scholarly journals Oral Ppi VS IV Ppi in Hospitalized Patient

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
University Hospital ◽  
Daily Cost ◽  
Cost Difference ◽  
Daily Consumption ◽  
Time Intervals ◽  
Oral Medications ◽  
Cost Impact ◽  
Effective Use ◽  
The Cost ◽  
The Impact

Objectives: Of this study have been produced in order to promote effective use of proton pump inhibitors (PPIs) and (H2RAs) histamine II receptor antagonists at AL-Zahraa University Hospital (ZUH) in Lebanon. The aims: Of the study are to ensure PPIs use is limited to situations where there is indicated and there is a clear evidence of benefit, in order to decrease the cost when possible without affecting the patient’s clinical outcome. Setting: Medical and surgical in-patients floors at AL-Zahraa University Hospital (ZUH) were used for this study, which include 57medical and 43 surgical beds. Methods: In this study 100 patients files were reviewed for appropriate IVPPIs uses in two separate time intervals, over six months period started on January 1st, 2016 and ended on June 30th, 2016 and divided into two equal separate time intervals, pre implementation and post implementation of restriction dispensing policy, in order to determine the proper indication and the cost impact of restriction procedure. The main outcomes measure the cost difference between pre and post restriction periods. Results: During the pre-restriction period, the majority of IVPPIs vials were dispensed to patients able to tolerate oral medications with no proper indications to IVPPIs use, the daily consumption of IVPPIs were 48 vials (960 $) in the pre-restriction period as compared to only 2 vials (40$) in the post restriction period, therefore the associated daily cost was reduced from 960$ to 40$. Conclusion: This study highlighted the impact of proper use of PPIs based on implantation of the dispensing authorization restriction form of IVPPIS use which based on the international protocols for peptic ulcer drugs uses, leading to statistically significant in hospital patient’s daily cost reduction by 24 folds.

scholarly journals The impact of a patient’s social status on the cost of vaginal deliveries: an observational study in a French university hospital

2019 ◽  
Vol 48 (1) ◽  
pp. 33-38
Author(s):  
Thomas Vermeulin ◽  
Mélodie Lucas ◽  
Loëtizia Froment ◽  
Valérie Josset ◽  
Pierre Czernichow ◽  
...  
Keyword(s):  
Observational Study ◽  
Social Status ◽  
University Hospital ◽  
Vaginal Deliveries ◽  
The Cost ◽  
The Impact

scholarly journals Cost Minimisation Study of the Impact of Generic Drugs on Glaucoma Management: 1-year Indian Experience

1970 ◽  
Vol 12 (4) ◽  
pp. 192-196
Author(s):  
Devindra Sood ◽  
Alka Pandey ◽  
Rajeev Sood ◽  
Nagesh Gupta ◽  
Ravinder Kumar Bajaj ◽  
...  
Keyword(s):  
Generic Drugs ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Brand Name ◽  
Cost Difference ◽  
Medication Costs ◽  
Generic Medications ◽  
The Mean ◽  
The Cost ◽  
The Impact

Aim: To study the medication costs of various topical glaucoma medications using data collected from real world use by patients.Methods: Patients with primary open angle glaucoma treated at glaucoma clinics in 5 hospitals (1 rural and 4 urban) in northern India from 1 January to 30 June 2008 were enrolled. The number of days each bottle of medication lasted was recorded, and the mean cost per day was computed from the maximum retail price and mean number of days each medication lasted.Results: 790 of 801 eligible patients completed the study. The mean number of days that a bottle of medication lasted was found to be highest for Xalatan® and Xalacom® at 35.23 days and 35.00 days, respectively. The brand name prostaglandin analogues all lasted for a mean of more than 30 days: Xalatan, 35.23 days (SD, 4.14 days); Lumigan®, 31.37 days (SD, 5.31 days); and Travatan®, 34.84 days (SD, 6.51 days), while the generic eye drops lasted for about 21 days: latanoprost, 20.69 days (SD, 3.69 days) and bimatoprost, 21.39 days (SD, 4.34 days). The cost of the generic medication was less than the brand name medication in all groups (for example, bimatoprost, Indian rupees 9.76 versus Indian rupees 12.33) except for brimonidine/timolol (Indian rupees 8.73 versus Indian rupees 8.66). Further analysis in 2009 showed that, for latanoprost, brimonidine and brimonidine/timolol, the difference between the brand name and generic medications decreased in 2009 over 2008 (in the latanoprost group, the cost difference over the year reduced from Indian rupees 592 in 2008 to Indian rupees 523 in 2009); the cost difference for bimatoprost increased from 2008 to 2009.Conclusion: When both cost and number of days a bottle lasts were considered over the long term, use of generic medications might not minimise the cost of glaucoma medical management by much when compared with the brand name medication.

scholarly journals The economics of altruistic punishment and the maintenance of cooperation

2008 ◽  
Vol 275 (1637) ◽  
pp. 871-878 ◽  
Author(s):  
Martijn Egas ◽  
Arno Riedl
Keyword(s):  
Impact Analysis ◽  
Low Cost ◽  
Threshold Level ◽  
Altruistic Punishment ◽  
Cost Impact ◽  
The Social ◽  
Subject Pool ◽  
The Cost ◽  
The Impact ◽  
Cognitive Cost

Explaining the evolution and maintenance of cooperation among unrelated individuals is one of the fundamental problems in biology and the social sciences. Recent findings suggest that altruistic punishment is an important mechanism maintaining cooperation among humans. We experimentally explore the boundaries of altruistic punishment to maintain cooperation by varying both the cost and the impact of punishment, using an exceptionally extensive subject pool. Our results show that cooperation is only maintained if conditions for altruistic punishment are relatively favourable: low cost for the punisher and high impact on the punished. Our results indicate that punishment is strongly governed by its cost-to-impact ratio and that its effect on cooperation can be pinned down to one single variable: the threshold level of free-riding that goes unpunished. Additionally, actual pay-offs are the lowest when altruistic punishment maintains cooperation, because the pay-off destroyed through punishment exceeds the gains from increased cooperation. Our results are consistent with the interpretation that punishment decisions come from an amalgam of emotional response and cognitive cost–impact analysis and suggest that altruistic punishment alone can hardly maintain cooperation under multi-level natural selection. Uncovering the workings of altruistic punishment as has been done here is important because it helps predicting under which conditions altruistic punishment is expected to maintain cooperation.

scholarly journals Self-report versus care provider registration of healthcare utilization: Impact on cost and cost-utility

2009 ◽  
Vol 25 (4) ◽  
pp. 588-595 ◽  
Author(s):  
Martine Hoogendoorn ◽  
Carel R. van Wetering ◽  
Annemie M. Schols ◽  
Maureen P. M. H. Rutten-van Mölken
Keyword(s):  
Resource Use ◽  
Care Provider ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Cost Utility ◽  
Self Report ◽  
Chronic Obstructive ◽  
Cost Difference ◽  
The Cost ◽  
The Impact

Objectives: This study aims to compare the impact of two different sources of resource use, self-report versus care provider registrations, on cost and cost utility.Methods: Data were gathered for a cost-effectiveness study performed alongside a 2-year randomized controlled trial evaluating the effect of an INTERdisciplinary COMmunity-based management program (INTERCOM) for patients with chronic obstructive pulmonary disease (COPD). The program was offered by physiotherapists, dieticians and respiratory nurses. During the 2-year period, patients reported all resource use in a cost booklet. In addition, data on hospital admissions and outpatient visits, visits to the physiotherapist, dietician or respiratory nurse, diet nutrition, and outpatient medication were obtained from administrative records. The cost per quality-adjusted life-year (QALY) was calculated in two ways, using data from the cost booklet or registrations.Results: In total, 175 patients were included in the study. Agreement between self-report and registrations was almost perfect for hospitalizations (rho = 0.93) and physiotherapist visits (rho = 0.86), but above 0.55, moderate, for all other types of care. The total cost difference between the registrations and the cost booklet was 464 euros with the highest difference for hospitalizations 386 euro. Based on the cost booklet the cost difference between the treatment group and usual care was 2,444 euros (95 percent confidence interval [CI], −819 to 5,950), which resulted in a cost-utility of 29,100 euro/QALY. For the registrations, the results were 2,498 euros (95 percent CI, −88 to 6,084) and 29,390 euro/QALY, respectively.Conclusions: This study showed that the use of self-reported data or data from registrations effected within-group costs, but not between-group costs or the cost utility.

Optimizing Product Cost with Supply Chain Cost Modeling

2012 ◽  
Vol 2012 (1) ◽  
pp. 000012-000017
Author(s):  
Chet Palesko ◽  
Alan Palesko
Keyword(s):  
Supply Chain ◽  
New Technologies ◽  
Cost Modeling ◽  
Cost Models ◽  
Modeling Framework ◽  
Cost Drivers ◽  
Cost Impact ◽  
The Right ◽  
The Cost ◽  
The Impact

Demands on the electronics industry for smaller, better, and cheaper packages have made the supply chain more complex. Outsourcing, new technologies, and increasing performance requirements make designing and building the right product for the right price more difficult than ever. We will present a framework for understanding and managing the supply chain through cost modeling. Cost models that accurately reflect the cost impact from technology and design decisions enable a more precise understanding of supply chain behavior. Cost models can show the extra cost of adding a layer, the expected savings from relaxing design rules, or the cost of package on package assembly compared to 3D packaging with through silicon vias (TSVs). The models also provide context to understanding the ″should cost″ of a product and the path to achieving it. Since the guidance from cost models is based on the actual supplier cost drivers and pricing behavior, designer cost reduction efforts will result in higher savings compared to not using the cost models. Without cost models, designers risk missing their suppliers' real cost drivers and, therefore, the opportunity to decrease cost. This cost modeling framework allows the designers to realize the lowest cost product by matching the right design with the right supplier. It is a method for understanding a design decision's cost impact: a design change, a supplier change, or even the impact of new technology.

An optimal order quantity with shelf-refill trips from backroom for efficient store operations

2016 ◽  
Vol 11 (4) ◽  
pp. 967-984
Author(s):  
Anukal Chiralaksanakul ◽  
Vatcharapol Sukhotu
Keyword(s):  
Supply Chain ◽  
Optimal Order ◽  
Type Model ◽  
Order Quantity ◽  
Shelf Space ◽  
Content Type ◽  
Cost Impact ◽  
Optimal Order Quantity ◽  
The Cost ◽  
The Impact

Purpose The purpose of this paper is to investigate the impact of backroom storage in supply chain replenishment decision parameters: the order quantity based on the well-established economic order quantity (EOQ) model. Design/methodology/approach The authors develop an EOQ-type model to investigate the operational cost impact of the order quantity with backroom storage. Because of the discrete and discontinuous nature of the problem, a modification of an existing algorithm is applied to obtain an optimal order quantity. Numerical experiments derived from a leading retailer in Thailand are used to study the cost impact of the backroom. Findings The paper shows that the backroom storage will significantly affect the decision regarding the order quantity. If its effect is ignored, the cost increase can be as high as 30 per cent. The costs and operations of additional shelf-refill trips from the backroom must be carefully analyzed and included in the decisions of replenishment operations. Research limitations/implications The model is a simplified version of the actual replenishment process. Validation from a real-world setting should be used to confirm the results. There are many additional opportunities to further integrate other issues in this problem such as shelf space decisions or joint order quantity between vendors and retailers. Practical implications The insights gained from the model will help managers, both retailers and vendors or manufacturers, make better decisions with regard to the order quantity policy in the supply chain. Originality/value Problems with backroom storage have been qualitatively described in the literature in the past decade. This paper is an early attempt to develop a quantitative model to analytically study the cost impact of backroom on order quantity decisions.

Unraveling Behavioral Ordering: Relative Costs and the Bullwhip Effect

2021 ◽  
Author(s):  
Brent B. Moritz ◽  
Arunachalam Narayanan ◽  
Chris Parker
Keyword(s):  
Supply Chain ◽  
Information Sharing ◽  
Human Behavior ◽  
Bullwhip Effect ◽  
Problem Definition ◽  
Supply Chain Costs ◽  
Cost Impact ◽  
Managerial Implications ◽  
The Cost ◽  
The Impact

Problem definition: We study the bullwhip effect and analyze the impact of human behavior. We separate rational ordering in response to increasing incoming orders from irrational ordering. Academic/practical relevance: Prior research has shown that the bullwhip effect occurs in about two-thirds of firms and impacts profitability by 10%–30%. Most bullwhip mitigation efforts emphasize processes such as information sharing, collaboration, and coordination. Previous work has not been able to separate the impact of behavioral ordering from rational increases in order quantities. Methodology: Using data from a laboratory experiment, we estimate behavioral parameters from three ordering models. We use a simulation to evaluate the cost impact of bullwhip behavior on the supply chain and by echelon. Results: We find that cost increases are not equally shared. Human biases (behavioral ordering) at the retailer results in higher relative costs elsewhere in the supply chain, even as similar ordering by a wholesaler, distributor, or factory results in increased costs within that echelon. These results are consistent regardless of the behavioral models that we consider. The cognitive profile of the decision maker impacts both echelon and supply chain costs. We show that the cost impact is higher as more decision makers enter a supply chain. Managerial implications: The cost of behavioral ordering is not consistent across the supply chain. Managers can use the estimation/simulation framework to analyze the impact of human behavior in their supply chains and evaluate improvement efforts such as coordination or information sharing. Our results show that behavioral ordering by a retailer has an out-sized impact on supply chain costs, which suggests that upstream echelons are better placed to make forecasting and replenishment decisions.

scholarly journals Paying for convenience: comparing the cost of takeaway meals with their healthier home-cooked counterparts in New Zealand

2017 ◽  
Vol 20 (13) ◽  
pp. 2269-2276 ◽  
Author(s):  
Sally Mackay ◽  
Stefanie Vandevijvere ◽  
Pei Xie ◽  
Amanda Lee ◽  
Boyd Swinburn
Keyword(s):  
New Zealand ◽  
Saturated Fat ◽  
Preparation Time ◽  
Cost Impact ◽  
The Mean ◽  
Cost Of Time ◽  
The Cost ◽  
Mean Cost ◽  
The Impact ◽  
Cost Differences

AbstractObjectiveConvenience and cost impact on people’s meal decisions. Takeaway and pre-prepared foods save preparation time but may contribute to poorer-quality diets. Analysing the impact of time on relative cost differences between meals of varying convenience contributes to understanding the barrier of time to selecting healthy meals.DesignSix popular New Zealand takeaway meals were identified from two large national surveys and compared with similar, but healthier, home-made and home-assembled meals that met nutrition targets consistent with New Zealand Eating and Activity Guidelines. The cost of each complete meal, cost per kilogram, and confidence intervals of the cost of each meal type were calculated. The time-inclusive cost was calculated by adding waiting or preparation time cost at the minimum wage.SettingA large urban area in New Zealand.ResultsFor five of six popular meals, the mean cost of the home-made and home-assembled meals was cheaper than the takeaway meals. When the cost of time was added, all home-assembled meal options were the cheapest and half of the home-made meals were at least as expensive as the takeaway meals. The home-prepared meals were designed to provide less saturated fat and Na and more vegetables than their takeaway counterparts; however, the home-assembled meals provided more Na than the home-made meals.ConclusionsHealthier home-made and home-assembled meals were, except one, cheaper options than takeaways. When the cost of time was added, either the home-made or the takeaway meal was the most expensive. This research questions whether takeaways are better value than home-prepared meals.

scholarly journals Time to Start Adjuvant Systemic Treatment in Breast Cancer; a Retrospective Cohort Study

2017 ◽  
Vol 6 (2) ◽  
pp. 60
Author(s):  
Amal Rayan ◽  
Hosam A. Hasan
Keyword(s):  
Breast Cancer ◽  
Adjuvant Treatment ◽  
Systemic Treatment ◽  
University Hospital ◽  
World Health ◽  
Optimal Time ◽  
Time Intervals ◽  
Free Survival ◽  
Adjuvant Systemic Treatment ◽  
The Impact

Background: According to the World Health Organization (WHO), early diagnosis of cancer was associated with increasing rates of survival for cancers as breast, cervix, mouth, larynx, colon, rectum and skin. Still the optimal time to start adjuvant treatment after definitive surgery is uncertainAim of study: to evaluate the impact of delay to start adjuvant treatment in different biologic subtypes of breast cancer on treatment outcomes as regard response, failure free survival (FFS).Patients and methods: It involved 107 patients with nonmetastatic breast cancer presented to clinical oncology department, Assiut university hospital from January 2011 to December 2012, and were eligible for adjuvant systemic treatment, The time from surgery to the start of 1st cycle of adjuvant systemic treatment was calculated, then this time was divided into three time intervals; ≤30 days, >30 - ≤60 days, and >60 days.Results: 41.1%, 45.8%, 13.1% of patients received adjuvant treatment within 30 days, <30-60 days, and more than 60 days respectively, the median failure free survival was 50±2.104 months (95% CI=45.877-54.125) and was significantly decreased with increasing the time but not significantly differed between different time intervals in the whole study patients, nor in different biologic subtypes except luminal B, patients started early adjuvant treatment, relapsed late with significant effect of different time intervals on the time to relapse, local and distant relapses (P<0.000, P<0.001, P<0.02).Conclusion: Adjuvant systemic treatment for breast cancer should be initiated as early as possible better within 30 days of surgery because of significant poor effect of delay to initiate adjuvant treatment on FFS and TTR.

scholarly journals The influence of endogenous innovative sources on the development of exports of industrial enterprises

2021 ◽  
Vol 187 (1-2) ◽  
pp. 99-113
Author(s):  
Alla Dunska ◽  
◽  
Hanna Zhaldak ◽  
Keyword(s):  
Social Capital ◽  
System Development ◽  
Enterprise Development ◽  
Foreign Markets ◽  
Industrial Enterprises ◽  
Depth Analysis ◽  
The Difference ◽  
Effective Use ◽  
The Cost ◽  
The Impact

This paper presents an in-depth analysis of the essence of economic system development, giving the understanding of the difference between the categories of social and human capital. The authors of the paper describe the composition of the structure of social capital by using the method of analysis of hierarchies basing on the example of JSC «Kyivmedpreparat» and assessing the impact of elements of social capital in the context of export activities of the enterprise. The application of this methodology provides an opportunity to ensure the effective use of social capital as a resource and an endogenous innovative source of export activities of the enterprise, and increase the level of competitiveness of the enterprise in foreign markets. The developed methodological recommendations will be useful to experts in estimating the cost of export activities and forming a strategy for enterprise development.

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