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Results for “Cost Effectiveness”

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At least 19 recordsLinked to original sources
PubMed1992

Effectiveness, costs, and cost-effectiveness of recruitment strategies for a mammographic screening program to detect breast cancer.

BACKGROUND AND PURPOSE: Since effective and affordable recruitment methods are essential for the widespread implementation of mammographic screening for detection of breast cancer, we studied the effectiveness, the costs, and the cost-effectiveness of various recruitment strategies in the population targeted by a pilot Australian program that offered free mammography screening between 1988 and 1990. METHODS: We evaluated three public recruitment strategies--local newspaper articles, community promotion, and promotion to physicians--and five personal strategies--invitation letters with or without specified appointment times, either alone or with a follow-up letter, or telephone call to nonattenders. The effectiveness of public recruitment strategies was estimated from monthly attendance rates by Poisson regression analysis, while the probability of attendance in response to personal strategies was calculated using logistic regression analysis. Costs were determined by resource usage studies. The cost-effectiveness ratios for personal strategies were determined using decision analysis. RESULTS: The costs in 1988-1989 Australian dollars per woman recruited were $22 for local newspaper articles and $106 for community promotion. No detectable increase in attendance resulted from promotion to physicians. When the cost of reserving an appointment was considered, the most cost-effective personal recruitment strategy was an invitation letter without a specified appointment time, followed by a second letter to nonattenders. This strategy recruited 35.6% of women in the sample targeted and cost $10.52 per attendee. In comparison, the most effective personal recruitment strategy was a letter with a specified appointment time followed by a second letter to nonattenders, which recruited 44.1% of women at an average cost of $19.99 and a marginal cost of $59.71 per additional attendee. CONCLUSIONS: Personal recruitment strategies were more cost-effective than public strategies. The most cost-effective personal strategy was an invitation letter without a specified appointment time, followed by a second letter to nonattenders.

Australia↗
PubMed1981

Are home hemodialysis aides cost-effective? Cost of home hemodialysis aides.

Payment for home hemodialysis aides has been proposed as a means of inducing shifts from center hemodialysis to less-expensive home hemodialysis. By using a simulation model, we computed the cost per life year of end-stage renal disease care when changes in the proportions of patients treated by center for home hemodialysis are brought about by paying for home hemodialysis aides. If all home hemodialysis patients receive payment for aides, total costs will increase unless there are sufficient shifts from center to home hemodialysis to offset the increased costs. The cost-effectiveness of home hemodialysis aides is critically dependent on who receives a paid aide, the salary of the aid, and the number of patients who move from center to home hemodialysis. Poorly formulated regulations may jeopardize the cost-effectiveness of home hemodialysis and increase the total cost of end-stage renal disease care.

Allied Health Personnel↗
PubMed1980

Cost accounting: the vital link to cost effectiveness.

Cost accounting--the identification, allocation, and measurement of costs incurred and values received--is the information complement to cost-effectiveness in foodservice management. It is a necessary adjunct to and entirely compatible with the professional skills of dietitians and foodservice administrators. Cost accounting provides the information for making decisions which enhance both the effectiveness (doing the right things) and the efficiency (doing things right). Cost accounting assists in maintaining the economic harmony of foodservice decisions and provides the proof that the right decisions were made. The heads-up professional will learn to make cost accounting work for survival and success in the arena of foodservice administration.

Accounting↗
PubMed1987

Effectiveness and cost effectiveness of persuasive communications and incentives in increasing safety belt use.

The Safety Belt Connection Project was a worksite health promotion project conducted at a medical school and hospital complex to test the effectiveness and cost effectiveness of four treatment conditions (TCs): TC1, Persuasive Communications (PCs) alone; TC2, PCs plus overt monitoring; TC3, PCs plus incentives; and TC4, PCs plus incentives and prompts. Parking lots were randomized to treatment condition. A community traffic intersection served as a comparison group. Trained observers recorded safety belt use rates (SBURs) of subjects (front seat occupants) over a two-week period at baseline and after a four-week period of intervention. Results were analyzed by chi-square comparisons of pre-treatment and post-treatment SBURs. At baseline, significant differences in SBURs between treatment groups were observed. Significant pre-to-post differences were found for TC3 and TC4: the SBUR in TC3 went from 18.3% - 38.4% (p less than 0.001) and the SBUR in TC4 went from 16.9% - 44.8% (p less than 0.001). Both TC3 and TC4 were effective, but TC4 cost 2.6 times more per person influenced to wear their safety belt.

Communication↗
PubMed1988

Will cost effectiveness analysis worsen the cost effectiveness of health care?

Cost effectiveness analysis is increasingly advocated as a basis for health policy. Analysts often compare expensive interventions with highly cost-effective programs such as hypertension screening, implying that if the former were curtailed resources would be reallocated to the latter and the efficiency of health care would improve. However, in practice, savings are unlikely to be targeted in this way. We present refined policy models that take into account actual patterns of resource allocation in the United States, and provide more realistic estimates of the likely uses of savings. We illustrate the implications of these models in an analysis of the effects of diverting funds from an expensive but effective practice. Eliminating such a practice would actually worsen the overall cost-effectiveness of U.S. health care unless there are radical changes in health policy. Cost effectiveness analysis incorrectly predicts health and cost outcomes of policy initiatives because it ignores the political constraints to health care decision-making.

Cost Control↗
PubMedDate not supplied

Cost effectiveness and cost benefit of vaccination against pneumococcal pneumonia: implications for clinical practice.

The economic techniques of cost-effectiveness and cost-benefit analysis have provided useful insights into the potential advantages of vaccination against pneumococcal pneumonia. They suggest that the cost of vaccinating persons 65 years and older and perhaps younger persons with high risk conditions would be reasonable when compared with the cost of treatment for pneumococcal pneumonia. These findings, together with other considerations, may guide physicians and health care policymakers in deciding which individuals might be expected to benefit from pneumococcal vaccination.

Adult↗
PubMed1989

Is patch testing cost-effective?

Costs for dermatitis can be evaluated against the costs and potential benefits of patch testing on the basis of data available from several sources. Consideration of cost for an individual patient suggests that costs become neutral and benefits become positive if the dermatitis is persistent and multiple physician visits are required. The appropriate use of patch testing should yield a positive test result 30% to 65% of the time.

Cost-Benefit Analysis↗
PubMed1985

Cost effects of restricting cost-effective therapy.

This article examines the cost effects of a closed pharmaceutical formulary on Medicaid expenditures for peptic ulcer disease. Studies were performed before and after the imposition of a closed pharmaceutical formulary and indicated that total Medicaid costs for peptic ulcer treatment were 15.0% lower during the closed formulary than open formulary periods. The overall savings were due mainly to a sharp decline in the number of peptic ulcer patients served by Medicaid. The cost per patient-month of therapy increased by 9.4% between study periods. Pharmaceutical costs per patient-month declined by 78.9%, monthly physician payments increased by 3.1%, and monthly inpatient hospital costs increased by 23.6%. The small, short-term savings may be negated by increased expenditures in the near future when sicker patients, previously denied peptic ulcer drug treatment, may reenter the Medicaid system in need of expensive inhospital treatment.

Cimetidine↗
PubMed1989

A utility-based model for comparing the cost-effectiveness of diagnostic studies.

The effective cost of a diagnostic test is the money spent per unit of diagnostic performance. The latter can be measured as diagnostic utility (DU), the probability-weighted sum of the utilities of the four test outcomes TP, TN, FP, and FN: DU = U(TP)P(TP) + U(TN)P(TN) + U(FP)P(FP) + U(FN)P(FN). DU (which also is called expected utility) incorporates the clinical decision analytic variables sensitivity (Se), specificity (Sp), equivocal fraction (EF), disease probability (P(D)), and outcome utility (U). DU is not an inherent property of a diagnostic test but of test-observer interactions in a clinical setting. The model sets the effective cost (EC) of a diagnostic test = actual direct cost (ADC)/DU. When DU = 1 (perfect test) EC = ADC and the patient benefits from the test dollar for dollar. When DU less than 1, EC exceeds ADC. If DU approaches O, EC becomes infinite; the test has no effectiveness at any cost. DU depends strongly on P(D) if Se and Sp differ significantly; then EC also depends on P(D), and the effective cost of a test performed in the wrong P(D) setting may be several times its actual direct cost. This model of comparing effective costs compares actual direct cost with clinical measures of test performance and utility values that allow expression of patient/doctor fears and preferences. It offers a more clinically realistic setting than models based on costs alone.

Cost-Benefit Analysis↗
PubMed1988

Cost-effectiveness study of cefotetan versus cefoxitin and cefotetan versus combination antibiotic regimens.

The clinical efficacy, adverse effects, cost of therapy, and administration time required to treat 141 patients were compared for cefotetan versus cefoxitin (Study A) and cefotetan versus combination antibiotic therapy (Study B). No major differences were observed in clinical efficacy or adverse effects in any of the treatment groups. Cefotetan was more cost-effective than cefoxitin, even though cefoxitin was given for shorter periods. Cefotetan was also more cost-effective than a combination of ampicillin, an aminoglycoside, and clindamycin. Although the ampicillin, aminoglycoside, and metronidazole combination appeared to be the most cost-effective regimen, this combination required the longest administration time (240 percent longer than cefotetan). Cefotetan appears to be comparably efficacious and more cost-effective than other currently used antianaerobic regimens in our institution.

Aminoglycosides↗