scholarly journals 495 Audit on Blood Ordering Requests in Mastectomies: The Need for a Routine Group and Hold

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Y Chan ◽  
S Keogh ◽  
N Aucharaz ◽  
J Buckley ◽  
A Merrigan ◽  
...  
Keyword(s):  
Financial Burden ◽  
Cost Savings ◽  
Cost Benefit ◽  
Preoperative Assessment ◽  
Blood Transfusions ◽  
Audit Data ◽  
Stratification System ◽  
The Cost ◽  
Low Prevalence ◽  
Average Drop

Abstract Aim A group and hold (G&H) forms part of the pretransfusion compatibility testing and is commonly requested in anticipation of a possible blood transfusion. Requests made in the context of elective procedures with a low transfusion probability, such as a mastectomy, are associated with added financial burden and increases workload in a healthcare system. This audit aims to analyse the cost-benefit associated with the routine request for a preoperative G&H in patients undergoing mastectomies. Method A total of 100 patients undergoing mastectomies from the period of September 2019 to October 2020 were included in the audit. Data regarding blood order requests, units of blood transfused, perioperative haemoglobin and the type of mastectomy (right, left or bilateral) were collected. Results All patients had a routine G&H as part of their preoperative assessment. The average age in this cohort was 60.3. Right-sided mastectomy was the commonest procedure in this cohort (N = 52). The average preoperative haemoglobin was 13.0g/dL. 2/100 patients received post-operative blood transfusions. The transfusion probability in this cohort was 2%. Only 15% of the cohort had a post-operative haemoglobin level checked. The average drop in haemoglobin in this cohort was 2.3g/dL. Conclusions This audit demonstrates the low prevalence of blood transfusions in patients undergoing mastectomies, consistent with current literature. The projected cost savings associated with selective requests for G&H are significant. However, the implementation of a safe and targeted blood ordering approach in patients with high bleeding risks will require a validated stratification system.

scholarly journals Transoperative refusion: a simple and safe method in emergency surgery

2014 ◽  
Vol 41 (4) ◽  
pp. 292-296
Author(s):  
Luiz Carlos Buarque Gusmão ◽  
Sérgio Henrique Chagas Valoes ◽  
José da Silva Leitão Neto
Keyword(s):  
Cost Benefit ◽  
Blood Transfusions ◽  
Factor V ◽  
West Nile Fever ◽  
Clotting Factors ◽  
Blood Contamination ◽  
Simple Method ◽  
Cost Benefit Ratio ◽  
The Cost ◽  
Selection Of

The objective is to reinforce the importance of blood reinfusion as a cheap, safe and simple method, which can be used in small hospitals, especially those in which there is no blood bank. Moreover, even with the use of devices that perform the collection and filtration of blood, more recent studies show that the cost-benefit ratio is much better when autologous transfusion is compared with blood transfusions, even when there is injury to hollow viscera and blood contamination. It is known that the allogeneic blood transfusion carries a number of risks to patients, among them are the coagulation disorders mediated by excess enzymes in the conserved blood, and deficiency in clotting factors, mainly the Factor V, the proacelerin. Another factor would be the risk of contamination with still unknown pathogens or that are not investigated during screening for selection of donors, such as the West Nile Fever and Creutzfeldt-Jacob, better known as "Mad Cow" disease. Comparing both methods, we conclude that blood autotransfusion has numerous advantages over heterologous transfusion, even in large hospitals. We are not against blood transfusions, just do not agree that the patient's own blood is discarded without making sure there will be enough blood in stock to get him out of the hemorrhagic shock.

scholarly journals Cost–effectiveness and cost-benefit analysis of oliceridine in the treatment of acute pain

2021 ◽  
Author(s):  
Kit N Simpson ◽  
Michael J Fossler ◽  
Linda Wase ◽  
Mark A Demitrack
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Cost Effective ◽  
Adverse Outcomes ◽  
Protein Signaling ◽  
Opioid Receptor Agonist ◽  
Cost Effective Alternative ◽  
Μ Opioid Receptor ◽  
The Cost

Aim: Oliceridine, a new class of μ-opioid receptor agonist, is selective for G-protein signaling (analgesia) with limited recruitment of β-arrestin (associated with adverse outcomes) and may provide a cost-effective alternative versus conventional opioid morphine for postoperative pain. Patients & methods: Using a decision tree with a 24-h time horizon, we calculated costs for medication and management of three most common adverse events (AEs; oxygen saturation <90%, vomiting and somnolence) following postoperative oliceridine or morphine use. Results: Using oliceridine, the cost for managing AEs was US$528,424 versus $852,429 for morphine, with a net cost savings of $324,005. Conclusion: Oliceridine has a favorable overall impact on the total cost of postoperative care compared with the use of the conventional opioid morphine.

Cost-benefit analysis of AR-V7 testing in patients (Pts) with metastatic castration resistant prostate cancer (mCRPC) eligible for abiraterone (Abi) or enzalutamide (Enza).

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 283-283
Author(s):  
Mark Christopher Markowski ◽  
Kevin D. Frick ◽  
James R. Eshleman ◽  
Jun Luo ◽  
Emmanuel S. Antonarakis
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Castration Resistant Prostate Cancer ◽  
The Us ◽  
Effective Option ◽  
Current Price ◽  
Societal Challenge ◽  
The Cost

283 Background: The rising cost of oncology care in the US is an ongoing societal challenge, and identifying biomarkers that inform clinical decisions and reduce the use of ineffective therapies remains elusive. A splice variant of the androgen receptor, AR-V7, was found to confer resistance to Abi and Enza in men with mCRPC, but did not negatively affect responses to taxanes, suggesting that early use of chemotherapy may be a more effective option for AR-V7(+) pts. With the recent development of a CLIA-certified clinical assay for AR-V7 at Johns Hopkins, we hypothesized that AR-V7 testing in mCRPC pts may result in cost savings by avoiding futile treatment with Abi/Enza in men with AR-V7(+) disease. Methods: We calculated the cost savings of performing AR-V7 testing in mCRPC pts prior to starting Abi/Enza (and avoiding these drugs in AR-V7(+) men) versus treating all mCRPC pts with Abi/Enza (without use of the biomarker). We have set the cost of the AR-V7 assay at $1000. The cost of 3 months of Abi/Enza (the minimum time it would take to determine resistance, clinically) was approximated at $20,000. We estimated that 30,000 mCRPC pts per year are eligible for Abi/Enza in the US. Results: In our prior studies, about 30% of mCRPC pts previously treated with Abi/Enza had detectable AR-V7 in CTCs. Assuming an AR-V7 prevalence of 30%, about 9,000 AR-V7(+) mCRPC pts per year would receive ineffective treatment with Abi/Enza, at an estimated cost of $180 Million. The upfront cost of testing all mCRPC pts who are Abi/Enza-eligible for AR-V7 is $30 Million, resulting in a net cost savings of $150 Million. When performing a continuous cost-benefit analysis after assuming other prevalences of AR-V7 (ranging from 4% to 50%) and a range of costs for Abi/Enza ($2000 to $24,000 per 3 months), we determined that AR-V7 testing would result in a cost savings as long as the prevalence of AR-V7 is > 5% (if the cost of 3 months of Abi/Enza remains at $20,000). Conclusions: AR-V7 testing in mCRPC pts (at $1000/test) is cost-beneficial when considering the current price of Abi/Enza, and may reduce the ineffective use of Abi/Enza leading to a net cost savings to the healthcare system.

How will the cost of biosimilars affect patients’ willingness to receive them?

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18338-e18338
Author(s):  
R Donald Harvey ◽  
Megan McGrath ◽  
John W. Cook ◽  
Margie D Dixon ◽  
Rebecca D. Pentz
Keyword(s):  
Financial Burden ◽  
Cost Savings ◽  
Drug Market ◽  
Oncology Patients ◽  
Convenience Sample ◽  
Anti Cancer ◽  
Negative Perceptions ◽  
Oncology Care ◽  
The Cost ◽  
Patients Experience

e18338 Background: The cost of oncology care is increasing. The NIH projects that the oncology drug market will reach $111.9 billion by 2020. Studies show that oncology patients experience considerable financial burden, regardless of insurance status and in general believe that oncology medications are too expensive. However, there is some evidence outside of oncology that suggests patients may not trust generics or cheaper medications. Therefore, there is a need to assess oncology patients’ views of a biosimilars and their potential to reduce costs. Methods: We surveyed a convenience sample of 79 oncology patients in clinics and the infusion center. The survey consisted of five questions on cost and patient participation in decision making. Results: Of 79 patients approached, 75 (95%) completed the survey. Fifty (66%) believed that expensive medications do not work better than less costly ones for the same disease; yet only 30 of those 50 (60%) and 44% overall (33/75) would prefer that their doctor prescribe them the cheaper version of their anti-cancer medication. Of the 20 respondents who believed that expensive drugs do not work better but still wanted the more expensive drugs for themselves, 8 believed cancer was too serious of an illness to take any chances with a cheaper medication, 5 wanted the most expensive that insurance would cover and 2 wanted the best possible medication. 90.67% respondents (68/75) wanted to know if their physician was prescribing a cheaper version of their drug. Conclusions: Our results show that, overall, oncology patients agree that cheaper medications work as well as more expensive ones, but there are definite concerns among some patients that drug price may be a proxy for quality, particularly in cancer. Overcoming these negative perceptions among patients will be important if optimal cost savings are going to be realized with expanded biosimilar use.

scholarly journals PREVENTION OF Β THALASSEMIA IN NORTHERN ISRAEL - A COST-BENEFIT ANALYSIS.

2014 ◽  
Vol 6 (1) ◽  
pp. e2014012 ◽  
Author(s):  
Ariel Koren ◽  
Lora Profeta ◽  
Luci Zalman ◽  
Haya Palmor ◽  
Carina Levin ◽  
...  
Keyword(s):  
Prevention Program ◽  
Cost Benefit Analysis ◽  
Iron Chelation ◽  
Cost Benefit ◽  
Thalassemia Major ◽  
World Population ◽  
Blood Transfusions ◽  
Benefit Analysis ◽  
The World ◽  
The Cost

Background:β Thalassemia major is characterized by hemolytic anemia, ineffectiveerythropoiesis and hemosiderosis. About 4 % of the world population carries a Thalassemiagene. Management includes blood transfusions and iron chelation, this treatmentis costly and population screening may be significantly more cost benefit. Purpose: Thepurpose of the current study is to analyze the cost of running a preventionprogram for β Thalassemia in Israel and compare it to the actual expensesincurred by treating Thalassemia patients. Methods: Threecost parameters were analyzed and compared: The prevention program, routinetreatment of patients and treatment of complications. An estimation of theexpenses needed to treat patients that present with complications werecalculated based on our ongoing experience in treatment of deterioratingpatients. Results andConclusions: The cost of preventing one affected newborn was $63,660 comparedto $1,971,380 for treatment of a patient during 50 years (mean annual cost:  $39,427). Thus, the prevention of 45 affectednewborns over a ten years period represents a net saving of $88.5 million tothe health budget. Even after deducting the cost of the prevention program ($413.795/yr.), the program still represents abenefit of $ 76 million over ten years. Each prevented case could pay thescreening and prevention program for 4.6 ys.

scholarly journals Cost Savings of Using Updated Thai Red Cross Intradermal Regimen in a High-Throughput Anti-Rabies Clinic in New Delhi, India

2019 ◽  
Vol 4 (1) ◽  
pp. 50 ◽  
Author(s):  
Bijit Kundu ◽  
Girish Meshram ◽  
Shrinath Bhargava ◽  
Omprakash Meena
Keyword(s):  
High Throughput ◽  
Financial Burden ◽  
Cost Savings ◽  
Red Cross ◽  
Post Exposure Prophylaxis ◽  
New Delhi ◽  
Before And After ◽  
Exposure Prophylaxis ◽  
The Cost ◽  
Rabies Vaccination

Replacement of the Essen intramuscular (EIM) by the updated Thai Red Cross intradermal (UTRCID) regimen for rabies post-exposure prophylaxis (PEP), in high-throughput hospitals of India, has been advocated since 2006 thanks to its cost-effectiveness. However, several anti-rabies clinics in India and other parts of the world have not initiated this switchover of regimens because of the paucity of financial literature, generated in realistic settings, regarding the same. We calculated the procurement costs of various items required for providing rabies vaccinations via the EIM regimen and UTRCID regimen, on an annual basis, a year before and after the switchover. From a healthcare provider’s perspective, the cost of vaccination per patient was calculated to be 5.60 USD for the EIM regimen and 2.40 USD for the UTRCID regimen. The switchover to the UTRCID regimen from the EIM regimen reduced the financial burden of the rabies vaccination by almost 60%. Procurement of vaccine vials contributed to the majority of the cost (>94%) in both of the regimens. Procurement of syringes with fixed needles contributed negligibly (<6%) to the financial burden in both the regimens. A policy to progressively switch over to the UTRCID regimen from the EIM in all high-throughput anti-rabies centers of India would dramatically reduce the economic burden of running a successful anti-rabies program.

scholarly journals Economic evaluation of passive monitoring technology for seniors

2019 ◽  
Vol 32 (7) ◽  
pp. 1375-1382
Author(s):  
John E. Schneider ◽  
Jacie Cooper ◽  
Cara Scheibling ◽  
Anjani Parikh
Keyword(s):  
Health Care ◽  
Conceptual Model ◽  
Independent Living ◽  
Care Pathway ◽  
Cost Savings ◽  
Cost Benefit ◽  
Standard Of Care ◽  
Passive Monitoring ◽  
Monitoring Technology ◽  
The Cost

Abstract Background Advances such as passive monitoring technology (PMT), which provides holistic supervision of chronically ill and elderly patients, enable and support improved monitoring and observation, thus empowering the growing population of older adults to live more independently while lowering health care expenses. Aims This study develops a conceptual model to estimate the potential savings associated with PMT. Methods We first develop a conceptual model to identify the main cost variables associated with independent living, focusing on three pathways: (1) PMT, (2) independent living supported by the current standard of care, and (3) facility-based care. We examined the impact on three outcomes [i.e., health care costs, institutional costs, and health-related quality of life (HRQoL)] along each of the three care pathways (i.e., PMT, independent living supported by the standard of care, and facility-based care) and developed a cost-benefit model to calculate the net costs and benefits associated with each care pathway. Results The cost–benefit model showed savings between approximately $425 per-member per-month (PMPM) for those using PMT compared to those on the standard of care pathway. Sensitivity analysis demonstrated that a 5% increase in nursing home utilization generates cost savings of more than 30% PMPM. Discussion The total projected cost savings for individuals on the PMT arm are projected to be more than $425 PMPM, with annual savings of $5069 per-person per-year, and over $5.1 million for a target population of 1000 individuals. Conclusions The cost calculations in our cost–benefit simulation model clearly demonstrate the value of PMT and show the potential value to payers and integrated delivery systems in offering PMT to individuals who are likely to benefit the most from the services.

Cost Savings and Service Strategies in the British National Bibliographic Service

1989 ◽  
Vol 1 (2) ◽  
pp. 17-26
Author(s):  
Peter Lewis
Keyword(s):  
Action Plan ◽  
Cost Savings ◽  
Cost Benefit ◽  
International Standards ◽  
British Library ◽  
Library Community ◽  
Data Content ◽  
The Cost ◽  
Service Strategies

The British Library launched in 1986 a Catalogue Action Plan to deal with the long-term prospect of declining financial and manpower resources, the absence of growth in the market for its services, an unacceptably large backlog of uncatalogued materials, and a steadily increasing annual output of British publications to be catalogued. The initial phase of the Plan was designed to contain staff costs by reduction and simplification in data content in BNBMARC and other British Library records, predicating their future use primarily in an online (OPAC) environment. It has had significant success for the British Library's aims in the first full year of implementation, but it has raised questions of the cost-benefit in centralized cataloguing services for the library community, in respect both of the costs and sizing of OPAC systems in local libraries and of the necessity of sustaining indefinitely the high cost of adherence to international standards established before OPACs, the CD-ROMs and OSI had changed the technology.

The Cost-Benefit Analysis for the Evaluation of Public Infrastructure Projects - The Case of the Subway of Potenza

2014 ◽  
Vol 1073-1076 ◽  
pp. 1362-1367
Author(s):  
Benedetto Manganelli
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Economic Feasibility ◽  
Transport Infrastructure ◽  
Benefit Analysis ◽  
Public Infrastructure ◽  
New Public ◽  
The Cost ◽  
The City

In the present work the economic feasibility of a project of public infrastructure, the expansion of the subway of the city Potenza, is estimated. The assessment has been developed through the application of the Cost-Benefit Analysis. As is known the advantage of this technique is the ability to express in monetary terms the externalities (positive and negative) generated by the project. In this case, the external cost savings related to the improvement of the mobility in the city have been internalized. The research has shown that the valuation of the externalities can be an effective way to manage the planning of new public transport infrastructure.

Sign in / Sign up

Export Citation Format

Share Document