scholarly journals 779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S434-S434
Author(s):  
Mohamed Yassin ◽  
Curtis Donskey ◽  
Ricardo Arbulu ◽  
Heather Dixon ◽  
Kenneth Smith
Keyword(s):  
Cost Saving ◽  
Current Practice ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Carrier Status ◽  
Local Data ◽  
Healthcare Perspective ◽  
Hospital Perspective

Abstract Background Clostridiodes difficile infection (CDI) has substantial morbidity, mortality and expense. Hospital surveillance to detect CD carriers could affect antibiotic use and determination of community-associated vs hospital-associated CDI. Methods A decision tree examined the cost-effectiveness of hospital CD surveillance compared to current practice (testing as indicated). Costs for CD testing, community-associated CDI and hospital-associated CDI came from US databases. CD carrier and infection probabilities came from literature and local data. Analyses examined potential benefits from 1) knowledge of CD carrier status affecting antibiotic use (healthcare perspective) and 2) avoiding penalties for hospital-acquired CDI (hospital perspective). Results From the healthcare perspective, if antibiotic use is unchanged by CD status, surveillance costs $39/patient than current practice with unchanged CDI risk. However, if knowing CD status changed antibiotic prescribing such that CDI risk decreased by 10% or 20%, then cost/CDI avoided becomes $15,519 and $3,822 respectively, with CD surveillance becoming cheaper and more effective current practice if CDI risk decreased ≥30%. From the hospital perspective, using published CDI incidence (2.7%) and a hospital-associated CDI penalty of $30,000, surveillance cost $336/patient less than current practice if patients colonized on admission were not considered hospital-associated CDI and $476/patient less with local data (incidence 4.2%). Conclusion Hospital CD surveillance is potentially a cost-effective or cost-saving strategy depending on perspective taken and clinical usage of these data. This strategy could be implemented hospital-wide or in high-risk populations. CD surveillance could be both cost-saving and decrease CDI risk if more appropriate antibiotic use results from its use. Disclosures All Authors: No reported disclosures

scholarly journals Cost-benefit analysis of pharmacist interventions over 36 months in a university hospital

2020 ◽  
Vol 54 ◽  
pp. 94
Author(s):  
Maurilio de Souza Cazarim ◽  
João Paulo Vilela Rodrigues ◽  
Priscila Santos Calcini ◽  
Thomas Einarson ◽  
Leonardo Régis Leira Pereira
Keyword(s):  
Marginal Cost ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
University Hospital ◽  
Cost Ratio ◽  
Benefit Analysis ◽  
Net Benefit ◽  
Hospital Perspective ◽  
Benefit Cost Ratio ◽  
Tertiary Teaching

OBJECTIVE: To perform a cost-benefits analysis of a clinical pharmacy (CP) service implemented in a Neurology ward of a tertiary teaching hospital. METHODS: This is a cost-benefit analysis of a single arm, prospective cohort study performed at the adult Neurology Unit over 36 months, which has evaluated the results of a CP service from a hospital and Public Health System (PHS) perspective. The interventions were classified into 14 categories and the costs identified as direct medical costs. The results were analyzed by the total and marginal cost, the benefit-cost ratio (BCR) and the net benefit (NB). RESULTS: The total 334 patients were followed-up and the highest occurrence in 506 interventions was drug introduction (29.0%). The marginal cost for the hospital and avoided cost for PHS was US$182±32 and US$25,536±4,923 per year; and US$0.55 and US$76.4 per patient/year. The BCR and NB were 0.0, -US$26,105 (95%CI -31,850 – -10,610), -US$27,112 (95%CI -33,160–11,720) for the hospital and; 3.0 (95%CI 1.97–4.94), US$51,048 (95%CI 27,645–75,716) and, 4.6 (95%CI 2.24–10.05), US$91,496 (95%CI 34,700–168,050; p < 0.001) for the PHS, both considering adhered and total interventions, respectively. CONCLUSIONS: The CP service was not directly cost-benefit at the hospital perspective, but it presented savings for forecast cost related to the occurrence of preventable morbidities, measuring a good cost-benefit for the PHS.

scholarly journals Modeling and Cost Benefit Analysis to Guide Deployment of POC Diagnostics for Non-typhoidal Salmonella Infections with Antimicrobial Resistance

2018 ◽  
Author(s):  
Carrie Manore ◽  
Todd Graham ◽  
Alexa Carr ◽  
Alicia Feryn ◽  
Shailja Jakhar ◽  
...  
Keyword(s):  
Cost Benefit Analysis ◽  
Point Of Care ◽  
Case Fatality ◽  
Cost Benefit ◽  
Antibiotic Use ◽  
Blood Stream ◽  
Antimicrobial Treatment ◽  
Sub Saharan Africa ◽  
Advantages And Disadvantages ◽  
Salmonella Infections

ABSTRACTInvasive non-typhoidal Salmonella (NTS) is among the leading causes of blood stream infections in sub-Saharan Africa and other developing regions, especially among pediatric populations. Invasive NTS can be difficult to treat and have high case-fatality rates, in part due to emergence of strains resistant to broad-spectrum antibiotics. Furthermore, improper treatment contributes to increased antibiotic resistance and death. Point of care (POC) diagnostic tests that rapidly identify invasive NTS infection, and differentiate between resistant and non-resistant strains, may greatly improve patient outcomes and decrease resistance at the community level. Here we present for the first time a model for NTS dynamics in high risk populations that can analyze the potential advantages and disadvantages of four strategies involving POC diagnostic deployment, and the resulting impact on antimicrobial treatment for patients. Our analysis strongly supports the use of POC diagnostics coupled with targeted antibiotic use for patients upon arrival in the clinic for optimal patient and public health outcomes. We show that even the use of imperfect POC diagnostics can significantly reduce total costs and number of deaths, provided that the diagnostic gives results quickly enough that patients are likely to return or stay to receive targeted treatment.

Wellbeing Cost-effectiveness Analysis and Existing Approaches

2021 ◽  
pp. 279-332
Author(s):  
Paul Frijters ◽  
Christian Krekel
Keyword(s):  
Cost Effectiveness ◽  
Current Practice ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Business Case ◽  
Cost Effectiveness Analysis ◽  
Important Distinction ◽  
Effectiveness Analysis ◽  
Public Resource ◽  
The Individual

The fourth chapter is targeted mainly at readers who wish to quantify how much benefits and costs are generated by future or existing policies and programmes. The chapter compares the authors’ basic methodology for wellbeing cost-effectiveness analysis (CEA) with existing approaches to decide on public resource allocations. The main comparison is with cost-benefit analysis (CBA), but they also compare it with multi-criterion approaches, social rates of return analyses, and business case scenarios or impact assessments. The authors start with a quick reminder of their basic methodology for wellbeing CEA, after which they sketch the current practice of CBA, highlighting the differences in a stylized, non-technical manner. They also sketch the relationship between WELLBYs (wellbeing years) and QALYs (quality-adjusted life-years), deriving a proper translation between the two measures, which will culminate in the important distinction between the individual willingness-to-pay for a WELLBY and the social costs of producing a WELLBY. They then answer some crucial questions as to how more wellbeing knowledge can be incorporated into existing approaches, including the question of the monetization of wellbeing effects for current-practice CBA. Apart from analysts, this chapter is also of interest to academics in the fields of health and wellbeing as it discusses in depth the differences between WELLBYs and QALYs. The discussion on wellbeing approaches from around the world is of importance to all those tasked with embedding wellbeing into their own country’s public-sector systems.

scholarly journals Application of Economic Indicators to Asses the Bridges of Rehablitation

2015 ◽  
Vol 11 (1) ◽  
pp. 69-75
Author(s):  
Martin Pitoňák ◽  
Milan Valuch
Keyword(s):  
Economic Analysis ◽  
Regional Development ◽  
Economic Efficiency ◽  
Current Practice ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Economic Indicators ◽  
Concrete Bridge ◽  
Benefit Analysis ◽  
Technology Project

Abstract The aim of this paper is to point out the advantage of Cost Benefit Analysis (CBA) and its economic indicators to assess a rehabilitation of bridges. The paper includes short example of assessment of the project economic efficiency in which economic indicators are applied in order to evaluate of two technology project variants of bridge object rehabilitation. It quantifies and compares the economic results of alternative 1 with the monolithic prestress construction and alternative 2, with the composite steel - concrete bridge. The contribution reflects the current practice of economic analysis recommended by the Ministry of Transport, Construction and Regional Development.

Costo-beneficio del trattamento con i farmaci antivirali ad azione diretta nei consumatori di sostanze con epatite C: una valutazione del percorso di point of care

MISSION ◽  
2021 ◽  
pp. 8-17
Author(s):  
Felice A. Nava ◽  
Lucia Trevisi ◽  
Alfio Lucchini
Keyword(s):  
Public Health ◽  
Cost Saving ◽  
Drug Users ◽  
Cost Benefit Analysis ◽  
Point Of Care ◽  
Cost Benefit ◽  
Health Concern ◽  
Hcv Treatment ◽  
The Public ◽  
The Cost

Background Hepatitis C is a disease correlated with severe systemic consequences having elevated social and health costs. The HCV elimination is a public health concern that may be solved reaching DAAs treatment for drug users. The principal aim of this work is to evaluate the cost-benefit of a point of care for HCV treatment of drug users inside Drug abuse services (Ser.D.). Methods The study consists in a cost-benefit analysis able to evaluate the "return of health" induced by a point of care for a HCV treatment. Results The work shows that the point of care is cost-benefit in comparison with the "traditional" treatment being cost saving for the public health system. The data suggest that the cost of the point of care is corresponding to euros 593,40 while the cost of not treatment of euros 8.679,60 (due to the direct and indirect costs of the disease). Conclusions The study demonstrate the point of care is an effective model of care able to reduce the barriers of treatment and to induce a "health return" in term of cost saving for the public health systems. Indeed, the work shows how the point of care may make the elimination HCV plans sustainable for the public health agencies.

scholarly journals Cost–benefit analysis of Xpert MTB/RIF for tuberculosis suspects in German hospitals

2015 ◽  
Vol 47 (2) ◽  
pp. 575-587 ◽  
Author(s):  
Roland Diel ◽  
Albert Nienhaus ◽  
Doris Hillemann ◽  
Elvira Richter
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Drug Susceptibility Testing ◽  
Sputum Smear ◽  
Test Accuracy ◽  
Potential Cost ◽  
Hospital Perspective ◽  
Mdr Tb ◽  
Smear Negative

Our objective was to assess the cost–benefit of enhancing or replacing the conventional sputum smear with the real-time PCR Xpert MTB/RIF method in the inpatient diagnostic schema for tuberculosis (TB).Recent data from published per-case cost studies for TB/multidrug-resistant (MDR)-TB and from comparative analyses of sputum microscopy, mycobacterial culture, Xpert MTB/RIF and drug susceptibility testing, performed at the German National Reference Center for Mycobacteria, were used. Potential cost savings of Xpert MTB/RIF, based on test accuracy and multiple cost drivers, were calculated for diagnosing TB/MDR-TB suspects from the hospital perspective.Implementing Xpert MTB/RIF as an add-on in smear-positive and smear-negative TB suspects saves on average €48.72 and €503, respectively, per admitted patient as compared with the conventional approach. In smear-positive and smear-negative MDR-TB suspects, cost savings amount to €189.56 and €515.25 per person, respectively. Full replacement of microscopy by Xpert MTB/RIF saves €449.98. In probabilistic Monte-Carlo simulation, adding Xpert MTB/RIF is less costly in 46.4% and 76.2% of smear-positive TB and MDR-TB suspects, respectively, but 100% less expensive in all smear-negative suspects. Full replacement by Xpert MTB/RIF is also consistently cost-saving.Using Xpert MTB/RIF as an add-on to and even as a replacement for sputum smear examination may significantly reduce expenditures in TB suspects.

scholarly journals A Cost–Benefit Analysis of COVID-19 Vaccination in Catalonia

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 59
Author(s):  
Francesc López ◽  
Martí Català ◽  
Clara Prats ◽  
Oriol Estrada ◽  
Irene Oliva ◽  
...  
Keyword(s):  
Cost Saving ◽  
Health System ◽  
Cost Benefit Analysis ◽  
Vaccination Campaign ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Social Perspective ◽  
System Perspective ◽  
The Social ◽  
Health System Perspective

(1) Background: In epidemiological terms, it has been possible to calculate the savings in health resources and the reduction in the health effects of COVID vaccines. Conducting an economic evaluation, some studies have estimated its cost-effectiveness; the vaccination shows highly favorable results, cost-saving in some cases. (2) Methods: Cost–benefit analysis of the vaccination campaign in the North Metropolitan Health Region (Catalonia). An epidemiological model based on observational data and before and after comparison is used. The information on the doses used and the assigned resources (conventional hospital beds, ICU, number of tests) was extracted from administrative data from the largest primary care provider in the region (Catalan Institute of Health). A distinction was made between the social perspective and the health system. (3) Results: the costs of vaccination are estimated at 137 million euros (€48.05/dose administered). This figure is significantly lower than the positive impacts of the vaccination campaign, which are estimated at 470 million euros (€164/dose administered). Of these, 18% corresponds to the reduction in ICU discharges, 16% to the reduction in conventional hospital discharges, 5% to the reduction in PCR tests and 1% to the reduction in RAT tests. The monetization of deaths and cases that avoid sequelae account for 53% and 5% of total savings, respectively. The benefit/cost ratio is estimated at 3.4 from a social perspective and 1.4 from a health system perspective. The social benefits of vaccination are estimated at €116.67 per vaccine dose (€19.93 from the perspective of the health system). (4) Conclusions: The mass vaccination campaign against COVID is cost-saving. From a social perspective, most of these savings come from the monetization of the reduction in mortality and cases with sequelae, although the intervention is equally widely cost-effective from the health system perspective thanks to the reduction in the use of resources. It is concluded that, from an economic perspective, the vaccination campaign has high social returns.

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