alcohol-dependent patients in German psychiatric care compared with matched non-alcohol-dependent individuals from the general population: a secondary analysis of two datasets

et al. 2018

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ObjectivesHeavy alcohol use can cause somatic and mental diseases, affects patients’ social life and is associated with social isolation, unemployment and reduced quality of life. Therefore, societal costs of alcohol dependence are expected to be high. The aim of this study was to estimate excess costs of patients with alcohol dependence diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria compared with individuals without alcohol dependence in Germany.DesignIn a secondary analysis, baseline data of patients with alcohol dependence enrolled in a randomised controlled trial (German Clinical Trials Register DRS00005035) were compared with data collected via a telephone survey from individuals without alcohol dependence and that had been matched by entropy balancing. Health service use was evaluated retrospectively for a 6-month period.SettingsFour German psychiatric university clinics (patients with alcohol dependence) and the German general adult population (individuals without alcohol dependence).Participantsn=236 adult patients with alcohol dependence and n=4687 adult individuals without alcohol dependence.Primary and secondary outcome measuresThe excess costs of health service use, absenteeism and unemployment of patients with alcohol dependence were calculated and compared with individuals without alcohol dependence. In subgroup analyses, the associations between excess cost and gender, comorbidities and the duration of disease were investigated.ResultsTotal 6-month excess costs of €11 839 (95% CI €11 529 to €12 147) were caused by direct excess costs of €4349 (95% CI €4129 to €4566) and indirect costs of €7490 (95% CI €5124 to €9856). In particular, costs of inpatient treatment, formal long-term care, absenteeism and unemployment were high.ConclusionsAlcohol dependence causes substantial direct and indirect excess costs. Cost-effective interventions to prevent and treat alcohol dependence are urgently needed.Trial registration numberDRKS00005035.

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Ermittlung standardisierter Bewertungssätze aus gesellschaftlicher Perspektive für die gesundheitsökonomische Evaluation

Abstract: The calculated unit costs can serve as a reference case in health economic evaluations and hence help to increase their comparability.

Cited by 155 publications

References 8 publications

Results of a randomized controlled trial analyzing telemedically supported case management in the first year after living donor kidney transplantation - a budget impact analysis from the healthcare perspective

Results of a randomized controlled trial analyzing telemedically supported case management in the first year after living donor kidney transplantation - a budget impact analysis from the healthcare perspective

Cost burden of type 2 diabetes in Germany: results from the population-based KORA studies

Excess costs of alcohol-dependent patients in German psychiatric care compared with matched non-alcohol-dependent individuals from the general population: a secondary analysis of two datasets

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