scholarly journals UNSTABLE ANGINA

2010 ◽  
Vol 23 (10) ◽  
pp. 1276-1280
Author(s):  
Shazia Alam ◽  
Syed Baqir Syum Naqvi ◽  
Maqsood Ahmed ◽  
Syed Baqir Syum Naqvi
Keyword(s):  
Unstable Angina ◽  
Conservative Management ◽  
Treatment Cost ◽  
Tertiary Care ◽  
Cost Of Care ◽  
Total Direct Cost ◽  
Care Hospital ◽  
Direct Treatment ◽  
Direct Treatment Cost ◽  
The Cost

Objective: To determine the direct treatment cost of unstable angina (UA) withlow molecular weight heparin (LMWH) in conservative management. Study design: Prospectivestudy. Settings: Government cardiovascular hospital and private tertiary care hospital, Karachi.Study period: One year. Method: All 487 patients with either sex having cardiac history ofischemic heart disease, presenting chest pain diagnosed to have unstable angina admitted inhospital for 2-8 days were recruited and entered in study. The current prospective study wasdesigned to analyze the direct treatment cost of UA with LMWH. Data was collected throughproforma and results were analyzed by SPSS version 20. Results: Results were represented interms of percentages, frequencies and means of cost contribution of LMWH. All costs valuesconverted from Pakistani currency (PKR) into US dollars ($) as per exchange rate of 2014. Lessnumber of prescriptions found for fondaparinux (24.85%) than enoxaparin (70%). The estimatedmean of drug cost particularly observed in three treatment groups of patients who receivedenoxaparin, fondaparinux and dalteparin was $36, $ 15 and $ 47 correspondingly. Moreover,4 days total direct cost of enoxaparin and fondaparinux was $191, $ 84 and 6 days treatmentcosts $ 149 with dalteparin to treat a single case of UA. It has been found that fondaparinuxsignificantly lowers the cost of care in comparison to enoxaparin and dalteparin. Conclusion:Current analysis concluded that in the treatment of unstable angina, fondaparinux found to bea dominant strategy that simultaneously lowers the cost of care in conservative management.

scholarly journals The Economic impact of Lower Extremity Amputations in Diabetics. A retrospective study from A Tertiary Care Hospital of Faisalabad, Pakistan

2020 ◽  
Vol 1 (1) ◽  
pp. 18-22
Author(s):  
Muhammad Labeeq ◽  
Muhammad Ahsan Tariq ◽  
Samra Atta Tung ◽  
Muhammad Asfand Yar ◽  
Waleed Rehman ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Economic Burden ◽  
Diabetic Foot ◽  
Treatment Cost ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Direct Treatment ◽  
Direct Treatment Cost ◽  
The Mean

Background: Among the various complications of diabetes, lower-extremity amputation due to diabetic foot is a common problem. In Pakistan, 6-7% of patients with diabetes suffer from diabetic foot ulceration. Objectives: Our primary objective was to explore the frequency of diabetic foot amputations, and the secondary objective was to calculate the economic burden of these preventable surgeries on the health budget of the provincial government. Materials & Methods: It was a retrospective cross-sectional observational study conducted after obtaining approval from the Ethical Review Committee of Allied hospital, Faisalabad Medical University. The data of diabetic foot patients who underwent amputations between July 2017 and December 2017 were retrieved from three Surgical Units (I, II & III), using a purposive sampling technique. All amputations carried out for reasons other than diabetic foot were excluded. The direct medical cost of one diabetic foot amputation was calculated via a local survey of the various private hospitals of Faisalabad. The indirect costs in terms of loss of productivity and disability costs, transport costs, rehabilitation costs were not included in this study. The data were evaluated by using SPSS Version 23. Results: A total of 85 patients were included in our study. The male to female ratio was 2.7 to 1. The mean direct treatment cost for minor amputation was PKR 46926.00 ± 11730.90 ($382.35 ± 95.58), and the mean direct treatment cost for major amputation was PKR 53720.00 ± 12401.24 ($437.71 ± 101.40). Out of 85 amputations, 63 (74%) were major amputations, and the remaining 22 (26%) were minor amputations. The total cost for 63 major amputations was PKR 3,384,360 ($27568.91) and for 22 minor amputation was PKR 1,032,372 ($8409.67). The net cost came out to be PKR 4,416,732 ($35978.59) for all the 85 cases being reported in a tertiary care hospital of Faisalabad for six months. Conclusion: Diabetic foot, a preventable complication of long-term diabetes mellitus, has an economic burden on the hospital budget, which, if adequately addressed via primary prevention programme, can yield not just economical but medical benefits as well.

scholarly journals Analysis of Direct Treatment Cost for Exacerbation of Chronic Obstructive Pulmonary Disease in E Hospital from October 2019 to March 2020

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Bui Thi Xuan ◽  
Ngo Tien Thanh ◽  
To Khanh Linh
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Treatment Cost ◽  
Respir Crit ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Direct Treatment ◽  
Direct Treatment Cost ◽  
Exacerbation Of Copd ◽  
The Cost

This study analyzes the direct treatment cost for exacerbation of chronic obstructive pulmonary disease (COPD) at the Department of Pulmonology, E Hospital from October 2019 to March 2020. The study results show that the average direct treatment cost for exacerbation of COPD was VND 9,102,311.71; the highest cost was VND 36,304,614 and the lowest cost, VND 2,309,961. Among the direct treatment cost components, drug cost showed the highest proportion, followed by hospital bed, then surgical procedures, tests, diagnostic imaging, functional exploration, examination and medical supplies. The cost of antibiotics accounted for 57.76% of the drug cost. The average number of hospitalization days was 10.77, closely relating to the direct cost. Besides, age and comorbidity also affected the number of hospitalization days. The average health insurance support for each patient was up to 94.46% of the total treatment cost. The results also show that the cost of treatment in Vietnam is lower than some countries in the region and the proportions of the cost components presented in different studies in Vietnam are different. Keywords Direct cost, exacerbation of COPD, E hospital. [1] Ngo Quy Chau, Nguyen Lan Viet, Nguyen Dat Anh, Pham Quang Vinh, Internal Pathology, Medical Publishing House 1 (2018) 42-50 (in Vietnamese).[2] R.A. Pauwels, A.S. Buist, P.M.A. Calverley, C. R. Jenkins, S. Hurd Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 163 (2001) 1256–1276. https://doi.org/10.1164/ajrccm.163.5.2101039[3] https://www.chestnet.org/News/Press-Releases /2014/07/CDC-reports-36-billion-in-annual financial-cost-of-COPD-in-US (15/10/2019)[4] S.D. Sullivan, S.D. Ramsey, T.A. Lee, The economic burden of COPD. Chest 2000 Feb 117(2), 5S-9S.https://journal.chestnet.org/article/S0012-3692(15)52748-7/fulltext[5] Vanfleteren, E.G.W. Lowie, et al Clusters of comorbidities based on validated objective measurements and systemic inflammation in patients with chronic obstructive pulmonary disease American journal of respiratory and critical care medicine 187(7) (2013) 728-735. https://www.atsjournals.org/doi/full/10.1164/rccm.201209-1665oc [6] Doan Quynh Huong Analysis of direct costs of inpatient treatment for EPI in Respiratory Center of Bach Mai Hospital from 2013-2015, 2017 (in Vietnamese).[7] Vu Xuan Phu, Duong Viet Tuan, Nguyen Thu Ha et al., Inpatient treatment costs of patients with chronic obstructive pulmonary disease at central lung hospital, 2009, Journal of Practical Medicine 1 (2012) 51-53 (in Vietnamese).http://yhth.vn/chi-phi-dieu-tri-noi-tru-cua-benh-nhan-benh-phoi-tac-nghen-man-tinh-tai-benh-vien-phoi-trung-uong-nam-2009_t3254.aspx[8] C.S. Rand, M. Nides, M.K. Cowles, R.A. Wise, J. Connett, Long-term metered-dose inhaler adherence in a clinical trial. The lung health study research group. Am J Respir Crit Care Med, Aug 152(2) (1995) 580-8. https://doi.org/10.1164/ajrccm.152.2.7633711[9] Phan Thi Thanh Hoa, Clinical features, clinical and direct treatment costs of patients with chronic obstructive pulmonary disease at Respiratory Center - Bach Mai Hospital Graduation thesis general practitioner, Hanoi Medical University 2013 (in Vietnamese).  

scholarly journals Cost of care of chronic non-communicable diseases in Jamaican patients: the role of obesity

2016 ◽  
Vol 17 (2) ◽  
pp. 81-95
Author(s):  
Christine M. Fray-Aiken ◽  
Rainford J. Wilks ◽  
Abdullahi O. Abdulkadri ◽  
Affette M. McCaw-Binns
Keyword(s):  
Cost Of Illness ◽  
Hospital Setting ◽  
Indirect Costs ◽  
Communicable Diseases ◽  
Cost Of Care ◽  
Total Direct Cost ◽  
Non Communicable Diseases ◽  
Female Patients ◽  
Per Capita ◽  
The Cost

OBJECTIVE: To estimate the economic cost of Chronic Non-Communicable Diseases (CNCDs) and the portion attributable to obesity among patients in Jamaica.METHODS: The cost-of-illness approach was used to estimate the cost of care in a hospital setting in Jamaica for type 2 diabetes mellitus, hypertension, coronary heart disease, stroke, gallbladder disease, breast cancer, colon cancer, osteoarthritis, and high cholesterol. Cost and service utilization data were collected from the hospital records of all patients with these diseases who visited the University Hospital of the West Indies (UHWI) during 2006. Patients were included in the study if they were between15 and 74 years of age and if female, were not pregnant during that year. Costs were categorized as direct or indirect. Direct costs included costs for prescription drugs, consultation visits (emergency and clinic visits), hospitalizations, allied health services, diagnostic and treatment procedures. Indirect costs included costs attributed to premature mortality, disability (permanent and temporary), and absenteeism. Indirect costs were discounted at 3% rate.RESULTS: The sample consisted of 554 patients (40%) males (60%) females. The economic burden of the nine diseases was estimated at US$ 5,672,618 (males 37%; females 63%) and the portion attributable to obesity amounted to US$ 1,157,173 (males 23%; females 77%). Total direct cost was estimated at US$ 3,740,377 with female patients accounting for 69.9% of this cost. Total indirect cost was estimated at US$ 1,932,241 with female patients accounting for 50.6% of this cost. The greater cost among women was not found to be statistically significant. Overall, on a per capita basis, males and females accrued similar costs-of-illness (US$ 9,451.75 vs. US$ 10,758.18).CONCLUSIONS: In a country with per capita GDP of less than US$ 5,300, a per capita annual cost of illness of US$ 10,239 for CNCDs is excessive and has detrimental implications for the health and development of Jamaica.

Costs of Management of Occupational Exposures to Blood and Body Fluids

2007 ◽  
Vol 28 (7) ◽  
pp. 774-782 ◽  
Author(s):  
Emily M. O'Malley ◽  
R. Douglas Scott ◽  
Julie Gayle ◽  
John Dekutoski ◽  
Michael Foltzer ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Occupational Exposures ◽  
Body Fluids ◽  
Healthcare Personnel ◽  
Care Hospital ◽  
Infection Status ◽  
Convenience Sample ◽  
The Cost ◽  
Mean Cost

Objective.To determine the cost of management of occupational exposures to blood and body fluids.Design.A convenience sample of 4 healthcare facilities provided information on the cost of management of occupational exposures that varied in type, severity, and exposure source infection status. Detailed information was collected on time spent reporting, managing, and following up the exposures; salaries (including benefits) for representative staff who sustained and who managed exposures; and costs (not charges) for laboratory testing of exposure sources and exposed healthcare personnel, as well as any postexposure prophylaxis taken by the exposed personnel. Resources used were stratified by the phase of exposure management: exposure reporting, initial management, and follow-up. Data for 31 exposure scenarios were analyzed. Costs were given in 2003 US dollars.Setting.The 4 facilities providing data were a 600-bed public hospital, a 244-bed Veterans Affairs medical center, a 437-bed rural tertiary care hospital, and a 3,500-bed healthcare system.Results.The overall range of costs to manage reported exposures was $71-$4,838. Mean total costs varied greatly by the infection status of the source patient. The overall mean cost for exposures to human immunodeficiency virus (HIV)-infected source patients (n = 19, including those coinfected with hepatitis B or C virus) was $2,456 (range, $907-$4,838), whereas the overall mean cost for exposures to source patients with unknown or negative infection status (n = 8) was $376 (range, $71-$860). Lastly, the overall mean cost of management of reported exposures for source patients infected with hepatitis C virus (n = 4) was $650 (range, $186-$856).Conclusions.Management of occupational exposures to blood and body fluids is costly, the best way to avoid these costs is by prevention of exposures.

scholarly journals Thyroid profile as a marker of poor prognostic factor in patients with acute coronary syndrome: a tertiary care hospital based observational study

2018 ◽  
Vol 15 (1) ◽  
pp. 39-41 ◽  
Author(s):  
Navaraj Paudel ◽  
Vijay Madhav Alurkar ◽  
Ramchandra Kafle ◽  
Abhishek Maskey ◽  
Subash Sapkota
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Unstable Angina ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hormonal Changes ◽  
Poor Prognostic Factor ◽  
Coronary Syndrome ◽  
St Segment ◽  
Significant Difference

Background and aims: Serum thyroid hormonal changes can occur in acute or chronic non-thyroidal systemic illness including acute coronary syndrome in otherwise euthyroid individuals. In this study we aimed to assess thyroid hormonal profile in patients presenting with acute coronary syndromes (ACS) and compare between ST segment elevated myocardial infarction and unstable angina/Non ST segment elevated myocardial infarction.Methods: A hospital based, retrospective, observational comparative study was designed. Data of all patients with acute coronary syndrome presenting to hospital were collected from July 2015 through June 2017 in a pre-structured proforma and analyzed.Results: A total of 200 ACS patients between 23 years to 88 years with mean age of 61.33 ± 12.30 years were studied. One hundred and twenty seven (63.5%) were males. Among them 116 (58%) was ST segment elevated myocardial infarction (STEMI) patients while 84 (42%) were unstable angina/ non-ST elevated myocardial infarction (UA/ NSTEMI) patients. Total 47 (23.5%) patients had abnormal TFT of which 28(59.5%) had Euthyroid Sick Syndrome, 12(25.5%) had subclinical hypothyroidism, 5(10.6%) had subclinical hyperthyroidism and 2(4.25%) had low fT4 with normal fT3 and normal TSH. There was significant difference in TFT in patients with STEMI and UA/NSTEMI (P=0.006).There were higher rates of heart failure (p= 0.001 & 0.003 in STEMI & UA/NSTEMI respectively), longer length of hospital stay (3+0.17 days) and high mortality (more than 4 fold) in all types of ACS patients with abnormal TFT than ACS patients with normal TFT.Conclusion: There is higher prevalence of abnormal thyroid hormonal findings in ACS causing significant morbidity and mortality.

scholarly journals AN EVALUATION ON PRESCRIBING PATTERN OF ANTIBIOTICS IN PAEDIATRIC INPATIENTS AT TERTIARY CARE HOSPITAL

2019 ◽  
pp. 53-57
Author(s):  
SABISHRUTHI S ◽  
KAVITHA S ◽  
JAGAN NATHAN B ◽  
KALICHETI PRIYANKA ◽  
ARSHATH A
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Minimum Cost ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Prescribing Pattern ◽  
Case Record ◽  
Tract Infections ◽  
The Cost

Objective: Our objective of the study was to evaluate the prescribing patterns of drugs with cost analysis in pediatric inpatients at tertiary care hospital. Methods: It is an observational prospective study carried out in pediatric inpatients with a sample of 180 patients based on age, inclusion, and exclusion criteria for period of 3 months. The patient’s data were collected using patient case record form and analysis of the data was done. Results: Of 180 patients data were collected, the results show that majority of gender admitted in the hospital were male children 94 (52%) and many are from age group of early childhood (2–5 years) 67 (37%). Respiratory tract infections are diagnosis most commonly analyzed and off overall 236 prescribed antibiotics cephalosporins 86 (43%) and combination of amoxicillin + clavulanic acid 25 (71%) is the class of antibiotics prescribed higher than other class of drugs. Parental 173 (73%) route of administration was observed to be followed more than other route. The percentage of cost variation of antibiotics observed in the study reveals that the huge variations were seen in the cost of medication in maximum and minimum cost. Conclusion: The present study reveals that the prescribed antibiotics were as per the diagnosis of the patient and not by proceeding proper culture sensitivity testing. Hence, awareness about antibiotic must be created among practicing physicians to increase the therapeutic compliance of the patient.

scholarly journals PMS7 Direct Treatment-Cost of Patients with Rheumatoid Arthritis in Medellin, Colombia

2011 ◽  
Vol 14 (7) ◽  
pp. A562
Author(s):  
N. Montoya ◽  
L. Gómez ◽  
M. Vélez ◽  
D. Rosselli
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Cost ◽  
Direct Treatment ◽  
Direct Treatment Cost

scholarly journals A prospective cross-sectional study to evaluate the economic burden of patients diagnosed with depression in a tertiary care hospital

2020 ◽  
Vol 9 (5) ◽  
pp. 722
Author(s):  
D. K. Dhodi ◽  
S. R. Sinha ◽  
F. Dawer ◽  
M. S. Chavan
Keyword(s):  
Economic Burden ◽  
Tertiary Care ◽  
Indirect Costs ◽  
Cross Sectional Study ◽  
Direct Costs ◽  
Cost Of Care ◽  
Hospitalisation Cost ◽  
Care Hospital ◽  
Cross Sectional ◽  
Case Record

Background: The objective of the study was to evaluate the cost of care of depression in terms of direct and indirect costs.Methods: 150 patients diagnosed with depression attending psychiatry OPD at Sir J.J. Group of Hospitals, Mumbai, fulfilling the inclusion criteria were explained about the study. Written informed consent were taken. Direct and Indirect costs were recorded in structured case record forms by interviewing the patients. Cost driving factors were identified.Results: Total annual direct cost were INR 6,378.16 which included drug costs, travel expenses, physician’s consultation, cost of investigations, hospitalisation cost while total Indirect costs were INR 16,860 which included days of work both of the patient and the caretaker.Conclusions: The indirect cost was almost thrice the direct costs. Hospitalisation cost and loss of working days due to depression was contributed the most to the direct costs and indirect costs respectively. Economic burden of depression is found out to be 16.30% of per capita gross domestic product in year 2018-19.

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