Personnel Costs Research Articles

Effects of restaurant expenses on enhanced profitability: Do Michelin-starred restaurants perform differently?

Despite their worldwide popularity, Michelin-starred restaurants often follow unprofitable business models that prize recognition ahead of economic benefit and thus need efficient cost management practices that can ensure their survival. The aim of our study, covering Spain from 2014 to 2019, was thus to examine the primary expenses of Michelin-starred restaurants and how they impact the restaurants’ potential for enhanced profitability depending on firm size compared to fine dining restaurants. To that aim, a sample of 140 Michelin-starred restaurants and 388 restaurants without Michelin-star in Spain were analysed using random-effect panel data models. The results show that although food costs are the main expense for the restaurant industry, personnel costs have a similar weight to food costs for Michelin-starred restaurants. At the same time, results reveal that the most profitable costs for this type of restaurant are food costs and also personnel costs, but in the latter case only for large restaurants. The results also confirm that being a Michelin-starred restaurant contributes to improved profitability regardless of cost management, suggesting that customers are willing to pay higher prices for the fact of being a Michelin-starred restaurant. Finally, the evidence of low profitability of Michelin-starred restaurants and even negative profitability for most of the other fine dining restaurants underscores the need for more efficient cost management practices.

A Cost Analysis of Rethink the Strip: De-implementing a Low-value Practice in Primary Care.

Routine self-monitoring of blood glucose is a low-value practice that provides limited benefit for patients with non-insulin-treated type 2 diabetes mellitus. We estimated the costs of Rethink the Strip (RTS), a multistrategy approach to the de-implementation of self-monitoring of blood glucose in primary care. RTS was conducted among 20 primary care clinics in North Carolina. We estimated the non-site-based and site-based costs of the 5 RTS strategies (practice facilitation, audit and feedback, provider champions, educational meetings, and educational materials) from the analytic perspective of an integrated health care system for 12 and 27-month time horizons. Material costs were tracked through project records, and personnel costs were assessed using activity-based costing. We used nationally based wage estimates. Total RTS costs equaled $68,941 for 12 months. Specifically, non-site-based costs comprised $16,560. Most non-site-based costs ($11,822) were from the foundational programming and coding updates to the electronic health record data to develop the audit and feedback reports. The non-site-based costs of educational meetings, practice facilitation, and educational materials were substantially lower, ranging between ~$400 and $1000. Total 12-month site-based costs equaled $2569 for a single clinic (or $52,381 for 20 clinics). Educational meetings were the most expensive strategy, averaging $1401 per clinic. The site-based costs for the 4 other implementation strategies were markedly lower, ranging between $51 for educational materials and $555 for practice facilitation per clinic. This study provides detailed cost information for implementation strategies used to support evidence-based programs in primary care clinics.

Challenges and recommendations for measuring time devoted to implementation and intervention activities in health equity-focused, resource-constrained settings: a qualitative analysis

BackgroundThere is little guidance for conducting health equity-focused economic evaluations of evidence-based practices in resource-constrained settings, particularly with respect to staff time use. Investigators must balance the need for low-touch, non-disruptive cost data collection with the need for data on providing services to priority subpopulations.MethodsThis investigation took place within a pilot study examining the implementation of a bundled screening intervention combining screening for social determinants of health and colorectal cancer at four federally qualified health centers (FQHCs) in the Boston metropolitan area. Methods for collecting data on personnel costs for implementation and intervention activities, including passive (automatic) and active (non-automatic, requiring staff time and effort) data collection, as well as three alternate wordings for self-reporting time-use, were evaluated qualitatively using data collected through interviews with FQHC staff (including clinicians, population health staff, and community health workers) and assessments of data completeness.ResultsPassive data collection methods were simple to execute and resulted in no missing data, but missed implementation and intervention activities that took place outside planned meetings. Active cost data collection using spreadsheets was simple for users when applied to care processes already tracked in this fashion and yielded accurate time use data. However, for tasks where this was not typical, and when tasks were broken up over multiple sessions, spreadsheets were more challenging to use. Questions asking about time use for a typical rather than specific time period, and for typical patients, yielded the most reliable and actionable data. Still, even the best-performing question had substantial variability in time use estimates. Participants noted that patient characteristics of interest for equity-focused research, including language spoken, adverse social determinants of health, and issues related to poverty or mental health, all contributed significantly to this variability.ConclusionsPassively collected time use data are the least burdensome and should be pursued in research efforts when possible, but should be accompanied by qualitative assessments to ensure the data are an accurate reflection of effort. When workflows are already tracked by active data collection, these are also strong data collection methods. Self-reported time use will be most accurate when questions inquire about “typical” tasks and specific types of patients.

La traslación del aumento de los costes de producción a los precios de venta de las empresas no financieras en 2022

Rationale The surge in energy and other commodity prices in 2021 H2 and a significant part of 2022 has led to firms’ costs increasing considerably. This article analyses how this rise in costs has been passed through to selling prices and what impact it has had on firms’ output, wages, employment and unit labour costs. Takeaways •On average, firms passed through a significant proportion of production cost increases to selling prices in 2022, albeit with a high degree of heterogeneity across sectors. •In sectors that have historically seen more rigid pricing (proxied by lower price volatility), pass-through of rising costs to selling prices has been slower. •Rising input prices directly cause selling prices and unit labour costs to grow. The latter is a consequence of the negative effect on labour productivity, owing to the adverse impact on output and the lack of an impact on personnel costs. •In any case, these direct effects, which are stronger in the sectors most exposed to this shock, do not account for the indirect (general equilibrium) effects that influence all sectors.

Socio-economic aspects in the management of enterprise personnel development

The article presents the research results on the generalization and formation of the main features of socio-economic guidelines in managing the development of the company's personnel. The issue of the importance of social and economic guidelines in the management of enterprise personnel development was raised. It has been established that social guidelines include ensuring employees' safety and health, developing and supporting the work team, developing social guarantees, and developing corporate culture. Economic guidelines provide for the efficient use of resources, development and maintenance of competitiveness, formation of an effective motivation system, and optimization of personnel costs. It was found that motivation plays a vital role in personnel development management and is a complex indicator, the results of which depend on several variables. The enterprise's labor motivation system was considered a complete form of motivation organization. The indicators of the social and economic components of the motivation system are characterized. The methodological approach's main steps in assessing social and economic motivation are highlighted. The results of the motivational profile of the personnel of the enterprises are substantiated according to the needs: high wages, proper working conditions in a clear structuring of work, social contacts, forming and maintaining long-term and stable relationships, in gaining recognition, in achieving goals, in influencing people and the authorities, in changes and diversity, to be creative, in self-improvement, in interesting and socially useful work. The results of the personnel motivation system of the enterprises LLC AF "Viktoria", PJSC "Iskra" and SFG "Urozhai" were interpreted. Keywords: personnel management, personnel development, socio-economic management, motivation, enterprise, employee, management.

Direct costs of blood drawings with pre-analytical errors in tertiary paediatric hospital care.

Blood drawings is a common hospital procedure involving laboratory and clinical disciplines that is important for the diagnosis and management of illnesses in children. Blood drawings with pre-analytical error (PAE) can lead to increased costs for hospitals and healthcare organisations. The direct cost of blood drawings after a PAE is not fully understood in paediatric hospital care. The aim of this study was to estimate the average direct cost of PAE per year and per 10,000 blood drawings in tertiary paediatric care. A cost analysis using a bottom-up approach was conducted on the basis of combined information from the hospital's laboratory register for the period 2013-2014 and clinical in-ward observations at a tertiary children's referral hospital in Sweden, the Astrid Lindgren Children's Hospital. For the analysis, we hypothesised the re-collection of all blood drawings with PAE and included the average costs of the sampling materials, the time of the healthcare personnel, the laboratory analyses, and in-ward premises based on the time spent on the blood sampling procedure. The annual cost of PAE was estimated to be 74,267 euros per 54,040 blood drawings, which corresponds to 13,756 euros per 10,000 blood drawings or 1.5 euros per draw. The personnel cost represented 60.1% (45,261 euros per year) of the cost due to PAE, followed by costs for hospitalisation (25.2%), laboratory analyses (8.1%), and materials (5.7%). PAEs lead to substantial increases in the costs in tertiary paediatric hospital care. If these PAEs can be avoided, costs related to the re-collection of blood drawings with PAE may be re-allocated to other health-promoting activities for children visiting hospital institutions.

Cognitive development among children in a low-income setting: Cost-effectiveness analysis of a maternal nutrition education intervention in rural Uganda.

Inadequate nutrition and insufficient stimulation in early childhood can lead to long-term deficits in cognitive and social development. Evidence for policy and decision-making regarding the cost of delivering nutrition education is lacking in low and middle-income countries (LMIC). In rural Uganda, we conducted a cluster-randomized controlled trial (RCT) examining the effect of a maternal nutrition education intervention on developmental outcomes among children aged 6-8 months. This intervention led to significantly improved cognitive scores when the children reached the age of 20-24 months. When considering the potential for this intervention's future implementation, the desired effects should be weighed against the increased costs. This study therefore aimed to assess the cost-effectiveness of this education intervention compared with current practice. Health outcome data were based on the RCT. Cost data were initially identified by reviewing publications from the RCT, while more detailed information was obtained by interviewing researchers involved in processing the intervention. This study considered a healthcare provider perspective for an 18-months' time horizon. The control group was considered as the current practice for the future large-scale implementation of this intervention. A cost-effectiveness analysis was performed, including calculations of incremental cost-effectiveness ratios (ICERs). In addition, uncertainty in the results was characterized using one-way and probabilistic sensitivity analyses. The ICER for the education intervention compared with current practice was USD ($) 16.50 per cognitive composite score gained, with an incremental cost of $265.79 and an incremental cognitive composite score of 16.11. The sensitivity analyses indicated the robustness of these results. The ICER was sensitive to changes in cognitive composite score and the cost of personnel. The education intervention can be considered cost-effective compared with the current practice. The outcome of this study, including the cost analysis, health outcome, cost-effectiveness, and sensitivity analysis, can be useful to inform policymakers and stakeholders about effective resource allocation processes in Uganda and possibly other LMIC.

Prospective Evaluation of the Cost of Performing Breast Imaging Examinations Using a Time-Driven Activity-Based Costing Method: A Single-Center Study.

Measuring the cost of performing breast imaging is difficult in healthcare systems. The purpose of our study was to evaluate this cost using time-driven activity-based costing (TDABC) and to evaluate cost drivers for different exams. An IRB-approved, single-center prospective study was performed on 80 female patients presenting for breast screening, diagnostic or biopsy exams from July 2020 to April 2021. Using TDABC, data were collected for each exam type. Included were full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), contrast-enhanced mammography (CEM), US and MRI exams, and stereotactic, US-guided and MRI-guided biopsies. For each exam type, mean cost and relative contributions of equipment, personnel and supplies were calculated. Screening MRI, CEM, US, DBT, and FFDM costs were $249, $120, $83, $28, and $30. Personnel was the major contributor to cost (60.0%-87.0%) for all screening exams except MRI where equipment was the major contributor (62.2%). Diagnostic MRI, CEM, US, and FFDM costs were $241, $123, $70, and $43. Personnel was the major contributor to cost (60.5%-88.6%) for all diagnostic exams except MRI where equipment was the major contributor (61.8%). Costs of MRI-guided, stereotactic and US-guided biopsy were $1611, $826, and $356. Supplies contributed 40.5%-49.8% and personnel contributed 30.7%-55.6% to the total cost of biopsies. TDABC provides assessment of actual costs of performing breast imaging. Costs and contributors varied across screening, diagnostic and biopsy exams and modalities. Practices may consider this methodology in understanding costs and making changes directed at cost savings.

What matters to program partners when implementing a community-based exercise program for people post-stroke? A theory-based qualitative study and cost analysis.

Community-based exercise programs integrating a healthcare-community partnership (CBEP-HCP) can facilitate lifelong exercise participation for people post-stroke. Understanding the process of implementation from multiple perspectives can inform strategies to promote program sustainability. To explore stakeholders' experiences with undertaking first-time implementation of a group, task-oriented CBEP-HCP for people post-stroke and describe associated personnel and travel costs. We conducted a descriptive qualitative study within a pilot randomized controlled trial. In three cities, trained fitness instructors delivered a 12-week CBEP-HCP targeting balance and mobility limitations to people post-stroke at a recreation centre with support from a healthcare partner. Healthcare and recreation managers and personnel at each site participated in semi-structured interviews or focus groups by telephone post-intervention. Interviews and data analysis were guided by the Consolidated Framework of Implementation Research and Theoretical Domains Framework, for managers and program providers, respectively. We estimated personnel and travel costs associated with implementing the program. Twenty individuals from three sites (4 recreation and 3 healthcare managers, 7 fitness instructors, 3 healthcare partners, and 3 volunteers) participated. We identified two themes related to the decision to partner and implement the program: (1) Program quality and packaging, and cost-benefit comparisons influenced managers' decisions to partner and implement the CBEP-HCP, and (2) Previous experiences and beliefs about program benefits influenced staff decisions to become instructors. We identified two additional themes related to experiences with training and program delivery: (1) Program staff with previous experience and training faced initial role-based challenges that resolved with program delivery, and (2) Organizational capacity to manage program resource requirements influenced managers' decisions to continue the program. Participants identified recommendations related to partnership formation, staff/volunteer selection, training, and delivery of program activities. Costs (in CAD) for first-time program implementation were: healthcare partner ($680); fitness coordinators and instructors ($3,153); and participant transportation (personal vehicle: $283; public transit: $110). During first-time implementation of a CBEP-HCP, healthcare and hospital managers focused on cost, resource requirements, and the added-value of the program, while instructors and healthcare partners focused on their preparedness for the role and their ability to manage individuals with balance and mobility limitations. Trial Registration: ClinicalTrials.gov, NCT03122626. Registered April 17, 2017-Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT03122626.

A method for automatic identification and separation of wildlife images using ensemble learning

Camera traps have revolutionized wildlife resource surveys by enabling the acquisition of comprehensive ecosystem information. Camera traps usually produce massive images. Snapshot datasets captured in nature reserves proximate to human habitation often comprise a significant volume of human activity images containing humans or livestock. Manually identifying and labeling wildlife images from large-scale datasets is a labor-intensive task that necessitates a substantial number of professionals and incurs expensive personnel costs. By harnessing the capabilities of deep learning technology to automatically differentiate between wildlife and human activity images, ecologists can solely focus on manually labeling wildlife images that account for a minor fraction of the dataset. This strategic shift can significantly reduce personnel expenses and enhance work efficiency. Existing research usually treats human activity images as ordinary categories and utilizes species recognition methods to automatically identify and filter them. However, when human activity images overwhelmingly predominate the dataset, established species recognition methods are susceptible to misclassifying a substantial proportion of wildlife images as human activity images. This misclassification can potentially result in ecologists missing opportunities to discover or observe wildlife. To tackle this challenge, we proposed an ensemble learning method based on a conservative strategy and current mainstream deep learning frameworks to automatically identify wildlife and human activity images. We validated our method on a camera trap dataset from Lasha Mountain (LSM) in Yunnan, China. The experimental results demonstrated that our method automatically identified wildlife images from the dataset with accuracy, recall, and precision of 95.75%, 94.07%, and 83.89%, respectively. This led to an approximately 80% reduction in personnel costs.

Analysis of the Main Difficulties and Future Operating Strategies of the Accounting Firm Industry

This paper discusses the main difficulties faced by the operation of the accounting firm industry, as well as the main operating strategies for it in the future. The data was sourced from the “2021 Investigation Report on the Accounting Firm Service Industry” conducted by the Financial Supervisory Commission in 2022, and statistical analysis was performed separately. Based on the analysis results, it is proposed in this study that the main difficulties in operation of the accounting firm industry are to reduce personnel costs as much as possible, train more skilled and excellent employees, and establish a sound client system. In terms of future operating strategy, efforts should be made to improve the service quality of the accounting firm, increase the number of professional assistants, strengthen staff training, and at least keep things ticking as far as possible, so as to provide managers with practical suggestions and improvement principles.

Long-term alliance for pathology equipment and technology acquisition: a paradigm shift for improved quality and efficiency.

Personnel costs are the largest single budget item in the clinical laboratory, other major expenses being equipment, analyzers, blood and blood components, and cost of day-to-day consumables. This report describes our experience with developing a long-term relationship with a single major vendor as a paradigm shift from the traditional multiple vendors, multiple contracts, and recurrent extended negotiations. Our objective was to develop a long-term approach for replacement of effete equipment and upgrades to operations in a pathology and laboratory medicine department in collaboration with vendors providing equipment and services. Major vendors were invited to visit the department to analyze the workload and workflow and suggest integrated solutions to meet the goals of the department. Multiple iterations of the proposals were evaluated, and a recommendation made to the medical center leadership. The vendor, the medical center, and the department jointly developed a 15-year partnership plan to improve the operations of pathology services. The agreement encompasses a range of management and performance criteria for both sides. The salient items discussed were laboratory staffing, turnaround time, workload change, test insourcing, reference laboratory costs, and scholarly productivity and teaching. The agreement reduced laboratory staffing by 21%, eliminated stat tests by reducing the turnaround time for routine tests to less than 45 minutes for 90% of tests, with an increase of 9.1% in the number of tests, Cost avoidance in salary and reference laboratory costs was $3,424,136/year against an expected target of $2 million in total savings, despite not including cost avoidance from promoting appropriate use of laboratory testing for inpatients and increase in revenue from increase in ambulatory testing. Vizient score in laboratory utilization improved from the 94th to 76th percentile. Scholarly output increased by more than 100%. This model of a long-term alliance with a chosen vendor led to improvements in quality and efficiency.

Biosensors; noninvasive method in detection of C-reactive protein (CRP).

Early diagnosis of C reactive protein (CRP) is critical to applying effective therapies for related diseases. Diagnostic technology in today's healthcare systems is mostly deployed in central laboratories, involves expensive and time-consuming processes, and is operated by specialized personnel. For example, the enzyme-linked immunosorbent assay (ELISA), considered the gold standard diagnostic method, is labor-intensive and requires complex procedures such as multiple washing and labeling steps. Due to these limitations of current diagnostic techniques, it is difficult for people to regularly monitor their health and ultimately the disease is more likely to be diagnosed at a later stage. The problem is exacerbated for economically disadvantaged people living in underdeveloped countries. To address these challenges in the traditional diagnostic field, point-of-care (POC) biosensors have emerged as a promising alternative. This allows patients to have their health checked regularly at or near their bedside without resorting to laboratory tests. Nanotechnology-based methods such as biosensors have been extensively researched and developed. Among biosensors, there are also label-free biosensors with high sensitivity that do not require complicated procedures and reduce test time. However, some drawbacks such as high cost, bulky size and need for trained personnel to operate have not been improved. In this review article, we provide an overview of routine methods in CRP diagnosis and then introduce biosensors as a modern, advanced alternative to older methods. Readers of this article can learn about biosensing and its benefits while being aware of the limitations of routine methods.

Cost Analysis of Magnetic Resonance Imaging and Computed Tomography in Cardiology: A Case Study of a University Hospital Complex in the Euro Region.

In recent years, several hospitals have incorporated MRI equipment managed directly by their cardiology departments. The aim of our work is to determine the total cost per test of both CT and MRI in the setting of a Cardiology Department of a tertiary hospital. The process followed for estimating the costs of CT and MRI tests consists of three phases: (1) Identification of the phases of the testing process; (2) Identification of the resources consumed in carrying out the tests; (3) Quantification and assessment of inputs. MRI involves higher personnel (EUR 66.03 vs. EUR 49.17) and equipment (EUR 89.98 vs. EUR 33.73) costs, while CT consumes higher expenditures in consumables (EUR 93.28 vs. EUR 22.95) and overheads (EUR 1.64 vs. EUR 1.55). The total cost of performing each test is higher in MRI (EUR 180.60 vs. EUR 177.73). We can conclude that the unit cost of each CT and MRI performed in that unit are EUR 177.73 and EUR 180.60, respectively, attributable to consumables in the case of CT and to amortization of equipment and staff time in the case of MRI.

Agricultural Machinery Adequacy for Handling the Mombaça Grass Biomass in Agroforestry Systems

The current scenario of Agroforestry Systems (AFS) worldwide lacks specific machinery, resulting in practically all operations being carried out manually. This leads to a significant physical effort for small-scale farmers and limits the implementation of AFS to small areas. The objective of the study was to evaluate the suitability of existing machines for performing agroforestry tasks. This research utilizes Descriptive Statistics and Exponentially Weighted Moving Average methods to evaluate the data and compare the treatments, where different machines are used to cut Mombaça grass (Megathyrsus maximus Jacq): (i) costal brushcutter (CBC); (ii) tractor-mounted rotary brushcutter (RBC); and (iii) mini grain reaper machine (GRM). The experiments were conducted in Jaguariúna, São Paulo, Brazil. GRM is recommended for achieving greater biomass production, reducing raking time, and minimizing operational costs. CBC is suitable for smaller areas due to its affordability and slow operation, which requires significant physical effort. RBC is recommended for reducing working time, physical effort, and personnel costs, making it suitable for larger-scale contexts.

Establishing and testing a robot-based platform to enable the automated production of nanoparticles in a flexible and modular way

Robotic systems facilitate relatively simple human–robot interaction for non-robot experts, providing the flexibility to implement different processes. In this context, shorter process times, as well as an increased product and process quality could be achieved. Robots short time-consuming processes, take over ergonomically unfavorable tasks and work efficiently all the time. In addition, flexible production is possible while maintaining or even increasing safety. This study describes the successful development of a dual-arm robot-based modular infrastructure and the establishment of an automated process for the reproducible production of nanoparticles. As proof of concept, a manual synthesis protocol for silica nanoparticle preparation with a diameter of about 200 nm as building blocks for photonic crystals was translated into a fully automated process. All devices and components of the automated system were optimized and adapted according to the synthesis requirements. To demonstrate the benefit of the automated nanoparticle production, manual (synthesis done by lab technicians) and automated syntheses were benchmarked. To this end, different processing parameters (time of synthesis procedure, accuracy of dosage etc.) and the properties of the produced nanoparticles were compared. We demonstrate that the use of the robot not only increased the synthesis accuracy and reproducibility but reduced the personnel time and costs up to 75%.

Subacromial Balloon Spacer Versus Partial Rotator Cuff Repair in the Treatment of Massive Irreparable Rotator Cuff Tears: Facility Personnel Allocation and Procedural Cost Analysis.

Background The subacromial balloon is a novel technology that has shown promise in managing a select patient population with massive irreparable rotator cuff tears. The purpose of this study was to quantify the true facility cost difference between subacromial balloon placement (SBP) and partial rotator cuff repair (PCR). Methodology A prospective cohort of patients with massive irreparable rotator cuff tears randomized to SBP versus PCR between2015 and 2018 was retrospectively reviewed. Demographic variables, medical comorbidities, and range-of-motion (ROM) outcomes for all patients were recorded. True facility costs with respect to personnel were calculated using a time-driven activity based-costing (TDABC) algorithm and were classified into personnel costs and supply costs. Results Seven patients were treated with PCR compared to nine treated with SBP. No significant differences were observed with respect to demographic characteristics. Postoperative mean external rotation was 37° in SBP patients significantly higher than that of PCR patients at 8° (P= 0.023). Personnel time and cost differences while in the operating room (OR) were significantly less for the SBP ($605.58) compared to PCR ($1362.76) (P< 0.001). Implant costs were higher for SBP when compared to PCR, whereas disposable equipment costs were higher for PCR when compared to SBP. The total mean true facility cost was $7658.00 for SBP, significantly higher than that of PCR at $3429.00 (P< 0.001). Conclusions Despite the substantial reduction in personnel costs seen with SBP, the true facility cost of SBP was significantly higher than that of PCR. As this novel technology is used more ubiquitously and its price is negotiated down, the cost savings seen in personnel and OR time will become more significant. Future prospective cost analyses should follow up on the changes in implant costs and account for potential anesthesia cost savings.

Time and personnel costs associated with adverse event (AE) management among patients with chronic lymphocytic leukemia (CLL)

ABSTRACT Objectives Novel therapies improve clinical outcomes in chronic lymphocytic leukemia (CLL), although adverse event (AE) profiles differ. This study evaluated time and personnel costs of AE management among healthcare professionals (HCPs) treating patients with CLL with novel therapies. Methods A non-interventional prospective survey was conducted over 2 months. Eligible HCPs reported the time per day spent performing AE management activities for CLL patients treated with acalabrutinib, ibrutinib, or venetoclax. Mean time and personnel costs (USD) per activity were summarized and used to estimate the total annual costs of AE management for an average-sized oncology practice. Results For an average-sized practice (28 HCPs with an average of 56 CLL patients), the mean annual personnel cost of AE management for CLL patients on novel agents was estimated at $115,733. The personnel cost associated with acalabrutinib ($20,912) was less than half that of ibrutinib ($53,801) and venetoclax ($41,884), potentially due to fewer severe AEs and less time spent by oncologists managing AEs compared to other HCP types. Conclusion The substantial burden of AE management for patients with CLL may vary by treatment used. Acalabrutinib was associated with lower annual costs of AE management at an oncology practice level compared to ibrutinib and venetoclax.

Local Versus General Anesthesia in Pediatric Otoplasty: A Cost and Efficiency Analysis.

Quantify the cost benefits of otoplasty under local as opposed to general anaesthesia. A cost analysis of all components of otoplasty surgery under local anaesthesia (LA) in a minor operating room (OR) and general anaesthesia in a main OR was performed. Our institution, compared to provincial/federal data, with costs converted into 2022 Canadian dollars. Patients undergoing otoplasty under LA in the last year. An efficiency analysis was performed by means of an opportunity cost, and the cost of failure was added to the overall LA costs. Expenses for infrastructure, surgical and anaesthetic material, salaries, and personnel costs were derived from the literature, our hospital OR catalog and federal/provincial salary data, respectively. The cost of failure to tolerate local anaesthesia for such cases was also tabulated. The true cost of LA otoplasty was computed as the absolute cost ($611.73) added to the cost of failure ($10.80), resulting in a total of $622.53/procedure. The true cost of GA otoplasty was calculated as the absolute cost ($2033.05) added to the opportunity cost ($1108.94), representing 3141.99$/procedure. The total savings when performing LA otoplasty to GA otoplasty are thus 2519.44$/case, with 1 GA otoplasty costing 5.05 LA otoplasties. Otoplasty under local anaesthesia offers significant cost savings when compared with the same procedure under general anaesthesia. Economic considerations must be given particular attention given the elective nature of this procedure, which is often publicly funded.

Determinants of High Facility Costs in Total Joint Arthroplasty Patients: A Time-driven Activity-based Costing Analysis.

Although several studies identify risk factors for high-cost patients in an episode of care for total hip (THA) and knee arthroplasty (TKA), few have looked at cost outliers from a facility perspective. The purpose of this study was to use time-driven activity-based costing (TDABC) to identify characteristics of high-cost patients. We reviewed a consecutive series of primary THA and TKA patients by 22 different surgeons at two hospitals between 2015 and 2020. Facility costs were calculated using a TDABC algorithm for their entire hospital stay. Patients in the top decile of costs were considered to be high-cost patients. Multivariate regression was done to identify independent patient factors that predicted high costs. Of the 8,647 patients we identified, 60.5% underwent THA and 39.5% underwent TKA. Implant purchase price accounted for 49.5% of total inpatient costs (mean $2,880), followed by intraoperative (15.9%, mean $925) and postoperative personnel costs (16.8%, mean $980). Implant price demonstrated the highest variation between high-cost and low-cost groups (4.4 times). Patient-related factors associated with high costs were female sex (OR = 1.332), Hispanic ethnicity (OR = 1.409), American Society of Anesthesiology score (OR = 1.658), need for transfusion (OR = 2.008), and lower preoperative HOOS/KOOS Jr (OR = 1.009). This study identifies several variables for patients at risk to have high facility costs after primary THA and TKA. From the hospital's perspective, efforts to reduce implant purchase prices may translate into substantial cost savings. At the patient level, multidisciplinary initiatives to optimize medical comorbidities, decrease transfusion risk, and control medication expenses in high-risk patients may narrow the existing variation in costs.