scholarly journals Epidemic risk and insurance coverage

2017 ◽  
Vol 54 (1) ◽  
pp. 286-303 ◽  
Author(s):  
Claude Lefèvre ◽  
Philippe Picard ◽  
Matthieu Simon
Keyword(s):  
Insurance Coverage ◽  
Infection Rates ◽  
Insurance Plan ◽  
Sir Epidemic ◽  
Epidemic Size ◽  
Actuarial Methods ◽  
Premium Calculation ◽  
The Cost ◽  
Epidemic Risk ◽  
Cost Components

AbstractIn this paper we aim to apply simple actuarial methods to build an insurance plan protecting against an epidemic risk in a population. The studied model is an extended SIR epidemic in which the removal and infection rates may depend on the number of registered removals. The costs due to the epidemic are measured through the expected epidemic size and infectivity time. The premiums received during the epidemic outbreak are measured through the expected susceptibility time. Using martingale arguments, a method by recursion is developed to calculate the cost components and the corresponding premium levels in this extended epidemic model. Some numerical examples illustrate the effect of removals and the premium calculation in an insurance plan.

Open reduction of pediatric lateral condyle fractures: a systematic review

2021 ◽  
pp. 175857322110102
Author(s):  
Michael D Eckhoff ◽  
Josh C Tadlock ◽  
Tyler C Nicholson ◽  
Matthew E Wells ◽  
EStephan J Garcia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Range Of Motion ◽  
Lateral Condyle ◽  
Elbow Fracture ◽  
Infection Rates ◽  
Fixation Techniques ◽  
K Wires ◽  
Pediatric Elbow Fracture ◽  
The Cost

Introduction Lateral condyle fractures are the second most common pediatric elbow fracture. There exist multiple options for internal fixation including buried K-wires, unburied K-wires, and screw fixation. Our study aims to review the current literature and determine if fixation strategy affects outcomes to include fracture union, postoperative range of motion, and need subsequent surgery. Methods A systematic review of Pubmed, MEDLINE, and EMBASE databases was performed. Included articles involve pediatric patients with displaced lateral condyle fractures treated with internal fixation that reported outcomes to include union rates and complications. Results Thirteen studies met inclusion criteria for a total of 1299 patients (472 buried K-wires, 717 unburied K-wires, and 110 screws). The patients’ average age was 5.8 ± 0.6 years, male (64%), and had 16.3 months of follow-up. No differences in union and infection rates were found. Unburied K-wires had the shortest time to union and the greatest elbow range of motion postoperatively. Conclusions Our systematic review demonstrates similar outcomes with union and infection rates between all fixation techniques. Unburied K-wires demonstrated a shorter time to union and the greatest postoperative range of motion. Additionally, unburied K-wires may be removed in clinic, decreasing the cost on the healthcare system. Evidence Level 3.

scholarly journals Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 888
Author(s):  
Leopoldo Sdino ◽  
Andrea Brambilla ◽  
Marta Dell’Ovo ◽  
Benedetta Sdino ◽  
Stefano Capolongo
Keyword(s):  
Healthcare Services ◽  
Construction Cost ◽  
Design Stage ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Early Design Stage ◽  
Hospital Facility ◽  
Italian Context ◽  
The Cost ◽  
Cost Components

The need for 24/7 operation, and the increasing requests of high-quality healthcare services contribute to framing healthcare facilities as a complex topic, also due to the changing and challenging environment and huge impact on the community. Due to its complexity, it is difficult to properly estimate the construction cost in a preliminary phase where easy-to-use parameters are often necessary. Therefore, this paper aims to provide an overview of the issue with reference to the Italian context and proposes an estimation framework for analyzing hospital facilities’ construction cost. First, contributions from literature reviews and 14 case studies were analyzed to identify specific cost components. Then, a questionnaire was administered to construction companies and experts in the field to obtain data coming from practical and real cases. The results obtained from all of the contributions are an overview of the construction cost components. Starting from the data collected and analyzed, a preliminary estimation tool is proposed to identify the minimum and maximum variation in the cost when programming the construction of a hospital, starting from the feasibility phase or the early design stage. The framework involves different factors, such as the number of beds, complexity, typology, localization, technology degree and the type of maintenance and management techniques. This study explores the several elements that compose the cost of a hospital facility and highlights future developments including maintenance and management costs during hospital facilities’ lifecycle.

Penetapan Tarif Ambulans Untuk Evakuasi Medis Berbasis Unit Cost

2021 ◽  
Vol 7 (1) ◽  
pp. 167-173
Author(s):  
Kelvin Riupassa ◽  
Narizma Nova ◽  
Endah Lestari ◽  
Sri Juniarti Azis ◽  
Wahyu Sulistiadi
Keyword(s):  
Recovery Rate ◽  
Unit Cost ◽  
Cost Recovery ◽  
Maintenance Costs ◽  
Total Cost ◽  
Medical Evacuation ◽  
Operational Costs ◽  
Emergency Ambulance ◽  
The Cost ◽  
Cost Components

Background: An ambulance is a vehicle designed to be able to handle emergency patients, provide first aid and carry out intensive care while on the way to a referral hospital. Ambulance operations require a large amount of funds obtained from APBD funds through tariffs that were passed through the DKI Jakarta Governor Regulation five years ago. For this reason, a new tariff is required to adjust to current conditions. Objectives: The purpose of this study is to calculate the unit cost of ambulance services in DKI Jakarta to be a consideration in the tariff setting policy in DKI Jakarta province. Research Metodes: This study uses a quantitative descriptive approach to obtain information about the unit cost of the Jakarta ambulance production unit. The method used is the calculation of real cost using the basis of the causes of costs. This research was conducted at the DKI Jakarta Emergency Ambulance using secondary data on investment costs, operational costs and maintenance costs in 2018. Results: The total cost of emergency ambulance in 2018 is known that the proportion of three cost components, namely operational costs, is 76%, followed by investment costs of 20% and maintenance costs of 3%. The calculation of the total cost of medical evacuation using the double distribution method is Rp. 98,915,016,805.00 divided by the number of medical evacuations in 2018 of 37,564 activities, the unit cost of medical evacuation for the AGD of DKI Jakarta Health Office is Rp. 2,633,215.00 without subsidies. APBD costs, while if the subsidy component is included in the calculation, the unit cost for one trip to the AGD of the Health Office is Rp. 604,071.00. This is still far above the current tariff of Rp. 450.00, so the cost recovery rate (CRR) is still below. 100%. Conclusion: From the three cost components consisting of investment, operational and maintenance costs,the largest proportion was operational costs at 76%. The Cost Recovery Rate has not reached 100% so that the existing rates have not covered the costs incurred.   Keywords: ambulance; price fixing; unit cost

Since blood transfusion is linked to the magnitude of the surgical procedure, comparing transfused patients to untransfused patients will always be confounded by infection risks due to factors related to the procedure. To control for these factors one must compare patients transfused with red cells from different sources or prepared in a manner which minimize infection risk. Patients transfused with homologous blood have infection rates several fold higher than recipients of equal values of autologous blood undergoing the same operative procedure (20-23). Homologous blood recipients have significantly longer hospital stays attributed to treating infections. The cost of a blood transfusion exceeds the cost of collection, storage and administration because of transfusion's association with length of stay. In this era of cost-containment the association with prolonged stay may ultimately curtail the use of blood. Homologous blood can be filtered to remove donor leukocytes which may be contributing to immune suppression and infection risk. A prospective randomized trial comparing the infection rates among colorectal cancer patients receiving filtered and unfiltered blood has been conducted (9). There were 17 infectious complications among the 56 recipients of whole blood and one infectious complication among the 48 recipients of filtered blood. Infections were prevented by the seemingly simplistic addition of a $25/filter to every bag of blood transfused. These clinical studies are very convincing: homologous blood transfusion is associated with increased risk of infection in every clinical situation examined. In multivariate analyses transfusion was a significant predictor of infection after consideration of other variables measured and in the majority of those studies transfusion was the single most significant factor. Patients receiving homologous blood exhibited an incidence of infectious complications that was approximately four times higher than patients receiving autologous blood. The association of transfusion with infection is found among patients undergoing surgery for cardiac, orthopedic and gastrointestinal disorders and for trauma as well as among unoperated patients transfused for bums and gastrointestinal bleeding. The observation that nosocomial infections are increased in these studies argues strongly that the association of transfusion with infection is not simply a reflection of transfusion as a marker of tissue destruction and contamination. Infections that develop in transfused patients away from the site of trauma or in the absence of trauma, cannot be attributed to the quantity of tissue destroyed or to the degree of bacterial contamination. Filtered blood can remove leukocytes and prevent postoperative infections. Since filtering blood can significantly reduce the incidence of infection among transfused patients, all transfused blood will be passing through filters in the very near future. EXPERIMENTAL STUDIES RELATING BLOOD TRANSFUSION TO INCREASED RISK OF INFECTION Patients are extremely heterogeneous and even in prospective randomized trials, factors which influence patients' participation affect the outcome despite double-blinding and randomization. In animal studies using syngeneic strains with identical housing, lighting, access to food and water, control over the extent of injury, use of antibiotics and exposure to other variables the influence of a single variable such as blood transfusion can be measured. Dr. Waymack's laboratory has intensively studied parameters which interact with transfusion in

1995 ◽  
pp. 296-296
Keyword(s):  
Blood Transfusion ◽  
Autologous Blood ◽  
Experimental Studies ◽  
Infection Risk ◽  
Infectious Complications ◽  
Risk Of Infection ◽  
Infection Rates ◽  
Homologous Blood ◽  
Increased Risk ◽  
The Cost

scholarly journals Trend Analysis of Cost Components in Select Pharmaceutical Companies

2019 ◽  
Vol 8 (4) ◽  
pp. 2289-2298
Keyword(s):  
Pharmaceutical Industry ◽  
Trend Analysis ◽  
Health Benefits ◽  
Annual Reports ◽  
Pharmaceutical Companies ◽  
Manufacturing Costs ◽  
Operating Profit ◽  
The Future ◽  
The Cost ◽  
Cost Components

The purpose in this paper is to identify the cost components which are vital in consideration towards manufacturing especially in pharmaceutical companies. The manufacturing costs are significant in total expenses in pharmaceutical industry. In this study, a thorough investigation on the cost components and the trend in expenses and operating profit of pharma companies are studied, giving due regard to cost components to have understanding and to find out how they may differ among various types of pharma companies. The data published in the annual reports from 2009 to 2018 of top five pharmaceutical companies based on their annual revenues has been selected for further diagnosis. The analysis reveals that manufacturing costs are different for all the five companies. The study also reveals that there is a considerable indication that the companies are conscious on the much-needed health benefits to the society in the future at an affordable cost

scholarly journals Prevention of refractoriness and HLA-alloimmunization using filtered blood products

Blood ◽  
1988 ◽  
Vol 71 (5) ◽  
pp. 1402-1407 ◽  
Author(s):  
I Sniecinski ◽  
MR O'Donnell ◽  
B Nowicki ◽  
LR Hill
Keyword(s):  
De Novo ◽  
Solid Phase ◽  
Hematologic Malignancy ◽  
Hla Antigens ◽  
Control Group ◽  
Red Cell ◽  
Blood Products ◽  
Leukocyte Depletion ◽  
Actuarial Methods ◽  
The Cost

Depletion of leukocytes from all blood products may decrease the incidence of alloimmunization to HLA antigens present on the white cells and thus delay the onset of refractoriness to random donor platelet support. In order to test this hypothesis, 54 patients with hematologic malignancy or marrow aplasia were entered on a prospective randomized trial using cotton-wool filtration as a method of leukocyte depletion of red cell and platelet concentrates. Forty patients were considered evaluable; 20 patients received filtered products and 20 patients in the control group received standard unfiltered products. The filter was 99% efficient in removal of leukocytes (average number of WBC/platelet product, 6 X 10(6)). Platelet loss by this technique was 8%. Alloimmunization was assessed by detection of de novo formed lymphocytotoxic and platelet specific antibodies by microcytotoxicity test, Staph A protein radioimmunoassay, and solid phase red cell adherence test. In the group receiving filtered products, three of 20 (15%) patients developed lymphocytotoxic antibodies while ten of 20 (50%) patients in the control group developed cytotoxic antibodies (P = .01 by actuarial methods). Platelet antibodies were detected in seven of ten alloimmunized patients in the control group and three of three patients in the study group. Clinical evidence of refractoriness was seen in three of 20 patients in the filtered group and ten of 20 in the control group (P = .01 by actuarial methods). The cost of filtration was a fraction of the cost of a plateletpheresis product. Filtration appears to be an effective and economical method for reducing alloimmunization and clinical refractoriness to random donor platelets in patient receiving long-term transfusion support.

scholarly journals Pharmacists’ Perceived Barriers to Human Papillomavirus (HPV) Vaccination: A Systematic Literature Review

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1360
Author(s):  
Oluwafemifola Oyedeji ◽  
Jill M. Maples ◽  
Samantha Gregory ◽  
Shauntá M. Chamberlin ◽  
Justin D. Gatwood ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
System Organization ◽  
Insurance Coverage ◽  
Hpv Vaccination ◽  
The United States ◽  
Perceived Barriers ◽  
Lack Of Information ◽  
Inadequate Knowledge ◽  
In Series ◽  
The Cost

About 45:000 cancers are linked to HPV each year in the United States alone. The HPV vaccine prevents cancer and is highly effective, yet vaccination coverage remains low. Pharmacies can play a meaningful role in increasing HPV vaccination access due to their availability and convenience. However, little is known about pharmacists’ perceived barriers to HPV vaccination. The objective of this systematic review was to summarize existing literature on perceived barriers to administering HPV vaccination reported by pharmacists. Barriers identified from selected studies were synthesized and further grouped into patient, parental, (pharmacist’s) personal, and system/organization barrier groups. Six studies were included in this review. The cost of the HPV vaccine, insurance coverage and reimbursement were commonly reported perceived barriers. Adolescent HPV vaccination barriers related to parental concerns, beliefs, and inadequate knowledge about the HPV vaccine. Perceived (pharmacist’s) personal barriers were related to lack of information and knowledge about HPV vaccine and recommendations. At the system/organization level, barriers reported included lack of time/staff/space; difficulty in series completion; tracking and recall of patient; perceived competition with providers; and other responsibilities/vaccines taking precedence. Future strategies involving pharmacy settings in HPV-related cancer prevention efforts should consider research on multilevel pharmacy-driven interventions addressing barriers.

Finding Minimum Cost Tool Grouping Schemes on Machining Systems

1997 ◽  
Author(s):  
Derek Yip-Hoi ◽  
Debasish Dutta
Keyword(s):  
Tool Life ◽  
Minimum Cost ◽  
Good Tool ◽  
Machining Center ◽  
Grouping Strategy ◽  
Cost Strategy ◽  
Grouping Strategies ◽  
Machining System ◽  
The Cost ◽  
Cost Components

Abstract Changing worn tools is a major concern in planning operations on machining systems. Strategies for replacing tools range from changing each tool as it reaches its projected tool life, to changing all tools when the tool with the shortest life on the machining system is expended. Intermediate strategies involve changing tools in groups. Each of these strategies has two cost components associated with it: (1) the cost of lost production due to machine tool stoppage, and (2) the cost of unused tool life. The best tool grouping strategy minimizes the combined cost of lost production. In this paper we present an approach for finding good tool grouping strategies from inputs that include the tool utilization for a given machining application, and the tooling and machining system costs. A genetic algorithm is used as the underlying optimization paradigm for finding the minimum cost strategy. An example is presented for a part produced on a machining center.

Abstract 18272: The Increasing Proportion of Acute Myocardial Infarction Represented by the Uninsured: a Growing Financial Burden in the United States

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bethany Doran ◽  
Yu Guo ◽  
Jinfeng Xu ◽  
Sripal Bangalore
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Insurance ◽  
Financial Burden ◽  
Insurance Coverage ◽  
The United States ◽  
The Us ◽  
Hospital Stays ◽  
Nationally Representative ◽  
The Cost

Introduction: Under the provisions of the Affordable Care Act, insurance coverage will markedly increase with the Congressional Budgetary Office estimating the number of insured to increase by approximately 13 million in 2014 and 25 million in 2016. However, approximately 31 million non-elderly US citizens are expected to remain without health insurance in 2016. Acute myocardial infarction (AMI) remains a source of significant morbidity and mortality, as well as cost to society. No prior studies have examined temporal rates of uninsured among patients presenting with an AMI using a nationally representative database. Hypothesis: We tested the hypothesis that the proportion of uninsured individuals with AMI and cost of uninsured to society will vary by year. Methods: We used the Nationwide Inpatient Sample (NIS), which contains estimates from approximately 8 million hospital visits and information related to number of discharges, aggregate charges, and principal diagnoses of all patients discharged in the US. We calculated the percentage of acute myocardial infarction by insurance status, and the sum of all charges of hospital stays in the US adjusted for inflation. Results: The cost to society due to acute myocardial infarction in the uninsured increased substantially from 1997 to 2012, with total cost in 1997 of $852,596,272 and $3,446,893,954 in 2012 after adjustment for inflation. In addition, although rates of AMI decreased in the general population (from 268.6/100,000 individuals in 1997 to 193.8/100,000 individuals in 2012), the proportion of individuals with AMI who were uninsured increased (from 3.83% in 1997 to 7.37% in 2012). Conclusions: The proportion of those experiencing AMI who are uninsured is rising, as is cost to society. It remains to be seen what the effects of expanding health insurance will have on the rate of AMI as well as proportion of AMI represented by the uninsured.

Sign in / Sign up

Export Citation Format

Share Document