Using tele-emergency to avoid patient transfers in rural emergency departments: An assessment of costs and benefits

2017 ◽  
Vol 24 (3) ◽  
pp. 193-201 ◽  
Author(s):  
Nabil Natafgi ◽  
Dan M Shane ◽  
Fred Ullrich ◽  
A Clinton MacKinney ◽  
Amanda Bell ◽  
...  
Keyword(s):  
Rural Areas ◽  
Emergency Departments ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Rural Hospitals ◽  
Costs And Benefits ◽  
Patient Transfers ◽  
Hospital Perspective ◽  
Stakeholder Perspectives ◽  
Hospital Revenues

Introduction Tele-emergency can address several challenges facing emergency departments in rural areas. The purpose of this paper is to (a) examine the rates of avoided transfers in rural emergency departments that adopted tele-emergency applications; and (b) estimate the costs and benefits of using tele-emergency to avoid transfers. Methods Analysis is based on 9048 tele-emergency encounters generated by the Avera eEmergency programme (Sioux Falls, South Dakota) in 85 rural hospitals across seven states between October 2009–February 2014. For each non-transfer patient, physicians indicated whether the transfer was avoided because of tele-emergency activation. The cost-benefit analysis is conducted from the hospital, patient and societal perspectives, and includes technology costs, local hospital revenues and patient-associated savings. All monetary values are expressed in US$. Sensitivity analysis is conducted by examining the worst and best case scenarios of costs, revenues and savings. Results In these analyses, 1175 avoided transfers were attributed to tele-emergency. From a rural hospital perspective, tele-emergency costs around US$1739 to avoid a single transfer. However, tele-emergency saves around US$5563 in avoided transportation and indirect patient costs. Combining these, from a societal perspective, tele-emergency has the potential to result in a net savings of US$3823 per avoided transfer while accounting for tele-emergency technology costs, hospital revenues, and patient-associated savings. Conclusion This study highlights various stakeholder perspectives on the financial impact of tele-emergency in avoiding patient transfers in rural emergency departments. Telemedicine has the potential to reduce the number of transfers of emergency department patients and generate some revenue for rural hospitals despite associated technology costs, while incurring substantial patient savings.

Hostile Takeovers and Anti-takeover Defenses in the Russian Corporate Market

2007 ◽  
pp. 70-84 ◽  
Author(s):  
E. Demidova
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Hostile Takeovers ◽  
Russian Market ◽  
Takeover Defenses ◽  
The Cost ◽  
European Markets

This article analyzes definitions and the role of hostile takeovers at the Russian and European markets for corporate control. It develops the methodology of assessing the efficiency of anti-takeover defenses adapted to the conditions of the Russian market. The paper uses the cost-benefit analysis, where the costs and benefits of the pre-bid and post-bid defenses are compared.

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 Intelligent transport systems deployment in Thessaloniki: Assessment of costs and benefits

Spatium ◽  
2015 ◽  
pp. 26-32
Author(s):  
Evangelos Mitsakis ◽  
Panagiotis Iordanopoulos ◽  
Evangelos Mintsis ◽  
Sokratis Mamarikas ◽  
Georgia Aifadopoulou
Keyword(s):  
Traffic Management ◽  
Travel Demand ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Sustainable Urban Development ◽  
Transport Systems ◽  
Costs And Benefits ◽  
Intelligent Transport Systems ◽  
Intelligent Transport ◽  
Transportation Projects

Transportation projects often require large initial investments and are expected to generate benefits extending far into the future. Thus, there is a need to compare benefits and costs that occur at different periods over time. Since money has a time value, the same amount of money at different time periods does not have the same value. Therefore, it is important to convert costs and benefits into equivalent values when conducting a Cost-Benefit Analysis (CBA). A special category of transportation projects is that of Intelligent Transport Systems (ITS). ITS comprise innovative solutions for travel demand and traffic management, and it is expected to play a key role in future sustainable urban development plans. Compared to other transportation projects, ITS have a lower initial investment. In this paper a framework based on a CBA is presented, assessing costs and benefits of three ITS projects implemented in Thessaloniki, Greece. The paper refers to future developments of ITS in the city of Thessaloniki. The examined systems have already been developed as demonstration systems in various regions throughout Europe. The benefits of the systems have been transferred and scaled up, so as to be in line with the specific characteristics of the Greek environment.

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 THE COST-BENEFIT ANALYSIS OF THE ROMANIAN NATIONAL GAMBLING OFFICE

2020 ◽  
Vol 13(62) (2) ◽  
pp. 157-166
Author(s):  
Ștefan Bulboacă ◽  
Ovidiu Mircea Țierean
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Economic Effects ◽  
Public Institution ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Societal Costs ◽  
Gambling Industry ◽  
The Cost ◽  
The Way

"This paper aims to evaluate the economic effects that the Romanian National Gambling Office has over the gambling industry and to determine whether this public institution brings enough benefits to cover the costs. The aim of the research was to gather information about the Romanian gambling industry, the way that this industry is managed and to make a comparison between its societal costs and benefits. "

PP017 Social Cost Benefit Analysis Of Cognitive Behavioral Therapy For Alcohol And Cannabis Addiction

2017 ◽  
Vol 33 (S1) ◽  
pp. 75-76
Author(s):  
Paul van Gils ◽  
Eelco Over ◽  
Anita Suijkerbuijk ◽  
Joran Lokkerbol ◽  
Ardine de Wit
Keyword(s):  
Quality Of Life ◽  
Traffic Accidents ◽  
Social Cost ◽  
Cost Benefit Analysis ◽  
Behavioral Therapy ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Addiction Care

INTRODUCTION:Due to their chronic nature and high prevalence, alcohol and cannabis addiction leads to a significant (disease) burden and high costs, both for those involved and for society. The latter includes effects on health care, quality of life, employment, criminality, education, social security, violence in the public and private domain, and traffic accidents. In the Netherlands, a considerable number of people with an alcohol or cannabis addiction currently do not receive addiction care. Cognitive Behavioral Therapy (CBT) is effective as a treatment for both alcohol and cannabis addiction and is widely used in specialized addiction care centers. This social cost-benefit analysis (SCBA) models costs and benefits of increasing the uptake of CBT for persons with an alcohol addiction and for adolescents with a cannabis addiction, taking into account a wide range of social costs and effects (1).METHODS:The method follows general Dutch guidance for performing SCBA. A literature search was conducted to evaluate efficacy of CBT for alcohol and cannabis dependence. In addition, the social costs of alcohol and cannabis addiction for society were mapped, and the costs of enhancing the uptake of CBT were explored. Costs and benefits of increased uptake of CBT for different social domains were modeled for a ten year period, and compared with current (unchanged) uptake during this period. Compliance problems (about 50 percent of clients do not finish CBT) and fall-back to addiction behavior (decrease of effects of CBT over time) were taken into account in model estimations.RESULTS:Per client treated with CBT, the estimated benefits to society are EUR10,000-14,000 and EUR9,700-13,000, for alcohol and cannabis addiction, respectively. These benefits result from reduced morbidity and mortality, improved quality of life, higher productivity, fewer traffic accidents, and fewer criminal activities.CONCLUSIONS:This SCBA shows that not only treated clients but also society will benefit from an increase in people treated with CBT in specialized addiction care centers.

Neonatal Intensive Care: Cost-Benefit Analysis

PEDIATRICS ◽  
1985 ◽  
Vol 75 (4) ◽  
pp. 798-799
Author(s):  
DONALD N. MANGRAVITE
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Tertiary Level ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Benefit Ratio ◽  
Comprehensive Examination ◽  
Cost Benefit Ratio

To the Editor.— I would like to commend Walker and colleagues1 for their comprehensive examination of the costs and benefits of neonatal intensive care for infants weighing less than 1,000 grams. However, examining only one group of infants served by a tertiary neonatal intensive care unit (NICU) can be misleading. By definition, a tertiary level NICU is designed to provide a broad range of services to infants with a wide variety of illnesses. As is true for any system expected to provide a broad range of services, some services will result in a more favorable cost-benefit ratio than others.

scholarly journals Guide to cost benefit analysis of community-based interventions

2014 ◽  
Vol 3 (5) ◽  
pp. 47
Author(s):  
Sanni Yaya ◽  
Xiaonan Li
Keyword(s):  
Net Present Value ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Ratio ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Community Based Interventions ◽  
Community Based ◽  
Benefit Cost Ratio ◽  
The Cost

This paper offers a general guide on how to conduct a proper economic analysis for community-based intervention projects. Identification and quantification of costs and benefits are the focus of the cost benefit analysis. We categorize costs and benefits from human and physical perspectives and pay special attention to the measures of saving human lives accompanied by the proposed calculation methods. We recommend net present value and benefit-cost ratio as the criteria to assess projects and highlight some challenges remaining in the analysis.

scholarly journals P013: Inter-facility transfers for CT scans from a rural emergency department: a pilot study

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S82-S82
Author(s):  
C. Bergeron ◽  
I. Lavallée-Bourget ◽  
F.K. Tounkara ◽  
R. Fleet
Keyword(s):  
Pilot Study ◽  
Rural Areas ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Ct Scans ◽  
Annual Number ◽  
Ct Scanner ◽  
Life Threatening ◽  
Ed Visits ◽  
Transfer Times

Introduction: Rural emergency departments (EDs) are an important gateway to care for the 20% of Canadians who live in rural areas. We recently reported that fewer than 15% of rural EDs in Canada have access to a CT scanner. Lack of CT scanners in rural hospitals can result in frequent inter-facility transfers and delays in diagnosing and treating life-threatening conditions. No recent study has examined this issue. Objective: With a future larger study in mind, we did a pilot assessment of inter-facility transfers for CT scans from one rural ED and evaluated the quality of the data and feasibility. Methods: This pilot study was part of our province-wide study on rural emergency care. Criteria were having 24/7 physician coverage and acute-care hospitalization beds. The hospital was also selected for its proximity and local interest. Two medical students collected data from hospital databases to determine annual number of ED visits, ED transfers, proportion of transfers for CT scans, reasons for examinations, and transfer times from April 1, 2010 to March 31, 2015. Descriptive statistics were reported as well as data quality and feasibility indicators. Results: For each year from 2010 to 2014, there was an average of 13,341 ED visits, 444 inter-facility transfers, and 125 CT scans. Over the five years an average of 28% of the inter-facility transfers were for CT scans, and the majority were abdominal CT scans. Inter-facility transfer data was 100% accessible through hospital databases but inter-facility transfer times and final diagnoses were not. Conclusion: More than a quarter of inter-facility transfers were for CT imaging. The limited electronic data in this Quebec rural ED precluded analysis of inter-facility times. While further cost-benefit analysis is required, preliminary data suggests local CTs may save time, money and lives.

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