scholarly journals Cost-Effectiveness Analysis Kloramfenikol Dan Seftriakson Untuk Pengobatan Demam Tifoid Pada Pasien Dewasa Di Rumah Sakit Sanglah Denpasar

2019 ◽  
Vol 2 (2) ◽  
pp. 105-112
Author(s):  
Amelia Lorensia ◽  
Doddy De Queljoe ◽  
Made Dwike Swari Santi
Keyword(s):  
Cost Effectiveness ◽  
Length Of Stay ◽  
Typhoid Fever ◽  
Medical Records ◽  
Cost Effective ◽  
Cost Effectiveness Ratio ◽  
Hospital Perspective ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Two Alternatives

The number of typhoid fever patient in Indonesia is still high. Typhoid fever can be treated by antibiotic therapy such as chloramphenicol and ceftriaxone. The purpose of this study was to compare the cost-effectiveness of chloramphenicol and ceftriaxone which was given to adult patients who were diagnosed with typhoid fever in Sanglah Denpasar Hospital. A comparative study between two alternatives was conducted using the hospital perspective. Retrospective method was used to collect data from patient medical records, who was diagnosed and hospitalized in Sanglah Denpasar Hospital during January 2017 until July 2018. The cost analysis was perform using cost-effectiveness grid and cost-effectiveness ratio (ACER) methods. Cost-effectiveness grid showed that dominant of ceftriaxone for patient with typhoid fever. ACER analysis for ceftriaxone was IDR 2,097,170.88 with effectivenes (length of stay) 4.27 days, and was IDR 2,097,170.88 with effectiveness (the time of reaching normal temperature) 2.42 days. ACER analysis for chloramphenicol was IDR 2,555,464.22        with effectivenes (length of stay) 10.22 days, and was IDR 2,555,464.22 with effectiveness (the time of reaching normal temperature) 3.44 days. ACER analysis showed lower degree of ceftriaxone and higher effectiveness based on length of stay and the time of reaching normal temperature. The conclusion of this study is that ceftriaxone is more cost-effective than chloramphenicol.

scholarly journals ANALISIS EFEKTIVITAS BIAYA PADA PASIEN ANAK DEMAM TIFOID DI RUMAH SAKIT BHAYANGKARA MANADO

PHARMACON ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 335
Author(s):  
Agatha Agnes ◽  
Gayatri Citraningtyas ◽  
Sri Sudewi
Keyword(s):  
Cost Effectiveness ◽  
Typhoid Fever ◽  
Incremental Cost ◽  
Pediatric Patients ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis ◽  
Record Data

ABSTRACT Typhoid fever is an endemic disease which it incidence rate is still high in Indonesian. Administering antibiotic therapy can do treatment of typhoid fever. This study was conducted since there are several pediatric patients diagnosed with typhoid fever but have different antibiotic therapies, namely cefotaxime and ceftriaxone therapy, so it is necessary to do calculations to determine the comparison and determine which treatment is more efficient in cost and effectiveness. The method used in this study is CEA (Cost-Effectiveness Analysis) with the design of retrieving medical record data of children with typhoid fever in Bhayangkara Manado Hospital retrospectively from January to December 2018. The samples  obtained were 28 pediatric patients, cinsisting of 12 patients using cefotaxime therapy and 16 patients using ceftriaxone therapy. The result of ACER (An Avarage Cost Effective Ratio) obtained by ceftriaxone were Rp. 526.609,-/day and cefotaxime Rp. 484.789,-/day. In this study, if patients under cefotaxime therapy want to swich treatment to ceftriaxone therapy, ICER calculation (Incremental Cost-Effectiveness Ratio) is carried out the result are Rp.340.528,-. Keyword: Typhoid fever, Antibiotics, CEA (Cost-Effectiveness Analysis) ABSTRAK Demam tifoid merupakan penyakit endemik yang angka kejadiannya masih tinggi di Indonesia. Pengobatan demam tifoid dapat diobati dengan cara pemberian terapi antibiotik. Penelitian ini dilakukan karena ada beberapa pasien anak yang di diagnosa demam tifoid tetapi memiliki terapi antibiotik yang berbeda, yaitu terapi sefotaksim dan seftriakson  sehingga perlu dilakukan perhitungan untuk mengetahui perbandingan dan menentukan pemilihan pengobatan mana yang lebih efisien dalam biaya maupun efektivitas. Metode yang digunakan dalam penelitian ini adalah CEA (Cost-Effectiveness Analysis) dengan rancangan pengambilan data rekam medik pasien anak demam tifoid di RS. Bhayangkara Manado secara retrospektif pada periode Januari – Desember 2018. Sampel yang didapat sebanyak 28 pasien anak, yang terdiri dari 12 pasien pengguna terapi sefotaksim dan 16 pasien pengguna terapi seftriakson. Hasil ACER (An Avarage Cost Effective Ratio) yang diperoleh sefotaksim Rp.526.609,-/hari dan seftriakson Rp.484.789,-/hari. Pada penelitian ini jika pasien terapi sefotaksim ingin berpindah pengobatan ke terapi seftriakson maka dilakukan perhitungan ICER (Incremental Cost-Effectiveness Ratio) dan didapat hasil Rp.340.582,-, sehingga jika ingin berpindah pengobatan maka perlu penambahan biaya sesuai nilaI ICER.Kata Kunci : Demam Tifoid, Antibiotik, CEA (Cost-Effectiveness Analysis).

scholarly journals COST-EFFECTIVENESS ANALYSIS OF CEFTRIAXONE AND NON-CEFTRIAXONE ON TYPHOID FEVER PATIENTS

2018 ◽  
Vol 10 (1) ◽  
pp. 87
Author(s):  
Citra Sari Purbandini ◽  
Rani Sauriasari
Keyword(s):  
Cost Effectiveness ◽  
Typhoid Fever ◽  
Health Care Services ◽  
Cost Effective ◽  
Analysis Data ◽  
Cost Effectiveness Analysis ◽  
Care Services ◽  
Effectiveness Analysis ◽  
Study Results ◽  
The Cost

Objective: This study aimed to evaluate the cost-effectiveness of ceftriaxone and non-ceftriaxone therapies in patients with typhoid fever.Methods: The applied method was a cost-effectiveness analysis. Data were retrospectively collected, and sampling was performed using totalsampling based on medical records and hospital information systems. Subjects were limited to patients diagnosed with typhoid fever and usingceftriaxone or non-ceftriaxone antibiotics. A total of 15 patients were investigated, comprising 10 patients on ceftriaxone and five patients using nonceftriaxoneantibiotics. Effectiveness was evaluated by the length of hospitalization. The cost was a median of total costs, consisting of the cost of thedrug, concomitant drugs, medical equipment, laboratory tests, doctor, health-care services, and hospitalization.Results: The results showed the effectiveness of ceftriaxone (3.80±0.789 days) did not differ with the non-ceftriaxone drugs (3.40±1.635 days).However, the total cost of ceftriaxone (Rp 1,929,355) was less than that of non-ceftriaxone antibiotics (Rp 2,787,003). The average cost-effectivenessratio of ceftriaxone group (Rp 507,725/effectiveness) was lower compared to the non-ceftriaxone (Rp 819,707/effectiveness).Conclusions: This study results showed that ceftriaxone was more cost-effective than non-ceftriaxone antibiotics.

scholarly journals COVID-19 Vaccination Scenarios: A Cost-Effectiveness Analysis for Turkey

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 399
Author(s):  
Arnold Hagens ◽  
Ahmet Çağkan İnkaya ◽  
Kasirga Yildirak ◽  
Mesut Sancar ◽  
Jurjen van der Schans ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Cost Effective ◽  
Incremental Cost Effectiveness Ratio ◽  
Vaccine Uptake ◽  
First Year ◽  
Cost Effectiveness Ratio ◽  
Scenario Analyses ◽  
Effectiveness Analysis ◽  
The Cost

As of March 2021, COVID-19 has claimed the lives of more than 2.7 million people worldwide. Vaccination has started in most countries around the world. In this study, we estimated the cost-effectiveness of strategies for COVID-19 vaccination for Turkey compared to a baseline in the absence of vaccination and imposed measures by using an enhanced SIRD (Susceptible, Infectious, Recovered, Death) model and various scenarios for the first year after vaccination. The results showed that vaccination is cost-effective from a health care perspective, with an incremental cost-effectiveness ratio (ICER) of 511 USD/QALY and 1045 USD/QALY if vaccine effectiveness on transmission is equal or reduced to only 50% of effectiveness on disease, respectively, at the 90% baseline effectiveness of the vaccine. From a societal perspective, cost savings were estimated for both scenarios. Other results further showed that the minimum required vaccine uptake to be cost-effective would be at least 30%. Sensitivity and scenario analyses, as well as the iso-ICER curves, showed that the results were quite robust and that major changes in cost-effectiveness outcomes cannot be expected. We can conclude that COVID-19 vaccination in Turkey is highly cost-effective or even cost-saving.

scholarly journals Optimal Control of Shigellosis with Cost-Effective Strategies

2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Stephen Edward ◽  
Nyimvua Shaban ◽  
Eunice Mureithi
Keyword(s):  
Optimal Control ◽  
Cost Effectiveness ◽  
Optimal Control Theory ◽  
Cost Effective ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Effective Strategies ◽  
Education Campaign ◽  
Effectiveness Analysis ◽  
The Cost

In this paper, we apply optimal control theory to the model for shigellosis. It is assumed that education campaign, sanitation, and treatment are the main controls for this disease. The aim is to minimize the number of infections resulting from contact with careers, infectious population, and contaminated environments while keeping the cost of associated controls minimum. We achieve this aim through the application of Pontryagin’s Maximum Principle. Numerical simulations are carried out by using both forward and backward in time fourth-order Runge-Kutta schemes. We simulate the model under different strategies to investigate which option could yield the best results. The findings show that the strategy combining all three control efforts (treatment, sanitation, and education campaign) proves to be more beneficial in containing shigellosis than the rest. On the other hand, cost-effectiveness analysis is performed via incremental cost-effectiveness ratio (ICER). The findings from the ICER show that a strategy incorporating all three controls (treatment, sanitation, and education campaign) is the most cost-effective of all strategies considered in the study.

scholarly journals COST-EFFECTIVENESS ANALYSIS OF COUNSELING IN THERAPY FOR OUTPATIENTS WITH HYPERTENSION

2018 ◽  
Vol 11 (13) ◽  
pp. 18
Author(s):  
Diah Ramadhani ◽  
Urip Harahap ◽  
Azizah Nasution
Keyword(s):  
Cost Effectiveness ◽  
Health Care Providers ◽  
Cost Effective ◽  
Care Providers ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis ◽  
Quasi Experimental ◽  
Group A ◽  
The Cost ◽  
The Impact

 Objectives: To determine the effect of counseling on effectiveness and cost of the treatment for outpatient with primary hypertension (HTN) in Cut Meutia Hospital, Indonesia.Methods: This 6-month prospective quasi-experimental study was undertaken to analyze the impact of counseling toward cost and effectiveness in the treatment in patients with primary HTN and evaluation of each month at Cut Meutia Hospital, Indonesia. The study sample consisted of 22 patients for each group. A cost analysis was conducted from the perspective of the health-care providers. The cost in the treatment of both groups was analyzed by calculating the cost-effectiveness ratio (CER) and incremental CER (ICER).Results: Most of the patients with HTN (54.55%) were males with ages ranging from 35 to 64 years old (77.27%). Patients who achieved a blood pressure <140/90 mmHg on HTN treatment: With counseling, 77.27%; without counseling, 18.18%. CER for HTN treatment with and without counseling were Rp 1,756,117,86 and Rp 6,704,247,91, respectively. The ICER was Rp 233,745.13.Conclusion: Treatment of HTN with counseling was more cost-effective than without counseling.

Cost-effectiveness analysis of a complementary health intervention: The case of smoking relapse prevention

2004 ◽  
Vol 20 (4) ◽  
pp. 475-480 ◽  
Author(s):  
Thomas N. Chirikos ◽  
Thaddeus A. Herzog ◽  
Cathy D. Meade ◽  
Monica S. Webb ◽  
Thomas H. Brandon
Keyword(s):  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Relapse Prevention ◽  
Cost Effective ◽  
Convincing Evidence ◽  
Cost Effectiveness Ratio ◽  
Smoking Relapse ◽  
Effectiveness Analysis ◽  
Prevention Interventions ◽  
The Cost

Objectives: We assess the cost-effectiveness of smoking relapse prevention interventions designed to keep quitters from resuming the use of cigarettes. Because relapse prevention is complementary to smoking cessation efforts, the appropriate test of its cost-effectiveness is whether it reduces the incremental cost-effectiveness ratio (ICER) of smoking cessation. The major goal of the study is to carry out such a test.Methods: Data from a randomized trial that ascertained the effectiveness of alternative modes of smoking relapse prevention are combined with ICER estimates of smoking cessation to assess whether relapse prevention is cost-effective.Results: The trial produced convincing evidence that relapse prevention yields statistically significant reductions in the proportion of quitters who are smoking at 24 months postquit. The intervention effects are substantial enough to raise the denominator terms of the smoking cessation ICER and, thereby, offset the amount relapse prevention adds to cost numerator terms. In this sense, smoking relapse prevention tends to pay for itself.Conclusions: Smoking relapse prevention is a highly cost-effective addition to current efforts to curb cigarette consumption. Complementary health interventions of this sort should be assessed by different methods than those commonly found in the cost-effectiveness literature.

scholarly journals Screening for Melanoma by Primary Health Care Physicians: A Cost—Effectiveness Analysis

1996 ◽  
Vol 3 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Afaf Girgis ◽  
Philip Clarke ◽  
Robert C Burton ◽  
Rob W Sanson—Fisher
Keyword(s):  
Cost Effectiveness ◽  
Screening Programme ◽  
Cost Effective ◽  
Economic Assessment ◽  
Screening Tests ◽  
Family Practitioners ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Primary Health Care Physicians ◽  
Melanoma Screening

Background and design— Australia has the highest rates of skin cancer in the world, and the incidence is estimated to be doubling every 10 years. Despite advances in the early detection and treatment of melanoma about 800 people still die nationally of the disease each year. A possible strategy for further reducing the mortality from melanoma is an organised programme of population screening for unsuspected lesions in asymptomatic people. Arguments against introducing melanoma screening have been based on cost and the lack of reliable data on the efficacy of any screening tests. To date, however, there has been no systematic economic assessment of the cost effectiveness of melanoma screening. The purpose of this research was to determine whether screening may be potentially cost effective and, therefore, warrants further investigation. A computer was used to simulate the effects of a hypothetical melanoma screening programme that was in operation for 20 years, using cohorts of Australians aged 50 at the start of the programme. Based on this simulation, cost—effectiveness estimates of melanoma screening were calculated. Results— Under the standard assumptions used in the model, and setting the sensitivity of the screening test (visual inspection of the skin) at 60%, cost effectiveness ranged from Aust$6853 per life year saved for men if screening was undertaken five yearly to $12137 if screening was two yearly. For women, it ranged from $11 102 for five yearly screening to $20 877 for two yearly screening. Conclusion— The analysis suggests that a melanoma screening programme could be cost effective, particularly if five yearly screening is implemented by family practitioners for men over the age of 50.

Cost-effectiveness Analysis of Submandibular Gland Preservation With Sialendoscopy for the Management of Sialolithiasis

2021 ◽  
pp. 019459982110268
Author(s):  
Joseph R. Acevedo ◽  
Ashley C. Hsu ◽  
Jeffrey C. Yu ◽  
Dale H. Rice ◽  
Daniel I. Kwon ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Submandibular Gland ◽  
Average Cost ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Life Years ◽  
Probability Of Success ◽  
Markov Decision Model ◽  
The Cost

Objective To compare the cost-effectiveness of sialendoscopy with gland excision for the management of submandibular gland sialolithiasis. Study Design Cost-effectiveness analysis. Setting Outpatient surgery centers. Methods A Markov decision model compared the cost-effectiveness of sialendoscopy versus gland excision for managing submandibular gland sialolithiasis. Surgical outcome probabilities were found in the primary literature. The quality of life of patients was represented by health utilities, and costs were estimated from a third-party payer’s perspective. The effectiveness of each intervention was measured in quality-adjusted life-years (QALYs). The incremental costs and effectiveness of each intervention were compared, and a willingness-to-pay ratio of $150,000 per QALY was considered cost-effective. One-way, multivariate, and probabilistic sensitivity analyses were performed to challenge model conclusions. Results Over 10 years, sialendoscopy yielded 9.00 QALYs at an average cost of $8306, while gland excision produced 8.94 QALYs at an average cost of $6103. The ICER for sialendoscopy was $36,717 per QALY gained, making sialendoscopy cost-effective by our best estimates. The model was sensitive to the probability of success and the cost of sialendoscopy. Sialendoscopy must meet a probability-of-success threshold of 0.61 (61%) and cost ≤$11,996 to remain cost-effective. A Monte Carlo simulation revealed sialendoscopy to be cost-effective 60% of the time. Conclusion Sialendoscopy appears to be a cost-effective management strategy for sialolithiasis of the submandibular gland when certain thresholds are maintained. Further studies elucidating the clinical factors that determine successful sialendoscopy may be aided by these thresholds as well as future comparisons of novel technology.

scholarly journals Simplified Mathematical Modelling of Uncertainty: Cost-Effectiveness of COVID-19 Vaccines in Spain

Mathematics ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 566
Author(s):  
Julio Emilio Marco-Franco ◽  
Pedro Pita-Barros ◽  
Silvia González-de-Julián ◽  
Iryna Sabat ◽  
David Vivas-Consuelo
Keyword(s):  
Cost Effectiveness ◽  
Health Planning ◽  
Cost Effective ◽  
Incremental Cost Effectiveness Ratio ◽  
Reliable Data ◽  
Simplified Model ◽  
Fatality Rate ◽  
Cost Effectiveness Ratio ◽  
Funeral Homes ◽  
The Cost

When exceptional situations, such as the COVID-19 pandemic, arise and reliable data is not available at decision-making times, estimation using mathematical models can provide a reasonable reckoning for health planning. We present a simplified model (static but with two-time references) for estimating the cost-effectiveness of the COVID-19 vaccine. A simplified model provides a quick assessment of the upper bound of cost-effectiveness, as we illustrate with data from Spain, and allows for easy comparisons between countries. It may also provide useful comparisons among different vaccines at the marketplace, from the perspective of the buyer. From the analysis of this information, key epidemiological figures, and costs of the disease for Spain have been estimated, based on mortality. The fatality rate is robust data that can alternatively be obtained from death registers, funeral homes, cemeteries, and crematoria. Our model estimates the incremental cost-effectiveness ratio (ICER) to be 5132 € (4926–5276) as of 17 February 2021, based on the following assumptions/inputs: An estimated cost of 30 euros per dose (plus transport, storing, and administration), two doses per person, efficacy of 70% and coverage of 70% of the population. Even considering the possibility of some bias, this simplified model provides confirmation that vaccination against COVID-19 is highly cost-effective.

Principles of Cost-Effective Resource Allocation in Health Care organizations

1990 ◽  
Vol 6 (1) ◽  
pp. 93-103 ◽  
Author(s):  
Milton C. Weinstein
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Cost Effectiveness ◽  
Health Care Organizations ◽  
Cost Effective ◽  
Limited Resources ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Common Understanding ◽  
Analytical Errors

Cost-effectiveness analysis (CEA) is a method of economic evaluation that can be used to assess the efficiency with which health care technologies use limited resources to produce health outputs. However, inconsistencies in the way that such ratios are constructed often lead to misleading conclusions when CEAs are compared. Some of these inconsistencies, such as failure to discount or to calculate incremental ratios correctly, reflect analytical errors that, if corrected, would resolve the inconsistencies. Others reflect fundamental differences in the viewpoint of the analysis. The perspectives of different decision-making entities can properly lead to different items in the numerator and denominator of the cost-effectiveness (C/E) ratio. Producers and consumers of CEA need to be more conscious of the perspectives of analysis, so that C/E comparisons from a given perspective are based upon a common understanding of the elements that are properly included.

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