Economic burden of injuries in children: cohort study based on administrative data in a northwestern Italian region.

Background: The aims of the present study were to identify which types of injuries are responsible for the major component of the health burden and to estimate the relative costs in a cohort of Italian children.

Methods: All children (0-14 years) residing in the Piedmont region, who were hospitalized for an injury (ICD-9-CM codes 800-995, excluding late effects from injury and allergies) between 1 January 2003 and 31 December 2003, were considered. The cohort was linked by a unique identifier to: all the hospitalizations, all the day-hospital care, and all the prescribed medicines.

Regression models for analyzing costs and their determinants in health care: an introductory review.

Objective: This article aims to describe the various approaches in multivariable modelling of healthcare costs data and to synthesize the respective criticisms as proposed in the literature.

Methods: We present regression methods suitable for the analysis of healthcare costs and then apply them to an experimental setting in cardiovascular treatment (COSTAMI study) and an observational setting in diabetes hospital care.

Results: We show how methods can produce different results depending on the degree of matching between the underlying assumptions of each method and the specific characteristics of the healthcare problem.

Using data mining techniques in monitoring diabetes care. The simpler the better?

We aim at evaluating how data-mining statistical techniques can be applied on medical records and administrative data of diabetes and how they differ in terms of capabilities of predicting outcomes (e.g. death).

An economic evaluation of water birth: the cost-effectiveness of mother well-being.

Purpose: To assess the cost-effectiveness of water compared with normal land delivery.

Methods: A retrospective controlled study was conducted over a two-year period in a Northern Italian hospital. The cohort included all the 110 women who completed a water birth and 110 women who had a land birth during the same period.

[Methodological aspects in valuing loss of production and informal care in cost-of-illness studies].

Estimating costs of illness in social terms requires the consideration of the loss of production costs due to absence from work. Costs related to informal care should also be counted. Costs due to the loss of production are valued through the human capital method and the frictional costs method.

[Bayesian approach for the cost-effectiveness evaluation of healthcare technologies].

The development of Bayesian statistical methods for the assessment of the cost-effectiveness of health care technologies is reviewed. Although many studies adopt a frequentist approach, several authors have advocated the use of Bayesian methods in health economics. Emphasis has been placed on the advantages of the Bayesian approach, which include: (i) the ability to make more intuitive and meaningful inferences; (ii) the ability to tackle complex problems, such as allowing for the inclusion of patients who generate no cost, thanks to the availability of powerful computational algorithms; (iii) the importance of a full use of quantitative and structural prior information to produce realistic inferences.

[Non-parametric methods for estimating confidence intervals around the incremental cost-effectiveness ratio].

In recent years, cost-effectiveness analysis has become a frequent component of randomized clinical trials. In statistical terms, the major efforts addressed the method for estimating the Incremental Cost Effectiveness Ratio (ICER) and its confidence interval both with parametric and non-parametric methods. The goal of the present work is to briefly present the main non-parametric methods, based on a bootstrap approach.

Extreme regression models for characterizing high-cost patients.

Objective: Healthcare cost distribution generally presents a high level of skewness, with a relatively small number of subjects accounting for a large portion of healthcare expenditures. Information on factors that predict high expenditures is of interest in healthcare planning. The aim of this paper was to inspect the behaviour of extreme regression (ER) models.

Normal glucose values are associated with a lower risk of mortality in hospitalized patients.

Objective: Hyperglycemia is a common condition in hospitalized patients. The aim of this study was to investigate the relationships between glycemia upon admission and mortality in a heterogeneous group of adult patients.

Research Design And Methods: The 3-year records released from a general hospital were associated with a plasma glucose dataset of its general laboratory.

Information on center characteristics as costs' determinants in multicenter clinical trials: is modeling center effect worth the effort?

Objectives: Several methodological problems arise when health outcomes and resource utilization are collected at different sites. To avoid misleading conclusions in multi-center economic evaluations the center effect needs to be taken into adequate consideration. The aim of this article is to compare several models, which make use of a different amount of information about the enrolling center.

Factors affecting hospitalization costs in Type 2 diabetic patients.

Objective: To evaluate Type 2 diabetes hospitalization costs and their determinants by applying a proper methodological approach, taking into account the presence of several observations with zero costs.

Methods: A cohort study using per-patient hospital discharge abstracts in a period of 4.5 years of follow-up (from 1/1/1996 to 30/6/2000).

Survival models for cost data: the forgotten additive approach.

The usage of the Aalen additive approach is proposed to model cost data. Using a Monte Carlo simulation, in a wide set of scenarios, we showed that the Aalen model is performing well and can be a reasonable alternative to the standard Gamma regression models. In addition, with reference to the COSTAMI trial data, we highlighted the ability of the Aalen model to offer additional information about the relationships between costs and specific covariates, as compared with standard regression techniques.

Proper modeling strategies selection for the assessment of post-infarction costs.

Background: The evaluation of the economic impact of ischemic disease has gained increasing interest. Such field of investigation is suffering however of the heterogeneity of methods used in evaluating costs, limiting the comparison of study results.

Objective: The aim of the study is to show how estimates of 1-year costs of treatment of patients with uncomplicated acute myocardial infarction can vary significantly in relation to the statistical method adopted in the analysis.