Cost-Benefit Analysis of Providing Non-Emergency Medical Transportation (2005) / Chapter Skim
Currently Skimming:
Pages 41-54
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 41... ...
Chapter 6: Method for Estimating Healthcare Costs and Outcomes In this chapter, we consider the optimal method to quantify the impacts of missed medical care on healthcare costs and health outcomes in light of the constraints imposed by the data. The work builds on the literature review presented in Chapter 2, and the set of non-emergency medical services needed by the target population identified in Chapter 3 and described in Chapter 4.
|
From page 42... ...
health insurance. Similarly, there is great potential for avoiding costly hospitalizations (Kruzikas et al., 2004)
|
From page 43... ...
6.2 Estimating Missed Trips from a Disease Perspective In this section, we discuss shortcomings in analytic approaches that rely on an estimate of the number of NEMT trips missed by the target population and explain why other approaches are superior, especially in the realm of preventive care. The resulting discussion sets the stage for use of cost-effectiveness analysis instead of a strict cost benefit analysis.
|
From page 44... ...
recommends that a patient suffering from mild to moderate asthma should see a primary care provider twice a year. Likewise, it recommends that patients with severe asthma see a primary care provider three times a year and a specialist once a year to ensure that their asthma is under control.
|
From page 45... ...
Instead of focusing on individuals with transportation barriers and aggregating their missed trips, in conjunction with changes in healthcare utilization, to get a macrolevel analysis, the benefit of added transportation services is analyzed through a series of disease specific, cost-effectiveness analyses. In this way, there is no need to estimate the number of missed trips per transportation-disadvantaged individual, and the problems associated with trip- and visit-layering for persons with multiple chronic conditions are negated.
|
From page 46... ...
approved by the panel convened for this project by the Transit Cooperative Research Program (TCRP) within TRB.
|
From page 47... ...
utilization data. Table 6-1 gives the means of the EuroQol 5-D broken down by whether the individual falls into the transportation-disadvantaged target population, and according to insurance status.
|
From page 48... ...
6.4.2.1 Demographic Information Comparing those who we believe to have missed healthcare due to transportation factors, with all others in the survey, Table 6-2 shows that the former group has more older adults, includes more females and minorities, and its members are more likely to have come from households with yearly income under $20,000 (this figure is low due to the focus on individuals, hence children, in the MEPS v. families or households)
|
From page 49... ...
Table 6-3: Insurance Status of the Target Population Rest of U.S. Population Target Population Uninsured 32,357,569 772,098 Weighted Frequency Insured 248,443,282 2,674,378 Uninsured 12% 22% Weighted Percentage Insured 88% 78% 6.4.2.3 Utilization of Healthcare Services The target population is much more likely to have an inpatient stay and emergency room visit as well as have more prescriptions written for them.
|
From page 50... ...
6.5 Establishing the Benefits of Well-Managed Care There are established standards of care intended to prevent complications for chronic diseases widely prevalent in the United States. When a patient receives wellmanaged care, his or her disease is under control, complications are minimized, costly care is avoided, and quality of life is enhanced.
|
From page 51... ...
observations, they synthesize the latest medical knowledge and best practices across the United States" (Milliman Consulting, 2004)
|
From page 52... ...
well managed for many reasons, including transportation deficiencies. Likewise, review their per capita cost of care.
|
From page 53... ...
6.7 Benefits and Costs of Providing Transportation for Preventive Health The expenditure data contained in the MEPS, while tremendously useful for the chronic conditions, cannot be straightforwardly applied to the analysis of preventive cases. Accordingly, we apply a literature-based approach to these.
|
From page 54... ...
they do not regularly see a physician, despite the likelihood of much higher future healthcare costs. While MEPS provides significant detail on healthcare costs and disease burden, there is insufficient data to determine, within diseases, the number of years the patient has had the condition, or the severity of the disease.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.