for info
Explanation: useful article http://ospp.od.nih.gov/ecostudies/COIreportweb.htm COI estimation has progressed to the point where many studies distinguish between the core (health-related) and other related (non-health) costs of illness and disability. The components of direct and indirect costs are more precisely defined as follows: Core direct costs are those connected with the use of medical care in the prevention, diagnosis, and treatment of disease and in the continuing care, rehabilitation, or terminal care of patients. Examples include expenditures for hospitalization, outpatient clinical care, nursing home care, and home health care; services of primary physicians and specialists, dentists, and other health practitioners; drugs and drug sundries; and rehabilitation counseling and other rehabilitation costs, such as for prostheses, appliances, eyeglasses, hearing aids, and other devices to overcome impairments resulting from illness or disease. Collectively, these expenditures represent the personal health care component of the United States National Health Accounts.4 Other related direct costs are borne by patients or other payers but are not included in the National Health Expenditures Accounts. Examples of such costs are expenditures for transportation to hospitals, to physicians' offices or to other health providers; certain household expenditures (e.g., help for cleaning, laundering, and cooking); special diets and clothing; relocation and moving expenses; and certain property losses, including the destruction of property resulting from alcohol abuse and criminal activity due to drug addiction. ***Core indirect costs*** measure the value of time that patients lose from employment or other productive activity due to mortality or morbidity. These costs also include reduced productivity once the patient returns to work, including unwanted job changes and loss of opportunities for promotion or education. ***Other related indirect costs*** include the value ascribed to time lost from work, housekeeping, etc., by family members or friends who transport, visit, and care for patients. Also included are indirect costs such as the value of productivity losses due to victimization by crime, incarceration, and criminal activities due to conditions such as alcoholism and drug abuse.
-------------------------------------------------- Note added at 1 hr (2007-03-29 14:17:48 GMT) --------------------------------------------------
So as you can see, without a precise explanation, it is very difficult to say what these indirect costs "au domicile" entail, but we can be fairly sure it's NOT to do with health care.
-------------------------------------------------- Note added at 1 hr (2007-03-29 14:21:27 GMT) --------------------------------------------------
Here's another article, in French, which expands a little on "coûts indirects": http://www.espace-congres-sfr.com/05-Bibliotheque/Livre-Blan... Les coûts indirects sont liés à la perte de « productivité » engendrée par une maladie chronique. Le terme « productivité » ne se limite pas à la capacité d’un individu à exercer une activité professionnelle, mais englobe toutes les activités ou fonctions qu’une personne peut remplir dans sa vie courante, lui permettant de tenir son rôle dans la société : travail rémunéré, bénévolat, tâches ménagères, éducation des enfants, aide à une tierce personne, etc. La détermination des coûts indirects est complexe. En effet, il est difficile de savoir ce qu’une personne aurait gagné en l’absence d’une maladie, ou de valoriser des tâches habituellement non rémunérées telles qu’élever un enfant pour ne citer qu’un exemple. Il existe de plus plusieurs méthodes de chiffrage, aboutissant à des estimations très différentes, pouvant varier d’un facteur 1 à 15 pour une même maladie (4).
| Dr Sue Levy (X) Local time: 02:42 Specializes in field Native speaker of: English PRO pts in category: 181
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