scholarly journals Cost Effectiveness Analysis of Crystalloid and Crystaloid-Colloid Combination on Dengue Fever without Shok in Bhakti Asih General Hospital Tangerang

2018 ◽  
Vol 8 (2) ◽  
pp. 70
Author(s):  
Suratni Suratni ◽  
Yusi Anggriani ◽  
Agusdini Banun
Keyword(s):  
Dengue Fever ◽  
Study Groups ◽  
Medical Patients ◽  
Cost Of Treatment ◽  
Total Cost ◽  
Effectiveness Analysis ◽  
Significant Difference ◽  
High Incidence ◽  
The Mean ◽  
Mean Cost

Dengue fever is an infectious disease caused by virus transmitted through Aedes aegypty. The high incidence dengue fever can lead to increased healthcare costs. This study was conducted to analyze the effectiveness and direct cost of medical patients dengue fever without shock use fluid therapy by comparing crystalloid and crystalloid colloid combination. The subjects were 171 patients divided into two groups: 106 patients with crystalloid and 65 patients with crystalloid colloid combination. Assessed of effectiveness treatment and the mean medical costs. The results showed reviewed from hematocrit value no difference (p>0.05) in both study groups. The mean total cost of treatment for crystalloid Rp 4.005.223, the crystalloid colloid combination Rp 5.525.407. The highest cost of drug costs was 31.75% of the total cost crystalloid, 40.9% of the total cost crystalloid colloid combination. There was a significant difference between mean cost and two study groups (p0.05) with effectiveness treatment. Conclusion crystalloid have the same effectiveness as crystalloid colloid combination fluids at lower costs.

scholarly journals Cost-effectiveness of using stone cone, balloon dilator, stone basket, and entrapment device in ureteroscopic laser lithotripsy for ureteric stones

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110610
Author(s):  
Kürşat Çeçen
Keyword(s):  
Laser Lithotripsy ◽  
Secondary Treatment ◽  
Auxiliary Equipment ◽  
Total Cost ◽  
End Of Treatment ◽  
Significant Difference ◽  
Total Treatment ◽  
The Mean ◽  
Mean Cost ◽  
First Time

Objective To evaluate the costs and stone-free rates of ureteroscopic laser lithotripsy (ULL) performed with and without auxiliary equipment and to compare first-time ULL with total treatment. Methods One hundred patients who underwent first-time ULL without the use of auxiliary equipment because its unavailability comprised the no-device ULL (ndULL) group. Additionally, 100 patients who underwent first-time ULL with the use of auxiliary equipment when necessary comprised the device ULL (dULL) group. Results In the ndULL and dULL groups, the stone-free rates after first-time ULL were 72% and 94% and the mean cost was US $1037 ± 15.10 and US $1452 ± 19.80 per case, respectively, with a statistically significant difference. The stone-free rates at the end of treatment were 98% and 99%, respectively, without a statistically significant difference. When secondary treatment costs were added to the first ULL costs after failed treatment, the mean total cost was US $1625 ± 12.60 in the ndULL group and US $1566 ± 11.01 in the dULL group without a statistically significant difference. Conclusions The stone-free rates and costs after first-time ULL were significantly different between the groups. However, after total treatment, there was no statistically significant difference between the two groups.

Comparison of stapler and handsewn anastomosis techniques in creating an ileal conduit following radical cystectomy

2021 ◽  
pp. 1
Keyword(s):  
Postoperative Complications ◽  
Ileal Conduit ◽  
Perioperative Complications ◽  
Movement Time ◽  
Oral Intake ◽  
Total Cost ◽  
Handsewn Anastomosis ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

Background and objective: Ileal conduit for urinary diversion can be completed using either end-to-end handsewn or stapled anastomosis. This study aimed to compare stepled and handsewn anastomosis methods in terms of complications, hospitalization and cost. Materials and methods: Forty-three patients were included in the hand-sewn and 44 patients in the stapler group. After creating an ileal conduit, continuity of the loop was achieved either with handsewn or stapler method. Patients' demographic data, time to onset of bowel movement, time to transit to oral intake, time to removal of the drain, perioperative and postoperative complications, mortality and total costs were retrospectively recorded and compared between the two groups. Results: There was no statistically significant difference between the groups in terms of the mean to the onset of bowel movements (p = 0.51) and the mean time to transit to oral intake (p = 0.23). The mean time to removal of the drain was significantly lower in the stapler group (p = 0.023). Perioperative complications were seen in eight patients in the handsewn group, while none of the patients in the stapler group developed perioperative complication (p = 0.003). Postoperative complications were similar between both groups (p = 0.75). The duration of hospitalization was statistically significantly lower in the stapler group (p = 0.004) and the mean total cost was statistically significantly more advantageous (p < 0.001). Conclusion: No significant difference was found between stapler and handsewn anastomosis techniques in terms of postoperative complications. On the other hand, hospitalization and total cost were in favour of stapler technique, showing that this technique can be used safely.

scholarly journals Potato Late Blight in the Columbia Basin: An Economic Analysis of the 1995 Epidemic

Plant Disease ◽  
1997 ◽  
Vol 81 (1) ◽  
pp. 103-106 ◽  
Author(s):  
D. A. Johnson ◽  
T. F. Cummings ◽  
P. B. Hamm ◽  
R. C. Rowe ◽  
J. S. Miller ◽  
...  
Keyword(s):  
Late Blight ◽  
Management Practice ◽  
Columbia Basin ◽  
Copper Hydroxide ◽  
Total Cost ◽  
Late Season ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
First Time

The cost of managing late blight in potatoes during a severe epidemic caused by new, aggressive strains of Phytophthora infestans in the Columbia Basin of Washington and Oregon in 1995 was documented. The mean number of fungicide applications per field varied from 5.1 to 6.3 for early- and midseason potatoes, and from 8.2 to 12.3 for late-season potatoes in the northern and southern Columbia Basin, respectively. In 1994, a year when late blight was not severe, the mean number of fungicide applications per field made to early- and midseason potatoes was 2.0; whereas late-season potatoes received a mean of 2.5 applications. The mean per acre cost of individual fungicides applied varied from $4.90 for copper hydroxide to $36.00 for propamocarb + chlorothalonil. Total per acre expenses (application costs plus fungicide material) for protecting the crop from late blight during 1995 ranged from $106.77 to $110.08 for early and midseason potatoes in different regions of the Columbia Basin and from $149.30 to $226.75 for lateseason potatoes in the northern and southern Columbia Basin, respectively. Approximately 28% of the crop was chemically desiccated before harvest as a disease management practice for the first time in 1995, resulting in an additional mean cost of $34.48/acre or $1.3 million for the region. Harvested yields were 4 to 6% less than in 1994. The total cost of managing late blight in the Columbia Basin in 1995 is estimated to have approached $30 million.

scholarly journals Efficacy of intrathecal midazolam on enhancing analgesic effect of fentanyl in patients undergoing lower limb surgery

2018 ◽  
Vol 5 (10) ◽  
pp. 2726-2732
Author(s):  
Masoum Khoshfetrat ◽  
Sima Davarpanah ◽  
Aliakbar Keykha
Keyword(s):  
Nerve Block ◽  
Lower Limb ◽  
Analgesic Effect ◽  
Synergistic Effects ◽  
Sensory Nerve ◽  
Study Groups ◽  
The Third ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
The Mean

Background: Co-administration of drugs with synergistic effects is considered as one of the methods to increase the effectiveness of intrathecal anesthesia and to reduce the need for injectable analgesics. The purpose of this study was to investigate the efficacy of intrathecal midazolam on enhancing the analgesic effect of fentanyl in patients undergoing lower limb surgery. Materials: The present double-blinded clinical trial was conducted on 90 candidate patients undergoing lower limb orthopedic surgery in 2017 at Khatam-Al-Anbiya Hospital in the city of Zahedan, Iran. To this end, the patients were selected via convenience sampling method and then randomly divided into three groups. Afterwards, 3 cc of 0.5% hyperbaric Marcaine was injected intrathecally in the first group, 3 cc of Marcaine + 25 ug of fentanyl was administered to the second group, and 3 cc of Marcaine + 25 ug of fentanyl + 1 mg of midazolam was administered to the third group (the final volume of all three syringes was brought up to 3.7 cc with normal saline). The duration of sensory nerve block and those of motor block and analgesia, as well as changes in vital signs, were then measured in these groups. Moreover, the data were analyzed using SPSS Statistics (Version 22.0) through Chi-square test and one-way analysis of variance (ANOVA). Results: The mean age and gender distribution of the patients in the three study groups did not differ significantly. The mean duration of sensory nerve block was equal to 98.6+/-11.1 min in the first group, 142.2+/-12.4 min in the second group, and 174.3+/-10.9 min in the third group; all showed a statistically significant difference (P=0.0001, P=0.001, P=0.000).The mean duration of analgesia was also reported to be 204.43+/-0.3 min in the first group, 323.62+/-7.4 min in the second group, and 526.22+/-0.9 min in the third group, indicating a statistically significant difference between the three study groups (P=0.0001, P=0.000, P=000). Conclusion: The results of this study demonstrated that adding midazolam to intrathecal fentanyl could significantly increase the duration of sensory nerve block and that of post-operative analgesia.  

scholarly journals Costs of care provided in a university hospital for children exposed to or infected with the HIV/AIDS

2007 ◽  
Vol 23 (suppl 3) ◽  
pp. S402-S413 ◽  
Author(s):  
Heloisa Helena de Sousa Marques ◽  
Bernard François Couttolenc ◽  
Maria do Rosário Dias de Oliveira Latorre ◽  
Maria Zilda de Aquino ◽  
Maria Ignez Garcia Aveiro ◽  
...  
Keyword(s):  
Medical Records ◽  
University Hospital ◽  
Accounting System ◽  
Cost Of Treatment ◽  
Costs Of Treatment ◽  
The Mean ◽  
Cost Accounting System ◽  
The Cost ◽  
Mean Cost ◽  
Hiv Aids

The objective of this study was to estimate and analyze the costs of treating children with HIV/AIDS at a university hospital in São Paulo, Brazil. The study collected and analyzed data from 291 medical records of children treated at the hospital as of March 2002. The costs of treatment were estimated for each category of patient (exposed and infected) and severity, based on the quantity of inputs and procedures used in treating each child, based on the cost accounting system used at the hospital. The total cost of treatment for children exposed to the HIV was R$ 956.41 and for those infected with HIV R$ 8,092.71 per year. The mean cost of ambulatory care was R$ 6,047.28 for children with severe conditions, R$ 3,714.45 for those with light/moderate conditions, and R$ 948.63 for the exposed. Hospitalized children had annual costs of R$ 19,353.34, R$ 18,823.16, and R$ 871.03, respectively. The medication was a major factor in the cost of treatment. Our estimates are comparable to the findings from other studies, but lower than corresponding findings from the international literature.

scholarly journals Uromyces appendiculatus in Honduras: Pathogen Diversity and Host Resistance Screening

Plant Disease ◽  
2013 ◽  
Vol 97 (5) ◽  
pp. 652-661 ◽  
Author(s):  
Maricelis Acevedo ◽  
James R. Steadman ◽  
Juan C. Rosas
Keyword(s):  
Uromyces Appendiculatus ◽  
Bean Rust ◽  
Sources Of Resistance ◽  
Pathogen Diversity ◽  
Major Constraint ◽  
Sampling Locations ◽  
Significant Difference ◽  
High Incidence ◽  
The Mean ◽  
Virulence Diversity

Bean rust, caused by the fungus Uromyces appendiculatus, is a major constraint for common bean production worldwide. Virulence of U. appendiculatus collected from wild and cultivated Phaseolus spp. was examined in 28 locations across Honduras. Host accessions representing wild and domesticated Phaseolus spp. collected at the same sampling locations were evaluated for resistance against U. appendiculatus. In total, 91 pathotypes were identified from 385 U. appendiculatus isolates according to their virulence on each of the 12 host differentials. No significant difference in pathogen total virulence, measured as the mean disease score, was found between locations. However, significant differences were found in pathotype virulence among isolates collected from different Phaseolus spp. within a location. Moreover, when locations were compared on the basis of pathotype occurrence and frequency, differences among locations were evident. No two locations had the same pathotype composition. The most common pathotype was virulent on 9 of the 12 differential lines. A high number of resistant accessions were identified in Phaseolus coccineus and P. lunatus. Although most wild P. vulgaris accessions were highly susceptible, rust resistance was observed in P. vulgaris landraces collected from farmer's fields. Thirty-two (52%) of the accessions screened showed intermediate to high levels of resistance and, of those, 16% were P. coccineus accessions. Our findings support the hypothesis that interaction of U. appendiculatus in host populations composed of diverse Phaseolus spp. and genotypes has favored highly diverse and virulent pathotypes, creating a center for virulence diversity of the pathogen in Honduras. The high percentage of intermediate and highly resistant accessions identified in the present study supports the strategy of collecting plants from the center of diversity of a pathogen or in locations with high incidence of disease and pathogen diversity to maximize the probability of identifying new sources of resistance.

scholarly journals Implementation strategy and cost of Mozambique’s HPV vaccine demonstration project

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Caroline Soi ◽  
Joseph B. Babigumira ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Annual Cost ◽  
Implementation Strategy ◽  
National Level ◽  
Vaccine Dose ◽  
Demonstration Project ◽  
Total Cost ◽  
School Based ◽  
The Mean ◽  
Mean Cost

Abstract Background Cost is an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total costs for the program, cost per fully immunized girl (FIG), and compute projections for the total cost of implementing a similar national level vaccination program. Methods We collected primary data through document review, participatory observation, and key informant interviews at all levels of the national health system and Ministry of Education. We used a combination of micro-costing methods—identification and measurement of resource quantities and valuation by application of unit costs, and gross costing—for consideration of resource bundles as they apply to the number of vaccinated girls. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique, to demonstrate the projected total annual cost for two scenarios of a similarly executed HPV vaccine program. Results The total cost of the Mozambique HPV vaccine demonstration project was $523,602. The mean cost per FIG was $72 (Credibility Intervals (CI): $62 - $83) in year one, $38 (CI: $37 - $40) in year two, and $54 CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from consideration was $60 (CI: $50 - $72) in year one, $38 (CI: $31 - $46) in year two, and $48 (CI: $42 - $55) for years one and two. The mean cost per FIG when only one HPV vaccine dose is considered was $30 (CI: $27 - $33)) in year one, $19 (CI: $15–$23) in year two, and $24 (CI: $22–$27) for both years. The projected annual cost of a two-and one-dose vaccine program targeting all 10-year-old girls in the country was $18.2 m (CI: $15.9 m - $20.7 m) and $9 m (CI: $8 m - $10 m) respectively. Conclusion National adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy may result in substantial costs depending on dosing. For sustainability, stakeholders will need to negotiate vaccine price and achieve higher efficiency in startup activities and demand creation.

scholarly journals Expenditure survey on continued veno-venous hemodialysis procedure in the intensive care unit

2007 ◽  
Vol 15 (6) ◽  
pp. 1138-1143 ◽  
Author(s):  
Lígia Maria dal Secco ◽  
Valéria Castilho
Keyword(s):  
Total Expenditure ◽  
Procedure Time ◽  
Time Duration ◽  
Total Cost ◽  
Acute Renal Insufficiency ◽  
Male Patients ◽  
The Mean ◽  
Procedure Duration ◽  
Mean Cost ◽  
Dialytic Treatment

This study aimed to characterize patients submitted to dialytic treatment with CVVHD in ICUs; monitor procedure time duration; estimate nurses' labor wages and; estimate the direct procedures mean costs. The study was developed in a public teaching hospital located in São Paulo, Brazil. A total of 93 procedures performed in 50 patients composed the sample. The results showed the predominance of male patients (62%); mean age was 60.8 years old; ICU hospitalization time was 19.2 days; 86% of the patients died; 76% of the patients presented acute renal insufficiency and, mean procedure time per patient was 1.9. The mean procedure duration was 26.6 hours. The mean cost of nurses' wages were R$ 592.04 which represented 28.7% of the total cost. The mean total expenditure was R$ 2,065.36 ranging from R$ 733.65 to R$ 6,994.18.

scholarly journals Effects of eye cover among high risk neonates at night shift on their distress levels

2019 ◽  
Vol 9 (7) ◽  
pp. 9
Author(s):  
Eman Ali Moselhi Mater ◽  
Huda Shawky Mahamud ◽  
Mohamed Farouk Mohamed
Keyword(s):  
High Risk ◽  
Night Shift ◽  
Newborn Infants ◽  
Study Groups ◽  
University Hospital ◽  
Control Group ◽  
Stressful Environment ◽  
Distress Level ◽  
Significant Difference ◽  
The Mean

Background and aim: The Neonatal Intensive Care Unit (NICU) is a stressful environment for high risk neonates. Persistent bright light is one of the main environmental stressors that are distressed newborn infants in NICU. Cycled lighting may decrease distress level of newborn infants by enhancing calming status. This study aimed to investigate effects of eye cover among high risk neonates at night shift on their distress levels.Methods: Quasi experimental research design was carried out on a randomized sample of 60 newborn infants attending the NICU of El Manial University Hospital (Kasr Al Ainy), (30 control group and 30 study group). Neonatal assessment tool and COMFORTneoNRS scale were utilized for data collection.Results: There was a statistically significant difference between control and study groups regarding the distress levels (p < .00). The mean score of distress levels were 6.80 ± 1.80 and 0.80 ± 1.15 respectively and the mean score of comfort levels in the newborn infants in the control and study groups were 23.22 ± 5.50 and 6.60 ± 1.06 respectively. Eye coved enhanced quite sleep (66.7%), relaxed muscle (73.3%), decrease movement (66.7%) and no crying (85.7%).Conclusions: The use of eye cover among high risk neonates at night shift is effective to decrease their distress level and improve their comfort state in the morning shift by promoting quite sleep and relaxation. Recommendations: The educational program is needed to raise awareness among neonatal nurses about the effect of light reduction methods such as eye patches on the distress level and comfort state that enhances the growth and development of newborn infants.

Effects of rising drug costs on efforts to control overall cost at a large academic cancer center.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 2-2
Author(s):  
Kerin B. Adelson ◽  
Maureen Canavan ◽  
Susanna N. Supalla ◽  
Tannaz Sedghi ◽  
Basit Chaudhry ◽  
...  
Keyword(s):  
Acute Care ◽  
Cost Of Care ◽  
Drug Costs ◽  
Cancer Center ◽  
Historical Period ◽  
Pharmaceutical Pricing ◽  
Total Cost ◽  
The Mean ◽  
Mean Cost ◽  
Post Acute Care

2 Background: Value-based payment programs like the Oncology Care Model (OCM) have focused efforts to reduce costly acute care use through improvements in access and coordination rather than targeting the exponential rise in pharmaceutical pricing. We assessed how participation in OCM affected total cost of cancer care at a large academic cancer center. Methods: Using Medicare claims for Yale-Smilow Cancer Hospital, an NCI-designated cancer center with an academic hub and 10 community practices, we identified episodes for chemotherapy initiated during a historical period (pre-OCM, 2012-2015) and performance period (post-OCM, 2016-2017) following OCM criteria to identify total cost of care. We reported frequency of utilization categories, the mean cost per episode, the proportion of total cost attributed to each utilization category and compared pre- and post-participation periods. Results: There were 8,843 episodes during the historical period and 6,679 episodes during the performance period. The mean total cost per episode increased from $28,645 to $32,666, but this was less than the Medicare-defined expected increase (target price). Between the two periods, the percentage of total episodes decreased for emergency department (ED) use from 36% to 33%, inpatient care from 33% to 29%, and post-acute care from 28% to 25% (p < 0.01). Mean costs of drugs per episode increased by 27% between periods, and from 52% to 58% of total cost of care (p < 0.01). While mean cost per episode for ED, inpatient, and post-acute care remained stable, the mean cost per episode for antineoplastics increased 39% from $10,676 to $14,843. Conclusions: After implementing OCM, we beat the Medicare target largely by decreasing acute care use and stabilizing the cost of hospitalizations and ED; however, actual cost increased largely due to pharmaceutical spending. Because drug costs were the largest proportion of overall cost of care, future value-based models must address the rising cost of pharmaceuticals. [Table: see text]

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