Areas Of Cost Savings Research Articles

METHODS OF MANAGEMENT IN PROFESSIONAL ACTIVITY AND PROFESSIONAL TRAINING OF MASTERS OF PHARMACY

The article outlines the importance and role of scientific management methods as a factor in improving the mechanisms of managerial influence on pharmaceutical employees and a component of technologies for training masters of pharmacy in educational institutions to ensure the effective performance of their general and specific functions in the industry. The purpose of the study is to characterize the economic methods of pharmaceutical management, which are related to the activities of a pharmacy manager by the nature of influence and the specifics of their mastering in the process of professional training. The survey of a group of 121 students majoring in the specialty 226 «Pharmacy» has allowed us to identify the demand of future masters of pharmacy for the use of methods of studying and building economic plans in the organization (strategic, tactical, operational), developing a budget for a separate structure (its functions, production and economic processes, areas of cost savings and increased revenues, targeted use of funds, development of internal monitoring, delegation of authority, etc. Aspects of the training content are proposed to fill the gaps in the knowledge of applicants identified during the survey. At the same time, a survey of 49 teachers of pharmaceutical faculties and higher education institutions has revealed the need to apply and study administrative management methods as a set of organizational, administrative, and disciplinary methods of influence on masters of pharmacy. It has been concluded that future masters of pharmacy need to study and master the set of methods of pharmaceutical management in the process of training and practical training at the enterprise.

Epidemiology and Healthcare Expenditure for Skin Disease in Emergency Departments in Alberta, Canada.

There are limited data on the epidemiology and costs associated with managing dermatologic conditions in emergency departments (EDs). To assess the incidence and mean cost per case of skin diseases in EDs in Alberta. Alberta Health Services' Interactive Health Data Application was used to determine the epidemiology and costs associated with nonneoplastic dermatologic diseases in EDs in the province of Alberta, Canada, from 2018 to 2022. Skin conditions were identified using the International Classification of Disease 10th edition diagnostic groupings. Skin disease represented 3.59% of all ED presentations in Alberta in 2022. The total costs associated with managing dermatologic conditions have remained stable over time at approximately 15 million Canadian Dollars (CAD) annually, but the mean cost per case has risen from 188.88 (SD 15.42) in 2018 to 246.25 CAD (SD 27.47) in 2022 (7.59%/year). Infections of skin and subcutaneous tissue were the most expensive diagnostic grouping. The most common dermatologic diagnostic groupings presenting to the ED were infections of skin and subcutaneous tissue [mean age-standardized incidence rate (ASIR) of 143.67 per 100,000 standard population (SD 241.99)], urticaria and erythema [mean ASIR 33.57 per 100,000 standard population (SD 59.13)], and dermatitis and eczema [mean ASIR 18.59 per 100,000 standard population (SD 23.65)]. Cellulitis was both the most common and the costliest individual diagnosis. The majority of patients were triaged as less urgent or nonurgent. Skin disease represents a substantial public health burden in EDs. Further research into drivers of cost change and areas for cost savings is essential.

Strategic Procurement Initiatives and Logistics Performance in Nigeria

This study investigated the strategic procurement initiatives and logistics performance in Nigeria. The study adopted analytical cross sectional design and correlation design. Randomized quota of business owners from ten selected logistics on basis of accidental sampling technique and quota sampling method was utilized for the study. A total population of 400 and sample size of 200 was determined using Slovin's Formula at 0.05 level of significance. The 200 copies of questionnaire were administered, only 196 was deem fit after processing, retriever, coding and cleansing. The Parallel reliability was used to determine the consistency of the instrument that results to 95.50 (0.955). Two research questions and two hypotheses were raised which was tested with parametric measurement using Pearson Product Moment Correlation because of its monotonic functionvia SPSS 25 version. From the findings, procurement sustainability initiatives concept strongly correlates with the logistic performance proxies. Hence, procurement initiatives and e-procurement significantly facilitates the effectiveness and efficiency of logistic performance. Hence, it was revealed that the alternate hypotheses were accepted. Based on the findings and conclusion, this study contributes to the knowledge that e-procurement facilitate logistics performance. It could be recommended that management of logistics firms should adopt strategic initiatives to enhance logistics performance in the area of cost savings; adopting and implementing initiatives such as outscoring, groups purchasing organization, just-in-time and suppliers management relationship.

Projected Impact on Labour Productivity Costs of Cancer-Related Premature Mortality in Europe 2018-2040.

To estimate the potential cost of lost labour productivity due to cancer-related premature mortality in Europe (EU-27 plus Norway, Switzerland, Iceland and United Kingdom) from 2018 to 2040. Deaths and years of potential productive life lost due to 23 types of cancer were estimated for 2018-2040, for 31 European countries. The data were analysed by age groups, by sex and by year. Projected productivity costs were estimated by calculating gross earnings by country, gender and age group using the Human Capital Approach, adjusting for projected labour force participation and unemployment rates. Various data sources were used. Sensitivity analyses were conducted. Between 2018 and 2040, cancer is expected to cause around eight million premature deaths (58% male). The cumulative projected productivity costs in this respect are €1.3 trillion, representing an annual average of €58.7 billion, or 0.43% of the EU-27 gross domestic product. Labour productivity costs are projected to decrease by 6% from 2018 to 2040. The highest cost region is Western Europe, where Germany and France will experience the highest cumulative losses (€288 and €192 billion, respectively). The most costly cancers, in terms of total costs related to productivity losses, are of the lung and colorectum (€264.4 and €116.3 billion, respectively). In terms of average productivity cost per death, the most costly forms of cancer are Hodgkin lymphoma (€301,157) and melanoma (€260,522). The novel information presented could help national policymakers anticipate possible areas for cost savings. Action should be taken on disease prevention, on reducing mortality and on delaying the age of death due to Hodgkin lymphoma, brain cancer, leukaemia and melanoma. Furthermore, the study findings enhance our understanding of macroeconomic variables and could be useful in determining a re-allocation of health expenditures.

Factors associated with target price status within the oncology care model population.

72 Background: The Oncology Care Model (OCM) is an alternative payment model put forth by the Centers for Medicare and Medicaid Services (CMS), which aims to improve quality of care for cancer beneficiaries, while reducing cost. One of the strategies implemented by CMS to achieve this goal was the development of an episode target price (TP), which uses historical data and episode specific adjusters to calculate a total cost of care goal for each episode. The goal of this analysis was to better understand how CMS risk adjustments could account for episode characteristics, as well as how these characteristics affect likelihood of meeting target price. Methods: OCM performance claims data were abstracted retrospectively from performance periods (PP) 1-6 (episodes initiated from 7/1/2016 – 12/31/2019), in which each episode captured 6 months of care. EHR data was linked to identify cancer staging for OCM Beneficiaries. Any OCM beneficiary with at least one episode in PP 1-6 was included. To assess odds of meeting TP, a logistic regression model with a generalized estimating equation was used to account for patients who contributed multiple episodes. Specific factors evaluated for their association with meeting TP included patient’s age and sex, cancer stage, cancer type, cancer related surgery, clinical trial participation, hospice status, inpatient admissions, observational stays, Medicare part B drug use and radiation therapy. Results: 4,612 episodes were included in analysis, which translated to 2,459 patients, who had an average age of 72 years old and were majority female (50.5%). 2,790 (60.5%) of the episodes met the TP set by OCM. When controlling for covariates, radiation treatment (OR = 1.75, 95%CI: 1.39-2.23), stage 2 compared to stage 4 cancers (OR = 1.86, 95%CI: 1.23-2.80), colorectal cancers (OR = 1.75, 95%CI: 1.11-2.77) and melanomas (OR = 4.35, 95%CI: 2.18-8.67) were significantly associated with increased odds of meeting TP. Novel therapies (OR = 0.19, 95%CI: 0.14-0.26), inpatient admissions (OR = 0.27, 95%CI: 0.22-0.33), observational stays (OR = 0.66, 95%CI: 0.51-0.87) and part B drug use (OR = 0.75, 95%CI: 0.60-0.93) were associated with significantly reduced odds of meeting TP. Conclusions: Our analysis suggests that radiation treatment, as well as selected cancer stage and types may contribute to increased likelihood of meeting TP, which may point to potential areas of cost savings. Conversely, specific resource utilizations such as novel therapy use, inpatient admissions, observational stays, and Medicare part B drug use may decrease the odds of meeting TP, despite being adjusted for in the OCM model. While CMS has recognized that late stage cancers require a more sensitive TP with the metastatic adjustment, other adjustments should also be considered to adequately account for episode characteristics. External validation at other OCM-participating practices is needed to corroborate these results.

Effects of Using Music Therapy for Patients Suffering From Dementia.

The purpose of this study was to discuss the mental and physical effects of using music therapy with patients suffering with dementia. Like any type of therapy, there are guidelines for measuring the effects. Music therapy can be used as a substitute for pharmaceuticals with dementia patients. The earlier the diagnosis and the earlier treatment commences for dementia patients, the more likely the treatment will work. Music therapy can reach the part of the brain where we hold memories, which is why it is used as a treatment option for dementia patients. Alzheimer disease and dementia are among the most expensive diseases to treat. However, if the onset of dementia can be delayed, money can be saved. Medicare does not require that music therapy be offered in assisted living, nursing homes, or hospices. Areas of cost savings were identified as use of medication, length of nursing visits, and number and length of home health-aid visits, which can all be measured in total cost savings. For health care managers, it is imperative that new therapies such as music therapy be applied in health care facilities that treat dementia patients.

Dizziness at a Canadian tertiary care hospital: a cost-of-illness study

BackgroundIn the Canadian health care system, determining overall costs associated with a particular diagnostic subgroup of patients, in this case dizzy patients, is the first step in the process of determining where costs could be saved without compromising patient care. This study is the first Canadian study that evaluates these costs at a tertiary care hospital and will allow for the extrapolation of cost data for other similar academic health science centers, regional health initiatives, and provincial healthcare planning structures.MethodsWe conducted a retrospective cohort study of patients of any age presenting to The Ottawa Hospital (TOH), a tertiary care hospital, between January 1st, 2009 and December 31st, 2014 with a main diagnosis of dizziness or dizziness-related disease.De-identified patient information was acquired through TOH Data Warehouse and included a patient’s sex, age, arrival and departure dates, Elixhauser co-morbidity score, location of presentation (emergency department or admitted inpatient) presenting complaint, final diagnosis code, any procedure codes linked to their care, and the direct and indirect hospital costs linked with any admission.We derived the mean hospital costs and 95% confidence interval for each diagnosis. We obtained the number of patients who were diagnosed with dizziness within Ontario in year 2015–16 from Canadian Institute for Health Information (CIHI). A simple frequency multiplication was performed to estimate the total cost burden for Ontario based on the cost estimate for the same year obtained from TOH. Cost data were presented in 2017 Canadian dollars.ResultsThe average total hospital cost per patient with dizziness for the entire cohort is $450 (SD = $1334), with ED only patients costing $359 (SD = $214). The total estimated hospital cost burden of dizziness in Ontario is $31,202,000 (95% CI $29,559,000 – 32,844,000).ConclusionsThe estimated annual costs of emergency department ambulatory and inpatient dizziness in Ontario was calculated to be approximately 31 million dollars per year. This is the first step in identifying potential areas for cost savings to aid local and provincial policy-makers in allocation of health care spending.

Learning Machine Identification of Ferromagnetic UXO Using Magnetometry

The fundamental problem in applying geophysical mapping to locate unexploded ordnance (UXO) is distinguishing true UXO from non-UXO. Enhancing the accuracy of UXO detection has multiple benefits, especially in the areas of cost savings and safety. We investigated discrimination approaches using both magnetic field data and numerically modeled data. Libraries of total field magnetic (TFM) responses were calculated using finite element modeling for three UXO types found at a Montana National Guard training site. UXO model parameters were varied over ranges of azimuth, declination, and depth resulting in approximately 600 models per UXO type. The modeled responses of finite-element model (FEM) and actual TFM field data were then used as training data in discrimination and classification approaches comparing neural networks (NN), random forests (RF), and support vector machines (SVMs). The prediction targets in the training process comprised three classes: 1) binary [UXO or noninteresting object (NIO)]; 2) multiclass (UXO round type and NIO); and 3) classes derived from multiclass self-organizing feature map (SOFM) analysis. The multiclass SOFM targets generated from site-specific field data were found to be optimal for UXO discrimination. The best performing combination of class selection types using recentered data for UXO detection rates of 100% resulted in a false alarm rate (FAR) of 28%.

Economics and Cost of Care of Stone Disease

Nephrolithiasis is associated with a high cost to society because of the high prevalence of disease and high recurrence rates. The total annual medical expenditures for urolithiasis in the United States were estimated at $2.1 billion in 2000. The cost of stone disease reflects the cost of health care services required to manage stone disease and the rate of utilization. Although the care of individuals with urolithiasis has shifted from the inpatient to the outpatient setting and the hospital length of stay has decreased, costs continue to rise because of increases in the prevalence of kidney stones. There are 2 potential areas that would allow for a decrease in stone disease-related costs, lower health care-related costs, and decreased prevalence of stone disease. Reducing treatment-related costs are unlikely to provide a solution to the high cost of caring for stone disease because physician-fee reductions did not result in a significant reduction in costs. Furthermore, there are no significant advancements in surgical technique or technologies in the horizon. One area of cost savings could be to develop better guidelines for acute management, optimizing timing for surgery in acute settings and increasing the practice of medical expulsive therapy. Another area with potential to reduce costs is the reduction of overall stone burden through the prevention of new stones or recurrences. Strategies for primary prevention in high-risk populations have not been studied and represent an area for future research. More efforts should be made to improve medical management of stone formers. These efforts include improving dietary recommendations, identifying barriers to evaluations and treatment of recurrent stone formers, improving patient compliance with recommendations, and development of new medications.

The Costs And Potential Savings Associated With Nursing Home Hospitalizations

Reducing nursing home hospitalizations has been identified as a possible area for cost savings, but little is known about the magnitude of spending associated with these hospitalizations. Using merged hospital and nursing home administrative files from New York State, we found that inflation-adjusted spending on nursing home hospitalizations increased 29 percent from 1999 through 2004. By 2004, aggregate spending totaled roughly $972 million, of which 23 percent was attributable to ambulatory care-sensitive conditions. These data highlight the potential for cost savings associated with programs designed to reduce these potentially avoidable hospitalizations from the nursing home setting.

An effective approach to prediction of the collapse mode in automotive seat structure

Safety is an important issue in automobile design, in which the seat structure plays a crucial part. Engineering of the seat structure has a wide range of benefits for the manufacturer in the areas of cost savings and better design techniques. The seat in an automobile must not only be comfortable for the passenger, but must also be designed to protect the occupant from a wide range of impact situations. The seat structure in our advancing automotive world must also have a simple, lightweight design to keep down material and manufacturing costs. Despite the importance of seat structure design, many manufacturers do not have the time or money to perform an in-depth analysis of multiple different designs. The nonlinear behaviour of the seat structure forces engineers to use virtual prototyping and numerical analysis in its design. Use of a complex model and the long computation time of a numerical model drive up the cost and limit the turn around time in the production and design of an automobile seat structure. This paper proposes a cost-effective analysis of a seat system to ensure the safety of the occupants in the case of a frontal impact. In order to predict the major collapse mode of a seat structure in this scenario, the strength effectiveness of each component in the seat system is examined using a self-developed experimental procedure. To be sure of shear deformation of the inner track section of the seat structure, a detailed FE simulation is carried out, leading to an effective 2-D finite element method with plastic hinge to represent the major collapse mode. The simulation results are then compared with corresponding tests in order to verify their validity.

Critical pathways : a review. Committee on Acute Cardiac Care, Council on Clinical Cardiology, American Heart Association.

Critical pathways, also known as critical paths, clinical pathways, or care paths, are management plans that display goals for patients and provide the sequence and timing of actions necessary to achieve these goals with optimal efficiency.1 As competition in the healthcare industry has increased, managers have embraced critical pathways as a method to reduce variation in care, decrease resource utilization, and potentially improve healthcare quality. Cardiovascular medicine in particular is an area in which critical pathways have been embraced. This is due in part to the high volume and high cost associated with cardiovascular diseases and procedures. In addition, the relatively mature guideline process has also contributed to the growth in use of critical pathways in cardiology. Although anchored in clinical guidelines, the critical pathway is a distinct tool that details processes of care and highlights inefficiencies regardless of whether there is evidence to warrant changes in those processes. Clinical guidelines, on the other hand, are consensus statements that are systematically developed to assist practitioners in making patient management decisions related to specific clinical circumstances.2 Although clinical guidelines can and should be used in pathway development, the majority of processes included in a pathway have not been rigorously tested and are generally not addressed in guidelines. Another term that should also be distinguished from critical pathways is clinical protocols. Protocols are treatment recommendations that are often based on guidelines. Like the critical pathway, the goal of the clinical protocol may be to decrease treatment variation. However, protocols are most often focused on guideline compliance rather than the identification of rate-limiting steps in the patient care process. In further contrast to critical pathways, protocols may or may not include a continuous monitoring and data-evaluation component. Critical pathway techniques were first developed for use in industry as a tool to …

Consensus Development Conference Intravenou men Drug on the Safety Systems: Balancing Safety and Cost

As cost-containment pressures on health care systems continue, traditional practices are searching for ways to deliver care less expensively. Intravenous drug delivery systems have become a targeted area for cost savings in many health care institutions because they are so extensively used. Benchmark systems that have been shown to improve safety, such as unit-dose drug distribution and IV admixture programs, are now being viewed as costly alternatives. Likewise, technologies and innovations that have the potential to improve efficiency and safety are being critically scrutinized. The decision matrix for selection of IV drug delivery systems needs to carefully balance cost, quality, efficiency, and safety—relative to the medication use process as a whole. This article presents the final statement of the Consensus Development Conference on the Safety of Intravenous Drug Delivery Systems, held on September 27–28, 1999, in Phoenix, AZ. The purpose of the conference was to provide a balanced assessment of available IV drug delivery systems.

ID3 Prescribing Patterns for Treatment of Upper Respiratory Infections

OBJECTIVE: To characterize the treatment received by patients with an upper respiratory infection (URI) in the South Carolina Medicaid Population during 1996. Literature suggests that antibiotics are commonly prescribed to patients presenting with symptoms of an URI even though less than 20% are bacterial in origin. Overuse of antibiotics may lead to antibiotic resistance and unnecessary costs. METHODS: Patients with a diagnosis for a cold (ICD-9-CM 460) or URI (ICD-9-CM 465) between 01/01/96 and 12/31/96 were identified. The study design allowed for each subjects to have multiple diagnosis (episodes). for each episode, subjects with prescriptions for antibiotics or symptomatic cold medications within 7 days after the diagnosis were identified. Any episode within 14 days of a claim for a bacterial infection, sinustis or otitis was removed from the study, to rule out the possibility that the antibiotic was related to another infection. RESULTS: A total of 22,791 patients was eligible for inclusion in the study, incurring 27,847 episodes (Range 1–7 episodes). 9468 (34%) of the episodes were treated with an antibiotic, accounting for $166,702.33. This rate is lower than that seen in previous studies; however, our inclusion were more stringent than was used previously. If 20% of URIs are bacterial, approximately 3,900 of these antibiotics were unnecessary. A 25% reduction in the excess prescriptions would provide a cost savings of $17,169.75 for South Carolina Medicaid. CONCLUSION: In spite of comprehensive documentation arguing against using antibiotics for treatment of URIs, it appears that they still remain a popular choice for physicians, with 34% of subjects in this study receiving antibiotics. This represents an area for cost savings for the South Carolina Medicaid Program.