scholarly journals Modeling and Cost Benefit Analysis to Guide Deployment of POC Diagnostics for Non-typhoidal Salmonella Infections with Antimicrobial Resistance

2018 ◽  
Author(s):  
Carrie Manore ◽  
Todd Graham ◽  
Alexa Carr ◽  
Alicia Feryn ◽  
Shailja Jakhar ◽  
...  
Keyword(s):  
Cost Benefit Analysis ◽  
Point Of Care ◽  
Case Fatality ◽  
Cost Benefit ◽  
Antibiotic Use ◽  
Blood Stream ◽  
Antimicrobial Treatment ◽  
Sub Saharan Africa ◽  
Advantages And Disadvantages ◽  
Salmonella Infections

ABSTRACTInvasive non-typhoidal Salmonella (NTS) is among the leading causes of blood stream infections in sub-Saharan Africa and other developing regions, especially among pediatric populations. Invasive NTS can be difficult to treat and have high case-fatality rates, in part due to emergence of strains resistant to broad-spectrum antibiotics. Furthermore, improper treatment contributes to increased antibiotic resistance and death. Point of care (POC) diagnostic tests that rapidly identify invasive NTS infection, and differentiate between resistant and non-resistant strains, may greatly improve patient outcomes and decrease resistance at the community level. Here we present for the first time a model for NTS dynamics in high risk populations that can analyze the potential advantages and disadvantages of four strategies involving POC diagnostic deployment, and the resulting impact on antimicrobial treatment for patients. Our analysis strongly supports the use of POC diagnostics coupled with targeted antibiotic use for patients upon arrival in the clinic for optimal patient and public health outcomes. We show that even the use of imperfect POC diagnostics can significantly reduce total costs and number of deaths, provided that the diagnostic gives results quickly enough that patients are likely to return or stay to receive targeted treatment.

scholarly journals 779. Clostridiodes difficile: Is it time for surveillance! Cost-benefit analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S434-S434
Author(s):  
Mohamed Yassin ◽  
Curtis Donskey ◽  
Ricardo Arbulu ◽  
Heather Dixon ◽  
Kenneth Smith
Keyword(s):  
Cost Saving ◽  
Current Practice ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Carrier Status ◽  
Local Data ◽  
Healthcare Perspective ◽  
Hospital Perspective

Abstract Background Clostridiodes difficile infection (CDI) has substantial morbidity, mortality and expense. Hospital surveillance to detect CD carriers could affect antibiotic use and determination of community-associated vs hospital-associated CDI. Methods A decision tree examined the cost-effectiveness of hospital CD surveillance compared to current practice (testing as indicated). Costs for CD testing, community-associated CDI and hospital-associated CDI came from US databases. CD carrier and infection probabilities came from literature and local data. Analyses examined potential benefits from 1) knowledge of CD carrier status affecting antibiotic use (healthcare perspective) and 2) avoiding penalties for hospital-acquired CDI (hospital perspective). Results From the healthcare perspective, if antibiotic use is unchanged by CD status, surveillance costs $39/patient than current practice with unchanged CDI risk. However, if knowing CD status changed antibiotic prescribing such that CDI risk decreased by 10% or 20%, then cost/CDI avoided becomes $15,519 and $3,822 respectively, with CD surveillance becoming cheaper and more effective current practice if CDI risk decreased ≥30%. From the hospital perspective, using published CDI incidence (2.7%) and a hospital-associated CDI penalty of $30,000, surveillance cost $336/patient less than current practice if patients colonized on admission were not considered hospital-associated CDI and $476/patient less with local data (incidence 4.2%). Conclusion Hospital CD surveillance is potentially a cost-effective or cost-saving strategy depending on perspective taken and clinical usage of these data. This strategy could be implemented hospital-wide or in high-risk populations. CD surveillance could be both cost-saving and decrease CDI risk if more appropriate antibiotic use results from its use. Disclosures All Authors: No reported disclosures

scholarly journals Acquisition of a Dose Management System with Consideration of Medico-Legal and Economic Aspects

2021 ◽  
Author(s):  
Thuy Duong Do ◽  
Claudius Melzig ◽  
Hans-Ulrich Kauczor ◽  
Marc-André Weber ◽  
Mark Oliver Wielpütz
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Steering Committee ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Current Status ◽  
Actual Condition ◽  
Utility Analysis ◽  
Advantages And Disadvantages ◽  
Dose Management

Background New radiation protection regulation encompassing additional obligations for monitoring, reporting and recording of radiation exposure, was enacted on December 31, 2018. As a consequence, dose management systems (DMS) are necessary to fulfill the requirements. The process of selection, acquisition and implementation of a suitable IT solution for this purpose is a challenge that all X-ray-applying facilities, including hospitals and private practices, are currently facing. Method A target/actual-analysis as well as a cost-utility analysis is presented for this specific case as a foundation for the acquisition decision-making process. Result An actual analysis is necessary in order to record the current status of dose documentation. An interdivisional approach is recommended to include all imaging modalities and devices. An interdisciplinary steering committee can be helpful in enabling consensus and rapid action. A target analysis includes additional criteria with respect to ease of operation, technical feasibility, process optimization and research opportunities to consider in addition to the statutory requirements. By means of a cost-benefit analysis, considerations between costs and the individually weighted advantages and disadvantages of eligible DMS result in a ranking of preference for the available solutions. Conclusion Requirements of a DMS can be summarized in a specification sheet. Deploying an actual condition analysis, target state analysis and cost-utility analysis can help to identify a suitable DMS to achieve rapid commissioning and highest possible user acceptance while optimizing costs at the same time. Key Points: Citation Format

Costo-beneficio del trattamento con i farmaci antivirali ad azione diretta nei consumatori di sostanze con epatite C: una valutazione del percorso di point of care

MISSION ◽  
2021 ◽  
pp. 8-17
Author(s):  
Felice A. Nava ◽  
Lucia Trevisi ◽  
Alfio Lucchini
Keyword(s):  
Public Health ◽  
Cost Saving ◽  
Drug Users ◽  
Cost Benefit Analysis ◽  
Point Of Care ◽  
Cost Benefit ◽  
Health Concern ◽  
Hcv Treatment ◽  
The Public ◽  
The Cost

Background Hepatitis C is a disease correlated with severe systemic consequences having elevated social and health costs. The HCV elimination is a public health concern that may be solved reaching DAAs treatment for drug users. The principal aim of this work is to evaluate the cost-benefit of a point of care for HCV treatment of drug users inside Drug abuse services (Ser.D.). Methods The study consists in a cost-benefit analysis able to evaluate the "return of health" induced by a point of care for a HCV treatment. Results The work shows that the point of care is cost-benefit in comparison with the "traditional" treatment being cost saving for the public health system. The data suggest that the cost of the point of care is corresponding to euros 593,40 while the cost of not treatment of euros 8.679,60 (due to the direct and indirect costs of the disease). Conclusions The study demonstrate the point of care is an effective model of care able to reduce the barriers of treatment and to induce a "health return" in term of cost saving for the public health systems. Indeed, the work shows how the point of care may make the elimination HCV plans sustainable for the public health agencies.

Is perfect the enemy of good? Weighing the evidence for biparametric MRI in prostate cancer

2021 ◽  
Author(s):  
Alexander P Cole ◽  
Bjoern J. Langbein ◽  
Francesco Giganti ◽  
Fiona M. Fennessy ◽  
Clare M. Tempany ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Multiparametric Mri ◽  
Benefit Analysis ◽  
Advantages And Disadvantages ◽  
Contrast Enhanced ◽  
Clinically Significant

The role of multiparametric MRI in diagnosis, staging and treatment planning for prostate cancer is well established. However there remain several challenges to widespread adoption. One such challenge is the duration and cost the examination. Abbreviated exams omitting contrast enhanced sequences may help address this challenge. In this review, we will discuss the rationale for biparametric MRI (bpMRI) for detection and characterization of clinically significant prostate cancer prior to biopsy and synthesize the published literature. We will weigh up the advantages and disadvantages to this approach and lay out a conceptual cost/benefit analysis regarding adoption of bpMRI.

The challenge of prostate biopsy guidance in the era of mpMRI detected lesion: ultrasound-guided versus in-bore biopsy

2021 ◽  
pp. 20210363
Author(s):  
Auke Jager ◽  
Joan C Vilanova ◽  
Massimo Michi ◽  
Hessel Wijkstra ◽  
Jorg R Oddens
Keyword(s):  
Real Time ◽  
Selection Criteria ◽  
Cost Benefit Analysis ◽  
Imaging Techniques ◽  
Specific Antigen ◽  
Cost Benefit ◽  
Ultrasound Images ◽  
Current Recommendation ◽  
Detection Rates ◽  
Advantages And Disadvantages

The current recommendation in patients with a clinical suspicion for prostate cancer is to perform systematic biopsies extended with targeted biopsies, depending on mpMRI results. Following a positive mpMRI [i.e. Prostate Imaging Reporting and Data System (PI-RADS) ≥3], three targeted biopsy approaches can be performed: visual registration of the MRI images with real-time ultrasound imaging; software-assisted fusion of the MRI images and real-time ultrasound images, and in-bore biopsy within the MR scanner. This collaborative review discusses the advantages and disadvantages of each targeting approach and elaborates on future developments. Cancer detection rates seem to mostly depend on practitioner experience and selection criteria (biopsy naïve, previous negative biopsy, prostate-specific antigen (PSA) selection criteria, presence of a lesion on MRI), and to a lesser extent dependent on biopsy technique. There is no clear consensus on the optimal targeting approach. The choice of technique depends on local experience and availability of equipment, individual patient characteristics, and onsite cost-benefit analysis. Innovations in imaging techniques and software-based algorithms may lead to further improvements in this field.

A regional approach to optimizing the location of rural handpumps

2015 ◽  
Vol 5 (3) ◽  
pp. 493-501 ◽  
Author(s):  
Omar S. Hopkins
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Optimal Number ◽  
Point Sources ◽  
Decision Makers ◽  
Sub Saharan Africa ◽  
Proposed Model ◽  
Rural Water ◽  
Time Savings ◽  
Sub Saharan

Many rural water supply projects in sub-Saharan Africa are based on the installation of public handpumps. One of the key benefits of these projects is distance and time savings. Surprisingly, references to rural water planning rarely provide systematic approaches to optimizing distance-related benefits. This paper develops a conceptual model to identify the number and location of point sources that maximizes benefits to consumers, thereby serving as an aid to decision makers in identifying good alternatives. The proposed model is based on willingness to pay, a location model to identify optimal locations of sources, and a cost–benefit analysis. The model shows that as the number of sources increases, the distance between households and sources decreases but the user fee must increase to generate the revenue required to maintain them. Higher fees will dissuade households from using the point sources and hence reduce the aggregate distance savings that accrue. This suggests that there is an optimal number and location of point sources.

scholarly journals Large scale electricity storage technology options for smart grid

2018 ◽  
Vol 7 (2) ◽  
pp. 635
Author(s):  
Surender Reddy Salkuti
Keyword(s):  
Energy Storage ◽  
Smart Grid ◽  
Large Scale ◽  
Cost Benefit Analysis ◽  
Renewable Energy Sources ◽  
Cost Benefit ◽  
Energy Storage Devices ◽  
Advantages And Disadvantages ◽  
Current Impact ◽  
Storage Technologies

This paper aims to establish a comparative analysis between various storage techniques available and to evaluate their current impact as well as potential to be employed more effectively in the future. This paper presents the classification of each storage technique on the basis of features, cost, location, mathematical modelling, advantages and disadvantages. This paper shows the energy storage devices behavior to effectively improve the renewable energy sources connected to the utility grid. The paper also identifies the different storage techniques that can be implemented in to a smart grid and a cost benefit analysis of the different storage techniques. The paper exhaustively reviews the functionality of a major sector of smart grid and energy storage. From this paper, it can be observed that the use of energy storage technologies will increase the supply, and balances the demand for energy.

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