Minimally Invasive Fixation versus Conservative Treatment of Undisplaced Scaphoid Fractures: A Cost-Effectiveness Study

2004 ◽  
Vol 29 (2) ◽  
pp. 116-119 ◽  
Author(s):  
M. Y. PAPALOIZOS ◽  
C. FUSETTI ◽  
T. CHRISTEN ◽  
L. NAGY ◽  
J. B. WASSERFALLEN
Keyword(s):  
Conservative Treatment ◽  
Minimally Invasive ◽  
Indirect Costs ◽  
Direct Costs ◽  
Effectiveness Study ◽  
Invasive Treatment ◽  
Direct And Indirect Costs ◽  
Scaphoid Fractures ◽  
Minimally Invasive Fixation ◽  
Cost Effectiveness Study

This study compares the direct and indirect costs of conservative and minimally invasive treatment for undisplaced scaphoid fractures. Costs data concerning groups of non-operated and operated patients were analysed. Direct costs were higher in operated patients. Although highly variable, indirect costs were significantly smaller in operated patients and the total costs were higher in nonoperated patients. In conclusion, operative treatment of scaphoid fractures is initially more expensive than conservative treatment but markedly decreases the work compensation costs.

scholarly journals POS0530 HOW DOES MULTIMORBIDITY IMPACT ON THE DIRECT AND INDIRECT COSTS IN PATIENTS WITH RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 498.3-499
Author(s):  
P. H. Hsieh ◽  
C. Geue ◽  
O. Wu ◽  
E. McIntosh
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Employment Status ◽  
Functional Disability ◽  
Hospital Admissions ◽  
Information Service ◽  
Indirect Costs ◽  
Direct Costs ◽  
Direct And Indirect Costs ◽  
The Impact

Background:Comorbidities are prevalent in patients with rheumatoid arthritis (RA) and associated with worse outcomes as well as higher economic burden. Little is known about the impact of multimorbidity on the direct and indirect costs of RA. Evidence of the incremental scale of these multimorbidity costs will usefully inform RA interventions and policies.Objectives:The aim of this study was to describe how multimorbidity impacts on the cost-of-illness, including direct and indirect costs, in patients with RA.Methods:The Scottish Early Rheumatoid Arthritis (SERA) is a registry of patients newly presenting with RA since 2011. It contains data on patient characteristics, clinical outcomes, health-related quality of life, and employment status data. These data were linked to routinely recorded hospital admissions and primary care prescribing data. Direct costs were estimated by applying relevant unit costs to healthcare resource use quantities. Indirect cost estimates were obtained from information on employment status and hospital admissions, valued by age and sex specific wages. Two-part models (probit followed by generalized linear model) were used to estimate direct and indirect costs, adjusting for age, gender, and functional disability. The Charlson Comorbidity Index (CCI) score was calculated using patient ICD-10 diagnoses from hospital records. The number of comorbidities was categorized into “RA alone”, “single comorbidity” and “multimorbidity (>1 comorbidity)”.Results:Data were available for 1,150 patients, 65.7% were female and a mean age of 57.5±14 years. The majority of patients only had RA (54.1%), followed by a single comorbidity (23.4%) and multimorbidity (22.5%). Annual total costs were significantly higher for patients with multimorbidity (£6,669 95% CI £4,871-£8,466; OR 11.3 95% CI 8.14-15.87) and for patients with a single comorbidity (£2,075 95% CI £1,559-£2,591; OR 3.52 95% CI 2.61-4.79), when compared with RA alone (£590). The excess costs were mainly driven by direct costs (£6,281 versus £1,875 versus £556). Although the difference in indirect costs between patients with multimorbidity and a single comorbidity were not statistically significant (£1,218 versus £914, p=0.11), patients with multimorbidity were associated with significantly higher costs than those with RA only (£594, p<0.01).Conclusion:The presence of comorbidity contributes significant excess to both direct and indirect costs among RA patients. In particular, patients with multimorbidity incurred substantially higher direct costs than those with a single comorbidity or RA only.Acknowledgements:The study analysed the data from the Scottish Early Rheumatoid Arthritis (SERA) study with a linkage to routinely recorded health data from Information Service Division, National Service Scotland. We would like to thank all the patients, clinical and nursing colleagues who have contributed their time and support to the study, the SERA steering committee for the approval, and Allen Tervit from the Robertson Centre for Biostatistics, University of Glasgow for the timely technical supports.Disclosure of Interests:Ping-Hsuan Hsieh: None declared, Claudia Geue: None declared, Olivia Wu Consultant of: OW has received consultancy fees from Bayer, Lupin and Takeda outside the submitted work., Emma McIntosh: None declared

scholarly journals Complications of laparoscopic cholecystectomy: an analysis of 1,695 laparoscopic operations

2017 ◽  
Vol 4 (9) ◽  
pp. 3049
Author(s):  
Dasharadha Jatothu ◽  
Rajkumar Sade ◽  
Kirthana Sade ◽  
. Taruni ◽  
Nagababu Pyadala
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conservative Treatment ◽  
Minimally Invasive ◽  
Treatment Options ◽  
Gallstone Disease ◽  
Minimally Invasive Treatment ◽  
Medical Sciences ◽  
Invasive Treatment ◽  
Gold Standard Method ◽  
Operative Complication

Background: Laparoscopic cholecystectomy (LCs) is the gold standard method to treat gallstone disease. But there are some complications which occur frequently as compared to open cholecystectomy.Methods: The prospective study was conducted in the Department of Surgery, Kamineni Institute of Medical Sciences, Telengana during the period of 2 years; March 2015 to February 2017. A total of 1,695 laparoscopic cholecystectomy cases were included in this study. Several treatment options such as, conservative treatment, minimally invasive treatment and open surgery was performed based on the severity of the disease.Results: Majority of patients were female (83.9%) and most common age group affected was above 40 years. Intra-operative and post-operative complication occurred in 4.5% and 1.9% patients respectively. Majority complications were treated by conservative treatment and minimally invasive treatment. So, in conclusion, we can use conservative and minimally invasive treatment to manage the complications from laparoscopic cholecystectomy.Conclusions: Conservative treatment options and minimally invasive treatment was more efficient to overcome the post-operative complication of laparoscopic cholecystectomy.

Impact of bovine respiratory disease (BRD) from the perspective of the Canadian beef producer

2009 ◽  
Vol 10 (2) ◽  
pp. 109-110 ◽  
Author(s):  
Kee Jim
Keyword(s):  
Respiratory Disease ◽  
Bovine Respiratory Disease ◽  
Indirect Costs ◽  
Direct Costs ◽  
Production Costs ◽  
Direct And Indirect Costs ◽  
Carcass Disposal ◽  
The Cost

AbstractThe costs of bovine respiratory disease (BRD) to the beef producer can be estimated by identifying and summing the direct and indirect costs associated with the disease. The major direct costs are attributable to the cost of the feeder, production costs and carcass disposal. The indirect costs are mainly associated with infrastructure and labour.

scholarly journals Guidelines of the Italian Society of Videosurgery (SIVI) in Infancy for the minimally invasive treatment of Hypertrophic Pyloric Stenosis in neonates and infants

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Salvatore Fabio Chiarenza ◽  
Cosimo Bleve ◽  
Maria Escolino ◽  
Ciro Esposito ◽  
Fabio Beretta ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Minimally Invasive ◽  
Pyloric Stenosis ◽  
Intravenous Administration ◽  
Hypertrophic Pyloric Stenosis ◽  
Minimally Invasive Treatment ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Invasive Treatment ◽  
Appropriate Treatment ◽  
Neonates And Infants

The most appropriate treatment for the infantile Hypertrophic Pyloric Stenosis (HPS) is still debated. The non-surgical conservative treatment with oral or intravenous administration of atropine does not enjoy a widespread appreciation for several factors (...)

scholarly journals Economic burden of Huntington’s disease in Peru

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gustavo Silva-Paredes ◽  
Rosa M. Urbanos-Garrido ◽  
Miguel Inca-Martinez ◽  
Danielle Rabinowitz ◽  
Mario R. Cornejo-Olivas
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Economic Burden ◽  
Annual Cost ◽  
Healthcare Costs ◽  
Neurodegenerative Disorder ◽  
Indirect Costs ◽  
Direct Costs ◽  
Cross Sectional ◽  
Direct And Indirect Costs

Abstract Background Huntington’s disease (HD) is a devastating and fatal neurodegenerative disorder that leads to progressive disability, and over time to total dependence. The economic impact of HD on patients living in developing countries like Peru is still unknown. This study aims to estimate the economic burden by estimating direct and indirect costs of Huntington’s disease in Peru, as well as the proportion of direct costs borne by patients and their families. Methods Disease-cost cross-sectional study where 97 participants and their primary caregivers were interviewed using a common questionnaire. Prevalence and human capital approaches were used to estimate direct and indirect costs, respectively. Results The average annual cost of HD reached USD 8120 per patient in 2015. Direct non-healthcare costs represented 78.3% of total cost, indirect costs 14.4% and direct healthcare costs the remaining 7.3%. The mean cost of HD increased with the degree of patient dependency: from USD 6572 for Barthel 4 & 5 (slight dependency and total independency, respectively) to USD 23,251 for Barthel 1 (total dependency). Direct costs were primarily financed by patients and their families. Conclusions The estimated annual cost of HD for Peruvian society reached USD 1.2 million in 2015. The cost impact of HD on patients and their families is very high, becoming catastrophic for most dependent patients, and thus making it essential to prioritize full coverage by the State.

scholarly journals Cost-effectiveness and Safety of Interspinous Process Decompression (Superion)

Pain Medicine ◽  
2019 ◽  
Vol 20 (Supplement_2) ◽  
pp. S2-S8
Author(s):  
Kevin Cairns ◽  
Tim Deer ◽  
Dawood Sayed ◽  
Kim van Noort ◽  
Kevin Liang
Keyword(s):  
Cost Effectiveness ◽  
Conservative Treatment ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Indirect Costs ◽  
Invasive Procedure ◽  
Direct And Indirect Costs ◽  
Interspinous Spacer ◽  
And Performance ◽  
Lumbar Spinal

Abstract Objective There are several treatment options for patients suffering from lumbar spinal stenosis, including surgical and conservative care. Interspinous spacer decompression using the Superion device offers a less invasive procedure for patients who fail conservative treatment before traditional decompression surgery. This review assesses the current cost-effectiveness, safety, and performance of lumbar spinal stenosis treatment modalities compared with the Superion interspinous spacer procedure. Methods EMBASE and PubMed were searched to find studies reporting on the cost-effectiveness, safety, and performance of conservative treatment, including medicinal treatments, epidural injections, physical therapy, and alternative methods, as well as surgical treatment, including laminectomy, laminectomy with fusion, and interspinous spacer decompression. Results were supplemented with manual searches. Results Despite substantial costs, persistent conservative treatment (&gt;12 weeks) of lumbar spinal stenosis showed only minimal improvement in pain and functionality. When conservative treatment fails, surgery is more effective than continuing conservative treatment. Lumbar laminectomy with fusion has considerably greater cost than laminectomy alone, as the length of hospital stay increases, the costs for implants are substantial, and complications increase. Although laminectomy and the Superion have comparable outcomes, the Superion implant is positioned percutaneously. This approach may minimize the direct and indirect costs of outpatient rehabilitation and absenteeism, respectively. Conclusions Superion interspinous lumbar decompression is a minimally invasive procedure for patients with lumbar spinal stenosis who have failed conservative treatment. Compared with extending conservative treatment or traditional spinal surgery, interspinous lumbar decompression reduces the direct and indirect costs associated with lumbar spinal stenosis.

Cost-effectiveness of MRI in managing suspected scaphoid fractures

2009 ◽  
Vol 34 (5) ◽  
pp. 627-630 ◽  
Author(s):  
T. B. HANSEN ◽  
R. B. PETERSEN ◽  
J. BARCKMAN ◽  
P. UHRE ◽  
K. LARSEN
Keyword(s):  
Cost Effectiveness ◽  
Sick Leave ◽  
Scaphoid Fracture ◽  
Treatment Algorithm ◽  
Hospital Costs ◽  
Clinical Signs ◽  
Cost Effective ◽  
Effectiveness Study ◽  
Scaphoid Fractures ◽  
Cost Effectiveness Study

In a cost-effectiveness study, we compared a treatment algorithm using repeated radiological examination with an algorithm using subacute MRI in patients with clinical signs of scaphoid fracture but normal initial radiography. Twenty-seven patients were included in both groups, and MRI reduced the immobilisation time from 20 days (range, 6–54) to 4 days (range, 1–19) and sick leave from 27 days (1–92) to 11 days (0–28). Use of MRI increased hospital costs by €151 ( P<0.05), but reduced non-hospital costs by €2869 ( P<0.05), making MRI cost-effective in the treatment of suspected scaphoid fractures.

scholarly journals Update on Robotic Total Mesorectal Excision for Rectal Cancer

2021 ◽  
Vol 11 (9) ◽  
pp. 900
Author(s):  
Simona Giuratrabocchetta ◽  
Giampaolo Formisano ◽  
Adelona Salaj ◽  
Enrico Opocher ◽  
Luca Ferraro ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery ◽  
Minimally Invasive ◽  
Total Mesorectal Excision ◽  
Indirect Costs ◽  
Population Based ◽  
Complication Rates ◽  
Mesorectal Excision ◽  
Invasive Treatment ◽  
Multicenter Studies

The minimally invasive treatment of rectal cancer with Total Mesorectal Excision is a complex and challenging procedure due to technical and anatomical issues which could impair postoperative, oncological and functional outcomes, especially in a defined subgroup of patients. The results from recent randomized controlled trials comparing laparoscopic versus open surgery are still conflicting and trans-anal bottom-up approaches have recently been developed. Robotic surgery represents the latest consistent innovation in the field of minimally invasive surgery that may potentially overcome the technical limitations of conventional laparoscopy thanks to an enhanced dexterity, especially in deep narrow operative fields such as the pelvis. Results from population-based multicenter studies have shown the potential advantages of robotic surgery when compared to its laparoscopic counterpart in terms of reduced conversions, complication rates and length of stay. Costs, often advocated as one of the main drawbacks of robotic surgery, should be thoroughly evaluated including both the direct and indirect costs, with the latter having the potential of counterbalancing the excess of expenditure directly related to the purchase and maintenance of robotic equipment. Further prospectively maintained or randomized data are still required to better delineate the advantages of the robotic platform, especially in the subset of most complex and technically challenging patients from both an anatomical and oncological standpoint.

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