1
|
Ryan JL, Rosa VR. Healthcare cost associations of patients who use illicit drugs in Florida: a retrospective analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:73. [PMID: 32993719 PMCID: PMC7523066 DOI: 10.1186/s13011-020-00313-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/03/2020] [Indexed: 11/10/2022]
Abstract
Background Illicit drug use increases visits to the hospital. Research is limited on the costs of these healthcare visits by illicit drug. Methods Florida’s Agency for Health Care Administration’s emergency department and inpatient datasets from 2016 to 2018 were analyzed. Adults who used an illicit drug were included in the study population resulting in 709,658 observations. Cost-to-charge ratios were used to estimate healthcare costs. Linear regression analyzed associations of illicit drugs with total healthcare cost. Results Total healthcare costs are estimated at $6.4 billion over the 3 year period. Medicare paid for the most patient care ($2.16 billion) with Medicaid and commercial insurance each estimated at $1.36 billion. Cocaine (9.25%) and multiple drug use (6.12%) increased the costs of an ED visit compared to a patient with cannabis SUD. Opioids (23.40%) and inhalants use (16.30%) increased the costs of inpatient compared to cannabis SUD. Conclusion Healthcare costs are high of patients with illicit drug SUD and poisoning, over half of which are paid for with tax payer dollars and to an unknown degree hospital write-offs. Injuries and illness of patients using cocaine and multiple drugs are associated with more expensive ED patient care and opioids and inhalants are associated with more expensive inpatient care.
Collapse
Affiliation(s)
- Jessica L Ryan
- University of West Florida, 11000 University Parkway, Pensacola, FL, 32514, USA.
| | - Veronica R Rosa
- University of West Florida, 11000 University Parkway, Pensacola, FL, 32514, USA
| |
Collapse
|
2
|
Mihailovic N, Szőllősi GJ, Rancic N, János S, Boruzs K, Nagy AC, Timofeyev Y, Dragojevic-Simic V, Antunovic M, Reshetnikov V, Ádány R, Jakovljevic M. Alcohol Consumption among the Elderly Citizens in Hungary and Serbia-Comparative Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1289. [PMID: 32079338 PMCID: PMC7068319 DOI: 10.3390/ijerph17041289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 01/03/2023]
Abstract
Studies in the alcohol consumption area are mostly related to the (ab)use of alcohol in young people. However, today, a growing number of researchers are emphasizing the clinical and public health significance of alcohol consumption in the elderly. In the WHO reports, harmful alcohol consumption is responsible for 5.3% of the global burden of the disease. The aim of this study was to investigate the prevalence of alcohol consumption among men and women aged 55 and over in Serbia and Hungary, leveraging data from the 2013 Serbian National Health Survey and from the 2014 Hungarian National Health Survey. Respondents aged 55 and over were analysed based on logistic multivariate models. The prevalence of alcohol consumption was 41.5% and 62.5% in Serbia and Hungary, respectively. It was higher among men in both countries, but among women, it was significantly higher in Hungary than in Serbia. The statistically significant predictors affecting alcohol consumption in Serbia included age, education, well-being index, long-term disease and overall health status, with marital status being an additional factor among men. In Hungary, education and long-term disease affected alcohol consumption in both sexes, while age and employment were additional factors among women. In both countries for both sexes, younger age, more significantly than primary education and good health, was associated with a higher likelihood of alcohol consumption.
Collapse
Affiliation(s)
- Natasa Mihailovic
- Institute of Public Health Kragujevac, Department of Biostatistics and Informatics, Nikole Pašića 1, 34000 Kragujevac, Serbia
| | - Gergő József Szőllősi
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, H-4002 Debrecen, Hungary
| | - Nemanja Rancic
- The Centre for Clinical Pharmacology, Medical Faculty, Military Medical Academy, University of Defence, Crnotravska 17, 11000 Belgrade, Serbia
| | - Sándor János
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, H-4002 Debrecen, Hungary
| | - Klára Boruzs
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, H-4002 Debrecen, Hungary
| | - Attila Csaba Nagy
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, H-4002 Debrecen, Hungary
| | - Yuriy Timofeyev
- National Research University Higher School of Economics, Shabolovka Ulitsa 26-28, 119049 Moscow, Russian
| | - Viktorija Dragojevic-Simic
- The Centre for Clinical Pharmacology, Medical Faculty, Military Medical Academy, University of Defence, Crnotravska 17, 11000 Belgrade, Serbia
| | - Marko Antunovic
- National Poison Control Center, Medical Faculty, Military Medical Academy, University of Defence, Crnotravska 17, 11000 Belgrade, Serbia
| | - Vladimir Reshetnikov
- N.A. Semashko Department of Public Health and Healthcare, I.M. Sechenov the First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Róza Ádány
- MTA-DE Public Health Research Group, Public Health Research Institute, University of Debrecen, H-4002 Debrecen, Hungary
| | - Mihajlo Jakovljevic
- N.A. Semashko Department of Public Health and Healthcare, I.M. Sechenov the First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
- Department of Global Health Economics and Policy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Institute of Comparative Economic Studies, Hosei University, Tokyo 194-0298, Japan
| |
Collapse
|
3
|
Krstic K, Janicijevic K, Timofeyev Y, Arsentyev EV, Rosic G, Bolevich S, Reshetnikov V, Jakovljevic MB. Dynamics of Health Care Financing and Spending in Serbia in the XXI Century. Front Public Health 2019; 7:381. [PMID: 31921746 PMCID: PMC6927281 DOI: 10.3389/fpubh.2019.00381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/26/2019] [Indexed: 11/20/2022] Open
Abstract
Serbia is an upper-middle income Eastern European economy. It has inherited system of health provision and financing, which is a mixture of Soviet Semashko and German Bismarck models. So far, literature evidence on long-term trends in health spending remains scarce on this region. Observational descriptive approach was utilized relying on nationwide aggregate data reported by the Republic Health Insurance Fund (RHIF) and the Government of Serbia to the WHO office. Consecutively, the WHO Global Health Expenditure Database was used. Long-term trends were extrapolated on existing data and underlying differences were analyzed and explained. The insight was provided across two distinctively different periods within 2000-2016. The first period lasted from 2000 till 2008 (the beginning of global recession triggered by Lehman Brothers' bankruptcy). This was a period of strong upward growth in ability to invest in health care. Spending grew significantly in terms of GDP share, national and per capita reported expenditures. During the second period (2009-2016), after the beginning of worldwide economic crisis, Serbia was affected in a way that its health expenditure growth in PPP terms slowed down effectively fluctuating around plateau values from 2014 to 2016. Serbia health spending showed promising signs of steady growth in its ability to invest in health care. Consolidation marked most of the past decade with certain growth rates in recent years (2017-2019), which were not captured in these official records. The future national strategy should be devised to take into account accelerated population aging as major driver of health spending.
Collapse
Affiliation(s)
- Kristijan Krstic
- Center for Rehabilitation Medicine, University Clinical Center Kragujevac, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Katarina Janicijevic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Yuriy Timofeyev
- National Research University Higher School of Economics, Moscow, Russia
| | - Evgeny V. Arsentyev
- Department of Public Health and Healthcare, First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Gvozden Rosic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Sergey Bolevich
- Department of Human Pathology, First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Vladimir Reshetnikov
- Department of Public Health and Healthcare, First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Mihajlo B. Jakovljevic
- Department of Public Health and Healthcare, First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Global Health Economics and Policy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| |
Collapse
|
4
|
Tresa E, Benmarhnia T, Clemens T, Burazeri G, Czabanowska K. Europeanization process impacts the patterns of alcohol consumption in the Western Balkans. Eur J Public Health 2019; 28:516-521. [PMID: 29059294 DOI: 10.1093/eurpub/ckx175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Western Balkan countries exhibit high levels of alcohol consumption, which constitutes a serious public health concern. We aimed to quantitatively assess the influence of the Europeanization process on levels of alcohol consumption in Western Balkans, an issue that has been under-researched. Methods The process of Europeanization was defined as the penetration of European dimension, procedures, policy paradigms, beliefs and norms in national arenas of politics and policy development. Data about alcohol consumption in six Western Balkan countries from 1991 to 2011 were gathered from the World Bank and World Health Organization databases. Azerbaijan and Georgia were considered control countries. A difference-in-differences approach was used to assess the impact of Europeanization process on levels of alcohol consumption. Results The Europeanization process impacts alcohol consumption in Western Balkan countries through the European Union directives and tax policies. After starting the Europeanization process, the spirits consumption in Croatia and The Former Yugoslav Republic of Macedonia decreased by 1.06 litter per capita (95% CI: from -1.63 to - 0.49) and 1.02 litter per capita in Serbia (95% CI: from -1.9 to - 0.1). Conclusion Our analysis provides useful evidence about the possible influence of Europeanization process especially on spirits consumption levels in Western Balkans. These findings draw attention to the need to implement new policies in order to prevent alcohol health-related harm due to the possible increase of wine and beer consumption.
Collapse
Affiliation(s)
- Eni Tresa
- Department of International Health, School CAPHRI (Care and Public Health Research Institute), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,EHESP School of Public Health, Rennes, Sorbonne-Paris Cité, France
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, La Jolla, CA, USA
| | - Timo Clemens
- Department of International Health, School CAPHRI (Care and Public Health Research Institute), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Genc Burazeri
- Department of International Health, School CAPHRI (Care and Public Health Research Institute), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Katarzyna Czabanowska
- Department of International Health, School CAPHRI (Care and Public Health Research Institute), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Institute of Public Health, Medical College, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland
| |
Collapse
|
5
|
Janicijevic KM, Kocic SS, Radevic SR, Jovanovic MR, Radovanovic SM. Socioeconomic Factors Associated with Psychoactive Substance Abuse by Adolescents in Serbia. Front Pharmacol 2017; 8:366. [PMID: 28659800 PMCID: PMC5468426 DOI: 10.3389/fphar.2017.00366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 05/26/2017] [Indexed: 01/18/2023] Open
Affiliation(s)
- Katarina M. Janicijevic
- Department of Social Medicine, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Sanja S. Kocic
- Department of Social Medicine, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Svetlana R. Radevic
- Department of Social Medicine, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Mirjana R. Jovanovic
- Department of Psychiatry, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Snezana M. Radovanovic
- Department of Social Medicine, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| |
Collapse
|
6
|
Jakovljevic M, Varavikova EA, Walter H, Wascher A, Pejcic AV, Lesch OM. Alcohol Beverage Household Expenditure, Taxation and Government Revenues in Broader European WHO Region. Front Pharmacol 2017; 8:303. [PMID: 28603498 PMCID: PMC5445193 DOI: 10.3389/fphar.2017.00303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/10/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Mihajlo Jakovljevic
- Health Economics and Pharmacoeconomics, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Elena A. Varavikova
- Federal Research Institute for Public Health Organization and Information (CNIIOIZ), Ministry of HealthMoscow, Russia
| | - Henriette Walter
- Department of Psychiatry and Psychotherapy, Medical University of ViennaVienna, Austria
| | | | - Ana V. Pejcic
- Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Otto M. Lesch
- Department of Psychiatry and Psychotherapy, Medical University of ViennaVienna, Austria
| |
Collapse
|
7
|
Kovacevic A, Rancic N, Segrt Z, Dragojevic-Simic V. Pharmaceutical Expenditure and Burden of Non-communicable Diseases in Serbia. Front Pharmacol 2016; 7:373. [PMID: 27790144 PMCID: PMC5062377 DOI: 10.3389/fphar.2016.00373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 09/27/2016] [Indexed: 12/29/2022] Open
Affiliation(s)
- Aleksandra Kovacevic
- Centre for Clinical Pharmacology, Military Medical Academy Medical Faculty, University of DefenseBelgrade, Serbia
| | - Nemanja Rancic
- Centre for Clinical Pharmacology, Military Medical Academy Medical Faculty, University of DefenseBelgrade, Serbia
| | - Zoran Segrt
- Military Medical Academy Medical Faculty, Management of the Military Medical Academy, University of DefenseBelgrade, Serbia
| | - Viktorija Dragojevic-Simic
- Centre for Clinical Pharmacology, Military Medical Academy Medical Faculty, University of DefenseBelgrade, Serbia
| |
Collapse
|
8
|
Jakovljevic M, Lazarevic M, Milovanovic O, Kanjevac T. The New and Old Europe: East-West Split in Pharmaceutical Spending. Front Pharmacol 2016; 7:18. [PMID: 26973521 PMCID: PMC4771948 DOI: 10.3389/fphar.2016.00018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/21/2016] [Indexed: 11/19/2022] Open
Abstract
HIGHLIGHTSSince the geopolitical developments of 1989, former centrally planned economies of Eastern Europe followed distinctively different pathways in national pharmaceutical expenditure evolution as compared to their free market Western European counterparts. Long term spending on pharmaceuticals expressed as percentage of total health expenditure was falling in free market economies as of 1989. Back in early 1990s it was at higher levels in transitional Eastern European countries and actually continued to grow further. Public financing share of total pharmaceutical expenditure was steadily falling in most Central and Eastern European countries over the recent few decades. Opposed scenario were EU-15 countries which successfully increased their public funding of prescription medicines for the sake of their citizens. Pace of annual increase in per capita spending on medicines in PPP terms, was at least 20% faster in Eastern Europe compared to their Western counterparts. During the same years, CEE region was expanding their pharmaceuticals share of health spending in eight fold faster annual rate compared to the EU 15. Private and out-of-pocket expenditure became dominant in former socialist countries. Affordability issues coupled with growing income inequality in transitional economies will present a serious challenge to equitable provision and sustainable financing of pharmaceuticals in the long run.
Collapse
Affiliation(s)
- Mihajlo Jakovljevic
- Health Economics and Pharmacoeconomics, The Faculty of Medical Sciences, University of Kragujevac Kragujevac, Serbia
| | - Marija Lazarevic
- Health Economics and Pharmacoeconomics, The Faculty of Medical Sciences, University of Kragujevac Kragujevac, Serbia
| | - Olivera Milovanovic
- Health Economics and Pharmacoeconomics, The Faculty of Medical Sciences, University of Kragujevac Kragujevac, Serbia
| | - Tatjana Kanjevac
- Department for Preventive and Pediatric Dentistry, Faculty of Medicine, University of Kragujevac Kragujevac, Serbia
| |
Collapse
|
9
|
Petrusic T, Jakovljevic M. Budget Impact of Publicly Reimbursed Prescription Medicines in the Republic of Srpska. Front Public Health 2015; 3:213. [PMID: 26442240 PMCID: PMC4564658 DOI: 10.3389/fpubh.2015.00213] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 08/27/2015] [Indexed: 12/02/2022] Open
|
10
|
Velickovic V, Simovic A, Lazarevic G, Lazarevic M, Jakovljevic M. Improvements in Neonatal and Childhood Medical Care - Perspective from the Balkans. Front Public Health 2015; 3:206. [PMID: 26380251 PMCID: PMC4550749 DOI: 10.3389/fpubh.2015.00206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 08/11/2015] [Indexed: 12/03/2022] Open
Affiliation(s)
- Vesna Velickovic
- Clinic for Pediatrics, University Clinical Centre Kragujevac , Kragujevac , Serbia
| | - Aleksandra Simovic
- Clinic for Pediatrics, University Clinical Centre Kragujevac , Kragujevac , Serbia ; Department of Pediatrics, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
| | - Gordana Lazarevic
- Clinic for Pediatrics, University Clinical Centre Kragujevac , Kragujevac , Serbia
| | - Marija Lazarevic
- Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
| | - Mihajlo Jakovljevic
- Health Economics & Pharmacoeconomics, Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
| |
Collapse
|
11
|
Kanjevac T. Dental Services Funding and Affordability in Serbia - Decade-Long Perspective. Front Public Health 2015; 3:145. [PMID: 26125016 PMCID: PMC4464199 DOI: 10.3389/fpubh.2015.00145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 05/07/2015] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tatjana Kanjevac
- Faculty of Medical Sciences, Integrated Academic Studies of Dentistry, University of Kragujevac, Kragujevac, Serbia
| |
Collapse
|
12
|
Jakovljevic MB, Milovanovic O. Growing Burden of Non-Communicable Diseases in the Emerging Health Markets: The Case of BRICS. Front Public Health 2015; 3:65. [PMID: 25954740 PMCID: PMC4407477 DOI: 10.3389/fpubh.2015.00065] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 04/06/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mihajlo B. Jakovljevic
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Olivera Milovanovic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| |
Collapse
|