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At least 19 recordsLinked to original sources
PubMed1983

Cost analysis and cost justification of automated data processing in the clinical laboratory.

Prospective cost analysis of alternative data processing systems can be facilitated by proper selection of the costs to be analyzed and realistic appraisal of the effect on staffing. When comparing projects with dissimilar cash flows, techniques such as analysis of net present value can be helpful in identifying financial benefits. Confidence and accuracy in prospective analyses will increase as more retrospective studies are published. Several accounts now in the literature describe long-term experience with turnkey laboratory information systems. Acknowledging the difficulty in longitudinal studies, they all report favorable effects on labor costs and recovery of lost charges. Enthusiasm is also expressed for the many intangible benefits of the systems. Several trends suggest that cost justification and cost effectiveness will be more easily demonstrated in the future. These are the rapidly decreasing cost of hardware (with corresponding reduction in service costs) and the entry into the market of additional systems designed for medium to small hospitals. The effect of broadening the sales base may be lower software prices. Finally, operational and executive data management and reporting are destined to become the premier extensions of the LIS for cost justification. Aptly applied, these facilities can promote understanding of costs, control of costs, and greater efficiency in providing laboratory services.

Computers↗
PubMed2006

Cost analysis and cost determinants in a European inflammatory bowel disease inception cohort with 10 years of follow-up evaluation.

BACKGROUND & AIMS: Economic analysis in chronic diseases is a prerequisite for planning a proper distribution of health care resources. We aimed to determine the cost of inflammatory bowel disease, a lifetime illness with considerable morbidity. METHODS: We studied 1321 patients from an inception cohort in 8 European countries and Israel over 10 years. Data on consumption of resources were obtained retrospectively. The cost of health care was calculated from the use of resources and their median prices. Data were analyzed using regression models based on the generalized estimating equations approach. RESULTS: The mean annual total expenditure on health care was 1871 Euro/patient-year for inflammatory bowel disease, 1524 Euro/patient-year for ulcerative colitis, and 2548 Euro/patient-year for Crohn's disease (P < .001). The most expensive resources were medical and surgical hospitalizations, together accounting for 63% of the cost in Crohn's disease and 45% in ulcerative colitis. Total and hospitalization costs were much higher in the first year after diagnosis than in subsequent years. Differences in medical and surgical hospitalizations were the primary cause of substantial intercountry variations of cost; the mean cost of health care was 3705 Euro/patient-year in Denmark and 888 Euro/patient-year in Norway. The outlay for mesalamine, a costly medication with extensive use, was greater than for all other drugs combined. Patient age at diagnosis and sex did not affect costs. CONCLUSIONS: In this multinational, population-based, time-dependent characterization of the health care cost of inflammatory bowel disease, increased expenditure was driven largely by country, diagnosis, hospitalization, and follow-up year.

Adolescent↗
PubMed1990

[Costs and cost analysis].

The costs of an activity is frequently the most conspicuous part in decision making when changes in health care services are considered. It is thus essential to be aware of the principles and considerations underlying the composition of costs. The concept of cost is not restricted to expenditures that have to be paid. It involves the notion of opportunity cost i.e. the cost of a service is the satisfaction or benefit foregone in not being able to use the resources involved to obtain some other service which is also desirable and therefore also provides satisfaction. Strictly, this relates to the best alternative way of using the resources. In order to estimate the costs of an activity, all costs, whether direct or indirect, tangible or intangible, ought to be taken into account. The fact that they may be difficult to measure a value is no excuse for ignoring them. In a cost analysis the result has to be assessed in the light of the types of costs employed and the aim of the analysis. Average cost is very often used, but is seldom the relevant costs. What is normally of concern is the cost of some change. Only by using marginal costs i.e. those costs that actually do change is it possible to obtain a true picture of resource consequences of that change. Regardless of the type of cost it is necessary to consider on whom the costs fall and to whom the benefits accrue. These may not be the same.

Costs and Cost Analysis↗
PubMed1995

Revision and primary hip and knee arthroplasty. A cost analysis.

The cost of health care in the United States has been rising steadily during the past 10 years. Total joint arthroplasty, a commonly performed orthopaedic procedure, accounts for approximately $10 billion dollars per year. The objective of this study was to perform a clinician-oriented cost analysis of primary and revision hip and knee arthroplasty. Twenty-five consecutive cases each of total knee arthroplasty, total hip arthroplasty, revision total knee arthroplasty, and revision total hip arthroplasty were analyzed. The length of stay and number of minutes spent in the operating room were significantly higher for the patients with revision hip surgery than for the other groups. The total charges for the prosthesis in the 4 groups exceeded 40% of the total charges for the procedure. Primary hip and knee surgery had similar billed costs, and work for revision hip surgery has a significantly higher billed cost than physician's work. The implant selection process by an orthopaedic surgeon performing arthroplasty of the hip and knee needs to include economic aspects.

Costs and Cost Analysis↗
PubMed2000

Development of a cost analysis spreadsheet for calculating the costs to raise a replacement dairy heifer.

Dairy operations have a variety of resources and objectives, such that the most economical method of obtaining replacement heifers is only determined by individual analysis of costs. The objective of this study was the development of a cost analysis spreadsheet and validation of that spreadsheet on milking and custom heifer operations throughout Pennsylvania. A cost analysis spreadsheet was developed with an Excel '97 Microsoft file. The spreadsheet estimated the costs to raise a replacement heifer by specific age classes for feed, labor, health, reproduction, bedding, facilities, equipment, mortality, and interest costs. The simplistic and broad-based nature of the spreadsheet was a key component in the spreadsheet's flexibility to estimate costs for a variety of operational objectives, feeding management, housing systems, and labor management. A convenience sample of 16 milking operations and 14 custom heifer operations was evaluated to validate the cost analysis spreadsheet. Results from the validation are discussed to highlight the success and performance of the cost analysis spreadsheet. The average total cost to raise a replacement heifer for this data set was $1124.06 and $1019.20 for milking and custom heifer operations, respectively. Feed costs contributed 60.3 and 64.0% of the average total cost for milking and custom heifer operations, respectively. While no two operations are alike, individual operations possessing the ability to address costs to raise a replacement heifer can utilize critical information that can be used to improve operation profitability.

Aging↗
PubMed1987

Automated and ambulatory record systems: a comparative cost analysis.

The cost of labor has continued to increase, while the cost of computers has decreased dramatically. Has this inverse cost relationship between labor and computers progressed far enough to affect large ambulatory medical record operations? That is the question addressed in this article.

California↗
PubMed2001

Pinch grafting in hospital and primary care: a cost analysis.

The cost of treating venous leg ulcers with pinch grafting was evaluated for 58 consecutive patients: 29 in hospital care and 29 in primary care. The mean age was 76.8 and 74.3 years and the mean ulcer size 15.1 and 13.5 cm2, respectively. The operation technique, pinch grafting, was the same for all patients but primary care patients were not immobilised postoperatively. Healing rate within 12 weeks was the same for patients in hospital care and primary care (31%). Treatment costs for one week pre-operatively and three weeks postoperatively amounted to 5109 Pounds per patient in hospital care and 870 Pounds per patient in primary care (p < 0.001), and the costs for one week pre-operatively and 12 weeks postoperatively were 6738 Pounds and 1806 Pounds, respectively (p < 0.001). Costs for patients whose ulcers healed within 12 weeks were 5552 Pounds for those receiving hospital care and 1676 Pounds for those receiving primary care (p < 0.001). Pinch grafting in primary care was shown to cost 3.3 to 5.9 times less, with the same healing outcome, than pinch grafting in hospital care.

Aged↗
PubMed2004

Preparation of candidates for renal transplantation: cost analysis.

While the costs of renal transplantation are lower than those of dialysis, little is known about the costs of managing the waiting list. We performed a cost analysis of admission and clinical management of a waiting list for renal and pancreas-kidney transplantation. Admission to the waiting list included (1) renal graft from cadaver: minimum cost Euros () 1784.56 for men < 55 years, maximum 2127.85 for women >/= 55 years; (2) pancreas-kidney transplantation: minimum 2475.50 for men, maximum 2540.10 for women >/= 35 years. Check of suitability state on waiting list after 2 and 5 years: minimum 1400.15 for men >/= 55 years (check every 2 years), maximum 1467.07 for women >/=40, <55 years (every 5 years). The differences are related to the imaging techniques: from 43.90 (Doppler ultrasonography) to 283.28 (coronary angiography). Maintenance of the waiting list: minimum cost 1885.21 in the first year and 3187.02 in the (fifth year) for men < 55 years; maximum 2228.50 (first year) and 5116.70 (fifth year) for women >/= 55 years. These results show different costs for recipients on the basis of sex and age ranges, due to the different requirements for imaging tests such as cardiac scintiscan at age >/= 55 years) and economic charges that increase with age. Reduced waiting times allow lowered total costs. This evaluation allowed us to calculate for our region (Piemonte, Northern Italy), the management costs of the patients presently on our waiting list (369 patients at December 31, 2002) from preparation to transplantation as 959,179.18.

Cadaver↗
PubMedDate not supplied

[Point care testing in blood gas and electrolyte analysis : examples of implementation and cost analysis].

An increasing proportion of laboratories manage and organize point of care testing (POCT). The purpose of this article is to describe the implementation made at Lariboisière hospital for three remote blood gas analysers. The most important aspect in this achievement is the comprehensive computerization, making possible real time management of POCT in agreement with the Point of Care unit Management team. In addition, we present a running cost analysis, comparing three Blood gas systems (Rapidlab860, Rapidpoint 400--Bayer Diagnostics and i-Stat Abbott Diagnostics). This study indicates that cost per test hugely varies based on the daily sample demand. In addition to analytical and organizational items, the clinical chemist should consider the testing demand as a key factor in choosing an analyser for POCT.

Blood Chemical Analysis↗
PubMedDate not supplied

Cost analysis of schistosomiasis.

Cost analysis of schistosomiasis is important both in assessing the economic impact of the disease and in identifying the most cost-effective approaches to control. Economic impact has been examined both within and without the health sector, but there is a lack of measurement of the effects of disease, or the threat of disease, on patterns of production and community development. The cost-effectiveness of control approaches has been examined empirically and by using static models. Future analyses require a stronger epidemiological basis incorporating realistic demography and the temporal dynamics of reinfection, and assessment of outcomes in terms of disease rather than infection.

Cost-Benefit Analysis↗
PubMed1986

A comparison of alternative mosquito abatement methods using benefit-cost analysis.

Benefit-cost analysis can be used to evaluate and compare projects that involve alternative mosquito control methods. A comparison of two such projects in Chatham County, GA indicated that source reduction was a contributing factor in the reduction of ground adulticide applications and quantities, and annual female densities per light-trap night of the predominant saltmarsh mosquito species in the area. Net benefits realized from source reduction were $591,319 as opposed to $409,823 and discounted net benefits were $377,729 versus $284,511 (source reduction project vs. chemical control project) demonstrating the relative effectiveness of the source reduction project in our application. Because of unique differences between areas and projects, generalizations of the above conclusion are cautioned, although the approach is easily adapted.

Cost-Benefit Analysis↗
PubMed1994

[Practical cost analysis of high-cost medicine at the Rikshospital--how do we value the clinical activities?].

How should the costs involved in clinical activities be calculated? The authors argue that interest for this question will increase in the years ahead. Costing requires several choices to be made both regarding principles and practical methodology. The results for high-cost treatments at the National Hospital in Norway (Rikshospitalet) are presented. The various treatments include bone marrow, liver, kidney, kidney-pancreas, heart and heart-lung transplantations, arterio-coronary bypass, valvular and aortic surgery, extra-corporal membrane oxygenation and surgical treatment of epilepsy. Methodological issues are presented and discussed. The costing is performed from an institutional perspective. Increased use of bottom-up, actual cost methodology, combined with the direct allocation of overheadcosts is recommended. This allows the study of interpatient variations in consumption of resources.

Cost-Benefit Analysis↗