scholarly journals A Model-Based Cost-Minimization Analysis as a Decision Tool in Obstetric Care in Helgeland, Northern Norway

2016 ◽  
Vol 9 (1) ◽  
pp. 191
Author(s):  
Halvard Angelsen ◽  
Jan Norum ◽  
Villy Angelsen ◽  
Fred A. Mürer ◽  
Randi Erlandsen
Keyword(s):  
Quality Of Care ◽  
Maternity Care ◽  
Cost Minimization ◽  
Cost Savings ◽  
Obstetric Care ◽  
Birth Registry ◽  
Cost Minimization Analysis ◽  
Model Based ◽  
Hospital Trust

BACKGROUND: Quality of care is of utmost importance in maternity care. Today, we base the choice of institution on risk factors. Recently, a Norwegian national plan introduced new guidelines concerning quality and staffing. Consequently, the hospital trusts had to increase the number of obstetricians and midwives and handle raised costs. One way to meet such challenges is to reduce the number of delivery units.OBJECTIVES: We aimed to clarify the costs and benefits of two alternative strategies in obstetric care in Helgeland hospital trust using a model-based cost-minimization analysis (CMA).METHODS: The consequences, in terms of cost/savings and mothers´ time of travelling, by closing two midwife-administered maternity units (MAMUs) and keeping the two departments of obstetrics (DOGs) running was analyzed. We implemented data from the Helgeland hospital trust and the Medical Birth Registry of Norway (MBRN) and the selected period was 2010-2012. The comparator was today’s organization. Costs were converted into Euros at the rate of € 1 = NOK 9.527.RESULTS: The model concluded the closing of two MAMUs created an annual net saving of € 584,346. The mothers´ mean time of travelling increased by 11 minutes and by 91 minutes for those directly affected by the closure. The organizational changes were concluded safe and of low risk with regard to quality of care. A sensitivity analysis revealed the number of midwives dismissed being the most important variable. CONCLUSION: A model-based CMA may be a supportive tool when evaluating maternity care.

VALUE AND PERFORMANCE OF ACCOUNTABLE CARE ORGANIZATIONS: A COST-MINIMIZATION ANALYSIS

2018 ◽  
Vol 34 (4) ◽  
pp. 388-392
Author(s):  
Sonal Parasrampuria ◽  
Allison H. Oakes ◽  
Shannon S. Wu ◽  
Megha A. Parikh ◽  
William V. Padula
Keyword(s):  
Cost Minimization ◽  
Cost Savings ◽  
Quality Data ◽  
Quality Level ◽  
Care Organization ◽  
Coordination Of Care ◽  
Accountable Care ◽  
Cost Minimization Analysis

Objectives:Determine the relationship between quality of an accountable care organization (ACO) and its long-term reduction in healthcare costs.Methods:We conducted a cost minimization analysis. Using Centers for Medicare and Medicaid cost and quality data, we calculated weighted composite quality scores for each ACO and organization-level cost savings. We used Markov modeling to compute the probability that an ACO transitioned between different quality levels in successive years. Considering a health-systems perspective with costs discounted at 3 percent, we conducted 10,000 Monte Carlo simulations to project long-term cost savings by quality level over a 10-year period. We compared the change in per-member expenditures of Pioneer (early-adopters) ACOs versus Medicare Shared Savings Program (MSSP) ACOs to assess the impact of coordination of care, the main mechanism for cost savings.Results:Overall, Pioneer ACOs saved USD 641.24 per beneficiary and MSSP ACOs saved USD 535.59 per beneficiary. By quality level: (a) high quality organizations saved the most money (Pioneer: USD 459; MSSP: USD 816); (b) medium quality saved some money (Pioneer: USD 222; MSSP: USD 105); and (c) low quality suffered financial losses (Pioneer: USD -40; MSSP: USD -386).Conclusions:Within the existing fee-for-service healthcare model, ACOs are a mechanism for decreasing costs by improving quality of care. Higher quality organizations incorporate greater levels of coordination of care, which is associated with greater cost savings. Pioneer ACOs have the highest level of integration of services; hence, they save the most money.

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

Pharmacoeconomic features of the use of drugs used in the treatment of allergic rhinitis

2021 ◽  
pp. 9-16
Author(s):  
Afanasyeva T.G. ◽  
Lavrova N.N. ◽  
Tumentseva V.R.
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Generic Drugs ◽  
Cost Minimization ◽  
Nasal Congestion ◽  
World Health ◽  
Cost Minimization Analysis ◽  
Wide Range

Rhinitis is an inflammation of the nasal mucosa; today, according to the World Health Organization, the prevalence of the disease is 40% of the world's population. Allergic rhinitis is the most common type of chronic rhinitis, affecting 10–20% of the world's population, and the severity of the disease is associated with a significant deterioration in the quality of life, sleep and performance. Allergic rhinitis is an inflammatory disease of the nasal mucosa caused by exposure to an allergen, causing IgE-mediated inflammation. Clinically, the disease is characterized by the following main symptoms: rhinorrhea, sneezing, itching and nasal congestion. Despite the general symptoms of allergic rhinitis, its impact on the quality of life of patients and the significant cost of treatment, including pharmacotherapy, many patients do not adhere to drug treatment regimens due to their insufficient effectiveness in eliminating the emerging symptoms. Pharmacoeconomic research identifies, measures and compares the costs and effects of drug use. This framework includes research methods related to cost minimization, cost-effectiveness, decision analysis, cost of illness, and patient quality of life. This article will consider one of the four main methods for assessing pharmacoeconomics - cost minimization analysis. A cost-minimization analysis is a pharmacoeconomic assessment by comparing the costs of two or more drug alternatives regardless of outcome. Since the pharmaceutical market is represented by a wide range of original, reference and generic drugs for the treatment of allergic rhinitis, an important aspect of our research is the selection of effective and economically acceptable therapy for outpatients.

scholarly journals Quality of Maternity Care and Client Satisfaction

2019 ◽  
Vol 2 (1) ◽  
pp. 73-76
Author(s):  
Saraswoti Kumari Gautam Bhattarai ◽  
Kanchan Gautam
Keyword(s):  
Quality Of Care ◽  
Child Health ◽  
Pregnant Women ◽  
Maternal And Child Health ◽  
Maternity Care ◽  
Client Satisfaction ◽  
Care Service ◽  
Postnatal Period ◽  
And Child Health

Health service provided to pregnant women during antenatal, childbirth and postnatal period is essential for maternal and child health. Proper care during pregnancy, childbirth and postnatal period are important for the health of mother and baby. High maternal, infant and child morbidity and mortality demand improved healthcare which does not concern to coverage of health services alone. The health issues of pregnant women, mothers, infants and children need to be addressed with the attention to the quality of care (QoC).  The Nepal Health Sector Strategy (NHSS) also identifies equity and quality of care gaps as areas of concern for achieving the maternal health sustainable development goal (SDG) target. So this review aims to sensitize and draw attention to the quality of maternity care and client satisfaction to improve maternal and child health. For this article, different studies related to the quality of maternity care and satisfaction from care service received on maternity care are reviewed.

scholarly journals Current Use of Intravenous (IV) Long Acting Antibiotic (LAA) Therapy in the Aetna Health Plan among Patients with Acute Bacterial Skin and Skin Structure Infection (ABSSSI)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S339-S340
Author(s):  
Rajesh Mehta ◽  
Alison Edwards ◽  
Katelyn R Keyloun ◽  
Nicole Bonine ◽  
Iver Juster
Keyword(s):  
Sensitivity Analysis ◽  
Quality Of Care ◽  
Cost Savings ◽  
Potential Cost ◽  
Treatment Pathways ◽  
Inpatient Management ◽  
Inpatient Population ◽  
Long Acting ◽  
Potential Opportunity

Abstract Background In an effort to lower costs and improve quality of care, there is potential to change the treatment landscape for low-risk (i.e., less severe) ABSSSI patients who historically required inpatient management, a costly option. Outpatient IV treatment pathways have been shown to be a cost-saving option for hospitals and insurers. The objective was to quantify the potential opportunity for reducing cost of ABSSSI treatment in an insured Commercial and Medicare Aetna population. Methods Adult patients between January 2013 and July 2016 were identified with a primary ABSSSI claim (Table 1) in the Aetna fully-insured Commercial and Medicare insurance claims database. ABSSSI encounters were identified with insurance eligibility for the 7 months prior to and no evidence of ABSSSI in the 30 days prior to the ABSSSI claim. Demographic and clinical data were described, including length of stay (LOS) and allowed cost for inpatient encounters with data. Inpatient encounters without evidence of severity (e.g., codes for major complications or comorbidities) were considered potential candidates for an outpatient LAA pathway. A sensitivity analysis for LOS and cost was run including all ABSSSI patients with LAA dispenses through 2016 (i.e., inclusion/exclusion criteria did not need to be met). Results 194,023 ABSSSI encounters were identified, most receiving non-IV treatment (90%). 18,603 received IV treatment, where 83% initially presented to the emergency room and the majority were admitted (97%). Of the 28 encounters with LAA use, 7 were inpatient. Of all current inpatient encounters (N = 9,019 after Jan 1, 2015), the majority (N = 7,005; 78%) where considered potential LAA pathway candidates. Comparing inpatient encounters with vs. without LAA use, mean LOS and cost differed (Table 2: 4.1 days and $14,295 vs. 9.0 days and $23,194, respectively). A sensitivity analysis supported similar mean LOS and cost for all inpatient LAA dispenses. Conclusion Current use of LAA in an inpatient population is limited but resulted in potential cost-savings. Most of the inpatient population was identified as potential candidates for an outpatient LAA pathway. Research on utilization and quality of care for outpatient IV treatment pathways with LAA is warranted. Disclosures K. R. Keyloun, Allergan: Employee, Salary N. Bonine, Allergan: Employee, Salary

Cost Containment and Mental Health Outcomes: Experiences from US Studies

1995 ◽  
Vol 166 (S27) ◽  
pp. 43-51 ◽  
Author(s):  
Kenneth B. Wells
Keyword(s):  
Mental Health ◽  
Quality Of Care ◽  
Cost Containment ◽  
Cost Savings ◽  
Poor People ◽  
Fee For Service ◽  
Us Studies ◽  
Outcomes Of Care ◽  
The Us

Background. Cost containment mechanisms, such as prepayment, are being considered or implemented in the US and elsewhere, but there have been few studies of the effects of such mechanisms on quality or outcomes of care for individuals with serious psychiatric disorders.Method. Key results from US studies on cost containment and their implications are reviewed.Results. Cost savings in out-patient mental health care can be achieved through increasing the share of costs paid by the covered individual or through prepayment, but individuals with the greatest psychological distress or poor people may achieve worse outcomes under greater cost containment. Quality of care may be poorer under some forms of prepayment than under fee-for-service care, yet a national prospective payment mechanism for depressed elderly in-patients was not associated with a marked drop in quality or outcomes of care among those admitted.Conclusions. Prepayment, relative to fee-for-service is not always associated with lower outcomes or quality of care for affective disorders. Under cost containment, quality and outcomes of care, especially for the sick poor, should be monitored to identify adverse consequences.

PD28-03 COST-SAVINGS PROTOCOL IN THE ENDOUROLOGY SUITE DECREASES HEALTH CARE EXPENDITURES WITHOUT COMPROMISING QUALITY OF CARE

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Dilan Gupta ◽  
August Matteis ◽  
Fotima Askarova ◽  
Chad Ritch ◽  
Mantu Gupta
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Cost Savings ◽  
Health Care Expenditures

scholarly journals The impact of COVID-19 on the provision of respectful maternity care: findings from a global survey of health workers

2021 ◽  
Author(s):  
Anteneh Asefa ◽  
Aline Semaan ◽  
Therese Delvaux ◽  
Elise Huysmans ◽  
Anna Galle ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Maternity Care ◽  
Qualitative Data ◽  
Health Workers ◽  
Qualitative Content Analysis ◽  
Standards Of Care ◽  
Respectful Maternity Care ◽  
The Impact ◽  
Maternal And Newborn

Background Significant adjustments to the provision of maternity care in response to the COVID-19 pandemic and the direct impacts of COVID-19 can compromise the quality of maternal and newborn care. Aim To explore how the COVID-19 pandemic affected frontline health workers' ability to provide respectful maternity care globally. Methods We conducted a global online survey of health workers to assess the provision of maternal and newborn healthcare during the COVID-19 pandemic. We collected quantitative and qualitative data between July and December 2020 and conducted a qualitative content analysis to explore open-ended responses. Findings Health workers (n=1,127) from 71 countries participated; and 120 participants from 33 countries provided qualitative data. The COVID-19 pandemic negatively affected the provision of respectful maternity care in multiple ways. Six central themes were identified: less family involvement, reduced emotional and physical support for women, compromised standards of care, increased exposure to medically unjustified caesarean section, and staff overwhelmed by rapidly changing guidelines and enhanced infection prevention measures. Further, respectful care provided to women and newborns with suspected or confirmed COVID-19 infection was severely affected due to health workers' fear of getting infected and measures taken to minimise COVID-19 transmission. Discussion Multidimensional and contextually-adapted actions are urgently needed to mitigate the impacts of the COVID-19 pandemic on the provision and continued promotion of respectful maternity care globally in the long-term. Conclusions The measures taken during the COVID-19 pandemic disrupted the quality of care provided to women during labour and childbirth generally, and respectful maternity care specifically. Keywords Maternal health; Quality of care; Labour; Childbirth; Newborn health; Intrapartum care, Antenatal care, Postnatal care

scholarly journals Development of a Phone Survey Tool to Measure Respectful Maternity Care During Pregnancy and Childbirth in India: Study Protocol (Preprint)

2018 ◽  
Author(s):  
Amnesty E LeFevre ◽  
Kerry Scott ◽  
Diwakar Mohan ◽  
Neha Shah ◽  
Aarushi Bhatnagar ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Maternity Care ◽  
Quality Data ◽  
Respectful Maternity Care ◽  
Validity And Reliability ◽  
Survey Tool ◽  
Face To Face ◽  
Pregnancy And Childbirth ◽  
Phone Survey

BACKGROUND Respectful maternity care (RMC) is a key barometer of the underlying quality of care women receive during pregnancy and childbirth. Efforts to measure RMC have largely been qualitative, although validated quantitative tools are emerging. Available tools have been limited to the measurement of RMC during childbirth and confined to observational and face-to-face survey modes. Phone surveys are less invasive, low cost, and rapid alternatives to traditional face-to-face methods, yet little is known about their validity and reliability. OBJECTIVE The primary objective of this study was to develop validated face-to-face and phone survey tools for measuring RMC during pregnancy and childbirth for use in India and other low resource settings. The secondary objective was to optimize strategies for improving the delivery of phone surveys for use in measuring RMC. METHODS To develop face-to-face and phone surveys for measuring RMC, we describe procedures for assessing content, criterion, and construct validity as well as reliability analyses. To optimize the delivery of phone surveys, we outline plans for substudies, which aim to assess the effect of survey modality, and content on survey response, completion, and attrition rates. RESULTS Data collection will be carried out in 4 districts of Madhya Pradesh, India, from July 2018 to March 2019. CONCLUSIONS To our knowledge, this is the first RMC phone survey tool developed for India, which may provide an opportunity for the rapid, routine collection of data essential for improving the quality of care during pregnancy and childbirth. Elsewhere, phone survey tools are emerging; however, efforts to develop these surveys are often not inclusive of rigorous pretesting activities essential for ensuring quality data, including cognitive, reliability, and validity testing. In the absence of these activities, emerging data could overestimate or underestimate the burden of disease and health care practices under assessment. In the context of RMC, poor quality data could have adverse consequences including the naming and shaming of providers. By outlining a blueprint of the minimum activities required to generate reliable and valid survey tools, we hope to improve efforts to develop and deploy face-to-face and phone surveys in the health sector. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12173

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