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Roundtable discussion. Cost justification of innovative drugs through assessment of total health care costs. 圆桌会议讨论。通过评估医疗保健总费用来确定创新药物的成本合理性。
Hospital formulary Pub Date : 1993-01-01
M J Rybak, R Allen, P C Craven, R Freeman, C H Nightingale, C Normand, E Rubinstein, G S Schaison, G Whitelaw
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引用次数: 0
Cost implications of malpractice and adverse events. 医疗事故和不良事件的成本影响。
Hospital formulary Pub Date : 1993-01-01
J Korin
{"title":"Cost implications of malpractice and adverse events.","authors":"J Korin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The ninth most common allegation against hospitals in 1989 was infection/contamination exposure, with the average claim costing nearly $34,000. Most malpractice claims are associated with inpatient surgery, according to 1990 statistics, and the average cost of a claim for infection and contamination related to surgery was over $64,000 in 1990. Physicians currently pay as much as $50,000 annually for malpractice insurance, and hospitals in some major metropolitan areas pay $8,000 per bed for insurance. An estimated 5% of hospitalized patients acquire nosocomial infections at an annual cost of approximately $10 billion. Prolonged hospitalization, usually for parenteral antibiotic treatment, accounts for more than three-fourths of this cost. To reduce the costs of malpractice, nosocomial infections can be prevented through infection-control programs, or damages can be reduced by treating infections with more efficacious and safer drugs that decrease the pain and suffering associated with the infection.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"28 Suppl 1 ","pages":"59-61"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The true cost of monitoring antibiotic levels. 监测抗生素水平的真实成本。
Hospital formulary Pub Date : 1993-01-01
R N Grüneberg
{"title":"The true cost of monitoring antibiotic levels.","authors":"R N Grüneberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Antibiotic assays are most often ordered for the purpose of toxicity monitoring, which usually involves determination of peak and trough antibiotic concentrations in the blood. The cost of monitoring antibiotic levels is probably higher than is commonly appreciated. Factors that contribute to the cost of this service include staffing the microbiology laboratory with appropriate personnel, who are responsible for determining the adequacy of sample collection and related patient information; analyzing the specimens in a timely manner; and taking action to modify drug dosage and dosage intervals in light of the test results. There are also costs related to the reagents, consumables, and equipment used in the assay, as well as to revenue and capital overheads. Additional clinical and laboratory costs can be incurred in the event of litigation pursuant to antibiotic-induced toxicity. With hospital and government policymakers devoting increasing attention to the escalating costs of health care, pressure to move away from the routine use of drugs having dose-related toxicity may increase, the objective being to save on assay costs.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"28 Suppl 1 ","pages":"55-8"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparisons among national health care systems in the European marketplace. 欧洲市场国家卫生保健系统的比较。
Hospital formulary Pub Date : 1993-01-01
C Normand
{"title":"Comparisons among national health care systems in the European marketplace.","authors":"C Normand","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Most European countries have adopted either a Bismarckian system of compulsory health care insurance or a national health care system funded by taxation. For both systems, a basic level of health care is free at the point of use for all citizens. Health care has been undergoing reforms in most European countries. In the western nations, the autonomy of providers of services has increased, elements of competition and cost control have been introduced, and incentives to provide more cost-effective care have been initiated. Most central and eastern European countries have begun to return to the social insurance model for funding services. The ownership of some hospitals in these countries has been transferred to the private sector or to not-for-profit organizations. The European countries vary widely in their standards of facilities and professional staffing, and these generally reflect the prosperity of the country. During the 1980s, western countries implemented measures to limit the growth of health care expenditure, resulting in some reduction in the proportion of the gross domestic product spent on health care. Cost controls may not be as effective in the 1990s, as a result of demographic changes. More modern health care systems will likely develop in some of the central and eastern European countries, although this change will probably be slow.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"28 Suppl 1 ","pages":"6-11"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20994333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-effectiveness issues for home i.v. therapy in the United States. 美国家庭静脉注射治疗的成本效益问题。
Hospital formulary Pub Date : 1993-01-01
R Allen
{"title":"Cost-effectiveness issues for home i.v. therapy in the United States.","authors":"R Allen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The popularity of home infusion therapy is increasing as it becomes recognized as a cost-effective alternative to hospitalization with the added benefit of improving patient quality of life. Selection of appropriate candidates for home i.v. therapy requires consideration of many variables pertaining to the medical and psychosocial suitability of the patient. Innovations in drug delivery devices have created opportunities for patients to receive parenteral therapy at home who would otherwise be considered inappropriate candidates for this treatment option. The cost of providing home IV therapy is mainly attributable to pharmacy and nursing services. Other contributing cost factors include the expense of ancillary supplies, supply delivery and management, and those costs created by administrative and regulatory requirements. When appropriately managed, home administration of IV medications can be a cost-effective way of delivering safe, effective, and quality care to an increasing population of patients.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"28 Suppl 1 ","pages":"37-40"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-control issues within the hospital environment in the United Kingdom. 英国医院环境中的成本控制问题。
Hospital formulary Pub Date : 1993-01-01
R Freeman
{"title":"Cost-control issues within the hospital environment in the United Kingdom.","authors":"R Freeman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Health care in the United Kingdom is dominated by the National Health Service, which operates under a system in which care is delivered free at the point of need and is funded by taxation. Experimentation with a number of different models has occurred since 1980 and has culminated in recent National Health Service reforms characterized by the separation of purchaser and provider functions. An inescapable result of this is the formal definition of the relationship between need and service provision (contracts or performance arrangements), and the equally unavoidable costing of \"patient episodes\" or equivalent as a tool for estimating both supply and demand. This change has completely altered the way in which individual capital and revenue costs are viewed in the National Health Service. With regard to drugs, costs can now be seen as part of a patient's consumption of resources as opposed to a hospital budget heading. The new system acknowledges that higher drug costs can be incurred if the overall patient-episode cost is reduced as a result. Such a reduction in average patient costs might then lead to more contract work and a higher revenue for the hospital. Quality of care specifications by purchasers may also affect drug costs.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"28 Suppl 1 ","pages":"12-5"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20994640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treating bone and joint infections with teicoplanin: hospitalization vs outpatient cost issues. 用替柯planin治疗骨关节感染:住院与门诊费用问题。
Hospital formulary Pub Date : 1993-01-01
P C Craven
{"title":"Treating bone and joint infections with teicoplanin: hospitalization vs outpatient cost issues.","authors":"P C Craven","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The relative cost of outpatient parenteral antibiotic treatment of bone and joint infections with the investigational drug teicoplanin was compared with the cost of inpatient treatment. A private practice infectious disease group used teicoplanin to treat 49 patients (53 treatment courses) with bone and joint infections. The outpatient treatment program \"saved\" $403,680 compared with inpatient treatment, based on per diem reimbursements of $700 for inpatient treatment and $220 for outpatient treatment. Any cost analysis should be interpreted carefully because accurate calculation of outpatient treatment savings requires distinguishing among actual costs, charges, and reimbursements. In addition, there may be hidden costs related to lack of efficacy, toxicity, or litigation. Consideration should also be given to whoever is the beneficiary of the savings. Is it the indemnity insurance company, the provider, or the patient? Specific characteristics of the treatment, including ease of use, effectiveness, and monitoring requirement, may affect the savings. Our study showed that teicoplanin allows once-daily dosing, is easily administered, is generally efficacious, and has minimum requirements for blood level monitoring. These characteristics improve the cost effectiveness of using the drug in an outpatient treatment program.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"28 Suppl 1 ","pages":"41-5"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current treatment of gram-positive infections: focus on efficacy, safety, and cost minimalization analysis of teicoplanin. 目前革兰氏阳性感染的治疗:重点是替柯planin的疗效、安全性和成本最小化分析。
Hospital formulary Pub Date : 1992-12-01
V S Crane, S M Garabedian-Ruffalo
{"title":"Current treatment of gram-positive infections: focus on efficacy, safety, and cost minimalization analysis of teicoplanin.","authors":"V S Crane,&nbsp;S M Garabedian-Ruffalo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The current health care environment has had a significant impact on hospital Pharmacy and Therapeutics Committee formulary decisions. In evaluating a new therapy for formulary inclusion, a cost savings along with equivalent or an improvement in patient care and safety is optimal. Teicoplanin is an investigational glycopeptide antimicrobial agent with a spectrum of activity similar to vancomycin. Unlike vancomycin, however, teicoplanin has a long elimination half-life permitting administration once daily, and is well tolerated when given intramuscularly. In addition, teicoplanin is associated with a favorable safety profile. Red man syndrome does not appear to be a significant clinical problem. Results of our cost minimalization analysis using the average acquisition costs of vancomycin revealed that teicoplanin (400 mg), at an average acquisition cost of less than $28.46 when administered intravenously and $30.93 when administered intramuscularly, offers a clinically efficacious, safe, and less expensive alternative to vancomycin therapy.</p>","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 12","pages":"1199-200, 1203-4, 1207-10"},"PeriodicalIF":0.0,"publicationDate":"1992-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20992963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost of treatment outcomes: a meeting sponsored by The Managed Health Care Congress Northeast--New York. 治疗结果的成本:由管理卫生保健大会主办的东北-纽约会议。
Hospital formulary Pub Date : 1992-11-01
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引用次数: 0
Issues in formulary management: therapeutic interchange. Establishing guidelines: roundtable discussion, Part 1. 处方管理中的问题:治疗互换。建立指导方针:圆桌讨论，第1部分。
Hospital formulary Pub Date : 1992-10-01
C Mahoney, M Cichon, M Cromer, H DeGiulio, B Renshaw, F A Rodriguez, D Wert
{"title":"Issues in formulary management: therapeutic interchange. Establishing guidelines: roundtable discussion, Part 1.","authors":"C Mahoney,&nbsp;M Cichon,&nbsp;M Cromer,&nbsp;H DeGiulio,&nbsp;B Renshaw,&nbsp;F A Rodriguez,&nbsp;D Wert","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76912,"journal":{"name":"Hospital formulary","volume":"27 Suppl 2 ","pages":"4-8"},"PeriodicalIF":0.0,"publicationDate":"1992-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20993708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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