THE COST ANALYSIS OF ANTIBIOTICS USED AT THE 268 MILITARY HOSPITAL IN 2016

2018 ◽  
pp. 104-111
Author(s):  
Phuoc Bich Ngoc Nguyen ◽  
Thi Trang Truong ◽  
Thi Binh Pham
Keyword(s):  
Cost Analysis ◽  
Group Analysis ◽  
Specific Treatment ◽  
Military Hospital ◽  
Oral Antibiotic ◽  
Total Drug ◽  
Beta Lactam ◽  
Total Consumption ◽  
Key Words Antibiotics ◽  
The Cost

Background: Irrational use of antibiotics is always the concern of public heath. The Ministry of Health has promulgated the manual on the management of antibiotics use in hospitals that emphasizes the analysis of antibiotic drugs consumption by using ABC and DDD analysis. Objective: Analyzing the cost of antibiotics used at the 268 Military hospital according to specific treatment groups, ABC and DDD analysis. Material and methods: The list of all antibiotics used at the 268 Military Hospital in 2016. Using ABC, DDD and treatment group analysis. Results: Antibiotics constituted 21.85% the total drug expense. Nine groups of antibiotics were used and the beta-lactam group had the highest proportion (84.5%). Cefadroxil was the oral antibiotic having the most consumption. Meanwhile, for injected antibiotics, was Ceftazidime. The A class antibiotics accounted for only 20.19% of the items listing, but 90.49% of the total consumption value. Conclusion: Antibiotics, particularly Cephalosporin, accounted for the highest proportion of total drug expense. Although the 268 Military hospital gave priority to the use of first-line oral antibiotics which often had the low cost per DDD, some injected antibiotics with high cost per DDD were still used quite a lot. Key words: Antibiotics, Cost Analysis, 268 Military Hospital, ABC and DDD analysis

Identyfikacja kosztów pogorszenia reputacji przedsiębiorstwa z perspektywy interesariuszy

2014 ◽  
pp. 10-15
Author(s):  
Danuta Szwajca ◽  
Alina Rydzewska ◽  
Tomasz Nawrocki
Keyword(s):  
Cost Analysis ◽  
Economic Costs ◽  
Crisis Situation ◽  
Modern Economy ◽  
The Cost ◽  
A Company ◽  
Crisis Situations

In the realities of modern economy even the best-managed company is not able to avoid threats and bad decisions, that can cause a crisis. Each crisis situation, that a company experiences, generates not only measurable economic costs, but also more difficult to assess and measure costs of a deteriorated reputation. These costs are the result of infringement of interests or failing to satisfy different stakeholders expectations. The aim of this article is an attempt to identify the cost of reputation deterioration in the context of the various interests of stakeholders groups. In the first part, the paper presents the effects of good and bad reputation, the reputation "contamination" path in a crisis situation and a cost analysis caused by it. The second part is empirical, where the identification of crisis situations measurable costs and reputation deterioration based on the examples of three selected companies was performed.

scholarly journals 284. Evaluation of Oral Step-Down Therapy for Enterobacteriaceae Bloodstream Infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S143-S143
Author(s):  
Sara Utley ◽  
Dawn Bouknight ◽  
Radha Patel ◽  
Kent Stock
Keyword(s):  
Bloodstream Infection ◽  
Oral Therapy ◽  
Common Source ◽  
Oral Antibiotic ◽  
Beta Lactam ◽  
Hospital System ◽  
Source Of Infection ◽  
Complete Treatment ◽  
Antibiotic Duration ◽  
Alternate Source

Abstract Background Oral antibiotic stepdown therapy for Gram-negative (GN) bloodstream infection (BSI) appears to be a safe option, though high bioavailability drugs like fluoroquinolones (FQ) and trimethoprim-sulfamethoxazole are often recommended without clear evidence demonstrating superiority. Due to increasing concerns of FQ resistance and collateral damage with an increasing community C. difficile rate, our organization sought to reduce overall FQ use and a shift toward oral beta-lactams (BL) was observed. A review was conducted to assess the outcomes of this shift. Methods This retrospective cohort included all patients within our 3-hospital system who had a positive GN blood culture and were transitioned to oral therapy to complete treatment outpatient for bacteremia between Jan 2017-Sept 2019. The primary outcome was recurrent BSI within 30 days of completing initial treatment. Secondary outcomes included 30-day mortality, 30-day recurrence of organism at an alternate source, 30-day readmission, and 90-day BSI relapse. Results Of 191 GN BSIs, 77 patients were transitioned to oral therapy. The mean age was 68 years, 60% were female. The most common source of infection was described as urine (39/77), intra-abdominal (16/77), unknown (13/77). Mean total antibiotic duration (IV plus PO) was 14 days (range 7–33). Patients received an average of 5 days IV prior to transitioning to PO therapy. The most common PO class was a 1st gen cephalosporin (29/77), followed by BL/BL inhibitor (16/77), and a FQ (13/77). There were no 30-day relapse BSIs observed in this cohort. There was 1 patient discharged to inpatient hospice, and no other 30-day mortality observed. There were 4 recurrent UTIs observed within 30 days, none of which required readmission. Of the twelve 30-day readmissions, 1 was considered by the investigators to be related to the initial infection. Conclusion An opportunity for education regarding duration of therapy was identified. Oral beta lactam use in our limited population appears to be a reasonable option to facilitate discharge. Results should be confirmed in additional, larger studies. Disclosures All Authors: No reported disclosures

scholarly journals National Antibiotic Consumption for Human Use in Sierra Leone (2017–2019): A Cross-Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 77
Author(s):  
Joseph Sam Kanu ◽  
Mohammed Khogali ◽  
Katrina Hann ◽  
Wenjing Tao ◽  
Shuwary Barlatt ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Defined Daily Dose ◽  
Oral Antibiotics ◽  
Sectional Study ◽  
Beta Lactam ◽  
Total Consumption ◽  
Cross Sectional ◽  
Procaine Penicillin

Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017–2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access, 31% were Watch, and no Reserve antibiotics were reported. The top ten oral antibiotics represented 97% of total oral antibiotics consumed, with metronidazole (35%) and ciprofloxacin (15%) together constituting half of the total. Of parenteral antibiotics consumed, procaine penicillin (32%) and ceftriaxone (19%) together comprised half of the total. Policy recommendations at global and national levels have been made to improve monitoring of antibiotic consumption and antibiotic stewardship.

Economic impact of the use of the National Surgical Quality Improvement Program

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Alvine Fansi ◽  
Angela Ly ◽  
Julie Mayrand ◽  
Maggy Wassef ◽  
Aldanie Rho ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cost Analysis ◽  
Economic Impact ◽  
Quality Improvement Program ◽  
Economic Evaluations ◽  
Complication Rates ◽  
Improvement Program ◽  
Surgical Quality ◽  
Acs Nsqip ◽  
The Cost

Objectives The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) is a validated, risk-adjusted database for improving the quality and security of surgical care. ACS NSQIP can help participating hospitals target areas that need improvement. The aim of this study was to systematically review the literature analyzing the economic impact of using NSQIP. This paper also provides an estimation of annual cost savings following the implementation of NSQIP and quality improvement (QI) activities in two hospitals in Quebec. Methods In June 2018, we searched in seven databases, including PubMed, Embase, and NHSEED for economic evaluations based on NSQIP data. Contextual NSQIP databases from two hospitals were collected and analyzed. A cost analysis was conducted from the hospital care perspective, comparing complication costs before and after 1 year of the implementation of NSQIP and QI activities. The number and the cost of complications are measured. Costs are presented in 2018 Canadian dollars. Results Out of 1,612 studies, 11 were selected. The level of overall evidence was judged to be of moderate to high quality. In general, data showed that, following the implementation of NSQIP and QI activities, a significant decrease in complications and associated costs was observed, which improved with time. In the cost analysis of contextual data, the reduction in complication costs outweighed the cost of implementing NSQIP. However, this cost analysis did not take into account the costs of QI activities. Conclusions NSQIP improves complication rates and associated costs when QI activities are implemented.

scholarly journals A cost analysis to address issues of budget constraints on the implementation of the indoor residual spray programme in two districts of Maputo Province, Mozambique

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Neide Canana
Keyword(s):  
Sensitivity Analysis ◽  
Cost Analysis ◽  
Financial Analysis ◽  
Indoor Residual Spraying ◽  
Economic Cost ◽  
Cost Information ◽  
Financial Cost ◽  
Provider Perspective ◽  
The Government ◽  
The Cost

Abstract Background It is frequently said that funding is essential to ensure optimal results from a malaria intervention control. However, in recent years, the capacity of the government of Mozambique to sustain the operational cost of indoor residual spraying (IRS) is facing numerous challenges due to restrictions of the Official Development Assistance. The purpose of the study was to estimate the cost of IRS operationalization in two districts of Maputo Province (Matutuíne and Namaacha) in Mozambique. The evidence produced in this study intends to provide decision-makers with insight into where they need to pay close attention in future planning in order to operationalize IRS with the existent budget in the actual context of budget restrictions. Methods Cost information was collected retrospectively from the provider perspective, and both economic and financial costs were calculated. A “one-way” deterministic sensitivity analysis was performed. Results The average economic costs totaled US$117,351.34, with an average economic cost per household sprayed of US$16.35, and an average economic cost per person protected of US$4.09. The average financial cost totaled US$69,174.83, with an average financial cost per household sprayed and per person protected of US$9.84 and US$2.46, respectively. Vehicle, salary, and insecticide costs were the greatest contributors to overall cost in the economic and financial analysis, corresponding to 52%, 17%, and 13% in the economic analysis and 21%, 27%, and 22% in the financial analysis, respectively. The sensitivity analysis was adapted to a range of ± (above and under) 25% change. There was an approximate change of 14% in the average economic cost when vehicle costs were decreased by 25%. In the financial analysis, the average financial cost was lowered by 7% when salary costs were decreased by 25%. Conclusions Altogether, the current cost analysis provides an impetus for the consideration of targeted IRS operationalization within the available governmental budget, by using locally-available human resources as spray operators to decrease costs and having IRS rounds be correctly timed to coincide with the build-up of vector populations.

scholarly journals 308. Re-purposing Beta-lactam Antibiotics as Fluoroquinolone Sparing Stepdown Therapy for the Treatment of Enterobacteriales Bloodstream Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S151-S152
Author(s):  
Matthew Davis ◽  
Dayna McManus ◽  
Michael Ruggero ◽  
Jeffrey E Topal
Keyword(s):  
Positive Culture ◽  
Retrospective Chart Review ◽  
Bloodstream Infections ◽  
Central Line ◽  
Cost Of Care ◽  
Cns Infection ◽  
Oral Antibiotic ◽  
Beta Lactam ◽  
Clostridioides Difficile ◽  
Secondary Outcomes

Abstract Background Oral antimicrobial therapy for Enterobacteriales bloodstream infection (EB-BSI) is advantageous to reduce the risk of central line complications, cost of care, and length of stay. Fluoroquinolones (FQ) given their high bioavailability have been utilized as the standard for stepdown therapy (SDT) for EB-BSI. Given the recent increased warnings around FQ use including Clostridioides difficile infection (CDI) and the increasing FQ resistance alternative oral options for treatment are warranted. Recent literature has suggested beta-lactams (BLM) may be an option for EB-BSI. To enhance the antimicrobial stewardship goal of reducing FQ use, our team began recommending de-escalation to a BLM for EB-BSI and the objective of this study is to evaluate the outcomes of this approach. Methods This study was a retrospective chart review of patients with EB-BSI due to ceftriaxone sensitive monomicrobial E. coli, Klebsiella spp., or P. mirabilis who received a BLM or a FQ as SDT. Patients were excluded if < 18 years of age; pregnant; ANC < 1000 cells/µL; had endocarditis, a bone/joint, or a CNS infection; discharged to hospice or expired prior to discharge; anaphylactic BLM allergy; or prior kidney transplant. SDT was defined as a switch to a definitive oral antibiotic after empiric IV therapy. The primary outcome was clinical cure defined as completion of therapy without signs of infection (increase in WBC > 2000 cells/mL if WBC was ≥ 12,000 cells/mL, fever (>38°C), or change in antibiotic due to failure). Secondary outcomes included 30 day re-admission rates, reinfection rate defined as positive culture within 30 days of completion of therapy, antibiotic associated adverse events defined as side effects leading to discontinuation and/or CDI within 90 days from start of treatment. Results A total of 159 patients were included in the study (Figure 1). The BLM patients had a higher median age (78 vs 72, p=0.008), higher median PITT bacteremia score (2 vs 1, p=0.037), were less likely to be immunosuppressed (9% vs 25%, p=0.045), and had shorter median duration of therapy (13 vs 14, p=0.034). There was no difference in the primary or secondary outcomes (Table 2). Conclusion BLM may enhance stewardship efforts as a FQ sparing option for treatment of EB-BSI; however, prospective studies in this area are warranted. Disclosures All Authors: No reported disclosures

The cost of depression – A cost analysis from a large database

2013 ◽  
Vol 147 (1-3) ◽  
pp. 137-143 ◽  
Author(s):  
Katja Kleine-Budde ◽  
Romina Müller ◽  
Wolfram Kawohl ◽  
Anke Bramesfeld ◽  
Jörn Moock ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Large Database ◽  
The Cost

scholarly journals Cost Analysis of Methylprednisolone Treatment of Multiple Sclerosis Patients

1998 ◽  
Vol 25 (3) ◽  
pp. 222-229 ◽  
Author(s):  
Lynda S. Robson ◽  
Charlene Bain ◽  
Shann Beck ◽  
Suzanne Guthrie ◽  
Peter C. Coyte ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cost Saving ◽  
Cost Analysis ◽  
Home Care ◽  
Care Program ◽  
Sensitivity Analyses ◽  
Patient Treatment ◽  
Fiscal Year ◽  
Multiple Sclerosis Patients ◽  
The Cost

ABSTRACT:Background:Intravenous methylprednisolone (IVMP) is the treatment of choice for multiple sclerosis (MS) patients undergoing acute exacerbation of disease symptoms and yet its cost has not been accurately determined. Determination of this cost in different settings is also pertinent to consideration of cost-saving alternatives to in-patient treatment.Methods:Cost analysis from the point of view of the health care system of IVMP treatment of MS patients receiving treatment in association with a selected Toronto teaching hospital in fiscal year 1994/95 was carried out. Costs of any concurrent treatments were excluded.Results:Total cost for 92 patients, based on a 4 dose regime, was estimated to be $78,527. The the cost per patient was $1,1181.84 for in-patients (IP), $714.64 for out-patients of the MS Clinic (OP) and $774.21 for patients whose treatment was initiated in the Clinic, but completed in the home (HC). Sensitivity analyses indicated: 1) IP treatment was in all cases more expensive than that of OP or HC; 2) the cost savings of OP vs. HC was sensitive to assumptions made regarding Clinic overhead, Clinic nursing costs and Home Care Program overhead.Conclusion:Alternatives to in-patient care must be considered carefully. In this study, both out-patient and in-home treatment were cost-saving alternatives to in-patient treatment, but large differences in the cost of hospital out-patient vs. in-home care could not be demonstrated.

scholarly journals Procedure for detecting tobamovirus in tomato and pepper seeds decreases the cost analysis

Bragantia ◽  
2018 ◽  
Vol 77 (4) ◽  
pp. 590-598
Author(s):  
João Eduardo Melo Almeida ◽  
Antonia dos Reis Figueira ◽  
Priscilla de Sousa Geraldino Duarte ◽  
Mauricio Antônio Lucas ◽  
Nara Edreira Alencar
Keyword(s):  
Cost Analysis ◽  
The Cost
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