WHICH DRUGS ARE BULLYING US FINANCIALLY? PRESCRIPTION COST ANALYSIS IN EX-SERVICEMAN POLYCLINIC DISPENSARY IN INDIA

2021 ◽  
pp. 60-64
Author(s):  
Bharat Singh ◽  
Saroj Kumar Patnaik ◽  
Chandrasekhara T ◽  
Bhaskar J Kalita ◽  
Kushagra Patel
Keyword(s):  
Cost Analysis ◽  
Health Care Providers ◽  
Unit Cost ◽  
Healthcare Facility ◽  
Essential Medicines ◽  
Care Providers ◽  
Educational Approach ◽  
Prescription Cost ◽  
The Cost ◽  
Cost Awareness

Aims: To carry out prescription cost analysis in Ex-Serviceman Contributory Health Scheme (ECHS) Polyclinic dispensary in India Study Design: Retrospective Prescription Cost Analysis Place And Duration Of Study: ECHS Polyclinic Dispensary from 01 December 2019 to 31 December 2019 on all working days Methodology: A total of 8295 prescriptions were received at ECHS dispensary in the month of December 2019 at an average of 346 prescriptions per day and a maximum of 445 per day and minimum of 242 per day. On each working day data were collected for previous day and segregated in pre-dened format as per National List of Essential Medicines (NLEM) 2015. The cost toward each group of drugs were calculated on prescribed quantity of medicines and added to calculate unit prescription cost at ECHS Dispensary. Results: It is observed that the highest number of prescriptions 4599 (55.44%) were from General OPD. The total cost of prescribed medicines worked out to be INR 25,55,103.81 for the month of December 2019. Most of the cost was ascribed to amount of INR 13,03,489.31 (51.02%) by section 21 (Hormones, other endocrine medicines and contraceptives). The estimated unit cost of prescription was INR 308.03. Conclusion: Implementing change in prescribing behaviors remains a major challenge for administrators and an inclusive approach with integrated with non-coercive educational approach should be utilized to change the behavior in prescriptions writing. Inculcating the culture of cost awareness amongst the health care providers pays good dividends in the long run. As far as cost containment in the healthcare facility is concerned, the rst step forward can be cost awareness toward what and how much clinician are prescribing.

scholarly journals Cost of Treatment Demam Berdarah Dengue (DBD) di Rawat Inap Berdasarkan Clinical Pathway di RS X Jakarta

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Vera Marietha Meinar Rejeki ◽  
Atik Nurwahyuni
Keyword(s):  
Health Care Providers ◽  
Clinical Pathway ◽  
Clinical Pathways ◽  
Unit Cost ◽  
Care Providers ◽  
Cost Of Treatment ◽  
Cross Sectional ◽  
Dengue Disease ◽  
Real Cost ◽  
The Cost

Abstrak Rumah Sakit sebagai pemberi layanan kesehatan saat ini dituntut untuk melakukan kendali mutu dan biaya, namun tetap berkualitas. Clinical pathway yang menjadi dasar pengendalian mutu dan biaya sudah ada tetapi belum diaudit penggunaan­nya oleh tim rumah sakit. Penelitian ini bertujuan untuk mengetahui unit cost layanan dan cost of treatment DBD di RS X Ja­karta. Penelitian kuantitatif melalui pengambilan data cross sectional dengan jumlah sampel penelitian sebanyak 190 pasien DBD. Hasil penelitian didapatkan adanya kesenjangan antara cost of treatment perawatan pasien DBD berdasarkan clinical pathway (Rp. 2.184.588) dan cost of treatment berdasarkan kondisi riil (Rp. 2.382.512) dengan selisih terbesar di rawat inap dan obat-obatan. Cost of treatment tanpa perhitungan gaji dan investasi untuk pasien DBD dapat berkurang menjadi 29% dari cost of treatment semula. Cost of Treatment tanpa perhitungan gaji maka cost of treatment dapat turun menjadi 42%. Diperlukan sistem pemantauan kepatuhan terhadap clinical pathway, pembentukan tim casemix rumah sakit untuk peman­tauan dan evaluasi implementasi JKN di rumah sakit .Abstract Hospitals as health care providers are now required to perform cost and quality control without neglecting the quality of services. Clinical pathways which underlying quality and cost control in the hospital are available but has not been audited. This study aims to determine the unit cost of services in RS X Jakarta, the utilization of hospital services for dengue disease and cost of treatment of DHF in RS X Jakarta. A cross-sectional study was performed in this study. A quantitative approach was done through data collection from hospital information system, medical record and financial data. The result showed that there was a gap between the cost of treat­ment of DHF patients which based on the clinical pathway (2,184,588 IDR) and the cost of treatment based on the real condition (2,382,512 IDR). The biggest difference between cost of treatment and real cost was in the hospitalization cost and medicine cost. Cost of treatment without salary and investation calculation for DHF patients can be reduced significantly by 29%. Cost of treatment without salary calculation for DHF patients can be reduced significantly by 42%. There is a need for monitoring system and the estab­lishment of hospital case mix team in order to optimize the hospital clinical pathway in the JKN era. 

scholarly journals Safeguarding Abuse in Health Care

2018 ◽  
Vol 12 (2) ◽  
pp. 5-10
Author(s):  
Chanda Karki Bhandari ◽  
Gehanath Baral
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Facility ◽  
Health Care Facility ◽  
Healthcare Facility ◽  
Structural Level ◽  
Care Providers ◽  
Ethical Guidelines ◽  
Abuse In Health Care

Aims: The aim of the review is to understand the concept of abuse in health care in general and its various forms. It includes- review what is meant by healthcare and health care abuse; identify its various forms and to recognize who may be the most potential victims; find out the reasons of abuse by health care providers; and know the role of  ethical guidelines and institutional policy in confronting abuse in health care.Methods: Literatures and publications on the subject were searched in order to identify research studies investigating abuse in health care that were studied, analyzed and presented.  Results: Abuse in health care today is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated. Medical professionals and institutions are being targeted worldwide today for negligence and the medical litigation has become a huge challenge. Throughout history, health care professionals have been trusted because of their competency and caring abilities. However, the disturbing reality is that physical and psychological maltreatment of patients do occur in the health care settings throughout the world. The abuse can vary from treating someone with disrespect in a way which significantly affects the person's quality of life, to causing actual physical suffering. Differently able and dependent people are more susceptible to such abuse. Work overload, Staff burnout, lack of information and instructions were also indicated to underlie instances of abuse in health care.Conclusions: We in the healthcare facility should first accept that abuse in health care does occur and causes distress. This change needs to occur at individual, cultural and structural level. Next step will be for the staffs to be aware of abuse in health care when it happens and recognize it as such. It is always better to create a situation where we could prevent abuse from happening at health centers. Hospital personnel must implement a change in workplace culture to stop abusive behaviors wherever they occur. Each and every health care facility should be client friendly and respecting their rights. Effective ethical guidelines were needed to minimize abuse as existing ethical codes were found to be ineffective and above all there was a lack of awareness of the contents of the relevant ethical documents.

Policy on the Development of Immunization Tracking Systems

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 927-927
Author(s):  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Tracking Systems ◽  
Public And Private ◽  
Immunization Status ◽  
Immunization Rates ◽  
Specialized Hardware ◽  
Public And Private Cooperation ◽  
The Cost

The American Academy of Pediatrics in its role as advocate for children supports public and private cooperation in the development of immunization tracking systems (ITSs) insofar as they benefit children. All ITSs as they are developed: • Should prospectively articulate their goals and desired outcomes, including documenting immunization status and the mechanics of immunization, increasing rates of immunization, decreasing cost of immunization, and facilitating immunization opportunities; • Must accurately document each child's current immunization status; • Must preserve children's and their health care provider's right to confidentiality; • Should ensure that data will be available to health care providers 24 hours a day, 7 days a week, so that health care providers can take advantage of all opportunities to immunize; • Should ensure that data will not be used for sanctions against health care providers; • Must ensure that data input and access mechanisms enable providers to supply and access data easily, without having to purchase specialized hardware or expensive software; input and access software mechanisms need to enable all providers to supply data to and retrieve data from the ITS; • Should entitle health care providers to be reimbursed or the cost of providing data to the ITS; • Must ensure that data reflecting evidence of incomplete immunizations will not be used to deny a child access to care or eligibility for benefits by any insurance plan; • Must be studied and/or evaluated to determine their effectiveness at increasing immunization rates and decreasing costs; if such systems do not fulfill these goals, they should be eliminated; and

scholarly journals Spending on World Health Organization essential medicines in Medicare Part D, 2011-15: retrospective cost analysis

BMJ ◽  
2019 ◽  
pp. l4257 ◽  
Author(s):  
David G Li ◽  
Mehdi Najafzadeh ◽  
Aaron S Kesselheim ◽  
Arash Mostaghimi
Keyword(s):  
Cost Analysis ◽  
World Health Organization ◽  
Unit Cost ◽  
Medicare Part D ◽  
Medicare Part ◽  
Essential Medicines ◽  
World Health ◽  
Part D ◽  
Total Spending ◽  
Health Organization

AbstractObjectivesTo characterize the trends, drivers, and potential modifiers of increased spending by US Medicare beneficiaries on medicines deemed essential by the World Health Organization.DesignRetrospective cost analysis of Medicare Part D Prescriber Public Use File, detailing annual generic and brand name drug prescribing and spending from 2011 through 2015 by Medicare Part D participants who filled prescriptions for WHO essential medicines.SettingUS Medicare System.Main outcome measuresTotal and per beneficiary Medicare spending, total and per beneficiary out-of-pocket patient spending, cumulative beneficiary count, claim count, and per unit drug cost. All spending measures were adjusted for inflation and reported in 2015 US dollars.ResultsMedicare Part D expenditures on 265 WHO essential medicines between 2011 and 2015 was $87.2bn (£68.4bn; €76.5bn), with annual spending increasing from $11.9bn in 2011 to $25.8bn in 2015 (116%). Patients’ out-of-pocket spending for essential medicines over the same period was $12.1bn. Total annual out-of-pocket spending increased from $2.0bn to $2.9bn (47%), and annual per beneficiary out-of-pocket spending on these drugs increased from $20.42 to $21.17 (4%). Total prescription count increased from 376.1m to 498.9m (33%), and cumulative beneficiary count grew from 95.9m to 135.8m (42%). Of the essential medicines included in the study, the per unit cost of 133 (50%) agents increased faster than the average inflation rate during this period. Overall, approximately 58% of the increase in total spending during this period can be attributed to the introduction of novel agents.ConclusionsSpending associated with essential medicines grew substantially from 2011 to 2015, driven largely by the increased use of two expensive novel drugs used in treating hepatitis C. Approximately 22% of increased total spending during this period can be attributed to increases in per unit cost of existing drugs. These trends may limit patients’ access to essential drugs while also increasing healthcare system costs.

scholarly journals Improving Access to Cancer Treatments: The Role of Biosimilars

2017 ◽  
Vol 3 (5) ◽  
pp. 596-610 ◽  
Author(s):  
Rakesh Chopra ◽  
Gilberto Lopes
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Health Care Providers ◽  
Cost Effective ◽  
Cancer Therapies ◽  
Care Providers ◽  
Cancer Treatments ◽  
Reference Drug ◽  
Effective Use ◽  
The Cost

Biologics play a key role in cancer treatment and are principal components of many therapeutic regimens. However, they require complex manufacturing processes, resulting in high cost and occasional shortages in supply. The cost of biologics limits accessibility of cancer treatment for many patients. Effective and affordable cancer therapies are needed globally, more so in developing countries, where health care resources can be limited. Biosimilars, which have biologic activity comparable to their corresponding reference drugs and are often more cost effective, have the potential to enhance treatment accessibility for patients and provide alternatives for decision makers (ie, prescribers, regulators, payers, policymakers, and drug developers). Impending patent expirations of several oncology biologics have opened up a vista for the development of corresponding biosimilars. Several countries have implemented abbreviated pathways for approval of biosimilars; however, challenges to their effective use persist. Some of these include designing appropriate clinical trials for assessing biosimilarity, extrapolation of indications, immunogenicity, interchangeability with the reference drug, lack of awareness and possibly acceptance among health care providers, and potential political barriers. In this review, we discuss the potential role and impact of biosimilars in oncology and the challenges related to their adoption and use. We also review the safety and efficacy of some of the widely used biosimilars in oncology and other therapeutic areas (eg, bevacizumab, darbepoetin, filgrastim, rituximab, and trastuzumab).

scholarly journals Knowledge, Perceptions and Effects of Ebola Virus Disease Outbreak on the Pig Value Chain in the Agro-pastoralist District of Luwero, Central Uganda

2021 ◽  
Author(s):  
Samuel Majalija ◽  
Doreen Birungi ◽  
Gabriel Tumwine ◽  
Charles Drago Kato ◽  
Tonny Ssekamatte ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Value Chain ◽  
Ebola Virus ◽  
Virus Disease ◽  
Unit Cost ◽  
Cross Sectional Study ◽  
Traditional Healers ◽  
Care Providers ◽  
Cross Sectional ◽  
Farming Communities

Abstract Background: Ebola outbreaks have continued to affect the health, wellbeing and livelihoods of communities. In particular, Ebola response interventions affect food value chains, food and income security of pig farming communities. There is paucity of information on the effect of Ebola outbreak on the pig value chain as well there is a gap on the knowledge and perceptions of those engaged in the pig value chain on Ebola. Therefore, this study aimed at assessing the knowledge, perceptions on the occurrence of Ebola and its effects on the pig value chain in the agro-pastoral district of Luweero, Central Uganda.Methods: A cross sectional study was conducted in two parishes of Ssambwe and Ngalonkulu, Luwero district. A total of 229 respondents were included in the study. Structured questionnaires, key informant interviews and focus group discussions were conducted to collect data. Quantitative data was analysed using SPSS version 22 while qualitative data was analysed using thematic content analysis.Results: Of the 229 respondents, 95.6% could recall the occurrence of the last Ebola outbreak in their locality. The proportion of respondents that associated touching pigs or eating pork with acquisition of Ebola virus was 24.5%. Ebola was perceived as a spiritual manifestation of witchcraft activities. Traditional healers were among the first line of health care providers to Ebola patients in the outbreak. There was no significant association between the perceived human practices such as bush meat consumption, contact with wild animals and acquiring of Ebola virus. The number of pigs sold during the outbreak was significantly reduced (p= 0.001) and this normalized 2 months after the area was declared Ebola free. There was a significant reduction (p= 0.03) in consumption of pork, as well as the unit cost per kilogram of pork during the Ebola outbreak due to fear of acquiring the disease from pork. Conclusion: The study showed that the pig value chain was negatively affected by Ebola outbreak. Therefore, there is need to sensitize the stakeholders on Ebola in order to minimize the negative economic impacts associated with EVD outbreaks.

Australian Health Care Workers Use of a Telephone Advice Line

2001 ◽  
Vol 7 (3) ◽  
pp. 70
Author(s):  
Patrick G. M. Bolton ◽  
Sharon M. Parker ◽  
Jag Chera
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Information Service ◽  
Target Population ◽  
Care Providers ◽  
Australian Health ◽  
Care Workers ◽  
Telephone Advice ◽  
The Cost ◽  
Area Health

An evaluation of the Health Resource Line (HRL), a telephone information service for use by General Practitioners and Area Health employees in Northern and Central Sydney Area Health Services, was conducted following an eight month pilot. This evaluation found that no more than half of the target population were aware of the service, and that fewer than a third of these had trialed the service. This is consistent with the experience in other published trials of this kind. The experience of health care providers using the service was generally positive, but despite this, overall levels of use were low and declined after an initial peak. The low level of use brings into question the cost effectiveness of such a service and the need for possible alternatives.

Abstract 480: Feasibility of an Augmented Reality Cardiopulmonary Resuscitation Training System for Health Care Providers

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Steve Balian ◽  
Shaun McGovern ◽  
Benjamin Abella ◽  
Audrey Blewer ◽  
Marion Leary
Keyword(s):  
Health Care ◽  
Augmented Reality ◽  
Health Care Providers ◽  
Training System ◽  
Feasibility Trial ◽  
Care Providers ◽  
Educational Approach ◽  
Convenience Sample ◽  
Resuscitation Training ◽  
Cpr Training

Introduction: Augmented reality (AR) has the potential to offer a novel approach to CPR training that supplements conventional training methods with gamification and a more interactive learning experience. This is done through computer-generated imagery superimposed on users’ view of the real environment to simulate interactive training scenarios. Objective: We sought to test the feasibility of an AR CPR training system (CPReality) for health care providers (HCPs). Methods: In this feasibility trial, a CPR training manikin was integrated with a commercial AR device (Microsoft HoloLens) to provide participants with real-time audio-visual feedback via a holographic overlay of blood flow to vital organs dependent on CC quality. In this system, higher quality CC visually improved virtual blood circulation. HCPs performed a 2-minute cycle of hands-only CPR using only the AR system, and CC parameters were recorded. Descriptive data on participants’ demographics, CC quality, and satisfaction with the training environment were reported. Results: Between 10/2019-11/2019, we enrolled a convenience sample of 51 HCPs. The median age of participants was 31 years (IQR 27-41), 71% (36/51) were female, and 67% (34/51) were registered nurses. CC rates (mean 126 ± 12.9 cpm), depths (median 53 mm, IQR 46-58), and percent with complete recoil (median 80%, IQR 12-100) were consistent with guideline recommendations for good quality CPR. Participants were predominantly satisfied with the system, with 82% perceiving the experience as realistic, 98% recognizing the visualizations as helpful for training, and 94% willing to use the application in future CPR training. Conclusions: As AR is increasingly applied in the healthcare setting, integration in CPR training offers a novel and promising educational approach. In this convenience sample of trained HCPs, high quality CC delivery was feasible using the AR CPR training system which was received favorably by most participants.

Budgetbereinigung zwischen Kollektiv- und Selektivvertrag: ökonomische Aspekte aus wettbewerblicher Sicht / Selective Contracting and Collectively Financed Fund: The Way of Appropriate Adjustment

2012 ◽  
Vol 232 (4) ◽  
Author(s):  
Jürgen Zerth ◽  
Stefanie Daum
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cost Sharing ◽  
Care Providers ◽  
Commitment Strategy ◽  
Dynamic Perspective ◽  
The Cost ◽  
Static World ◽  
Selective Contracts ◽  
Method Of Adjustment

SummaryThe extraction of a selective contract from a collectively financed fund needs an appropriate method of adjustment. This is necessary as long as the fund guarantees basic benefits, irrespective of the contractual form of service provision. In this context externalities arise which may not be internalized by the partner of a selective contract.We look at externalities in the context of a collectively financed fund where insurers and health care providers can contract forms of managed care that need an adjustment scheme.We show that in a first-best static world, unique reimbursement schemes between collective and selective contracts are appropriate. From a dynamic perspective problems of externalities between collective and selective contracts increase due to the requirement of an enduring commitment scheme between the health care providers and the cost-payers. But some simple form of cost-sharing ideas in which the patient is also involved can help to achieve a pareto-optimal equilibrium. This commitment strategy will be easier to organise if the selective contract is connected with a process innovation. Altogether, the dynamic commitment strategy may only work if health care providers as well as cost-payers compete actively.

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