Medical economics最新文献_第4页

Post-Implementation Cost-Analysis of the ICD-10-CM Transition on Small andMedium-Sized Medical Practices ICD-10-CM在中小型医疗实践中的转换实施后成本分析

Medical economics Pub Date : 2018-01-01 DOI: 10.21767/2471-9927.100037

Parth M. Desai, Rachelle Eljazzar

{"title":"Post-Implementation Cost-Analysis of the ICD-10-CM Transition on Small andMedium-Sized Medical Practices","authors":"Parth M. Desai, Rachelle Eljazzar","doi":"10.21767/2471-9927.100037","DOIUrl":"https://doi.org/10.21767/2471-9927.100037","url":null,"abstract":"Introduction: On October 1, 2015, the United States made a major transition in its medical billing and coding system, by switching from ICD-9-CM to ICD-10-CM. Several cost-analysis studies have attempted to estimate the eventual impact of the ICD-10-CM transition on medical practices, but all were completed prior to the actual transition deadline. Our study seeks to assess the post-implementation financial impact of the transition on small and medium medical practices which used a set of non-profit resources for their implementation. Methods: 6,000 medical practices were randomly selected from the approximately 70,000 user database of a non-profit ICD-10 provider and emailed a seven question survey. 419 practices completed the full survey (8.5% response rate), providing practice demographics, as well as estimates for the hours spent and cost accrued on the implementation. Results: Based on the reported data, the average total explicit cost of the ICD- 10-CM implementation was $1,206 for small medical practices and $2,462 for medium medical practices. The average total number of staff hours spent was 61.2 hours for small practices and 139 hours for medium-sized practices. The average total number of physician hours spent was 35.6 hours and 75.1 hours, respectively. Discussion: The total average cost of the ICD-10-CM implementation was calculated to be between $6,748 to $9,564 for a small medical practice and between $14,577 to $23,062 for a medium-sized medical practice. The results of this study suggest that for practices which used a set of free online resources, the eventual financial impact of the ICD-10-CM transition was less than predicted by the landmark Nachimson report for the American Medical Association (AMA), but greater than the study by Kravis et al (3M).","PeriodicalId":79685,"journal":{"name":"Medical economics","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2471-9927.100037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145561","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: 1

Functioning of RNTCP in Kashmir Division of J&K State (India) RNTCP在查谟克什米尔邦克什米尔司的运作(印度)

Medical economics Pub Date : 2018-01-01 DOI: 10.21767/2471-9927.100036

S. Saleem

引用次数: 0

Cost-Effectiveness Analysis of Regorafenib for Third-line Metastatic Colorectal Cancer Compared to Cetuximab Plus Irinotecan in China 瑞非尼治疗三线转移性结直肠癌与西妥昔单抗联合伊立替康的成本-效果分析

Medical economics Pub Date : 2018-01-01 DOI: 10.21767/2471-9927.100038

Shuiqing Zhu, Jin Liu, Wentao Sun, L. Tao, D. Xiao, J. Xuan

{"title":"Cost-Effectiveness Analysis of Regorafenib for Third-line Metastatic Colorectal Cancer Compared to Cetuximab Plus Irinotecan in China","authors":"Shuiqing Zhu, Jin Liu, Wentao Sun, L. Tao, D. Xiao, J. Xuan","doi":"10.21767/2471-9927.100038","DOIUrl":"https://doi.org/10.21767/2471-9927.100038","url":null,"abstract":"Objective: While the clinical effect of regorafenib for third-line metastatic colorectal cancer has been established, the economic effect of adopting the new therapy (regorafenib) is still unclear. The present study aimed to examine the costeffectiveness of regorafenib compared to cetuximab plus irinotecan in the Chinese setting. Methods: A Markov model was constructed to conduct the cost-effectiveness analysis from a third-party payer perspective. The cost of oncology drug, utilization of both in-hospital and outpatient care facilities, administration of medications via parenteral routes, use of supportive care medications, clinical monitoring with lab tests and diagnostic imaging, and care for treatment-emergent severe adverse events were considered. Clinical effectiveness data were obtained from the clinical trials. One-way sensitivity and probability sensitivity analyses were conducted to examine the robustness of the base-case findings. Results: The model projected patients on regorafenib had an incremental gain of 0.03 QALYs relative to cetuximab plus irinotecan (0.68 Vs 0.65) at a cost-saving of ¥195,756 (¥221,860Vs¥417,616). For the subpopulation who received no previous targeted treatment, compared to cetuximab plus irinotecan, regorafenib was expected to result in additional gains of 0.15 QALYs at cost-saving of ¥95,987. Probability sensitivity analyses show that at the threshold of 3 times of GDP per capita of China (¥53,980*3), regorafenib has the probability of 82% to be costeffective against with cetuximab plus irinotecan. Conclusions: Regorafenib monotherapy is cost-saving and more effective compared with cetuximab plus irinotecan regimen in treatment patients with mCRC at third-line treatment setting in China.","PeriodicalId":79685,"journal":{"name":"Medical economics","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2471-9927.100038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145672","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: 2

Cost-Effectiveness of Recombinant HumanTNK Tissue-Type Plasminogen Activator(Rhtnk-Tpa) Versus Recombinant TissuePlasminogen Activator (Rt-PA) in Treating STElevationMyocardial Infarction (STEMI) 重组人tnk组织型纤溶酶原激活剂(rhtink - tpa)与重组组织型纤溶酶原激活剂(Rt-PA)治疗STEMI的成本-效果比较

Medical economics Pub Date : 2018-01-01 DOI: 10.21767/2471-9927.100035

Shuiqing Zhu, H. Yin, Dennis Xuan, D. Xiao, Yingrui Xu, Qingcheng Yang, J. Xuan

{"title":"Cost-Effectiveness of Recombinant HumanTNK Tissue-Type Plasminogen Activator(Rhtnk-Tpa) Versus Recombinant TissuePlasminogen Activator (Rt-PA) in Treating STElevationMyocardial Infarction (STEMI)","authors":"Shuiqing Zhu, H. Yin, Dennis Xuan, D. Xiao, Yingrui Xu, Qingcheng Yang, J. Xuan","doi":"10.21767/2471-9927.100035","DOIUrl":"https://doi.org/10.21767/2471-9927.100035","url":null,"abstract":"Objective: While the clinical effect of rhTNK-tPA in STEMI treatment has been established, the economic effect of adopting the new therapy (rh-TNK-tPA) is still unclear. The present study aimed to examine the cost-effectiveness of rhTNK-tPA compared with rt-PA in the Chinese setting. Methods: A Markov model was constructed to conduct the cost-effectiveness analysis from a third-party payer perspective. Costs of PCI, rehabilitation after discharge, CABG, myocardial ischemia recurrence, cardiac shock, reinfarction, and adverse events were considered. Clinical effectiveness data were obtained from the pivotal phase II clinical trial. Sensitivity analyses were conducted to examine the robustness of the base-case findings. Results: The total cost of treatment for the 30 days after STEMI onset in the rhTNK-tPA and rt-PA arms were ¥30,846 and ¥31,314, respectively. The QALYs of rhTNK-tPA and rt- PA arms were 0.0345 and 0.0343 respectively. RhTNK-tPA was dominant. The total cost of lifetime in the rhTNK-tPA and rt-PA arms were ¥134,519 and ¥134,311, respectively. The corresponding QALYs in the rhTNK-tPA and rt-PA arms were 6.397 and 6.356, respectively. The ICER of rhTNK-tPA vs. rt-PA treatment was ¥5,020/QALY. The sensitivity analyses showed that rhTNK-tPA was dominant in most scenarios. Conclusions: RhTNK-tPA therapy is cost-saving and more effective compared with rt-PA for STEMI treatment in the Chinese population.","PeriodicalId":79685,"journal":{"name":"Medical economics","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2471-9927.100035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145715","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

Cardiometabolic Syndrome 代谢疾病综合症

Medical economics Pub Date : 2018-01-01 DOI: 10.5772/33050

A. Ala’a, Albert Adelin, G. Michèle

引用次数: 4

Improving Individual Engagement in Care with Big Data 利用大数据提高个人在护理中的参与度

Medical economics Pub Date : 2018-01-01 DOI: 10.21767/2471-9927.100034

Peter Meyer

引用次数: 0

Principles of Soft Tissue Management in Dental Implants 植牙软组织处理原则

Medical economics Pub Date : 2017-02-27 DOI: 10.21767/2471-9927.100027

Xiao-quan Mao

{"title":"Principles of Soft Tissue Management in Dental Implants","authors":"Xiao-quan Mao","doi":"10.21767/2471-9927.100027","DOIUrl":"https://doi.org/10.21767/2471-9927.100027","url":null,"abstract":"Objective: To evaluate the impact of soft tissue factors in dental implants. Data: Studies evaluating the role of soft tissues in dental implants were included in this review. \u0000Sources: A comprehensive literature search of English and Chinese language articles was performed via electronic databases (PubMed, Cochrane Library, Web of Science, CNKI and VIP) using the appropriate key words(esthetic; evaluation; impact factor; soft tissue). The most recent search took place in January 2016. \u0000Study selection: Potentially appropriate articles were identified and evaluated for eligibility through a predefined review process conducted by two examiners. Only 16 out of the 346 identified records met criteria and were included in the final analysis. \u0000Conclusion: The success of dental implants depends on two outcomes, the functional utility of the implant and its beauty. During the early phase of treatment, the main objective of a dental implant is to achieve adequate function. In clinical practice, however, subsequent soft tissue retraction and implant exposure have a significantly negative impact on implant esthetics, especially in young women's teeth, which can also be considered as implant failure. It is particularly important to understand how to support the surrounding soft tissue so that it is esthetically pleasing.","PeriodicalId":79685,"journal":{"name":"Medical economics","volume":"3 1","pages":"36-39"},"PeriodicalIF":0.0,"publicationDate":"2017-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2471-9927.100027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44498238","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

An Economic Analysis of the CostEffectiveness of Blood Gene ExpressionProfiling in Kidney Transplant Recipients 肾移植受者血液基因表达谱成本效益的经济分析

Medical economics Pub Date : 2017-01-01 DOI: 10.21767/2471-9927.100029

M. RoyFirst, Darren Lee, P. Lewis, S. Rose

{"title":"An Economic Analysis of the CostEffectiveness of Blood Gene ExpressionProfiling in Kidney Transplant Recipients","authors":"M. RoyFirst, Darren Lee, P. Lewis, S. Rose","doi":"10.21767/2471-9927.100029","DOIUrl":"https://doi.org/10.21767/2471-9927.100029","url":null,"abstract":"Background: Significant challenges exist to detecting kidney injury early in patients with kidney transplants. The current standard of care includes monitoring serum creatinine levels and immunosuppressive drug levels, both of which are poor early predictors of kidney graft damage. Protocol (surveillance) biopsies provide an accurate assessment of the transplanted kidney but are expensive, invasive, risking infection and bleeding and even graft loss, such that they are unsuited for frequent monitoring. Objectives: An economic analysis was performed to assess the economic impact of replacing protocol biopsies with blood molecular gene profiling in kidney transplant recipients. Methods: For the economic analysis, we utilized CMS fee schedule data, actual patient billing examples and published literature to estimate the per-patient tested savings of replacing protocol biopsies with the TruGraf blood test to monitor kidney transplant recipients. Results: The TruGraf test provides a net savings of $1,302 per patient per year, including the TruGraf test costs. In 2016, 19,060 kidney transplants were performed; replacing protocol biopsies with TruGraf testing could save $24.8 million in direct treatment costs per year. Conclusions: Use of the TruGraf blood test could spare patients unnecessary protocol biopsies. The healthcare system will realize significant economic benefits; in addition, the ability to intervene early with therapies to fend off clinical acute rejection may provide the added benefit of improving long term outcomes.","PeriodicalId":79685,"journal":{"name":"Medical economics","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2471-9927.100029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145032","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: 11

Efficient Use of Diagnostic Imaging andObjective Evaluation of Work that ReflectsPatient Condition 诊断影像的有效利用和反映病人状况的客观评价

Medical economics Pub Date : 2017-01-01 DOI: 10.21767/2471-9927.100030

K. Shida, Y. Uto, F. Muranaga, T. Iwaanaguchi, I. Kumamoto

{"title":"Efficient Use of Diagnostic Imaging andObjective Evaluation of Work that ReflectsPatient Condition","authors":"K. Shida, Y. Uto, F. Muranaga, T. Iwaanaguchi, I. Kumamoto","doi":"10.21767/2471-9927.100030","DOIUrl":"https://doi.org/10.21767/2471-9927.100030","url":null,"abstract":"In this study, as a secondary use of data stored on the hospital’s information system, we developed a tool for calculating scan time and personnel cost based on patient condition with a view to realizing safe photographic testing that is tailored to the needs of the aging society, and improving the labour environment. We also calculated personnel costs-as a medical resources input-with the aim to promote the appropriate placement of medical staff and the objective evaluations of work. We utilized data accumulated in the hospital information system to ascertain patient conditions and classified the patients according to patient condition. We calculated the non-enhanced head CT scan times, and then obtained scan time coefficients and personnel cost coefficients. The mean scan time per non-enhanced head CT scan was 5.82 ± 3.83 minutes. The equivalent figure for “carried/freedom level 1” patients was, at 6.59 ± 4.27 minutes, longer than the mean examination time. The personnel costs for scans administered to “unassisted walking” patients were one third of the costs for scans administered to “carried/freedom level 1” patients, suggesting that personnel costs for the same type of scan vary depending on patient condition. Thus, more accurate scan time predictions can be achieved by referring to conveyance category, and especially to freedom level. Furthermore, personnel cost coefficients can serve as a yardstick for making objective evaluations of work.","PeriodicalId":79685,"journal":{"name":"Medical economics","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21767/2471-9927.100030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68144672","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

Colorado Medicaid Hospital Rate Change:The Importance of the Broader Multi-Provider, Multi-Payer Environment 科罗拉多州医疗补助医院费率变化:更广泛的多提供者，多付款人环境的重要性

Medical economics Pub Date : 2017-01-01 DOI: 10.21767/2471-9927.100031

AnaMaria Conley, K. Davidson

引用次数: 0