scholarly journals Efektivitas Biaya Penggunaan Antibiotik Pasien ISPA Pediatri di RSUD Kajen Kabupaten Pekalongan Tahun 2019

2021 ◽  
Vol 1 ◽  
pp. 108-116
Author(s):  
Siti Aliyah ◽  
Yulian Wahyu Permadi ◽  
St Rahmatullah ◽  
Ainun Mutoharoh

AbstractAcute respiratory infection (ARI) is an acute infectious disease that attacks one or more parts of the respiratory system, starting from the nasal alveoli, including the adnexa (sinus of the pleural middle ear cavity). The purpose of this study was to determine the type of antibiotics in pediatric ARI patients at Kajen Hospital in 2019 and to determine the effectiveness of treatment costs based on the use of antibiotics issued by pediatric ARI patients at Kajen Hospital in 2019. This study is a type of non-experimental research that is descriptive and takes retrospectively through medical record data of ARI patients. The number of samples used as many as 80 patients. The pharmacoeconomic method used in this study is the CEA method/cost effectiveness analysis. The data taken include: data on respondent characteristics, total costs or direct medical costs, the results of the study on the effectiveness of antibiotic therapy Cefotaxim 52.90%, Efotax 54.50% and Viccillin 61.50%. The average total cost of antibiotics for Cefotaxim was Rp. 817,392, Efotax was Rp. 1,392,189, Viccillin was Rp. 1,318,838, Ampicillin was Rp. 1,107,059, Cefadroxil was Rp. 850,564 and Cefixim was Rp. 858,479. The ACER value was the most cost effective for Cefotaxim compared to other therapies. while the ICER value is the most cost effective, namely the comparison between Cefotaxim and Viccillin with an ICER value of Rp - 63,081,937. Suggestions for further research are expected to be able to compare the cost of treatment for outpatients and inpatients and increase sampledata. Keywords: Cost Effectiviness, ARI, antibiotik AbstrakInfeksi saluran pernafasan akut (ISPA) merupakan penyakit infeksi akut yang menyerang salah satu / lebih bagian dari sistem pernafasan mulai dari hidung alveoli termasuk adneksanya (sinus rongga telinga tengah pleura). Tujuan penelitian ini adalah untuk mengetahui jenis antibiotik pada pasien ISPA pediatri di RSUD Kajen tahun 2019 dan untuk mengetahui keefektifan biaya pengobatan berdasarkan penggunaan antibiotik yang dikeluarkan oleh pasien ISPA pediatri di RSUD kajen tahun 2019. Penelitian ini merupakan jenis penelitian non eksperimental yang bersifat deskriptif dan pengambilan data secara retrospektif melalui data rekam medik pasien ISPA. Jumlah sampel yang digunakan sebanyak 80 pasien. Metode farmakoekonomi yang digunakan pada penelitian ini yaitu metode CEA/Analisis efektifitas biaya. Data yang diambil meliputi: data karakteristik responden, biaya total atau biaya medik langsung, Hasil penelitian efektivitas terapi antibiotik Cefotaxim 52,90%, Efotax 54,50% dan Viccillin 61,50%. Hasil rata-rata total biaya antibiotik Cefotaxim sebesar Rp 817.392, Efotax Rp 1.392.189, Viccillin Rp 1.318.838, Ampicillin Rp 1.107.059, Cefadroxil Rp 850.564 dan Cefixim Rp 858.479. Nilai ACER yang paling cost efffective pada antibiotik Cefotaxim dibandingkan dengan terapi lainnya. sedangkan pada nilai ICER yang paling cost effecttive yaitu pada perbandingan antara Cefotaxim dengan Viccillin dengan nilai ICER Rp - 63.081.937. Saran untuk penelitian selanjutnya diharapkan dapat membandingkan biaya pengobatan pasien rawat jalan dan rawat inap serta memperbanyak data sampelKata kunci: Efektivitas biaya; ISPA; antibiotik

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16150-e16150
Author(s):  
J. Godoy ◽  
A. F. Cardona ◽  
H. Cáceres ◽  
J. M. Otero ◽  
M. Lujan ◽  
...  

e16150 Background: Renal cell carcinoma has increased its incidence by 126% since 1950. A local study developed a complete economic evaluation of sunitinib versus IFN in first-line treatment of mRCC in Colombia, finding that sunitinib was more cost-useful and cost-effective. Methods: A Markov model was developed using 6-week cycles for evaluating the cost-effectiveness of four interventions (IFN, sunitinib, bevacizumab+IFN, sorafenib) approved as first-line treatment for mRCC in Colombia. The model used the third-party payer perspective and a 5-year time-line; it also presumed that all the patients (pts) continued with active treatment until progression when it became acceptable to continue with a second-line treatment or BSC. Overall survival (OS) and progression-free survival (PFS) curves of IFN were used as reference framework; they were obtained form a published clinical trial. The hazard ratios (HR) for PFS and OS were estimated for comparing new generation medicaments with IFN. The information about frequency of use and health service cost units consumed in Colombia was taken from a series of 24 pts treated in Manizales, Pereira, Medellín and Bogotá. Service costs were requested from an external consultant and corresponded to the average value billed by the EPSs, calculated from 33 sources of information which were representative of the country's market. The cost of the medicaments was obtained from LCLC. The costs and benefits were discounted annually at 3%. (all cost are presented in Colombian pesos Col$ 2008 with an exchange rate 1 USD = 1836.20 Col$). Results: Incremental analysis indicated a difference of 41.1 million Col$ in the average total cost of treatment when Sunitinib was compared to IFN; in contrast, comparing sorafenib and Bevacizumab+INF to sunitinib demonstrated that the average total cost was less for the sunitinib by 8.3 and 104.2 million Col$, respectively. Additionally, the ratios of incremental cost-effectiveness by life years (LY) gained demonstrated sunitinib's simple dominance over sorafenib and the combination of bevacizumab+IFN, and an average by LY gained of 100.5 million Col$ compared to IFN. Conclusions: Sunitinib is the most cost-effective option as first-line treatment for mRCC pts in Colombia. [Table: see text]


1996 ◽  
Vol 3 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Afaf Girgis ◽  
Philip Clarke ◽  
Robert C Burton ◽  
Rob W Sanson—Fisher

Background and design— Australia has the highest rates of skin cancer in the world, and the incidence is estimated to be doubling every 10 years. Despite advances in the early detection and treatment of melanoma about 800 people still die nationally of the disease each year. A possible strategy for further reducing the mortality from melanoma is an organised programme of population screening for unsuspected lesions in asymptomatic people. Arguments against introducing melanoma screening have been based on cost and the lack of reliable data on the efficacy of any screening tests. To date, however, there has been no systematic economic assessment of the cost effectiveness of melanoma screening. The purpose of this research was to determine whether screening may be potentially cost effective and, therefore, warrants further investigation. A computer was used to simulate the effects of a hypothetical melanoma screening programme that was in operation for 20 years, using cohorts of Australians aged 50 at the start of the programme. Based on this simulation, cost—effectiveness estimates of melanoma screening were calculated. Results— Under the standard assumptions used in the model, and setting the sensitivity of the screening test (visual inspection of the skin) at 60%, cost effectiveness ranged from Aust$6853 per life year saved for men if screening was undertaken five yearly to $12137 if screening was two yearly. For women, it ranged from $11 102 for five yearly screening to $20 877 for two yearly screening. Conclusion— The analysis suggests that a melanoma screening programme could be cost effective, particularly if five yearly screening is implemented by family practitioners for men over the age of 50.


2021 ◽  
pp. 019459982110268
Author(s):  
Joseph R. Acevedo ◽  
Ashley C. Hsu ◽  
Jeffrey C. Yu ◽  
Dale H. Rice ◽  
Daniel I. Kwon ◽  
...  

Objective To compare the cost-effectiveness of sialendoscopy with gland excision for the management of submandibular gland sialolithiasis. Study Design Cost-effectiveness analysis. Setting Outpatient surgery centers. Methods A Markov decision model compared the cost-effectiveness of sialendoscopy versus gland excision for managing submandibular gland sialolithiasis. Surgical outcome probabilities were found in the primary literature. The quality of life of patients was represented by health utilities, and costs were estimated from a third-party payer’s perspective. The effectiveness of each intervention was measured in quality-adjusted life-years (QALYs). The incremental costs and effectiveness of each intervention were compared, and a willingness-to-pay ratio of $150,000 per QALY was considered cost-effective. One-way, multivariate, and probabilistic sensitivity analyses were performed to challenge model conclusions. Results Over 10 years, sialendoscopy yielded 9.00 QALYs at an average cost of $8306, while gland excision produced 8.94 QALYs at an average cost of $6103. The ICER for sialendoscopy was $36,717 per QALY gained, making sialendoscopy cost-effective by our best estimates. The model was sensitive to the probability of success and the cost of sialendoscopy. Sialendoscopy must meet a probability-of-success threshold of 0.61 (61%) and cost ≤$11,996 to remain cost-effective. A Monte Carlo simulation revealed sialendoscopy to be cost-effective 60% of the time. Conclusion Sialendoscopy appears to be a cost-effective management strategy for sialolithiasis of the submandibular gland when certain thresholds are maintained. Further studies elucidating the clinical factors that determine successful sialendoscopy may be aided by these thresholds as well as future comparisons of novel technology.


Author(s):  
Milton C. Weinstein

Cost-effectiveness analysis (CEA) is a method of economic evaluation that can be used to assess the efficiency with which health care technologies use limited resources to produce health outputs. However, inconsistencies in the way that such ratios are constructed often lead to misleading conclusions when CEAs are compared. Some of these inconsistencies, such as failure to discount or to calculate incremental ratios correctly, reflect analytical errors that, if corrected, would resolve the inconsistencies. Others reflect fundamental differences in the viewpoint of the analysis. The perspectives of different decision-making entities can properly lead to different items in the numerator and denominator of the cost-effectiveness (C/E) ratio. Producers and consumers of CEA need to be more conscious of the perspectives of analysis, so that C/E comparisons from a given perspective are based upon a common understanding of the elements that are properly included.


2021 ◽  
Vol 104 (5) ◽  
pp. 818-824

Background: Diabetic retinopathy (DR) causes blindness of the population in many countries worldwide. Early detection and treatment of this disease via a DR screening program is the best way to secure the vision. An annual screening program using pharmacological pupil dilatation becomes the standard method. Recently, non-mydriatic ultrawide-field fundus photography (UWF) has been proposed as a choice for DR screening. However, there was no cost-effectiveness study between the standard DR screening and this UWF approach. Objective: To compare the cost-effectiveness between UWF and pharmacological pupil dilatation in terms of hospital and societal perspectives. Materials and Methods: Patients with type 2 diabetes mellitus that visited the ophthalmology clinic at Chulabhorn Hospital for DR screening were randomized using simple randomization method. The patients were interviewed by a trained interviewer for general and economic information. The clinical characteristics of DR and staging were recorded. Direct medical costs, direct non-medical costs, and informal care costs due to DR screening were recorded. Cost analyses were calculated for the hospital and societal perspectives. Results: The present study presented the cost-effectiveness analyses of UWF versus pharmacological pupil dilatation. Cost-effectiveness analysis from the hospital perspective showed the incremental cost-effectiveness ratio (ICER) of UWF to be –13.87. UWF was a cost-effective mean in DR screening in the societal perspective when compared with pharmacologically pupil dilatation with the ICER of 76.46, under the threshold of willingness to pay. Conclusion: The UWF was a cost-effective mean in DR screening. It can reduce screening duration and bypass post-screening blurred vision. The results suggested that UWF could be a viable option for DR screening. Keywords: Diabetic retinopathy, Diabetic retinopathy screening, Non-mydriatic ultrawide-field fundus photography, Cost-effectiveness analysis


2019 ◽  
Vol 2 (2) ◽  
pp. 105-112
Author(s):  
Amelia Lorensia ◽  
Doddy De Queljoe ◽  
Made Dwike Swari Santi

The number of typhoid fever patient in Indonesia is still high. Typhoid fever can be treated by antibiotic therapy such as chloramphenicol and ceftriaxone. The purpose of this study was to compare the cost-effectiveness of chloramphenicol and ceftriaxone which was given to adult patients who were diagnosed with typhoid fever in Sanglah Denpasar Hospital. A comparative study between two alternatives was conducted using the hospital perspective. Retrospective method was used to collect data from patient medical records, who was diagnosed and hospitalized in Sanglah Denpasar Hospital during January 2017 until July 2018. The cost analysis was perform using cost-effectiveness grid and cost-effectiveness ratio (ACER) methods. Cost-effectiveness grid showed that dominant of ceftriaxone for patient with typhoid fever. ACER analysis for ceftriaxone was IDR 2,097,170.88 with effectivenes (length of stay) 4.27 days, and was IDR 2,097,170.88 with effectiveness (the time of reaching normal temperature) 2.42 days. ACER analysis for chloramphenicol was IDR 2,555,464.22        with effectivenes (length of stay) 10.22 days, and was IDR 2,555,464.22 with effectiveness (the time of reaching normal temperature) 3.44 days. ACER analysis showed lower degree of ceftriaxone and higher effectiveness based on length of stay and the time of reaching normal temperature. The conclusion of this study is that ceftriaxone is more cost-effective than chloramphenicol.


Author(s):  
L. I. Kovalyev ◽  
I. L. Kovalyev ◽  
M. N. Kostomakhin

Maintenance and repair of livestock machinery and equipment is carried out as a rule by specialized repair and service enterprises on the basis of service contracts in accordance with the procedure established by law. However, with the renewal of the park’s farms with machines and equipment with automated and computerized process control, as well as the reconstruction of dairy farms and complexes, it became necessary to have a production base and highly qualified specialists for the maintenance of equipment. The most important and key provisions of the improved methodology of planning and accounting of work in the technical service of animal husbandry with the use of a number of standards are given, some features of accounting and planning of these types of work have been noted. The concepts of “repair unit” and “category of complexity of technical service” have been defined. The general provisions of the methodology for calculating costs and determining the cost of carrying out maintenance and repair of livestock equipment have been considered. On the base of calculations, the average total cost standards for carrying out maintenance and repair of livestock equipment have been established. These standards greatly simplify the planning of costs during the operation of equipment, and also allow us to determine the cost of maintenance and repair at different stages of the creation of new machines.


2020 ◽  
pp. 1-11
Author(s):  
Osvaldinete Lopes de Oliveira Silva ◽  
Marina Ferreira Rea ◽  
Flávia Mori Sarti ◽  
Gabriela Buccini

Abstract Objective: To analyse the cost-effectiveness of Baby-Friendly Hospital Initiative (BFHI) in promoting breast-feeding during the first hour of life (BFFHL) and reducing late neonatal mortality. Design: Cost-effectiveness economic assessment from the health system perspective, preceded by a prospective cohort of mother–baby followed from birth to 6 months of life. The direct costs associated with two health outcomes were analysed: intermediate end point (BFFHL) and final end point (reduction in late neonatal mortality). Setting: Study was carried out in six hospitals in the city of São Paulo (Brazil), three being Baby-Friendly Hospitals (BFH) and three non-BFH. Participants: Mothers with 24 h postpartum, over 18 years old, single fetus and breast-feeding at the time of the interview were included. Poisson regressions adjusted for maternal age and level of education were estimated to identify factors related to BFFHL and late neonatal mortality. Sensitivity analysis was performed to ensure robustness of the economic assessment. Results: Cost-effectiveness analysis showed that BFHI was highly cost-effective in raising BFFHL by 32·0 % at lower cost in comparison with non-BFHI. In addition, BFHI was cost-effective in reducing late neonatal mortality rate by 13·0 % from all causes and by 13·1 % of infant mortality rate from infections. Conclusions: The cost-effectiveness of the BFHI in promoting breast-feeding and reducing neonatal mortality rates justifies the investments required for its expansion within the Brazilian health system.


2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Honghao Shi ◽  
Wanjie Guo ◽  
He Zhu ◽  
Meng Li ◽  
Carolina Oi Lam Ung ◽  
...  

Xiyanping injection (andrographolide sulfonate) has shown clinical effects on community acquired pneumonia. However, there is little known about the effectiveness and costs of combining Xiyanping injection with conventional treatment on adult community acquired pneumonia in daily practice. The aim of this study was to evaluate the cost-effectiveness of combining Xiyanping injection with conventional treatment for treatment of adult community acquired pneumonia by comparing with conventional treatment from a societal perspective. Using retrospective cohort method, this study demonstrates that Xiyanping injection combined with conventional treatment is superior to conventional treatment for patients using cephalosporins and antibiotics under the effectiveness index of length of hospital stay and is more cost-effective.


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