The cost saving effect of advanced dietetic practice in an acute setting

In this paper, we estimate the socio-economic impacts the National Information Infrastructure(NII) will bring to our society and recognize the importance of the NII construction project. We estimate the quantitative cost-saving effects of NII, through we admit the methodology contains a lot of constraints. We expect NII will increase efficiency in almost every aspect of our society and choose only 7 sectors in which the cost-saving effect of NII will realize vividly; medical service, environmental management, disaster management, civil affairs administration, manufacturing, distribution & shipment, and education. The estimates for the net-benefit of cost-saving effects in the seven sectors in the period 1996-2015 are 6.7-20.4 trillion won for medical service, 3.6-8.0 trillion won for environmental management, 0.2-0.6 trillion won for disaster management, 0.6-1.0 trillion won for civil affairs administration, 61.3-152.7 trillion won for manufacturing, 11.7-15.3 trillion won for distribution & shipment, and 1.9-6.2 trillion won for education.

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The cost-saving effect of continuity of care (COC): an analysis of institutional COC on diabetic treatment costs using panel 2SLS regressions

BMC Health Services Research ◽

10.1186/s12913-021-07052-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yu-Ping Wen ◽

Sandra S. Liu ◽

Ji-Tian Sheu ◽

Hong-Huei Wang ◽

Edmund R. Becker ◽

...

Keyword(s):

Cost Saving ◽

Integrated Care ◽

Continuity Of Care ◽

Care Delivery ◽

Treatment Costs ◽

Diabetic Patients ◽

Substantial Impact ◽

Saving Effect ◽

The Cost ◽

Diabetes Patients

Abstract Background The high costs of chronic conditions call for new treatment approaches that reduce costs while ensuring desirable health outcomes. There has been a growing transformation of care delivery models from conventional referral systems to integrated care models. This study seeks to evaluate the cost-saving impact of integrated care delivery model under pay-for-performance (P4P) scheme with continuity of care at institution level (ICOC). Methods We analyzed the Taiwan National Health Insurance claim data of 21,725 diabetic patients who visited clinics and/or hospitals at least four times a year for 8 years. Using average local provider P4P participation rate (for each accreditation level) as an instrumental variable in two-stage least squares (2SLS) regressions, we have estimated consistent estimates of the ICOC elasticities for all-cause inpatient and outpatient costs. Results Our results show that ICOC significantly reduced inpatient costs but increased outpatient costs with the elasticity for treatment costs of -11.6 and 1.03, respectively. The decrease in inpatient costs offset the increase in outpatient costs and the resulting total cost saving showed significant association with ICOC. The saving effect of ICOC is especially robust among patients who used clinics as their principal source of care. Conclusions Institutional continuity of care has a substantial impact on the treatment costs of diabetes patients. In the context where inpatient care costs are significantly higher than that of the outpatient care, ICOC would lead to a meaningful cost-saving effect. For new diabetes patients, care by clinics demonstrated the strongest saving effect.

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The cost-saving effect of centralized histological reviews with soft tissue and visceral sarcomas, GIST, and desmoid tumors: The experiences of the pathologists of the French Sarcoma Group

PLoS ONE ◽

10.1371/journal.pone.0193330 ◽

2018 ◽

Vol 13 (4) ◽

pp. e0193330 ◽

Cited By ~ 11

Author(s):

Lionel Perrier ◽

Pauline Rascle ◽

Magali Morelle ◽

Maud Toulmonde ◽

Dominique Ranchere Vince ◽

...

Keyword(s):

Soft Tissue ◽

Cost Saving ◽

Desmoid Tumors ◽

Saving Effect ◽

The Cost

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An Outreach Rehabilitation Program for Nursing Home Residents After Hip Fracture May Be Cost-Saving

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa074 ◽

2020 ◽

Vol 75 (10) ◽

pp. e159-e165

Author(s):

Lauren A Beaupre ◽

Doug Lier ◽

Jay S Magaziner ◽

C Allyson Jones ◽

D William C Johnston ◽

...

Keyword(s):

Nursing Home ◽

Hip Fracture ◽

Cost Saving ◽

Incremental Cost ◽

Usual Care ◽

Nursing Home Residents ◽

Rehabilitation Program ◽

Study Entry ◽

Rehabilitation Intervention ◽

The Cost

Abstract Background We compared the cost-effectiveness of 10 weeks of outreach rehabilitation (intervention) versus usual care (control) for ambulatory nursing home residents after hip fracture. Methods Enrollment occurred February 2011 through June 2015 in a Canadian metropolitan region. Seventy-seven participants were allocated in a 2:1 ratio to receive a 10-week rehabilitation program (intervention) or usual care (control) (46 intervention; 31 control). Using a payer perspective, we performed main and sensitivity analyses. Health outcome was measured by quality-adjusted life years (QALYs), using the EQ5D, completed at study entry, 3-, 6-, and 12-months. We obtained patient-specific data for outpatient visits, physician claims, and inpatient readmissions; the trial provided rehabilitation utilization/cost data. We estimated incremental cost and incremental effectiveness. Results Groups were similar at study entry; the mean age was 87.9 ± 6.6 years, 54 (71%) were female and 58 (75%) had severe cognitive impairment. EQ5D QALYs scores were nonsignificantly higher for intervention participants. Inpatient readmissions were two times higher among controls, with a cost difference of −$3,350/patient for intervention participants, offsetting the cost/intervention participant of $2,300 for the outreach rehabilitation. The adjusted incremental QALYs/patient difference was 0.024 favoring the intervention, with an incremental cost/patient of −$621 for intervention participants; these values were not statistically significant. A sensitivity analysis reinforced these findings, suggesting that the intervention was likely dominant. Conclusion A 10-week outreach rehabilitation intervention for nursing home residents who sustain a hip fracture may be cost-saving, through reduced postfracture hospital readmissions. These results support further work to evaluate postfracture rehabilitation for nursing home residents.

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The cost implication of primary prevention in the HOPE 3 trial

European Heart Journal - Quality of Care and Clinical Outcomes ◽

10.1093/ehjqcco/qcz001 ◽

2019 ◽

Vol 5 (3) ◽

pp. 266-271

Author(s):

Andre Lamy ◽

Eva Lonn ◽

Wesley Tong ◽

Balakumar Swaminathan ◽

Hyejung Jung ◽

...

Keyword(s):

Developing Countries ◽

Primary Prevention ◽

Cost Saving ◽

Developed Countries ◽

Sensitivity Analyses ◽

Clinical Trial Registration ◽

Pressure Lowering ◽

The Cost ◽

Care Costs ◽

Country Specific

Abstract Aims The Heart Outcomes Prevention Evaluation-3 (HOPE-3) found that rosuvastatin alone or with candesartan and hydrochlorothiazide (HCT) (in a subgroup with hypertension) significantly lowered cardiovascular events compared with placebo in 12 705 individuals from 21 countries at intermediate risk and without cardiovascular disease. We assessed the costs implications of implementation in primary prevention in countries at different economic levels. Methods and results Hospitalizations, procedures, study and non-study medications were documented. We applied country-specific costs to the healthcare resources consumed for each patient. We calculated the average cost per patient in US dollars for the duration of the study (5.6 years). Sensitivity analyses were also performed with cheapest equivalent substitutes. The combination of rosuvastatin with candesartan/HCT reduced total costs and was a cost-saving strategy in United States, Canada, Europe, and Australia. In contrast, the treatments were more expensive in developing countries even when cheapest equivalent substitutes were used. After adjustment for gross domestic product (GDP), the costs of cheapest equivalent substitutes in proportion to the health care costs were higher in developing countries in comparison to developed countries. Conclusion Rosuvastatin and candesartan/HCT in primary prevention is a cost-saving approach in developed countries, but not in developing countries as both drugs and their cheapest equivalent substitutes are relatively more expensive despite adjustment by GDP. Reductions in costs of these drugs in developing countries are essential to make statins and blood pressure lowering drugs affordable and ensure their use. Clinical trial registration HOPE-3 ClinicalTrials.gov number, NCT00468923.

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Cost-saving effect of early less invasive surfactant administration versus continuous positive airway pressure therapy alone for preterm infants with respiratory distress syndrome

European Journal of Hospital Pharmacy ◽

10.1136/ejhpharm-2020-002465 ◽

2021 ◽

pp. ejhpharm-2020-002465

Author(s):

Carlo Federici ◽

Giulia Fornaro ◽

Charles Christopher Roehr

Keyword(s):

Continuous Positive Airway Pressure ◽

Cost Saving ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Airway Pressure ◽

Distress Syndrome ◽

Positive Airway Pressure ◽

Pressure Therapy ◽

Surfactant Administration ◽

Saving Effect

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Cost-effectiveness of zoledronic acid compared with sequential denosumab/alendronate for older osteoporotic women in Japan

Archives of Osteoporosis ◽

10.1007/s11657-021-00956-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Takahiro Mori ◽

Carolyn J. Crandall ◽

Tomoko Fujii ◽

David A. Ganz

Keyword(s):

Health Economic ◽

Cost Effectiveness ◽

Zoledronic Acid ◽

Cost Saving ◽

Fragility Fracture ◽

Community Dwelling ◽

Sensitivity Analyses ◽

Term Care ◽

Lifetime Horizon ◽

The Cost

Abstract Summary Among hypothetical cohorts of older osteoporotic women without prior fragility fracture in Japan, we evaluated the cost-effectiveness of two treatment strategies using a simulation model. Annual intravenous zoledronic acid for 3 years was cost-saving compared with biannual subcutaneous denosumab for 3 years followed by weekly oral alendronate for 3 years. Purpose Osteoporosis constitutes a major medical and health economic burden to society worldwide. Injectable treatments for osteoporosis require less frequent administration than oral treatments and therefore have higher persistence and adherence with treatment, which could explain better efficacy for fracture prevention. Although annual intravenous zoledronic acid and biannual subcutaneous denosumab are available, it remains unclear which treatment strategy represents a better value from a health economic perspective. Accordingly, we examined the cost-effectiveness of zoledronic acid for 3 years compared with sequential denosumab/alendronate (i.e., denosumab for 3 years followed by oral weekly alendronate for 3 years, making the total treatment duration 6 years) among hypothetical cohorts of community-dwelling osteoporotic women without prior fragility fracture in Japan at ages 65, 70, 75, or 80 years. Methods Using a previously validated and updated Markov microsimulation model, we obtained incremental cost-effectiveness ratios (Japanese yen [¥] (or US dollars [$]) per quality-adjusted life-year [QALY]) from the public healthcare and long-term care payer’s perspective over a lifetime horizon with a willingness-to-pay of ¥5 million (or $47,500) per QALY. Results In the base case, zoledronic acid was cost-saving (i.e., more effective and less expensive) compared with sequential denosumab/alendronate. In deterministic sensitivity analyses, results were sensitive to changes in the efficacy of zoledronic acid or the cumulative persistence rate with zoledronic acid or denosumab. In probabilistic sensitivity analyses, the probabilities of zoledronic acid being cost-effective were 98–100%. Conclusions Among older osteoporotic women without prior fragility fracture in Japan, zoledronic acid was cost-saving compared with sequential denosumab/alendronate.

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