scholarly journals P9‐76: FP/SALM maintenance plus SABA reliever versus Bud/Form MART regimen in the treatment of uncontrolled asthma in a Philippine government hospital setting: Direct cost comparison

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 392-392
2017 ◽  
Vol 132 (2) ◽  
pp. 122-128 ◽  
Author(s):  
N Patel ◽  
A Mohammadi ◽  
N Jufas

AbstractObjective:Totally endoscopic ear surgery is a relatively new method for managing chronic ear disease. This study aimed to test the null hypothesis that open and endoscopic approaches have similar direct costs for the management of attic cholesteatoma, from an Australian private hospital setting.Methods:A retrospective direct cost comparison of totally endoscopic ear surgery and traditional canal wall up mastoidectomy for the management of attic cholesteatoma in a private tertiary setting was undertaken. Indirect and future costs were excluded. A direct cost comparison of anaesthetic setup and resources, operative setup and resources, and surgical time was performed between the two techniques.Results:Totally endoscopic ear surgery has a mean direct cost reduction of AUD$2978.89 per operation from the hospital perspective, when compared to canal wall up mastoidectomy.Conclusion:Totally endoscopic ear surgery is more cost-effective, from an Australian private hospital perspective, than canal wall up mastoidectomy for attic cholesteatoma.


Hand ◽  
2019 ◽  
pp. 155894471987314
Author(s):  
Mark Henry ◽  
Forrest H. Lundy

Background: Acute, direct inoculation osteomyelitis of the hand has traditionally been managed by intravenous antibiotics. With proven high levels of bone and joint penetration, specific oral antimicrobials may deliver clinical efficacy but at substantially lower cost. Methods: Sixty-nine adult patients with surgically proven acute, direct inoculation osteomyelitis of the hand were evaluated for clinical response on a 6-week postdebridement regimen of susceptibility-matched oral antibiotics. Inclusion required gross purulence and bone loss demonstrated at the initial debridement and radiographic evidence of bone loss. Excluded were 2 patients with extreme medical comorbidities. There were 53 men and 16 women with a mean age of 46 years. Mean follow-up was 16 weeks (±10). The cost model for the outpatient oral antibiotic treatment was intentionally maximized using Walgreen’s undiscounted cash price. The cost model for the traditional intravenous treatment regimen was intentionally minimized using the fully discounted Medicare fee schedule. Results: All patients achieved resolution of osteomyelitis by clinical and radiographic criteria. In addition, 7 patients underwent successful subsequent osteosynthesis procedures at the previously affected site without reactivation. The mean postdebridement direct cost of care per patient in the study cohort was $482.85, the cost of the antibiotic alone. The postdebridement direct cost of care per patient on a regimen of vancomycin 1.5 g every 12 hours via peripherally inserted central catheter line was $21 646.90. Conclusions: Acute, direct inoculation osteomyelitis of the hand can be successfully managed on oral antibiotic agents with substantial direct and indirect cost savings.


2006 ◽  
Vol 195 (6) ◽  
pp. S52
Author(s):  
Clayton Fitzpatrick ◽  
Leo Brancazio ◽  
Terrence Allen ◽  
Geeta Swamy ◽  
Phillip Heine

2021 ◽  
pp. 52-54
Author(s):  
Nitin Dutt Bhardwaj ◽  
John Paul G. Momin ◽  
Supriya Singh ◽  
Amit Kumar

Aim:To study the diet cost per meal per patient admitted in a Tertiary Care Government Hospital. Objectives:To estimate direct cost, indirect cost and total unit cost of various types of diets. Methodology: It was a cross sectional, observational and descriptive type of study conducted in a tertiary care government hospital over a period of 4 weeks. Results: It was observed that the total cost of Normal diet was ₹122.8 per day per diet and ₹130.5 per day per diet for high protein diet.


2007 ◽  
Vol 64 (18) ◽  
pp. 1943-1949 ◽  
Author(s):  
Francis Vekeman ◽  
R. Scott McKenzie ◽  
Patrick Lefebvre ◽  
Sue H. Watson ◽  
Samir H. Mody ◽  
...  

2018 ◽  
Vol 39 (4) ◽  
pp. 240-248 ◽  
Author(s):  
Caroline Harris ◽  
Rowena Mills ◽  
Ezgi Seager ◽  
Sarah Blackstock ◽  
Tamanda Hiwa ◽  
...  

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0029
Author(s):  
Azeem Tariq Malik ◽  
Safdar N Khan ◽  
Carmen E Quatman ◽  
Thuan V Ly ◽  
Laura Phieffer

Category: Ankle, Trauma Introduction/Purpose: Free-standing Ambulatory Surgical Centers (ASCs) typically provide uncomplicated surgical procedures in a non-hospital setting, and function as ‘focused factories’ that replicate the delivery of quality care while achieving lower costs as compared to hospital-owned outpatient facilities (HOPD). Despite an increasing interest towards outpatient foot and ankle surgery, few studies have compared the safety and cost-savings associated with surgical fixation of isolated ankle fractures in a free-standing ASC vs. a HOPD. Methods: The 2007-2014 Humana Administrative Claims (HAC) database was queried using Current Procedural Terminology codes to identify patients undergoing open reduction internal fixation (ORIF) for uni-malleolar (27766, 27769, 27792), bi-malleolar (27814) and tri-malleolar (27822, 27823) ankle fractures. Patients with polytrauma or those undergoing a concurrent surgical fixation of the upper extremity, hip, femur, knee or tibia were removed from the study to capture a relevant cohort of isolated ankle fracture patients. Location of surgery was identified using Service Location codes 22 (HOPD) and 24 (ASC). Propensity- score matching and multi-variate regression analyses were used to compare differences in 90-day complications, ED-visits and readmissions between the two groups. A 90-day cost comparison was also carried out to assess savings associated with surgery in an ASC vs. HOPD. Results: A total of 4,832 (80.1%) ankle fractures treated in a HOPD and 1,198 (19.9%) in a free-standing ASC were included in the study. Following propensity-score matching to account for differences in baseline demographics and clinical characteristics, each group consisted of 1,138 patients. Following multi-variate analyses, undergoing surgery in a free-standing ASC vs. a HOPD was not associated with a higher rate of 90-day complications (0.73 [95% CI 0.54 -1.00]; p=0.05), ED visits (OR 0.86 [95% CI 0.64- 1.16]; p=0.331) and readmissions (0.79 [95% CI 0.53 -1.18]; p=0.251). Furthermore, undergoing surgery in a free-standing ASC was associated with nearly $2500 cost-savings/case over the 90-day episode of care (ASC = $8,058 vs. HOPD = $10,619; p<0.001). Conclusion: Using national administrative claims of Commercial insurance beneficiaries, the results of the study show that performing surgical fixation of ankle fractures in a free-standing ASC is a safe and cost-effective option in a carefully selected patient population.


Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 462-465 ◽  
Author(s):  
Logan W. Carr ◽  
Brad Morrow ◽  
Brett Michelotti ◽  
Randy M. Hauck

Background: The increased efficiency and cost savings have led many surgeons to move their practice away from the traditional operating room (OR) or outpatient surgery center (OSC) and into the clinic setting. With the cost of health care continuing to rise, the venue with the lowest cost should be utilized. We performed a direct cost analysis of a single surgeon performing an open carpal tunnel release in the OR, OSC, and clinic. Methods: Four treatment groups were prospectively studied: the hospital OR with monitored anesthesia care (OR-MAC), OSC with MAC (OSC-MAC), OSC with local anesthesia (OSC-local), and clinic with local anesthesia (clinic). To determine direct costs, a detailed inventory was recorded including the weight and disposal of medical waste. Indirect costs were not included. Results: Five cases in each treatment group were prospectively recorded. Average direct costs were OR ($213.75), OSC-MAC ($102.79), OSC-local ($55.66), and clinic ($31.71). The average weight of surgical waste, in descending order, was the OR (4.78 kg), OSC-MAC (2.78 kg), OSC-local (2.6 kg), and the clinic (0.65 kg). Using analysis of variance, the clinic’s direct costs and surgical waste were significantly less than any other setting ( P < .005). Conclusions: The direct costs of an open carpal tunnel release were nearly 2 times more expensive in the OSC compared with the clinic and almost 7 times more expensive in the OR. Open carpal tunnel release is more cost-effective and generates less medical waste when performed in the clinic versus all other surgical venues.


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