Cost Saving of Stress Ulcer Prophylaxis Used in Non-Intensive Care Unit (ICU) Inpatients

2020 ◽  
Vol 3 (1) ◽  
pp. 37-43
Author(s):  
Hening Pratiwi ◽  
Laksmi Maharani ◽  
Ika Mustikaningtias
Keyword(s):  
Cost Saving ◽  
Stress Ulcer ◽  
Cost Savings ◽  
Stress Ulcer Prophylaxis ◽  
Rank Test ◽  
Potential Cost ◽  
Significant Difference ◽  
Before And After ◽  
Ulcer Prophylaxis ◽  
American Society

Stress ulcer prophylaxis (SUP) is largely prescribed to ICU and non-ICU patients. SUP, an acid-suppressive drug, is overused in hospital settings mainly due to inadequate prescriptions in low-risk patients. In this context, the appropriate administration of SUP needs to be analyzed, and the potentially saved money from reducing excessive use can thereby be quantified. This study was intended to calculate potential cost savings in inappropriate SUP therapy in non-ICU inpatients. With a non-experimental retrospective design, it analyzed medical records and details obtained from the financial department of “X” hospital in Purwokerto, Indonesia. The data were collected from 80 non-ICU inpatients in May 2015, which were selected by purposive sampling. We calculated potential cost savings by referring to the American Society of Health-System Pharmacists (ASHP) guidelines that had been modified by Zeitoun (2011) for stress ulcer prophylaxis in non-ICU inpatients. The results showed that inappropriate indications and doses were found in 32.5% and 18% of selected patients, respectively. Before the cost-saving calculation, patients had to spend USD 2,411. However, after the analysis eliminated unnecessary SUP use, this number was proven to be potentially decreased by USD 512 to only USD 1,899. Based on the Wilcoxon Sign Rank Test result (p = 0.000 (≤ 0.05)), there was a significant difference between the total cost before and after the application of modified ASHP guidelines for appropriateness. After a thorough assessment, we concluded that the treatment cost could be reduced by identifying and excluding inappropriateness in SUP therapy.

Analysis of the use and cost of stress ulcer prophylaxis for surgical inpatients

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Dhani Wijaya ◽  
Elfri Padolo ◽  
Chrismawan Ardianto ◽  
Fendy Matulatan ◽  
Chris Alderman ◽  
...  
Keyword(s):  
Stress Ulcer ◽  
Stress Ulcer Prophylaxis ◽  
Drug Costs ◽  
Ulcer Bleeding ◽  
Hospital Data ◽  
Stress Ulcers ◽  
Inappropriate Use ◽  
Ulcer Prophylaxis ◽  
American Society ◽  
The Cost

AbstractBackgroundStress ulcer is a superficial and asymptomatic lesion and causes bleeding. As many as 50% of death cases are reported as the result of stress ulcer bleeding. Stress ulcer prophylaxis (SUP) is a drug used to prevent gastrointestinal tract injuries due to stress ulcers. The inappropriate use of SUP drugs can cause adverse drug reactions, and thus SUP drugs are only given to patients in accordance with guidelines in order to avoid the overuse of SUP drugs. The aim of this present study is to analyse the suitability of SUP drug usage based on the criteria from the American Society of Health-System Pharmacists (ASHP) and the drug costs of SUP overuse.MethodsAn observational descriptive study was conducted from April 24, 2019, to May 17, 2019, in the inpatient surgical ward of Dr. Soetomo General Hospital. Data were obtained from patient medical health records.ResultsOne hundred fifty-two patients used 1404 SUP drugs. Approximately 48% of usage did not suit the ASHP criteria and was considered as medication overuse. The cost of excessive SUP usage during the study period was more than US $65, which is 30.08% of the total drug cost of prescribed stress ulcer drugs.ConclusionsThe present study suggests that the relatively high excessive drug costs for SUP show a need for monitoring of the application of SUP therapy guidelines.

Analysis of stress ulcer prophylaxis drug regimentation in surgical patients

2021 ◽  
Vol 32 (4) ◽  
pp. 645-649
Author(s):  
Dhani Wijaya ◽  
Suharjono ◽  
Fendy Matulatan ◽  
Elfri Padolo
Keyword(s):  
Stress Ulcer ◽  
Frequency Standard ◽  
Cross Sectional Study ◽  
Stress Ulcer Prophylaxis ◽  
World Health ◽  
Cross Sectional ◽  
Injection Dose ◽  
Ulcer Prophylaxis ◽  
American Society ◽  
Health Organization

Abstract Objectives The World Health Organization (WHO) estimated that more than 50% of drugs were prescribed incorrectly, including stress ulcer prophylaxis (SUP) drugs. Prescribing SUP drugs in incorrect doses and frequencies are considered irrational, and may affects to the effectivity of the therapy. This research aimed to assess the appropriateness of the SUP drugs regimentation in the inpatient surgery room at Dr. Soetomo Hospital, Surabaya, Indonesia. Methods This research was cross-sectional study and conducted for 4 weeks in 2019 in the inpatient surgery room of Dr. Soetomo Hospital. The population was SUP drugs that were prescribed in inpatient surgery room. Those SUP drugs with indications for the prevention of stress-induced ulcers that complied to the terms listed on the American Society of Health-System Pharmacists (ASHP) were included as the samples, and vice versa. The samples then assessed for their regimentation appropriateness using the dose and frequency standard of ASHP. Results There were 224 dose units taken as sample, from the total population of 1,404 SUP drugs. The result showed that as much as 48.2% of SUP medications were given to the patients in inappropriate regimentation. Of that number, all ranitidine injection were inappropriately regimented. On the contrary all omeprazole injection dose units were appropriately regimented, meanwhile the amount of appropriate regimentation of sucralfate suspension were 74.6%. Conclusions According to ASHP standard, the SUP drugs in the inpatient surgery room at Dr. Soetomo Hospital were mostly given in inappropriate regimentation. Further research is needed to explore how will those inappropriate regimentation affect on the efficacy of therapy in the patients.

scholarly journals Clinical and economic benefits of de-escalating stress ulcer prophylaxis therapy in the intensive care unit: A quality improvement study

2019 ◽  
Vol 47 (6) ◽  
pp. 503-509 ◽  
Author(s):  
Matthew H Anstey ◽  
Edward Litton ◽  
Robert N Palmer ◽  
Sneha Neppalli ◽  
Benedict J Tan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Intensive Care Units ◽  
Stress Ulcer ◽  
Cost Savings ◽  
Economic Benefits ◽  
Stress Ulcer Prophylaxis ◽  
Prescribing Patterns ◽  
Ulcer Prophylaxis

Stress ulcer prophylaxis is commonly prescribed in the intensive care unit but can be inappropriately commenced or continued on discharge, exposing patients to potential harm. We aimed to evaluate whether a prescribing guideline, education program and pharmacist oversight would reduce inappropriate continuation of stress ulcer prophylaxis. This was a multicentre pre- (2014) and post- (2016) quality improvement study across five Australian intensive care units. Cost data were estimated using local information about prescribing patterns, and the relationship between long-term use and adverse events. A total of 531 patients were included in the pre- and 393 in the post-implementation periods. The proportion of hospital survivors inappropriately continued on stress ulcer prophylaxis reduced from 78/184 (42.4%) to 11/143 (7.7%) in the post-implementation period (odds ratio = 8.83; 95% confidence interval 4.47–17.45; P < 0.0001). Clostridium difficile–associated disease reduced from 10 patients to one in the pre- to post-implementation groups. The extrapolated direct savings to all Australian intensive care units from reduced proton pump inhibitor prescribing are relatively small (AUD$2.08 million/year), but the reduction in complications has both benefits for patients and indirect savings of AUD$16.59 million/year nationally. In patients admitted to the intensive care unit, the introduction of a simple, bundled intervention resulted in a significant decrease in inappropriate continuation of stress ulcer prophylaxis at hospital discharge and a reduction in recognised complications, and substantial cost savings.

PERBEDAAN FINANCIAL PERFORMANCE PASCA SECONDARY OFFERINGS

Wahana ◽  
2019 ◽  
Vol 22 (1) ◽  
pp. 41-49
Author(s):  
Djaja Perdana ◽  
Herbowo Herbowo
Keyword(s):  
Financial Performance ◽  
Stock Exchange ◽  
Hypothesis Test ◽  
Poor Performance ◽  
Rank Test ◽  
Growth Ratio ◽  
Significant Difference ◽  
Before And After ◽  
Signed Rank Test ◽  
Asset Turnover

This study aims to examine the differences in corporate financial performance before and after secondary offerings. The financial performance is proxied by WCR, DER, Solvency, ROA, ROE, Asset Turnover (ATO) and Growth ratio which representing the value of liquidity, financing, activity, performance and growth of the firm. The study involved 67 samples of the companies listed on the Indonesia Stock Exchange conducting secondary offerings during 2008-2013 period and selected through purposive random sampling method and using Financial Statement data from 2005-2016 period. Hypothesis test is performed using Wilcoxon Signed Rank test. The results of this study indicate that there is no significant difference in the ratio of Solvency, ROA and ROE between before and after secondary offerings, but there are significant differences in the ratio of WCR, DER, Asset Turnover and Growth. WCR ratio after secondary offerings increased, while DER ratio after secondary offerings decreased, the condition of both ratios showed better performance. While the indication of poor performance seen in decreasing asset turnover ratio and growth ratio.Keywords : agency theory, financial performance, secondary offerings

Reply: The effectiveness of enteral nutrition as stress ulcer prophylaxis remains uncertain

2018 ◽  
Vol 45 ◽  
pp. 251-252
Author(s):  
Karim El-Kersh ◽  
Rodrigo Cavallazzi ◽  
Stephen A. McClave ◽  
Mohamed Saad
Keyword(s):  
Enteral Nutrition ◽  
Stress Ulcer ◽  
Stress Ulcer Prophylaxis ◽  
Ulcer Prophylaxis ◽  
As Stress
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