A microcosting analysis of ICU expenditure in the interval between brain death and organ donation

2021 ◽  
Vol 23 (2) ◽  
pp. 211-214
Author(s):  
Meghan K Bowtell ◽  
◽  
Melissa J Ankravs ◽  
Timothy Fazio ◽  
Jeffrey J Presneill ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Indirect Costs ◽  
Organ Donors ◽  
Total Cost ◽  
Median Proportion ◽  
The Mean ◽  
The Cost ◽  
Death Care

OBJECTIVE: The cost of providing care in an intensive care unit (ICU) after brain death to facilitate organ donation is unknown. The objective of this study was to estimate expenditure for the care delivered in the ICU between the diagnosis of brain death and subsequent organ donation. DESIGN: Cohort study of direct and indirect costs using bottom-up and top-down microcosting techniques. SETTING: Single adult ICU in Australia. PARTICIPANTS: All patients who met criteria for brain death and proceeded to organ donation during a 13-month period between 1 January 2018 and 31 January 2019. MAIN OUTCOME MEASURES: A comprehensive cost estimate for care provided in the ICU from determination of brain death to transfer to theatre for organ donation. RESULTS: Forty-five patients with brain death became organ donors during the study period. The mean duration of post-death care in the ICU was 37.9 hours (standard deviation [SD], 16.5) at a mean total cost of $7520 (SD, $3136) per donor. ICU staff salaries were the greatest contributor to total costs, accounting for a median proportion of 0.72 of total expenditure (interquartile range, 0.68–0.75). CONCLUSIONS: Substantial costs are incurred in ICU for the provision of patient care in the interval between brain death and organ donation.

scholarly journals Rehabilitation cost share and cost analysis of traumatic hand injuries: Our single-center results

2021 ◽  
Vol 67 (3) ◽  
pp. 308-314
Author(s):  
Merih Özgen ◽  
Ayşe Merve Aydoğan ◽  
Ali Uygur ◽  
Onur Armağan ◽  
Funda Berkan ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Direct Cost ◽  
Injury Severity ◽  
Indirect Costs ◽  
Hand Injury ◽  
Economic Policies ◽  
Wrist Injuries ◽  
Total Cost ◽  
The Mean ◽  
The Cost

Objectives: This study aims to evaluate the cost expenses and rehabilitation share of hand and/or wrist injuries and to contribute to the development of health and economic policies. Patients and methods: A total of 59 patients (55 males, 4 females; mean age: 39.1±11.3 years; range, 20 to 64 years) who presented with hand and/or wrist injuries between January 2015 and December 2017 were retrospectively reviewed. Demographic data, hand injury information, and the Modified Hand Injury Severity Scores (MHISS) were retrieved from the patient file system. The cost analysis with direct and indirect costs was performed. Results: According to the MHISS, 27.1% of patients had a minor injury, 23.7% had a moderate injury, 18.6% had a severe injury, and 30.5% had a major injury. The mean direct cost of the patients was $726.00±641.87 and the total cost of the indirect cost was $2,776.93±1,619.00. The mean day-off time was 125±68.62 days. Indirect costs accounted for 79% of the total cost. The mean cost of rehabilitation was $150.18±86.88. Rehabilitation costs accounted for 4% of the total cost. There was a positive correlation between the MHISS and direct, indirect and total cost, but not between the MHISS and rehabilitation cost. Conclusion: The proportion of the share allocated to rehabilitation expenditures, which is the subunit of direct cost, is low and not related to the injury severity. The data obtained from the study contributed to the creation of evidence-based health and economic policies. We believe that these data also contribute to the planning of rehabilitation services according to the severity of injury which would improve the quality of life and return to work.

Financial cost of treating out-patients with schizophrenia in Nigeria

1997 ◽  
Vol 171 (4) ◽  
pp. 364-368 ◽  
Author(s):  
Toyin G. Suleiman ◽  
Jude U. Ohaeri ◽  
Rahman A. Lawal ◽  
Adam Y. Haruna ◽  
O. B. Orija
Keyword(s):  
Antipsychotic Drugs ◽  
Indirect Costs ◽  
Financial Cost ◽  
Total Cost ◽  
Duration Of Illness ◽  
Government Hospitals ◽  
Insulin Dependent ◽  
The Mean ◽  
Cost Of Drugs ◽  
The Cost

BackgroundAn assessment of the monetary costs of treating a group of Nigerian out-patients with schizophrenia, in comparison with insulin-dependent diabetics, was made.MethodFifty out-patients with schizophrenia (mean age 42.9) and 40 with diabetes (mean age 41.9), attending government hospitals in Lagos, were assessed at six-monthly intervals, for direct and indirect costs (US$=82 naira; minimum monthly wage=500 naira)ResultsTwenty (40%) of those with schizophrenia and eight (20%) of the diabetics had no income at all. The mean total cost of schizophrenia in six months (2951.4 naira) or US$ 35.9) was significantly less than that of diabetes (11 791 naira or US$ 143). The cost of antipsychotic drugs accounts for 52.8% of the cost of schizophrenia; insulin injections accounted for 92.8% of the total cost of diabetes. Patients with schizophrenia and their relatives suffered significantly more loss of working days. Cost of illness was not significantly correlated with age and duration of illness.ConclusionsBecause of drastic currency devaluation, and lack of disability benefits and nursing homes, the findings contrast with Western reports where cost of drugs constitutes 2–5%, and indirect costs constitute over 50% of the total cost of schizophrenia.

scholarly journals Cost of hypertension illness and associated factors among patients attending hospitals in Southwest Shewa Zone, Oromia Regional State, Ethiopia

2019 ◽  
Author(s):  
Addisu Bogale ◽  
Teferi Daba ◽  
Dawit Wolde Daka
Keyword(s):  
Linear Regression Analysis ◽  
Indirect Costs ◽  
Total Direct Cost ◽  
Multivariate Linear Regression Analysis ◽  
Total Cost ◽  
Direct And Indirect Costs ◽  
Regional State ◽  
The Mean ◽  
The Cost ◽  
The Impact

AbstractBackgroundHypertension is a common vascular disease and the main risk factor for cardiovascular diseases. The impact of hypertension is on the rise in Ethiopia, so that, it is predictable that the cost of healthcare services will further increase in the future. We aimed to estimate the total cost of hypertension illness among patients attending hospitals in Southwest Shewa zone, Oromia Regional State, Ethiopia.Patients and methodsInstitution based cross-sectional study was conducted from July 1-30, 2018. All hypertensive patients who were on treatment and whose age was greater than eighteen years old were eligible for this study. The total cost of hypertension illness was estimated by summing up the direct and indirect costs. Bivariate and multivariate linear regression analysis was conducted to identify factors associated with hypertension costs of illness.ResultsOverall, the mean monthly total cost of hypertension illness was US $ 22.3 (95% CI, 21.3-23.3). Direct and indirect costs share 51% and 49% of the total cost, respectively. The mean total direct cost of hypertension illness per patient per month was US $11.39(95% CI, 10.6-12.1). Out of these, drugs accounted of a higher cost (31%) followed by food (25%). The mean total indirect cost per patient per month was US $10.89(95% CI, 10.4-11.4). Educational status, distance from hospital, the presence of companion and the stage of hypertension were predictors of the cost of illness of hypertension.ConclusionThe cost of hypertension illness was very high when compared with the mean monthly income of the patients letting patients to catastrophic costs. Therefore, due attention should be given by the government to protect patients from financial hardships.

Brain Death and Organ Donation

2018 ◽  
Author(s):  
Thomas I. Cochrane
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Cardiac Death ◽  
Donation After Cardiac Death ◽  
Donation After Brain Death ◽  
Brain Death Determination ◽  
Brain Dead ◽  
American Academy Of Neurology ◽  
Death Determination

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.

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.

Experience with Determination of Brain Death and Organ Donation

1989 ◽  
pp. 246-250
Author(s):  
W. I. Steudel ◽  
F. Kreth ◽  
R. Lorenz ◽  
A. Fürsch ◽  
W. Faßbinder ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation

Acceptability and Validity of Use of a Patient-Reported Cost Diary To Capture Health Resource Utilization and Costs Associated with Deep Venous Thrombosis and Post-Thrombotic Syndrome.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 5173-5173
Author(s):  
Wissam El-Hadi ◽  
Thierry Ducruet ◽  
Mira Johri ◽  
Susan R. Kahn
Keyword(s):  
Internal Consistency ◽  
External Validity ◽  
Indirect Costs ◽  
Health Resource ◽  
Health Resource Utilization ◽  
Cost Diary ◽  
Patient Reported ◽  
The Mean ◽  
The Cost

Abstract OBJECTIVE: To assess the acceptability and validity of a patient-reported cost diary to estimate health resource utilization (HRU) and costs associated with deep vein thrombosis (DVT) and post-thrombotic syndrome (PTS). METHODS: We developed a cost diary for use in the Venous Thrombosis Outcomes (VETO) Study, a prospective multicenter cohort study of long-term outcomes after DVT. The VETO cost diary is a 28-item patient-reported questionnaire used to capture information pertaining to HRU and direct and indirect costs attributable to DVT and PTS. Data for HRU and direct costs included hospitalizations, physician visits, purchase of prescription and over-the-counter medications, use of transportation and other medical services and purchase or rental of equipment. Data pertaining to indirect costs included time lost from work by patients or their caregivers. Patients were asked to complete the cost diary monthly for 1 year, then for 3 randomly chosen months for the 2nd year. Acceptability of the cost diary was assessed by estimating the percent of time coverage per patient over the study follow-up period. Internal consistency was assessed by comparing data reported by patients in the cost diary to similar data collected in nurse-administered study questionnaires. External validity was assessed by comparing HRU data reported in the cost diaries to patient-specific data obtained from the administrative database of the Province of Quebec Health Insurance Board (RAMQ) for the same time period. RESULTS: 387 patients with objectively diagnosed DVT participated in the VETO Study, of whom 359 from 7 hospitals in Quebec, Canada contributed to this analysis (∼ 40% developed PTS). Analyses showed that acceptability of the cost diary was high, with more than 82% of patients reporting data for > 90% of the study follow-up period. Internal consistency analyses revealed discrepancies in reporting of hospitalizations in cost diaries compared to nurse-administered questionnaires (144 vs. 97 hospitalizations, respectively, reported in the first year of the study). Analyses of external validity showed that for the first 4-month study period, the mean number of DVT-related prescriptions reported in the cost diary was comparable to that reported in the RAMQ database (2.48 vs. 3.84, respectively), as was the mean number of DVT-related medical visits (6.39 vs. 7.18, respectively). CONCLUSION: Overall, the VETO cost diary appears to be an acceptable and valid patient-reported instrument that can be used to estimate HRU, direct and indirect costs attributable to DVT and PTS. Further analyses are needed to identify the factors affecting the internal consistency of the cost diary.

scholarly journals Retrospective Analysis of Brain Death Cases

2021 ◽  
Author(s):  
Özlem Özkan Kuşcu ◽  
Meltem Aktay
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Death ◽  
Organ Donation ◽  
Death Time ◽  
The Family ◽  
The Mean ◽  
End Stage ◽  
Cadaveric Donors ◽  
Death Cases

Objective: Organ transplantation is important for patients with end-stage organ failure to survive. For this reason, detection of brain death cases and adequate number of donations are necessary. Methods: 31 cases diagnosed with brain death between 01.01.2018-01.01.2020 were evaluated retrospectively. Demographic characteristics, diagnoses causing brain death, time to detect brain death, additional tests applied for the diagnosis of brain death, time to diagnosis of brain death and cardiopulmonary arrest or donation, the proportion of families accepting organ donation, the proportion of donors, organ removed from donors the number and blood types of the cases were recorded Results: The number of cases diagnosed with brain death was 31, and the mean age of the cases was 46,71 (1-89) years. 71% (n=22) of the patients were admitted to the intensive care unit from the emergency department. The most common reason for admission to the intensive care unit 67.7% (n=21) was intracranial bleeding. While the family donation rate was 19% (n=5), three cases who accepted the donation could be donors. The mean age of the patients for whom organ donation was accepted was 35.80±11 years, while the mean age of the patients for whom organ donation was not accepted was 57.43±21.30 years (p=0.04). Conclusion: Due to the increasing number of end-stage organ failure patients awaiting transplantation, it is necessary to increase the number of cadaveric donors. Timely and sufficient detection of brain death cases, increasing the family donation rate and increasing the number of cadaveric donors will be contributed.

scholarly journals Implementation Strategy and Cost of Mozambique’s HPV vaccine demonstration project

2019 ◽  
Author(s):  
Caroline Soi ◽  
Joseph B. Babigumira ◽  
Baltazar Chilundo ◽  
Vasco Muchanga ◽  
Luisa Matsinhe ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
National Level ◽  
Demonstration Project ◽  
Immunization Program ◽  
Total Cost ◽  
School Based ◽  
Demand Creation ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Background Cost is as an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total cost of the program and the cost per fully immunized girl (FIG), and to project the total cost of implementing a similar immunization program at the national level. Methods We collected primary data through document review, participatory observation, and key informant interviews with project implementers at the central offices of the national immunization program, provincial and district health directorates, and in health facilities. We used a combination of micro-costing methods— the identification and measurement of resources quantities and valuation by application of unit costs, and gross costing—the consideration of resource bundles as they apply to the number of FIGs. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique under current guidelines to demonstrate the projected total annual cost for a similarly executed HPV vaccine program. Results The total cost of the Mozambique HPV vaccine demonstration project was $523,601. The mean cost per FIG was $72 (95% CI: $62 - $83) in year one, $38 (95% CI: $37 - $40) in year two, and $54 (95% CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from implementation was $60 (95% CI: $50 - $72) in year one, $38 (95%CI: $31 - $46) in year two, and $48 (95%CI: $42 - $55) for years one and two. The projected annual cost of a two-dose vaccine program targeting all 10-year-old girls in the country was $18,156,549 ($15,865,384 - $20,748,196). The main cost drivers in the analysis were vaccine price, number of doses administered per recipient, program startup costs, and the costs of demand creation. Conclusion National adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy would result in substantial costs. To achieve national-level HPV vaccine roll out and sustainability, stakeholders will need to negotiate vaccine prices and achieve better efficiency in startup activities and demand creation.

Sign in / Sign up

Export Citation Format

Share Document