Cost Of Medical Procedures Research Articles

Reduced cervical sampling of hysterectomy specimens with negative margins on conization: An opportunity to improve resource utilization.

The current recommendation for hysterectomy specimens performed for cervical cancer following conization is that the entire cervix be submitted for histologic examination. Given the high cost of medical procedures and concerns regarding difficulties with laboratory staffing, we sought to evaluate the potential for selective histologic examination in this setting. Post-conization hysterectomy cases were reviewed for the presence of residual disease in relation to the findings of the prior conization, with consideration of margin status. Residual disease was then assessed for clinical significance. The number of submitted blocks was recorded and the associated costs were estimated. Among 32 cases with invasive carcinoma, only cases with margins positive for invasive carcinoma on the conization specimen had residual invasion in the hysterectomy (n = 7), and there were no upgrades due to subtle microscopic disease; 1 case had a change in pathologic stage from pT1b1 to pT2b due to parametrial involvement in the setting of a grossly apparent lesion. Among 20 cases performed following a diagnosis of dysplasia, none were upgraded to invasive carcinoma. Based on protocol-based submission of the entire cervix, 16 blocks of cervix were submitted on average (range, 4-41). We estimate that representative sections from each cervical quadrant would save approximately 2 work hours for laboratory staff per case and up to 6 hours for larger cases, reducing costs for the laboratory accordingly. Selective cervical sampling in the setting of negative margins on conization provides an opportunity for improved resource utilization without compromising patient care; as this is a small study, confirmation of these findings in a larger number of cases may be warranted. Additional studies are necessary to determine what other contexts in surgical pathology could benefit from a similar reductive approach.

A Rule-Based Solution to Opaque Medical Billing in the U.S.

Patients and physicians do not know the cost of medical procedures. Opaque medical billing thus contributes to exorbitant, rising medical costs, burdening the healthcare system and individuals. After criticizing two proposed solutions to the problem of opaque medical billing, I argue that the Centers for Medicare and Medicaid Services should pursue a rule requiring that patients be informed by the physician of a reasonable out-of-pocket expense estimate for non-urgent procedures prior to services rendered.

Stand-alone or run together: artificial intelligence as an enabler for other technologies

PurposeThe purpose of this study is to examine the role of artificial intelligence (AI) in transforming the healthcare sector, with a focus on how AI contributes to entrepreneurship and value creation. This study also aims to explore the potential of combining AI with other technologies, such as cloud computing, blockchain, IoMT, additive manufacturing and 5G, in the healthcare industry.Design/methodology/approachExploratory qualitative methodology was chosen to analyze 22 case studies from the USA, EU, Asia and South America. The data source was public and specialized podcast platforms.FindingsThe findings show that combining technologies can create a competitive advantage for technology entrepreneurs and bring about transitions from simple consumer devices to actionable healthcare applications. The results of this research identified three main entrepreneurship areas: 1. Analytics, including staff reduction, patient prediction and decision support; 2. Security, including protection against cyberattacks and detection of atypical cases; 3. Performance optimization, which, in addition to reducing the time and costs of medical procedures, includes staff training, reducing capital costs and working with new markets.Originality/valueThis study demonstrates how AI can be used with other technologies to cocreate value in the healthcare industry. This study provides a conceptual framework, “AI facilitators – AI achievers,” based on the findings and offer several theoretical contributions to academic literature in technology entrepreneurship and technology management and industry recommendations for practical implication.

A Cost-Benefit Analysis of School Nursing in One Large Urban School District.

This study is a cost-benefit analysis examining an urban district's partial school nurse coverage conversion to full-time coverage. Through a partnership with a health care system, the district received funding, resulting in the hiring of full-time nurses to cover all K-8 elementary schools. Researchers compared the cost of nursing services to the savings in teacher, secretary, principal, and parent productivity, reduced medical procedure costs, and grants nurses managed. The year before implementing additional nurses, the return on investment (ROI) to the community for nursing services was calculated to be $1.59 for every dollar invested in schools with full-time coverage and $1.29 for schools with partial coverage. After implementing full-time nurses in each school, there was an ROI of $1.50 during the 2015-2016 school year, $1.64 for 2016-2017, and $1.67 for 2017-2018. The analysis provides evidence that full-time coverage could result in a positive ROI for schools and the community.

Cost of bladder cancer in Lebanon before and after the economic collapse: a probabilistic modeling study

Background and objectivesLebanon has one of the highest incidence rates of bladder cancer (BC) in the world. In 2019, Lebanon’s economy collapsed which majorly impacted healthcare costs and coverage. This study assesses the overall direct costs of urothelial BC in Lebanon, from the perspective of public and private third-party payers (TPP) and households, and evaluates the impact of the economic collapse on these costs.MethodsThis was a quantitative, incidence-based cost-of-illness study, conducted using a macro-costing approach. Costs of medical procedures were obtained from the records of various TPPs and the Ministry of Public Health. We modeled the clinical management processes for each stage of BC, and conducted probabilistic sensitivity analyses to estimate and compare the cost of each stage, pre-and post-collapse, and for each payer category.ResultsBefore the collapse, the total annual cost of BC in Lebanon was estimated at LBP 19,676,494,000 (USD 13,117,662). Post-collapse, the total annual cost of BC in Lebanon increased by 768% and was estimated at LBP 170,727,187,000 (USD 7,422,921). TPP payments increased by 61% whereas out-of-pocket (OOP) payments increased by 2,745% resulting in a decrease in TPP coverage to only 17% of total costs.ConclusionOur study shows that BC in Lebanon constitutes a significant economic burden costing 0.32% of total health expenditures. The economic collapse induced an increase of 768% in the total annual cost, and a catastrophic increase in OOP payments.

Healthcare resource use and associated costs in patients receiving pirfenidone or nintedanib for idiopathic pulmonary fibrosis

BackgroundReal-world data regarding health-care resource use (HCRU) and costs of idiopathic pulmonary fibrosis (IPF) are scarce. In France, at the time of the study, pirfenidone and nintedanib were reimbursed for documented IPF only, with similar reimbursement criteria with regard to disease characteristics, prescription through a dedicated form, and IPF diagnosis established in a multidisciplinary setting. The objective of this study was to evaluate costs related to HCRU in patients newly treated with pirfenidone or nintedanib in 2015–2016, in France, using the exhaustive claims data of the French National Health System. MethodsPatients aged <50 years or who had pulmonary fibrosis secondary to an identified cause were excluded. HCRU-related costs up to 31 December 2017 were compared using generalized linear models adjusted for age, sex, year of treatment initiation, time to treatment initiation and proxies of disease severity identified during a pre-treatment period. ResultsDuring the study period, a treatment with pirfenidone or nintedanib was newly initiated in 804 and 509 patients, respectively. No difference was found between groups for age, sex, time to treatment initiation, Charlson comorbidity score, and number of hospitalisations or medical visits prior to treatment initiation. As compared to pirfenidone, nintedanib was associated with higher costs for medications (1.2; 95% CI, 1.1–1.3) and medical visits (1.3; 95% CI, 1.2–1.4), as well as a higher global cost (1.1; 95% CI, 1.0–1.2). The costs of medical procedures, hospitalizations and indirect HCRU did not statistically differ between the two cohorts. ConclusionsThis observational study identified potential differences in HCRU-related costs under newly prescribed antifibrotic drugs, deserving further explorations.

Awareness of the costs of selected medical procedures and the use of healthcare among young adults in Poland

Aim: The study aimed to test students' awareness of the costs of selected medical procedures. Another aim was to identify the frequency of used medical benefits both as part of public and private medical care.&#x0D; Materials and Methods: The research group included 246 people, both women, and men, aged 19-29, studying in Poland. An anonymous research questionnaire was used to conduct the study, which was sent to 21 universities in Poland (medical universities and physical education academies). The questionnaire asked participants to estimate the costs of treatments and investigations. The respondents were also asked which services of medical specialists they used in the last year.&#x0D; Results: Outpatient specialist care services under the public health care system were used by the majority of respondents (N = 200; 81.3%). Most often it was 1-2 times in the last year (54.5% of all respondents used the public health service). The respondents most often used gynecological (33%), ophthalmological (21%), and dermatological (15.5%). In turn, private medical care was used by 192 respondents (78%) out of all the respondents. Respondents revalued all assessed medical procedures by 27% for the diagnostic colonoscopy to 790% for a 20-minute massage at a rehabilitation clinic.&#x0D; Conclusion: Cost awareness among polish students is poor. Lack of awareness of the costs of medical procedures (the amount that the public payer pays for specific procedures medical) that may have an impact on the use of healthcare services as well as health care expenses.

Medical costs of cervical cancer

In Ecuador, cervical cancer is among the main causes of death per year and generates a large outlay of resources. The Cancer Society is the governing body in cancer care and treatment, however, the determination of the costs involved in these procedures is not established, in this sense, the objective of the research is to present a cost determination mechanism of the medical procedures associated with the areas of responsibility that deal with cervical cancer. A retrospective-descriptive cross-sectional study was carried out in the year 2020 of the expenses that were generated in all the patients attended. The results show that the outpatient clinic (56%) was the area of ​​responsibility that deals with cervical cancer that generated the most costs, while the clinical laboratory area (0.2%) was the one that did the least. The research reveals the need for a tool that calculates the cost of medical procedures, ensuring that the resources allocated to cervical cancer, the subject of this article, are optimized and serve to improve the quality of life of patients.

Internet of Things adoption barriers in the Indian healthcare supply chain: An ISM-fuzzy MICMAC approach.

Internet of things (IoT) plays a significant role in offering a wide range of benefits to the healthcare supply chain. It improves the quality of patient care, reduces the cost of medical procedures, maintaining flawless operations and supports clinical decisions. Despite strong policy interest and vast potential benefits of IoT in the healthcare supply chain, the actual adoption rate is relatively low and it's in the nascent stage in developing countries like India. The objective of this paper is to identify and analyze the potential barriers which would restrain the healthcare industry from adopting IoT. Based on the review of the literature and brainstorming with experts from industry and academia, 14 barriers were identified for IoT adoption. The contextual relationship between the identified barriers was developed using interpretive structural modeling and the obtained results were used as input to fuzzy MICMAC analysis to determine the driving and dependence power of the IoT adoption barriers. From the result, Legal and regulatory standards, Lack of IT Infrastructure are major barriers influencing the adoption of IoT in the healthcare supply chain. The findings will support the decision-makers to understand the contextual relationship between the IoT adoption barriers in the Indian healthcare supply chain.

Epidemiology, management, and economic impact of acute myeloid leukemia and myelodysplastic syndrome in Spain at the hospital level: a claims database analysis

Objectives This study reviewed patient characteristics, management, and medical costs of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDSs) in Spanish hospitals. Methods Data were extracted from the Spanish Ministry of Health records via a claims database containing patient records from 192 private and 313 public hospitals between 1997 and 2015 for AML, and 2008 and 2015 for MDS. Direct medical costs at the hospital level were calculated based on mean medical procedure costs determined per the Spanish Ministry of Health. Results Records for 39,568 patients with AML and 33,091 with MDS were analyzed. The median age of AML patients was 65 years (interquartile range (IQR) = 27) and of MDS patients was 81 years (IQR = 12). In terms of disease management, 58% and 83% of admissions were due to emergencies for patients with AML and MDS, respectively; median length of hospital stay was 14 days (IQR = 25) for AML and seven days (IQR = 9) for MDS. There was an increase in allogeneic hematopoietic stem cell transplantations over time for patients with AML or MDS. Mean annual direct medical costs of AML and MDS, respectively, were €66,422,245 and €42,635,313 for total costs, and €30,775 and €10,312 per patient. Of the total costs, transplantations contributed total annual costs of €15,843,982 and €2,705,791 for patients with AML and MDS, respectively. Conclusions This study provides novel data to assist decision makers in allocating resources. AML and MDS represent a significant burden for the National Spanish Healthcare System, with substantial costs incurred in secondary care, principally associated with the increasing number of transplantations.

Modelling the barriers of Health 4.0–the fourth healthcare industrial revolution in India by TISM

In healthcare industry, the phenomenon of Industry 4.0 is popular as Health 4.0 where the modern technologies are integrated with available data along with the use of artificial intelligence. The main objective of this paper is to explore the barriers of Health 4.0 application in healthcare sector in India. Fifteen barriers which can affect the adoption of Health 4.0 in the Indian healthcare sector have been identified through extensive literature review and opinions of healthcare industry and academic experts. A TISM (Total Interpretive Structural Modelling) model has been developed to extract the key barriers influencing Health 4.0 adoption which will guide the healthcare managers and decision makers to explore the effect of each barrier on other barriers as well as the degree of relationships among them. The result shows that lack of top management support, exclusive and skilled workforce requirement, inadequate maintenance support systems and political support are the major barriers as they have strong driving power. Timely action taken by the management to remove these hurdles will not only reduce the cost of medical procedures but also improve the quality of treatment so that the true potential of Health 4.0 can be utilized.

The hospital cost of hip replacement for old inpatients in Belgium.

The objectives of this research are (i) to describe the medico-administrative characteristics of inpatients aged 65 and more who are hospitalized for hip joint replacement, (ii) to evaluate the complete hospital cost into costs of medical procedures, drugs costs, prostheses costs, and the administrative costs, and (iii) to identify and to evaluate from administrative database predictors influencing the complete hospital costs. The study was based on 961 inpatient stays aged 65 and more, with the APR-DRG 301 "Hip joint replacement". The sample for this study was based on data collected in 2014 among nine Belgian general hospitals. We used the linear regression method for isolating predictors of hospital cost. The study highlights three different types of patients hospitalized for hip replacement, depending on the primary diagnosis: osteoarthritis problems (57%), femur neck fracture (30%), or other reasons (13%) (complications, infections, or problems with the existing hip prosthesis). The median length of stay (P25-P75) was 9days (6.29-20.91). The median cost (P25-P75) was 8,023.91 EUR (6678.32-13,670.78). The total cost was composed of the direct hospital cost (30%), the cost of medical procedures (31%), cost of drugs (4%), the cost of hip prosthesis (18%), and other costs (17%). The linear regression reveals that an extreme SOI or risk of mortality, an ICU stay, an in-hospital death, an index of Charlson comorbidities of 4 or 5, to be hospitalized for a hip replacement because of complications, infections, or problems with the existing hip prosthesis, and the length of stay, were predictors of an increase in hospital cost. The cost is not increasing with the age of the patient, but mainly with the length of stay and the comorbidities linked to the age which are considered in the severity of illness and the Charlson comorbidities index. The hospital cost is higher for patients hospitalized for complications linked to an existing hip prosthesis than for a hip replacement linked to osteoarthritis problems.

Modelling the factors affecting Indian medical tourism sector using interpretive structural modeling

PurposeMedical tourism encourages the traveling of patients, expert healthcare professionals and promotes cross-border trade in healthcare services. The Indian medical tourism sector is facing new challenges as well as certain ethical and legal issues because of continuous market changes and patient’s requirements while at the same time advancements in current health services have also been observed. It is therefore very important to understand and address the issues of the medical tourists. The purpose of this paper is to evaluate the important factors which can make India an affordable medical tourism destination.Design/methodology/approachIn this paper, the factors influencing Indian medical tourism sector have been explored by conducting literature review, they are ranked according to the results of a questionnaire-based survey and further analyzed by using the interpretive structural modeling (ISM) approach. The mutual relationships between these factors were identified to develop an ISM model so as to find out the important factors which can make India an affordable place for medical tourism.FindingsThe results of the survey and the model show that cost of medical procedures, facilitation, and care, the infrastructure of Indian hospitals, clinical excellence and the competence of doctors and staff are the top level factors.Practical implicationsIt is very important to address the concerns of the patients coming to a developing country like India for availing medical services. This research has evaluated the important factors which can make India an affordable medical tourism destination.Originality/valueThis research assesses the effects of globalization on delivery of healthcare services in India by conducting critical analysis of the medical tourism industry by collecting original data from the international patients coming to India for different types of medical procedures so that a comprehensive model can be prepared which will help the hospitals and policymakers to improve the processes related to medical tourism.

Medical tourism: the role of the primary care provider.

With medical costs rising and millions uninsured or underinsured, patients are paying cash in developing nations to access deeply discounted medical procedures. While medical tourism can be a cost-effective option, the phenomenon is not without risk: communication difficulties, endemic tropical diseases, unregulated hospitals, and organ trafficking complicate the landscape. These risks are precisely what put the well-informed provider in a position to educate patients to safely engage in the process. The incidence is difficult to calculate. An estimated 50 million patients travel abroad each year seeking medical services and 3–20% of Europeans receive treatment in another European Union country.1,2 Patients cite shorter waiting times, and lower costs as the primary motivators.2 Cardiac surgery or a knee replacement in a developing country can be a fraction of the cost due to currency exchange rates, lower labour costs, fewer regulations, little or no involvement of insurance companies, and low malpractice premiums.3 For example, a cardiac surgery averaging $113 000 (£85 880) in the US is done in India for only $10 000 (£7600).4 Figure 1 shows a cost comparison in GBP.4 Figure 1. Comparative costs of medical procedures in different countries in US$.4 CABG = coronary artery bypass grafting. Medical tourists usually …

How much do rheumatologists and orthopaedists doctors' modalities impact the cost of arthritis in Cyprus?

BackgroundOsteoarthritis is one of the primary causes of long-term functional disability. With an estimated 13.5 % prevalence in the general population contributes to a significant financial burden both for patients and healthcare systems. The purpose of this research is to highlight the direct annual cost of the disease to the private healthcare sector of Nicosia.MethodsA questionnaire based on Greek and international research was completed between 10/1/2012 and 11/30/2012, with a sample of 20 doctors specialists in orthopaedics and rheumatology (50 % of practising physicians in the private sector). An assessment of the annual cost of medical procedures and tests, pharmacologic therapies (modalities) and supplies per patient followed, based on current costs. Direct costs were assessed through the micro-costing “bottom-up” approach. We isolated and separately priced the original diagnosis, followed by each stage of the disease.ResultsThe cost for the six predominant medical tests to establish a diagnosis and exclude mainly RA such as ESR, CPR, and X-ray as well as a physician’s office visit was 150€ per patient. The average direct cost per patient during stages 1, 2 and 3 of the disease was 280.54€, 1,834.64€ and 5,641.72€ annually, respectively, with an annual average of 2,573€ per patient.ConclusionsEven though during the period of the study, the country had not yet established clinical guidelines, the participating physicians followed international practices. Significant rise in the cost in each stage of the disease was found, with additional increases in the following years as a result of the expected increased prevalence of the disease. It is noted here that uninsured patients, as well as those who qualified for free medical care, they seek these services in the private sector, and had to pay out of pocket money for examination and treatment. These patients, thus, contended with a serious financial burden. Therefore, it is important to inform them very extensively regarding evidence-based management of the disease to aid them in coping with this chronic illness.

Cost-benefit study of school nursing services.

In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in the Massachusetts ESHS schools were a cost-beneficial investment of public money, warranting careful consideration by policy makers and decision makers when resource allocation decisions are made about school nursing positions.

Simulation modelling for contracting hospital emergency services at the regional level

Hospital emergency services are closely connected to demographic issues and population changes. The methodology presented here helps to assess the effects of the forecasted demand changes on the next-year emergency unit workloads. The objective of the study is to estimate the expected volume of emergency hospital services, as measured by the number and costs of medical procedures provided to patients, to be contracted by the Polish National Health Fund (NFZ) branch at the regional level to cover the forecasted demand. A discrete-event simulation model was developed to elaborate the credible forecasts of the function components, the fundamental elements of the contract values granted by the NFZ for emergency departments for the following year. Emergency department-level data were drawn from the NFZ regional branch registry to perform a statistical analysis of emergency services provided to patients in 17 admission units and emergency wards in 2010. The model results indicate that the predicted increase in two age groups, i.e., the youngest children and the older population, will have different effects on the number and value of hospital emergency services to be considered in the contracting policy. There is potential for a discrete-event simulation to support strategic health policy decision making at the regional level. The value of this approach lies in providing estimates for the what-if scenarios related to the prognosis of changing acute demand.

222 ACTIVE SURVEILLANCE FOR EARLY PROSTATE CANCER COMPARED WITH IMMEDIATE TREATMENT: A UNITED STATES - CANADIAN ECONOMIC COMPARISON

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History (I)1 Apr 2013222 ACTIVE SURVEILLANCE FOR EARLY PROSTATE CANCER COMPARED WITH IMMEDIATE TREATMENT: A UNITED STATES - CANADIAN ECONOMIC COMPARISON Alice Dragomir, Fabio Cury, and Armen Aprikian Alice DragomirAlice Dragomir Montreal, Canada More articles by this author , Fabio CuryFabio Cury Montreal, Canada More articles by this author , and Armen AprikianArmen Aprikian Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1602AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active surveillance is an accepted management strategy for patients with low-risk prostate cancer. The costs associated with active surveillance (AS) strategy compared with immediate treatment (IT) were recently evaluated in the US healthcare system by Keegan et al (Cancer, 2012). The corresponding estimates in the Canadian context are unknown. Objectives The main objective of this study was to evaluate the costs associated with active surveillance and treatment in Canadian context over a 6-year and 11-year period following the diagnosis of prostate cancer. The secondary objective was to compare the US and Canadian cost estimates, and to develop a model able to provide estimates including additional treatment cost and the rate of death, elements not considered in the previous study. METHODS A Markov model with Monte-Carlo microsimulations was developed and adapted to estimate the Canadian cost of prostate cancer under the IT and AS strategies. The patients on AS were assumed to receive delayed treatment at a rate of 7% per year for the first 5-year period of follow-up, and of 4.5% for the following 5-year period. The model assumptions were derived from Keegan et al. in order to allow direct comparison. Cost assignments All costs were assigned in Canadian dollars ($) and reflect Quebec's public health system (RAMQ). The costs of drugs, costs of medical procedures related to treatments and medical visit costs were based on RAMQ's lists. Other Canadian published sources were used to complete cost calculation. RESULTS With AS, the average cost of prostate cancer management over the 6-year period was estimated at $6,394 (95% Confidence Interval: $6,323 to $6,474) per patient. The average cost corresponding to the IT strategy was estimated at $11,765 per patient. In addition, 30% of patients on AS will have received a delayed treatment and have incurred higher costs estimated at $12,210 per patient. CONCLUSIONS Our study demonstrates that AS could offer important economic benefits from the Canadian health system perspective, estimated at $69 million over a 6-year period for each annual cohort of incident prostate cancer. The US and Canadian evaluation of costs shows differences principally attributed to medical costs. These figures translate into a relative reduction of cost for prostate cancer management obtained with AS of approximately 36% in US when compared to 46% in Canada. This is mainly attributed to the relatively low cost of AS in the Canadian system. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e92 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alice Dragomir Montreal, Canada More articles by this author Fabio Cury Montreal, Canada More articles by this author Armen Aprikian Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The impact of therapeutic procedure innovation on hospital patient longevity: Evidence from Western Australia, 2000–2007

Assessing the benefits of medical innovation—its impact on health outcomes—is as important as assessing the costs—its impact on health expenditure. Most formal studies have focused on the expenditure impacts of medical technology, partly because costs are more easily identified and quantified than are benefits. Moreover, most quantitative research relating to the impact of broad categories of technology on health outcomes has focused on pharmaceuticals. This is the first study that investigates the benefits and costs of another broad category of medical innovation—inpatient therapeutic procedure innovation—using data on over one million hospital discharges.We investigate the effect of therapeutic procedure innovation in general on the longevity of Western Australia (WA) hospital patients with a variety of medical conditions. We can measure survival for a period as long as 8 years after admission. We know the date each procedure was added to the Medicare Benefits Schedule (MBS). First, we perform an analysis using cross-sectional patient-level data, controlling for the patient's age, sex, Diagnosis Related Group (DRG, over 600 categories), Aboriginal status, marital status, insurance coverage (whether or not the patient had private insurance), postcode (over 400 postcodes), year of hospital admission, and number of procedures performed. The estimates indicate that therapeutic procedure innovation increased the life expectancy of WA hospital patients (whose mean life expectancy was about 10 years) by almost 3 months between 2000 and 2007.Estimates based on longitudinal DRG-level data also indicate that therapeutic procedure innovation increased the life expectancy of WA hospital patients, but the implied increase may be smaller—about 2 months. In either case, therapeutic procedure innovation in WA hospitals appears to have been remarkably cost-effective, because it increased the cost of medical procedures by a negligible amount.

Healthcare marketing: Contemporary salient issues and future research directions

The purpose of this paper is to discern the current salient issues in healthcare marketing by looking at the perspective of healthcare consumers and providers, and providing a scope of marketing prospects and opportunities for healthcare improvement as an avenue for future research, as well as guiding how scholars could obtain relevant healthcare data which may be useful for future write-ups on the subject. A review of existing journals in the healthcare and marketing scholarship under the ERA 2010 List of Journals was conducted. We examine the salient issues in healthcare marketing from the patient and healthcare provider perspective. Following the review, we examine what future research is required to solve these issues. Notably, salient issues concerning patients revolve around healthcare quality, dissatisfaction, cognitive dissonance, anxiety, ambiguity or uncertainty, and the lack of control, and the concerns of healthcare providers were in terms of mutation of medical focus, rising cost of medical procedures, and escalading numbers of healthcare providers. Our findings indicate six areas of future research to overcome the identified salient issues – improving patient satisfaction, identifying trends in satisfaction–loyalty relations, effective targeting, health promotion, medical tourism, and looking beyond the brick and mortar context for possible healthcare marketing solutions.