Processing of Adenoid and Tonsil Specimens in Children: A National Survey of Standard Practices and a Five-Year Review of the Experience at the Children's Hospital of Pittsburgh

1996 ◽  
Vol 115 (1) ◽  
pp. 94-97 ◽  
Author(s):  
Joseph E. Dohar ◽  
Jose A. Bonilla
Keyword(s):  
Microscopic Analysis ◽  
Cost Effective ◽  
Glycogen Storage ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Clinically Significant ◽  
American Society ◽  
Standard Practices ◽  
Glycogen Storage Disorder ◽  
The Cost

The best means of pathologically examining routine tonsillectomy and adenoidectomy specimens in children remains controversial. Otolaryngologists fear missing an unsuspected diagnosis. However, the cost-effectiveness of microscopic analysis, given the rare incidence of unsuspected diagnosis, is questionable. If a significant pathologic diagnosis is missed, the medicolegal implications could be significant. A questionnaire was sent to 111 members of the American Society of Pediatric Otolaryngology. Additionally, we reviewed our experience at the Children's Hospital of Pittsburgh for the 5-year span from 1989 to 1994 to determine our incidence of unsuspected pathologic diagnoses. Sixty-five questionnaires were returned (59% response rate). More than half (56%) of the respondents stated that microscopic analysis was routinely performed on all specimens, and 42% replied that only gross examination was performed, reserving microscopic examination for selected cases. Three respondents said that they discarded their specimens in the operating room. From March 1989 to October 1994, in 1985 children undergoing bilateral tonsillectomy and adenoidectomy at the Children's Hospital of Pittsburgh, no significant pathologic diagnoses were found. Twenty-seven additional children who underwent only tonsillectomy between January 1991 and October 1994 were also reviewed. One lymphoma, suspected before surgery, and a glycogen storage disorder, not suspected before surgery, were diagnosed. Therefore, in a total of 2012 children, we found only one clinically significant unsuspected diagnosis. In conclusion, we found no national consensus governing the best way to examine routine adenotonsillectomy specimens in children. Given that unsuspected diagnoses are rare, reserving microscopic analysis for specific clinical indications may be both more cost-effective and medically feasible.

The cost-effectiveness of teleradiology at the Women's and Children's Hospital in Adelaide

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 23-25 ◽  
Author(s):  
Tina Hayward ◽  
John Mitchell
Keyword(s):  
Cost Effectiveness ◽  
Case Studies ◽  
Cost Effective ◽  
Social Value ◽  
Children's Hospital ◽  
Special Cases ◽  
Children’S Hospital ◽  
Tertiary Hospitals ◽  
New Form ◽  
The Cost

The cost-effectiveness of teleradiology was examined in a trial conducted at the Women's and Children's Hospital (WCH) in Adelaide, from February 1998 to February 1999. The trial showed that, with the large distances between remote hospitals and metropolitan hospitals, teleradiology, relative to the transfer of remote patients, could be highly cost-effective, but that a new form of cost justification is required for teleradiology for tertiary hospitals providing second opinions in special cases. A series of compelling case studies proved the economic and social value of teleradiology at the WCH.

scholarly journals Cost and Cost-Effectiveness of Childhood Cancer Treatment in El Salvador: A Collaborative Budget Model

2017 ◽  
Vol 3 (2_suppl) ◽  
pp. 19s-19s
Author(s):  
Soad Fuentes-Alabi ◽  
Roberto Franklin Vasquez ◽  
Nickhill Bhakta ◽  
Carlos Rodriguez-Galindo ◽  
A. Lindsay Frazier ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Childhood Cancer ◽  
El Salvador ◽  
Cost Effective ◽  
Treatment Center ◽  
Model Framework ◽  
Budget Model ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Cost

Abstract 32 Background: Cure rates for childhood cancer in El Salvador (ES) have increased from 5% in 1991 to 68% today as a result of national and international support. Approximately 200 new cases of pediatric cancer are diagnosed annually in ES—all are treated centrally at the National Children’s Hospital Benjamin Bloom. The cost of childhood cancer treatment in low- and middle-income countries (LMICs), such as ES, has not been well investigated. Such data are integral to inform national childhood cancer treatment plans. We undertook this work to determine the cost of operating a national childhood cancer treatment center in ES and to provide an analytic model framework for similar cost analyses in other LMICs. Methods: We conducted a cross-sectional study to evaluate the cost of childhood cancer treatment covered by a collaborative budget model in ES. We calculated costs on the basis of annual cases diagnosed and admitted to National Children’s Hospital Benjamin Bloom, and captured supportive expenses for families that are essential to reducing abandonment. Cost-effective analyses were performed and compared with traditional thresholds. Results: Initial estimates indicate an annual total operating budget of $5.3 million to treat 200 new cases annually. When combined with current survival outcomes, this represents a cost-effective model using WHO-CHOICE thresholds. Conclusion: Providing the first such comprehensive, institution-based estimate for the cost of treatment of childhood cancer in LMICs, we show that a childhood cancer treatment center represents a cost-effective intervention. This baseline information can be used to prioritize future treatments and interventions in ES. This methodology also allows similar studies to be conducted in other LMICs. Together, these data will inform a case for investment in global access to childhood cancer treatment. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Soad Fuentes-Alabi No relationship to disclose Roberto Franklin Vasquez No relationship to disclose Nickhill Bhakta No relationship to disclose Carlos Rodriguez-Galindo Honoraria: Novimmune A. Lindsay Frazier Consulting or Advisory Role: Decibel Therapeutics Rifat Atun No relationship to disclose Sumit Gupta No relationship to disclose Susan Horton No relationship to disclose

Tuberculosis among Families of Children with Suspected Tuberculosis and Employees at a Children's Hospital

2011 ◽  
Vol 32 (2) ◽  
pp. 188-190 ◽  
Author(s):  
Andrea T. Cruz ◽  
Denise Medina ◽  
Elaine M. Whaley ◽  
Kathy M. Ware ◽  
Tjin H. Koy ◽  
...  
Keyword(s):  
Cost Effective ◽  
Children's Hospital ◽  
Suspected Tuberculosis ◽  
Children’S Hospital ◽  
Contact Investigations ◽  
The Cost

Children with tuberculosis are rarely contagious, but their caregivers may be. Only 7 (12%) of 59 children were potentially contagious, and 10 (17%) were accompanied by contagious adults. Screening caregivers was more cost-effective than performing employee contact investigations, with one-sixteenth the cost ($5,470 vs $88,323) and requiring screening of 35 times fewer persons.

Making E-Training Cost Effective through Quality Assurance

2009 ◽  
pp. 623-631
Author(s):  
Lichia Yiu ◽  
Raymond Saner
Keyword(s):  
High Performance ◽  
Cost Effective ◽  
Web Based ◽  
Corporate Learning ◽  
Use Of Technology ◽  
Training Cost ◽  
E Learning ◽  
American Society ◽  
High Level ◽  
The Cost

Since the 1990s, more and more corporate learning has been moved online to allow for flexibility, just-in-time learning, and cost saving in delivering training. This trend has been evolved along with the introduction of Web-based applications for HRM purposes, known as electronic Human Resource Management (e-HRM). By 2005, 39.67% of the corporate learning, among the ASTD (American Society for Training and Development) benchmarking forum companies, was delivered online in comparison to 10.5% in 2001. E-learning has now reached “a high level of (technical) sophistication, both in terms of instructional development and the effective management of resources” in companies with high performance learning function (ASTD, 2006, p.4). The cost per unit, reported by ASTD in its 2006 State of Industry Report, has been declining since 2000 despite the higher training hours received per employee thanks to the use of technology based training delivery and its scalability. However, the overall quality of e-learning either public available in the market or implemented at the workplace remains unstable.

American Society of Clinical Oncology Guidance Statement: The Cost of Cancer Care

2009 ◽  
Vol 27 (23) ◽  
pp. 3868-3874 ◽  
Author(s):  
Neal J. Meropol ◽  
Deborah Schrag ◽  
Thomas J. Smith ◽  
Therese M. Mulvey ◽  
Robert M. Langdon ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Clinical Oncology ◽  
Cancer Care ◽  
Cost Effective ◽  
The United States ◽  
Cost Of Care ◽  
High Quality ◽  
American Society ◽  
The Cost

Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates in the United States. In parallel with these advances have come significant increases in the cost of cancer care. It is well established that the cost of health care (including cancer care) in the United States is growing more rapidly than the overall economy. In part, this is a result of the prices and rapid uptake of new agents and other technologies, including advances in imaging and therapeutic radiology. Conventional understanding suggests that high prices may reflect the costs and risks associated with the development, production, and marketing of new drugs and technologies, many of which are valued highly by physicians, patients, and payers. The increasing cost of cancer care impacts many stakeholders who play a role in a complex health care system. Our patients are the most vulnerable because they often experience uneven insurance coverage, leading to financial strain or even ruin. Other key groups include pharmaceutical manufacturers that pass along research, development, and marketing costs to the consumer; providers of cancer care who dispense increasingly expensive drugs and technologies; and the insurance industry, which ultimately passes costs to consumers. Increasingly, the economic burden of health care in general, and high-quality cancer care in particular, will be less and less affordable for an increasing number of Americans unless steps are taken to curb current trends. The American Society of Clinical Oncology (ASCO) is committed to improving cancer prevention, diagnosis, and treatment and eliminating disparities in cancer care through support of evidence-based and cost-effective practices. To address this goal, ASCO established a Cost of Care Task Force, which has developed this Guidance Statement on the Cost of Cancer Care. This Guidance Statement provides a concise overview of the economic issues facing stakeholders in the cancer community. It also recommends that the following steps be taken to address immediate needs: recognition that patient-physician discussions regarding the cost of care are an important component of high-quality care; the design of educational and support tools for oncology providers to promote effective communication about costs with patients; and the development of resources to help educate patients about the high cost of cancer care to help guide their decision making regarding treatment options. Looking to the future, this Guidance Statement also recommends that ASCO develop policy positions to address the underlying factors contributing to the increased cost of cancer care. Doing so will require a clear understanding of the factors that drive these costs, as well as potential modifications to the current cancer care system to ensure that all Americans have access to high-quality, cost-effective care.

The Nutrition Team in a Children's Hospital

1987 ◽  
Vol 5 (3-4) ◽  
pp. 137-144 ◽  
Author(s):  
S. Smallman ◽  
D. Handy ◽  
J. W. L Puntis ◽  
I. W. Booth
Keyword(s):  
Cost Effectiveness ◽  
Nutritional Assessment ◽  
Care Team ◽  
Nutritional Care ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Cost

This paper discusses the reasons for a paediatric nutritional care team, the members involved, and their role within the team. The methods used for nutritional assessment are described and the cost effectiveness of the nutrition team's involvement is discussed.

Prognostic Factors for Post-Thrombotic Syndrome in Children with Limb DVT: A Bi-Institutional Cohort Study

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3401-3401
Author(s):  
Courtney A. Lyle ◽  
Elizabeth Gibson ◽  
Amy Lovejoy ◽  
Neil A Goldenberg
Keyword(s):  
Cohort Study ◽  
Prognostic Factors ◽  
Therapeutic Interventions ◽  
Significant Prognostic Factor ◽  
Advisory Committees ◽  
Children's Hospital ◽  
Post Thrombotic Syndrome ◽  
Glycoprotein I ◽  
Children’S Hospital ◽  
Clinically Significant

Abstract Abstract 3401 Background: Early identification of children with deep venous thrombosis (DVT) of the limb, whoare at heightened risk for post-thrombotic syndrome (PTS), is important in order to evaluate therapeutic interventions aimed at decreasing the risk and severity of PTS. Objective: We sought to evaluate prognostic factors for PTS in children following DVT of the limbs. Methods: In this bi-institutional mixed cohort study with prospective ascertainment of PTS using a validated pediatric instrument, we collected data on patient/thrombus characteristics, thrombophilia testing results, and outcomes in children (<21 years at event) diagnosed with acute limb DVT at Rady Children's Hospital of San Diego and Children's Hospital Colorado. Results: Median age at presentation was 13 years (range, 0–18 years). Cumulative incidence (i.e., risk of PTS) was 23%, at a median follow-up duration of 33 months (range: 13.2–65 months). The presence of a lupus anticoagulant by dilute Russell Viper venom time (dRVVT) testing within two weeks of DVT diagnosis was associated with markedly increased odds of developing clinically-significant PTS (OR 16.8, 95%CI (1.60–176.2); P=0.02). The presence of an infectious or inflammatory condition at DVT presentation was neither associated with PTS risk nor dRVVT positivity. Conclusions: An acutely positive dRVVT following diagnosis of limb DVT appears to be a significant prognostic factor for development of clinically significant PTS in children. Larger collaborative cohort studies are required to substantiate these findings, evaluate other prognostic factors, and determine whether the present association is modulated by persistent dRVVT positivity or beta-2-glycoprotein-I dependence. Disclosures: Goldenberg: Eisai Inc: Research Funding; Pfizer Inc: Membership on an entity's Board of Directors or advisory committees; CPC Clinical Research: Consultancy.

Making E-Training Cost Effective through Quality Assurance

2011 ◽  
pp. 1413-1422
Author(s):  
Lichia Yiu ◽  
Raymond Saner
Keyword(s):  
High Performance ◽  
Cost Effective ◽  
Web Based ◽  
Corporate Learning ◽  
Use Of Technology ◽  
Training Cost ◽  
E Learning ◽  
American Society ◽  
High Level ◽  
The Cost

Since the 1990s, more and more corporate learning has been moved online to allow for flexibility, just-in-time learning, and cost saving in delivering training. This trend has been evolved along with the introduction of Web-based applications for HRM purposes, known as electronic Human Resource Management (e-HRM). By 2005, 39.67% of the corporate learning, among the ASTD (American Society for Training and Development) benchmarking forum companies, was delivered online in comparison to 10.5% in 2001. E-learning has now reached “a high level of (technical) sophistication, both in terms of instructional development and the effective management of resources” in companies with high performance learning function (ASTD, 2006, p.4). The cost per unit, reported by ASTD in its 2006 State of Industry Report, has been declining since 2000 despite the higher training hours received per employee thanks to the use of technology based training delivery and its scalability. However, the overall quality of e-learning either public available in the market or implemented at the workplace remains unstable.

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