scholarly journals The Cost of Potentially Inappropriate Medications in Nursing Homes in West Occitanie

Pharmacy ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 39
Author(s):  
Marie Caucat ◽  
Alice Zacarin ◽  
Vanessa Rousseau ◽  
Jean-Louis Montastruc ◽  
Haleh Bagheri
Keyword(s):  
Nursing Homes ◽  
Drug Prescription ◽  
The Elderly ◽  
Care Homes ◽  
Drug Misuse ◽  
Potentially Inappropriate Medications ◽  
Homes For The Elderly ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Introduction: As of 2019, people older than 65 years represent 20% of the French population. Despite several guidelines suggesting to avoid potentially inappropriate medication (PIM) use in elderly, the prevalence of their prescription remains high (25%). Furthermore, PIM could lead to preventable adverse drug reactions (ADRs). The main objective of this study was to determine the direct cost of PIM in older persons living in residential care homes for the elderly (nursing homes). A secondary objective was to assess the potential impact of PIM deprescribing on drug-related health care costs. Methods: We undertook a multicenter, retrospective study in 19 care homes for the elderly including 1240 residents. The analysis of prescriptions was carried out according to the European EU(7) PIM list. The cost of each drug was estimated according to the French Medication Insurance database. Furthermore, patient’s comorbidities were studied using Charlson’s comorbidity index. In order to estimate the economic impact of PIM, we used the list of alternative appropriate drugs suggested by EU(7) PIM list and French National Health Authority. An incremental cost per patient was calculated by the difference in costs between PIMs and alternative drugs. Results: A total of 7768 lines of drug prescriptions were analyzed. The mean age was 87.6 ± 7.6 years. About 70% (n = 872) of residents received more than five drugs. We identified 959 residents (77.3%) with at least one PIM. The mean cost of PIM was 0.58 euros versus 0.48 euros for alternatives. PIM substitution by alternatives led to save 12 centimes/resident/day. The mean cost of prescription with PIM was 2.8 euros per resident per day (28% of the overall cost of prescription). According to these results, more than 25 million euros can be overall saved for aged persons living in nursing homes for the older people in France per year. Conclusion: The prevalence of PIMs among the elderly in nursing homes is high and leads to a significant cost. Deprescribing of these medications could decrease both drug misuse and cost of drug prescription. Further research is needed to estimate the overall cost of PIM exposure outcomes, taking into account the ADRs leading to hospitalization.

scholarly journals DIRECT COST OF DRUG AND PRESCRIBING PATTERN IN THE OUTPATIENT SERVICES OF A TEACHING HOSPITAL IN MALAYSIA

2018 ◽  
Vol 11 (7) ◽  
pp. 120
Author(s):  
Sit Wai Lee ◽  
Syed Mohamed Aljunid
Keyword(s):  
Drug Cost ◽  
Generic Drugs ◽  
Drug Prescription ◽  
Electronic Prescribing ◽  
Median Cost ◽  
Outpatient Services ◽  
Prescribing Pattern ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Objective: This study aims to impute the direct drug cost and to assess the prescribing pattern on patients getting dyslipidemia drugs at outpatients’ Pharmacy Department in Universiti Kebangsaan Malaysia Medical Centre (UKMMC).Methods: Patients receiving at least one dyslipidemia drug were randomly selected from UKMMC pharmacy electronic prescribing system from January 2012 to December 2012. The patients’ gender, age, and ethnic, and all the drugs received by the patients during the visits were recorded. The brand name of the drugs and the cost was recorded for the calculation of generic drug prescription rate (GDPR) and direct drug cost.Results: A total of 380 patients were randomly selected from the system. There were 829 prescriptions with the total amount of 5512 drugs prescribed. From the total of drugs, the number of generic drugs prescribed was 3967 (72%). The percentage of patients with GDPR of more than 75% for this study was 48% (n=183). The total drug cost for all 380 patients was RM240,244. The mean cost for each patient was RM637 (Range: RM1.20– RM27,972.30) and the median cost was RM233. The total formulary dyslipidemia drugs cost was RM11,003. The mean formulary dyslipidemia drugs cost for each patient was RM38 (Range: RM1.20–RM810), and the median cost was RM13.50. Predictors of high drug cost were GDPR of ≤75% and a number of drugs per prescription of >10.Conclusion: This study could contribute toward short- and long-term strategies to reduce the drug cost expenditure of dyslipidemia drugs in the hospital.

The Unusual Cruelty of Nursing Homes Behind Bars

2020 ◽  
Vol 32 (5) ◽  
pp. 264-271
Author(s):  
Rachel E. López
Keyword(s):  
Nursing Homes ◽  
Human Dignity ◽  
Prison Population ◽  
Financial Burden ◽  
The Elderly ◽  
The United States ◽  
Term Care ◽  
Trained Staff ◽  
State Prisons ◽  
The Cost

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

The cost of a general stochastic epidemic

1972 ◽  
Vol 9 (02) ◽  
pp. 257-269 ◽  
Author(s):  
J. Gani ◽  
D. Jerwood
Keyword(s):  
Recursive Equation ◽  
Stieltjes Transform ◽  
Stochastic Epidemic ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
General Stochastic

This paper is concerned with the cost Cis = aWis + bTis (a, b > 0) of a general stochastic epidemic starting with i infectives and s susceptibles; Tis denotes the duration of the epidemic, and Wis the area under the infective curve. The joint Laplace-Stieltjes transform of (Wis, Tis ) is studied, and a recursive equation derived for it. The duration Tis and its mean Nis are considered in some detail, as are also Wis and its mean Mis . Using the results obtained, bounds are found for the mean cost of the epidemic.

scholarly journals Comparison of the costs of HPV testing through community health campaigns versus home-based testing in rural Western Kenya: a microcosting study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e033979
Author(s):  
Easter Elizabeth Olwanda ◽  
James G Kahn ◽  
Yujung Choi ◽  
Jessica Yasmine Islam ◽  
Megan Huchko
Keyword(s):  
Community Health ◽  
Outcome Measures ◽  
Health Campaigns ◽  
Capital Goods ◽  
Western Kenya ◽  
Home Based ◽  
Registration Number ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

ObjectivesTo estimate the cost of human papillomavirus (HPV)-based screening through community health campaigns (CHCs) and home-based testing.SettingCHCs and home-based testing in six communities in rural Western Kenya.ParticipantsCHCs and home-based screening reached 2297 and 1002 women aged 25–65 years, respectively.Outcome measuresOutcome measures were overall cost per woman screened achieved through the CHCs and home-based testing and the cost per woman for each activity comprising the screening intervention.ResultsThe mean cost per woman screened through CHCs and home-based testing were similar, at $37.7 (range $26.4–$52.0) and $37.1 (range $27.6–$54.0), respectively. For CHCs, personnel represented 49% of overall cost, supplies 25%, services 5% and capital goods 23%. For home-based testing, these were: personnel 73%, supplies 25%, services 1% and capital goods 2%. A greater number of participants was associated with a lower cost per participant.ConclusionsThe mean cost per woman screened is comparable for CHC and home-based testing, with differences in type of input. The CHCs generally reached more eligible women in the six communities, whereas home-based strategies more efficiently reached populations with low screening rates.Trial registration numberNCT02124252.

scholarly journals Load on the Low Back of Care Workers in Nursing Homes for the Elderly

2005 ◽  
Vol 47 (4) ◽  
pp. 131-138 ◽  
Author(s):  
Shinji Kumagai ◽  
Hidetsugu Tainaka ◽  
Keiko Miyajima ◽  
Naoko Miyano ◽  
Junko Kosaka ◽  
...  
Keyword(s):  
Nursing Homes ◽  
The Elderly ◽  
Low Back ◽  
Homes For The Elderly ◽  
Care Workers

Scabies outbreaks in care homes for the elderly

2018 ◽  
Vol 18 (12) ◽  
pp. 1308-1309 ◽  
Author(s):  
Sally Millership ◽  
Smita Kapadia
Keyword(s):  
The Elderly ◽  
Care Homes ◽  
Homes For The Elderly

scholarly journals Potato Late Blight in the Columbia Basin: An Economic Analysis of the 1995 Epidemic

Plant Disease ◽  
1997 ◽  
Vol 81 (1) ◽  
pp. 103-106 ◽  
Author(s):  
D. A. Johnson ◽  
T. F. Cummings ◽  
P. B. Hamm ◽  
R. C. Rowe ◽  
J. S. Miller ◽  
...  
Keyword(s):  
Late Blight ◽  
Management Practice ◽  
Columbia Basin ◽  
Copper Hydroxide ◽  
Total Cost ◽  
Late Season ◽  
The Mean ◽  
The Cost ◽  
Mean Cost ◽  
First Time

The cost of managing late blight in potatoes during a severe epidemic caused by new, aggressive strains of Phytophthora infestans in the Columbia Basin of Washington and Oregon in 1995 was documented. The mean number of fungicide applications per field varied from 5.1 to 6.3 for early- and midseason potatoes, and from 8.2 to 12.3 for late-season potatoes in the northern and southern Columbia Basin, respectively. In 1994, a year when late blight was not severe, the mean number of fungicide applications per field made to early- and midseason potatoes was 2.0; whereas late-season potatoes received a mean of 2.5 applications. The mean per acre cost of individual fungicides applied varied from $4.90 for copper hydroxide to $36.00 for propamocarb + chlorothalonil. Total per acre expenses (application costs plus fungicide material) for protecting the crop from late blight during 1995 ranged from $106.77 to $110.08 for early and midseason potatoes in different regions of the Columbia Basin and from $149.30 to $226.75 for lateseason potatoes in the northern and southern Columbia Basin, respectively. Approximately 28% of the crop was chemically desiccated before harvest as a disease management practice for the first time in 1995, resulting in an additional mean cost of $34.48/acre or $1.3 million for the region. Harvested yields were 4 to 6% less than in 1994. The total cost of managing late blight in the Columbia Basin in 1995 is estimated to have approached $30 million.

scholarly journals REVEALING FEATURES OF THE ARCHITECTURAL TYPOLOGY OF NURSING HOMES

2020 ◽  
pp. 33-39
Author(s):  
I. Zhdanova ◽  
A. Kuznecova ◽  
P. Mihaylina
Keyword(s):  
Social Interaction ◽  
Nursing Homes ◽  
Functional Organization ◽  
The Elderly ◽  
Comfort Level ◽  
Functional Improvement ◽  
Foreign Experience ◽  
Homes For The Elderly ◽  
Care Health

The article focuses on the study of modern approaches in the typology of nursing homes. Global data on the increase in the share of older people in the total population are presented. In addition, Rosstat data confirm the relevance of studying this topic. Examples of foreign experience in designing and building homes for the elderly show the developed functional composition of the premises, along with the function of accommodation and care - health care, leisure, trade, sports, food and multifunctional spaces to ensure social interaction of different groups of the population. The research reveals a method of "functional improvement" aimed at developing optimal functional interactions between public and residential spaces. A concept project for a "dynamic" scheme has been developed, showing the inclusion of residential blocks in a multifunctional complex. The chosen functional organization allows the creation of private spaces for residents of retirement age and walking areas for visitors to the complex. It is determined that in Russia it is necessary to implement modern approaches adapted to Russian conditions, based on foreign experience. This will enhance the consumer quality of the facility and the comfort level of the elderly, which will undoubtedly provide social interaction through the introduction of educational and leisure functions, as well as improve the ecological and aesthetic qualities of the environment.

scholarly journals Vaccine effectiveness for influenza in the elderly in welfare nursing homes during an influenza A (H3N2) epidemic

2000 ◽  
Vol 125 (2) ◽  
pp. 393-397 ◽  
Author(s):  
Y. DEGUCHI ◽  
Y. TAKASUGI ◽  
K. NISHIMURA
Keyword(s):  
Nursing Homes ◽  
Influenza Vaccine ◽  
Influenza A ◽  
Hospital Admissions ◽  
Influenza Virus Infection ◽  
Severe Infection ◽  
The Elderly ◽  
Trivalent Influenza Vaccine ◽  
Homes For The Elderly ◽  
Vaccine Effect

Influenza vaccine effect on the occurrence and severity of influenza virus infection in a population residing in nursing homes for the elderly was studied as a cohort study during an influenza A (H3N2) epidemic in Japan. Of 22462 individuals living in 301 welfare nursing homes, 10739 voluntarily received inactivated, sub-unit trivalent influenza vaccine in a programme supported by the Osaka Prefectural Government. There were statistically significantly fewer cases of influenza, hospital admissions due to severe infection, and deaths due to influenza in the vaccinated cohort compared to the unvaccinated controls. No serious adverse reactions to vaccination were recorded. Thus influenza vaccination is effective for preventing influenza disease in persons aged 65 years and over, and should be an integral part of the care of this population residing in nursing homes.

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