Clinical and cost-effectiveness conducted simultaneous operations in women with combined surgical and extragenital gynecological pathology

2017 ◽  
pp. 93-97
Author(s):  
V.L. Dronova ◽  
◽  
O.I. Dronov ◽  
O.V. Lutsenko ◽  
R.S. Teslyuk ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Economic Efficiency ◽  
Surgical Pathology ◽  
Simultaneous Operation ◽  
Significant Prolongation ◽  
Medical Institutions ◽  
Simultaneous Operations ◽  
Planning Department ◽  
The Cost

The article presents data of economic efficiency of simultaneous operations in women with combined surgical and extra-gynecological pathology, allowing rational use of material and technical base of medical institutions, and conducted simultaneous operations leading to significant financial savings, both in hospital and at the outpatient . The objective: to determine the clinical and economic effectiveness of simultaneous operations in women with combined extra-gynecological and surgical pathology operated in the department of operative gynecology control IPOG (Institute of Pediatrics, Obstetrics and Gynecology) NAMS of Ukraine for 2015 and modified using special formulas. Patients and methods. The study laid out a retrospective analysis of the immediate results of surgical treatment of 40 patients department of operative gynecology control IPOG NAMS Ukraine. The calculation was performed on the following parameters: value of preoperative examination, providing perioperative medical support, operational support, anesthesia and postoperative laboratory monitoring. Results. Analysis of the research shows that simultaneous operation in two to three times shortens the patient’s stay in hospital and the duration of temporary disability, three times increases the cost-effectiveness of treatment and improve the quality of life of patients. To increase the profitability of the surgical departments recommended minimum break-even calculate the intensity of operations, which is the base for operational planning department. Conclusion. Conducting simultaneous operations in women with combined extra-gynecological and surgical pathology can effectively reduce the cost of surgical treatment of patients with no significant prolongation of the transaction period and the postoperative period. Simultaneous operations may be performed in specialized hospitals with modern equipment available and a multidisciplinary team of surgeons in identifying women with two or more diseases requiring surgical correction. Key words: simultaneous operation, economic efficiency, combined surgical and gynecological extragenital pathology in women.

scholarly journals The Cost-Effectiveness of Surgical Treatment of Medial Unicompartmental Knee Osteoarthritis in Younger Patients

2015 ◽  
Vol 97 (10) ◽  
pp. 807-817 ◽  
Author(s):  
Joseph F. Konopka ◽  
Andreas H. Gomoll ◽  
Thomas S. Thornhill ◽  
Jeffrey N. Katz ◽  
Elena Losina
Keyword(s):  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Knee Osteoarthritis ◽  
Younger Patients ◽  
Unicompartmental Knee ◽  
The Cost

scholarly journals Incremental cost-effectiveness of adult spinal deformity surgery: observed quality-adjusted life years with surgery compared with predicted quality-adjusted life years without surgery

2014 ◽  
Vol 36 (5) ◽  
pp. E3 ◽  
Author(s):  
Ian McCarthy ◽  
Michael O'Brien ◽  
Christopher Ames ◽  
Chessie Robinson ◽  
Thomas Errico ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Incremental Cost ◽  
Adult Spinal Deformity ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Nonsurgical Patients ◽  
The Cost ◽  
Quality Adjusted Life

Object Incremental cost-effectiveness analysis is critical to the efficient allocation of health care resources; however, the incremental cost-effectiveness ratio (ICER) of surgical versus nonsurgical treatment for adult spinal deformity (ASD) has eluded the literature, due in part to inherent empirical difficulties when comparing surgical and nonsurgical patients. Using observed preoperative health-related quality of life (HRQOL) for patients who later underwent surgery, this study builds a statistical model to predict hypothetical quality-adjusted life years (QALYs) without surgical treatment. The analysis compares predicted QALYs to observed postoperative QALYs and forms the resulting ICER. Methods This was a single-center (Baylor Scoliosis Center) retrospective analysis of consecutive patients undergoing primary surgery for ASD. Total costs (expressed in 2010 dollars) incurred by the hospital for each episode of surgical care were collected from administrative data and QALYs were calculated from the 6-dimensional Short-Form Health Survey, each discounted at 3.5% per year. Regression analysis was used to predict hypothetical QALYs without surgery based on preoperative longitudinal data for 124 crossover surgical patients with similar diagnoses, baseline HRQOL, age, and sex compared with the surgical cohort. Results were projected through 10-year follow-up, and the cost-effectiveness acceptability curve (CEAC) was estimated using nonparametric bootstrap methods. Results Three-year follow-up was available for 120 (66%) of 181 eligible patients, who were predominantly female (89%) with average age of 50. With discounting, total costs averaged $125,407, including readmissions, with average QALYs of 1.93 at 3-year follow-up. Average QALYs without surgery were predicted to be 1.6 after 3 years. At 3- and 5-year follow-up, the ICER was $375,000 and $198,000, respectively. Projecting through 10-year follow-up, the ICER was $80,000. The 10-year CEAC revealed a 40% probability that the ICER was $80,000 or less, a 90% probability that the ICER was $90,000 or less, and a 100% probability that the ICER was less than $100,000. Conclusions Based on the WHO's suggested upper threshold for cost-effectiveness (3 times per capita GDP, or $140,000 in 2010 dollars), the analysis reveals that surgical treatment for ASD is cost-effective after a 10-year period based on predicted deterioration in HRQOL without surgery. The ICER well exceeds the WHO threshold at earlier follow-up intervals, highlighting the importance of the durability of surgical treatment in assessing the value of surgical intervention. Due to the study's methodology, the results are dependent on the predicted deterioration in HRQOL without surgery. As such, the results may not extend to patients whose HRQOL would remain steady without surgery. Future research should therefore pursue a direct comparison of QALYs for surgical and nonsurgical patients to better understand the cost-effectiveness of surgery for the average ASD patient.

scholarly journals EVALUATION OF THE COST-EFFECTIVENESS OF THE PUBLIC SECTOR SERVICES: VARIABILITY OF THE METHODOLOGICAL TOOLS

2019 ◽  
Vol 8 (4) ◽  
pp. 34-48
Author(s):  
Oksana Yurievna Dyagel
Keyword(s):  
Health Insurance ◽  
Cost Effectiveness ◽  
Public Sector ◽  
Economic Effects ◽  
The Public ◽  
Medical Institutions ◽  
Compulsory Health Insurance ◽  
Definition Of ◽  
The Cost ◽  
Analytical Tools

The purpose of the article was to reveal the analytical tools for evaluating the effectiveness of the allocated financing funds for the provision of the services provided in the public sector of the economy, the application of which does not have a uniform methodology today. The possibility to solve this issue is shown with regard to the compulsory health insurance system. To achieve the goal, the study reveals the definition of such categories as “effect” and “efficiency” of the medical institutions activities, “efficiency of spending” of the Territorial Fund for Compulsory Health Insurance. There is revealed the analytical significance of the existing methodological approaches to assessing the effectiveness of health care costs; their comparative analysis is carried out. Based on the results, the alternative is proposed, based on the system of the cost-effectiveness indices to achieve the health, social and economic effects of medical institutions; the analytical advantages of the alternative proposed are justified.

Analysis of the telemedical services application results in the Novosibirsk region

2020 ◽  
pp. 110-117
Author(s):  
Е.Е. Истратова ◽  
В.А. Астапчук
Keyword(s):  
Regression Model ◽  
Multiple Regression ◽  
Economic Efficiency ◽  
Systematic Approach ◽  
Economic Effect ◽  
Multiple Regression Model ◽  
Novosibirsk Region ◽  
Medical Institutions ◽  
The Cost ◽  
Services Effectiveness

В статье приведены результаты исследования динамики применения телемедицины на базе государственных лечебно-профилактических учреждений Новосибирска и Новосибирской области в период с 2004 по 2019 годы. Для оценки экономической эффективности оказания телемедицинских услуг был использован системный подход, основанный на сопоставлении стоимости, качества и объемов телемедицинских услуг с экономическим эффектом, получаемым в результате. В ходе исследования была построена множественная регрессионная модель, которую можно применять для прогнозирования эффективности оказываемых телемедицинских услуг в Новосибирской области. The article includes the results of the study of the use of telemedicine dynamics on the basis of state medical institutions in Novosibirsk and the Novosibirsk region in the period from 2004 to 2019. To assess the economic efficiency of telemedicine services provision, a systematic approach was used. It was based on a comparison of the cost, quality and volume of telemedicine services with the economic effect obtained as a result. During the study, a multiple regression model was constructed that can be used to predict the telemedicine services effectiveness provided in the Novosibirsk Region.

scholarly journals New Approach of Costs of Quality According their Trend of During Long Period in Industrial Enterprises in SMEs

2021 ◽  
Vol 29 (1) ◽  
pp. 20-26
Author(s):  
Katarína Teplická ◽  
Soňa Hurná
Keyword(s):  
Cost Effectiveness ◽  
Economic Efficiency ◽  
Cost Ratio ◽  
Cost Index ◽  
Cost Of Quality ◽  
Average Value ◽  
Industrial Enterprises ◽  
Long Period ◽  
Quality Costs ◽  
The Cost

AbstractVery important in SMEs is to monitor cost of quality and economic indicators for valuation of cost effectiveness. The main goal of this article is to create classification on cost quality categories in SMEs and to analyze economic quality indicators and their trend during long period. In this article authors use economical and statistical indicators for costs of quality. We use common model PAF, that include prevention costs, evaluation costs, internal failure costs, external failure costs. Total costs, individual simple cost index, cost ratio and cost structure were used. We analyzed data from 50 small enterprises with 10-40 employees with their yearly turnover max 3 mil €. The research sample of enterprises was focused on industrial areas of business such as engineering, metallurgy, automotive industry. We analyzed the quality costs in SMEs by the average value of quality cost in all surveyed enterprises. Results of this research brought labeling of cost of quality in SMEs by model the PAF for 10 categories for various enterprises, what is very important for comparing of results of QMS in SMEs. Based on the reference indicators of the total costs of quality in SMEs we can conclude their drop. Reducing the costs of quality was reflected in particular in reducing the costs of internal and external errors. In assessing the economic efficiency in SMEs plays an important role the overall cost that were increasing in reporting period. Very important result is that the cost of quality did not influenced overall cost. This fact is positive for competitiveness in SMEs because it shows a quality of production and product. Reducing of cost of quality brought improving of product quality; reduced customer’s complaints brought financial savings. The economic efficiency indicator shows a value above e > 1. It means that, despite rising cost enterprises generate revenues that are significantly higher than the input factors of production. Cost effectiveness helps to improve TQM performance.

scholarly journals THE ANALYSIS AND ESTIMATION OF ECONOMIC EFFICIENCY OF RISK MANAGEMENT

2015 ◽  
pp. 72-83 ◽  
Author(s):  
V. A. Makarova
Keyword(s):  
Risk Management ◽  
Cost Effectiveness ◽  
Economic Impact ◽  
Economic Efficiency ◽  
Wide Range ◽  
The Cost ◽  
Corporate Government

Enterprise-wide risk management is a relatively new scientific and practical area of a corporate government, which has a special mission to deal with corporate risks and exposures and to achieve beneficial risk management outcomes. Risk management has a wide range of methods, techniques and tools, but quite expensive, but in the case of a successful application, can stimulate an increase in the company's value. Nevertheless, despite its relevance, risk management reluctantly introduced to the company, this is due, primarily, to the inability to pre-determine the economic impact of existing activities. Most methods for assessing the cost-effectiveness of risk management, as a rule, designed to assess the economic impact after the fact, in this article, the author has provided the tools for assessing the financial and economic impact of the implementation of risk management in advance.

Imaging versus Intervention in Managing Small Unruptured Intracranial Aneurysms: A Cost-Effectiveness Analysis

2021 ◽  
pp. 1-11
Author(s):  
Clark A. Veet ◽  
Stephen Capone ◽  
David Panczykowski ◽  
Natasha Parekh ◽  
Kenneth J. Smith ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Active Surveillance ◽  
Intracranial Aneurysms ◽  
Surgical Complication ◽  
Cost Effective ◽  
Anterior Circulation ◽  
Complication Risk ◽  
Immediate Surgery ◽  
The Cost

<b><i>Objective:</i></b> Current guidelines recommend active surveillance with serial magnetic resonance angiography (MRA) for management of small, asymptomatic unruptured anterior circulation aneurysms (UIAs). We sought to determine the cost-effectiveness of active surveillance compared to immediate surgery. <b><i>Methods:</i></b> We developed a Markov cost-effectiveness model simulating patients with small (&#x3c;7 mm) UIAs managed by active surveillance via MRA, immediate surgery, or watchful waiting. Inputs for the model were abstracted from the literature and used to construct a comprehensive model following persons from diagnosis to death. Outcomes were quality-adjusted life-years (QALYs), lifetime medical costs (2015 USD), and incremental cost-effectiveness ratios (ICERs). Cost-effectiveness, deterministic, and probabilistic sensitivity analyses were performed. <b><i>Results:</i></b> Immediate surgical treatment was the most cost-effective management strategy for small UIAs with ICER of USD 45,772 relative to active surveillance. Sensitivity analysis demonstrated immediate surgery was the preferred strategy, if rupture rate was &#x3e;0.1%/year and if the diagnosis age was &#x3c;70 years, while active surveillance was preferred if surgical complication risk was &#x3e;11%. Probabilistic sensitivity analysis demonstrated that at a willingness-to-pay of USD 100,000/QALY, immediate surgical treatment was the most cost-effective strategy in 64% of iterations. <b><i>Conclusion:</i></b> Immediate surgical treatment is a cost-effective strategy for initial management of small UIAs in patients &#x3c;70 years of age. While more costly than MRA, surgical treatment increased QALY. The cost-effectiveness of immediate surgery is highly sensitive to diagnosis age, rupture rate, and surgical complication risk. Though there are a wide range of rupture rates and complications associated with treatment, this analysis supports the treatment of small, unruptured anterior circulation intracranial aneurysms in patients &#x3c;70 years of age.

Is-it worth investing in NBS aiming at mitigating water risks? Insights from the economic assessment of NAIAD case studies

2020 ◽  
Author(s):  
Philippe Le Coent ◽  
Cécile Herivaux ◽  
Javier Calatrava ◽  
Roxane Marchal ◽  
David Mouncoulon ◽  
...  
Keyword(s):  
Risk Management ◽  
Cost Effectiveness ◽  
Case Studies ◽  
Economic Efficiency ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Economic Assessment ◽  
Physical Models ◽  
Valuation Methods ◽  
The Cost

&lt;p&gt;The economic advantage of NBS solutions aiming at mitigating water-risk is widely put forward as an argument for their development. There is nevertheless limited scientific evidence to support this argument. This paper therefore elaborates a methodological framework for the economic assessment of NBS and presents its application to three NAIAD case studies (the Lez catchment, France; Rotterdam, the Netherlands and Brague catchment, France). Robust methods are particularly applied for the estimation of the benefits associated with NBS. Physical models coupled with damage estimation models are developed to estimate the avoided damages generated by NBS. A diversity of ecosystem service valuation methods are also applied to evaluate the monetary value of NBS co-benefits: contingent valuation (Brague), choice experiment (Lez) and direct valuation methods (Rotterdam). We estimate the cost of implementation and maintenance mainly through the transfer of values coming from studies in similar contexts. Proxies are used to estimate the opportunity costs associated with the development of NBS. Finally, these estimations are compiled in a cost-benefit indicator allowing the estimation of the economic efficiency of NBS strategies. The study confirms that the cost of implementation and maintenance of NBS strategies is lower than the cost of grey solutions for the same level of water risk management, emphasizing the better cost-effectiveness of these solutions. Benefits in terms of avoided damages are however not sufficient to cover investment and maintenance costs. The cost&amp;#8211;effectiveness of NBS strategies, which are combinations of individual NBS measures, may be improved by combining cost effective individual NBS measures. There is indeed a very large heterogeneity of cost-effectiveness of individual NBS measures (cost/m&lt;sup&gt;3&lt;/sup&gt; of water retention). Results also reveal that co-benefits represent the largest share of the value generated by NBS strategies. It is therefore of utmost importance that co-benefits are integrated in the economic valuation of NBS for them to be judged economically efficient. This conclusion must be taken into account in the elaboration of NBS funding strategies.There is finally no clear-cut conclusion on the overall economic efficiency of NBS throughout the case studies. Lez reveal a positive cost-benefit analysis, while Rotterdam and Brague cases do not. Results are therefore case-specific and confirm the importance to carry out thorough economic valuations of a diversity of strategies at each sites, including NBS, grey and hybrid solutions, in order to identify the most adequate strategy for water risk management and to address territorial challenges.&lt;/p&gt;

scholarly journals Cost-Effectiveness of Percutaneous Automated Lumbar Nucleotomy

1999 ◽  
Vol 5 (1) ◽  
pp. 35-42 ◽  
Author(s):  
R. Dullerud ◽  
H. Lie ◽  
B. Magnæs
Keyword(s):  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Lumbar Disc ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Clinical Results ◽  
Complication Rates ◽  
Success Rates ◽  
One Year ◽  
The Cost

This study was conducted in order to evaluate the cost-effectiveness of percutaneous automated lumbar nucleotomy in comparison with traditional macro-procedure discectomy in the treatment of herniated discs. Sixty-eight patients undergoing surgical procedures and 90 treated with nucleotomy were consecutively included. Both cohorts were assessed pre-operatively and at regular intervals for one year or more after treatment by independent observers, using a clinical overall scoring system (COS) with 0 being the best attainable result and 1000 the poorest conceivable status of the patients. There were better clinical results after surgery with 78% successes after one year compared to 62% after nucleotomy. By including subsequent operations and re-operations after failure to respond to the primary treatment, the success rates rose to 79% and 77%, respectively. The cost of surgical treatment was calculated to USD 6.119 per patient and the cost of a nucleotomy procedure was USD 1.252. Owing to an almost five times higher price of surgery than nucleotomy, the latter turned out to be 2.7 to 3.9 times more cost-effective, depending on whether secondary treatment was included or not. Due to the minimal difference in final outcome between the groups, however, the marginal cost per extra success in patients primarily treated with surgery was as high as USD 205.850. The study concludes that nucleotomy, as a mini-invasive procedure with low complication rates and the potential of a quick recovery, is more cost-effective than traditional surgical treatment for lumbar disc herniation.

Sign in / Sign up

Export Citation Format

Share Document