The Economic Impact of COVID-19 Treatment at a Hospital-level: Investment and Financial Registers of Brazilian Hospitals

Background: The economic impact associated with the treatment strategies of coronavirus disease-2019 (COVID-19) patients by hospitals and health-care systems in Brazil is unknown and difficult to estimate. This research describes the investments made to absorb the demand for treatment and the changes in occupation rates and billing in Brazilian hospitals. Methods: This research covers the initial findings of “COVID-19 hospital costs and the proposition of a bundled reimbursement strategy for the health-care system,” which includes 10 hospitals. The chief financial officer, the chief medical officer, and hospital executives of each participating hospital provided information regarding investments attributed to COVID-19 patient treatment. The analysis included variations in occupation rates and billing from 2019 to 2020 observed in each institution, and the investments for medical equipment, individual protection materials and building construction per patient treated. Results: The majority of hospitals registered a decrease in hospitalization rates and revenue from 2019 to 2020. For intensive care units (ICUs), the mean occupancy rate ranged from 88% to 83%, and for wards, it ranged from 85% to 73%. Monthly average revenue decreased by 10%. The mean hospital investment per COVID-19 inpatient was I$6800 (standard deviation 7664), with the purchase of ventilators as the most common investment. For this item, the mean, highest and lowest acquisition cost per ventilator were, respectively, I$31 468, I$48 881 and I$17 777. Conclusion: There was significant variability in acquisition costs and investments by institution for responding to the COVID-19 pandemic. These findings highlight the importance of continuing microeconomic studies for a comprehensive assessment of hospital costs. Only with more detailed analyses, will it be possible to define and drive sustainable strategies to manage and reimburse COVID-19 treatment in health-care systems.

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PMH24 MODELING THE ECONOMIC IMPACT OF GALANTAMINE TREATMENT IN PATIENTS WITH ALZHEIMER’S DISEASE IN DIFFERENT HEALTH CARE SYSTEMS

Value in Health ◽

10.1016/s1098-3015(10)61089-3 ◽

2002 ◽

Vol 5 (3) ◽

pp. 235-236

Author(s):

J Caro ◽

M Salas ◽

A Ward ◽

D Getsios ◽

K Migliaccio-Walle ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Health Care ◽

Economic Impact ◽

Health Care Systems ◽

Care Systems

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Assessing the Health and Economic Impact of Galantamine Treatment in Patients with Alzheimer???s Disease in the Health Care Systems of Different Countries

Drugs & Aging ◽

10.2165/00002512-200421100-00005 ◽

2004 ◽

Vol 21 (10) ◽

pp. 677-686 ◽

Cited By ~ 16

Author(s):

Jaime Caro ◽

Maribel Salas ◽

Alexandra Ward ◽

Denis Getsios ◽

Kristen Migliaccio-Walle ◽

...

Keyword(s):

Health Care ◽

Economic Impact ◽

Health Care Systems ◽

Care Systems

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P09.56 Comparison of the effect of different treatment strategies within discrepant health-care systems on survival of glioblastoma patients

Neuro-Oncology ◽

10.1093/neuonc/nox036.311 ◽

2017 ◽

Vol 19 (suppl_3) ◽

pp. iii82-iii83

Author(s):

P. Stavrinou ◽

A. Kalyvas ◽

S. Katsigiannis ◽

C. Hamisch ◽

B. Krischek ◽

...

Keyword(s):

Health Care ◽

Health Care Systems ◽

Treatment Strategies ◽

Care Systems

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Intensive Treatments in Adolescent Anorexia Nervosa

Nutrients ◽

10.3390/nu13041265 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1265

Author(s):

Beate Herpertz-Dahlmann

Keyword(s):

Health Care ◽

Anorexia Nervosa ◽

Intensive Care ◽

Health Care Systems ◽

Intensive Treatment ◽

Stepped Care ◽

Patient Treatment ◽

Care Systems ◽

Treatment Research ◽

Adolescent Anorexia Nervosa

Approximately one-fifth to one-third of patients with adolescent anorexia nervosa (AN) need intensive care in the course of their illness. This article provides an update and discussion on different levels of intensive care (inpatient treatment (IP), day patient treatment (DP) and home treatment (HoT)) in different health care systems based on recently published literature. Important issues discussed in this article are new recommendations for the refeeding process and the definition of target weight as well as principles of medical stabilization and psychotherapeutic approaches. The pros and cons of longer or shorter hospitalization times are discussed, and the advantages of stepped care and day patient treatment are described. A new promising intensive treatment method involving the patient, their caregivers and the direct home environment is introduced. Parents and caregivers should be included in treatment research to foster collaborative work with the attending clinicians. There is an urgent need to evaluate the mid- to long-term outcomes of various intensive treatment programs to compare their effectiveness and costs across different health care systems. This could help policy makers and other stakeholders, such as public and private insurances, to enhance the quality of eating disorder care.

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Errores de conciencia situacional. 200 casos de incidentes críticos en anestesia y cuidados intensivos.

Revista Electrónica AnestesiaR ◽

10.30445/rear.v10i11.400 ◽

2018 ◽

Vol 10 (11) ◽

pp. 4

Author(s):

Jorge Becerra Astaiza ◽

Paula Pérez Caballero ◽

Pilar Argente Navarro

Keyword(s):

Health Care ◽

Human Error ◽

Situational Awareness ◽

Health Care Systems ◽

Patient Treatment ◽

Incident Report ◽

Care Systems ◽

Report System

El análisis de la conciencia situacional supone un abordaje prometedor para mejorar nuestro conocimiento sobre el desarrollo de los errores humanos en los sistemas de salud. Una adecuada conciencia situacional forma parte del tratamiento integral y seguro de los pacientes, y los errores derivados de su pérdida, están implicados en la génesis de eventos adversos. El presente estudio analiza la frecuencia de errores de CS en 200 casos reportados en un sistemas de comunicación de incidentes en Alemania. ABSTRACT Situational awareness analysis means a promising developement in order to improve our knowledge about human error among health care systems. A suitable situational awareness is part of comprehensive and safe patient treatment, and errors related to its lost are involved in the genesis of harmful events. This current study analyzes the frecuence of SA errors in 200 reported cases in a german incident report system.

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Accuracy of Broad-Panel PCR-Based Bacterial Identification for Blood Cultures in a Pediatric Oncology Population

Microbiology Spectrum ◽

10.1128/spectrum.00221-21 ◽

2021 ◽

Author(s):

C. D. Garner ◽

J. Brazelton de Cardenas ◽

S. Suganda ◽

R. T. Hayden

Keyword(s):

Health Care ◽

Pediatric Oncology ◽

Health Care Systems ◽

Bloodstream Infections ◽

Rapid Identification ◽

Blood Cultures ◽

Patient Treatment ◽

Bacterial Identification ◽

Improved Outcomes ◽

Care Systems

Bloodstream infections are a major cause of morbidity and mortality and result in significant costs to health care systems. Rapid identification of the causative agent of bloodstream infections is critical for patient treatment and improved outcomes.

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Patient Preferences Regarding Informed Consent Models for Participation in a Learning Health Care System for Oncology

JCO Oncology Practice ◽

10.1200/jop.19.00300 ◽

2020 ◽

Vol 16 (9) ◽

pp. e977-e990

Author(s):

Rochelle D. Jones ◽

Chris Krenz ◽

Michele Gornick ◽

Kent A. Griffith ◽

Rebecca Spence ◽

...

Keyword(s):

Health Care ◽

Health Care Systems ◽

Patient Data ◽

Patient Choice ◽

Group Discussions ◽

Societal Welfare ◽

Opt Out ◽

Care Systems ◽

The Mean ◽

Learning Health Care System

PURPOSE: The expansion of learning health care systems (LHSs) promises to bolster research and quality improvement endeavors. Stewards of patient data have a duty to respect the preferences of the patients from whom, and for whom, these data are being collected and consolidated. METHODS: We conducted democratic deliberations with a diverse sample of 217 patients treated at 4 sites to assess views about LHSs, using the example of CancerLinQ, a real-world LHS, to stimulate discussion. In small group discussions, participants deliberated about different policies for how to provide information and to seek consent regarding the inclusion of patient data. These discussions were recorded, transcribed, and de-identified for thematic analysis. RESULTS: Of participants, 67% were female, 61% were non-Hispanic Whites, and the mean age was 60 years. Patients' opinions about sharing their data illuminated 2 spectra: trust/distrust and individualism/collectivism. Positions on these spectra influenced the weight placed on 3 priorities: promoting societal altruism, ensuring respect for persons, and protecting themselves. In turn, consideration of these priorities seemed to inform preferences regarding patient choices and system transparency. Most advocated for a policy whereby patients would receive notification and have the opportunity to opt out of including their medical records in the LHS. Participants reasoned that such a policy would balance personal protections and societal welfare. CONCLUSION: System transparency and patient choice are vital if patients are to feel respected and to trust LHS endeavors. Those responsible for LHS implementation should ensure that all patients receive an explanation of their options, together with standardized, understandable, comprehensive materials.

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Modifying Interhospital Hepatopancreatobiliary Transfers Based on Predictive Analytics: Moving from a Center of Excellence to a Health-Care System of Excellence

The American Surgeon ◽

10.1177/000313481908500949 ◽

2019 ◽

Vol 85 (9) ◽

pp. 1033-1039

Author(s):

Ryan C. Pickens ◽

Ainsley K. Bloomer ◽

Jesse K. Sulzer ◽

Keith Murphy ◽

William B. Lyman ◽

...

Keyword(s):

Health Care ◽

Predictive Models ◽

Health Care Systems ◽

Low Risk ◽

Brier Score ◽

Fully Integrated ◽

Northeast Region ◽

Care Systems ◽

Risk Patients ◽

The Mean

Regionalization of complex surgical care has increased interhospital transfers to quaternary centers within large health-care systems. Risk-based patient selection is imperative to improve resource allocation without compromising care. This study aimed to develop predictive models for identifying low-risk patients for transfer to a fully integrated satellite hepatopancreatobiliary (HPB) service in the northeast region of the health-care system. HPB transfers to the quaternary center over 15 months from hospitals in proximity to the satellite HPB center. A predictive tool was developed based on simple pretransfer variables and outcomes for 30-day major complications (Clavien grade ≥ 3), readmission, and mortality. Thresholds for “low risk” were set at different SDs below mean for each model. Predictive models were developed from 51 eligible northeast region patient transfers for major complications (Brier score 0.1948, receiver operator characteristic (ROC) 0.7123, P = 0.0009), readmission (Brier score 0.0615, ROC 0.7368, P = 0.0020), and mortality (Brier score 0.0943, ROC 0.7989, P = 0.0023). Thresholds set from 2 SD below the mean for all models identified 2 as “low risk.” Adjusting the threshold for the serious complication model to only 1 SD below the mean increased the “low-risk” cohort to five patients. These models demonstrate an easy-to-use tool to assist surgeons in identifying low-risk patients for diversion to a fully integrated satellite center. Improved interhospital transfers within a region could begin a transition from centers of excellence toward health-care systems of excellence.

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