We use novel data to study genetic testing among individuals at risk for Huntington disease (HD), a hereditary disease with limited life expectancy. Although genetic testing is perfectly predictive ...and carries little economic cost, presymptomatic testing is rare. Testing rates increase with increases in ex ante risk of having HD. Untested individuals express optimistic beliefs about their health and make decisions (e.g., retirement) as if they do not have HD, even though individuals with confirmed HD behave differently. We suggest that these facts can be reconciled by an optimal expectations model (Brunnermeier and Parker 2005).
Parkinson's disease (PD) is one of the world's fastest growing neurological disorders. Much is unknown about PD-associated economic burdens in the United States (U.S.) and other high-income nations. ...This study provides a comprehensive analysis of the economic burdens of PD in the U.S. (2017) and projections for the next two decades. Multiple data sources were used to estimate the costs of PD, including public and private administrative claims data, Medicare Current Beneficiary Survey, Medical Expenditure Panel Survey, and a primary survey (n = 4,548) designed for this study. We estimated a U.S. prevalence of approximately one million individuals with diagnosed Parkinson's disease in 2017 and a total economic burden of $51.9 billion. The total burden of PD includes direct medical costs of $25.4 billion and $26.5 billion in indirect and non-medical costs, including an indirect cost of $14.2 billion (PWP and caregiver burden combined), non-medical costs of $7.5 billion, and $4.8 billion due to disability income received by PWPs. The Medicare program bears the largest share of excess medical costs, as most PD patients are over age 65. Projected PD prevalence will be more than 1.6 million with projected total economic burden surpassing $79 billion by 2037. The economic burden of PD was previously underestimated. Our findings underscore the substantial burden of PD to society, payers, patients, and caregivers. Interventions to reduce PD incidence, delay disease progression, and alleviate symptom burden may reduce the future economic burden of PD.
Telemedicine 2020 and the next decade Dorsey, E Ray; Topol, Eric J
The Lancet (British edition),
03/2020, Letnik:
395, Številka:
10227
Journal Article
Recenzirano
A small randomised controlled trial of acutely ill patients compared hospital versus home care involving audio and video calls with clinicians and remote monitoring of vital signs showed there were ...fewer readmissions, less unnecessary testing and consultations, and lower costs for home care. For chronic conditions, virtual and in-person care might be integrated with a diverse set of health workers (physicians, nurses, dietitians, therapists) who could provide care centred around a patient's home. Faith Hark/Scripps Research Translational Institute ERD is supported by the US National Institutes of Health grant 5P50NS108676-02 and receives consulting fees from American Well (a US telemedicine company), serves as editor for Digital Biomarkers, and has stock ownership in and is on the Medical Advisory Board of Grand Rounds (a remote second opinion service for large employers).
Over the past 20 years, the use of telemedicine has increased exponentially. Its fundamental aim is to improve access to care. In this review, we assess the extent to which telemedicine has fulfilled ...this promise across medical domains. Additionally, we assess whether telemedicine has improved related health outcomes. Finally, we determine who has benefited from this novel form of health care delivery. A review of the literature indicates that (
a
) telemedicine has improved access to care for a wide range of clinical conditions ranging from stroke to pregnancy; (
b
) telemedicine in select circumstances has demonstrated improved health outcomes; and (
c
) telemedicine has addressed geographical, but less so social, barriers to care. For telemedicine to fulfill its promise, additional evidence needs to be gathered on health outcomes and cost savings, the digital divide needs to be bridged, and policy changes that support telemedicine reimbursement need to be enacted.
PDF
