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S Charvet-Protat

Publications and source records attributed to S Charvet-Protat.

11 recordsLinked to original sources
PubMed2000

[Medico-economic analysis of nosocomial infections].

OBJECTIVES: The purpose of this study was to examine analyses of the micro-economic and macro-economic consequences of hospital-acquired nosocomial infections. MATERIAL AND METHODS: We performed a critical analysis of the methods reported in the literature for economic estimations of the cost of nosocomial infections and determined the objectives that can be assigned to them. DISCUSSION: Macro-economic estimations of the consequences of nosocomial infections clearly have methodological limitations but nevertheless have an important impact since concern about global cost of nosocomial infections is a persuasive argument in favor of prevention programs. Studies based on calculating the estimated mean cost by type of nosocomial infection cannot alone provide a sufficiently reliable data to determine the pertinence of preventive strategies. Cost-efficiency studies (cost per year of saved life, or cost per nosocomial infection avoided) appear to be more adapted. CONCLUSION: One must carefully examine the underlying methodology when using cost-efficacy ratios associated with different strategies as a decision-making tool.

Communicable Disease Control↗
PubMed2000

Can improving quality decrease hospital costs?

PURPOSE: To determine whether the concept of 'cost of quality' and the techniques used for its study in the industrial sector are also applicable to hospitals. DATA SOURCES: We undertook a systematic review of the literature published since 1992 (five electronic databases and a manual search) using keywords relating to quality of health care and costs. STUDY SELECTION: We selected all articles relating cost and quality, providing indicators for quality failure, determining the cost of failure, and itemizing the cost of quality. Twelve articles met these criteria (USA, nine; UK, one; Australia, one; France, one); six referred to total quality management, three to hidden costs, and three to adverse events. DATA ABSTRACTION: For each article, we recorded the test hypothesis, the focus of the study and the main results on costs and quality. RESULTS OF DATA SYNTHESIS: Preventing failure by applying total quality management to a variety of projects (managed care project, setting-up a standard procedure . . .) led to financial savings; quality was maintained, even enhanced. Better communication and co-ordination reduced hidden costs and also increased quality. Adverse events prolonged hospital stays by 1.74-4 days and increased costs. CONCLUSION: Very few detailed articles related cost and quality and, although they all noted a positive impact of an emphasis on quality, they nevertheless had their shortcomings. Study periods were too short, the indirect aspects of costs and savings were not taken into account, economic reference values were omitted. We conclude that more precise and strict methods for quantifying costs are needed.

Cost Savings↗
PubMed1999

[Analysis of economic data and elaboration of professional guidelines].

As medicine becomes increasingly complex, economic constraints are beginning to weight more heavily on the actors of our health system. It follows that one of ANAES' missions is to initiate and promote professional guidelines that take full account of economic arguments. One of the benefits of economic evaluation is to provide professionals with information about the economic consequences of their practices. This implies determining to what extent the methodological principles used to develop clinical guidelines can also apply to the incorporation of economic criteria in professional guidelines. Economic evaluation offers those active in the field of health an information that can be absorbed into the reality of what they actually do in practice. Professionals can thus orient themselves towards practices which have not only been clinically validated but are also cost-effective. This is the objective that underlies the critical appraisal of economic evaluation publications. Such appraisals help professionals to base their choices on objective grounds.

Cost-Benefit Analysis↗
PubMed1998

[Economic and organizational evaluation of an imaging network (PACS)].

OBJECTIVE: Over the last twenty years, imaging modalities featuring new image production methods (ultrasound, nuclear magnetic resonance, etc.) have appeared on the market. Nevertheless, conventional radiology still accounts for 70% of the image examinations carried out in most western countries, including France. The conventional radiological image is in the process of evolving from analog to digital form. Digitalization of radiology means that image acquisition, archiving and distribution functions that were previously carried out by hand can now be automated using a Picture Archiving and Communication System. Decision-makers are having to decide whether or not to promote the development of PACS which, while they considerably modernize the way in which images are managed, also require heavy capital outlays. METHOD: A critical appraisal of the literature allowed us to evaluate the relative cost and the efficiency of these image networks in comparison with film-based archiving and communication systems. RESULTS: It is clear from the economic evaluation that a PACS strategy involves greater costs than a film system. While PACS systems do generate savings on film and on storage space and obviate the need for certain staff, these savings do not offset the extra equipment and maintenance costs. This situation is likely to persist for some years yet, even when future price reductions are taken into account. The objective of this new radiological information management method is to improve organizational efficiency and hospital productivity. However, the economic evaluations that have been published to date are cost studies which do not take the efficiency criterion into account. A number of potential organizational benefits such as the fact that medical decisions can be made more quickly or that the average length of hospital stays can be reduced, are often claimed for PACS. However, for methodological reasons, these results cannot be generalised to cover all PACS. It is difficult to compare PACS and film systems because the PACS technology is continuously evolving and because each PACS is specific to a site. CONCLUSION: After having weighted these different points, the ANAES has made the following recommendations concerning the development of PACS. A strategic analysis should be carried out before any decision is made to install a PACS. Moreover, hospitals will have to define the precise functions of their PACS in relation to the objectives of their medical project and each network must be configurated coherently.

Analog-Digital Conversion↗
PubMed1997

[Should we screen for hemochromatosis? Critical analysis of the literature].

This paper focus on the main issues to evaluate before planning public health interventions which may optimise the prevention of hemochromatosis. The main indicators are considered: prevalence, morbidity and mortality of the disease, efficacy of the available treatment, sensitivity, specificity and predictive values of the screening tests; potential benefit of a national screening program in a public health perspective. These are evaluated through a critical appraisal of the clinical, epidemiologic and economic literature on hemochromatosis. The paper emphasizes how individual behavior and preferences become crucial to take into account when well-being subjects will face a population-based screening program. We conclude that further arguments are required before the implementation of a national screening program for hemochromatosis.

Community Health Planning↗
PubMed1996

[Proton and neutron radiation in cancer treatment: clinical and economic outcomes].

The French National Agency for Medical Evaluation (ANDEM) was requested to assess the effectiveness of proton and neutron beam therapy in cancer treatment compared to conventional radiotherapy. This task was accomplished by a critical appraisal of the clinical and economic literature. According to the published economic literature and the capital and staffing cost analysis, it appears that the costs of proton therapy are likely to be two or three times greater than those of photon conformal therapy. According to the published clinical literature, proton beam therapy should be proposed as a routine treatment only for uveal melanoma and skull base cancers. Neutron beam therapy should be proposed as a routine treatment for inoperable salivary gland tumors; its use may be also discussed in cases of stage C-D1 prostate cancers and soft tissue sarcomas. Based on the current scientific evidence and given the incidence rate of these tumors, the time and material requirements, the current French proton/neutron beam facilities are able to meet the current demand. For other cancers the medical and economic potential of proton therapy is still an open question.

Cost-Benefit Analysis↗