Two Nosocomial Pertussis Outbreaks and Their Associated Costs—King County, Washington, 2004

2007 ◽  
Vol 28 (05) ◽  
pp. 537-543 ◽  
Author(s):  
Henry C. Baggett ◽  
Jeffrey S. Duchin ◽  
William Shelton ◽  
Danielle M. Zerr ◽  
Joan Heath ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Indirect Costs ◽  
Hospital Staff ◽  
Direct Costs ◽  
Contact Tracing ◽  
King County ◽  
Care Hospital ◽  
Total Cost ◽  
Personnel Costs ◽  
Medication Costs

Objective.Pertussis outbreaks in healthcare settings result in resource-intensive control activities, but studies have rarely evaluated the associated costs. We describe and estimate costs associated with 2 nosocomial pertussis outbreaks in King County, Washington, during the period from July 25 to September 15, 2004. One outbreak occurred at a 500-bed tertiary care hospital (hospital A), and the other occurred at a 250-bed pediatric hospital (hospital B).Methods.We estimated the costs of each outbreak from the hospitals' perspective through standardized interviews with hospital staff and review of contact tracing logs. Direct costs included personnel time and laboratory and medication costs, whereas indirect costs were those resulting from hospital staff furloughs.Results.Hospital A incurred direct costs of $195,342 and indirect costs of $68,015; hospital B incurred direct costs of $71,130 and indirect costs of $50,000. Cost differences resulted primarily from higher personnel costs at hospital A ($134,536), compared with hospital B ($21,645). Total cost per pertussis case was $43,893 for hospital A (6 cases) and $30,282 for hospital B (4 cases). Total cost per person exposed to a pertussis patient were $357 for hospital A (738 exposures) and $164 for hospital B (737 exposures).Conclusions.Nosocomial pertussis outbreaks result in substantial costs to hospitals, even when the number of pertussis cases is low. The cost-effectiveness of strategies to prevent nosocomial pertussis outbreaks, including vaccination of healthcare workers, should be evaluated.

scholarly journals A prospective cross-sectional study to evaluate the economic burden of patients diagnosed with depression in a tertiary care hospital

2020 ◽  
Vol 9 (5) ◽  
pp. 722
Author(s):  
D. K. Dhodi ◽  
S. R. Sinha ◽  
F. Dawer ◽  
M. S. Chavan
Keyword(s):  
Economic Burden ◽  
Tertiary Care ◽  
Indirect Costs ◽  
Cross Sectional Study ◽  
Direct Costs ◽  
Cost Of Care ◽  
Hospitalisation Cost ◽  
Care Hospital ◽  
Cross Sectional ◽  
Case Record

Background: The objective of the study was to evaluate the cost of care of depression in terms of direct and indirect costs.Methods: 150 patients diagnosed with depression attending psychiatry OPD at Sir J.J. Group of Hospitals, Mumbai, fulfilling the inclusion criteria were explained about the study. Written informed consent were taken. Direct and Indirect costs were recorded in structured case record forms by interviewing the patients. Cost driving factors were identified.Results: Total annual direct cost were INR 6,378.16 which included drug costs, travel expenses, physician’s consultation, cost of investigations, hospitalisation cost while total Indirect costs were INR 16,860 which included days of work both of the patient and the caretaker.Conclusions: The indirect cost was almost thrice the direct costs. Hospitalisation cost and loss of working days due to depression was contributed the most to the direct costs and indirect costs respectively. Economic burden of depression is found out to be 16.30% of per capita gross domestic product in year 2018-19.

Cost of illness of epilepsy per patient per year in a tertiary care hospital in New Delhi: A Prospective Observational study

2021 ◽  
Vol 12 (6) ◽  
pp. 59-64
Author(s):  
Eijaz Ahmed Bhat ◽  
Maqsood Ahmad Dar ◽  
Peer Abdul Lateef Sidiqui ◽  
Farukh Jabeen
Keyword(s):  
Cost Of Illness ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Indirect Costs ◽  
Medical Costs ◽  
New Delhi ◽  
Care Hospital ◽  
Total Cost ◽  
Costs Of Illness ◽  
The Cost

Background: Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures that imposes heavy burden on individuals, families, and also on healthcare systems. As the better understanding of economic aspects of epilepsy will lead to better development of epilepsy care this study was conducted to estimate the cost of illness in epilepsy per patient per year in a tertiary care hospital in New Delhi. Aims and Objectives: The aim of study was to study the direct, indirect and total cost of illness in epilepsy per patient per year in a tertiary care hospital. Materials and Methods: Patients with epilepsy attending the Department of Neurology at Batra Hospital and Medical Research Centre in New Delhi were included in this study. All epilepsy patients fulfilling the inclusion and exclusion criteria were included in the study. The cost of illness was estimated as total, direct and indirect costs of illness per year for each patient. The information was collected on a properly formed format which consists of the demographic details of the patient, general biodata of patient, information about the direct medical costs and direct non-medical costs and information about indirect costs. The results are presented in Mean ± SD frequencies and percentages. The Kruskal-Wallis test was used to compare the costs of illness among different strata. The Mann-Whitney U test was used to compare the costs of illness between strata. The p-value<0.05 was considered significant. All the analysis was carried out on SPSS 16.0 version (Chicago, Inc., USA). Results: A total of 70 patients were included in the study. The median age of patients was 28.50 years and the mean age was 33.36 years. The total indirect and direct cost of illness was Rs. 5265.30±6363.42 and Rs. 25249.38±14480.09 respectively. The total cost of illness was Rs. 26808.42±16108.05. The highest mean cost was for Carbamazepine (Rs. 14500.00), followed by Levetiracetam (Rs.13300.00) and rest by the other commonly used drugs. Conclusion: We concluded that economic burden of epilepsy on the family and patients can be decreased by decreasing the hospitalization rates of patients, avoiding poly therapy as much as possible and rationalizing the investigations.

scholarly journals 2455. Outbreak of carbapenemase-producing Enterobacteriaceae in cardiology units associated with contaminated water dispenser and sink drain in Korea

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S849-S850
Author(s):  
Jiwon Jung ◽  
Hye-Suk Choi ◽  
Jeong-Young Lee ◽  
Min Jee Hong ◽  
Sun Hee Kwak ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Tertiary Care ◽  
Water Environment ◽  
Water System ◽  
Contact Tracing ◽  
Contact Precaution ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Patient Room ◽  
Large Outbreak

Abstract Background There is a growing concern about the importance of hospital water environment for the transmission of carbapenemase-producing Enterobacteriaceae (CPE). Herein, we report a large outbreak in cardiology units involving intensive care units (ICU) and wards at a tertiary care hospital. Methods During a CPE outbreak between July and December 2018, contact tracing and environmental sampling were performed. For outbreak control, we performed education to healthcare workers, hand hygiene enforcement, active surveillance test, preemptive isolation, chlorhexidine bathing for CPE positive patients, and deep terminal cleaning including UV and hydrogen peroxide non-touch disinfection. Patients with CPE were isolated at a single room with dedicated staffs, contact precaution was implemented, and when case patients were located in multi-patient room, we performed surveillance culture for exposed patients in the room. Results A total of 87 patients with CPE infection or colonization were identified at two cardiology ICUs and three cardiology wards. CPE from the first two index patients were identified from sputum culture suspecting pneumonia, and the remaining 85 patients were identified to harbor CPE through surveillance culture (exposed patients n = 22, active surveillance test n = 63). Diverse organisms were identified; organisms with blakpc (n = 13), blaNDM-1 (n = 55), blaVIM or blaIMP (n = 12), blaOXA-48 (n = 3), and co-producing organisms (n = 4). We performed environmental culture; KPC-producing Escherichia coli was isolated from water dispenser in ICU and NDM-1 producing Citrobacter freundii and Enterobacter cloacae were isolated from sinks in the patient room. Outbreak ended after the removal of water dispenser and the replacement of sink drain with pouring bleach to the sink drain. Conclusion Water dispenser and sink drain were suspected for the possible reservoirs of CPE in this outbreak. Replacement of plumbing system and use of bleach for pouring to sink as well as the removal of water dispenser was needed to control outbreak. Investigation of water system is warranted for finding the source of CPE. Disclosures All authors: No reported disclosures.

scholarly journals Measuring the Total Cost of Ankle Fractures: A Prospective Analysis

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0006
Author(s):  
Peter C. Noback ◽  
Tess Dougherty ◽  
Christina Freibott ◽  
Eric F. Swart ◽  
Melvin P. Rosenwasser ◽  
...  
Keyword(s):  
Return To Work ◽  
Indirect Cost ◽  
Direct Cost ◽  
Indirect Costs ◽  
The United States ◽  
Direct Costs ◽  
Cost Data ◽  
Ankle Fractures ◽  
Total Cost ◽  
True Value

Category: Trauma; Ankle Introduction/Purpose: Ankle fractures (AFx) are the most common foot and ankle fracture seen at hospitals in the United States, and are undoubtedly costly to patients. Quantification of the costs of fractures and their associated treatments has garnered increased attention in orthopedics in recent years through cost-effectiveness analysis. However, literature pertaining to AFx’s almost never reports on the indirect costs of AFx’s, and thus fails to accurately assess the true value of treatments. The purpose of this study was to prospectively assess the direct and indirect costs of AFx’s in operatively and nonoperatively treated patients. Secondary analysis included evaluation of the composition of indirect cost, the duration these costs are endured, and the factors that influence their magnitude. Methods: A prospective observational single-center study was performed. Adult patients presenting for initial consult for an AFx that could speak English or Spanish were enrolled. Polytrauma patients and those unable to provide complete indirect cost data were excluded. Patients completed a cost form that asked the money they had spent in the last week on transportation, household chores, and self-care due to their AFx. Patients were considered to have complete indirect cost data if they returned for follow-up visits until they reported no recurring indirect costs and had returned to work. Direct cost data was obtained directly from the hospital billing department. Amount collected was utilized. Direct costs included any costs incurred from staff treating the patient, supplies required for treatment, and the use of healthcare facilities. A descriptive analysis of the entire cohort and stratification by operative status was performed for the primary comparative analysis. Results: 60 patients were ultimately analyzed. Average age was 46.5 years. 55% were female. 10% of patients were diabetic. 17% smoked cigarettes actively. Weber A, B, and C fractures composed 12%, 72%, and 18% of fractures, respectively. Operatively treated patients (n=37) had a significantly higher total and direct cost than non-operative patients (P<0.01). Average salary of the 39 employed patients was $61,416 and return to work period was 11.2 weeks. In all patients, lost income accounted for the largest portion of total and indirect cost, averaging 38% of total cost. Longer periods of return to work were significantly associated with undergoing surgery and having less than a college-level education (P<0.05). Average number of weeks for indirect costs to amount to zero was 19.1. Conclusion: In patients treated operatively and nonoperatively, the largest cost component was an indirect cost: missed wages at 28.6% and 63.3%, respectively. While the majority of the direct costs of AFx’s are accrued in the period immediately following the injury, indirect cost components will regularly be incurred for nearly 5 months and often longer. The degree and duration to which these indirect costs accumulate are novel findings. Future research should no longer neglect reporting on an intervention’s impact on the indirect costs of AFx’s. [Table: see text]

Pharmacoeconomic Analysis of Using Sinemet CR over Standard Sinemet in Parkinsonian Patients with Motor Fluctuations

1998 ◽  
Vol 32 (9) ◽  
pp. 878-883 ◽  
Author(s):  
Alan G Hempel ◽  
Mary L Wagner ◽  
Mohamed A Maaty ◽  
Jacob I Sage
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Pharmacoeconomic Analysis ◽  
Tertiary Care ◽  
Motor Fluctuations ◽  
University Teaching ◽  
Total Cost ◽  
Medication Costs ◽  
The Cost

OBJECTIVE: To compare the costs of pharmacotherapy in patients with Parkinson's disease before and after converting from standard Sinemet to extended-release Sinemet CR. DESIGN: Investigators retrospectively reviewed records of patients converting from Sinemet to Sinemet CR for efficacy and total drug costs. Cost-effectiveness was evaluated retrospectively from data collected in prospective Sinemet CR efficacy trials. SETTING: Parkinson's disease clinic at a tertiary care university teaching hospital. PATIENTS: 100 patients with motor fluctuations who had undergone an initial 6-month course of Sinemet therapy, followed by a 6-month course of Sinemet CR. MAIN OUTCOME MEASURES: Total cost was measured as the cost of Sinemet formulations plus the costs of other antiparkinson medications. Differences in pre- and postconversion costs were compared by using the paired, two-tailed Student's t-test. A substudy of 39 patients on the cost-effectiveness of conversion measured the ratio of daily medication costs to the daily hours “on” without chorea. RESULTS: While total daily medication costs after conversion increased by 21%, patients experienced either a comparable or an improved degree of disease control with Sinemet CR. Patients who were also taking selegiline were able to decrease selegiline expense by 20%. The costs of other adjunctive medications did not differ significantly after conversion. The cost-effectiveness analysis revealed an increase in postconversion on time by 2.2 hours (p = 0.0001), accompanied by a $2.85 decrease in total cost per hour on without chorea (p = 0.11). CONCLUSIONS: Although Sinemet CR is more costly, it may be more cost-effective in patients with motor fluctuations. Some patients may be able to reduce adjunctive medications.

scholarly journals Cord Care Methods in Neonates

2021 ◽  
Vol 15 (10) ◽  
pp. 3509-3510
Author(s):  
Andleeb Kanwal ◽  
Zahid Anwar ◽  
Mateen Akram ◽  
Shahid Anwar ◽  
Saima Pirzada
Keyword(s):  
Urban Areas ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Newborn Care ◽  
Hospital Staff ◽  
Care Hospital ◽  
Cord Care ◽  
Level 3 ◽  
The Mean ◽  
Nurses And Midwives

Background: Proper cord care methods in neonates have been known to reduce infections, sepsis, and death. This study intends to document the frequency of cord care methods. Methods: A questionnaire-based study was done in 6 months in a tertiary care hospital with a level 3 nursery and NICU (Fatima Memorial Hospital, Lahore). We interviewed mothers and female companions of neonates in wards and outpatient clinics. Answers were added to SPSS in socio-demographic categories and cord care methods. Result: A total of 778 females were interviewed. The mean age is 28 + 8.1 years, mostly educated (90%) and resided in urban areas (83%). 39.4% of the participants had personal experience of newborn care. Most were housewives (74.4%). 36.8% would not apply anything to the cord, but the other majority would apply some agent to the newborn cord, methylated spirit being the favourite (48.5%), remaining being mostly antibiotics and antimicrobial agents. Chlorhexidine was used only by one participant. Doctors and nurses had counselled 70% of the participants, but 10% listened to the advice of relatives and grandmothers. 18.5% declined any knowledge of safe practices. Conclusions: Our study emphasizes the need to educate our hospital staff (doctors, nurses and midwives) as well as family members of neonates with standardised cord care methods. Keywords: Neonates, Cord care, Umbilical cord,Methylated spirit.

scholarly journals A study on waiting time and out-patient satisfaction at Gujarat medical education research society hospital, Valsad, Gujarat, India

2017 ◽  
Vol 4 (3) ◽  
pp. 857
Author(s):  
Ravikant Patel ◽  
Hinaben R. Patel
Keyword(s):  
Medical Education ◽  
Patient Satisfaction ◽  
Waiting Time ◽  
Treatment Cost ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hospital Staff ◽  
Research Society ◽  
Care Hospital ◽  
The Mean

Background: Gujarat Medical Education Research society started GMERS medical college and tertiary care Hospital in Valsad since last 4 years. As civil Hospital is converted in to tertiary care hospital and many of the departments running in different buildings so, searching the concern OPDs is difficult for patients, waiting time and patients satisfaction is important to avail the services. Patient satisfaction is one of the important goals of any health system, but it is difficult to measure the satisfaction. Aims & objectives were (1) to study the waiting time at various Out Patient Department (OPDs). and various investigation; (2) To study the accessibility of various department of hospital;  (3) To study the patient satisfaction on hospital process, behavior of hospital staff and treatment cost.Methods: This was a cross sectional observational study conducted in G.M.E.R.S. Hospital-Valsad for the period of 2 months and total 135 patients were interviewed availing the OPD Services.Results: The mean age of patient attending the OPD was 30.31±15.65 years and majority of them are female patient (54.07%). Hospital staff (48.89%) was main source of guidance for searching the OPDs for consulting the doctor. 54.07% patient registered 20 min after standing in queue. The mean waiting time was 12.16±2.35 min. 94.07% and 98.52% patients were satisfied with treatment cost and behavior of staff respectively.Conclusions: Many patients face the difficulties in finding the various departments. On an average 12 minutes of waiting time outside the various O.P.Ds. They were also satisfied with the treatment cost and behaviour of hospital staff.

scholarly journals Microbiological profile of patients attending sexually transmitted infection/reproductive tract infection clinic in a tertiary care hospital

2017 ◽  
Vol 5 (8) ◽  
pp. 3649
Author(s):  
Sonal Prakash Chavan ◽  
Sharmila Sanjay Raut ◽  
Pragati Sharma ◽  
Ravindra Kashinath Khadse
Keyword(s):  
Reproductive Tract ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Contact Tracing ◽  
Care Hospital ◽  
Important Public Health Problem ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Reproductive Tract Infection ◽  
Tract Infections

Background: Sexually transmitted infections (STIs)/reproductive tract infections (RTIs) are an important public health problem worldwide. Growing spread of RTIs/STIs are an augmenting factor for HIV transmission. Due to lack of adequate laboratory infrastructure, there is limited data. Hence information regarding STIs lies essentially on syndromic basis.Methods: This was an observational, cross-sectional study carried from June 2016 to September 2016 with sample size of 300 patients attending STI/RTI clinic. Various samples were collected like scrapings, exudates and swabs from ulcerative lesions for microscopy. Urethral, vaginal and cervical swabs for wet mount, gram stain and culture. Blood sample were collected for RPR, TPHA, ELISA HSV II, HIV, HBsAg. Processing and identification of organism as per NACO guidelines.Results: Out of total 300 cases, 255 (85%) are females and 45 (15%) are males. Maximum cases are from 25-44 years age group. Genital discharge syndrome is more common in females while genital ulcerative syndrome more in males. Coinfection with HIV is found in 17% cases. Herpes genitals (20%) is the most common causative agent for ulcerative STIs in males. VDS is the most common syndrome in Females. Candida (27.8%), G. vaginalis (12.2%) and T. vaginalis (3.5%).Conclusions: Viral and fungal STIs are more common than bacterial STIs. Targeted intervention and contact tracing as done for HIV should be effectively emphasised for STI/RTI also. Syndromic approach should be supplemented by Laboratory diagnosis for more effective outcome.

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