Minimum retesting intervals in practice: 10 years experience

BackgroundMinimum retesting intervals (MRI) are a popular demand management solution for the identification and reduction of over-utilized tests. In 2011 Association of Clinical Biochemistry and Laboratory Medicines (ACB) published evidence-based recommendations for the use of MRI.AimThe aim of the paper was to review the use of MRI over the period since the introduction of these recommendations in 2011 to 2020 and compare it to previous published data between 2000-2010.MethodsA multi-source literature search was performed to identify studies that reported the use of a MRI in the management or identification of inappropriate testing between the years prior to (2000–2010) and after implementation (2011–2020) of these recommendations.Results31 studies were identified which met the acceptance criteria (2000–2010 n=4, 2011–2020 n=27). Between 2000 and 2010 4.6% of tests (203,104/4,425,311) were identified as failing a defined MRI which rose to 11.8% of tests (2,691,591/22,777,288) in the 2011–2020 period. For those studies between 2011 and 2020 reporting predicted savings (n=20), 14.3% of tests (1,079,972/750,580) were cancelled, representing a total saving of 2.9 M Euros or 2.77 Euro/test. The most popular rejected test was Haemoglobin A1c which accounted for nearly a quarter of the total number of rejected tests. 13 out 27 studies used the ACB recommendations.ConclusionsMRI are now an established, safe and sustainable demand management tool for the identification and management of inappropriate testing. Evidence based consensus recommendations have supported the adoption of this demand management tool into practice across multiple healthcare settings globally and harmonizing laboratory practice.

Optimal control of an inventory system under whole sale price changes

Nowadays business owners use lots of incentive schemes to make customers buy more products. In this paper optimal ordering policy for customers is obtained when the manufacturer increases the purchasing price or temporary decreases it. Offering a special sale from the manufacturer is probabilistic and shortage occurs as partial backlogging. In this paper, the initial level of inventory when the purchasing price changes is not equal to zero. With respect to the assumptions, the amount of special order quantity, the shortage quantity, and the expected total saving from making an special order is optimized for the customer. The optimal amount of decision variables are obtained by maximizing the expected total saving function and a closed-form solution is derived. Several numerical examples are solved and sensitivity analysis is performed to prove the applicability of the proposed model. Finally, the impact of some parameters of the model including the demand, the probability of making a special order, the future prices, and the initial inventory is investigated. Optimal ordering policy for the customers is obtained in cases when an announced price increase occurs and when the prices temporarily decrease.

AN OPTIMAL ORDER QUANTITY OF SPARE PARTS TO MINIMIZE TOTAL INVENTORY COST USING PERIODIC REVIEW APPROACH (R,s,S) METHOD IN PT XYZ BANDUNG

The availability of spare parts is very crucial thing for manufacturing company in order to support the continuity of production activities. PT XYZ is a manufacturing company which produces thread into fabric. In this case, inventory control of spare part is not properly managed. Inventory position of spare parts in warehouse is always more than inventory policy of the company itself or called overstock which causes total inventory cost is always high. Company only consider on the order fulfillment of spare parts to prevent downtime on the machine that increase performance of production. Hence, order quantity of spare parts is always excessive or not optimal. In this research, global inventory policy conducted in order to minimize total inventory cost is periodic review approach (R, s, S) method. This inventory policy will be calculated using power approximation and obtained total saving cost of holding cost by 31 % while total saving cost of order cost decreased by 7 %. Overall, total inventory cost minimized by 7 % or equal to Rp138.902.742. Keywords—Inventory, Overstock, Spare Parts, Periodic Review, Power Approximation

An Optimal Order Quantity Of Spare Parts To Minimize Total Inventory Cost Using Periodic Review Approach (R,s,s) Method In PT. XYZ Bandung

The availability of spare parts is very crucial thing for manufacturing company in order to support the continuity of production activities. PT XYZ is a manufacturing company which produces thread into fabric. In this case, inventory control of spare part is not properly managed. Inventory position of spare parts in warehouse is always more than inventory policy of the company itself or called overstock which causes total inventory cost is always high. Company only consider on the order fulfillment of spare parts to prevent downtime on the machine that increase performance of production. Hence, order quantity of spare parts is always excessive or not optimal. In this research, global inventory policy conducted in order to minimize total inventory cost is periodic review approach (R, s, S) method. This inventory policy will be calculated using power approximation and obtained total saving cost of holding cost by 31 % while total saving cost of order cost decreased by 7 %. Overall, total inventory cost minimized by 7 % or equal to Rp138.902.742.

VP07 Collaboratively Modelling The Impact Of Interventions Retrospectively

INTRODUCTION:A conventional approach to communicating value is to model the budget impact of a medicine and the associated formulations in which it is available to be prescribed. However, such an approach does not demonstrate the actual realization of the proposed impact. This abstract outlines an approach to presenting retrospective data back to healthcare professionals (HCP) that blends assumptions and real-world data. For illustrative purposes, we present the results of an application of the model for subcutaneously delivered trastuzumab in an anonymized trust in Yorkshire and Humber.METHODS:The authors developed a model that examined one calendar year (from April 2014) of redistributed sales data for both the intravenous and subcutaneous formulations of trastuzumab for every National Health Service (NHS) trust in England. A series of baseline assumptions (1) were used to model the resource impact of different formulations such as chair time, HCP time, pharmacy preparation time, consumables, wastage, and other considerations. Impacts were estimated at the individual attendance level and scaled to the caseload. These baseline assumptions could then be overwritten by the individual trust using local data.RESULTS:The site delivered approximately 985 doses of subcutaneous trastuzumab over a period of 12 months from April 2014, which represented about 76 percent of the total number of doses delivered. Chair time is estimated to have reduced by 22 minutes per attendance, resulting in a total saving of 361hours. HCP administration time is estimated to have reduced by 23 minutes per attendance, resulting in a total saving of 378 hours based on changing 985 IV doses to SC therapy.CONCLUSIONS:Blending real data and assumptions to provide a retrospective assessment of actual benefits realized back to HCPs is a powerful tool for demonstrating real-world value at both an individual trust and system level.

Active vs. Passive Decisions and Crowd-Out in Retirement Savings Accounts: Evidence from Denmark *

Using 41 million observations on savings for the population of Denmark, we show that the effects of retirement savings policies on wealth accumulation depend on whether they change savings rates by active or passive choice. Subsidies for retirement accounts, which rely on individuals to take an action to raise savings, primarily induce individuals to shift assets from taxable accounts to retirement accounts. We estimate that each $1 of government expenditure on subsidies increases total saving by only 1 cent. In contrast, policies that raise retirement contributions if individuals take no action—such as automatic employer contributions to retirement accounts—increase wealth accumulation substantially. We estimate that approximately 15% of individuals are “active savers” who respond to tax subsidies primarily by shifting assets across accounts; 85% of individuals are “passive savers” who are unresponsive to subsidies but are instead heavily influenced by automatic contributions made on their behalf. Active savers tend to be wealthier and more financially sophisticated. We conclude that automatic contributions are more effective at increasing savings rates than subsidies for three reasons: (i) subsidies induce relatively few individuals to respond, (ii) they generate substantial crowd-out conditional on response, and (iii) they do not increase the savings of passive individuals, who are least prepared for retirement.

The Role of Saving In Pakistans Economic Growth

<span>We study the relationship between saving and economic growth using time series data for Pakistan for 1960-95. We find that both total saving and private saving have a long run positive relationship with GDP. The augmented Granger causality indicate that the growth of GDP Granger causes the growth rates of both private saving and total saving. However, the growth rate of private saving is found not to be Granger causing growth of GDP while the growth of total saving is found to be causing the growth of GDP.</span>

A suitable waiting room? Hospital transfer outcomes and delays from two London prisons

Aims and MethodTo describe a group of prisoners who required transfer to mental health units from two London prisons. Data were collected from prison clinical records.ResultsOverall, 149 patient-prisoners were transferred over a 17-month period. Around a quarter were not previously known to services. the aggregate wait was 36.5 years (averaging between 93 and 102 days per prisoner) and the total saving to the National Health Service (NHS) has been estimated at £6.759 million.Clinical ImplicationsBoth prisons manage a large number of prisoners with untreated psychosis. While in prison, they save the NHS considerable sums of money, but transfer delays prevent timely treatment and could now be legally challenged.

Results of the largest residential demand management program in Australia

This paper provides details and the results of an evaluation study carried out on the largest residential demand management program in Australia, the Sydney Water Corporation (SWC) ‘Every Drop Counts’ (EDC) residential retrofit program. The evaluation measured the water savings of program participants and compared them to a control group. Savings of 20.9 ± 2.5 kilolitres per household per annum (kL/hh/a) were found from statistical analysis of water meter readings of the sample of single residential households analysed. These individual savings effectively provide SWC with a potential total saving of 3,344 ± 400 megalitres per annum (ML/a) for the single residential houses retrofitted alone, i.e. 80% of the 200,000 households retrofitted to date. The evaluation identified that no ‘decay’ in average savings were found over the maximum four year period assessed. Other factors evaluated during the study included: analysis of individual water efficiency measures; comparison of savings with other evaluations; and savings related to occupancy ratio, geographical grouping, income category and defined socioeconomic categories.

The Relevance of Precautionary Saving

This paper develops a model of personal saving that includes, unlike previous models appearing in the literature, an explicit role for the Leland-Kimball measure of prudence. Estimation of the model using Bank of Italy survey data suggests that about 20 per cent of total saving is driven by precautionary reasons.