This study reports a retrospective analysis of 16 patients to determine changes in medication costs associated with deep brain stimulation of the bilateral subthalamic nucleus (DBS B-STN). Antiparkinsonian medication (APMED) costs were evaluated pre- and post-operatively at 1 and 2 years, based on prescribed dosages. After treatment with DBS, patients ...

BACKGROUND: Three medical conditions--cervical carotid artery disease, atrial fibrillation, and hypertension--cause the majority of strokes. Discovering these silent, immediate causes of stroke through screening, so they can be treated before stroke occurs, can potentially prevent strokes on an epidemiologic scale. METHODS: A rapid, accurate, and cost-effective stroke prevention screening (SPS) ...

PURPOSE: Prescription medication use is essential to the health and well-being of many elderly persons. However, the cost of medications may be prohibitive and contribute to noncompliance with medical recommendations. This study identifies community-dwelling elders who reported a delay in medication use because of prescription medication cost. DESIGN AND METHODS: ...

OBJECTIVE: To determine factors that influence patient willingness to accept a medication change to a unified, restrictive formulary. DESIGN: Prospective cohort study. SETTING: University-affiliated hospital-based primary care internal medicine practice. PATIENTS/PARTICIPANTS: Two hundred ninety-seven members of a managed care plan who had received a prescription for a nonformulary medication in ...

PURPOSE: We evaluated the cost-effectiveness and stone recurrence rates of common management strategies in stone formers. MATERIALS AND METHODS: A decision tree model was created to compare the costs of 6 medical treatment strategies, namely dietary measures alone (conservative), empiric drug treatment (empiric), or directed drug therapy based on simple ...

Medical costs data with administratively censored observations often arise in cost-effectiveness studies of treatments for life-threatening diseases. Mean of medical costs incurred from the start of a treatment until death or a certain time point after the implementation of treatment is frequently of interest. In many situations, due to the ...

A cost-utility analysis, based on published data from multiple observational studies, comparing boys circumcised at birth and those not circumcised was undertaken using the Quality of Well-being Scale, a Markov analysis, the standard reference case, and a societal perspective. Neonatal circumcision increased incremental costs by $828.42 per patient and resulted ...

BACKGROUND: For individuals with chemotherapy-related anemia, the clinical effectiveness of epoetin alfa (EPO) dosed once weekly ([QW], 40,000 units per dose) has been demonstrated to be indistinguishable from that observed with thrice-weekly dosing ([TIW], 10,000 units per dose). Whether the advantage of less-frequent administration justifies the higher EPO dosage used ...

GOALS: To estimate and compare the direct medical cost in the management of chronic hepatitis B (CHB) infection and its complications from the perspective of public health organizations in Hong Kong and Singapore. BACKGROUND: Hong Kong and Singapore are endemic hepatitis B virus areas with about 10% and 5%, respectively, ...

OBJECTIVE: To compare rates of cost-related medication underuse and other problems due to medication costs among Department of Veterans Affairs (VA) patients with rates among patients with Medicaid, private health insurance, Medicare, and no insurance coverage. STUDY DESIGN: Nationwide survey. METHODS: A total of 4055 chronically ill patients completed an ...

BACKGROUND: There has been no documented data regarding the cost of asthma in our country. OBJECTIVE: In this 1-year prospective study, we aimed to determine the annual cost of asthma in Ankara, Turkey. METHODS: Direct medical cost analysis was performed in 118 patients. Results: Mean annual direct medical costs of ...

BACKGROUND: Unable to resolve a medical problem, gastroenterologists occasionally choose an ineffectual intervention instead. The elusive path to effectual management becomes substituted with an ineffectual but readily available medical ritual. The term 'ritual' refers to the utilization of an ineffectual intervention with little chances of achieving a medically relevant goal. ...

OBJECTIVE: To describe the medical care use and costs associated with migraine. DESIGN: Retrospective case-control design in which migraine case status was ascertained via validated telephone interview and linked with comprehensive claims data. Unadjusted and adjusted use and cost differences by migraine status were evaluated using exponential score tests and ...

OBJECTIVE: This study compares the total cost of treatment, skin-condition management and prevention of skin breakdown of perianal/buttock skin in incontinent patients receiving 3M Cavilon No Sting Barrier Film (Cavilon NSBF) and zinc oxide oil. METHOD: This single-centre open-label prospective randomised study involved 40 patients with at least moderate skin ...

BACKGROUND: Angina pectoris is one of the principal manifestations of coronary artery disease (CAD). Chronic angina is a debilitating condition that affects millions of people in the United States. OBJECTIVE: The objective of the study is to estimate, from a societal perspective, the direct costs of chronic angina in the ...

Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality affecting reproductive age women. Population-based studies estimate a prevalence of 5-10% [Obstet Gynecol 101 (2003) 995; Aust N Z J Obstet Gynaecol 41 (2001) 202]. The clinical characteristics of PCOS include hyperandrogenism, chronic anovulation, insulin resistance and infertility. Hyperandrogenism is ...

OBJECTIVES: We sought information about the cost-related underuse of medications-which medications are underused, by whom, and how often. METHODS: Chronically ill adults were asked to identify how often they underused prescription medication for 16 health conditions because of the cost. RESULTS: Eighteen percent of respondents cut back on medication use ...

Biostatistics are indispensable in clinical medicine because doctors increasingly need to publish and understand medical articles that use statistical methods. An opportunity is needed for medical doctors to interact with biostatisticians on statistical issues. This paper's objective is to determine how much it costs to establish a biostatistics clinic and ...

BACKGROUND: Although many chronically ill patients underuse prescription medications because of cost concerns, we know little about their discussions with clinicians about this issue. METHODS: Nationwide survey of 660 older adults with chronic illnesses who reported underusing medication in the prior year because of cost. We assessed whether patients discussed ...

Summary Akka oasis, in the province of Tata, southern Morocco, is one of the oldest foci of urinary schistosomiasis in Morocco where transmission is still taking place. We report the results of two studies: a cross-sectional snail survey investigated the distribution of Bulinus truncatus in relation to habitat factors in ...

In a decade of economic growth and rising income, obesity has risen dramatically. This is puzzling when researchers have found that there is an inverse relation between income and obesity. This paper argues that new location patterns produced by suburban sprawl are an important cause of rising obesity rates. New ...

OBJECTIVE: To examine utilization, treatment costs, lost workdays, and compensation paid workers with musculoskeletal injuries treated by medical doctors (MDs) and doctors of chiropractic (DCs). DESIGN: Retrospective review of 96,627 claims between 1975 and 1994. RESULTS: Average cost of treatment, hospitalization, and compensation payments were higher for patients treated by ...

Cancer is the second cause of death in developed countries. Many efforts to educate the public to more tumor free life-style and screening practice have been therefore adopted. Considering the high costs of diagnostic procedures and educational programs a cancer prevention/screening practice monitoring system is required to reduce costs, to ...

CONTEXT: Febrile nonhemolytic transfusion reactions (FNHTRs) cause unwelcome interruptions during the course of blood product transfusions and necessitate measures to verify the nature of the reaction and to exclude certain dangerous reactions, such as hemolytic and septic phenomena. OBJECTIVE: To examine transfusion medicine data to determine the clinical implications of ...

OBJECTIVE: To investigate the medical management costs of estrogen plus progestogen hormone therapy (HT) among postmenopausal women taking HT primarily as a preventive treatment for osteoporosis. DESIGN: Retrospective longitudinal comparative analysis of HT users and demographically matched nonusers using administrative databases on physician services, hospital stays and prescription medications. Setting: ...

Many people voluntarily incur costs to punish violations of social norms. Evolutionary models and empirical evidence indicate that such altruistic punishment has been a decisive force in the evolution of human cooperation. We used H2 15O positron emission tomography to examine the neural basis for altruistic punishment of defectors in ...

A new rapid and low-cost preparation of the (3E,5Z)-3,5-alkadienyl system, encountered in several insect pheromone constituents, was developed. Knoevenagel condensation of (E)-2-alkenals with ethyl hydrogen malonate in dimethyl sulfoxide, in the presence of a catalytic amount of piperidinium acetate, led to a mixture of geometrical isomers of ethyl 3,5-alkadienoates and ...

Treatment guidelines offer a credible approach to MCO management of specialty pharmaceuticals by basing decisions on the best available scientific evidence. Drawbacks to using guidelines include lack of available evidence, bias on the part of the expert team, a lack of currency, and difficulties in implementation. Treatment guidelines can and ...

The lifespan of medical equipment must be maximised to ensure cost-effectiveness. Flexible ureterorenoscopes have become widely used in the diagnosis and treatment of urolithiasis. They are relatively expensive and current literature shows that they require frequent repair and replacement. We have analysed our data for the number of procedures and ...

Cardiovascular disease remains a serious medical problem, which can be associated with death and disability on one hand, and considerable resource utilization on the other. The primary driver for choice of therapy must remain clinical efficacy. Once efficacy is established, cost-effectiveness analysis has an important role. Resources are limited, and ...

OBJECTIVE: To conduct an economic evaluation of the prevention of venous thromboembolism in acutely ill medical patients. METHOD: We used a previously described economic model created in the context of the UK National Health Service and applied it to St. Thomas' Hospital, London. A clinical review to determine the number ...

For clinicians, it's tempting to draw conclusions that new medications are easier to use and monitor, are safer, and therefore result in better outcomes. Similarly, for CFOs, it's tempting to view an older medication with a lower cost as the best choice. Both physicians and CFOs need reliable data that ...

BACKGROUND: A Nurse Practitioner (NP) Concurrent Intervention Model shown effective for controlling telemetry usage was extended to patients with community-acquired pneumonia (CAP) and patients with chronic obstructive pulmonary disease (COPD). METHODS: In spring 2000, investigators at Hackensack University Medical Center and the University of Medicine and Dentistry of New Jersey-New ...

This Article considers whether infertile taxpayers can deduct their fertility treatment costs as medical expenses under Internal Revenue Code section 213 and whether they should be able to deduct them. Internal Revenue Code section 213 defines medical expenses as "amounts paid-for the diagnosis, cure, mitigation, treatment, or prevention of disease, ...

PURPOSE: We developed an algorithm for the management of urethral stricture based on cost-effectiveness. MATERIALS AND METHODS: United Kingdom medical and hospital costs associated with the current management of urethral stricture were calculated using private medical insurance schedules of reimbursement and clean intermittent self-catheterization supply costs. These costs were applied ...

OBJECTIVE: To examine the incremental cost effectiveness of the five first line pharmacological smoking cessation therapies in the Seychelles and other developing countries. DESIGN: A Markov chain cohort simulation. SUBJECTS: Two simulated cohorts of smokers: (1) a reference cohort given physician counselling only; (2) a treatment cohort given counselling plus ...

About 20 million American families-representing 43 million people-reported problems paying medical bills in 2003, according to a new study by the Center for Studying Health System Change (HSC). While uninsured families are more likely to have medical bill problems, two-thirds of families with problems paying medical bills have health insurance ...

Emerging, rapid, multivalent, microbial diagnostic technologies can produce results in hours, as contrasted to the standard methods that require at least the better part of a week. Used in bioterrorism surveillance in medical settings, the new biodetectors could significantly reduce the time between a covert attack and its detection. By ...

Expenditure on healthcare in Ireland, which is mainly derived from taxation, has increased considerably in recent years to an estimated 9.2 billion euro in 2003. Pharmaceuticals account for approximately 10% of total healthcare expenditure. Approximately one-third of patients receive their medications free of charge whilst the remaining two-thirds are subject ...

Virtual reality (VR) has provoked enormous interest in the medical community. In particular, VR offers therapists new approaches for improving rehabilitation effects. However, most of these VR assistant tools are not very portable, extensible or economical. Due to the vast amount of 3D data, they are not suitable for Internet ...

PP volumes for use in medical applications increase every year for some obvious reasons. The polymer can be processed by practically all techniques and sterilisation and transparency processes, and its properties are continuously improved. Furthermore, it can replace many other materials, and is attractive from a cost and versatility perspective.

Intangible assets--patents and know-how, brands, a skilled workforce, strong customer relationships, software, unique processes and organizational designs, and the like--generate most of a company's growth and shareholder value. Yet extensive research indicates that investors systematically misprice the shares of intangibles-intensive enterprises. Clearly, overpricing wastes capital. But underpricing raises the cost ...

Cost-effectiveness analysis is a formal method of comparing alternative medical interventions with regard to their resource utilization (costs) and outcomes (effectiveness). The incremental cost-effectiveness ratio is an informative measure generated from such an analysis and represents the ratio of the difference in cost between two medical interventions to the difference ...

OBJECTIVES: For patients with reflux esophagitis, long-term therapeutic options include proton pump inhibitor (PPI) therapy and/or antireflux surgery. An earlier cost-effectiveness analysis concluded that at 5 yr, medical therapy was less expensive but similarly effective to fundoplication, but the results were sensitive to estimates on quality of life and long-term ...

BACKGROUND: The purpose of this review is to understand how changes in costs of illness are related to the effects of antipsychotic medications on symptoms in schizophrenia patients. METHOD: A search of the MEDLINE database was performed using the keywords costs, symptoms, and schizophrenia. Studies published between 1965 and 2003 ...

PURPOSE: Based on the data of clinical trial CHI-F-02 comparing the efficacy and safety of basiliximab (Simulect) vs. anti-thymocyte globulin (Thymoglobulin) in renal transplant induction, we carried out an economic evaluation. METHOD: This pharmacoeconomic study was a cost-minimization study, i.e. given the equivalent efficacy of the products, the strategy that ...

OBJECTIVE: To determine pharmacy costs for glycemic treatment and its relationship to glycemic control in the Department of Veterans Affairs (VA) between 1994 and 2000. RESEARCH DESIGN AND METHODS: Patients with diabetes in the VA in FY1994, FY1996, FY1998, and FY2000 were identified using an ambulatory care pharmacy-derived database. Total ...

Rhinosinusitis is highly prevalent in the United States, affecting an estimated 16% of the adult population annually. The prevalence of the illness is increased in women and, relative to other US regions, in individuals living in the South. The direct costs associated with chronic rhinosinusitis are higher than the background ...

OBJECTIVE: To review the extent to which the literature supports the position that a medical home is important and to review the extent to which insurance is related to having a medical home. METHODS: A review of literature concerning the benefits of a medical home on effectiveness, costs, and equity ...

When Robert Wood Johnson Health System challenged a CMS gain-sharing demonstration project, its complaint was that it was excluded. But now a judge has shut down the experiment. The ruling could have ripple effects on other hospitals seeking creative ways to enlist doctors in containing costs. Hunterdon Medical Center had ...