No Cover Image

E-Thesis 304 views 101 downloads

Assessing the excess health service utilisation and direct medical costs of injuries. / Steven Michael Macey

Swansea University Author: Steven Michael Macey

Abstract

This study was undertaken with the aim to develop improved measures of health service utilisation (HSU) and direct medical costs following an index injury, utilising large scale datasets linked via anonymous patient identifiers.A cohort of anonymous injury patients resident in Swansea and attending...

Full description

Published: 2010
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
URI: https://cronfa.swan.ac.uk/Record/cronfa42913
first_indexed 2018-08-02T18:55:50Z
last_indexed 2019-10-21T16:48:41Z
id cronfa42913
recordtype RisThesis
fullrecord <?xml version="1.0"?><rfc1807><datestamp>2018-08-29T14:58:27.7457751</datestamp><bib-version>v2</bib-version><id>42913</id><entry>2018-08-02</entry><title>Assessing the excess health service utilisation and direct medical costs of injuries.</title><swanseaauthors><author><sid>7c4753be9cdef947c341bb3db8b1d6f3</sid><ORCID>NULL</ORCID><firstname>Steven Michael</firstname><surname>Macey</surname><name>Steven Michael Macey</name><active>true</active><ethesisStudent>true</ethesisStudent></author></swanseaauthors><date>2018-08-02</date><abstract>This study was undertaken with the aim to develop improved measures of health service utilisation (HSU) and direct medical costs following an index injury, utilising large scale datasets linked via anonymous patient identifiers.A cohort of anonymous injury patients resident in Swansea and attending an emergency department (ED) or admitted to hospital between 01/04/2005 and 31/03/2007 were identified and tracked as they progressed through various treatment stages following their index injury, incorporating ED attendances, inpatient stay and outpatient contacts. To determine the extent of the subsequent HSU and direct medical costs associated with the index injury a unique model was developed whereby the numbers, lengths and treatment costs of health service contacts observed amongst the cohort of injured individuals during the follow-up period were compared with the equivalent figures expected in the absence of an injury.On average each index injury was found to lead to an excess of 0.12 (95% Cl 0.11, 0.13) ED attendances, 0.07 (95% Cl 0.06, 0.08) inpatient admissions, 1.00 (95% Cl 0.78, 1.23) inpatient bed days and 0.55 (95% Cl 0.52, 0.58) outpatient contacts being estimated over the follow-up period. Moreover, every index injury resulted in mean excess ED, inpatient and outpatient treatment costs of &#xA3;12.05 (95% Cl &#xA3;11.05, &#xA3;13.05), &#xA3;492.43 (95% Cl &#xA3;415.66, &#xA3;569.21) and &#xA3;73.30 (95% Cl &#xA3;68.44, &#xA3;78.17), respectively, equating to a combined figure of &#xA3;577.79 (95% Cl &#xA3;500.32, &#xA3;655.26). Across the entire injured cohort this amounts to an overall excess direct medical cost total of &#xA3;17.6 million being incurred, with the equivalent figure for the whole of Wales potentially being as high as &#xA3;306.4 million.Together with signifying the magnitude of the HSU and direct medical costs resulting from injury, this study has introduced and implemented improved methods for estimating these outcome measures based on the use of anonymous patient record linkage.</abstract><type>E-Thesis</type><journal/><journalNumber></journalNumber><paginationStart/><paginationEnd/><publisher/><placeOfPublication/><isbnPrint/><issnPrint/><issnElectronic/><keywords>Health care costs</keywords><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2010</publishedYear><publishedDate>2010-12-31</publishedDate><doi/><url/><notes/><college>COLLEGE NANME</college><department>Swansea University Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><degreelevel>Doctoral</degreelevel><degreename>Ph.D</degreename><apcterm/><lastEdited>2018-08-29T14:58:27.7457751</lastEdited><Created>2018-08-02T16:24:30.7730028</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Steven Michael</firstname><surname>Macey</surname><orcid>NULL</orcid><order>1</order></author></authors><documents><document><filename>0042913-02082018162531.pdf</filename><originalFilename>10821303.pdf</originalFilename><uploaded>2018-08-02T16:25:31.7070000</uploaded><type>Output</type><contentLength>12099331</contentLength><contentType>application/pdf</contentType><version>E-Thesis</version><cronfaStatus>true</cronfaStatus><embargoDate>2018-08-02T16:25:31.7070000</embargoDate><copyrightCorrect>false</copyrightCorrect></document></documents><OutputDurs/></rfc1807>
spelling 2018-08-29T14:58:27.7457751 v2 42913 2018-08-02 Assessing the excess health service utilisation and direct medical costs of injuries. 7c4753be9cdef947c341bb3db8b1d6f3 NULL Steven Michael Macey Steven Michael Macey true true 2018-08-02 This study was undertaken with the aim to develop improved measures of health service utilisation (HSU) and direct medical costs following an index injury, utilising large scale datasets linked via anonymous patient identifiers.A cohort of anonymous injury patients resident in Swansea and attending an emergency department (ED) or admitted to hospital between 01/04/2005 and 31/03/2007 were identified and tracked as they progressed through various treatment stages following their index injury, incorporating ED attendances, inpatient stay and outpatient contacts. To determine the extent of the subsequent HSU and direct medical costs associated with the index injury a unique model was developed whereby the numbers, lengths and treatment costs of health service contacts observed amongst the cohort of injured individuals during the follow-up period were compared with the equivalent figures expected in the absence of an injury.On average each index injury was found to lead to an excess of 0.12 (95% Cl 0.11, 0.13) ED attendances, 0.07 (95% Cl 0.06, 0.08) inpatient admissions, 1.00 (95% Cl 0.78, 1.23) inpatient bed days and 0.55 (95% Cl 0.52, 0.58) outpatient contacts being estimated over the follow-up period. Moreover, every index injury resulted in mean excess ED, inpatient and outpatient treatment costs of £12.05 (95% Cl £11.05, £13.05), £492.43 (95% Cl £415.66, £569.21) and £73.30 (95% Cl £68.44, £78.17), respectively, equating to a combined figure of £577.79 (95% Cl £500.32, £655.26). Across the entire injured cohort this amounts to an overall excess direct medical cost total of £17.6 million being incurred, with the equivalent figure for the whole of Wales potentially being as high as £306.4 million.Together with signifying the magnitude of the HSU and direct medical costs resulting from injury, this study has introduced and implemented improved methods for estimating these outcome measures based on the use of anonymous patient record linkage. E-Thesis Health care costs 31 12 2010 2010-12-31 COLLEGE NANME Swansea University Medical School COLLEGE CODE Swansea University Doctoral Ph.D 2018-08-29T14:58:27.7457751 2018-08-02T16:24:30.7730028 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Steven Michael Macey NULL 1 0042913-02082018162531.pdf 10821303.pdf 2018-08-02T16:25:31.7070000 Output 12099331 application/pdf E-Thesis true 2018-08-02T16:25:31.7070000 false
title Assessing the excess health service utilisation and direct medical costs of injuries.
spellingShingle Assessing the excess health service utilisation and direct medical costs of injuries.
Steven Michael Macey
title_short Assessing the excess health service utilisation and direct medical costs of injuries.
title_full Assessing the excess health service utilisation and direct medical costs of injuries.
title_fullStr Assessing the excess health service utilisation and direct medical costs of injuries.
title_full_unstemmed Assessing the excess health service utilisation and direct medical costs of injuries.
title_sort Assessing the excess health service utilisation and direct medical costs of injuries.
author_id_str_mv 7c4753be9cdef947c341bb3db8b1d6f3
author_id_fullname_str_mv 7c4753be9cdef947c341bb3db8b1d6f3_***_Steven Michael Macey
author Steven Michael Macey
author2 Steven Michael Macey
format E-Thesis
publishDate 2010
institution Swansea University
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description This study was undertaken with the aim to develop improved measures of health service utilisation (HSU) and direct medical costs following an index injury, utilising large scale datasets linked via anonymous patient identifiers.A cohort of anonymous injury patients resident in Swansea and attending an emergency department (ED) or admitted to hospital between 01/04/2005 and 31/03/2007 were identified and tracked as they progressed through various treatment stages following their index injury, incorporating ED attendances, inpatient stay and outpatient contacts. To determine the extent of the subsequent HSU and direct medical costs associated with the index injury a unique model was developed whereby the numbers, lengths and treatment costs of health service contacts observed amongst the cohort of injured individuals during the follow-up period were compared with the equivalent figures expected in the absence of an injury.On average each index injury was found to lead to an excess of 0.12 (95% Cl 0.11, 0.13) ED attendances, 0.07 (95% Cl 0.06, 0.08) inpatient admissions, 1.00 (95% Cl 0.78, 1.23) inpatient bed days and 0.55 (95% Cl 0.52, 0.58) outpatient contacts being estimated over the follow-up period. Moreover, every index injury resulted in mean excess ED, inpatient and outpatient treatment costs of £12.05 (95% Cl £11.05, £13.05), £492.43 (95% Cl £415.66, £569.21) and £73.30 (95% Cl £68.44, £78.17), respectively, equating to a combined figure of £577.79 (95% Cl £500.32, £655.26). Across the entire injured cohort this amounts to an overall excess direct medical cost total of £17.6 million being incurred, with the equivalent figure for the whole of Wales potentially being as high as £306.4 million.Together with signifying the magnitude of the HSU and direct medical costs resulting from injury, this study has introduced and implemented improved methods for estimating these outcome measures based on the use of anonymous patient record linkage.
published_date 2010-12-31T04:25:12Z
_version_ 1851365693878960128
score 11.089572

Similar Items