Investigating the relationship between costs and outcomes for English mental health providers: a bi-variate multi-level regression analysis

Moran, Valérie; Jacobs, Rowena

doi:10.1007/s10198-017-0915-5

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…Given the budget constraints and the need to allocate healthcare resources in an equitable way, our stratification of T2DM patients into cost subgroups could inform treatment decisions and the allocation of related resources in a way that matches patients' needs. Our results are useful especially because of the growing importance of the budget allocation from the perspective of activity-based provider payment systems [43], bundle payments and value-based bundle payments [44].…”

Section: Discussionmentioning

confidence: 99%

Medical Costs of Patients with Type 2 Diabetes in a Single Payer System: A Classification and Regression Tree Analysis

Rucci

Avaldi

Travaglini

et al. 2019

PharmacoEconomics Open

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Background and Objectives Many studies and systematic reviews have estimated the healthcare costs of diabetes using a cost-of-illness approach. However, in the studies based on this approach patients' heterogeneity is rarely taken into account. The aim of this study was to stratify patients with type 2 diabetes into homogeneous cost groups based on demographic and clinical characteristics. Methods We conducted a retrospective cost-of-illness study by linking individual data on health services utilization retrieved from the administrative databases of Emilia-Romagna Region (Italy). Direct medical costs (either all-cause or diabetesrelated) were calculated from the perspective of the regional health service, using tariffs for hospitalizations and outpatient services and the unit costs of prescriptions for drugs. The determinants of costs identified in a generalized linear regression model were used to characterize subgroups of patients with homogeneous costs in a classification and regression tree analysis. Results The study population consisted of a cohort of 101,334 patients with type 2 diabetes, followed up for 1 year, with a mean age of 70.9 years. Age, gender, complications, comorbidities and living area accounted significantly for cost variability. The classification tree identified ten patient subgroups with different costs, ranging from a median of €483 to €39,578. The two subgroups with highest costs comprised dialysis patients, and the largest subgroup (57.9%) comprised patients aged ≥ 65 years without renal, cardiovascular and cerebrovascular complications. Conclusions Classification of patients into homogeneous cost subgroups can be used to improve the management of, and budget allocation for, patients with type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Medical Costs of Patients with Type 2 Diabetes in a Single Payer System: A Classification and Regression Tree Analysis

Rucci

Avaldi

Travaglini

et al. 2019

PharmacoEconomics Open

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Measuring the overall performance of mental healthcare providers

Aragón,

Gravelle,

Castelli

et al. 2024

Social Science & Medicine

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A trend analysis of surgical operations under a global payment system in Tehran, Iran (2005-2015)

et al. 2018

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BackgroundGlobal payment system is a first example of per-case payment system that contains 60 commonly used surgical operations for which payment is based on the average cost per case in Iran.ObjectiveThe aim of the study was to determine the amount of reduction, increase or no change in the trend of global operations.MethodsIn this retrospective longitudinal study, data on the 60 primary global surgery codes was gathered from Tehran Health Insurance Organization within the ten-year period of 2005–2015 separately, for each month. Out of 60 surgery codes, only acceptable data for 46 codes were available based on the insurance documents sent by medical centers. A quantitative analysis of time series through Regression Analysis Model using STATA software v.11 was performed.ResultsSome global surgery codes had an upward trend and some were downwards. Of N Codes, N83, N20, N28, N63, and N93 had an upward trend (p<0.05) and N32, N43, N81 and N90 showed a significant downward trend (p<0.05). Similarly, all H Codes except for H18 had a significant upward trend (p<0.000). As such, K Codes including K45, K56 and K81 had an increasing movement. S Codes also experienced both increasing and decreasing trends. However, none of the O Codes changed according to time. Other global surgical codes like C61, E07, M51, L60, J98 (p<0.000), I84 (p<0.031) and I86 (p<0.000) shown upward and downward trends. Total global surgeries trend was significantly upwards (B=24.26109, p<0.000).ConclusionThe varying trend of global surgeries can partly reflect the behavior of service providers in order to increase their profits and minimize their costs.

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Investigating the relationship between costs and outcomes for English mental health providers: a bi-variate multi-level regression analysis

Cited by 3 publications

References 21 publications

Medical Costs of Patients with Type 2 Diabetes in a Single Payer System: A Classification and Regression Tree Analysis

Medical Costs of Patients with Type 2 Diabetes in a Single Payer System: A Classification and Regression Tree Analysis

Measuring the overall performance of mental healthcare providers

A trend analysis of surgical operations under a global payment system in Tehran, Iran (2005-2015)

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