Cost Effectiveness and Resource Allocation最新文献

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Exploring patient's clinical outcomes, hospital costs, and satisfaction after the implementation of integrated clinical pathway-based nursing practice model. 探讨实施基于临床路径的综合护理实践模式后患者的临床效果、医院成本和满意度。
IF 2.5 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-07-30 DOI: 10.1186/s12962-025-00645-5
Rini Rachmawaty, Elly Wahyudin, Agussalim Bukhari
{"title":"Exploring patient's clinical outcomes, hospital costs, and satisfaction after the implementation of integrated clinical pathway-based nursing practice model.","authors":"Rini Rachmawaty, Elly Wahyudin, Agussalim Bukhari","doi":"10.1186/s12962-025-00645-5","DOIUrl":"10.1186/s12962-025-00645-5","url":null,"abstract":"<p><strong>Introduction: </strong>Hospitals provide essential health services, focusing on quality, safety, and patient-centered care. The rising prevalence of communicable and non-communicable diseases in Indonesia has led to increased National Health Insurance (NHI) costs, with communicable diseases representing a significant burden despite global progress in disease control. Tuberculosis remains a major global health concern, causing 1.25 million deaths in 2023, while Indonesia ranks second globally for tuberculosis burden, accounting for 10% of global TB cases with an estimated 969,000 cases annually. Despite efforts to improve quality, Haji and Labuang Baji Hospitals face challenges, including financial losses and suboptimal patient outcomes. This study aims to assess the impact of an Integrated Clinical Pathway (ICP)-based Professional Nursing Practice Model on clinical outcomes, hospital costs, and patient satisfaction at these hospitals.</p><p><strong>Methods: </strong>This study employed action research methodology by developing, implementing, and evaluating the clinical guidelines and ICP for 10 diseases that were categorized as high volume, high risk, and high cost based on secondary data analysis using the NHI databases. Data was collected through observation of the ICP implementation on 40 patients and interviews of Professional Care Providers (PCPs) and was analyzed using IBM SPSS Statistics version 28.</p><p><strong>Results: </strong>A total of 40 patients from Haji Hospital (n = 20) and from Labuang Baji Hospital (n = 20) with diagnoses of pulmonary tuberculosis, pneumonia, dyspepsia, typhoid fever, normal delivery, and COPD were included and analyzed. Compliance with ICPs in both hospitals was quite low: 50.02% in Haji Hospital and 44.46% in Labuang Baji Hospital. However, the length of patients' stays (LOS) generally complied with ICP standards, although some cases exceeded the benchmarks. Hospital costs varied across different disease diagnoses, impacting overall financial outcomes. Patient satisfaction improved across all diagnostic categories.</p><p><strong>Conclusion: </strong>The implementation of ICP at both hospitals showed that all indicators of patient clinical outcomes improved according to the time specified in ICP, resulting in patients' LOS being shorter than stipulated in ICP and an increase in patient satisfaction. ICP implementation has also led to hospitals earning different profits in almost all diagnoses.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"38"},"PeriodicalIF":2.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-utility analysis of omalizumab for the treatment of chronic spontaneous urticaria in China. 奥玛珠单抗治疗中国慢性自发性荨麻疹的成本效用分析。
IF 2.5 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-07-22 DOI: 10.1186/s12962-025-00643-7
Yueyang Huang, Hongmei Yuan, Zhe Huang
{"title":"Cost-utility analysis of omalizumab for the treatment of chronic spontaneous urticaria in China.","authors":"Yueyang Huang, Hongmei Yuan, Zhe Huang","doi":"10.1186/s12962-025-00643-7","DOIUrl":"10.1186/s12962-025-00643-7","url":null,"abstract":"<p><strong>Background: </strong>Chronic spontaneous urticaria (CSU) is a common inflammatory immune skin disease. It has a serious impact on the patients' quality of life and imposes a serious financial burden on patients. The standard therapy for CSU (using antihistamines), while less costly, has limited efficacy and no longer adequately meets the clinical needs of CSU patients. Omalizumab is the world's first and currently the only biologic approved for the treatment of CSU. Several studies have confirmed the efficacy and safety of omalizumab for CSU. However, the economics of omalizumab treatment relative to standard therapies remains unknown in China.</p><p><strong>Objective: </strong>The purpose of this study was to analyze the cost-effectiveness of omalizumab versus standard treatments for CSU after omalizumab's inclusion in the National Drug Insurance List from the patient's perspective.</p><p><strong>Methods: </strong>We developed a Markov model based on the Urticaria Activity Score over 7 days (UAS7). The modeling period was 4 weeks. The time horizon was 10 years. The willingness-to-pay threshold (WTP) of 1-3 times gross domestic product (GDP) per capita was selected. Incremental cost-effectiveness ratio (ICER) was calculated from the base-case analysis, and one-way sensitivity analysis and probabilistic sensitivity analysis were performed.</p><p><strong>Results: </strong>The ICER of omalizumab treatment relative to standard treatment was ¥160,411/QALY, which was between 1 and 3 times GDP per capita. Sensitivity analyses illustrated that the direct cost of omalizumab had a significant effect on the ICER and demonstrated the stability of the results.</p><p><strong>Conclusions: </strong>Omalizumab treatment is a cost-effective regimen compared with standard therapy under certain circumstances. This demonstrates the important role that health insurance policies play in reducing the burden on CSU patients. However, the limitations of applying foreign clinical data in this paper and the uncertainty of cost-effectiveness at a low WTP threshold are two aspects that cannot be ignored, and subsequent related studies are needed. This study will help patients to make decisions about treatment options, and will be a reference to relevant healthcare organizations.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"37"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The cost of delivering COVID-19 vaccines in four districts in Malawi. 在马拉维四个地区提供COVID-19疫苗的费用。
IF 2.5 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-07-22 DOI: 10.1186/s12962-025-00610-2
Anika Ruisch, Simon Ntopi, Ishani Mathur, Maeve Conlin, Anna McCaffrey, Damian G Walker, Christian Suharlim
{"title":"The cost of delivering COVID-19 vaccines in four districts in Malawi.","authors":"Anika Ruisch, Simon Ntopi, Ishani Mathur, Maeve Conlin, Anna McCaffrey, Damian G Walker, Christian Suharlim","doi":"10.1186/s12962-025-00610-2","DOIUrl":"10.1186/s12962-025-00610-2","url":null,"abstract":"<p><p>While COVID-19 vaccines became available in late 2020, low-income countries (LICs) faced challenging COVID-19 vaccine distribution efforts in terms of both a delayed and scarce vaccine supply and barriers reaching the target populations. The cost of delivering COVID-19 vaccines in LICs is uncertain, which complicates planning and budgeting for country leadership as well as major funders. In the absence of such data, a global model was developed by the COVAX Working Group on Delivery Costing using data on the costs of similar immunization campaigns and assumptions. This study has two objectives, firstly to estimate the costs of delivering COVID-19 vaccine delivery using primary data collected in Malawi, and secondly comparing these estimates to modeled estimates based on secondary data, to contribute to a growing evidence base on the cost of the COVID-19 vaccination delivery in LICs.This retrospective study used a bottom-up method to estimate the financial and economic costs. Data were collected from health facilities and health posts via a COVID-19 cost survey. The data sources included existing records and interviews with relevant districts and facility staff. Twenty representative vaccine delivery sites were purposively selected across four districts. We focused on major cost drivers that contributed to the highest proportion and variability in delivery costs.The total financial cost of COVID-19 vaccine delivery in 20 facilities across four districts in Malawi (from April 1, 2021-March 31, 2022) was US$ 322,786. During that period, the 20 facilities delivered 70,947 vaccines. The financial cost per dose delivered was US$ 4.55. Considering the reallocation of existing staff time toward COVID-19 vaccination, volunteer opportunity costs, and donated vehicles, the economic cost per dose delivered was nearly four times greater at US$ 16.15. The economic cost of labor was estimated at US$ 10.75 per dose delivered and accounts for two-thirds of the total economic cost.This study is the first to provide evidence on the cost of COVID-19 vaccine delivery in Malawi. The financial cost of delivering the COVID-19 vaccine in twenty health facilities across 4 districts in Malawi, at US$ 4.55 [US$ 3.23- US$ 6.33] per dose delivered. We observed a large amount of labor reallocation towards COVID-19 vaccination.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"36"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Regional disparities, dynamic evolution, and spatial spillover effects of medical resource allocation efficiency in TCM hospitals. 中医医院医疗资源配置效率的区域差异、动态演化与空间溢出效应
IF 1.7 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-07-18 DOI: 10.1186/s12962-025-00644-6
Zhihao Wang, Zhiguang Li, Ruijin Xie
{"title":"Regional disparities, dynamic evolution, and spatial spillover effects of medical resource allocation efficiency in TCM hospitals.","authors":"Zhihao Wang, Zhiguang Li, Ruijin Xie","doi":"10.1186/s12962-025-00644-6","DOIUrl":"10.1186/s12962-025-00644-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To analyze the regional disparities, dynamic evolution, and influencing factors of medical resource allocation efficiency in TCM hospitals across China from 2016 to 2022, providing references for optimizing resource allocation in TCM hospitals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study employed a super-efficiency Slack-Based Measure (SBM) model considering undesirable outputs to assess regional equity in efficiency, utilized the Dagum Gini coefficient to measure regional disparities in efficiency, and applied kernel density estimation and spatial econometric models to analyze the dynamic evolution and spatial spillover effects of medical resource allocation efficiency in TCM hospitals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 17 provinces, the efficiency is higher than the average value of 0.839, and in 8 provinces, the average value has exceeded 1. The regional pattern of efficiency shows a gradient characteristic of \"high in the east and stable in the west, with the Northeast lagging behind.\" There is a significant spatial difference in the efficiency of resource allocation. The overall difference in the allocation of resources for traditional Chinese medicine (TCM) hospitals shows a fluctuating upward trend. The contribution rate of regional differences reaches 53.45%, which is the dominant factor. The largest regional differences are found within the central region, while the gaps between the eastern and central regions continue to widen, and those between the western and northeastern regions tend to become more balanced. The most significant interregional differences are observed between the central and western regions. The efficiency of resource allocation for TCM hospitals is on the rise, with the kernel density curve shifting to the right. The main peak height first decreases and then increases, while the width first expands and then contracts. The absolute difference first increases and then decreases. The rightward convergence of the tail indicates that there are efficient hospitals, but the gaps are narrowing. The multi-peak distribution reveals a multi-level differentiation pattern with the coexistence of low-efficiency and high-efficiency clusters. Per capita GDP, urbanization level, aging rate, population density, and the number of graduates from higher medical colleges can promote efficiency improvement. Population density and the proportion of TCM physicians have a positive spatial spillover effect on efficiency, while per capita GDP has a negative spatial spillover effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The efficiency of medical resource allocation in traditional Chinese medicine (TCM) hospitals is steadily improving, and the regional differences are continuously narrowing. The degree of efficiency multi-polarization is becoming more moderate, and the development of regional equilibrium is being achieved. Both internal and external environmental factors jointly influence the improvement of medical re","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"35"},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-effectiveness of dabigatran for thromboembolic events prevention in atrial fibrillation patients in Chile. 达比加群预防智利房颤患者血栓栓塞事件的成本效益。
IF 1.7 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-07-07 DOI: 10.1186/s12962-025-00642-8
Tomás Abbot, Nicolás Armijo, Luis Rojas Orellana, Andrés Giglio Jiménez, Carlos Balmaceda, Manuel Espinoza
{"title":"Cost-effectiveness of dabigatran for thromboembolic events prevention in atrial fibrillation patients in Chile.","authors":"Tomás Abbot, Nicolás Armijo, Luis Rojas Orellana, Andrés Giglio Jiménez, Carlos Balmaceda, Manuel Espinoza","doi":"10.1186/s12962-025-00642-8","DOIUrl":"10.1186/s12962-025-00642-8","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most common sustained arrhythmia in adults, associated with significant morbidity, mortality, and economic burden due to thromboembolic events. In Chile, acenocoumarol is the most widely used anticoagulant, while access to direct oral anticoagulants (DOACs) such as dabigatran, rivaroxaban, and apixaban remains limited for AF patients. Among DOACs, dabigatran is the only one with an approved specific reversal agent (idarucizumab) available in the Chilean public system. Evaluating the cost-effectiveness of these alternatives is critical for informing resource allocation.</p><p><strong>Aims: </strong>To evaluate the cost-effectiveness of dabigatran compared to acenocoumarol, rivaroxaban and apixaban, for thromboembolic events prevention in atrial fibrillation (AF) patients, from the Chilean public health payer perspective.</p><p><strong>Methods: </strong>A Markov cohort model was used to represent the natural history of AF in terms of ischemic and hemorrhagic complications. Direct costs were obtained from local official sources and converted to US dollars (1 USD = 710.9 CLP at 2022). Data about major events and utilities were obtained from the literature. We applied an undifferentiated discount rate of 3% for costs and outcomes over a lifetime time horizon. Uncertainty was characterized through deterministic and probabilistic sensitivity analysis. We also examined the use of idarucizumab and prothrombin-complexes-concentrate (PCC) as reversal agents in an emergency setting as an additional scenario-analysis.</p><p><strong>Results: </strong>Dabigatran was the most (cost-)effective among all alternatives (8.53 QALYs). Considering the Chilean cost-effectiveness threshold of USD 17,200 (1 GDP per capita), dabigatran was cost-effective (USD 11,042 per QALY gained), while both rivaroxaban and apixaban were dominated by dabigatran. Regarding the second-order uncertainty, at the suggested threshold, dabigatran exhibit the highest probability of being cost-effective (approximately 60%). In the reversal agent scenario, dabigatran plus idarucizumab was also found to be cost-effective in the Chilean context.</p><p><strong>Conclusion: </strong>Dabigatran is cost-effective and dominates both rivaroxaban and apixaban at current publicly available prices in Chile. In addition, we expect dabigatran-idarucizumab is also expected to be cost-effective for Chilean health system when is compared against acenocoumarol-PCC as reversal agents.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"34"},"PeriodicalIF":1.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prescription cost analysis and economic impact of drug treatment in patients with chronic illness, attending the medicine out-patient department in a tertiary care hospital at South Delhi. 处方成本分析和药物治疗对慢性疾病患者的经济影响,在南德里一家三级护理医院的门诊部就诊。
IF 1.7 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-06-20 DOI: 10.1186/s12962-025-00628-6
Nusrat Nabi, Ayushi Manghani, Azhar Uddin, Neha Dhillon, Dharmander Singh, Kailash Chandra, Vineet Jain, Riyan Jain, Razi Ahmad, Sunil Kohli
{"title":"Prescription cost analysis and economic impact of drug treatment in patients with chronic illness, attending the medicine out-patient department in a tertiary care hospital at South Delhi.","authors":"Nusrat Nabi, Ayushi Manghani, Azhar Uddin, Neha Dhillon, Dharmander Singh, Kailash Chandra, Vineet Jain, Riyan Jain, Razi Ahmad, Sunil Kohli","doi":"10.1186/s12962-025-00628-6","DOIUrl":"10.1186/s12962-025-00628-6","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence of chronic diseases is rising globally along with the consumption of nutraceuticals. It is documented that 80% of the deaths due to chronic illnesses occur in low and middle-income countries, including India. In addition, chronic diseases not only affect the patients but also their family income. Besides Southeast Asia is also the fastest-growing market for nutraceuticals with less stringent cost regulation. Hence, this research primarily focuses on the financial impact of the drug treatment for chronic illness, extensively comparing the therapeutic and non-therapeutic drug (nutraceutical) costs.</p><p><strong>Methods: </strong>This was a retrospective, cross-sectional study with a sample size of 7877 prescriptions of medicine outpatient clinic, extracted from the hospital information system after 5 level screening for their inclusion in the study. The cost of drugs prescribed to the patient for chronic illness was calculated per month and its impact on the monthly family income was evaluated. The data analysis was stratified into the cost of therapeutic drug treatment and non-therapeutic drug treatment which was correlated with various chronic diseases and demographic parameters.</p><p><strong>Results: </strong>A total of 465 patients were enrolled after screening and a high prescription rate of 88% for non-therapeutic treatment was reported. The total average monthly cost of chronic illness treatment was INR 1879 (22.42 USD), with therapeutic drug treatment of INR 1319 (15.74 USD) and non-therapeutic drug treatment of INR 560 (6.68 USD). Comprising 36% of patients, males spent higher amount on therapeutic drug treatment (INR 1780 or USD 21.26), while women spent higher on non-therapeutic drug treatment (INR 593 or USD 7.08). A catastrophic 11% of patients from 'lower' socioeconomic spent ≥ 10% of family income on non-therapeutic treatment.</p><p><strong>Conclusion: </strong>Our study highlights the financial strain that chronic illnesses impose on families, emphasizing the need for policymakers to improve access to specialized care and cost capping of nutraceuticals.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"33"},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Handling uncertainty in cost-effectiveness analysis in dental medicine: a systematic review with a focus on affordability and risk-aversion. 处理牙科医学成本效益分析中的不确定性:一项侧重于可负担性和风险规避的系统综述。
IF 1.7 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-06-19 DOI: 10.1186/s12962-025-00641-9
Pedram Sendi, Mojdeh Walterscheidt, Michael M Bornstein
{"title":"Handling uncertainty in cost-effectiveness analysis in dental medicine: a systematic review with a focus on affordability and risk-aversion.","authors":"Pedram Sendi, Mojdeh Walterscheidt, Michael M Bornstein","doi":"10.1186/s12962-025-00641-9","DOIUrl":"10.1186/s12962-025-00641-9","url":null,"abstract":"<p><strong>Background: </strong>The number of published cost-effectiveness analyses in dental medicine has substantially increased in recent years. A key methodological issue in these analyses is how to address uncertainty in costs and effects, which also impacts uncertainty around the expected cost-effectiveness ratio. The cost-effectiveness acceptability curve has become the standard method to summarize uncertainty in probabilistic cost-effectiveness analyses. However, it does not inform decision-makers about budget impact or account for the fact that they are often risk-averse. The cost-effectiveness affordability curve and the cost-effectiveness risk-aversion curve have been proposed to address these limitations. In this systematic review, we assess how uncertainty has been handled in cost-effectiveness analyses in dental medicine, with a particular focus on affordability and risk-aversion.</p><p><strong>Methods: </strong>We conducted a systematic literature search across electronic databases (MEDLINE, Web of Science, Cochrane Library, EconLit, Embase) on April 18, 2025, and performed manual searches of selected references. Articles published after January 1, 2021, were included. From each study, we extracted information on the first author, year of publication, country, intervention evaluated, study design (model-based, trial-based, or combined), use of deterministic and/or probabilistic sensitivity analysis, and whether budget impact and risk-aversion were considered.</p><p><strong>Results: </strong>From a total of 57 published cost-effectiveness analyses, 49 (85%) used a deterministic sensitivity analysis and 37 (65%) used a probabilistic sensitivity analysis. Budget impact analysis was performed in five studies (9%), and only one study formally applied both the cost-effectiveness affordability curve and the cost-effectiveness risk-aversion curve.</p><p><strong>Conclusion: </strong>The use of methods to address uncertainty related to budget constraints and risk-aversion remains limited in dental medicine. As decision-makers often operate within budget constraints and health is considered the most valuable good, incorporating methods that address affordability and risk-aversion could enhance the relevance and impact of cost-effectiveness analyses in dental care.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"32"},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Healthcare professionals' perceptions of electronic prescription systems in outpatient services: a qualitative study at UNS hospital. 医疗保健专业人员对门诊服务电子处方系统的看法:一项在UNS医院进行的定性研究。
IF 1.7 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-06-18 DOI: 10.1186/s12962-025-00639-3
Joko Sudarsono, Satibi Satibi, Lutfan Lazuardi, Anna Wahyuni Widayanti
{"title":"Healthcare professionals' perceptions of electronic prescription systems in outpatient services: a qualitative study at UNS hospital.","authors":"Joko Sudarsono, Satibi Satibi, Lutfan Lazuardi, Anna Wahyuni Widayanti","doi":"10.1186/s12962-025-00639-3","DOIUrl":"10.1186/s12962-025-00639-3","url":null,"abstract":"<p><strong>Background: </strong>The outpatient prescription service at UNS Hospital has traditionally relied on paper-based prescriptions. The outpatient prescription service at UNS Hospital is transitioning from paper-based to electronic prescription systems (EPSs). While existing literature highlights EPS benefits, gaps remain in understanding healthcare professionals' subjective experiences during implementation. This qualitative study explores doctors' and pharmacists' perceptions regarding the motivations, benefits, challenges, readiness, and system development suggestions for EPS implementation in outpatient services at UNS Hospital.</p><p><strong>Methods: </strong>In-depth interviews were conducted with six doctors and four pharmacists between January and April 2024. The study participants were prescription doctors and pharmacists at UNS Hospital. The data were analyzed using thematic analysis techniques. Thematic analysis was used to identify the themes that emerged from the interviews.</p><p><strong>Results: </strong>Five themes emerged: (1) Motivations centered on reducing medication errors and enhancing operational efficiency; (2) Benefits included improved communication, cost control, and streamlined workflows; (3) Readiness revealed pharmacists' enthusiasm versus doctors' cautious adaptation. (4) System suggestions emphasized real-time drug stock integration and advanced search features. (5)Electronic Prescription System Features included Information on adverse drug reaction.</p><p><strong>Conclusion: </strong>While healthcare professionals perceive EPS as beneficial for safety and efficiency, addressing challenges like user training and system interoperability is critical for successful adoption. Implementing participant-driven suggestions, such as real-time inventory alerts, could optimize EPS effectiveness. These insights provide actionable strategies for hospitals transitioning to digital prescribing systems.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"31"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of family physician program and health transformation plan on utilization and cost of health services. 家庭医生计划和健康转型计划对卫生服务利用和成本的影响。
IF 1.7 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-06-16 DOI: 10.1186/s12962-025-00637-5
Zeynab Safarpoor, Farhad Lotfi, Mohsen Bayati, Hossein Moordzade, Zahra Goudarzi, Khosro Keshavarz
{"title":"The effect of family physician program and health transformation plan on utilization and cost of health services.","authors":"Zeynab Safarpoor, Farhad Lotfi, Mohsen Bayati, Hossein Moordzade, Zahra Goudarzi, Khosro Keshavarz","doi":"10.1186/s12962-025-00637-5","DOIUrl":"10.1186/s12962-025-00637-5","url":null,"abstract":"<p><strong>Introduction: </strong>Health system reforms are essential. In Iran, some of the most significant changes include the implementation of the Family Physician Program (FPP) and the Health Transformation Plan (HTP). The aim of this study was to assess the impact of these programs on the cost and use of services.</p><p><strong>Methods: </strong>This quasi-experiment targeted insured individuals under the Iranian Health Insurance Organization in Fars province from 2010 to 2021. ANOVA, T-tests, and interrupted time-series analysis were used to investigate the impacts of FPP and HTP on service utilization and cost changes before and after the introduction of these programs.</p><p><strong>Results: </strong>FPP decreased specialist visits, drug utilization, and drug expenditure in the short run. But eventually, it resulted in more general practitioner (GP) consultations, laboratory services, and imaging, hospitalization, and drug spending. The HTP first resulted in more GP consultations, laboratory services, drug use, and hospitalization but less use of imaging services and more total service spending. Eventually, the HTP resulted in more GP consultations, fewer GP prescriptions, and less laboratory test and imaging service spending.</p><p><strong>Conclusion: </strong>FPP was successful in achieving some initial goals, such as decreasing expenditure and service usage through a referral system. It was finally unsuccessful in the long run due to the dissolution of this system and lack of proper supervision. At the beginning, the HTP imposed significant costs to insurance providers; however, it ultimately led to a reduction in the cost for particular services over a prolonged interval.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"30"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pembrolizumab plus chemotherapy in advanced endometrial cancer: a cost-effectiveness analysis. 派姆单抗联合化疗治疗晚期子宫内膜癌:成本-效果分析
IF 1.7 4区 医学
Cost Effectiveness and Resource Allocation Pub Date : 2025-06-12 DOI: 10.1186/s12962-025-00625-9
Xinqiang Zhao, Longjiang She, Xiaoning Liu, Zhenggang Bi
{"title":"Pembrolizumab plus chemotherapy in advanced endometrial cancer: a cost-effectiveness analysis.","authors":"Xinqiang Zhao, Longjiang She, Xiaoning Liu, Zhenggang Bi","doi":"10.1186/s12962-025-00625-9","DOIUrl":"10.1186/s12962-025-00625-9","url":null,"abstract":"<p><strong>Objectives: </strong>Recently, NRG-GY018 clinical trial demonstrated that adding pembrolizumab to chemotherapy led to significantly longer progression-free survival than chemotherapy alone in the first-line treatment of advanced or recurrent endometrial cancer (a/rEC). This analysis aimed to estimate the cost-effectiveness of pembrolizumab plus paclitaxel plus carboplatin chemotherapy (PC) as the first-line treatment for a/rEC in the US and China.</p><p><strong>Methods: </strong>A Markov model based on the clinical data from NRG-GY018 trial was established to estimate the cost and efficacy of PC and paclitaxel plus carboplatin groups for a/rEC in mismatch repair-proficient (pMMR) and mismatch repair-deficient (dMMR) populations. Direct medical costs and utility values were collected from the government databases, local databases, and published literatures. The main outcomes were incremental cost-effectiveness ratios (ICERs), incremental monetary benefit (INMB), and incremental net-health benefit (INHB). The robustness of the model was assessed using one-way and probabilistic sensitivity analyses.</p><p><strong>Results: </strong>With the 5-year time horizon, treatment with PC gained an additional 0.87 QALYs (1.34 LYs) in pMMR and 4.17 QALYs (5.14 LYs) in the dMMR population. In the US, the ICERs of PC compared to chemotherapy were 404,575 $/QALY in pMMR and 124,406 $/QALY in dMMR patients, respectively. In China, the ICERs of PC compared to chemotherapy were 220,259 $/QALY and 70,207 $/QALY in pMMR and dMMR populations, respectively. The results of sensitivity analyses supported the robustness of our models.</p><p><strong>Conclusions: </strong>For patients with a/rEC, PC was cost-effective compared with chemotherapy in the first-line treatment for dMMR populations in the US. However, the combination of pembrolizumab with chemotherapy was not a cost-effective strategy for pMMR a/rEC in the US and a/rEC in China regardless of the MMR status, a price reduction process is required to reach the traditional cost-effectiveness threshold.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"23 1","pages":"29"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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