A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective
Most atrial fibrillation (AF) patients need anticoagulation management to reduce the risk of thromboembolic events and stroke. Currently, two major drug therapies are available: warfarin and direct oral anticoagulant (DOAC). This study examined the spatial costs of these therapies and derived the le...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2019-11-01
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| Series: | Geospatial Health |
| Subjects: | |
| Online Access: | https://www.geospatialhealth.net/index.php/gh/article/view/809 |
| _version_ | 1811264275976552448 |
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| author | Mikko Pyykönen Aapeli Leminen Juho Tynkkynen Markku Tykkyläinen Tiina Laatikainen |
| author_facet | Mikko Pyykönen Aapeli Leminen Juho Tynkkynen Markku Tykkyläinen Tiina Laatikainen |
| author_sort | Mikko Pyykönen |
| collection | DOAJ |
| description | Most atrial fibrillation (AF) patients need anticoagulation management to reduce the risk of thromboembolic events and stroke. Currently, two major drug therapies are available: warfarin and direct oral anticoagulant (DOAC). This study examined the spatial costs of these therapies and derived the least-cost market areas for both therapies in the study area. The concepts of spatial costs and the principles of forming market areas were used as theoretical starting points, and the patients’ travel, time-loss, and medication cost parameters combined with geographical information systems methods were incorporated into the geospatial model. Results showed that for AF patients who live near the international normalized ratio (INR) monitoring sample collection point and have less than 15 annual INR monitoring visits, warfarin therapy resulted in the lowest cost regardless of patient’s travel mode and their assumed working or retirement status. If the AF patient needs more frequent INR monitoring visits or lives farther from the nearest sample collection point, DOAC would be the least costly option. The modelled results reveal the variety and importance of patients’ cost of time loss and travel costs when a physician selects the appropriate anticoagulation therapy. |
| first_indexed | 2024-04-12T20:00:12Z |
| format | Article |
| id | doaj.art-84a94682acdd4f318ffc601f972b0e58 |
| institution | Directory Open Access Journal |
| issn | 1827-1987 1970-7096 |
| language | English |
| last_indexed | 2024-04-12T20:00:12Z |
| publishDate | 2019-11-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Geospatial Health |
| spelling | doaj.art-84a94682acdd4f318ffc601f972b0e582022-12-22T03:18:33ZengPAGEPress PublicationsGeospatial Health1827-19871970-70962019-11-0114210.4081/gh.2019.809A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspectiveMikko Pyykönen0Aapeli Leminen1Juho Tynkkynen2Markku Tykkyläinen3Tiina Laatikainen4Department of Geographical and Historical Studies, University of Eastern Finland, JoensuuDepartment of Geographical and Historical Studies, University of Eastern Finland, JoensuuFaculty of Medicine and Health Technology, Tampere University, Tampere; Department of Radiology, Kanta-Häme Central Hospital, HämeenlinnaDepartment of Geographical and Historical Studies, University of Eastern Finland, JoensuuInstitute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio; Joint Municipal Authority for North Karelia Social and Health Services, Joensuu; Department of Public Health Solutions, National Institute for Health and Welfare, HelsinkiMost atrial fibrillation (AF) patients need anticoagulation management to reduce the risk of thromboembolic events and stroke. Currently, two major drug therapies are available: warfarin and direct oral anticoagulant (DOAC). This study examined the spatial costs of these therapies and derived the least-cost market areas for both therapies in the study area. The concepts of spatial costs and the principles of forming market areas were used as theoretical starting points, and the patients’ travel, time-loss, and medication cost parameters combined with geographical information systems methods were incorporated into the geospatial model. Results showed that for AF patients who live near the international normalized ratio (INR) monitoring sample collection point and have less than 15 annual INR monitoring visits, warfarin therapy resulted in the lowest cost regardless of patient’s travel mode and their assumed working or retirement status. If the AF patient needs more frequent INR monitoring visits or lives farther from the nearest sample collection point, DOAC would be the least costly option. The modelled results reveal the variety and importance of patients’ cost of time loss and travel costs when a physician selects the appropriate anticoagulation therapy.https://www.geospatialhealth.net/index.php/gh/article/view/809Geographical information systemsAtrial fibrillationLeast-cost therapyMarket areasNetwork analysis |
| spellingShingle | Mikko Pyykönen Aapeli Leminen Juho Tynkkynen Markku Tykkyläinen Tiina Laatikainen A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective Geospatial Health Geographical information systems Atrial fibrillation Least-cost therapy Market areas Network analysis |
| title | A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective |
| title_full | A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective |
| title_fullStr | A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective |
| title_full_unstemmed | A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective |
| title_short | A geospatial model to determine the spatial cost-efficiency of anticoagulation drug therapy: Patients’ perspective |
| title_sort | geospatial model to determine the spatial cost efficiency of anticoagulation drug therapy patients perspective |
| topic | Geographical information systems Atrial fibrillation Least-cost therapy Market areas Network analysis |
| url | https://www.geospatialhealth.net/index.php/gh/article/view/809 |
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