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case costing

Christopher D Witiw, Fabrice Smieliauskas, John E O'Toole, Michael G Fehlings, Richard G Fessler
BACKGROUND: Surgery for cervical radiculopathy is often approached by either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). ACDF is more common; however, recent single center studies suggest comparable efficacy and significant cost savings with PCF in appropriately selected patients. OBJECTIVE: To compare utilization, adverse events, and costs for each approach from a national perspective. METHODS: Adults undergoing single level ACDF or PCF for cervical radiculopathy were included from a US commercial health insurance claims database spanning 2003 to 2014...
March 14, 2018: Neurosurgery
Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Anatole Manzi, Jean Claude Mugunga, Hari S Iyer, Hema Magge, Fulgence Nkikabahizi, Lisa R Hirschhorn
BACKGROUND: Integrated management of childhood illness (IMCI) can reduce under-5 morbidity and mortality in low-income settings. A program to strengthen IMCI practices through Mentorship and Enhanced Supervision at Health centers (MESH) was implemented in two rural districts in eastern Rwanda in 2010. METHODS: We estimated cost per improvement in quality of care as measured by the difference in correct diagnosis and correct treatment at baseline and 12 months of MESH...
2018: PloS One
Gennaro Ilardi, Daniela Russo, Silvia Varricchio, Giovanni Salzano, Giovanni Dell'Aversana Orabona, Virginia Napolitano, Rosa Maria Di Crescenzo, Alessandra Borzillo, Francesco Martino, Francesco Merolla, Massimo Mascolo, Stefania Staibano
Human Papilloma Virus (HPV) can play a causative role in the development of sinonasal tract malignancies. In fact, HPV may be the most significant causative agent implicated in sinonasal tumorigenesis and is implicated in as many as 21% of sinonasal carcinomas. To date, there are no definitive, reliable and cost-effective, diagnostic tests approved by the FDA for the unequivocal determination of HPV status in head and neck cancers. We followed an exhaustive algorithm to correctly test HPV infection, including a sequential approach with p16INK4a IHC, viral DNA genotyping and in situ hybridization for E6/E7 mRNA...
March 16, 2018: International Journal of Molecular Sciences
Lucy P Allen, Jorge Baez, Mary Elizabeth C Stern, Ken Takahashi, Frank George
Although some countries have reduced asbestos consumption and instituted bans, other countries continue to produce and consume asbestos even as asbestos-related deaths mount and the associated societal costs are high. Asbestos production and consumption has declined globally; the number of bans has increased; and the speed at which countries have tapered off consumption has increased. Using country-level data, we study the economic impact of historical changes in the production and use of asbestos. We compare changes in gross domestic product (GDP) following the enactment of asbestos bans...
March 16, 2018: International Journal of Environmental Research and Public Health
Yves Lacasse, Ai-Yui M Tan, François Maltais, Jerry A Krishnan
Two landmark trials conducted more than 35 years ago provided scientific evidence that, under very specific circumstances, long-term oxygen therapy (LTOT) may prolong life. These two trials enrolled 290 patients with chronic obstructive pulmonary disease (COPD) and severe daytime hypoxemia documented by direct arterial blood gas measurement. From this moment, LTOT became a standard of care and the indications for oxygen therapy have expanded to include nocturnal oxygen therapy for isolated nocturnal oxygen desaturation, ambulatory oxygen to correct exercise-induced desaturation, and short-burst oxygen to relieve dyspnea...
March 16, 2018: American Journal of Respiratory and Critical Care Medicine
Si Xuan She, Jie Yu, Wan Qi Tang, Yinlong Zhu, Yu Bo Chen, Jaka Sunarso, Wei Zhou, Zongping Shao
Perovskite oxide is an attractive low-cost alternative catalyst for oxygen evolution reaction (OER) relative to the precious metal oxide-based eletrocatalysts (IrO2 and RuO2). In this work, a series of Sr-doped La-based perovskite oxide catalysts with compositions of La1-xSrxFeO3-δ (x = 0, 0.2, 0.5, 0.8, and 1) are synthesized and characterized. The OER specific activities in alkaline solution increase in the order of LaFeO3-δ (LF), La0.8Sr0.2FeO3-δ (LSF-0.2), La0.5Sr0.5FeO3-δ (LSF-0.5), SrFeO3-δ (SF) and La0...
March 16, 2018: ACS Applied Materials & Interfaces
S Renshaw, I L Silva, A Hotouras, S D Wexner, J Murphy, C Bhan
The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulcerative Colitis"). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis...
March 15, 2018: Techniques in Coloproctology
Shadi Saleh, Mohamad Alameddine, Angie Farah, Nour El Arnaout, Hani Dimassi, Carles Muntaner, Christo El Morr
OBJECTIVES: Assess the effect of selected low-cost eHealth tools on diabetes/hypertension detection and referrals rates in rural settings and refugee camps in Lebanon and explore the barriers to showing-up to scheduled appointments at Primary Healthcare Centers (PHC). METHODS: Community-based screening for diabetes and hypertension was conducted in five rural and three refugee camp PHCs using an eHealth netbook application. Remote referrals were generated based on pre-set criteria...
March 15, 2018: International Journal of Public Health
Rebecca Shirley, Janka Fazekas, Martin McNally, Alex Ramsden
Aim : This study aimed to define the costs of surgical management of chronic osteomyelitis where free tissue transfer was required in addition to debridement of bone, particularly the increased costs incurred by a return to theatre. We hypothesised that there would be a significantly greater cost when patients required re-exploration for vascular compromise. Method : We retrospectively analysed the costs of a consecutive series of sixty patient episodes treated at the Bone Infection Unit in Oxford from 2012 to 2015...
2018: Journal of Bone and Joint Infection
Anat Rabinovich, Susan R Kahn
The post-thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT) that imposes significant morbidity, reduces quality of life and is costly. After DVT, 20-50% of patients will develop PTS, and up to 5% will develop severe PTS. The principal risk factors for PTS are anatomically extensive DVT, recurrent ipsilateral DVT, obesity and older age. By preventing the initial DVT and DVT recurrence, primary and secondary prophylaxis of DVT will reduce the occurrence of PTS. The effectiveness of elastic compression stockings (ECS) for PTS prevention is controversial...
March 15, 2018: Blood
Alexandra Colvin, Amanda F Saltzman, Jonathan Walker, Jennifer Bruny, Nicholas G Cost
Pheochromocytoma is a rare chromaffin cell tumor that is may be associated with a genetic predisposition, such as Von Hippel-Lindau (VHL) disease. VHL is an autosomal dominant disorder that is characterized by a predisposition to multiple tumors including retinal and central nervous system hemangioblastomas, renal cell carcinoma and pheochromocytomas. The classic presentation of pheochromocytoma is episodic hypertension, headaches, palpitations, and diaphoresis. In the pediatric population, 40% of pheochromocytomas have a hereditary basis...
March 12, 2018: Urology
Adam Whitworth
BACKGROUND: Health-related unemployment is a major issue across advanced economies. Modified versions of well-evidenced Individual Placement and Support (IPS) models of employment support for health cohorts offer considerable potential. A significant gap currently however is the lack of evidence around their financial return on investment. OBJECTIVE/HYPOTHESIS: To provide robust financial return on investment estimates for analytically derived alternative specifications of modified IPS services for the first time in the literature, sensitivity tested across various levels of performance...
March 9, 2018: Disability and Health Journal
Franck Maunoury, Aurore Clément, Chizoba Nwankwo, Laurie Levy-Bachelot, Armand Abergel, Vincent Di Martino, Eric Thervet, Isabelle Durand-Zaleski
OBJECTIVE: To assess the cost-effectiveness of the elbasvir/grazoprevir (EBR/GZR) regimen in patients with genotype 1 chronic hepatitis C virus (HCV) infection with severe and end-stage renal disease compared to no treatment. DESIGN: This study uses a health economic model to estimate the cost-effectiveness of treating previously untreated and treatment experienced chronic hepatitis C patients who have severe and end stage renal disease with the elbasvir-grazoprevir regimen versus no treatment in the French context...
2018: PloS One
Michelle Wong, Esther Bejarano, Graeme Carvlin, Katie Fellows, Galatea King, Humberto Lugo, Michael Jerrett, Dan Meltzer, Amanda Northcross, Luis Olmedo, Edmund Seto, Alexa Wilkie, Paul English
Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with the scientific rigor or continuity needed to conduct public health surveillance and inform policy. In Imperial County, California, near the U.S./Mexico border, we used a collaborative, community-engaged process to develop a community air monitoring network that attains the scientific rigor required for research, while also achieving community priorities...
March 15, 2018: International Journal of Environmental Research and Public Health
Qi Zhao, Yunchao Liu, Xiao Yuan, Eric Chitambar, Xiongfeng Ma
Manipulation and quantification of quantum resources are fundamental problems in quantum physics. In the asymptotic limit, coherence distillation and dilution have been proposed by manipulating infinite identical copies of states. In the nonasymptotic setting, finite data-size effects emerge, and the practically relevant problem of coherence manipulation using finite resources has been left open. This Letter establishes the one-shot theory of coherence dilution, which involves converting maximally coherent states into an arbitrary quantum state using maximally incoherent operations, dephasing-covariant incoherent operations, incoherent operations, or strictly incoherent operations...
February 16, 2018: Physical Review Letters
Fenhong Song, Dapeng Ju, Fangwei Gu, Yan Liu, Yuan Ji, Yulin Ren, Xiaocong He, Baoyong Sha, Ben Q Li, Qingzhen Yang
Electric field induced micro/nano patterns in thin polymer film, sometimes referred as electrohydrodynamic patterning, is a promising technique to fabricate micro/nano structures. Extensive attentions have been attracted due to its advantages in micro contact (easy demolding) and low cost. Although considerable work has been done on this technique, including both experimental and theoretical ones, there still appears a requirement for understanding the mechanism of electrohydrodynamic patterning. Thus we systematically studied the effect of different parameters on electrohydrodynamic patterning with a numerical phase field model...
March 15, 2018: Langmuir: the ACS Journal of Surfaces and Colloids
Jee Young Joo, Diane L Huber
Case management is a cost-effective strategy for coordinating chronic illness care. However, research showing how case management affects health care is mixed. This study systematically synthesizes and critically evaluates evidence in systematic reviews of health care utilization outcomes from case management interventions for the care of chronic illnesses. Results are synthesized from seven English language systematic reviews published between January 1990 and June 2017. Hospital readmissions, length of hospital stay, institutionalization, emergency department visits, and hospitals/primary care visits were all identified as health care utilization outcomes of case management interventions...
March 1, 2018: Western Journal of Nursing Research
Liancheng Bing, Aixiu Tian, Fang Wang, Kaifeng Yi, Xingyuan Sun, Guangjian Wang
Hierarchical SSZ-13 microspheres with abundant mesoporous channels have been successfully synthesized by addition of calcined SSZ-13 crystals in the starting gel in the absence of any organic templates. This strategy not only remarkably reduces the production cost and environmental pollution but also significantly decreases the crystallization time as well as evidently reducing the zeolite crystal sizes in many cases. The synthesized sample was characterized by XRD, BET, ICP, SEM, TEM, TG, and NH3-TPD, which indicates that the organic template free synthesized SSZ-13 exhibits high crystallinity, textural properties, and acidity...
March 15, 2018: Chemistry: a European Journal
Xiao Wu, Ajay Malhotra, Bertie Geng, Vivek B Kalra, Khalid Abbed, Howard P Forman, Pina Sanelli
Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...
March 14, 2018: JAMA Surgery
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