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At least 991 records · Page 55Linked to original sources
PubMed2002

Supplies in demand. Managing medical supplies under PPS.

It is no longer news that the consolidated billing requirement under the home care prospective payment system (PPS) mandates that home care providers are responsible for providing specified supplies to patients under a current episode of care. With more than one year of experience and data measuring the cost of providing supplies, providers are now looking at ways to better manage distribution, control utilization, and minimize costs. Although each organization must make decisions based on its own needs, several steps in this process have proven to be consistently effective.

Decision Making, Organizational↗
PubMedDate not supplied

Restocking the sample closet: results of a trial to alter medication prescribing.

BACKGROUND: Although medication costs make up a large and growing portion of health care costs, few interventions have successfully encouraged physicians to alter prescribing patterns. METHODS: To promote the use of an open formulary, we altered the contents of the sample closets of five primary care practices in eastern Massachusetts. In these practices, we removed all nonformulary drugs in five drug classes and restocked with purchased generic samples. We performed a time series analysis of formulary compliance, before and during an 8-month intervention, with five concurrent control practices for comparison. RESULTS: Although providers in both the intervention and control practices complied well with the formulary, we found no incremental effect of the sample closet intervention on absolute formulary compliance (P = .46) or on the secular trend in formulary compliance (P = .60). We also found no effect on these measures in any of the individual drug classes studied. CONCLUSIONS: This sample closet intervention did not appear to improve further the good formulary compliance in these practices. In such settings, better ways are needed to guide prescribing behavior.

Boston↗
PubMed1975

[Ultrasound in obstetrics. Marking sheets, documentation, programming of summative data. Translation of code into full text (author's transl)].

Report on system of documentation and electronic data analysis of results of ultrasound examinations as used for 5 years at the obstetric department of Bonn University. Special marking sheets were used for primary data collection. Storage and analysis were handled with the author's own programming language SEQAS (Voigt, 1971). The system has worked well. 4 types of sheets used for coding are shown and program examples given.

Computers↗
PubMed2002

Health-related quality of life measurements and studies in rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is a major cause of disability and impairment of health-related quality of life (HRQOL) in the United States. Increasingly, HRQOL assessments are becoming part of a package of materials reviewed by managed care providers in making formulary and reimbursement decisions. OBJECTIVE: To help managed care administrators understand how to interpret and apply the results of HRQOL assessment scales. METHODS: Several patient-reported instruments in common use in RA were reviewed, including the Health Assessment Questionnaire (HAQ), Modified HAQ, Arthritis Impact Measurement Scale, and the 36-item Short-Form Health Survey. RESULTS: These self-assessment scales help improve patient/physician communication and thus enable better treatment decision-making. The scales can also aid managed care administrators in evaluating the efficacy and the financial benefits of therapies. The HAQ was one scale that stood out as being short, easy to administer, and disease-specific for RA. CONCLUSIONS: Self-assessment reports, such as the HAQ, provide key data on disability and HRQOL from the patient's perspective. The information so gained enables the clinician to select the most cost-effective therapies and interventions that slow disease progression, maintain functional status, and improve HRQOL.

Activities of Daily Living↗
PubMed2002

Medicines management. Fit to bust.

The drugs bill is rising above the rate of general and NHS inflation. Medicines expenditure currently accounts for 15 per cent of primary care trust and NHS expenditure. The advent of the National Institute for Clinical Excellence and national service frameworks is likely to push up prescribing. Prescribers should have easy access to the best advice on prescribing practice. PCTs and hospitals should establish Joint formularies, make use of independent advisers and cut down their contact with drug company representatives.

Drug Costs↗
PubMed2002

[An analysis of the frequency of formulations and crude drugs described in Shan-Han-Lun].

A systematic database was constructed to investigate the frequency of reporting formulations and crude drugs described in Shang-Han-Lun, a famous formulary in traditional Chinese medicine. It contains 112 kinds of genuine formulations, but because of overlapping or repetition, the number of formulations total as many as 430. The best two frequently mentioned in the formulary were Da-cheng-qi-tang and Guizhi-tang. Da-cheng-qi-tang, which is Dai-joki-to in Japanese, is a formulation composed mainly of Rhizoma Rhei and Cortex Magnoliae used for the treatment of interior heat- and excess-syndrome. Guizhi-tang, Keishi-to, contains Radix Glycyrrhizae, Ramulus Cinnamoni, and Radix Paeoniae as major crude drugs and is used for the treatment of exterior cold- and deficiency-syndrome. It was revealed that Shang-Han-Lun explained directions for using 112 formulations prescribed for acute febrile diseases and the associated syndromes by revealed clinical cases treated with Da-cheng-qi-tang and Guizhi-tang.

China↗
PubMed2002

Impact of formulary restrictions on the cost-effectiveness of antidepressant treatment.

Newer antidepressants are associated with higher costs of treatment of anxiety and depression. Managed care organizations are challenged to control treatment costs by implementing restricted formularies based on price and perceived medical value. Despite unfavorable side effects of efficacious tricyclic antidepressants, the low acquisition cost rationalizes the inclusion of this older class of agents on a formulary. On the other hand, cost-containment approaches have been taken toward more expensive drug classes (e.g., selective serotonin reuptake inhibitors) despite a superior safety profile of these drug classes over tricyclics. There is compelling evidence that dual reuptake inhibitors (e.g., venlafaxine extended-release), which have acquisition costs similar to serotonin reuptake inhibitors, have a broad spectrum of efficacy and thus added value, contributing to the cost-effectiveness of including this agent in the managed care formulary. Assessment of overall cost-effectiveness should not be limited by acquisition costs but should take total healthcare costs into consideration.

Antidepressive Agents↗