scholarly journals Introduction of Pediatric Robot-Assisted Pyeloplasty in A Low-Volume Centre

2021 ◽  
Vol 11 (1) ◽  
pp. 143-150
Author(s):  
Niklas Pakkasjärvi ◽  
Seppo Taskinen
Keyword(s):  
Cost Analysis ◽  
Daily Activities ◽  
Patient Records ◽  
Matched Cohort ◽  
Cost Difference ◽  
Robot Assisted ◽  
Low Volume ◽  
The Difference ◽  
Open Pyeloplasty ◽  
The Cost

(1) Background: This study investigated the introduction of pediatric robot-assisted pyeloplasty in a low-volume centre with reference to open pyeloplasty with regards to operative times, length of stay (LOS) and outcomes and cost analysis. (2) Methods: Data from 10 consecutive robot-assisted pyeloplasties was compared retrospectively to an age and weight matched cohort of open pyeloplasties operated on during two previous years. Operative times were analyzed in conjunction with LOS, outcomes and cost-analysis from patient records. (3) Results: Operative times remain longer in robot-assisted pyeloplasties (168 (IQR 68) vs. 141 (IQR 51) min), but patients are discharged from the hospital earlier and may return to daily activities earlier. In our hospital, the difference in LOS levels to some degree the cost difference between operations. (4) Conclusions: Robot-assisted pyeloplasty can be safely and economically introduced and maintained in a low-volume centre.

scholarly journals Prospective cost analysis of laparoscopic vs. open pyeloplasty in children: Single centre contemporary evaluation comparing two procedures over a 1-year period

2013 ◽  
Vol 7 (3-4) ◽  
pp. 94-8 ◽  
Author(s):  
Katherine Moore ◽  
Armando J. Lorenzo ◽  
Suzanne Turner ◽  
Darius J. Bägli ◽  
Joao L. Pippi Salle ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Operating Room ◽  
Cost Containment ◽  
Cost Difference ◽  
Economic Implications ◽  
Median Hospital Stay ◽  
Open Pyeloplasty ◽  
The Cost ◽  
Room Time ◽  
Main Factor

Introduction: Laparoscopy in pediatric urological surgery continues to gradually gain acceptance. Since economic implications are of increasing importance in our cost-containment environment, few studies have compared the expense associated with open to laparoscopic approaches. We present a prospective comparative cost-analysis between the laparoscopic (LP) and open pediatric pyeloplasty (OP).Methods: Over a period of a year (2007-2008), 54 consecutives pyeloplasties were performed. The “traditional” OP was performed in 33 patients and the remaining 21 children underwent LP. Costs were prospectively collected for each group and divided based on amounts incurred by all different departments involved: nursing, laboratory, diagnostic imaging, pharmacy and operative room.Results: Overall, the average cost for a LP was CDN$6240 compared to CDN$5079 for an OP with a median hospital stay of 2 days (range OP: 1-18, LP: 1-7). The main difference was found in operative room expenses (OP: $2508 vs. LP: $3925). The higher cost could not be solely explained by the use of disposable items, which only subtracts $335 per procedure (23.6% of the cost difference between OP and LP). Length of time spent in the operating room was 1.2 hours longer for the LP and appears to be the main factor explaining the cost difference.Conclusion: Our findings show that at our institution, pediatric LP is more expensive than OP. This cost difference is mainly due to operating room time. For cost-containment purposes, efforts aimed at increasing efficiency in the operating room may help equalize both approaches.

661 EFFICACY OF ROBOT ASSISTED MINIMALLY INVASIVE ESOPHAGECTOMY: PROPENSITY MATCHED ANALYSIS OF RAMIE IN COMPARISON WITH CONVENTIONAL MIE

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Takeo Fujita ◽  
Kazuma Sato ◽  
Asako Ozaki ◽  
Tomohiro Akutsu ◽  
Hisashi Fujiwara ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Surgical Results ◽  
Matched Cohort ◽  
Robot Assisted ◽  
Nerve Paralysis ◽  
Invasive Esophagectomy ◽  
Significant Difference ◽  
The Difference

Abstract   Robot assisted minimally invasive esophagectomy (RAMIE) has been reported to be potential advantages in previous reports. Here we demonstrate the difference between these two minimally invasive procedures and investigated the surgical results of RAMIE in comparison with MIE using propensity matched-cohort. Methods We investigated 154 cases of thoracic esophagectomy conducted between 2020/1 to 2021/1. Among these cases, we analyzed 30 cases of RAMIE in comparison with 30 cases of matched-cohort which conducted conventional thoracoscopic esophagectomy (MIE) in the prone. Then we evaluated the surgical results between two groups. Results There were no differences in age (69.2 vs 69.1 yo), gender (M:F = 24:6 vs 24:6), cStage (Stage I,II,III,IV:6,3,14,7 vs 8,3,14,5), and preoperative chemotherapy (70% vs 66.7%) between RAMIE and matched-cohort MIE. There was statistically significant difference in total time of thoracic phase (233.1 vs 173.3 min; p < 0.01). There were no significant differences in postoperative events in RAMIE vs MIE (Clavien-Dindo Grade 1≧; Recurrent laryngeal nerve paralysis (RLNP) (16.7 vs 20.0%; p = 0.19). However, after the learning curve archived, seldom cases were diagnosed postoperative RLNP in RAMIE cases in comparison with MIE (p = 0.06). Conclusion We demonstrated the formalization of our procedure and surgical results of RAMIE. There were no significant differences in postoperative events between two groups. However RLNP was lower after the learning peak. Incidence of RLNP could be reduced in RAMIE.

Implications of the WTP–WTA Disparity for Benefit–Cost Analysis

2015 ◽  
Vol 6 (1) ◽  
pp. 207-216 ◽  
Author(s):  
James K. Hammitt
Keyword(s):  
Economic Theory ◽  
Cost Analysis ◽  
Fundamental Question ◽  
Willingness To Accept ◽  
Benefit Cost Analysis ◽  
The Difference ◽  
The Cost ◽  
Benefit Cost ◽  
Benefits And Costs ◽  
Willingness To Accept Compensation

Differences between estimated willingness to accept compensation (WTA) and willingness to pay (WTP) that are larger than can be explained by standard economic theory raise questions about which measures should be used for benefit–cost analysis (BCA). These differences do not create a new problem but accentuate an existing one: the fact that the Kaldor–Hicks compensation test is ambiguous when its two components conflict. This conflict is more likely when the difference between WTA and WTP measures of a change is large. In many cases, the same individuals receive benefits and incur costs from a policy change and their preferences for the policy cannot depend on whether they ask whether their WTP for the benefit exceeds the cost they will incur or their WTA to forgo the benefit exceeds the cost they will save. In cases where benefits and costs are incurred by different people, it seems more useful to evaluate the fundamental question – whether the benefits to some justify the harms to others – than to obscure this question through a technical debate about valuation measures.

scholarly journals Optimization of Replaced Grinding Wheel Diameter for Surface Grinding Based on a Cost Analysis

Metals ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 448 ◽  
Author(s):  
Thi-Hong Tran ◽  
Anh-Tung Luu ◽  
Quoc-Tuan Nguyen ◽  
Hong-Ky Le ◽  
Anh-Tuan Nguyen ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Cost Analysis ◽  
Surface Grinding ◽  
Grinding Wheel ◽  
Wheel Wear ◽  
Steel Material ◽  
The Difference ◽  
Set Up ◽  
The Cost ◽  
The Impact

Based on a cost analysis, a method of identifying and predicting optimum replaced grinding wheel diameter (De.op) in a surface grinding operation for 9CrSi steel material was developed in this study. The De.op value was determined by minimizing the cost function. An experimental design was set up, and a computational program was developed to perform the experiment in order to calculate the De.op value. Furthermore, the impact of the grinding process parameters such as the initial grinding wheel diameter, the grinding wheel width, the total dressing depth, the Rockwell hardness of the workpiece, the radial grinding wheel wear per dress, and the wheel life on the De.op value were investigated. Moreover, the impacts of the cost components such as the machine tool hourly rate and the grinding wheel cost on the De.op value were given. Based on that, a mathematical model was proposed to determine the De.op value. The predicted De.op value was also verified by an experiment. The obtained result shows that the difference between the experimental De.op value and the predicted De.op value is within 1.7%, indicating that the mathematical model proposed in the study is reliable.

Identyfikacja kosztów pogorszenia reputacji przedsiębiorstwa z perspektywy interesariuszy

2014 ◽  
pp. 10-15
Author(s):  
Danuta Szwajca ◽  
Alina Rydzewska ◽  
Tomasz Nawrocki
Keyword(s):  
Cost Analysis ◽  
Economic Costs ◽  
Crisis Situation ◽  
Modern Economy ◽  
The Cost ◽  
A Company ◽  
Crisis Situations

In the realities of modern economy even the best-managed company is not able to avoid threats and bad decisions, that can cause a crisis. Each crisis situation, that a company experiences, generates not only measurable economic costs, but also more difficult to assess and measure costs of a deteriorated reputation. These costs are the result of infringement of interests or failing to satisfy different stakeholders expectations. The aim of this article is an attempt to identify the cost of reputation deterioration in the context of the various interests of stakeholders groups. In the first part, the paper presents the effects of good and bad reputation, the reputation "contamination" path in a crisis situation and a cost analysis caused by it. The second part is empirical, where the identification of crisis situations measurable costs and reputation deterioration based on the examples of three selected companies was performed.

SELISIH BIAYA PRODUKSI SEBAGAI ALAT PENGENDALIAN MANAJEMEN PT INDO PUSAKA BERAU

2019 ◽  
Vol 3 (02) ◽  
pp. 397
Author(s):  
SAFITRI NURHIDAYATI ◽  
RIZKI AMELYA SYAM
Keyword(s):  
Raw Materials ◽  
Field Research ◽  
Analytical Tool ◽  
Production Costs ◽  
Raw Material ◽  
Labor Costs ◽  
Material Costs ◽  
Library Research ◽  
The Difference ◽  
The Cost

This study aims to analyze whether the difference that occurs in the cost of raw materials, direct labor, and factory overhead costs between the standard costs and the actual costs in PLTU LATI is a difference that is favorable or unfavorable. Data collection techniques with field research and library research. The analytical tool used is the analysis of the difference in raw material costs, the difference in direct labor costs and the difference in factory overhead costs. The hypothesis in this study is that the difference allegedly occurs in the cost of raw materials, direct labor costs, and factory overhead costs at PT Indo Pusaka Berau Tanjung Redeb is a favorable difference. The results showed that the difference in the cost of producing MWh electricity at PT Indo Pusaka Berau Tanjung Redeb in 2018, namely the difference in the price of raw material costs Rp. 548,029.80, - is favorable, the difference in quantity of raw materials is Rp. 957,216,602, - is (favorable) , the difference in direct labor costs Rp 2,602,642,084, - is (unfavorable), and the difference in factory overhead costs Rp 8,807,051,422, - is (favorable) This shows that the difference in the overall production cost budget is favorable or profitable. This beneficial difference shows that the company is really able to reduce production costs optimally in 2018.  

Costs and the cost-effectiveness threshold

2017 ◽  
Author(s):  
Jan Abel Olsen
Keyword(s):  
Societal Perspective ◽  
Threshold Value ◽  
Quality Adjusted Life Year ◽  
Healthcare Sector ◽  
The Difference ◽  
The Cost ◽  
Qaly Threshold ◽  
Cost Effectiveness Threshold ◽  
Effectiveness Threshold ◽  
Quality Adjusted Life

Chapter 19 starts by distinguishing between the two contrasting perspectives that an economic evaluation would take: the healthcare sector perspective versus the societal perspective. The former is considered a ‘narrow analysis’ which includes only the costs accruing within the healthcare sector, while the latter represents a ‘broad analysis’ that accounts for all resource implications in all sectors of the economy. After an investigation into various types of costs, a ‘limited societal perspective’ is suggested to be more appropriate than either of the two ‘extreme perspectives’. The chapter continues with a discussion of the cost per quality-adjusted life year (QALY) threshold and explains the difference between a demand side- versus a supply-side approach to determining a threshold value for a QALY.

Economic impact of the use of the National Surgical Quality Improvement Program

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Alvine Fansi ◽  
Angela Ly ◽  
Julie Mayrand ◽  
Maggy Wassef ◽  
Aldanie Rho ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cost Analysis ◽  
Economic Impact ◽  
Quality Improvement Program ◽  
Economic Evaluations ◽  
Complication Rates ◽  
Improvement Program ◽  
Surgical Quality ◽  
Acs Nsqip ◽  
The Cost

Objectives The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) is a validated, risk-adjusted database for improving the quality and security of surgical care. ACS NSQIP can help participating hospitals target areas that need improvement. The aim of this study was to systematically review the literature analyzing the economic impact of using NSQIP. This paper also provides an estimation of annual cost savings following the implementation of NSQIP and quality improvement (QI) activities in two hospitals in Quebec. Methods In June 2018, we searched in seven databases, including PubMed, Embase, and NHSEED for economic evaluations based on NSQIP data. Contextual NSQIP databases from two hospitals were collected and analyzed. A cost analysis was conducted from the hospital care perspective, comparing complication costs before and after 1 year of the implementation of NSQIP and QI activities. The number and the cost of complications are measured. Costs are presented in 2018 Canadian dollars. Results Out of 1,612 studies, 11 were selected. The level of overall evidence was judged to be of moderate to high quality. In general, data showed that, following the implementation of NSQIP and QI activities, a significant decrease in complications and associated costs was observed, which improved with time. In the cost analysis of contextual data, the reduction in complication costs outweighed the cost of implementing NSQIP. However, this cost analysis did not take into account the costs of QI activities. Conclusions NSQIP improves complication rates and associated costs when QI activities are implemented.

The Direct and Indirect Costs of Treating the Victims of the 2016 Nice Terror Attacks in a Single Pediatric Hospital

2021 ◽  
pp. 1-4
Author(s):  
Federico Solla ◽  
Eytan Ellenberg ◽  
Virginie Rampal ◽  
Julien Margaine ◽  
Charles Musoff ◽  
...  
Keyword(s):  
Indirect Costs ◽  
Medical Costs ◽  
Pediatric Hospital ◽  
Terror Attack ◽  
Direct And Indirect Costs ◽  
Terror Attacks ◽  
Direct Medical Costs ◽  
Annual Budget ◽  
The Difference ◽  
The Cost

Abstract Objective: To analyze the cost of the terror attack in Nice in a single pediatric institution. Methods: We carried out descriptive analyses of the data coming from the Lenval University Children’s Hospital of Nice database after the July 14, 2016 terror attack. The medical cost for each patient was estimated from the invoice that the hospital sent to public insurance. The indirect costs were calculated from the hospital’s accounting, as the items that were previously absent or the difference between costs in 2016 versus the previous year. Results: The costs total 1.56 million USD, corresponding to 2% of Lenval Hospital’s 2016 annual budget. Direct medical costs represented 9% of the total cost. The indirect costs were related to human resources (overtime, sick leave), revenue shortfall, and security and psychiatric reinforcement. Conclusion: Indirect costs had a greater impact than did direct medical costs. Examining the level and variety of direct and indirect costs will lead to a better understanding of the consequences of terror acts and to improved preparation for future attacks.

scholarly journals A cost analysis to address issues of budget constraints on the implementation of the indoor residual spray programme in two districts of Maputo Province, Mozambique

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Neide Canana
Keyword(s):  
Sensitivity Analysis ◽  
Cost Analysis ◽  
Financial Analysis ◽  
Indoor Residual Spraying ◽  
Economic Cost ◽  
Cost Information ◽  
Financial Cost ◽  
Provider Perspective ◽  
The Government ◽  
The Cost

Abstract Background It is frequently said that funding is essential to ensure optimal results from a malaria intervention control. However, in recent years, the capacity of the government of Mozambique to sustain the operational cost of indoor residual spraying (IRS) is facing numerous challenges due to restrictions of the Official Development Assistance. The purpose of the study was to estimate the cost of IRS operationalization in two districts of Maputo Province (Matutuíne and Namaacha) in Mozambique. The evidence produced in this study intends to provide decision-makers with insight into where they need to pay close attention in future planning in order to operationalize IRS with the existent budget in the actual context of budget restrictions. Methods Cost information was collected retrospectively from the provider perspective, and both economic and financial costs were calculated. A “one-way” deterministic sensitivity analysis was performed. Results The average economic costs totaled US$117,351.34, with an average economic cost per household sprayed of US$16.35, and an average economic cost per person protected of US$4.09. The average financial cost totaled US$69,174.83, with an average financial cost per household sprayed and per person protected of US$9.84 and US$2.46, respectively. Vehicle, salary, and insecticide costs were the greatest contributors to overall cost in the economic and financial analysis, corresponding to 52%, 17%, and 13% in the economic analysis and 21%, 27%, and 22% in the financial analysis, respectively. The sensitivity analysis was adapted to a range of ± (above and under) 25% change. There was an approximate change of 14% in the average economic cost when vehicle costs were decreased by 25%. In the financial analysis, the average financial cost was lowered by 7% when salary costs were decreased by 25%. Conclusions Altogether, the current cost analysis provides an impetus for the consideration of targeted IRS operationalization within the available governmental budget, by using locally-available human resources as spray operators to decrease costs and having IRS rounds be correctly timed to coincide with the build-up of vector populations.

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