ABSTRACT: BACKGROUND: Two anaesthetic machines, the "Primus(R)" and the "Zeus(R)" (Draeger AG, Lubeck, Germany), were subjected to a cost analysis by evaluating the various expenses that go into using each machine. METHODS: These expenses included the acquisition, maintenance, training and device-specific accessory costs. In addition, oxygen, medical air and volatile ...

Objective: The Medicaid Buy-In (Buy-In) program allows people with disabilities to "buy into" Medicaid when their earnings or assets would typically make them ineligible. This program may be advantageous to youth with psychiatric disabilities by providing continuous health care coverage while they are employed. Methods: State-submitted participant-level Buy-In enrollment data ...

Technological and medical advances have greatly improved survival rates for many disorders; therefore, more attention is being given to functional outcomes in individuals who have been diagnosed with neurological diseases or disorders. One example of such an endeavor consists of a cognitive rehabilitation program to improve attentional abilities. The current ...

BACKGROUND:: Interventions considered to be particularly controversial or expected to significantly impact the Medicare program in the United States are considered in National Coverage Determinations. Medicare coverage for such interventions is limited to those deemed "reasonable and necessary" for the diagnosis or treatment of an illness or injury. What constitutes ...

ABSTRACT: BACKGROUND: Adherence to antiretroviral medication regimens is essential to good clinical outcomes for HIV-infected patients. Little is known about the costs of case management (CM) designed to improve adherence for patients identified as being at risk for poor adherence in resource-constrained settings. This study analyzed the costs, outputs, unit ...

This study investigates how average costs for an episode of care in outpatient drug-free (ODF) treatment relate to clinical intensity (length of stay and weekly counseling hours) and program structure (e.g., size, staffing), controlling for prices paid and selected clientele measures. Based on cost assessments from a naturalistic sample of ...

We tested the cost-effectiveness of giving low-income parents childcare discounts contingent on their participation in the Chicago Parent Program, a 12-session preventive parent training (PT) program offered at their child's daycare center. Eight centers were matched and randomized to an experimental condition in which parents received a discount on their ...

The Department of Veterans Affairs (VA) is issuing this interim final rule that amends the regulations governing the Servicemembers' Group Life Insurance Traumatic Injury Protection (TSGLI) program by adding certain genitourinary (GU) system losses to the TSGLI Schedule of Losses and defining terms relevant to these new losses. This amendment ...

Little is known about the costs of managing rare diseases, and comprehensive healthcare costs have not been reported for myasthenia gravis (MG). We evaluated the direct costs and healthcare resource utilization in insured MG patients. Costs were obtained from 1288 patients diagnosed with MG who were identified from the Accordant ...

Hemodialysis (HD) is often used as an example of the most expensive chronic medical intervention that society will pay for on an ongoing basis. More intensive forms of HD have been associated with improved clinical outcomes, but concerns have been raised regarding the possibility of increased costs. We review recent ...

Implementation of positron-emission tomography (PET) is variable depending on jurisdiction in part due to uncertainty about cost-effectiveness. Our objective was to perform a systematic review describing cost-effectiveness of PET in staging of non-small-cell lung cancer (NSCLC) and management of solitary pulmonary nodules (SPN). Systematic literature searches were conducted using separate ...

Background: Despite the discrepancy in results from Spanish studies on the costs of dialysis, it is assumed that peritoneal dialysis (PD) is more efficient than haemodialysis (HD). Objectives: To analyse the costs and added value of HD and PD outsourcing agreements in Galicia, the medical transport for HD and the ...

Providers say the administration's growing emphasis on billing audits is pushing them to the limit and threatens to increase their costs. Many billing problems stem from simple errors, not fraud, they say. "When you get into the nuts and bolts of some of these programs you realize it's not as ...

The sunk cost error occurs when individuals persist with a non-optimal course of action because they have already invested time or resources in it. The current study examined the effect of specific experiences on the likelihood of the sunk cost error. Six pigeons were given repeated choices between persisting with ...

The need for improved cost planning methods for solid waste management (SWM) is particularly strong in emerging economies where problems are severe, expectations for improvements are high, but finances are constrained. Estimating cost functions is suggested as an improved cost planning method. The research uses 1999 data from 298 Indian ...

Abstract. We conducted a cost analysis of Haiti's Ministry of Public Health and Population neglected tropical disease program, Projet des Maladies Tropicales Negligées and collected data for 9 of 55 communes participating in the May 2008-April 2009 mass drug administration (MDA). The Projet des Maladies Tropicales Negligées Program partnered with ...

In our previous study, in 1997, we evaluated the cost of teleconsultations in a primary care centre compared with the cost of the conventional alternative, travelling to the hospital. The results showed that teleconsultations were cheaper than patient travel when the annual workload was more than 110 patients in ophthalmology ...

Explaining the evolution of sex is challenging for biologists. A 'twofold cost' compared with asexual reproduction is often quoted. If a cost of this magnitude exists, the benefits of sex must be large for it to have evolved and be maintained. Focusing on benefits can be misleading, as this sidelines ...

OBJECTIVE: Develop and apply new costing methodologies to estimate costs of opioid dependence treatment in countries worldwide. DATA SOURCES/STUDY SETTING: Micro-costing methodology developed and data collected during randomized controlled trial (RCT) involving 126 patients (July 2003-May 2005) in Malaysia. Gross-costing methodology developed to estimate costs of treatment replication in 32 ...

Background: Cluster headache (CH) is the most frequent trigemino-autonomic cephalgia. CH can manifest as episodic (eCH) or chronic cluster headache (cCH) causing significant burden of disease and requiring attack therapy and prophylactic treatment. Methods: Treatment costs (direct costs) due to healthcare utilisation, as well as costs caused by disability and ...

PURPOSE: We undertook a cost-utility analysis to compare traditional fasciectomy for Dupuytren with 2 new treatments, needle aponeurotomy and collagenase injection. METHODS: We constructed an expected-value decision analysis model with an arm representing each treatment. A survey was administered to a cohort of 50 consecutive subjects to determine utilities of ...

This paper studies the effect of a large-scale policy change in the Austrian disability insurance program, which tightened eligibility criteria for men above a certain age. Using administrative data on the universe of Austrian private-sector employees, the results of difference-in-difference regressions suggest a substantial and statistically significant decline in disability ...

To measure adherence and assess medical utilization among employees enrolled in a disease management (DM) program offering copayment waivers (value-based insurance design [VBID]). Retrospective matched case control study. Cases were defined as those enrolled in DM, of whom 800 received health education mailings (HEMs) and 476 received telephonic nurse counseling ...

Background: Information about cost of multiple sclerosis (MS) is available from a number of European countries, but no data from the Czech Republic have been published so far. Objective: The objective of this study was to establish the cost of MS in the Czech Republic, overall and by level of ...

Few studies examine the costs of conducting screening and brief intervention (SBI) in settings outside health care. This study addresses this gap in knowledge by examining the employer-incurred costs of SBI in an employee assistance program (EAP) when delivered by counselors. Screening was self-administered as part of the intake paperwork, ...

Dispersal costs can be classified into energetic, time, risk and opportunity costs and may be levied directly or deferred during departure, transfer and settlement. They may equally be incurred during life stages before the actual dispersal event through investments in special morphologies. Because costs will eventually determine the performance of ...

In the United States, insurance against flood hazard (inland flooding or storm surge from hurricanes) has been provided mainly through the National Flood Insurance Program (NFIP) since 1968. The NFIP covers $1.23 trillion of assets today. This article provides the first analysis of flood insurance tenure ever undertaken: that is, ...

PURPOSE: Ventral hernia repair (VHR) lacks standardization of care and exhibits variation in delivery. Complications of VHR, notably recurrence and infection, increase costs. Efforts at obtaining federal funding for VHR research are frequently unsuccessful, in part due to misperceptions that VHR is not a clinical challenge and has minimal impact ...

A structured review of the literature was undertaken to examine the direct costs of adult systemic lupus erythematosus (SLE) in a US population. English-language studies published from January 2000 to April 2010 were systematically reviewed from both Medline's PubMed and the Cochrane databases. Studies were included if they reported direct ...

Accessory costs of reproduction frequently equal or exceed direct investment in offspring, and can limit the evolution of small offspring sizes. Early angiosperms had minimum seed sizes, an order of magnitude smaller than their contemporaries. It has been proposed that changes to reproductive features at the base of the angiosperm ...

The American Academy of Pediatrics believes that pediatric residents and fellows should be fully informed of the scope and limitations of their professional liability insurance coverage while in training. The academy states that residents and fellows should be educated by their training institutions on matters relating to medical liability and ...

PURPOSE: To quantify changes in radiotherapy costs occurring in a decade of medical-technological evolution. MATERIALS AND METHODS: The activity-based costing (ABC) model of the University Hospitals Leuven (UHL) radiotherapy (RT) department was adapted to current RT standards. It allocated actual resource costs to the treatments based on the departmental work-flow ...

OBJECTIVE: To evaluate the cost-effectiveness of strategies to reduce morbidity from venous thromboembolism in critically ill patients. METHODS: A Markov decision analytic model to compare weekly compression ultrasound screening (screening) plus investigation for clinically suspected DVT (case finding) versus case finding alone; and, a hypothetical program to increase adherence to ...

Surgical faculty participation in Morbidity and Mortality Conference (MMC) satisfies criteria for Continuing Medical Education (CME) credit. We hypothesize that using teleconferencing between the main campus to 2 satellite campuses will quantitatively increase faculty attendance and participation as a moderator at surgical MMC. We also want to perform a cost-benefit ...

OBJECTIVE:: To estimate the time to breakeven and 5-year net costs for laparoscopic adjustable gastric banding among obese patients with diabetes taking direct and indirect costs into account. METHODS:: Indirect cost savings were generated by quantifying the cross-sectional relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism ...

OBJECTIVE: To evaluate provider responsiveness and beneficiary satisfaction with insurance carriers participating in the Republic of Georgia's Medical Insurance for the Poor. STUDY SETTING: A dedicated survey of approximately 3500 households in two types of regions - with different eligibility thresholds - in November and December 2008. STUDY DESIGN: Regression-based ...

BACKGROUND General practitioners will often consult with patients in situations where professional skill is required to support a decision regarding insurance. OBJECTIVE The aim of this article is to assist doctors' understanding of the basis of insurance and risk, in order to support their own practice in this important area. ...

Studies of interventions for dyslexia have focused entirely on outcomes related to literacy. In this study, we considered a broader picture assessing improved quality of life compared with costs. A model served as a tool to compare costs and effects of treatment according to a new protocol and care as ...

BACKGROUND: Telecardiology is a tool that can aid in cardiovascular care, mainly in towns located in remote areas. However, economic assessments on this subject are scarce and have yielded controversial results. OBJECTIVE: To evaluate the cost-benefit of implementing a Telecardiology service in remote, small towns in the state of Minas ...

ABSTRACT: BACKGROUND: XELOX (capecitabine + oxaliplatin) and FOLFOX 4 (5-FU + folinic acid + oxaliplatin) have shown similar improvements in survival in patients with metastatic colorectal cancer (MCRC). A US cost-minimization study found that the two regimens had similar costs from a healthcare provider perspective but XELOX had lower costs ...

Introduction: Psoriasis is a chronic, inflammatory disease afflicting 2% of the US population; it results in significant morbidity. The annual healthcare costs related to psoriasis are an estimated $11.3 billion and, with an expanding biologic market, an updated costs analysis is needed. Areas covered: Current treatments, including systemic agents (acitretin, ...

The Medicare program faces a serious challenge: it must find ways to control costs but must do so through a system of congressional oversight that necessarily limits its choices. We look at one approach to prudent purchasing - competitive pricing - that Medicare has attempted many times and in various ...

ABSTRACT. Objective: The goal of this research was to evaluate economically three interventions designed to prevent substance use in general populations of adolescents, specifically focusing on the prevention of methamphetamine use and its subsequent benefits to employers. Method: In a randomized, controlled trial, three preventive interventions were delivered to 6th- ...

To estimate, according to the states of disease (remission or relapse) and her level of progression (EDSS), the cost of treatment of Multiple Sclerosis (MS) in Colombia. From the perspective of the third payer, a cost study of MS was performed using two-way estimation techniques: a) "Top down" to estimate ...

As antiretroviral treatment (ART) for HIV/AIDS is scaled up globally, information on per-person costs is critical to improve efficiency in service delivery and to maximize coverage and health impact. The objective of this study was to review studies on unit costs for delivery of adult and paediatric ART per patient-year, ...

Given rising healthcare costs and a growing population of patients with chronic kidney disease (CKD), there is an urgent need to identify health interventions that provide good value for money. For this review, the English-language literature was searched for studies of interventions in CKD reporting an original incremental cost-utility (cost ...

OBJECTIVES: The objective of this study was to evaluate the methodological characteristics of cost-effectiveness evaluations carried out in Spain, since 1990, which include LYG as an outcome to measure the incremental cost-effectiveness ratio. METHODS: A systematic review of published studies was conducted describing their characteristics and methodological quality. We analyse ...

Social barriers to effective medical care are mandated to be routinely assessed as part of evaluation for liver transplantation. This study explores how frequently liver transplant programs encounter such barriers in patients undergoing evaluation, and whether programs with higher proportions of Medicaid patients, historically disadvantaged minority patients, and rural-dwelling patients ...

BACKGROUND CONTEXT: Laminectomy for lumbar stenosis-associated radiculopathy is associated with improvement in pain, disability, and quality of life. However, given rising health-care costs, attention has been turned to question the cost-effectiveness of lumbar decompressive procedures. The cost-effectiveness of multilevel hemilaminectomy for radiculopathy remains unclear. PURPOSE: To assess the comprehensive medical ...

Comprehensive pulmonary rehabilitation and respiratory therapy services benefit patients with chronic lung disease and other diseases of the lung by reducing symptoms and restoring independent function. Although the science of these therapies is not new, commercial payers and Medicare have generally been slow to support adequate coverage and reimbursement. These ...