ClinicoEconomics and Outcomes Research最新文献

{"title":"Cost-Benefit Analysis of Genetic Testing as a Prenatal Diagnostic Tool for Thalassemia: A Single-Center Study From Central Thailand.","authors":"Kwandao Malasai, Jiraphun Jittikoon, Wanvisa Udomsinprasert, Pattarawalai Talungchit, Sitaporn Youngkong, Sermsiri Sangroongruangsri, Surakameth Mahasirimongkol, Usa Chaikledkaew","doi":"10.2147/CEOR.S500802","DOIUrl":"10.2147/CEOR.S500802","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the costs and benefits of genetic testing, specifically mutation analysis and prenatal diagnostic testing, for the confirmation of thalassemia in at-risk pregnancies in Thailand, providing crucial insights to inform public health policy decision-making.</p><p><strong>Patients and methods: </strong>We analyzed the costs and benefits of following standard screening guidelines, which included a sequence of tests such as mean corpuscular volume (MCV)/mean corpuscular hemoglobin (MCH) with dichlorophenol indophenol precipitation (DCIP), hemoglobin (Hb) typing, genetic testing, and amniocentesis. A decision-tree model was employed for this analysis. The study compared the scenarios with and without genetic testing, adopting a societal perspective that accounted for costs during pregnancy and the lifetime of a child born with thalassemia. Both one-way and probabilistic sensitivity analyses were conducted to account for uncertainties in the parameters used.</p><p><strong>Results: </strong>The results revealed that adhering to the standard screening program with genetic testing resulted in a cost-savings of approximately 490 USD per prevented thalassemia case. Among the diagnostic methods, the specificity of the MCV/MCH with DCIP showed a higher degree of sensitivity relative to other testing methods, significantly influencing the outcomes. From a governmental perspective, with a full uptake of genetic testing, the incremental budget required was estimated to be 3.7 million USD (131 million THB) for one year.</p><p><strong>Conclusion: </strong>These findings are particularly valuable for policymakers, as they provide robust evidence supporting potential revisions to the reimbursement structure within Thailand's Universal Health Coverage benefit package, facilitating better management of thalassemia and improving prenatal care.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"17 ","pages":"33-43"},"PeriodicalIF":2.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Cost of Treating Polytrauma in a Public Tertiary Hospital in the South-Eastern Democratic Republic of Congo: A Case Series Study.","authors":"Chadrack Kabeya Diyoka, Laetitia Ngongo Mwanvua, Marcellin Shauri Kalemera, Pascal Pambi Mukanga, Criss Koba Mjumbe","doi":"10.2147/CEOR.S496402","DOIUrl":"10.2147/CEOR.S496402","url":null,"abstract":"<p><strong>Context: </strong>Polytrauma constitutes a major public health issue that is steadily increasing. In developing countries, including the Democratic Republic of Congo, this phenomenon is exacerbated by a combination of factors, such as inadequate funding mechanisms, the high cost of healthcare services and the low socio-economic level of the populations at risk. This study aims to assess the financial cost of treating polytrauma in a tertiary hospital in the Democratic Republic of the Congo.</p><p><strong>Patients and methods: </strong>A case series study was conducted at the Jason SENDWE provincial referral general hospital in Lubumbashi, with data collected from 1 January to 31 December 2023. The study was based on the operational definitions of Heinrich and the economic burden of care at the individual level was calculated by dividing the average direct costs by the GDP per capita, PPP of the country.</p><p><strong>Results: </strong>The present study comprised forty patients with polytrauma, with a mean age of 29.73 ± 9.9 years, ranging from 9 to 45 years.Approximately 65% of cases were attributed to road accidents, with a male predominance of 82.5%.The most frequently observed form of vital distress was neurological, accounting for 60% of cases, and le parage chirurgical comme acte chirurgical (28.11%). The overall survival rate was 7.50%, with a mean direct cost per patient of USD 608.77 ± 370.85 (range: USD 139.78 to USD 1826.34). This equates to a financial burden of 93.79 ± 57.13% of GDP per capita, ranging from 21.54 to 281.36% of GDP per capita.The proportion of out-of-pocket payments was 97.5%. The highest proportion of expenditure (42.2%) was attributed to medications, followed by the cost of surgical procedures (23.21%), and then imaging examinations (19.8%). Conversely, the lowest expenditure was observed to be related to resuscitation (1.21%) and laboratory tests (1.83%). It was observed that only polytrauma patients admitted to intensive care and hospitalised for 43 days or more exhibited a higher mean direct cost, with statistically significant differences (at a risk of 5%).</p><p><strong>Conclusion: </strong>Patients with polytrauma are at significant risk of incurring catastrophic health expenditures. The results provide insight into the financial implications of polytrauma, which may inform the organisation of trauma care.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"17 ","pages":"45-54"},"PeriodicalIF":2.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Comparison of Cost-Effectiveness Between Magnetic Resonance Spectroscopy and Provocative Discography in the Identification of Chronic Low Back Pain Surgery Candidates.","authors":"Leslie Wilson, Douglas P Beall, Robert Kenneth Eastlack, Sigurd Berven, Jeffrey C Lotz","doi":"10.2147/CEOR.S501058","DOIUrl":"10.2147/CEOR.S501058","url":null,"abstract":"<p><strong>Background/context: </strong>Chronic low back pain (CLBP) is a significant US healthcare burden with millions of lumbar spine procedures annually. Diagnostic tests are essential to guide treatment but provocative discography (PD), the most common diagnostic procedure, is without robust evidence of its value. A non-invasive alternative using Magnetic Resonance Spectroscopy (MRS) offers a potential solution.</p><p><strong>Context/purpose: </strong>We assess cost-effectiveness of MRS with NOCISCAN diagnostic algorithm compared to PD for identifying lumbar discs requiring surgical intervention.</p><p><strong>Study design/setting: </strong>We conducted cost-effectiveness analysis using modelling.</p><p><strong>Patient sample: </strong>We used data from a clinical study of 139 CLBP patients who met criteria for and received PD of lumbar spine and presented with an ODI score ≥40; comparing PD and MRS-based diagnostics.</p><p><strong>Outcome measures: </strong>We considered diagnostic costs, adverse events, surgical costs and outcomes based on a 15-point improvement on the Oswestry Disability Index.</p><p><strong>Methods: </strong>Incremental cost-effectiveness ratios (ICERS) and probabilistic sensitivity analyses were determined. Some authors have consulted for Aclarion.</p><p><strong>Results: </strong>Mean total cost per PD patient was $59,711, and $57,998 for MRS, demonstrating $1712 cost savings per MRS diagnosed patient. Diagnostic costs ($1950 for PD; $1450 for MRS), saved $500 per MRS patient. PD incurred adverse event costs ($57,323) for 1% of patients, which MRS eliminated. MRS-based diagnosis showed 78% surgical success, whereas PD achieved 68%. MRS was the dominant diagnostic strategy, with better clinical outcomes and cost savings. Probabilistic sensitivity analysis confirmed MRS dominance and was cost-effective across a wide range of willingness-to-pay thresholds and across 2 different scenarios which vary base-case outcomes and surgical rates.</p><p><strong>Conclusion: </strong>This study demonstrates cost-effectiveness dominance of MRS with the Nociscan diagnostic algorithm over PD for identifying CLBP surgical candidates. MRS provides significant cost savings and leads to better surgical outcomes, making it a preferred choice for insurers and health systems.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"17 ","pages":"19-31"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Model Using ML Techniques for Clinical Trial Design and Expedited Patient Onboarding Process.","authors":"Abhirvey Iyer, Sundaravalli Narayanaswami","doi":"10.2147/CEOR.S479603","DOIUrl":"10.2147/CEOR.S479603","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical trials are critical for drug development and patient care; however, they often need more efficient trial design and patient enrolment processes. This research explores integrating machine learning (ML) techniques to address these challenges. Specifically, the study investigates ML models for two critical aspects: (1) streamlining clinical trial design parameters (like the site of drug action, type of Interventional/Observational model, etc) and (2) optimizing patient/volunteer enrolment for trials through efficient classification techniques.</p><p><strong>Methods: </strong>The study utilized two datasets: the first, with 55,000 samples (from ClinicalTrials.gov), was divided into five subsets (10,000-15,000 rows each) for model evaluation, focusing on trial parameter optimization. The second dataset targeted patient eligibility classification (from the UCI ML Repository). Five ML models-XGBoost, Random Forest, Support Vector Classifier (SVC), Logistic Regression, and Decision Tree-were applied to both datasets, alongside Artificial Neural Networks (ANN) for the second dataset. Model performance was evaluated using precision, recall, balanced accuracy, ROC-AUC, and weighted F1-score, with results averaged across k-fold cross-validation.</p><p><strong>Results: </strong>In the first phase, XGBoost and Random Forest emerged as the best-performing models across all five subsets, achieving an average balanced accuracy of 0.71 and an average ROC-AUC of 0.7. The second dataset analysis revealed that while SVC and ANN performed well, ANN was preferred for its scalability to larger datasets. ANN achieved a test accuracy of 0.73714, demonstrating its potential for real-world implementation in patient streamlining.</p><p><strong>Discussion: </strong>The study highlights the effectiveness of ML models in improving clinical trial workflows. XGBoost and Random Forest demonstrated robust performance for large clinical datasets in optimizing trial parameters, while ANN proved advantageous for patient eligibility classification due to its scalability. These findings underscore the potential of ML to enhance decision-making, reduce delays, and improve the accuracy of clinical trial outcomes. As ML technology continues to evolve, its integration into clinical research could drive innovation and improve patient care.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"17 ","pages":"1-18"},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actions to Improve the Secondary Prevention of Fragility Fractures in Women with Postmenopausal Osteoporosis: A Social Return on Investment (SROI) Study.","authors":"Francisco Jesús Olmo-Montes, José Ramón Caeiro-Rey, Pilar Peris, Verónica Pérez Del Río, Íñigo Etxebarria-Foronda, José Manuel Cancio-Trujillo, Teresa Pareja, Esteban Jódar, Antonio Naranjo, María Jesús Moro-Álvarez, Manuel García-Goñi, Josep Vergés, Stefano Maratia, Ignasi Campos Tapias, Miriam Prades, Susana Aceituno","doi":"10.2147/CEOR.S480674","DOIUrl":"10.2147/CEOR.S480674","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the Social Return on Investment (SROI) of implementing measures to prevent fragility fractures in postmenopausal women with osteoporosis (OP) in Spain.</p><p><strong>Methods: </strong>A group of 13 stakeholders identified necessary actions for improving refracture prevention and assessed the investment required from the Spanish National Health System (SNHS), considering direct, indirect, and intangible costs over a one-year period. Unitary costs were sourced from scientific literature and official data, and intangible costs were estimated through surveys on women's willingness to pay for better health-related quality of life. The SROI ratio was calculated from both a social perspective (including all returns) and the SNHS perspective (including only direct and intangible costs). A sensitivity analysis evaluated the returns in worst- and best-case scenarios over three years.</p><p><strong>Results: </strong>Stakeholders agreed on four main actions: 1) establishing fracture liaison services; 2) harmonizing clinical practice guidelines and provide training for healthcare professionals (HCPs); 3) promoting HCPs' adherence to fracture registries and 4) raising awareness of OP and fragility fractures. From the social perspective, implementing these actions would cost the SNHS €4,375,663 but yield a social return of €96,939,931 in the first year, resulting in a SROI ratio of €22.15 per euro invested (€28.69, 23.14, 24.29, and 10.70 for the four actions, respectively). From the SNHS perspective, the return would be €36,453,509 (€21,523,444 tangible), with a SROI of €8.33 (€4.92 tangible) and for the four actions: €9.99, 9.39, 8.45, and 3.79, respectively (€5.89, 5.54, 4.96 and 2.27 tangible). The investment would be lower than the return for all actions (3.49%, 4.32%, 4.12% and 9.34% of social perspective return, respectively) and scenarios.</p><p><strong>Conclusion: </strong>According to our SROI method, implementing different actions to improve secondary fracture prevention would achieve a considerable social benefit, which, in terms of direct, indirect, and intangible costs, would far outweigh the investment.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"889-901"},"PeriodicalIF":2.1,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Budget Impact Analysis of Implementing Patient Blood Management in the Cardiovascular Surgery Department of a Turkish Private Hospital.","authors":"Mehtap Tatar, Cansu Selcan Akdeniz, Utku Zeybey, Salih Şahin, Çavlan Çiftçi","doi":"10.2147/CEOR.S481565","DOIUrl":"10.2147/CEOR.S481565","url":null,"abstract":"<p><strong>Purpose: </strong>In cardiovascular surgeries, iron deficiency anemia and transfusion of blood products are associated with mortality and morbidity, prolonged hospital stay and poor patient outcomes. Patient blood management (PBM) is a patient-centered approach based on a 'three pillar' model that promotes optimum use of blood and blood products to improve outcomes. This study assessed the potential budget impact of implementing PBM in patients undergoing elective cardiovascular surgery in a private hospital in Turkey.</p><p><strong>Methods: </strong>Two models were developed to estimate the hospital budget impact of PBM. The first model encompassed implementation of the first pillar of PBM, which proposes treatment of iron deficiency anemia before a surgical procedure. The second covered implementation of all three pillars of PBM. Budget impact was estimated from the number of avoided complications after treating iron deficiency anemia and reducing blood transfusions. Rates of complication (sepsis, myocardial infarction, renal failure and stroke) with and without PBM were taken from published meta-analyses. Data on 882 cardiovascular operations performed during 2020-2022 were taken from the Florence Nightingale Istanbul Hospital. The costs of treating complications were estimated by applying Turkish Social Security Institution prices to a healthcare resource utilization tool for each complication completed by experts.</p><p><strong>Results: </strong>Results from the budget impact analysis showed that, by implementing the first pillar of PBM, the department could have avoided 30 complications and saved 4,189,802 TRY. For the second model based on implementing all three pillars of PBM, 29 complications could have been avoided by reducing the number of transfusions, with budget savings of 6,174,434 TRY. Reducing the length of hospital stay could have enabled 137 additional operations in the given period.</p><p><strong>Conclusion: </strong>Implementation of PBM in patients undergoing elective cardiovascular surgery in private hospitals could be a budget-saving strategy in Turkey and may provide an opportunity to increase revenue.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"877-887"},"PeriodicalIF":2.1,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resources Utilization Assessment and Cost-Minimization Analysis of the 6-Monthly Formulation of Triptorelin in the Treatment of Prostate Cancer in China.","authors":"Ying Chen, Jiahua Pan, Yan Zhong, Bin Wu, Mengxia Yan, Ruiyun Zhang","doi":"10.2147/CEOR.S485856","DOIUrl":"10.2147/CEOR.S485856","url":null,"abstract":"<p><strong>Objective: </strong>Prostate Cancer can be treated with various formulations of Gonadotropin-Releasing Hormone Agonists (GnRHa), but cost analyses of these treatments in China are lacking. This study aims to evaluate the differences in cost and resource utilization between various formulations of GnRHa for Prostate Cancer by conducting a resource utilization assessment and cost minimization analysis.</p><p><strong>Methods: </strong>From the perspective of society and medical healthcare, this study used the cost minimization model to generate cost and resource estimates for GnRHa drug acquisition and administration for \"Current practice\" and for a \"Base case\" scenario. In the \"Base case\" scenario, all of the patients who were receiving 1-monthly or 3-monthly GnRHa therapy in \"Current practice\" switched to a 6-monthly formulation triptorelin. Cost/Resource estimates were calculated per patient per administration and scaled to annualized population levels. Deterministic sensitivity analysis was conducted to explore the uncertainty of the model variables and applied assumptions.</p><p><strong>Results: </strong>From a societal perspective, if all 1-monthly and 3-monthly formulations of GnRHa were switched to a 6-monthly formulation triptorelin, it is conservatively estimated that the annual societal cost could be reduced by ¥13,382,951.13, with an average annual cost savings of ¥46.53 per patient. Additionally, the 6-monthly formulation could save 3,608,973.91 hours annually, translating to an average time savings of 12.55 hours per patient, reducing treatment time by 78%. From a healthcare system perspective, if the introduction of the 6-monthly formulation of GnRHa is delayed, it would lead to an annual increase of ¥94 million in medical costs, and require an additional 64,445.96 working days for doctors and nurses. Deterministic sensitivity analysis demonstrated the model's robustness, showing the 6-monthly GnRHa remains cost-effective across various parameter changes, with drug price being the most influential factor.</p><p><strong>Conclusion: </strong>Compared to current 1-monthly and 3-monthly formulations, the 6-monthly GnRHa can reduce the total burden associated with prostate cancer treatment.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"869-875"},"PeriodicalIF":2.1,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive and Interpretable Machine Learning of Economic Burden: The Role of Chronic Conditions Among Elderly Patients with Incident Primary Merkel Cell Carcinoma (MCC).","authors":"Yves Paul Vincent Mbous, Zasim Azhar Siddiqui, Murtuza Bharmal, Traci LeMasters, Joanna Kolodney, George A Kelley, Khalid M Kamal, Usha Sambamoorthi","doi":"10.2147/CEOR.S456968","DOIUrl":"10.2147/CEOR.S456968","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate chronic conditions as leading predictors of economic burden over time among older adults with incident primary Merkel Cell Carcinoma (MCC) using machine learning methods.</p><p><strong>Methods: </strong>We used a retrospective cohort of older adults (age ≥ 67 years) diagnosed with MCC between 2009 and 2019. For these elderly MCC patients, we derived three phases (pre-diagnosis, during-treatment, and post-treatment) anchored around cancer diagnosis date. All three phases had 12 months baseline and 12-months follow-up periods. Chronic conditions were identified in baseline and follow-up periods, whereas annual total and out-of-pocket (OOP) healthcare expenditures were measured during the 12-month follow-up. XGBoost regression models and SHapley Additive exPlanations (SHAP) methods were used to identify leading predictors and their associations with economic burden.</p><p><strong>Results: </strong>Congestive heart failure (CHF), chronic kidney disease (CKD) and depression had the highest average incremental total expenditures during pre-diagnosis, treatment, and post-treatment phases, respectively ($25,004, $24,221, and $16,277 (CHF); $22,524, $19,350, $20,556 (CKD); and $21,645, $22,055, $18,350 (depression)), whereas the average incremental OOP expenditures during the same periods were $3703, $3,013, $2,442 (CHF); $2,457, $2,518, $2,914 (CKD); and $3,278, $2,322, $2,783 (depression). Except for hypertension and HIV, all chronic conditions had higher expenditures compared to those without the chronic conditions. Predictive models across each of phases of care indicated that CHF, CKD, and heart diseases were among the top 10 leading predictors; however, their feature importance ranking declined over time. Although depression was one of the leading drivers of expenditures in unadjusted descriptive models, it was not among the top 10 predictors.</p><p><strong>Conclusion: </strong>Among older adults with MCC, cardiac and renal conditions were the leading drivers of total expenditures and OOP expenditures. Our findings suggest that managing cardiac and renal conditions may be important for cost containment efforts.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"847-868"},"PeriodicalIF":2.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral Economic Strategies Increase Adverse Event Reporting in Pediatric Anesthesia.","authors":"Tiffany K Guan, Brittany L Willer, Jack Stevens, Joseph D Tobias, Vanessa A Olbrecht","doi":"10.2147/CEOR.S499363","DOIUrl":"10.2147/CEOR.S499363","url":null,"abstract":"<p><strong>Introduction: </strong>Identification and reporting of severe adverse events (SAEs) during anesthesia care remains critical in identifying areas of improvement in perioperative patient care. Although many healthcare organizations rely on the self-reporting of SAEs, under-reporting may limit the identification of the true incidence of these events. To circumvent these barriers, many healthcare systems leverage the Electronic Medical Record (EMR) by incorporating an Anesthesia Information Management System (AIMS).</p><p><strong>Methods: </strong>We followed the Institute for Healthcare Improvement's Model of Improvement and implemented behavioral economic-based interventions to our perioperative practice including adding a deliberation-promoting \"hard stop\" that required the anesthesiologists to report the occurrence or absence of a \"notable event\" prior to closing a patient's encounter in the EMR system.</p><p><strong>Results: </strong>At baseline, 53% of SAEs were self-reported. The interventions resulted in a baseline shift to more than 75% self-reporting, a relative increase of 42%.</p><p><strong>Conclusion: </strong>An increase in reporting of SAEs was achieved with simple interventions including modifications of the EMR which were done with limited financial impact or interruption in the work flow.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"841-845"},"PeriodicalIF":2.1,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Service Satisfaction and Sustainability of the Afya Health Insurance Scheme in Kuwait: An Exploratory Analysis [Response to Letter].","authors":"Maha Alnashmi, Nuzhat Masud Bhuiyan, Nour AlFaham, Ahmad Salman, Hanadi AlHumaidi, Nabeel Akhtar","doi":"10.2147/CEOR.S504544","DOIUrl":"10.2147/CEOR.S504544","url":null,"abstract":"","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"16 ","pages":"839-840"},"PeriodicalIF":2.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}