Medicine and Health Sciences Commons^™

A Comparative Analysis Of Costs Associated With Assisted Reproductive Technology; Invitro Fertilization Of Singleton, Twin, And Multiple Gestations Compared To Non-Invitro Fertilization Singleton Gestations, Ruth Arthur-Asmah

MUSC Theses and Dissertations

This study examines IVF and non-IVF costs associated with prenatal, delivery, and postpartum care using claims data from Merative MarketScan Commercial and Encounter data from 2018-2020 to understand the costs associated with respective IVF singleton, twin, and multiple gestations, as compared to non-IVF singleton gestations. These patients identified as females at birth, were continuously enrolled in private insurance, and have not experienced termination of pregnancy. The Student T-test was performed on continuous variables, and logistic regression was performed on binary variables with the overall outcome variables being cost, IVF, and non-IVF, controlling for age. The cost data was gamma log …

Benefits And Barriers Of Using Prefilled Precedex Syringes In The Operating Room: A Cost Comparison, Ashley White

Graduate Theses, Dissertations, and Problem Reports

According to a report published by the Institute of Medicine, at least 44,000 and possibly up to 98,000 Americans die each year because of medical errors in hospitals. More than 7,000 of those deaths are from medication errors alone (Stucki et al., 2013). Anesthesia providers in the operating room (OR) are at even greater risk to commit medication errors due to their easy access to medications and their autonomy to make independent choices for medication administration. A small rural community hospital in Pennsylvania lacks a protocol for Precedex preparation. Evidence-based research show the benefit of prefilled ready-to-administer syringes, but the …

Telerehabilitation: An Updated View Of Practices, Cost Analysis, And Client Perceptions, Gokcen Akyurek, Selen Aydoner

Internet Journal of Allied Health Sciences and Practice

Telerehabilitation is an alternative and complementary rehabilitation method in which information and communication technologies are used to remove the distance between healthcare professionals and clients. The COVID-19 pandemic has led to the rapid adoption of telerehabilitation services, limiting the in-person rehabilitation services available all over the world. The restrictions that started with the COVID-19 pandemic also negatively affected rehabilitation services, clients, and healthcare professionals, and it was considered essential to provide services using telerehabilitation technology. Therefore, this review aimed to examine and inform health professionals' telerehabilitation practices such as remote assessment, evaluation, intervention, monitoring, supervision, education, and follow-up during the …

Comprehensive Overview Of Causative Agents Of Alzheimer's Disease: Tau Protein And Amyloid Betas With Their Biochemical Pathways And Proposed Treatments Including Cost Analysis, Ethan Johnson

Honors College

Alzheimer’s is a neurodegenerative disease found within the brain, interfering with neuron function, eventually leading to widespread atrophy. The disease effects millions of Americans with neurofibrillary tangles and amyloid beta plaques, both protein deposits with unclear causes. The goal for this thesis was not only to understand how these proteins form but how to safely interfere with their production. This was completed by a comprehensive overview of the form of the buildups and their precursors, tau proteins and amyloid beta precursor protein, respectively. An emphasis was put on the molecular biology and genetic causes of the amyloids rather than the …

Healthcare Utilization Among Infants Discharged From The Neonatal Intensive Care Unit: A Descriptive Cost Analysis, Nutan B Hebballi, Elenir Bc Avritscher, Elisa Garcia, Andrew Bain, Marisa A Bartz-Kurycki, Kuojen Tsao, Mary T Austin

Student and Faculty Publications

The cost of readmissions of neonatal intensive care unit (NICU) graduates within 6 months and a year of their life is well-studied. However, the cost of readmissions within 90 days of NICU discharge is unknown. This study’s objective was to estimate the overall and mean cost of healthcare use for unplanned hospital visits of NICU graduates within 90 days of discharge A retrospective review of all infants discharged between 1/1/2017 and 03/31/2017 from a large hospital system NICUs was conducted. All unplanned hospital visits (readmissions or stand-alone emergency department (ED) visits) occurring within 90 days post NICU discharge were included. …

Healthcare Utilization Among Infants Discharged From The Neonatal Intensive Care Unit: A Descriptive Cost Analysis, Nutan B Hebballi, Elenir Bc Avritscher, Elisa Garcia, Andrew Bain, Marisa A Bartz-Kurycki, Kuojen Tsao, Mary T Austin

Student and Faculty Publications

The cost of readmissions of neonatal intensive care unit (NICU) graduates within 6 months and a year of their life is well-studied. However, the cost of readmissions within 90 days of NICU discharge is unknown. This study's objective was to estimate the overall and mean cost of healthcare use for unplanned hospital visits of NICU graduates within 90 days of discharge A retrospective review of all infants discharged between 1/1/2017 and 03/31/2017 from a large hospital system NICUs was conducted. All unplanned hospital visits (readmissions or stand-alone emergency department (ED) visits) occurring within 90 days post NICU discharge were included. …

Rapid Rhino Vs. Merocel: A Retrospective Analysis Of Patients With Anterior Epistaxis Visiting Emergency Rooms In London, Ontario, Dhatri Shukla

Electronic Thesis and Dissertation Repository

When patients present to an emergency room (ER) with a nosebleed, one technique that physicians employ is the application of nasal packing. Merocel is a common nasal pack utilized in ER because of their low cost. Rapid Rhino is a nasal packing that is more comfortable for patients but is more costly than Merocel. Costing for epistaxis treatment is more than initial treatment costs and needs to consider rebleed rates. Using a retrospective cohort study design with covariates adjusted by propensity scores, we compared the costs associated with Merocel, and Rapid Rhino from the hospital and provincial healthcare perspectives. Merocel …

Cost Analysis Of Implementing An Exercise Program For Fall And Fracture Prevention In Older Adults On Proton Pump Inhibitor Therapy, Thomas Adam Wichelmann, Nhan Dang, David H. Kruchko, Sufyan Abdulmujeeb, Eli D. Ehrenpreis

Journal of Patient-Centered Research and Reviews

Purpose: Falls have significant financial impact. Proton pump inhibitor (PPI) therapy is associated with an increased risk of falls and fractures. Exercise programs have been shown to decrease risk of falls in the elderly population and are recommended by the U.S. Preventive Services Task Force for patients over age 65 to reduce falls. Our study aimed to explore the potential financial benefit of implementing three different Centers for Disease Control and Prevention-recommended exercise-based interventions for fall prevention (Tai Chi, Stepping On, and Otago Exercise Program) in ≥ 65-year-old patients on PPI therapy.

Methods: A Markov model was developed to predict …

Analysis Of Health Care Costs Over A One-Year Period Following Anticoagulant Therapy Among Ontario Patients Diagnosed With Atrial Fibrillation, Michael Situ

Electronic Thesis and Dissertation Repository

Atrial fibrillation patients are at high risk of ischemic strokes, which can be drastically reduced using oral anticoagulants (OACs). Warfarin has been the standard OAC for this population but its effectiveness rests on consistent monitoring with the potential for severe bleeding events. Newer OACs, like rivaroxaban and apixaban, address these drawbacks but have a comparatively higher upfront cost. Uncertainty remains over which OAC is cost-saving from a health care system perspective. Using a retrospective cohort study design and inverse probability weighting regression adjustment estimators, one-year health care costs among patients treated with warfarin, rivaroxaban, and apixaban were compared. Compared to …

Cost Efficacy Of Rapid Whole Genome Sequencing In The Pediatric Intensive Care Unit, Erica Sanford Kobayashi, Bryce Waldman, Branden M Engorn, Katherine Perofsky, Erika Allred, Benjamin Briggs, Chelsea Gatcliffe, Nanda Ramchandar, Jeffrey J Gold, Ami Doshi, Elizabeth G Ingulli, Courtney D Thornburg, Wendy Benson, Lauge Farnaes, Shimul Chowdhury, Seema Rego, Charlotte Hobbs, Stephen F Kingsmore, David P Dimmock, Nicole G Coufal

Student and Faculty Publications

The diagnostic and clinical utility of rapid whole genome sequencing (rWGS) for critically ill children in the intensive care unit (ICU) has been substantiated by multiple studies, but comprehensive cost-effectiveness evaluation of rWGS in the ICU outside of the neonatal age group is lacking. In this study, we examined cost data retrospectively for a cohort of 38 children in a regional pediatric ICU (PICU) who received rWGS. We identified seven of 17 patients who received molecular diagnoses by rWGS and had resultant changes in clinical management with sufficient clarity to permit cost and quality adjusted life years (QALY) modeling. Cost …

Frailty, Clinical Outcomes, And Cost In Patients Undergoing Trans-Catheter Aortic Valve Implantation (Tavi), Zhe Li

Electronic Thesis and Dissertation Repository

The objective of this doctoral was three-fold: 1) to systematically review frailty measures and prognosis of frail patients undergoing TAVI, 2) to examine the performance of frailty indices in predicting clinical outcomes after TAVI, and 3) to examine the performance of frailty indices in predicting one-year costs of TAVI and high-cost TAVI patients.

For the first objective, we systematically reviewed the literature published in 2006 or later. We found that frailty instruments varied across studies, leading to a wide range of frailty prevalence estimates for TAVI recipients and substantial heterogeneity.

For the second objective, we utilized data from the CorHealth …

Revisiting A Funding Model For University-Led Dental Clinics: The Case Of Complete Denture Fabrication, Rohana Ahmad, Nur Amalina Zul, Siti Anisah Mohtar, Marc Tennant, Tuti Ningseh Mohd-Dom

Journal of Dentistry Indonesia

Objectives: University-led dental clinics are rarely seen as core to the national healthcare system. Thus, when publicly funded universities experience a decline in government support, dental clinic services operated by students are confronted by a potentially inadequate operating budget. Prompted by the need for strategic resource allocation, this study seeks to quantify the resources consumed in the construction of complete dentures by undergraduate students in an effort to identify opportunities for cost-cutting measures. Methods: Clinical cases were retrieved from the logbooks of graduating students of Class 2015, and patient records were reviewed to identify and quantify all clinical …

A Systematic Search And Review On The Efficacy, Safety, And Cost-Effectiveness Of Utilizing Lactobacillus Probiotics In Concurrence With Prescribing Antibiotics To Reduce Clostridium Difficile Infection Rates In Hospitalized Patients, Laura Sheehan

Nursing Masters Papers

Incidence of Clostridium difficile infection, (CDI) in patients receiving antibiotics is significant. In 2017, there were approximately 223,900 cases of CDI in hospitalized patients alone (Center for Disease Control [CDC], 2017). Despite enhanced infection control measures, CDI rates remain prevalent and are associated with increased costs to healthcare. An integrative literature review and synthesis was performed. Studies were analyzed to delineate if Lactobacillus containing probiotics, when administered concurrently with high risk antibiotics, decrease CDI rates for patients in the inpatient hospital setting. Additional analysis of probiotic safety and a cost versus benefit analysis was researched. The purpose of the review …

Hepatitis C Virus Screening And Treatment, Dani Loftus, Emily Machens, Crista Jamous

Doctor of Nursing Practice Projects

Hepatitis C Virus (HCV) is classified as a contagious liver disease that can be either acute or chronic, and the illness ranges in severity from mild to lifelong. It is estimated that 2.7 million people in the United States (US) have HCV, but only half are diagnosed. The CDC recommends testing by birth-cohort, focusing on adults born between 1945 and 1965. Three main objectives for this project included implementation of a clinical decision support system (CDSS) for providers, increasing HCV screening by providing education to the support staff in primary care clinics of a local hospital which would increase the …

Impact Of Macra Legislation And Mips Scores On Cost Effective Analysis For Negative Pressure Wound Therapy Devices, Jeremy W. Kubiak, Subhas Gupta

Subhas Gupta, MD, PhD, FRCSC, FACS

The Medicare Access and CHIP Reauthorization Act (MACRA) changes reimbursement from a fee-for-service payment system to fee-for-value. Physicians will be scored according to the quality of their care in the MIPS program and will receive a positive or negative modifier to their Medicare reimbursement based on that score.

Cost Analysis Of The Ctlb Study, A Multitherapy Antenatal Education Programme To Reduce Routine Interventions In Labour, Kate M. Levett, Hannah G. Dahlen, Caroline A. Smith, Kenneth William Finlayson, Soo Downe, Federico Girosi

Medical Papers and Journal Articles

Objective: To assess whether the multitherapy antenatal education ‘CTLB’ (Complementary Therapies for Labour and Birth) Study programme leads to net cost savings.

Design: Cost analysis of the CTLB Study, using analysis of outcomes and hospital funding data.

Methods: We take a payer perspective and use Australian Refined Diagnosis-Related Group (AR-DRG) cost data to estimate the potential savings per woman to the payer (government or private insurer). We consider scenarios in which the intervention cost is either borne by the woman or by the payer. Savings are computed as the difference in total cost between the control group and the study …

Impact Of Macra Legislation And Mips Scores On Cost Effective Analysis For Negative Pressure Wound Therapy Devices, Jeremy W. Kubiak, Subhas Gupta

Loma Linda University Student Journal

The Medicare Access and CHIP Reauthorization Act (MACRA) changes reimbursement from a fee-for-service payment system to fee-for-value. Physicians will be scored according to the quality of their care in the MIPS program and will receive a positive or negative modifier to their Medicare reimbursement based on that score.

Societal Costs Of Micronutrient Deficiencies In 6- To 59-Month-Old Children In Pakistan, Simon Wieser, Beatrice Brunner, Christina Tzogiou, Rafael Plessow, Michael B. Zimmermann, Jessica Farebrother, Sajid Bashir Soofi, Zaid Ahmad Bhatti, Imran Ahmed, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: In Pakistan, nearly half of children younger than 5 years are stunted, and 1 in 3 is underweight. Micronutrient deficiencies, a less visible form of undernutrition, are also endemic. They may lead to increased morbidity and mortality as well as to impaired cognitive and physical development.
Objective: To estimate the lifetime costs of micronutrient deficiencies in Pakistani children aged between 6 and 59 months.
Methods: We develop a health economic model of the lifetime health and cost consequences of iodine, iron, vitamin A, and zinc deficiencies. We assess medical costs, production losses in terms of future incomes lost, and …

Analisis Biaya Dan Faktor-Faktor Penentu Inefisiensi Layanan Hemodialisis Pada Pasien Gagal Ginjal Kronik Rumah Sakit Rk Charitas Palembang Tahun 2016, Noer Triyanto Rusli

Jurnal ARSI (Administrasi Rumah Sakit Indonesia)

Enactment of JKN in hospital changes the payment system from retrospective payment (fee for service) into prospective payment (INA-CBG's). As a healthcare facility, RK Charitas Hospital has a role to provide not only quality but also to consider cost effective of services. This study aimed to analyze costs and identify the determinants of the inefficiency of hemodialysis services in patients with chronic renal failure at RK Charitas Hospital. This is a descriptive analysis research using primary and secondary data. Approach of cost analysis is Activity Based Costing (ABC) with "Bottom Up" method. ABC method is used to allocate costs by …

Evaluation Of Quality Of Life And Cost-Effectiveness Of Definitive Surgery And The Levonorgestrel Intrauterine System As Treatment Options For Heavy Menstrual Bleeding, Cevdet Adigüzel, Sevtap Seyfetti̇noğlu, Deni̇z Aka Satar, Sefa Arlier, Eda Eski̇mez, Fatma Kaya, Hakan Nazi̇k

Turkish Journal of Medical Sciences

Background/aim: This study aimed to compare the levonorgestrel intrauterine system (LNG-IUS) with abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH) as first-line treatments for heavy menstrual bleeding (HMB). Materials and methods: Ninety-eight patients aged 20-55 years who complained of regular heavy menstrual bleeding were enrolled in the study. The TAH group included 29 patients, the LNG-IUS group included 34, and the TLH group included 35. These groups were compared in terms of quality of life and the cost-effectiveness of the selected methods. Quality of life was assessed using the 36-Item Short Form (SF-36), and cost-effectiveness was assessed according to the …

A Systematic Review Of The Cost-Effectiveness Of Chemotherapy Regimens, Chelsea R. Manion, Eric Blizzard, Emily Bruce, Hannah Chittenden, David Fisher, Lia G. Hickinbotham, Abigail Moon, Nicholas Rudy, Aleda Chen, Kristi Coe

The Research and Scholarship Symposium (2013-2019)

Background: The rising cost of chemotherapy dramatically increases the burden on healthcare and presents new challenges in achieving optimal patient outcomes. New treatments, in general, are more specialized but show minor progress in regards to efficacy. Accordingly, the threat of overpaying for chemotherapy regimens has increased. There is a need for a comprehensive review to compile relevant studies in order to inform clinician decisions on the basis of cost-effectiveness and quality of life.

Objectives: The objective of this project is to assess the cost-effectiveness of anticancer medications with a special focus on the quality of life of patients undergoing chemotherapy, …

Cost Analysis And Evaluation Of Nosocomial Infections In Intensive Care Units, Uğur Kostakoğlu, Sedat Saylan, Mevlüt Karataş, Serap İskender, Fi̇rdevs Aksoy, Gürdal Yilmaz

Turkish Journal of Medical Sciences

Background/aim: The purpose of this study was to evaluate nosocomial infections occurring in our hospital intensive care units (ICUs) and the risk factors for these, and to determine the effect of these infections on mortality and cost. Materials and methods: This retrospective study was performed via infection control committee surveillance data, ICU records, and information processing data between 1 January and 31 December 2013 at the Kanuni Education and Research Hospital. Results: A total of 309 nosocomial infections were observed in 205 out of 566 patients. The density of nosocomial infections was 25.4 in 1000 patient days. Hospitalization was prolonged, …

A Systematic Review Of The Cost-Effectiveness Of Chemotherapy Regimens, Nicholas Rudy, Hannah Chittenden, David Fisher, Abigail Moon, Lia G. Hickinbotham, Emily Bruce, Eric Blizzard, Aleda Chen, Chelsea Manion

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Background

The rising cost of chemotherapy dramatically increases the burden on healthcare and presents new challenges in achieving optimal patient outcomes. New treatments, in general, are more specialized but show minor progress in regards to efficacy. Accordingly, the threat of overpaying for chemotherapy regimens has increased. There is a need for a comprehensive review to compile relevant studies in order to inform clinician decisions on the basis of cost-effectiveness and quality of life.

Objectives

Therefore, the aim of this project is to assess the cost-effectiveness of anticancer medications with a special focus on the quality of life of patients undergoing …

A Cost Analysis Of The 1-2-3 Pap Intervention, Kristina M. Rabarison, Rui Li, Connie L. Bish, Robin C. Vanderpool, Richard A. Crosby, Mehran S. Massoudi

Frontiers in Public Health Services and Systems Research

Background: Cervical cancer places a substantial economic burden on our healthcare system. The three-dose human papillomavirus (HPV) vaccine series is a cost-effective intervention to prevent HPV infection and resultant cervical cancer. Despite its efficacy, completion rates are low in young women aged 18 through 26 years. 1-2-3 Pap is a video intervention tested and proven to increase HPV vaccination completion rates.

Purpose: To provide the full scope of available evidence for 1-2-3 Pap, this study adds economic evidence to the intervention’s efficacy. This study tested the economies of scale hypothesis that the cost of 1-2-3 Pap intervention per number of …

A Comparison Of Clinical Trial And Model-Based Cost Estimates In Glaucoma – The Case Of Repeat Laser Trabeculoplasty In Ontario, Omar Akhtar

Electronic Thesis and Dissertation Repository

Background and objective: For cost-effectiveness analyses (CEA) of glaucoma interventions to be of use they require valid and accurate cost and effectiveness data. Costs remain understudied relative to effectiveness. The impact of cost estimation methods on resultant estimates is unknown in glaucoma. Direct measurement of costs is labour-intensive and expensive. Decision-analytic modelling of costs using literature sources, expert opinion, institutional experience and assumptions provides a quicker, less laborious alternative to empirical costing. A lack of long-term effectiveness data in chronic diseases like glaucoma means that modelling is widespread and inevitable, both for CEAs and budget impact projections. The same problem …

Statewide Penetration And Standard Costs Of Psychotropic Medications, Mary R. Murrin

Mental Health Law & Policy Faculty Publications

This study will examine differences in pharmaceutical utilization rates relative to financial risk arrangements of differing insurance plans. During the last four years we have noted consistent differences in utilization of expensive, psychotropic medications between individuals enrolled in Health Maintenance Organizations (HMOs), which are at financial risk for the provision of pharmaceuticals, and the MediPass program in which the state bears the risk of pharmacy expenses. Persons in HMOs had lower levels of utilization.

Health Promoting Behavior Among Students Ofupper Secondary Schools In Bangkok, N. Jiraradtanawanna, J. Sriratanaban, O. Viputsiri

Chulalongkorn Medical Journal

No abstract provided.

Successful Repair Of Post Myocardial Infarctionleft Ventricular Aneurysm, Kittichai Luengtaviboon, Supot Srimahachoti, Supranee Niruthisard

Chulalongkorn Medical Journal

No abstract provided.

Meta-Analysis On Costing Out Nursing Services, Judith G. Eckhart Dnsc

Dissertations

This descriptive meta-analytic study investigated 73 primary studies on costing out nursing services. A critical review of the literature revealed that findings from the various published and unpublished studies were inconsistent and inconclusive. This meta-analysis integrated the literature to identify the relationships between nursing costs and a second variable. The most frequently reported variables among the primary studies were compared using Pearson r correlations and percentages. The variables of total and direct nursing costs were correlated to the variables of length of stay, direct nursing care hours, hospital costs, and diagnostic related grouping (DRG) reimbursements. Analysis was conducted two ways. …

Atrophic Rhinitis In Pigs, A R. Mercy

Journal of the Department of Agriculture, Western Australia, Series 4

Severe atrophic rhinitis in pigs recurred recently in Australia after an apparent absence of some 20 years. The first of these recent cases occurred in a Westerm Australian herd in late 1984 and since then six other local herds have reported the disease. Severe atrophic rhinitis has also been seen recently in South Australia.

Atrophic rhinitis is a complex disease which causes degeneration of the nasal cavity, twisting of the snout and sometimes occasional bleeding from the nose.

It occurs only in pigs and severely affected animals may have a slower growth rate.