scholarly journals Custo da terapia tópica em pacientes com lesão por pressão

2018 ◽  
Vol 12 (10) ◽  
pp. 2555
Author(s):  
Daniel De Macêdo Rocha ◽  
Sandra Maria Gonçalves Bezerra ◽  
Aline Costa De Oliveira ◽  
Josiane Santos Silva ◽  
Italo Arão Pereira Ribeiro ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Pressure Ulcer ◽  
Chronic Wounds ◽  
Topical Therapy ◽  
Lower Limbs ◽  
Cross Sectional ◽  
Stage 4 ◽  
The Cost ◽  
The Impact ◽  
Complex Wounds

RESUMOObjetivo: avaliar o custo da terapia tópica em pacientes com lesão por pressão. Método: estudo quantitativo, transversal e analítico realizado em um ambulatório de referência para tratamento de feridas complexas. A amostra constituiu-se de 20 participantes que procuraram o serviço para a avaliação e o tratamento da lesão. Utilizou-se, para a coleta de dados, um formulário para a caracterização sociodemográfica, clínica, terapêutica e de análise de custo. Realizou-se a análise por meio da estatística descritiva e inferencial. Resultados: houve o predomínio do sexo masculino, com idade média de 56,6 anos e de pacientes procedentes de Teresina. Prevaleceram feridas crônicas, localizadas na região sacral e em estágio 4. A análise do custo mostrou que as lesões em membros inferiores com odor fétido, tecido desvitalizado, exsudato intenso e que foram tratadas com o carvão ativado, espuma com prata e hidrofibra apresentaram maior custo. Conclusão: mostrou-se que a lesão por pressão apresentou alto custo determinado pelas características clínicas e métodos terapêuticos adotados. Evidenciou-se a necessidade da implementação de medidas preventivas e de novos estudos para mostrar o impacto da lesão nos serviços de saúde. Descritores: Ferimentos e Lesões; Lesão por Pressão; Bandagem; Custo e Análise de Custos; Enfermagem; Cuidados de Enfermagem.ABSTRACT Objective: to evaluate the cost of topical therapy in patients with pressure ulcers. Method: quantitative, cross-sectional and analytical study carried out at a reference outpatient clinic for the treatment of complex wounds. The sample consisted of 20 participants who sought the service for evaluation and the treatment of the ulcer. A form for sociodemographic, clinical, therapeutic and cost analysis was used for data collection. The analysis was carried out through descriptive and inferential statistics. Results: there was a predominance of males, with a mean age of 56.6 years and of patients coming from Teresina. Chronic wounds prevailed, located in the sacral region and in stage 4. The cost analysis showed that lesions in the lower limbs, with fetid odor, devitalized tissue, intense exudate and that were treated with activated charcoal, silver foam and hydrofiber presented higher cost. Conclusion: it was shown that the pressure ulcer presented a high cost determined by the clinical characteristics and therapeutic methods adopted. The need to implement preventive measures and new studies to show the impact of the injury on health services was evidenced. Descriptors: Wounds and Injuries; Pressure Ulcer; Bandages; Costs and Cost Analysis; Nursing; Nursing Care. RESUMEN Objetivo: evaluar el costo de la terapia tópica en pacientes con lesión por presión. Método: estudio cuantitativo, transversal y analítico realizado en un ambulatorio de referencia para el tratamiento de heridas complejas. La muestra se constituyó de 20 participantes que buscaban el servicio para la evaluación y el tratamiento de la lesión. Se utilizó, para recolección de datos, un formulario para caracterización sociodemográfica, clínica, terapéutica y análisis de costo. Se realizó el análisis por medio de la estadística descriptiva e inferencial. Resultados: hubo el predominio del sexo masculino, con una edad media de 56,6 años y de pacientes procedentes de Teresina. Prevalecían heridas crónicas, localizadas en la región sacra y en etapa 4. El análisis del costo mostró que las lesiones en miembros inferiores, con olor fétido, tejido desvitalizado, exudado intenso y que fueron tratadas con el carbón activado, espuma con plata e hidrofibra presentaron mayor costo. Conclusión: se mostró que la lesión por presión presentó alto costo, siendo determinada por las características clínicas y métodos terapéuticos adoptados. Se evidenció la necesidad de la aplicación de medidas preventivas y de nuevos estudios para mostrar el impacto de la lesión en los servicios de salud. Descriptores: Heridas y Lesiones; Úlcera por Presión; Vendajes; Costos y Análisis de Costo; Enfermería; Atención de Enfermería.

scholarly journals Risk factors and costs of household perspectives in hemodialysis patients on Hospital Of Bhayangkara Tk. I. R. Said Sukanto

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Anggelina Aprilia Pangalila ◽  
Prih Sarnianto ◽  
Shirly Kumala
Keyword(s):  
Risk Factors ◽  
Cost Analysis ◽  
Control Method ◽  
Hemodialysis Patients ◽  
Primary Data ◽  
Cross Sectional ◽  
Western Herbs ◽  
The Cost ◽  
The Impact ◽  
Structured Questionnaire

The incidence and prevalence of chronic kidney disease (CKD) patients in Indonesia is increasing every year. In the promotion of health promotion and prevention efforts, data related to risk factors and cost analysis are needed from the perspective of patients and / or families related to CKD treatment that requires replacement therapy for kidney function (Hemodialysis / HD). CKD patients undergo HD therapy generally twice a week, making it a relatively large burden on them. This study aims to determine the risk factors for CKD in hemodialysis patients at Bhayangkara Hospital Tk. I R. Said Sukanto and the impact of the cost of HD therapy from a household perspective. In an observational study with this case control method. Primary data was taken through interviews using a structured questionnaire with 100 HD patients (cases) and 100 patients from other poly (control), cross sectional. Risk factor analysis was carried out by logistic regression (p <0.05) and cost analysis using the accounting method. The results showed that in terms of socio-demography, ages above 40-49 years had a risk of 32.7 times and ≥ 50 years had a risk of 17.9 times having CKD compared to <30 years of age with an education level ≤ SD-SMA at risk 16.9 times affected by CKD from the academy / university group, and the income of Rp. 2,000,000 - Rp. 4,000,000 has a risk of 8.4 times being affected by CKD from income groups> Rp. 6,000,000. In terms of biophysiology, hypertension, diabetes and anemia had a risk of 516 times, 54 times and 272 times the effect of CKD. The habit of consuming Chinese and Western herbs increases the risk of developing CKD up to 10.9 times. The cost of the household perspective issued by the patient includes a meal cost of Rp360,000, transportation costs Rp.320,000 and drugs and multivitamins Rp250,000. The potential loss of productivity reaches Rp1,241,904 per patient per month.

scholarly journals A call for harmonization of European kidney care: dialysis reimbursement and distribution of kidney replacement therapies

2020 ◽  
Vol 35 (6) ◽  
pp. 979-986 ◽  
Author(s):  
Arjan van der Tol ◽  
Vianda S Stel ◽  
Kitty J Jager ◽  
Norbert Lameire ◽  
Rachael L Morton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Expenditure ◽  
European Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Expenditure ◽  
Home Dialysis ◽  
Kidney Replacement Therapy ◽  
The Cost ◽  
The Impact

Abstract Background We compare reimbursement for haemodialysis (HD) and peritoneal dialysis (PD) in European countries to assess the impact on government healthcare budgets. We discuss strategies to reduce costs by promoting sustainable dialysis and kidney transplantation. Methods This was a cross-sectional survey among nephrologists conducted online July–December 2016. European countries were categorized by tertiles of gross domestic product per capita (GDP). Reimbursement data were matched to kidney replacement therapy (KRT) data. Results The prevalence per million population of patients being treated with long-term dialysis was not significantly different across tertiles of GDP (P = 0.22). The percentage of PD increased with GDP across tertiles (4.9, 8.2, 13.4%; P &lt; 0.001). The HD-to-PD reimbursement ratio was higher in countries with the highest tertile of GDP (0.7, 1.0 versus 1.7; P = 0.007). Home HD was mainly reimbursed in countries with the highest tertile of GDP (15, 15 versus 69%; P = 0.005). The percentage of public health expenditure for reimbursement of dialysis decreased across tertiles of GDP (3.3, 1.5, 0.7%; P &lt; 0.001). Transplantation as a proportion of all KRT increased across tertiles of GDP (18.5, 39.5, 56.0%; P &lt; 0.001). Conclusions In Europe, dialysis has a disproportionately high impact on public health expenditure, especially in countries with a lower GDP. In these countries, the cost difference between PD and HD is smaller, and home dialysis and transplantation are less frequently provided than in countries with a higher GDP. In-depth evaluation and analysis of influential economic and political measures are needed to steer optimized reimbursement strategies for KRT.

scholarly journals Impact of 123I-MIBG Scintigraphy on Clinical Decision-Making in Pheochromocytoma and Paraganglioma

2019 ◽  
Vol 104 (9) ◽  
pp. 3812-3820 ◽  
Author(s):  
Dipti Rao ◽  
Anouk van Berkel ◽  
Ianthe Piscaer ◽  
William F Young ◽  
Lucinda Gruber ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Diagnostic Value ◽  
Mibg Scintigraphy ◽  
Cross Sectional ◽  
First Choice ◽  
Cross Sectional Imaging ◽  
The Cost ◽  
The Impact

Abstract Context Cross-sectional imaging with CT or MRI is regarded as a first-choice modality for tumor localization in patients with pheochromocytoma and paraganglioma (PPGL). 123I-labeled metaiodobenzylguanidine (123I-MIBG) is widely used for functional imaging but the added diagnostic value is controversial. Objective To establish the virtual impact of adding 123I-MIBG scintigraphy to CT or MRI on diagnosis and treatment of PPGL. Design International multicenter retrospective study. Intervention None. Patients Two hundred thirty-six unilateral adrenal, 18 bilateral adrenal, 48 unifocal extra-adrenal, 12 multifocal, and 26 metastatic PPGL. Main Outcome Measures Patients underwent both anatomical imaging (CT and/or MRI) and 123I-MIBG scintigraphy. Local imaging reports were analyzed centrally by two independent observers who were blinded to the diagnosis. Imaging-based diagnoses determined by CT/MRI only, 123I-MIBG only, and CT/MRI combined with 123I-MIBG scintigraphy were compared with the correct diagnoses. Results The rates of correct imaging-based diagnoses determined by CT/MRI only versus CT/MRI plus 123I-MIBG scintigraphy were similar: 89.4 versus 88.8%, respectively (P = 0.50). Adding 123I-MIBG scintigraphy to CT/MRI resulted in a correct change in the imaging-based diagnosis and ensuing virtual treatment in four cases (1.2%: two metastatic instead of nonmetastatic, one multifocal instead of single, one unilateral instead of bilateral adrenal) at the cost of an incorrect change in seven cases (2.1%: four metastatic instead of nonmetastatic, two multifocal instead of unifocal and one bilateral instead of unilateral adrenal). Conclusions For the initial localization of PPGL, the addition of 123I-MIBG scintigraphy to CT/MRI rarely improves the diagnostic accuracy at the cost of incorrect interpretation in others, even when 123I-MIBG scintigraphy is restricted to patients who are at risk for metastatic disease. In this setting, the impact of 123I-MIBG scintigraphy on clinical decision-making appears very limited.

Pressure Ulcer Prevention and Management

2002 ◽  
Vol 20 (1) ◽  
pp. 35-61 ◽  
Author(s):  
COURTNEY H. LYDER
Keyword(s):  
Pressure Ulcer ◽  
Applied Research ◽  
Pressure Ulcers ◽  
Pressure Ulcer Prevention ◽  
Randomized Control ◽  
Support Surfaces ◽  
The Cost ◽  
The Impact ◽  
Unpublished Research ◽  
Ulcer Prevention

This chapter reviews 218 published and unpublished research reports of pressure ulcer prevention and management by nurse researchers and researchers from other disciplines. The electronic databases MEDLINE (1966-July 2001), CINAHL (1982-June 2001), AMED (1985-July 2001), and El Compedex*Plus (1980-June 2001) were selected for the searches because of their focus on health and applied research. Moreover, evaluations of previous review articles and seminal studies that were published before 1966 are also included. Research conducted worldwide and published in English between 1930 and 2001 was included for review. Studies using descriptive, correlational, longitudinal, and randomized control trials were included. This review found that numerous gaps remain in our understanding of effective pressure ulcer prevention and management. Moreover, the majority of pressure ulcer care is derived from expert opinion rather than empirical evidence. Thus, additional research is needed to investigate pressure ulcer risk factors of ethnic minorities. Further studies are needed that examine the impact of specific preventive interventions (e.g., turning intervals based on risk stratification) and the cost-effectiveness of comprehensive prevention programs to prevent pressure ulcers. Finally, an evaluation is needed of various aspects of pressure ulcer management (e.g., use of support surfaces, use of adjunctive therapies) and healing of pressure ulcers.

scholarly journals Polysomnographic evaluation of sleep quality and quantitative variables in women as a function of mood, reproductive status, and age

2012 ◽  
Vol 14 (4) ◽  
pp. 413-424
Keyword(s):  
Sleep Onset ◽  
Onset Time ◽  
Sleep Time ◽  
Reproductive Status ◽  
Cross Sectional ◽  
Stage 4 ◽  
Stage 1 ◽  
Main Effects ◽  
The Impact ◽  
Normal Controls

This archival cross-sectional investigation examined the impact of mood, reproductive status (RS), and age on polysomnographic (PSG) measures in women. PSG was performed on 73 normal controls (NC) and 64 depressed patients (DP), in the course of studies in menstruating, pregnant, postpartum, and peri- and postmenopausal women. A two-factor, between-subjects multivariate analysis of variance (MANOVA) was used to test the main effects of reproductive status (RS: menstrual vs pregnant vs postpartum vs menopausal) and diagnosis (NC vs DP), and their interaction, on PSG measures. To further refine the analyses, a two-factor, between subjects MANOVA was used to test the main effects of age (19 to 27 vs 28 to 36 vs 37 to 45 vs 46+ years) and diagnosis on the PSG data. Analyses revealed that in DP women, rapid eye movement (REM) sleep percentage was significantly elevated relative to NC across both RS and age. Significant differences in sleep efficiency, Stage 1%, and REM density were associated with RS; differences in total sleep time, Stage 2 percentage, and Stage 4 percentage were associated with differences in age. Both RS and age were related to differences in sleep latency, Stage 3 percentage, and Delta percentage. Finally, wake after sleep onset time, REM percentage, and REM latency did not vary with respect to RS or age. Overall, this investigation examined three major variables (mood, RS, and age) that are known to impact sleep in women. Of the variables, age appeared to have the greatest impact on PSG sleep measures, reflecting changes occurring across the lifespan.

Economic Impact Assessment of Mega-Events in the United Kingdom and Brazil

2019 ◽  
Vol 43 (7) ◽  
pp. 1044-1067 ◽  
Author(s):  
Shui Ki Wan ◽  
Haiyan Song
Keyword(s):  
Economic Growth ◽  
Olympic Games ◽  
World Cup ◽  
Cross Sectional ◽  
Mega Events ◽  
Economic Impact Assessment ◽  
The United Kingdom ◽  
Infrastructure Investments ◽  
The Cost ◽  
The Impact

Hosting mega-events is often perceived as a way to stimulate economic growth through tourism. However, the cost of infrastructure investments and promotion may outweigh the benefits generated by the mega-events. Measuring the impact of such events on a hosting country’s economy is not easy, especially as mega-events generally involve many sectors of a destination’s economy. In this study, we adopt a panel data approach to evaluate the impact of the London Olympic Games, Brazil World Cup, and Rio Olympic Games on the economic growth of the respective destinations. Using cross-sectional correlations between countries, we construct scenarios in which the hosting countries did not hold the mega-events and then estimate the time-varying impact of the events on the economy. The developed and developing countries exhibit different results.

scholarly journals Cost Analysis of Chaff Harvesting Concepts in Germany

Agronomy ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. 579 ◽  
Author(s):  
Jannike Sophie Unger ◽  
Christoph Glasner
Keyword(s):  
Cost Analysis ◽  
Supply Chains ◽  
Cost Estimation ◽  
Base Case ◽  
End User ◽  
Harvesting Process ◽  
The Cost ◽  
The Impact ◽  
Harvesting Costs ◽  
Harvest Residue

This work assesses the costs of exploiting the biomass feedstock chaff. Chaff is a harvest residue generated during the conventional grain harvesting process and usually remains on the field. In this paper, the costs of collecting and supplying chaff to the end user with different harvesting methods and supply chains are analyzed. The costs are estimated for a base case defining a set of general assumptions. The impact of these assumptions is analyzed in a sensitivity analysis by means of tornado diagrams. A full costing method based on the VDI guideline 2067 part 1 is applied for the cost estimation. The cost analysis reveals that ceasing the fractioning of grain, straw and chaff during harvesting and transporting them as a mixture reduces the harvesting costs significantly. The costs are decreased due to a reduction in agricultural operations and processing large amounts of material. The lowest total costs originate from the production of chaff-straw bales. Harvesting chaff as a single fraction leads to the highest costs with the investigated supply chains. Comparing the costs of chaff supply to potential revenues shows that an exploitation of the harvest residue can be economically feasible.

Use and misuse of blood and blood products: Evaluation of the impact of new fridge lock system and the cost analysis

2010 ◽  
Vol 27 ◽  
pp. 110
Author(s):  
S. Sharafudeen ◽  
R. Wadhwani ◽  
J. Chieza ◽  
M. Lawn ◽  
P. Found
Keyword(s):  
Cost Analysis ◽  
Blood Products ◽  
The Cost ◽  
The Impact

scholarly journals Cost and pollution by the use of xylene in cervical cytology in four Peruvian hospitals

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 848
Author(s):  
Jeel Moya-Salazar ◽  
Richard Salazar-Hernández ◽  
Victor Rojas-Zumaran ◽  
Gloria Cruz-Gonzales ◽  
Hans Contreras-Pulache
Keyword(s):  
Environmental Pollution ◽  
Economic Impact ◽  
Pap Test ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Two Stages ◽  
The Cost ◽  
High Degree ◽  
The Impact

Background: Cytological samples are cleared with xylene in two or three baths during a Pap test, however, this solvent has a high degree of toxicity, and being a controlled reagent infers high costs for its purchase and implications for environmental pollution. We estimated the impact of xylene during the Pap test in terms of the number of liters and cost of two baths of xylene, and also estimated the impact with three baths  Methods: This cross-sectional study was carried out in four hospitals of EsSalud in Peru in two stages. First, the analysis of the impact due to the use of two baths of xylene was conducted during the period 2015–2019, and second, the estimates were calculated based on the assumption of three baths of xylene for the years 2020–2025. The assumption was based on the recommendations of the 2018 EsSalud cytology guideline. The monthly amount of xylene was ~10 liters per bath/month and the cost per liter was estimated at 8.13 USD (27 soles).  Results: For the staining of 594,898 cytology tests, 7,848 liters of xylene were necessary, resulting in a cost of 60,861 USD (202,068 soles) during the period 2015–2019. The estimates showed a maximum assumption of 9,483 liters and 77,110 USD (256,040 soles) for the use of three baths of xylene in the four EsSalud hospitals (p = 0.0025) during the period 2020–2025.   Conclusions: We determined that there was a high economic impact of using xylene with two baths from 2015 to 2019 and a dramatic increase in costs with the possible use of three baths of xylene in the Pap test for the following five years.

scholarly journals A Descriptive Study to Assess Wellbeing, Quality of Life and Satisfaction of Omani Patients with Chronic Wounds

2021 ◽  
Author(s):  
Jansi Rani Natarajan ◽  
Mickael Antoine Joseph ◽  
Rashid Mohammed Al Alawi ◽  
Taimoor Al Balushi ◽  
Ibrahim Al Alawi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Wounds ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Cross Sectional ◽  
Mean Differences ◽  
The Impact

Abstract Background: A chronic wound is one that has failed to proceed through the normal phases of wound healing in an orderly manner. Chronic wounds are a common problem around the world. They can be distressing to the patients causing physical, social and emotional damage such as decreased activities of daily living, pain, discomfort, unpleasant odor, and insomnia. Wellbeing, quality of life and satisfaction of these patients with chronic wounds can be impaired by a complex set of aspects. The purpose of this article is to describe the impact of chronic wounds on the wellbeing, quality of life and satisfaction of Omani patients with chronic wounds. Methods: This is a descriptive cross-sectional study of 275 patients with chronic wounds attending three tertiary care hospitals in Muscat city, Sultanate of Oman. Adult patients of 18 years and above with wounds of duration of more than 4weeks were chosen by consecutive non-probability sampling. A pre-tested, semi-structured self-reported questionnaire was provided to each patient to complete. Data was analysed using SPSS IBM version 23.Results: The average age of the patients was 47.13±16.917 and the majority of them (64.7%) were males. Most of them (29.1%) had diabetic ulcers and 45.8% of them presented with mildly severe wounds based on Bates-Jensen wound assessment scale. Patients with chronic wounds reported a poor wellbeing scores (M=10.47, SD= 1.813), moderate quality of life (M=5.22, SD= 2.388) and satisfaction scores (M=6.89, SD= 2.388). Significant mean differences were reported with age, gender, educational level, and type of wound at p<.05 levels.Conclusion: These findings demonstrated that chronic wounds could influence the wellbeing, quality of life and overall satisfaction with the quality of life of patients suffering with it. These results also suggest a need to pay increased attention by the healthcare providers to the patients suffering from chronic wounds on the aspects of wellbeing and quality of life along with treating the physical symptoms.

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