scholarly journals Can a University Reproductive Medicine Centre Be Financed Under the Pre-Existing General Conditions in Germany?

2019 ◽  
Vol 79 (01) ◽  
pp. 63-71
Author(s):  
Thomas Hildebrandt ◽  
Nicola Oversohl ◽  
Ralf Dittrich ◽  
Laura Lotz ◽  
Matthias Beckmann ◽  
...  
Keyword(s):  
Health System ◽  
Reproductive Medicine ◽  
Treatment Cycle ◽  
Financial Burden ◽  
University Hospital ◽  
Demographic Development ◽  
Icsi Cycle ◽  
German Health ◽  
The Cost ◽  
The University

Abstract Background Reduced resources for financing healthcare services are available to the German health system. For this reason, demographic development represents one of the greatest challenges for the German health system. Reproductive medicine can offer potential solutions and counteract the ageing of the population through an increase in the birth rate. Most reproductive medical treatments take place in private centres. For the development of new, innovative therapeutic approaches, continuing education and scientific advancement, university centres are essential. Materials and Methods Using multistage contribution margin accounting, IVF and ICSI treatments at the University Fertility Centre Franken (UFF) were investigated in 2012. The cost situation from the perspective of the patient couple and the statutory payer were contrasted with the cost and revenue situation of the service provider as a university reproductive medicine centre. Results The costs for the patient couple for an IVF treatment cycle were 538.71 € and for an ICSI cycle, 700.07 €. For the payer, the costs, including the university flat rate (194.80 €) to be paid, amount to 733.51 € for an IVF cycle and 894.87 € for an ICSI cycle. The payments of the patient couple and the payer were added and this yielded total costs of 1272.22 € and 1594.94 €. The University Fertility Centre Franken, as a part of the Department of Gynaecology of the Erlangen University Hospital, incurred costs of 1364.47 € for an IVF treatment cycle and 1423.48 € for an ICSI treatment cycle. In addition, the OB/GYN clinic had to pay the university hospital a flat general expense rate of 14.9% of the income. There was thus a loss for the department of gynaecology of 281.81 € for an IVF cycle and 66.19 € for an ICSI cycle. Discussion From the perspective of a university reproductive medicine centre, IVF and ICSI treatments currently cannot be performed in a cost-covering manner. At the same time, a reproductive medicine treatment cycle represents a significant financial burden on the patient couple due to only partial cost coverage by most statutory health insurance funds. This therefore demonstrates a need for action in health policy to revise and, in the interest of the patient couples, reproductive medicine centres and, not least of all, in the interest of society, to improve existing cost absorption policies and thus also benefit from this as a society over the long term.

scholarly journals Cost Savings as a Result of Bortezomib Vial Sharing in Albania

2018 ◽  
Vol 14 (21) ◽  
pp. 278
Author(s):  
Florjana Rustemi ◽  
Ledjan Malaj ◽  
Ela Hoti ◽  
Enida Balla
Keyword(s):  
Treatment Cycle ◽  
Financial Burden ◽  
Cost Savings ◽  
University Hospital ◽  
Mother Teresa ◽  
Emerging Therapies ◽  
Cost Efficacy ◽  
The Cost ◽  
The University ◽  
Hospital Center

The costs associated with current and emerging therapies, as well as supportive care, are significant and pose a tremendous financial burden to both patients and healthcare system. The objective of this study was to calculate the cost savings as a result of bortezomib vial sharing in the University Hospital Center “Mother Teresa” Tirana. This study was a retrospective analysis of the use of bortezomib in patients with multiple myeloma, using vial sharing technique to minimize wastage. The study has been conducted during the period January 1, 2015 to June 30, 2015 before vial sharing and January 1, 2016 to June 30, 2016 after vial sharing, thereby enabling us to share vial contents between patients. We compared the cost in euro for the treatment with bortezomib in order to determine the cost savings of vial sharing and cost-efficacy of individualised preparation. As a result, the cost savings for one cycle/patient using vial sharing was calculated 226.81 euro, a reduction of 25.96% compared to the period when we did not use vial sharing. During January 1, 2015 to June 30, 2015 the average treatment cost was calculated 873.36 euro/cycle/patient, compared with January 1, 2016 to June 30, 2016 when it was calculated 646.55 euro/cycle/patient. Due to cost savings of each treatment cycle we administered 62 individualised preparations of bortezomib more during January 1, 2016 to June 30, 2016 for the same budget allocated. The same approach should be adopted for other suitable drugs prepared in the University Hospital Center “Mother Teresa” Tirana.

scholarly journals Costs of bariatric surgery in a teaching hospital and the financing provided by the Public Unified Health System

2010 ◽  
Vol 25 (2) ◽  
pp. 201-205 ◽  
Author(s):  
Wilson Salgado Júnior ◽  
Karoline Calfa Pitanga ◽  
José Sebastião dos Santos ◽  
Ajith Kumar Sankarankutty ◽  
Orlando de Castro e Silva Jr ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health System ◽  
Perioperative Period ◽  
University Hospital ◽  
Retrospective Evaluation ◽  
The Public ◽  
Unified Health System ◽  
The Government ◽  
The Cost ◽  
The University

PURPOSE: Analyze the effect of some measures on the costs of bariatric surgery, adopting as reference the remuneration of the procedure provided by the Unified Health System (SUS). METHODS: A retrospective evaluation conducted in the Costs Section of the University Hospital of Ribeirão Preto, of the costs involved in the perioperative period for patients submitted to bariatric surgery from 2004 to 2007. Changes in the routines and protocols of the service aiming at the reduction of these costs during the study period were also analyzed. RESULTS: Nine patients in 2004 and seven in 2007 submitted to conventional vertical banded "Roux-en-Y" gastric bypass were studied. All patients presented good postoperative evolution. The average cost with these patients was R$ 6,845.17 in 2004. Even though an effort was made to contain expenditures, the cost in 2007 was of R$ 7,525.64 because of the increase in the price of materials and medicines. The Government remuneration of the procedure in the two years was R$ 3,259.72. CONCLUSION: Despite the adoption of diverse measures to reduce the expenditures of bariatric surgery, in fact there was an increase in the costs, a fact supporting the necessity of permanent evaluation of the financing of public health.

scholarly journals Assessing The Cost of Medical Care For Patients Hospitalized After A Stroke Event in Gabon

2021 ◽  
Author(s):  
Gaetan MOUKOUMBI LIPENGUET ◽  
Prudence GNAMIEN AMANI ◽  
Euloge IBINGA ◽  
Jean Engohang-Ndong ◽  
Edgard Brice NGOUNGO NGOUNGOU ◽  
...  
Keyword(s):  
Health Insurance ◽  
Hospital Cost ◽  
Financial Burden ◽  
University Hospital ◽  
Stroke Management ◽  
Stroke Patients ◽  
Stroke Event ◽  
The Cost ◽  
The University ◽  
Very High

Abstract Background: The increasing incidence of recorded stroke cases is straining the economies of many developing countries. Very few studies have assessed the financial burden of stroke management in Gabon. The aim of this study was to assess the direct costs of stroke management in the neurology and cardiology departments at the University Hospital of Libreville.Methods: This retrospective study was based on a detailed review of financial records directly associated with the management of stroke cases admitted and treated in the CHUL between January 2018 and December 2019. The records reviewed were those of all stroke patients admitted and treated in the aforementioned timeframe, regardless of treatment outcome. The analysis of data focused on direct hospital cost.Results: Three hundred and thirteen stroke patients were admitted over the aforementioned period, 72.52% in neurology and 27.48% in cardiology. The average age of the patients was 58.44 (± 13.73) years. 56.23% of patients had health insurance. Ischemic stroke was more common than hemorrhagic stroke, 79.55% and 20.45% respectively. The expenditure per patient was estimated at 570,023 CFA francs.Of this global direct cost, government assistance in the form of health insurance was estimated at 422,883 CFA francs while the balance of approximately 147,140 CFA francs was paid by the patient.Conclusion: The hospital cost of stroke is very high for both patients and administrations. This observation pleads for the implementation of prevention programs for this pathology. The results of this study may be useful for work on the efficiency of these programs.

Ultra-resistant schizophrenia and potentiation strategies

2017 ◽  
Vol 41 (S1) ◽  
pp. s834-s834 ◽  
Author(s):  
S. Khouadja ◽  
R. Ben Soussia ◽  
S. Younes ◽  
A. Bouallagui ◽  
I. Marrag ◽  
...  
Keyword(s):  
Treatment Resistance ◽  
Cost Benefit ◽  
Clinical Excellence ◽  
University Hospital ◽  
Dsm Iv ◽  
Competing Interest ◽  
A Prospective Study ◽  
Psychiatric Department ◽  
The Cost ◽  
The University

IntroductionTreatment resistance to clozapine is estimated at 40–70% of the treated population. Several clozapine potentiation strategies have come into clinical practice although often without evidence-based support.ObjectiveThe aim of our work was to identify the potentiation strategies in ultra-resistant schizophrenia depending on the subtype of schizophrenia.MethodologyThis is a prospective study conducted on patients with the diagnosis of schizophrenia, based on DSM-IV-TR criteria, and hospitalized in the psychiatric department of the university hospital in Mahdia, Tunisia. The study sample consisted of patients meeting the resistant schizophrenia criteria as defined by national institute for clinical excellence (NICE), and the prescription of clozapine for 6 to 8 weeks was shown without significant improvement.Resultswe have collected 10 patients. The mean serum level of clozapine was 462.25 mg/L. The potentiation strategies were different depending on the subtype of schizophrenia. For the undifferentiated schizophrenia, we have chosen ECT sessions. For the disorganized schizophrenia, we opted for amisulpiride and aripiprazole. For the paranoid forms, we have chosen the association of risperidone and ECT. A psychometric improvement was noted in BPRS ranging from 34 to 40%.ConclusionEvery potentiation strategy entails a cost, whether it is an additional monetary cost, adverse effects or greater stress to caregivers. The cost/benefit equation should be thoroughly evaluated and discussed before commencing a strategy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Locked intramedullary nailing technique of the femur without brilliance amplifier at the trauma and orthopedics department of the university hospital of peace series on 35 cases during 1 year

2021 ◽  
Vol 13 (5) ◽  
pp. 95-97
Author(s):  
Augustin Delange Hendrick ◽  
Almenord Pharol ◽  
Khawly Clifford PG ◽  
Augustin Delange ◽  
Pierre Marie Woolley
Keyword(s):  
Hospital Stay ◽  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Patient Morbidity ◽  
Duration Of Hospitalization ◽  
The Cost ◽  
The University

Femoral fractures increase the length of hospital stay for our patients for several reasons such as lack of blood, economic resources, and lack of infrastructure. The use of a C-arm has been shown to reduce patient morbidity due to early functional recovery and reduced hospital stay. Objective: To develop an intramedullary nailing technique without c-arm with a closed focus to reduce the duration of hospitalization of its patients as well as the cost related to the equipment used for follow-up. Methodology: prospective study on 35 patients for 1 year August 2020 to August 2021 Results: We followed 35 patients in which the mean age was 37.83 years with extremes of 18 and 78 years. The male sex predominates 21 against 14 women or 60% against 40% respectively. The sex ratio is 1.5. A total of 19 diaphyseal fractures (54.3%) were nailed, 9 supracondylar (25.7%) and 7 subtrochanteric (20%). Twenty-seven were closed fractures (71.1%), and 8 were open fractures (22.9%). The length of hospitalization was less than 3 days for 30 patients (85.7%), and more than 3 days for 5 patients (14.3%). Conclusion: We recommend that we promote this closed-hearth technique because it improves the postoperative follow-up of patients. Additionally, it would reduce exposure to radiation from c-arm in hospitals that have this equipment.

scholarly journals Administrative Growth At The University: A Case Study

2005 ◽  
Vol 2 (1) ◽  
Author(s):  
Leon B. Hoshower ◽  
David Kirch
Keyword(s):  
Student Loans ◽  
Financial Burden ◽  
College Education ◽  
Cumulative Effect ◽  
Government Support ◽  
Administrative Costs ◽  
Current Topic ◽  
Study Programs ◽  
The Cost ◽  
The University

During the past two decades, the cost of higher education has increased at a higher rate than inflation.  Although this increase is small each year, the cumulative effect is great.  These increased costs are funded mainly through increased tuition and increased government support, either through subsidies to state funded universities or through government supported student loans, grants, work-study programs, and tax credits.  These subsidies are straining governmental budgets.  Many students are graduating with large debt burdens.  There is a rising fear among the working class that providing a college education for their children will be beyond their financial means. Thus, it is generally understood that the cost of a college education is rising faster than inflation and that these rising costs are creating a financial burden for both governments and individuals.  What is not generally understood is the source of these rising costs.  This study examined the financial records of a state supported, mid-western university with enrollment between 15,000 and 20,000 students, hereafter referred to as the University, over an eighteen-year period.  The study found that the rising cost of the University’s administration was the major source of the university’s cost increases.  This paper documents this finding and offers five possible explanations for these rising administrative costs.  The paper neither condemns nor justifies the rises in costs and it offers no suggestions for effectively decreasing administrative costs.  Diagnosis of the problem is the current topic of discussion, while possible solutions remain to be devised at a later date

Radiological videoconferencing in Sweden

1996 ◽  
Vol 2 (3) ◽  
pp. 161-164 ◽  
Author(s):  
M Kehler ◽  
P O Bengtsson ◽  
M Freitag ◽  
B Lindstrom ◽  
And J Medin
Keyword(s):  
University Hospital ◽  
Average Salary ◽  
Travelling Time ◽  
Video Link ◽  
The Cost ◽  
The University ◽  
Everyday Routine

For the last four years there has been a videoconferencing link between the Karlskrona hospital and the university hospital of Lund. Because of a need to transmit angiographic films, its use has been gradually expanded to become an everyday routine, used for both elective and emergency examinations. During 1994 and 1995, 1121 cases were examined over the video link. Apart from 156 normal cases all were discussed with surgeons, most at 96 weekly conferences but approximately 50 at conferences taking place as soon as possible after the examination. Assuming that an average of three doctors attended the conferences before the video link was available, this amounts to a saving of 3 8 h in travelling time per videoconference. The average salary was 300 SKr/h and train tickets cost a further 400 SKr per person. The cost of the ISDN connection was approximately 1800 SKr/conference. The net gain was thus about 6500 SKr per videoconference, without taking into account the work that could be done with the doctors still in Karlskrona after the conference.

scholarly journals On the effectiveness of treatment options in epistaxis: an analysis of 678 interventions

2011 ◽  
Vol 49 (4) ◽  
pp. 474-478
Author(s):  
M.B. Soyka ◽  
G. Nikolaou ◽  
K. Rufibach ◽  
D. Holzmann
Keyword(s):  
Retrospective Cohort ◽  
Health Care Systems ◽  
Financial Burden ◽  
Treatment Options ◽  
University Hospital ◽  
Level Of Evidence ◽  
Significant Difference ◽  
The World ◽  
Care Systems ◽  
The University

Background: Epistaxis represents one of the most common emergencies in ENT clinics around the world. It creates great physical and emotional stress to the patient as well as a financial burden on health-care systems. A lot of research has been performed with regard to aetiology and possible treatment, however, not much effort has been put into analysing the effectiveness of common treatment forms. It is the objective of this study to clarify which of these treatment forms is reliable. Study design: Retrospective cohort study. Level of evidence: 2b. Methods: Between 03/2007 and 04/2008, all epistaxis therapies including relapses and treatment failures at the University Hospital of Zurich have been documented using a computerised questionnaire. Different treatments were compared to each other. Results: An analysis of 678 interventions in 537 patients was performed with emphasis on failure proportions and time to occurrence. The estimated failure proportions of coagulation in anterior epistaxis accounts for 14%. Successful treatment of epistaxis in posterior bleedings could be achieved in 62% by packing and in 97% by surgery with a statistically significant difference between the respective groups. Conclusion: Using our treatment options, anterior epistaxis can be cured reliably by cauterisation. Surgical therapies in posterior bleedings are able to successfully salvage failed packing therapies.

scholarly journals Coverage for the cost of outpatient nursing procedures by the Unified Health System: a percentage analysis

2021 ◽  
Vol 55 ◽  
Author(s):  
Elisabete Finzch Sportello ◽  
Valéria Castilho ◽  
Antônio Fernandes Costa Lima
Keyword(s):  
Health System ◽  
Unit Cost ◽  
University Hospital ◽  
Actual Cost ◽  
Descriptive Case Study ◽  
Unified Health System ◽  
System A ◽  
Percentage Difference ◽  
The Cost

ABSTRACT Objective: To analyze the percentage of the coverage of transfers from the Brazilian Unified Health System regarding nursing procedures conducted in the Outpatient facility of a University Hospital. Method: Quantitative, exploratory, descriptive case study. The sample for calculating the mean total direct costs was composed of non-participant observations of 656 procedures. The obtained costs were compared to transfers from the Unified Health System by multiplying the amount of procedures agreed upon by the unit cost in the Unified Table of Procedures in 2016 and 2017. Results: The Unified Health System transferred a percentage corresponding to 11.13% of the actual cost in 2016 and to 16.02% in 2017. In these two years, transfer values covered only a mean of 13.4%, resulting in a percentage difference in revenue significantly smaller than the actual cost. Conclusion: The higher the productivity of the performed procedures, the higher was the hospital deficit and, consequently, the higher were the costs not covered by the Unified Health System.

scholarly journals Risk for Falls in Patients with Limb Amputations in the Clinical Institute for Rehabilitation and Orthopedic Aids of the University Hospital Centre Zagreb

2021 ◽  
Vol 5 (1) ◽  
pp. 67-73
Author(s):  
Danijela Golub ◽  
Slađana Režić
Keyword(s):  
Hospital Setting ◽  
Clinical Problem ◽  
Primary Diagnosis ◽  
University Hospital ◽  
Patient Falls ◽  
Number Of Patients ◽  
Increased Risk ◽  
Risk Of Falls ◽  
The Cost ◽  
The University

Introduction. Patient falls are a significant clinical problem, as the fall can result in disability and, in some cases, death. The fall affects the patients’ quality of life, prolongs hospitalization, and increases the cost of treatment. Falls are the result of interaction between various factors. In the hospital setting, falls are considered adverse events. Aim. To determine the number of patients’ falls at the Clinical Institute for Rehabilitation and Orthopedic Aids of the University Hospital Centre Zagreb (UHC Zagreb) between September 1, 2019, and February 29, 2020. Methods. The data was extracted after the event from the Hospital Information System (Nursing records) and then processed. The study included 212 patients with limb amputations (both sexes) who were hospitalized in the Clinical Institute for Rehabilitation and Orthopedic Aids. Results. The results showed that patients with limb amputations have a risk for falls when doing rehabilitation for their primary diagnosis. Of the 212 patients admitted, 209 were at risk of falling according to the Morse Falls Scale, but of the total number of patients, only 2 fell. Conclusion. Patients with limb amputations have a higher risk of falls. The retrospective study shows that despite the increased risk of falls, the actual number of falls is very small. This shows that the medical staff are doing excellent work.

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