scholarly journals The Financial Burden of Surgery for Congenital Malformations—The Austrian Perspective

2021 ◽  
Vol 18 (21) ◽  
pp. 11166
Author(s):  
Paolo Gasparella ◽  
Georg Singer ◽  
Bernhard Kienesberger ◽  
Christoph Arneitz ◽  
Gerhard Fülöp ◽  
...  
Keyword(s):  
Congenital Malformations ◽  
Hospital Admissions ◽  
Financial Burden ◽  
Duodenal Atresia ◽  
National Public Health Institute ◽  
National Public Health ◽  
Related Group ◽  
Surgical Conditions ◽  
Mean Cost ◽  
Postnatal Surgery

Neonatal “surgical” malformations are associated with higher costs than major “non-surgical” birth defects. We aimed to analyze the financial burden on the Austrian health system of five congenital malformations requiring timely postnatal surgery. The database of the Austrian National Public Health Institute for the period from 2002 to 2014 was reviewed. Diagnosis-related group (DRG) points assigned to hospital admissions containing five congenital malformations coded as principal diagnosis (esophageal atresia, duodenal atresia, congenital diaphragmatic hernia, gastroschisis, and omphalocele) were collected and compared to all hospitalizations for other reasons. Out of 3,518,625 total hospitalizations, there were 1664 admissions of patients with the selected malformations. The annual mean number was 128 (SD 17, range 110–175). The mean cost of the congenital malformations per hospital admission expressed in DRG points was 26,588 (range 0–465,772, SD 40,702) and was significantly higher compared to the other hospitalizations (n = 3,516,961; mean DRG 2194, range 0–834,997; SD 6161; p < 0.05). Surgical conditions requiring timely postnatal surgery place a significant financial burden on the healthcare system. The creation of a dedicated national register could allow for better planning of resource allocation, for improving the outcome of affected children, and for optimizing costs.

scholarly journals The hidden cost of deep neck space infections

2018 ◽  
Vol 100 (2) ◽  
pp. 129-134 ◽  
Author(s):  
RH Hurley ◽  
CM Douglas ◽  
J Montgomery ◽  
LJ Clark
Keyword(s):  
Hospital Admissions ◽  
Financial Burden ◽  
Antibiotic Prescribing ◽  
Contributing Factors ◽  
Source Of Infection ◽  
Hidden Cost ◽  
The Mean ◽  
Using Data ◽  
The Cost ◽  
Mean Cost

Introduction The incidence of deep neck space infection (DNSI) is rising and appears to be related to falling rates of tonsillectomy. The purpose of this study was to assess demographics of patients presenting with DNSI and the financial burden to the National Health Service (NHS). Methods Data were collected retrospectively on patients aged over 16 years admitted to NHS Greater Glasgow and Clyde with DNSI between 2012 and 2016. Demographics, aetiology and use of hospital resources were reviewed. The cost of hospital admissions was calculated using data from NHS Scotland’s Information Services Division, the local diagnostics division and the British National Formulary. Results Seventy-four patients were admitted with DNSI during the study period. Forty (54%) were male. The mean age was 44.0 years (range: 16–86 years). The most frequent source of infection was the tonsil (n=30, 40.5%). The most common infective organism was Streptococcus constellatus (n=9, 12.2%). The mean length of stay was 11 days. Fifty-five patients (74.3%) required operative intervention. The mean cost of admission per patient was £5,700 (range: £332–£46,700). Conclusions This study highlights the high cost burden of DNSI to the NHS. The incidence of DNSI in Glasgow has risen over the study period; contributing factors may include the reduced tonsillectomy rate and a reduction in antibiotic prescribing. As the incidence of DNSI continues to rise, there will be an increase in cost to the NHS, which must be planned for.

scholarly journals The Financial Burden of Setting up a Pediatric Robotic Surgery Program

Medicina ◽  
2019 ◽  
Vol 55 (11) ◽  
pp. 739 ◽  
Author(s):  
Boia ◽  
David
Keyword(s):  
Robotic Surgery ◽  
Surgical Procedure ◽  
Pediatric Surgery ◽  
Pathological Condition ◽  
Financial Burden ◽  
Insurance Company ◽  
Pediatric Treatment ◽  
Cost Efficient ◽  
Robotic Instruments ◽  
Mean Cost

Background and Objectives: Robotic surgery is currently at the forefront of both adult and pediatric treatment. The main limit in the wide adoption of this technology is the high cost of purchasing and running the robotic system. This report will focus on the costs assessment of running a robotic program in a pediatric surgery center in Romania. Materials and Methods: In 12 months we performed 40 robot-assisted procedures in children. We recorded and analyzed data regarding their age, gender, pathological condition and comorbidities, surgical procedure, time of surgery, complications, hospital stay and related costs, medication, robotic instruments and consumables, additional cost, and income per case received from the National Insurance Company (NIC). Results: Mean cost per case was €3260.63 (€1880.07 to €9851.78) and was influenced by type of the procedure, intraoperative incidents, postoperative complication, and non-scheduled reinterventions (p < 0.05). The direct costs for operating the surgical robot were relatively constant, regardless of the surgical procedure (mean €1579.81). The reimbursement from the NIC ranged from 5% to 56% (mean 16.9%) of the total cost per case. Conclusion: In Romania, a pediatric surgery robotic program is not cost-efficient and cannot operate relying solely onto the health insurance system.

CONGENITAL ATRESIA AND STENOSIS OF THE DUODENUM

PEDIATRICS ◽  
1969 ◽  
Vol 43 (1) ◽  
pp. 79-83
Author(s):  
Eric W. Fonkalsrud ◽  
Alfred A. deLorimier ◽  
Daniel M. Hays
Keyword(s):  
Congenital Malformations ◽  
Duodenal Obstruction ◽  
Duodenal Atresia ◽  
Operative Techniques ◽  
Congenital Atresia ◽  
Late Mortality ◽  
Congenital Duodenal Obstruction ◽  
American Academy Of Pediatrics ◽  
Associated Malformations ◽  
Major Congenital Malformations

A review is presented of 503 patients with congenital duodenal obstruction, compiled from 65 hospitals by the Surgical Section of the American Academy of Pediatrics. Four hundred eighty-seven patients underwent primary operative correction of the malformation with an overall early and late mortality rate of 36%. Complications from associated major congenital malformations were the leading cause of death. Many of these anomalies were potentially correctable had they been recognized and early treatment instituted. More than half of the infants with duodenal atresia had associated malformations. Thirty percent of the patients had Down's syndrome. End-to-side or side-to-side duodenoduodenostomy or jejunostomy are the most commonly used operative techniques for duodenal atresia. General anesthesia and tube gastrostomy are usually employed.

Atlas of Infant Surgery, by Dr. J. Eugene Lewis, Jr. St. Louis: The C. V. Mosby Company, 1967, 258 pp., $21.00

PEDIATRICS ◽  
1968 ◽  
Vol 42 (4) ◽  
pp. 720-720
Author(s):  
W. Hardy Hendren
Keyword(s):  
Congenital Malformations ◽  
Operative Procedure ◽  
Early Infancy ◽  
General Terms ◽  
Surgical Conditions ◽  
Stated Purpose

This book describes most of the more common general surgical conditions seen in infants. Each entity is described in general terms, followed by artist's drawings depicting the major steps of the operative procedure. The author's stated purpose in this book is to "assist physicians and surgeons who encounter and who must help solve surgical problems of early infancy." The book does outline the essential steps of correction of many of these congenital malformations, but some of the procedures seem unduly simplified.

scholarly journals Adverse Drug Reaction (ADR) as a Cause of Hospitalization at a Government Hospital in Saudi Arabia: A Prospective Observational Study

2019 ◽  
Vol 14 (3) ◽  
pp. 192-198 ◽  
Author(s):  
Nouf Alayed ◽  
Bushra Alkhalifah ◽  
Munirah Alharbi ◽  
Naief Alwohaibi ◽  
Maryam Farooqui
Keyword(s):  
Saudi Arabia ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Hospital Admissions ◽  
Financial Burden ◽  
Length Of Hospital Stay ◽  
Morbidity And Mortality ◽  
Severity Assessment ◽  
Hospitalization Rates ◽  
Naranjo Algorithm

Background: ADRs represent a substantial burden on health care resources worldwide and are considered as one of the leading causes of morbidity and mortality which significantly affects hospitalization rates. However, ADR related hospital admissions are not well explored in Saudi Arabia. Objectives: The current study aims to evaluate ADR-related admissions at King Saud Hospital, Unaizah, Qassim, Saudi Arabia. Method: A prospective, observational study was conducted at King Saud Hospital Unaizah. Over a period of 6 months, patients above 12 years of age who visited the Emergency Department (ED) with an ADR were included in this study. The investigators collected patient data by reviewing the patient's medical records and the ED records for admission. The Naranjo algorithm was used to assess the causality of the suspected ADR, and Hartwig’s Severity Assessment Scale was used to assess the severity of the ADR. Results: Out of 4739 admissions to the wards, 38 (0.801%) were related to an ADR. The majority of patients were male (52.6%), with a mean age of ± 49.08 years. The total length of hospital stay was 565 days with a mean of ± 14.87 days. The causality assessment shows that 35 (92.1%) cases were probable ADRs, whereas 3 (7.9%) cases were possible ADRs. Moreover, the severity assessment showed that 6 (15.1%) cases were mild, and 27 (71.1%) and 5 (13.2%) cases were moderate and severe, respectively. In regard to the outcome of patients, most patients recovered after the ADR, and 2 ADRs resulted in the death of the patient. Conclusion: Our study shows that ADRs as a cause of hospitalization in Qassim population is considerably low. However, ADRs may contribute to morbidity and mortality and result in a considerable financial burden.

scholarly journals National Public Health Institute Legal Framework: A Tool to Build Public Health Capacity

2020 ◽  
Vol 18 (S1) ◽  
pp. S-43-S-52 ◽  
Author(s):  
Emily L. Rosenfeld ◽  
Sue Binder ◽  
C. Adam Brush ◽  
Ellen A. Spotts Whitney ◽  
Dennis Jarvis ◽  
...  
Keyword(s):  
Public Health ◽  
Legal Framework ◽  
National Public Health Institute ◽  
Health Institute ◽  
National Public Health ◽  
Public Health Institute

scholarly journals Disease modeling for public health: added value, challenges, and institutional constraints

2019 ◽  
Vol 41 (1) ◽  
pp. 39-51 ◽  
Author(s):  
Mirjam Kretzschmar
Keyword(s):  
Public Health ◽  
Mathematical Modeling ◽  
Disease Modeling ◽  
Scientific Evidence ◽  
Policy Support ◽  
Added Value ◽  
National Public Health Institute ◽  
Health Institute ◽  
National Public Health ◽  
Public Health Institute

AbstractPublic health policymakers face increasingly complex questions and decisions and need to deal with an increasing quantity of data and information. For policy advisors to make use of scientific evidence and to assess available intervention options effectively and therefore indirectly for those deciding on and implementing public health policies, mathematical modeling has proven to be a useful tool. In some areas, the use of mathematical modeling for public health policy support has become standard practice at various levels of decision-making. To make use of this tool effectively within public health organizations, it is necessary to provide good infrastructure and ensure close collaboration between modelers and policymakers. Based on experience from a national public health institute, we discuss the strategic requirements for good modeling practice for public health. For modeling to be of maximal value for a public health institute, the organization and budgeting of mathematical modeling should be transparent, and a long-term strategy for how to position and develop mathematical modeling should be in place.

Cost of colon cancer care: Results of nationwide inpatient sample (NIS) data.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 692-692 ◽  
Author(s):  
Pranshu Bansal ◽  
Ian Rabinowitz ◽  
Yanis Boumber ◽  
Dhruv Bansal
Keyword(s):  
Colon Cancer ◽  
Cancer Care ◽  
Hospital Admissions ◽  
Hospital Costs ◽  
Cost Of Care ◽  
Inpatient Setting ◽  
Hospital Data ◽  
For Profit ◽  
The Mean ◽  
Mean Cost

692 Background: Cost of cancer care including colon cancer continues to rise. Most of the recent advances in colon cancer inlcude biologics and targeted agents which are adminstered in an oupatient setting and more commonly thought to be responsible for increasing economic burden. Cost of care for cancer patients in an inpatient setting however continues to be a significant factor that needs to be identified better to help adopt cost effective quality improvement in future. Methods: We used NIS to extract data for patients hospitalized with primary diagnosis of colon cancer using clinical classification software code 14, and corresponding ICD9 codes for the years 2003-2013. ICD codes for colorectal and rectal cancer were eliminated. NIS is a nationally representative survey of hospitalizations conducted by the Healthcare Cost and Utilization Project. It represents 20% of all hospital data in US. Trend of rate of hospitalization, mean length of stay (LOS), mean cost of hospitalization and mean cost of hospitalization based on owner type- government, private not for profit (PNFP) and private for profit (PFP) was performed. Results: From the year 2003 to 2013 rate of hospitalizations for colon cancer decreased from 37.4 to 28.1 per 100,000 hospital admissions. Mean LOS declined from 9.06 to 7.76 between 2003-2013. In the same time period the mean cost of hospital stay increased from $39,430 to $73,219. The mean cost of hospitalization based on owner type in 2003 was government $33,507; PNFP $33,735 and PFP was $55,553 and in 2013 the mean costs were $63,194; $68,555 and $107,428 respectively. Conclusions: In the decade of 2003-2013 the rate of hospitalization decreased by approximately 25%, LOS decreased by 14% but the mean cost of hospitalization continued to increase throughout the decade with a mean increase of approximately 85% in hospital costs. The increase was observed across the spectrum of all owner types with the maximum increase of 104% in PNFP followed by PFP owner type at 93%, national inflation rate was 26% during this time. Progress made in decreasing LOS has not directly translated into reducing hospital costs and further studies focusing on factors in addition to cost of biologic agents that contribute to cancer care costs should be considered.

Comparing costs of home- versus hospital-based treatment of infections in adults in a specialist cystic fibrosis center

2005 ◽  
Vol 21 (4) ◽  
pp. 506-510 ◽  
Author(s):  
Rachel A. Elliott ◽  
Judith Thornton ◽  
A. Kevin Webb ◽  
Mary Dodd ◽  
Mary P. Tully
Keyword(s):  
Cystic Fibrosis ◽  
Hospital Admissions ◽  
Respiratory Infections ◽  
Alternative Methods ◽  
Factors Affecting ◽  
Intention To Treat ◽  
Home Based ◽  
Clinical Records ◽  
Mean Cost ◽  
At Home

Objectives: This study aimed to produce valid patient-based UK National Health Service (NHS) costs for adults with cystic fibrosis to identify differences between hospital- and home-based treatments for infections.Methods: A costing study was carried out in adults with cystic fibrosis (CF) in the United Kingdom, who required intravenous antibiotic treatments for respiratory infections, administered either at home or in the hospital. The perspective was that of the NHS hospital trust. Data were collected retrospectively for each patient for 1 year using clinical records. Data were collected for 116 adults with CF between 2000 and 2001, when 42,382 treatment days (454 courses) of intravenous antibiotics were administered; 213 courses with intention-to-treat at home and 241 courses with intention-to-treat in the hospital. The mean length of a course was 15.3 days.Results: Patients who had >60 percent of courses at home over 1 year had a mean cost of £13,528, compared with £22,609 for patients who had >60 percent of courses in the hospital, and a mean cost of £19,927 for patients who had an equal mix of home and hospital care (p = .0001).Conclusions: The key cost-generating events in CF respiratory infections are hospital admissions. Future studies assessing costs should concentrate on factors affecting admissions, length of stay, staff input, and alternative methods of home-care provision, rather than marginal effects, such as using different antibiotics.

Sign in / Sign up

Export Citation Format

Share Document