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Costs Related (cost + relate)
Selected AbstractsNeonatal health care costs related to smoking during pregnancyHEALTH ECONOMICS, Issue 3 2002E. Kathleen Adams Abstract Research objective: Much of the work on estimating health care costs attributable to smoking has failed to capture the effects and related costs of smoking during pregnancy. The goal of this study is to use data on smoking behavior, birth outcomes and resource utilization to estimate neonatal costs attributable to maternal smoking during pregnancy. Study design: We use 1995 data from the Center for Disease Control's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS) database. The PRAMS collects representative samples of births from 13 states (Alabama, Alaska, California, Florida, Georgia, Indiana, Maine, Michigan, New York (excluding New York City), Oklahoma, South Carolina, Washington, and West Virginia), and the District of Columbia. The 1995 PRAMS sample is approximately 25 000. Multivariate analysis is used to estimate the relationship of smoking to probability of admission to an NICU and, separately, the length of stay for those admitted or not admitted to an NICU. Neonatal costs are predicted for infants ,as is' and ,as if' their mother did not smoke. The difference between these constitutes smoking attributable neonatal costs; this divided by total neonatal costs constitutes the smoking attributable fraction (SAF). We use data from the MarketScanÔ database of the MedStatÔ Corporation to attach average dollar amounts to NICU and non-NICU nursery nights and data from the 1997 birth certificates to extrapolate the SAFs and attributable expenses to all states. Principal findings: The analysis showed that maternal smoking increased the relative risk of admission to an NICU by almost 20%. For infants admitted to the NICU, maternal smoking increased length of stay while for non- NICU infants it appeared to lower it. Over all births, however, smoking increased infant length of stay by 1.1%. NICU infants cost $2496 per night while in the NICU and $1796 while in a regular nursery compared to only $748 for non-NICU infants. The combination of the increased NICU use, longer stays and higher costs result in a positive smoking attributable fraction (SAF) for neonatal costs. The SAF across all states is 2.2%. Across the states, the SAF varied from a low of 1.3% in Texas to a high of 4.6% in Indiana. Conclusions: These results further confirm the adverse effects of smoking. Among mothers who smoke, smoking adds over $700 in neonatal costs. The smoking attributable neonatal costs in the US represent almost $367 million in 1996 dollars; these costs vary from less than a million in smaller states to over $35 million in California. These costs are highly preventable since the adverse effects of maternal smoking occur in the short-run and can be avoided by even a temporary cessation of maternal smoking. These cost estimates can be used by managed care plans, state and local public health officials and others to evaluate alternative smoking cessation programs. Copyright © 2002 John Wiley & Sons, Ltd. [source] Cost Comparison of Catheter Ablation and Medical Therapy in Atrial FibrillationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2007F.R.C.P.C., YAARIV KHAYKIN M.D. Introduction: There is emerging evidence for clinical superiority of catheter ablation over rate and rhythm control strategies in paroxysmal atrial fibrillation (PAF). The objective of this study was to compare costs related to medical therapy versus catheter ablation for PAF in Ontario (Canada). Methods: Costs related to medical therapy in the analysis included the cost of anticoagulation, rate and rhythm control medications, noninvasive testing, physician follow-up visits, and hospital admissions, as well as the cost of complications related to this management strategy. Costs related to catheter ablation were assumed to include the cost of the ablation tools (electroanatomic mapping or intracardiac echocardiography-guided pulmonary vein ablation), hospital and physician billings, and costs related to periprocedural medical care and complications. Costs related to these various elements were obtained from the Canadian Registry of Atrial Fibrillation (CARAF), government fee schedules, and published data. Sensitivity analyses looking at a range of initial success rates (50,75%) and late attrition rates (1,5%), prevalence of congestive heart failure (CHF) (20,60%), as well as discounting varying from 3% to 5% per year were performed. Results: The cost of catheter ablation ranged from $16,278 to $21,294, with an annual cost of $1,597 to $2,132. The annual cost of medical therapy ranged from $4,176 to $5,060. Costs of ongoing medical therapy and catheter ablation for PAF equalized at 3.2,8.4 years of follow-up. Conclusion: Catheter ablation is a fiscally sensible alternative to medical therapy in PAF with cost equivalence after 4 years. [source] OPTIMIZATION CRITERIA FOR BATCH RETORT BATTERY DESIGN AND OPERATION IN FOOD CANNING-PLANTSJOURNAL OF FOOD PROCESS ENGINEERING, Issue 6 2003R. SIMPSON ABSTRACT Optimization of thermal processing in the commercial sterilization of canned foods is of great interest because the canning industry plays an important role within the economy of the food processing sector. Many food canning plants operate in a batch mode with a battery of individual batch retorts. The aim of this study was to propose and analyze several criteria and methodologies for optimum design and operation of such retort systems. Two criteria were proposed in the case of choosing the optimum number of retorts to be installed when designing a new batch-operated canning line. The third criterion dealt with seeking optimum process conditions for maximizing output from a fixed number of retorts when processing small batches of different products and container sizes. In the case of new plant design optimization, one objective was to determine the optimum number of retorts that would minimize on-going processing costs related to labor and energy. Retort scheduling (programming) was studied from which a simple mathematical expression was derived for this purpose. A second objective was to determine the optimum number of retorts that would maximize the net present value of initial investment. Approaches based upon engineering economics were studied from which to develop a mathematical procedure for this purpose. In the case of maximizing output from a fixed number of retorts for different products and container sizes, isolethal processes were identified for various product/containers from which a common set of process conditions could be chosen for simultaneous processing of different product lots in the same retort. [source] Two-week target for laparoscopic cholecystectomy following gallstone pancreatitis is achievable and cost neutral,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2009S. J. W. Monkhouse Background: The British Society of Gastroenterology recommends that all patients with gallstone pancreatitis should undergo cholecystectomy within 2 weeks. This study assessed whether these guidelines are feasible and cost-effective. Methods: Admissions for gallstone pancreatitis between January 2006 and January 2008 were reviewed. Readmissions for subsequent pancreatitis or biliary pathology were noted together with additional investigations, severity scores, hospital stay and time to cholecystectomy. The costs of readmission and theoretical costs of developing a dedicated operating list were provided by independent accountants. Results: During the 2 years, 153 patients were admitted. Twenty-one patients (13·7 per cent) had further attacks requiring 40 readmissions. There were no deaths. Additional hospital costs related to readmissions were £172 170, including bed occupancy (£67 860), investigations (£12 510) and 153 cholecystectomies on an existing theatre list (£91 800). The estimated cost of staffing a half-day theatre list every fortnight, performing 153 cholecystectomies, was £170 391. Conclusion: Instigating a dedicated theatre for cholecystectomy after biliary pancreatitis has many potential benefits. The costs of readmissions and ad hoc operating are balanced by those of a dedicated theatre list in the long term. Implementation of the guidelines would save approximately £900 annually and be cost neutral. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | ||||||||||