scholarly journals Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia

2021 ◽  
Vol 6 (3) ◽  
pp. 531-537
Author(s):  
Bilge YILMAZ KARA ◽  
Neslihan ÖZÇELİK ◽  
Songül ÖZYURT
Keyword(s):  
Direct Cost

Direct cost of treatment in patients with acute ST-elevation myocardial infarction in Vietnam

MedPharmRes ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 7-11
Author(s):  
Sy Van Hoang ◽  
Tuan Thanh Tran ◽  
Kha Minh Nguyen
Keyword(s):  
Myocardial Infarction ◽  
Direct Cost ◽  
Treatment Cost ◽  
Financial Burden ◽  
Intervention Group ◽  
St Elevation Myocardial Infarction ◽  
Related Factors ◽  
Female Ratio ◽  
Conservative Group ◽  
St Elevation

Background: Acute myocardial infarction has become a serious financial burden for patients, healthcare system, and society. It is therefore necessary to assess treatment cost of myocardial infarction that had been conducted in many countries in the world and still not fully analysed in Vietnam. Thus, we sought to describe acute ST-elevation myocardial infarction treatment cost and analyse related factors to acute ST-elevation myocardial infarction treatment cost. Methods and Materials: A retrospective cross-sectional study. Patients who was diagnosed by ST-elevation myocardial infarction at Cho Ray Hospital from June 2018 to February 2019, satisfied inclusion and exclusion criteria. Results: We collected 130 patients with acute ST-elevation myocardial infarction with male: female ratio of 3:1, at average age of mean ± Standard deviation (SD) = 62.9 ± 12.6. The length of stay in hospital was mean ± SD = 7.1 ± 3.3 days and the median direct cost of MI was 68,902,500 VND (interquartile range (IQR): 5,737,200 – 104,266,000 VND). The average total cost of acute ST-elevation myocardial infarction in the percutaneous coronary intervention group was more than 16 times as the conservative group. The treatment strategies and hospital complications were major factors that affected treatment cost. Conclusion: The median direct cost of acute ST-elevation myocardial infarction was accounted for 68,902,500 VND. Complications directly affected costs.

scholarly journals Direct and indirect costs and cost-driving factors of Tuberous sclerosis complex in children, adolescents, and caregivers: a multicenter cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Janina Grau ◽  
Johann Philipp Zöllner ◽  
Susanne Schubert-Bast ◽  
Gerhard Kurlemann ◽  
Christoph Hertzberg ◽  
...  
Keyword(s):  
Tuberous Sclerosis ◽  
Direct Cost ◽  
Nursing Care ◽  
Tuberous Sclerosis Complex ◽  
Indirect Costs ◽  
Mtor Inhibitors ◽  
Direct Costs ◽  
Driving Factors ◽  
Care Level ◽  
Organ Manifestations

Abstract Background Tuberous sclerosis complex (TSC), a multisystem genetic disorder, affects many organs and systems, characterized by benign growths. This German multicenter study estimated the disease-specific costs and cost-driving factors associated with various organ manifestations in TSC patients. Methods A validated, three-month, retrospective questionnaire was administered to assess the sociodemographic and clinical characteristics, organ manifestations, direct, indirect, out-of-pocket, and nursing care-level costs, completed by caregivers of patients with TSC throughout Germany. Results The caregivers of 184 patients (mean age 9.8 ± 5.3 years, range 0.7–21.8 years) submitted questionnaires. The reported TSC disease manifestations included epilepsy (92%), skin disorders (86%), structural brain disorders (83%), heart and circulatory system disorders (67%), kidney and urinary tract disorders (53%), and psychiatric disorders (51%). Genetic variations in TSC2 were reported in 46% of patients, whereas 14% were reported in TSC1. Mean total direct health care costs were EUR 4949 [95% confidence interval (95% CI) EUR 4088–5863, median EUR 2062] per patient over three months. Medication costs represented the largest direct cost category (54% of total direct costs, mean EUR 2658), with mechanistic target of rapamycin (mTOR) inhibitors representing the largest share (47%, EUR 2309). The cost of anti-seizure drugs (ASDs) accounted for a mean of only EUR 260 (5%). Inpatient costs (21%, EUR 1027) and ancillary therapy costs (8%, EUR 407) were also important direct cost components. The mean nursing care-level costs were EUR 1163 (95% CI EUR 1027–1314, median EUR 1635) over three months. Total indirect costs totaled a mean of EUR 2813 (95% CI EUR 2221–3394, median EUR 215) for mothers and EUR 372 (95% CI EUR 193–586, median EUR 0) for fathers. Multiple regression analyses revealed polytherapy with two or more ASDs and the use of mTOR inhibitors as independent cost-driving factors of total direct costs. Disability and psychiatric disease were independent cost-driving factors for total indirect costs as well as for nursing care-level costs. Conclusions This study revealed substantial direct (including medication), nursing care-level, and indirect costs associated with TSC over three months, highlighting the spectrum of organ manifestations and their treatment needs in the German healthcare setting. Trial registration: DRKS, DRKS00016045. Registered 01 March 2019, http://www.drks.de/DRKS00016045.

scholarly journals Direct costs of common osteoporotic fractures (Hip, Vertebral and Forearm) in Iran

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marziyeh Rajabi ◽  
Afshin Ostovar ◽  
Ali Akbari Sari ◽  
Sayed Mahmoud Sajjadi-Jazi ◽  
Noushin Fahimfar ◽  
...  
Keyword(s):  
Direct Cost ◽  
Osteoporotic Fractures ◽  
Direct Costs ◽  
Fracture Incidence ◽  
Inpatient Cost ◽  
First Year ◽  
Forearm Fractures ◽  
Medical Sciences ◽  
The Us ◽  
The Mean

Abstract Background Osteoporotic fractures impose significant costs on society. The objective of this study was to estimate the direct costs of the hip, vertebral, and forearm fractures in the first year after fracture incidence in Iran. Methods We surveyed a sample of 300 patients aged over 50 years with osteoporotic fractures (hip, vertebral, and forearm) admitted to four hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2017 and were alive six months after the fracture. Inpatient cost data were obtained from the hospital patient records. Using a questionnaire, the data regarding outpatient costs were collected through a phone interview with patients at least six months after the fracture incidence. Direct medical and non-medical costs were estimated from a societal perspective. All costs were converted to the US dollar using the average exchange rate in 2017 (1USD = IRR 34,214) Results The mean ± standard deviation (SD) age of the patient was 69.83 ± 11.25 years, and 68% were female. One hundred and seventeen (39%) patients had hip fractures, 56 (18.67%) patients had vertebral fractures, and 127 (42.33%) ones had forearm fractures. The mean direct cost (medical and non-medical) during the year after hip, vertebral and forearm fractures were estimated at USD5,381, USD2,981, and USD1,209, respectively. Conclusion The direct cost of osteoporotic fracture in Iran is high. Our findings might be useful for the economic evaluation of preventive and treatment interventions for osteoporotic fractures as well as estimating the economic burden of osteoporotic fractures in Iran.

scholarly journals Modified early warning score-based clinical decision support: cost impact and clinical outcomes in sepsis

JAMIA Open ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 261-268
Author(s):  
Devin J Horton ◽  
Kencee K Graves ◽  
Polina V Kukhareva ◽  
Stacy A Johnson ◽  
Maribel Cedillo ◽  
...  
Keyword(s):  
Decision Support ◽  
Acute Care ◽  
Direct Cost ◽  
Clinical Decision Support ◽  
Early Warning ◽  
Clinical Decision ◽  
Early Warning Score ◽  
Total Direct Cost ◽  
Intervention Period ◽  
Support Cost

Abstract Objective The objective of this study was to assess the clinical and financial impact of a quality improvement project that utilized a modified Early Warning Score (mEWS)-based clinical decision support intervention targeting early recognition of sepsis decompensation. Materials and Methods We conducted a retrospective, interrupted time series study on all adult patients who received a diagnosis of sepsis and were exposed to an acute care floor with the intervention. Primary outcomes (total direct cost, length of stay [LOS], and mortality) were aggregated for each study month for the post-intervention period (March 1, 2016–February 28, 2017, n = 2118 visits) and compared to the pre-intervention period (November 1, 2014–October 31, 2015, n = 1546 visits). Results The intervention was associated with a decrease in median total direct cost and hospital LOS by 23% (P = .047) and .63 days (P = .059), respectively. There was no significant change in mortality. Discussion The implementation of an mEWS-based clinical decision support system in eight acute care floors at an academic medical center was associated with reduced total direct cost and LOS for patients hospitalized with sepsis. This was seen without an associated increase in intensive care unit utilization or broad-spectrum antibiotic use. Conclusion An automated sepsis decompensation detection system has the potential to improve clinical and financial outcomes such as LOS and total direct cost. Further evaluation is needed to validate generalizability and to understand the relative importance of individual elements of the intervention.

scholarly journals Management of focal epilepsy in adults treated with polytherapy in France: The direct cost of drug resistance (ESPERA study)

Seizure ◽  
2014 ◽  
Vol 23 (5) ◽  
pp. 349-356 ◽  
Author(s):  
M. de Zélicourt ◽  
B. de Toffol ◽  
H. Vespignani ◽  
C. Laurendeau ◽  
L. Lévy-Bachelot ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Direct Cost ◽  
Focal Epilepsy

scholarly journals The Direct Cost Components in Heart Failure with Reduced Ejection Fraction (HF-REF) in Turkey: The Results of A Delphi Panel

2016 ◽  
Vol 19 (7) ◽  
pp. A646
Author(s):  
D Aras ◽  
S Aydogdu ◽  
E Bozkurt ◽  
Y Cavusoglu ◽  
M Eren ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Direct Cost ◽  
Delphi Panel ◽  
Reduced Ejection Fraction ◽  
Cost Components

Optimal Design of Paired Built Environment Interventions for Control of MDROs in Acute Care and Community Hospitals

2020 ◽  
pp. 193758672097658
Author(s):  
Marietta M. Squire ◽  
Gareth K. Sessel ◽  
Gary Lin ◽  
Edward N. Squire ◽  
Takeru Igusa
Keyword(s):  
Built Environment ◽  
Infection Control ◽  
Acute Care ◽  
Direct Cost ◽  
Environmental Control ◽  
Meta Analysis ◽  
Cost Savings ◽  
Incidence Rates ◽  
Resistant Organism ◽  
Environment Design

Objectives: Our goal was to optimize infection control of paired environmental control interventions within hospitals to reduce methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacteriaceae (CRE), and vancomycin-resistant Enterococci (VRE). Background: The most widely used infection control interventions are deployment of handwashing (HW) stations, control of relative humidity (RH), and negative pressure (NP) treatment rooms. Direct costs of multidrug-resistant organism (MDRO) infections are typically not included in the design of such interventions. Methods: We examined the effectiveness of pairing HW with RH and HW with NP. We used the following three data sets: A meta-analysis of progression rates from uncolonized to colonized to infected, 6 years of MDRO treatment costs from 400 hospitals, and 8 years of MDRO incidence rates at nine army hospitals. We used these data as inputs into an Infection De-Escalation Model with varying budgets to obtain optimal intervention designs. We then computed the infection and prevention rates and cost savings resulting from these designs. Results: The average direct cost of an MDRO infection was $3,289, $1,535, and $1,067 for MRSA, CRE, and VRE. The mean annual incidence rates per facility were 0.39%, 0.034%, and 0.011% for MRSA, CRE, and VRE. After applying the cost-minimizing intervention pair to each scenario, the percentage reductions in infections (and annual direct cost savings) in large, community, and small acute care hospitals were 69% ($1.5 million), 73% ($631K), 60% ($118K) for MRSA, 52% ($460.5K), 58% ($203K), 50% ($37K) for CRE, and 0%, 0%, and 50% ($12.8K) for VRE. Conclusion: The application of this Infection De-Escalation Model can guide cost-effective decision making in hospital built environment design to improve control of MDRO infections.

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