scholarly journals 386 Is the Routine Histopathology of Haemorrhoidectomy Specimens Cost Effective?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G S Ng
Keyword(s):  
Anal Carcinoma ◽  
Microscopic Analysis ◽  
Cost Effective ◽  
Regional Hospital ◽  
Histopathological Analysis ◽  
Human Research Ethics ◽  
Microscopic Evaluation ◽  
Pathological Evaluation ◽  
Histopathologic Evaluation ◽  
The Cost

Abstract Introduction The necessity for routine histopathologic evaluation of hemorrhoidectomy specimens has been controversial, yet it is commonplace in many hospitals. The cost effectiveness was analysed in a regional hospital in Queensland. Our secondary aim was to also determine the incidence of unexpected abnormality in haemorrhoidectomy specimens. Method This is a retrospective study between March 21st 2012 – April 30th 2020 in a regional hospital in Queensland, and approved by the Health Service Human Research Ethics Committee as a low risk research project. We used Operating Room Management Information System (ORMIS) to obtain a total number of 122 haemorrhoidectomies. The cost of histopathological analysis of a haemorrhoidectomy specimen is AUD$174.65. Results We found that 122 haemorrhoidectomies were performed over the study period. Of these, 66.39% (n = 81) haemorrhoidectomy specimens were sent for routine histopathology. 84.4% (n = 103) were done via the Milligan-Morgan technique. There was intra-operative suspicion of abnormality in 2 cases; histology showed no dysplasia. In total, no specimens had any evidence of dysplasia or neoplasia. Conclusions Routine pathological evaluation of hemorrhoidectomy specimens is not useful and is expensive, as unsuspected anal carcinoma is a rare occurrence and was not demonstrable in the study period. However, a careful pre-operative examination should be performed as unsuspected carcinoma of the anus diagnosed solely by microscopic analysis has been described in the literature. Any suspicious areas should be sent for microscopic evaluation. At a cost of AUD$174.65 per specimen, approximately AUD$1,768.33 could have been saved per annum, or AUD$14,146.65 in 8 years.

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.

scholarly journals The cost-effectiveness of a program to reduce intrapartum and neonatal mortality in a referral hospital in Ghana

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242170
Author(s):  
Stephanie Bogdewic ◽  
Rohit Ramaswamy ◽  
David M. Goodman ◽  
Emmanuel K. Srofenyoh ◽  
Sebnem Ucer ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Neonatal Mortality ◽  
Clinical Skills ◽  
Cost Effective ◽  
Regional Hospital ◽  
Sensitivity Analyses ◽  
Neonatal Deaths ◽  
Disability Adjusted Life ◽  
The Cost ◽  
Disability Adjusted Life Year

Objective To evaluate the cost-effectiveness of a program intended to reduce intrapartum and neonatal mortality in Accra, Ghana. Design Quasi-experimental, time-sequence intervention, retrospective cost-effectiveness analysis. Methods A program integrating leadership development, clinical skills and quality improvement training was piloted at the Greater Accra Regional Hospital from 2013 to 2016. The number of intrapartum and neonatal deaths prevented were estimated using the hospital’s 2012 stillbirth and neonatal mortality rates as a steady-state assumption. The cost-effectiveness of the intervention was calculated as cost per disability-adjusted life year (DALY) averted. In order to test the assumptions included in this analysis, it was subjected to probabilistic and one-way sensitivity analyses. Main outcome measures Incremental cost-effectiveness ratio (ICER), which measures the cost per disability-adjusted life-year averted by the intervention compared to status quo. Results From 2012 to 2016, there were 45,495 births at the Greater Accra Regional Hospital, of whom 5,734 were admitted to the newborn intensive care unit. The budget for the systems strengthening program was US $1,716,976. Based on program estimates, 307 (±82) neonatal deaths and 84 (±35) stillbirths were prevented, amounting to 12,342 DALYs averted. The systems strengthening intervention was found to be highly cost effective with an ICER of US $139 (±$44), an amount significantly lower than the established threshold of cost-effectiveness of the per capita gross domestic product, which averaged US $1,649 between 2012–2016. The results were found to be sensitive to the following parameters: DALYs averted, number of neonatal deaths, and number of stillbirths. Conclusion An integrated approach to system strengthening in referral hospitals has the potential to reduce neonatal and intrapartum mortality in low resource settings and is likely to be cost-effective. Sustained change can be achieved by building organizational capacity through leadership and clinical training.

scholarly journals Safety and cost-effectiveness of single-use endolaser probe reprocessing in vitreoretinal surgery

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Leandro Cabral Zacharias ◽  
Lívia da Silva Conci ◽  
Bianca Partezani Megnis ◽  
Janaina Guerra Falabretti ◽  
Taurino dos Santos Rodrigues Neto ◽  
...  
Keyword(s):  
Average Cost ◽  
Vitreoretinal Surgery ◽  
Cost Effective ◽  
University Hospital ◽  
Second Phase ◽  
Microscopic Evaluation ◽  
Single Use ◽  
Laser Probes ◽  
Two Phases ◽  
The Cost

Abstract Background Endolaser probes have been designed and sold for single-use only. However, in Brazil, they are not included in the list of single-use medical products that are prohibited from being reprocessed and could potentially be reused if safety requirements are accomplished. Therefore, this study aimed to determine and compare the quality, safety and costs of reprocessed versus original single-use endolaser probes of a specific brand and model. Methods The study, conducted at a university hospital in Sao Paulo, Brazil, was divided in two phases. The first one tested the feasibility, sterility and physical integrity of ten reprocessed laser probes. In the second phase, all vitrectomy procedures using endolaser probes (reprocessed and original ones) from August 2017 to October 2019 were evaluated. The operated cases were followed for any signs of infection and number of defective probes for each group were counted. The cost of acquiring a new probe and for all reprocessing stages were evaluated and quantified in US dollars($). Results Microbiologic, residual ethilen oxide and microscopic evaluation of integrity of reprocessed laser probes were all within acceptable range. The second phase of this study included 590 endolaser probes, of which 375 were original and 215 were reprocessed. Functionality rates differed significantly between groups. Among the original probes, 373 (99.47%) were functioning and 2 (0.53%) were non-functioning. Among the reprocessed ones, 201 (93.5%) were functioning and 14 (6.5%) were non-functioning (p < .001). The average cost of one reprocessing was $3.00, and the average cost of an original probe was $150.00. Considering the loss rates, potential savings were $147.60 for each once-reprocessed probe. The frequency of infectious endophthalmitis was null in both groups. Conclusions Our study showed that a single cycle endolaser probe reprocessing was safe and efficient, not associated with increase in endophthalmitis rate and proved to be significantly cost-effective, even considering a greater malfunction rate when compared to the original devices.

The IBM-PC in electron microscopy

1996 ◽  
Vol 54 ◽  
pp. 612-613
Author(s):  
James F. Mancuso
Keyword(s):  
Head Start ◽  
Image Acquisition ◽  
Cost Effective ◽  
Financial Applications ◽  
Number Of Factors ◽  
Instrument Control ◽  
The Cost ◽  
Training And Support ◽  
Control Image ◽  
Ibm Pc

IBM PC compatible computers are widely used in microscopy for applications ranging from control to image acquisition and analysis. The choice of IBM-PC based systems over competing computer platforms can be based on technical merit alone or on a number of factors relating to economics, availability of peripherals, management dictum, or simple personal preference.IBM-PC got a strong “head start” by first dominating clerical, document processing and financial applications. The use of these computers spilled into the laboratory where the DOS based IBM-PC replaced mini-computers. Compared to minicomputer, the PC provided a more for cost-effective platform for applications in numerical analysis, engineering and design, instrument control, image acquisition and image processing. In addition, the sitewide use of a common PC platform could reduce the cost of training and support services relative to cases where many different computer platforms were used. This could be especially true for the microscopists who must use computers in both the laboratory and the office.

Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein

Phlebologie ◽  
2007 ◽  
Vol 36 (06) ◽  
pp. 309-312 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Cost Effective ◽  
Duplex Sonography ◽  
Foam Sclerotherapy ◽  
Average Loss ◽  
One Year ◽  
The Cost

Summary Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.

A Digital Economy Model for Talent Prediction Data Analytic

2019 ◽  
Vol 2 (4) ◽  
pp. 260-266
Author(s):  
Haru Purnomo Ipung ◽  
Amin Soetomo
Keyword(s):  
Business Model ◽  
Industrial Revolution ◽  
Technology Innovation ◽  
Cost Effective ◽  
Sharing Economy ◽  
Token Economy ◽  
Economy Model ◽  
New Business ◽  
The Cost ◽  
Data Analytic

This research proposed a model to assist the design of the associated data architecture and data analytic to support talent forecast in the current accelerating changes in economy, industry and business change due to the accelerating pace of technological change. The emerging and re-emerging economy model were available, such as Industrial revolution 4.0, platform economy, sharing economy and token economy. Those were driven by new business model and technology innovation. An increase capability of technology to automate more jobs will cause a shift in talent pool and workforce. New business model emerge as the availabilityand the cost effective emerging technology, and as a result of emerging or re-emerging economic models. Both, new business model and technology innovation, create new jobs and works that have not been existed decades ago. The future workers will be faced by jobs that may not exist today. A dynamics model of inter-correlation of economy, industry, business model and talent forecast were proposed. A collection of literature review were conducted to initially validate the model.

CAD Of Anticorrosive Protection Of Steel Structures

2019 ◽  
pp. 18-23
Keyword(s):  
Protective Coating ◽  
Computer Aided Design ◽  
Steel Structures ◽  
Cost Effective ◽  
Operating Conditions ◽  
Computational Tool ◽  
Protection Method ◽  
Cost Effective Method ◽  
The Cost ◽  
Aided Design

The choice of cost-effective method of anticorrosive protection of steel structures is an urgent and time consuming task, considering the significant number of protection ways, differing from each other in the complex of technological, physical, chemical and economic characteristics. To reduce the complexity of solving this problem, the author proposes a computational tool that can be considered as a subsystem of computer-aided design and used at the stage of variant and detailed design of steel structures. As a criterion of the effectiveness of the anti-corrosion protection method, the cost of the protective coating during the service life is accepted. The analysis of existing methods of steel protection against corrosion is performed, the possibility of their use for the protection of the most common steel structures is established, as well as the estimated period of effective operation of the coating. The developed computational tool makes it possible to choose the best method of protection of steel structures against corrosion, taking into account the operating conditions of the protected structure and the possibility of using a protective coating.

Production of Asbestos-free Brake Pad Using Groundnut Shell as Filler Material

2018 ◽  
Vol 4 (12) ◽  
Author(s):  
W. C. Solomon ◽  
M. T. Lilly ◽  
J. I. Sodiki
Keyword(s):  
Phenolic Resin ◽  
Cost Effective ◽  
Filler Material ◽  
Particle Sizes ◽  
Brake Pad ◽  
Brake Pads ◽  
Environmental Friendly ◽  
Sieve Size ◽  
Groundnut Shell ◽  
The Cost

The development and evaluation of brake pads using groundnut shell (GS) particles as substitute material for asbestos were carried out in this study. This was with a view to harnessing the properties of GS, which is largely deposited as waste, and in replacing asbestos which is carcinogenic in nature despite its good tribological and mechanical properties. Two sets of composite material were developed using varying particle sizes of GS as filler material, with phenolic resin as binder with percentage compositions of 45% and 50% respectively. Results obtained indicate that the compressive strength and density increase as the sieve size of the filler material decreases, while water and oil absorption rates increase with an increase in sieve size of GS particle. This study also indicates that the cost of producing brake pad can be reduced by 19.14 percent if GS is use as filler material in producing brake pad. The results when compared with those of asbestos and industrial waste showed that GS particle can be used as an effective replacement for asbestos in producing automobile brake pad. Unlike asbestos, GS-based brake pads are environmental friendly, biodegradable and cost effective.

Janus – A New Approach to Air Combat Pilot Training

2019 ◽  
Vol 2019 (4) ◽  
pp. 7-22
Author(s):  
Georges Bridel ◽  
Zdobyslaw Goraj ◽  
Lukasz Kiszkowiak ◽  
Jean-Georges Brévot ◽  
Jean-Pierre Devaux ◽  
...  
Keyword(s):  
Low Cost ◽  
Cost Effective ◽  
High Energy ◽  
Training System ◽  
Embedded Sensors ◽  
Pilot Training ◽  
New Approach ◽  
Combat Aircraft ◽  
Air Combat ◽  
The Cost

Abstract Advanced jet training still relies on old concepts and solutions that are no longer efficient when considering the current and forthcoming changes in air combat. The cost of those old solutions to develop and maintain combat pilot skills are important, adding even more constraints to the training limitations. The requirement of having a trainer aircraft able to perform also light combat aircraft operational mission is adding unnecessary complexity and cost without any real operational advantages to air combat mission training. Thanks to emerging technologies, the JANUS project will study the feasibility of a brand-new concept of agile manoeuvrable training aircraft and an integrated training system, able to provide a live, virtual and constructive environment. The JANUS concept is based on a lightweight, low-cost, high energy aircraft associated to a ground based Integrated Training System providing simulated and emulated signals, simulated and real opponents, combined with real-time feedback on pilot’s physiological characteristics: traditionally embedded sensors are replaced with emulated signals, simulated opponents are proposed to the pilot, enabling out of sight engagement. JANUS is also providing new cost effective and more realistic solutions for “Red air aircraft” missions, organised in so-called “Aggressor Squadrons”.

Pound Wise and Penny Foolish? Weight Loss and The Dynamics of Health Care Spending

2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch
Keyword(s):  
Weight Loss ◽  
Cost Savings ◽  
Cost Effective ◽  
Economic Consequences ◽  
Health Care Spending ◽  
Order Of Magnitude ◽  
Dynamic Measures ◽  
The Cost ◽  
The Impact ◽  
The Relationship

Current estimates of obesity costs ignore the impact of future weight loss and gain, and may either over or underestimate economic consequences of weight loss. In light of this, I construct static and dynamic measures of medical costs associated with body mass index (BMI), to be balanced against the cost of one-time interventions. This study finds that ignoring the implications of weight loss and gain over time overstates the medical-cost savings of such interventions by an order of magnitude. When the relationship between spending and age is allowed to vary, weight-loss attempts appear to be cost-effective starting and ending with middle age. Some interventions recently proven to decrease weight may also be cost-effective.

Sign in / Sign up

Export Citation Format

Share Document