Opportunity cost of the dermatologist’s consulting time in the economic evaluation of teledermatology

Introduction This study, through a systematic review and meta-analysis, has sought to demonstrate that the opportunity cost is a value to take into account in studies of economic cost in telemedicine, illustrated through the time of the dermatologist’s consultation in teledermatology and traditional consultation. Methods Economic evaluation studies have been identified that compare teledermatology and traditional dermatological consultation during the period 1998–2015. We carried out a meta-analysis considering the work cost and the dermatologist’s consultation time, analysing their differences. The opportunity cost represented by these differences in the dermatological remote consultation time was subsequently calculated based on the design of a cost/time variable. Results It was not possible to meta-analyse the cost of the dermatologist’s consultation due to insufficient standardized complete data. It was possible to carry out a meta-analysis of the consultation time, and three articles were selected (2945 patients). Teledermatology accounts for more time (7.54 min) than conventional consultation ( p < 0.00001) and this difference is an opportunity cost of teledermatology of €29.25 per each remote consultation, with a unitary factor cost/time of 3.88€/minute. Conclusions There is no unanimity in the literature regarding which of the two procedures is cheaper; further studies with the necessary standardized variables are required. In this meta-analysis, teledermatology takes more time than a conventional dermatology consultation, which leads to an opportunity cost, increasing the total cost of consultation. The opportunity cost is a value that should be included in an analysis of economic costs, in the context of an economic assessment, when we evaluate a health activity.

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The Cost-Effectiveness of Mobile Health (mHealth) Interventions for Older Adults: Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155290 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5290

Author(s):

Zartashia Ghani ◽

Johan Jarl ◽

Johan Sanmartin Berglund ◽

Martin Andersson ◽

Peter Anderberg

Keyword(s):

Older Adults ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Empirical Evidence ◽

Mobile Health ◽

Evaluation Studies ◽

Health Economic Evaluation ◽

Reporting Quality ◽

Economic Evaluations ◽

The Cost

The objective of this study was to critically assess and review empirical evidence on the cost-effectiveness of Mobile Health (mHealth) interventions for older adults. We systematically searched databases such as Pubmed, Scopus, and Cumulative Index of Nursing and Allied Literature (CINAHL) for peer-reviewed economic evaluations published in English from 2007 to 2018. We extracted data on methods and empirical evidence (costs, effects, incremental cost-effectiveness ratio) and assessed if this evidence supported the reported findings in terms of cost-effectiveness. The consolidated health economic evaluation reporting standards (CHEERS) checklist was used to assess the reporting quality of the included studies. Eleven studies were identified and categorized into two groups: complex smartphone communication and simple text-based communication. Substantial heterogeneity among the studies in terms of methodological approaches and types of intervention was observed. The cost-effectiveness of complex smartphone communication interventions cannot be judged due to lack of information. Limited evidence of cost-effectiveness was found for interventions related to simple text-based communications. Comprehensive economic evaluation studies are warranted to assess the cost-effectiveness of mHealth interventions designed for older adults.

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Erratum: An assessment of the cost-effectiveness of magnetic resonance, including diffusion-weighted imaging, in patients with transient ischaemic attack and minor stroke: a systematic review, meta-analysis and economic evaluation

Health Technology Assessment ◽

10.3310/hta18270-c201509 ◽

2015 ◽

Vol 18 (27) ◽

pp. 369-370

Author(s):

Joanna Wardlaw ◽

Miriam Brazzelli ◽

Hector Miranda ◽

Francesca Chappell ◽

Paul McNamee ◽

...

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Diffusion Weighted Imaging ◽

Meta Analysis ◽

Minor Stroke ◽

Forest Plot ◽

Ischaemic Attack ◽

The Right ◽

The Cost

AbstractCorrections to thex-axis title of the right-hand side forest plot in Figures 10–12

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Cost of oropharyngeal dysphagia after stroke: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2018-022775 ◽

2018 ◽

Vol 8 (12) ◽

pp. e022775 ◽

Cited By ~ 3

Author(s):

Sergio Marin ◽

Mateu Serra-Prat ◽

Omar Ortega ◽

Pere Clavé

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Respiratory Infections ◽

Evaluation Studies ◽

Hospital Costs ◽

Oropharyngeal Dysphagia ◽

Indirect Costs ◽

Registration Number ◽

Hospital Stays ◽

The Cost

IntroductionOropharyngeal dysphagia (OD) is a major disorder following stroke. OD can produce alterations in both the efficacy and safety of deglutition and may result in malnutrition, dehydration, frailty, respiratory infections and pneumonia. These complications can be avoided by early detection and treatment of OD in poststroke patients, and hospital stays, medication and mortality rates can be reduced. In addition to acute in-hospital costs from OD complications, there are other costs related to poststroke OD such as direct non-healthcare costs or indirect costs. The objective of this systematic review is to assess and summarise literature on the costs related to OD in poststroke patients.Methods and analysisA systematic review of studies on the cost of OD and its complications (aspiration, malnutrition, dehydration, aspiration pneumonia and death) in patients who had a stroke will be performed from the perspectives of the hospital, the healthcare system and/or the society. The main outcomes of interest are the costs related to poststroke OD. We will search MEDLINE, Embase and the National Health Service Economic Evaluation Database. Studies will be included if they are partial economic evaluation studies, studies that provide information on costs in adult (>17 years) poststroke patients with OD and/or its complications (malnutrition, dehydration, frailty, respiratory infections and pneumonia) or economic evaluation studies in which the cost of this condition has been estimated. Studies will be excluded if they refer to oesophageal dysphagia or OD caused by causes other than stroke. Main study information will be presented and summarised in tables, separately for studies that provide incremental costs attributable to OD or its complications and studies that report the effect of OD or its complications on total costs of stroke, and according to the perspective from which costs were measured.Ethics and disseminationThe results of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018099977.

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Some Factors to Consider when Using the Results of Economic Evaluation Studies at the Population Level

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300006681 ◽

1994 ◽

Vol 10 (3) ◽

pp. 467-478 ◽

Cited By ~ 10

Author(s):

Reiner M. Leidl

Keyword(s):

Economic Evaluation ◽

Treatment Effectiveness ◽

Evaluation Studies ◽

Population Level ◽

Medical Intervention ◽

Community Capacity ◽

Decision Makers ◽

Time Perspectives ◽

Patient Level ◽

The Cost

AbstractThe cost-effectiveness of a medical intervention at the population level may deviate from that reported for evaluations at the patient level. It is important for researchers and decision makers to know about the relevance of externalities, phasing-in effects, treatment effectiveness in the community, capacity issues, and different time perspectives in the evaluation of an intervention.

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Choosing a logistics supply chain on the basis of opportunity cost

Corporate Ownership and Control ◽

10.22495/cocv10i4c2art6 ◽

2013 ◽

Vol 10 (4) ◽

pp. 291-296

Author(s):

John Vogt ◽

Wessel Pienaar

Keyword(s):

Supply Chain ◽

Opportunity Cost ◽

Economic Cost ◽

Practical Method ◽

Logistics Cost ◽

Approach Method ◽

The One ◽

The Cost ◽

In Transit ◽

Cost Factors

The total logistics cost (TLC) is the traditional expenditure-approach method of calculating the logistics cost of a supply chain as the goods are moved from the source to the end destination. This method uses the sum of all expenditure associated with the movement of goods (i.e. transport and handling), in-transit storage of goods and the generation of information to enable these movements to occur. As logistics chains become more complex and longer, calculating the TLC becomes increasingly difficult. The question that this paper answers is how to define and calculate the four logistics supply chain economic, or opportunity, cost factors of (1) physical movement (i.e. transport and handling); (2) in-transit cost of holding the stock while not available to the end customer; (3) the cost of the information needed to enable the movement; and (4) the effect of the reliability of the logistics chain on the safety stock. A practical method is developed whereby the TLC, incorporating these four aspects, is shown for a hypothetical movement. The costs highlight the total logistics opportunity cost (TLOC) for a multiple-leg voyage and the costs associated with all four aspects of the movement. The most attractive logistics supply chain would be the one with the lowest TLOC, and the choice can be made with confidence, as it incorporates the full economic logistics cost of the chain. (‘Economic cost’ and ‘opportunity cost’ are terms used synonymously in this work.)

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A protocol for a systematic literature review of economic evaluation studies of interventions to address antimicrobial resistance

Systematic Reviews ◽

10.1186/s13643-021-01794-3 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Aparna Ananthakrishnan ◽

Chris Painter ◽

Yot Teerawattananon

Keyword(s):

Economic Evaluation ◽

Cost Effectiveness ◽

Antimicrobial Resistance ◽

Literature Review ◽

Systematic Literature Review ◽

Evaluation Studies ◽

Grey Literature ◽

World Health ◽

Economic Evaluations ◽

The Cost

Abstract Background Antimicrobial resistance (AMR) is accelerated by the widespread and often indiscriminate use of antimicrobials in humans, animals, and the environment. In 2015, the World Health Organization recognised AMR as one of the top ten global health threats, due to its potential to neutralise humanity’s advancements in western medicine by enabling the emergence of new strains of existing pathogens, many of which have no available treatments. Over the past decade, several countries, including those in low- and middle-income contexts, have started implementing interventions to tackle AMR. However, economic evidence regarding the cost-effectiveness of these interventions remains weak. To address this evidence gap, we will conduct a systematic literature review to provide a comprehensive summary on the value for money of different AMR interventions. Methods We aim to conduct a systematic literature review of all available economic evaluations on interventions addressing AMR and will provide a narrative synthesis of our findings. Systematic searches for relevant studies will be performed across all suitable databases as well as in grey literature sources such as unpublished studies, reports, and other relevant documents. All economic evaluation studies will be included as long as they report an economic outcome and have stated that the analysed intervention will reduce antimicrobial resistance or antimicrobial use in the abstract. Those studies reporting clinical endpoints alone will be excluded. Selection for final inclusion and data extraction will be performed by two independent reviewers. Discussion The review will be one of the first of its kind, and the most recent, to systematically review literature on the cost-effectiveness of AMR interventions, an important evidence gap in the economics of AMR. The findings will enable policy and decision-makers, particularly in resource-constrained settings, to better use available resources when selecting interventions to address AMR burdens, Systematic review registration PROSPERO CRD42020190310

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Pneumococcal Vaccination for Children in Asian Countries: A Systematic Review of Economic Evaluation Studies

Vaccines ◽

10.3390/vaccines8030426 ◽

2020 ◽

Vol 8 (3) ◽

pp. 426 ◽

Cited By ~ 1

Author(s):

Neily Zakiyah ◽

Widya N. Insani ◽

Auliya A. Suwantika ◽

Jurjen van der Schans ◽

Maarten J. Postma

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Evaluation Studies ◽

Pneumococcal Vaccination ◽

Cost Effective ◽

Asian Countries ◽

Life Years ◽

Key Drivers ◽

The Cost

Background: Evidence on costs and health benefits of pneumococcal conjugate vaccine (PCV) for children in Asian countries is limited but growing. As a region with a considerably high burden of pneumococcal disease, it is prominent to have a comprehensive overview on the cost-effectiveness of implementing and adopting a PCV vaccination program. Methods: We conducted a systematic review from Pubmed and Embase to identify economic evaluation studies of PCV for children in Asian countries up to May 2020. Data extraction included specific characteristics of the study, input parameters, cost elements, cost-effectiveness results, and key drivers of uncertainty. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement was followed for this systematic review. The reporting quality of the included studies was evaluated using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Results: After the screening process on both the title and abstract and full text of 518 records, a total of 25 studies fulfilled the inclusion criteria, and were included in the review. The majority of included studies demonstrates that PCV for children is cost-effective in most of the Asian region, and even cost-saving in some countries. Most of the included studies implemented cost utility analysis (CUA) using either quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Overall, the main drivers affecting the cost effectiveness were vaccine price, burden regarding pneumonia-related parameters, and the inclusion of herd effects. Conclusion: The children pneumococcal vaccination program appears to be a cost-effective intervention in Asia, and even cost-saving in certain conditions. Vaccine price, pneumonia-related disease burden, and the inclusion of the herd effect are observed as important key drivers in estimating cost-effectiveness in this region. Incorporating PCV in vaccination programs in this region was found to be highly favorable.

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A Techno-Economic Analysis of a PV-Battery System in Greece

Energies ◽

10.3390/en12071357 ◽

2019 ◽

Vol 12 (7) ◽

pp. 1357 ◽

Cited By ~ 8

Author(s):

Ioannis Kosmadakis ◽

Costas Elmasides ◽

Dimitrios Eleftheriou ◽

Konstantinos Tsagarakis

Keyword(s):

Economic Cost ◽

Economic Assessment ◽

Energy System ◽

Economic Feasibility ◽

System Model ◽

Energy Yield ◽

Optimal Model ◽

Battery System ◽

Energy System Model ◽

The Cost

A techno-economic assessment has been carried out to evaluate the economic feasibility of energy self-consumption from a combination of photovoltaics and lead-acid batteries (PV-BAT). The Total annual economic cost (TAEC) and the cost per unit of energy were first calculated, from PV-BAT data collected over a 12 month period and then from energy system model data for the same period. A comparison of the actual renewable energy yield to optimal model output revealed that energy was restrained partially due to limited storage resources. The cost per kilowatt-hour for the two examined scenarios ranged from 0.55 to 0.62 €/kWh and from 0.42 to 0.46 €/kWh, respectively, showing room for further cost reductions. Despite currently lower energy purchasing costs from electricity providers, these findings constitute a significant price indication of the kilowatt-hour produced by PV-BAT, showing the need for further investigation into battery sizing can be optimized and battery cost can be reduced.

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The clinical effectiveness and cost-effectiveness of heated humidified high-flow nasal cannula compared with usual care for preterm infants: systematic review and economic evaluation

Health Technology Assessment ◽

10.3310/hta20300 ◽

2016 ◽

Vol 20 (30) ◽

pp. 1-68 ◽

Cited By ~ 14

Author(s):

Nigel Fleeman ◽

James Mahon ◽

Vickie Bates ◽

Rumona Dickson ◽

Yenal Dundar ◽

...

Keyword(s):

Economic Evaluation ◽

Usual Care ◽

Preterm Infants ◽

Meta Analysis ◽

Secondary Analysis ◽

Clinical Effectiveness ◽

High Flow ◽

High Flow Nasal Cannula ◽

Primary Analysis ◽

The Cost

BackgroundRespiratory problems are one of the most common causes of morbidity in preterm infants and may be treated with several modalities for respiratory support such as nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive-pressure ventilation. The heated humidified high-flow nasal cannula (HHHFNC) is gaining popularity in clinical practice.ObjectivesTo address the clinical effectiveness of HHHFNC compared with usual care for preterm infants we systematically reviewed the evidence of HHHFNC with usual care following ventilation (the primary analysis) and with no prior ventilation (the secondary analysis). The primary outcome was treatment failure defined as the need for reintubation (primary analysis) or intubation (secondary analysis). We also aimed to assess the cost-effectiveness of HHHFNC compared with usual care if evidence permitted.Data sourcesThe following databases were searched: MEDLINE (2000 to 12 January 2015), EMBASE (2000 to 12 January 2015), The Cochrane Library (issue 1, 2015), ISI Web of Science (2000 to 12 January 2015), PubMed (1 March 2014 to 12 January 2015) and seven trial and research registers. Bibliographies of retrieved citations were also examined.Review methodsTwo reviewers independently screened all titles and abstracts to identify potentially relevant studies for inclusion in the review. Full-text copies were assessed independently. Data were extracted and assessed for risk of bias. Summary statistics were extracted for each outcome and, when possible, data were pooled. A meta-analysis was only conducted for the primary analysis, using fixed-effects models. An economic evaluation was planned.ResultsClinical evidence was derived from seven randomised controlled trials (RCTs): four RCTs for the primary analysis and three RCTs for the secondary analysis. Meta-analysis found that only for nasal trauma leading to a change of treatment was there a statistically significant difference, favouring HHHFNC over NCPAP [risk ratio (RR) 0.21, 95% confidence interval (CI) 0.10 to 0.42]. For the following outcomes, there were no statistically significant differences between arms: treatment failure (reintubation < 7 days; RR 0.76, 95% CI 0.54 to 1.09), bronchopulmonary dysplasia (RR 0.92, 95% CI 0.72 to 1.17), death (RR 0.56, 95% CI 0.22 to 1.44), pneumothorax (RR 0.33, 95% CI 0.03 to 3.12), intraventricular haemorrhage (grade ≥ 3; RR 0.41, 95% CI 0.15 to 1.15), necrotising enterocolitis (RR 0.41, 95% CI 0.15 to 1.14), apnoea (RR 1.08, 95% CI 0.74 to 1.57) and acidosis (RR 1.16, 95% CI 0.38 to 3.58). With no evidence to support the superiority of HHHFNC over NCPAP, a cost-minimisation analysis was undertaken, the results suggesting HHHFNC to be less costly than NCPAP. However, this finding is sensitive to the lifespan of equipment and the cost differential of consumables.LimitationsThere is a lack of published RCTs of relatively large-sized populations comparing HHHFNC with usual care; this is particularly true for preterm infants who had received no prior ventilation.ConclusionsThere is a lack of convincing evidence suggesting that HHHFNC is superior or inferior to usual care, in particular NCPAP. There is also uncertainty regarding whether or not HHHFNC can be considered cost-effective. Further evidence comparing HHHFNC with usual care is required.Study registrationThis review is registered as PROSPERO CRD42015015978.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Corrigendum: A systematic review and economic evaluation of bisphosphonates for the prevention of fragility fractures

Health Technology Assessment ◽

10.3310/hta20780-c201803 ◽

2018 ◽

Vol 20 (78) ◽

pp. 407-424 ◽

Cited By ~ 1

Author(s):

Sarah Davis ◽

Marrissa Martyn-St James ◽

Jean Sanderson ◽

John Stevens ◽

Edward Goka ◽

...

Keyword(s):

Systematic Review ◽

Economic Evaluation ◽

Meta Analysis ◽

Fragility Fractures ◽

Appraisal Committee ◽

Technology Appraisal ◽

Effectiveness Analysis ◽

Original Report ◽

The Cost ◽

The Impact

Abstract During the course of providing additional analyses for the National Institute for Health and Care Excellence Technology Appraisal Committee, two errors were identified in the data entered in the network meta-analysis that informed the cost-effectiveness analysis described in the original report. This corrigendum notice describes the errors identified and the impact of correcting these errors on the main analyses presented in the original report.

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