Home About us Contact
|
Home About us Contact | ||
|
|
||
Potential Cost Savings (potential + cost_savings)
Selected AbstractsSick day management using blood 3-hydroxybutyrate (3-OHB) compared with urine ketone monitoring reduces hospital visits in young people with T1DM: a randomized clinical trialDIABETIC MEDICINE, Issue 3 2006L. M. B. Laffel Abstract Aims Diabetic ketoacidosis (DKA), a life-threatening acute complication of Type 1 diabetes, may be preventable with frequent monitoring of glycaemia and ketosis along with timely supplemental insulin. This prospective, two-centre study assessed sick day management using blood 3-hydroxybutyrate (3-OHB) monitoring compared with traditional urine ketone testing, aimed at averting emergency assessment and hospitalization. Methods One hundred and twenty-three children, adolescents and young adults, aged 3,22 years, and their families received sick day education. Participants were randomized to receive either a blood glucose monitor that also measures blood 3-OHB (blood ketone group, n = 62) or a monitor plus urine ketone strips (urine ketone group, n = 61). All were encouraged to check glucose levels , 3 times daily and to check ketones during acute illness or stress, when glucose levels were consistently elevated (, 13.9 mmol/l on two consecutive readings), or when symptoms of DKA were present. Frequency of sick days, hyperglycaemia, ketosis, and hospitalization/emergency assessment were ascertained prospectively for 6 months. Results There were 578 sick days during 21 548 days of follow-up. Participants in the blood ketone group checked ketones significantly more during sick days (276 of 304 episodes, 90.8%) than participants in the urine ketone group (168 of 274 episodes, 61.3%) (P < 0.001). The incidence of hospitalization/emergency assessment was significantly lower in the blood ketone group (38/100 patient-years) compared with the urine ketone group (75/100 patient-years) (P = 0.05). Conclusions Blood ketone monitoring during sick days appears acceptable to and preferred by young people with Type 1 diabetes. Routine implementation of blood 3-OHB monitoring for the management of sick days and impending DKA can potentially reduce hospitalization/emergency assessment compared with urine ketone testing and offers potential cost savings. [source] A Cost-Benefit Analysis of External Hip Protectors in the Nursing Home SettingJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2005Lisa A. Honkanen MD Objectives: To estimate potential cost savings generated by a program of hip protectors in the nursing home from a Medicare perspective. Design: A state-transition Markov model considering short-term and long-term outcomes of hip protectors for a hypothetical nursing home population, stratified by age, sex, and functional status. Costs, transition probabilities between health states, and estimates of hip protectors' effectiveness were derived from published secondary data. Setting: Nursing home facilities in the United States. Participants: Hypothetical cohort of permanent nursing home residents aged 65 and older without a previous hip fracture. Intervention: Program of hip protectors reimbursed by Medicare. Measurements: Number of fractures, life years, and dollars saved. Results: Three pairs of hip protectors replaced annually would result in a weighted average lifetime absolute risk reduction for hip fracture of 8.5%, with net lifetime savings to Medicare of $223 per resident. When the annual cost of hip protectors is less than $151 per person, relative risk of fracture is less than or equal to 0.65 with hip protectors, or adherence is greater than 42%, hip protectors are cost saving to Medicare over a wide range of assumptions. Extrapolating these results to the estimated population of U.S. nursing home residents without a previous hip fracture, Medicare could save $136 million in the first year of a hip-protector reimbursement program. Conclusion: From a Medicare perspective, hip protectors are a cost-saving intervention in the nursing home setting when hip protector effectiveness is less than or equal to 0.65 over the remaining lifetime of subjects. [source] Size Economies of a Pacific Threadfin Polydactylus sexfilis Hatchery in HawaiiJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 4 2002Lotus E. Kam A spreadsheet model has been developed to determine the viable scale for a commercial Pacific threadfin Polydactylus sexfilis hatchery in Hawaii. The production scheme is modeled after current practices performed at the Oceanic Institute in Waimanalo, Hawaii. For a hatchery enterprise producing 1.2 million fry per year, the cost associated with raising one 40-d-old 1.00-g fry is estimated at 22.01ø. The largest variable costs are in labor and supplies, which comprise 49% and 9% of the total production cost. The combined annualized fixed cost for development and equipment is approximately 12% of total production cost. At a sale price of 25ø per fry, the 20-yr internal rate of return (IRR) is 30.63%. In comparison to the 22.01ø unit cost for 1.2 million fry production, analyses of smaller enterprises producing 900,000 and 600,000 fry per year reflected significant size diseconomies with unit costs of 27.41ø and 38.82ø, respectively. Demand to support a large scale Pacific threadfin commercial hatchery is uncertain. Since smaller scale commercial hatcheries may not be economically feasible, facilities may seek to outsource live feed production modules or pursue multiproduct and multiphase approaches to production. An analysis of the production period length, for example, indicates that the cost for producing a day-25 0.05-g fry is 17.25ø before tax and suggests the financial implications of transferring the responsibility of the nursery stage to grow-out farmers. Evaluation of the benefits gained from changes in nursery length, however, must also consider changes in facility requirements, mortality, and shipping costs associated with transit, and the growout performance of and market demand for different size fry. Sensitivity analyses also indicate the potential cost savings associated with the elimination of rotifer, microalgae, and enriched artemia production. Managerial decisions, however, must also consider the quality and associated production efficiencies of substitutes. [source] Dose rounding of chemotherapy in colorectal cancer: An analysis of clinician attitudes and the potential impact on treatment costsASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 3 2010Kathryn FIELD Abstract Aim: The aims of this study were to calculate theoretical cost savings of oxaliplatin dose rounding in colorectal cancer (CRC), and to assess clinician attitudes to chemotherapy dose rounding. Methods: Data were obtained from a prospective data repository (BioGrid Australia) from four hospitals regarding the use of oxaliplatin, given at a standard dose of 85 mg/m2. We examined potential cost savings for patients with a body surface area (BSA) between 1.77 m2 and 1.94 m2, resulting in a calculated dose up to 10% above 150 mg (a 100 mg and 50 mg vial). The attitudes of oncologists at these hospitals toward minor dose reductions were assessed. Results: From January 2003 to June 2008, of 676 patients with Stages III or IV CRC, 227 (33.58%) received oxaliplatin. Overall 66 patients (29%) had a calculated BSA between 1.77 m2 and 1.94 m2. The potential cost saving for these hospitals in one year, if oxaliplatin doses were rounded down to 150 mg, is $AU51 898. Extrapolated to the Australian population, estimated savings are over $AU2.5 million per year. Three of nine (33.3%) oncologists were comfortable with an initial dose reduction of up to 10% in the adjuvant disease setting, and seven of nine (77.8%) in the setting of metastatic disease. Conclusion: Minor dose reductions for CRC to accommodate vial sizes would lead to significant cost savings. Oncologists are more comfortable with minor dose reductions when treatment is given in a palliative setting. [source] Physical activity, Body Mass Index and health care costs in mid-age Australian womenAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2008Wendy J. Brown Abstract Objective: This study examined the relationships between combined categories of physical activity (PA) and Body Mass Index (BMI) with health care costs in women and assessed the potential cost savings of improving PA and BMI in sedentary mid-age women. Methods: Cross-sectional analysis of 2001 survey data linked to health service use data for the same year from 7,004 mid-age women (50-55 years) participating in the Australian Longitudinal Study on Women's Health. Results: The mean (median; interquartile range) annual cost of Medicare-subsidised services was $542 (355; 156-693) per woman. Costs were 17% higher in obese than in healthy-weight women and 26% higher in sedentary than in moderately active women. For sedentary obese women, mean costs were 43% higher than in healthy weight, moderately active women. After adjustment for potential confounders, the relative risk of ,high' claims (,15 claims per year) for overweight women who reported ,moderate' or ,high' PA were lower than for women with healthy BMI who reported no PA. Conclusions and Implications: Lower PA and higher BMI are both associated with higher health care costs, but costs are lower for overweight active women than for healthy-weight sedentary women. At the population level these data suggest that there would be significant cost savings if all sedentary mid-age women could achieve at least ,low' levels of PA (60-150 minutes a week). [source] | ||||||||||