Cost Of Hospital Services Research Articles

Economies of Scale, Efficiency and Optimal Size of the Hospital

Hospitals are being expanded all over the world. Hospitals are becoming larger (i.e., increasing patient admissions each year) and more complex (i.e., offering a wider range of services to patients with more diverse medical care needs). In the hospital sector and other branches of the economy, economies of scale are important, according to which the volume of medical services can be increased by reducing average costs and increasing quality. However, measuring this relationship between the volume of medical services and costs is difficult because hospitals differ substantially in terms of specialization, patient composition, and other parameters that affect the volume of costs. The paper discusses the features of economies of scale in the healthcare sector and the dependence of the volume of medical services on costs and quality. Studies confirm that the influence of various factors on the costs and quality of medical services depends on the environment and the system of incentives in which hospitals operate. Relationships between patients and healthcare providers based solely on price negotiations do not ensure adequate healthcare quality. Due to informational asymmetry with respect to the real cost of hospital services and quality of treatment, medical service buyers cannot influence cost reductions and increase the quality of treatment, which increases hospital power. Thus, when evaluating the impact of hospital competition on costs and quality of care, we must remember that market mechanisms in health care do not always increase public welfare.

Cost Sharing Paid by Social Askes Participants at Pelamonia Hospital Makassar and Faisal Islamic Hospital Makassar

The cost of hospital services in Indonesia in general is a complex problem with many obstacles and we can see that the publication of cost information is often unclear. In Government Hospitals, in particular, budget allocations are still inadequate, this is due, among other things, to the costs that must be borne by the Hospital, especially equipment costs, operational and maintenance costs, which seem to tend to increase following advances in increasingly sophisticated health technology. The aim of the research is to obtain an overview of the cost sharing that will be incurred by Askes Social participants at Pelamonia Hospital and Islamic Faisal Hospital Makassar, reviewed in terms of additional costs incurred/types of patient inpatient treatment in terms of class/rank and linked to Regional Regulations. The type of research used is survey research with a descriptive approach, with the aim of obtaining information about cost sharing costs for health services in the inpatient unit of Pelamonia Hospital Makassar and Islamic Faisal Hospital Makassar. The results of this study and previous research show that patients participating in Askes tend to use nursing classes that are better than those specified. The conclusion is that the Cost Sharing for Social Health Insurance patients based on group/rank in the inpatient unit at Faisal Islamic Hospital is IDR 795,000,- while at Pelamonia Hospital Makassar it is IDR 1,125,000.

"We always felt psychologically unstable": A qualitative study of midwives' experiences in providing maternity care during the COVID-19 pandemic in Tanzania.

We explored midwives' experiences and challenges in providing maternity care during the period of the first surge of the COVID-19 pandemic in Dodoma. Phenomenological study design was used to explore midwives' experiences and challenges in providing maternity care during the COVID-19 pandemic in Tanzania. We conducted interviews with a total of 23 midwives, using semi-structured interviews and an audio recorder. Five focus group discussions (FGDs) were conducted. To analyse the data, we used interpretive phenomenological thematic data analysis with NVivo software. To analyse templates, we followed a step-by-step process, starting with familiarizing ourselves with the data, followed by preliminary coding, organizing themes, developing an initial coding template, using the initial template, refining the template and finally applying it to the entire dataset. It was found that three themes and eight subthemes merged in the current study. The main themes were ① mental health distress, ② work environment challenges and ③ isolation of midwives by different groups. Reducing risk and protecting midwives from infectious diseases will improve the workforce, reduce the number of hospital stays, reduce the cost of hospital services, improve birth outcomes and indirectly improve family, community and national economies. Due to the system's failure to provide psychological support, protective environment and isolation rooms for confirmed or suspected cases put midwives at a higher risk of contracting the virus and had to work in a stressful environment. In addition to having the right tools, midwives must also receive emotional and psychological support in order to be at their best. The system must ensure that midwives are ready for uncertain times, such as pandemic infectious disease outbreaks, by providing protective work place environment such as personal protective equipment, psychological support and isolation room for confirmed COVID-19 cases.

Costs Analysis for Pathology Clinic Services at “RSK” District Hospital in Central Java Province, Indonesia

The local government-owned hospital, “RSK”, in the northern region of Central Java Province, is expected to propose a new clinical tariff for pathology clinic services urgently. A more accurate calculation method is necessary because the current process of determining hospital service costs lacks a broader cost analysis. This is particularly important for pathology clinics, which are not just a part of the hospital’s services but are essential for diagnosing illnesses and determining the risk and prognosis of diseases. Therefore, this research aimed to form part of the broader cost analysis for “RSK” hospitals. The secondary data collected were investment, operational, and maintenance costs and other relevant input and output data. The cost analysis adopted a modified double distribution or step-down method, which used two distributions of costs. Firstly, an indirect cost was distributed to direct costs, followed by a second distribution to direct costs. Finally, laboratory consumables costs were added to the final distribution results. The analysis results showed that there were 54 types of services, with unit costs (UC) of pathology clinic services ranging from IDR 46.566 (USD 2.95) to IDR 406,220 (USD 25.71). However, hospital management was expected to prepare a new hospital tariff for the local government. Several factors that needed to be considered for new hospital rates included UC, government subsidies, Ina-CBG (Indonesia-Case Based Groups) rates from BPJS, competitive hospital tariff, and the community’s ability to pay.

Multiobjective Optimization of Public Health Service Delivery Networks

Providing an effective health service as a state is equivalent to giving life. Health services, whose pillar is to optimize the supply chain with public policies based on equity, are equal to providing life. Identifying all the variables and characteristics of the services allows the development of a multiobjective model to represent a public health services network. A case of the National Public Network of Colombia has been analyzed, minimizing costs and contributing to the decision making process. In this paper, a multiobjective approach to optimize the National Public Network in Colombia has been proposed. The proposed scheme combines mathematical techniques with managerial aspects related to public network health. Thus, we identify the distribution of services by the municipality to minimize the total cost and maximize coverage. The opening of services is suggested according to the demanding complexity and transport of patients between institutions. The results contrast with the current hospital services of Valle del Cauca in Colombia. The proposed scheme results show a reduction in the transfer of patients with a minimum increase in the costs of hospital services. The service proposal is based on improving access and quality in the provision of services, avoiding du- plication of supply, and generating an impact on the sustainability of the network of Valle del Cauca.

Prevented cases of neural tube defects and cost savings after folic acid fortification of flour in Brazil.

Anencephaly, encephalocele, and spina bifida are congenital neural tube defects and are the main causes of neonatal morbidity and mortality and impose a heavy economic burden on health systems. This study to estimates the direct costs of neural tube defects from the perspective of the Brazilian Ministry of Health, and the prevented cases and cost savings during the period in which mandatory folic acid fortification was in effect in the country (2010-2019). It is a top-down cost-of-illness oriented study based on the prevalence of the disorders in Brazil. Data were collected from the Brazilian Ministry of Health's outpatient and hospital information system databases. The direct cost was estimated from the total patient-years, allocated by age and type of disorder. Prevented cases and cost savings were determined by the difference in the prevalence of the disorders in the pre- and post-fortification periods based on the total number of births and the sum of outpatient and hospital costs during the period. The total cost of outpatient and hospital services for these disorders totaled R$ 92,530,810.63 (Int$ 40,565,896.81) in 10 years; spina bifida accounted for 84.92% of the total cost. Hospital costs were expressive of all three disorders in the first year of the patient's life. Between 2010 and 2019, mandatory folic acid fortification prevented 3,499 live births with neural tube defects and resulted in R$ 20,381,586.40 (Int$ 8,935,373.25) in hospital and outpatient cost savings. Flour fortification has proved to be a valuable strategy in preventing pregnancies with neural tube defects. Since its implementation, there has been a 30% decrease in the prevalence of neural tube defects and a 22.81% decrease associated in hospital and outpatient costs.

Cost of hospital services in India: a multi-site study to inform provider payment rates and Health Technology Assessment

The 'Cost of Health Services in India (CHSI)' is the first large scale multi-site facility costing study to incorporate evidence from a national sample of both private and public sectors at different levels of the health system in India. This paper provides an overview of the extent of heterogeneity in costs caused by various supply-side factors.A total of 38 public (11 tertiary care and 27 secondary care) and 16 private hospitals were sampled from 11 states of India. From the sampled facilities, a total of 327 specialties were included, with 48, 79 and 200 specialties covered in tertiary, private and district hospitals respectively. A mixed methodology consisting of both bottom-up and top-down costing was used for data collection. Unit costs per service output were calculated at the cost centre level (outpatient, inpatient, operating theatre, and ICU) and compared across provider type and geographical location.The unadjusted cost per admission was highest for tertiary facilities (₹ 5690, 75 USD) followed by private facilities (₹ 4839, 64 USD) and district hospitals (₹ 3447, 45 USD). Differences in unit costs were found across types of providers, resulting from both variations in capacity utilisation, length of stay and the scale of activity. In addition, significant differences in costs were found associated with geographical location (city classification).The reliance on cost information from single sites or small samples ignores the issue of heterogeneity driven by both demand and supply-side factors. The CHSI cost data set provides a unique insight into cost variability across different types of providers in India. The present analysis shows that both geographical location and the scale of activity are important determinants for deriving the cost of a health service and should be accounted for in healthcare decision making from budgeting to economic evaluation and price-setting.

Key predictors and burden of meticillin-resistant Staphylococcus aureus infection in comparison with meticillin-susceptible S. aureus infection in an Australian hospital setting

Staphylococcus aureus is associated with significant mortality and increased burden on the healthcare system. Relatively few reliable estimates are available regarding the impact of meticillin-resistant S.aureus (MRSA) infection compared with meticillin-susceptible S.aureus (MSSA) infection. To compare patients with MRSA infection and MSSA infection to identify differences in inpatient mortality, length of stay and costs of hospital services, and identify predictors of MRSA as a cause of S.aureus infection. An analytical, retrospective, longitudinal study using non-identifiable linked data on adults admitted to hospitals of a health district in Australia with a diagnosis of S.aureus infection over a 10-year period. The main outcome measure was 30-day inpatient mortality. Secondary endpoints included total overnight stays, all-cause inpatient mortality, and hospitalization costs within 1 year of index admission. Inpatient mortality at 30, 100 and 365 days was estimated to be significantly greater for patients with MRSA infection. The mean additional cost of MRSA infection when controlling for additional factors was $5988 and 4 nights of additional hospital stay per patient within 1 year of index admission. Key predictors of MRSA infection were: date of index admission; higher comorbidity score; greater socio-economic disadvantage; admission to hospital other than via the emergency department; older age; and prior admission to hospital within 28 days of index admission. MRSA infection is associated with increased inpatient mortality, costs and hospital length of stay compared with MSSA infection. Efforts are required to alleviate the additional burden of MRSA infection on patients and healthcare systems.

Novel Stacking Classification and Prediction Algorithm Based Ambient Assisted Living for Elderly

Recognition of human activity is a significant area of research with numerous uses. In developed countries, the rising age of citizens requires the improvement of the medical service structure, which raises the price of resources, both financial and human. In that sense, ambient assisted living (AAL) is a relatively novel information and communication technology (ICT) that presents services and recognizes various products that enable older people and the disabled to live autonomously and improve their quality of life. It further assists in reducing the cost of hospital services. In the AAL environment, various sensors and devices are fixed to gather a broad range of data. Moreover, AAL will be the motivating technology for the latest care models by acting as an adjunct. This will become thought-provoking research in a fast-growing world, but exploring different ADL and self-classification will become a major challenge. This paper proposed a Novel Stacking Classification and Prediction (NSCP) algorithm based AAL for the elderly with Multi-strategy Combination based Feature Selection (MCFS) and Novel Clustering Aggregation (NCA) algorithms. This paper’s main aim is to recognize the activity of older people, such as standing, walking, sitting, falling, cramps, and running. The dataset is derived from the Kaggle repository, which refers to data collection from wearable IoT devices. The experimental outcomes demonstrate that the MCFS, NCA, and NSCP algorithms work more efficiently than existing feature selection, clustering, and classification algorithms, respectively, regarding the accuracy, sensitivity, specificity, precision, recall, F-measure, and execution time dataset size and the number of features. Furthermore, the NSCP algorithm provided high accuracy, precision, recall, and F-measure are 98%, 0.96, 0.95, and 0.98, respectively.

Hospital unit costs in Jordan: insights from a country facing competing health demands and striving for universal health coverage

BackgroundPublic providers in Jordan are facing increasing health demands due to human crises. This study aimed to benchmark the unit costs of hospital services in public providers in Jordan to provide insights into the outlook for public health care costs.MethodsThe unit costs of hospital services per admission, inpatient days, outpatient visits, emergency visits and surgical operations were estimated using the standard average costing method (top-down) for the fiscal year 2018–2019. The unit costs per inpatient day were estimated for nine specialities and staff in Jordanian dinars (exchange rate JOD 1 = USD 1.41).ResultsThe average unit cost per admission in Jordan was JOD 782.300 (USD 1101.80), the per inpatient day cost was JOD 236.600 (USD 333.20), the per bed day cost was JOD 172.900 (USD 244.90), the per outpatient visit cost was JOD 58.400 (USD 82.30), the per operation cost was JOD 449.600 (USD 633.20) and the per emergency room visit cost was JOD 31.800 (USD 44.80). The specialities of ICU/CCU and OB/GYN presented the highest unit costs per inpatient day across providers: JOD 377.800 (USD 532.90) and JOD 362.600 (USD 510.70), respectively. The average salaried unit cost of staff depended mainly on year of employment. Nonetheless, the unit costs varied depending on the service utilization, type of service and organizational outlet.ConclusionsKnowledge of how unit costs vary across public providers in Jordan is essential to outline cost control strategies and inform future research. Institutionalization of the cost information system and high-level governmental support are necessary to generate a routine practice of collecting and sharing cost information.

Abstract 11419: Outcomes of Transcatheter Aortic Valve Replacement in Patients with High Comorbidity versus Low Comorbidity Burden

Introduction: Transcatheter aortic valve replacement (TAVR)’s on-par performance with surgical aortic valve replacement in clinical trials has led to its successful adoption in patients with high and low mortality risk. Here we evaluate if a correlation exists between comorbidity burden and in-hospital mortality (IHM) in TAVR patients and examine the factors associated with increased IHM. Methods: Using the National Inpatient Sample database, 148,315 adult patients who underwent TAVR from 2016 through 2018 were included in the study. The Elixhauser Comorbidity Index 2020 was used to identify comorbidities. All comorbidities were weighted equally. Patients with <3 comorbidities were assigned to the low comorbidity group (LCG) and those with ≥3 comorbidities to the high comorbidity group (HCG). The primary outcome of interest was IHM in the HCG versus the LCG. Secondary outcomes were average length of stay (LOS) and average hospital charges. Results: The overall IHM rate in our sample was 1.52%. Unadjusted and adjusted IHM odds were not different between groups (unadjusted odds ratio=1.024, P=0.7994; adjusted odds ratio=1.022, P=0.8225). Female sex, non-elective admission for TAVR, and transapical access were found to be independent predictors of IHM when adjusted for other factors (Table). The adjusted average LOS was significantly higher in the HCG than the LCG (3.07 vs. 2.7 days, P<0.0001). The adjusted average total hospital charges billed and average actual cost of hospital services were significantly higher in the HCG than the LCG (213,507 vs 208,019 USD, P=0.0032 and 55,284 vs 54,278 USD, P=0.0078; respectively). Conclusion: In-hospital mortality in TAVR patients is not significantly correlated with comorbidity burden. Female sex and procedural characteristics like transapical access and non-electiveness are more important in determining IHM. Resource utilization is higher in the HCG than the LCG.

Predictors of Mortality among Non Traumatic Non COVID Emergencies during Early COVID-19 Outbreak: An Observational Study on Clinical Profile and Outcome of Patients in North India

Context: Severe acute respiratory distress corona virus 2 (SARS COV 2) unleashed an unprecedented medical emergency and led to exemplary global containment response to limit the Corona Virus disease (COVID-19). These responses began in the initial phase of the pandemic itself and came at the cost of non-COVID hospital services. Aims: The aim of this study was to highlight the profile of patients, their outcomes and predictors of mortality in non-traumatic emergencies presenting to the non-Covid section of a north Indian tertiary care center during the early phase of COVID outbreak. Settings and Design: Single center observational study. Methods: After obtaining Institute ethics committee approval, data of patients presenting in emergency from February 1, 2020 to April 30, 2020 were obtained retrospectively. Patients coming with trauma related emergencies were excluded. Statistical analysis used: The data was categorized as survivors and non-survivors. Student t test/Mann Whitney test was used to compare continuous variables and Chi square test was used to compare categorical data. Univariate and multivariate binary logistic regression analysis were used to identify the predictors of non-survival. Results: Out of 800 patients admitted in emergency, 2 were found to be SARS COV2 positive. Of the remaining 798 patients, 27 (3.4%) patients expired. On multivariate analysis, greater age, hemoptysis, oxygen or ventilatory requirement and need of vasopressors at admission were predictors of non-survival. Conclusions: Greater age, need for oxygen, ventilator and vasopressors at time of admission are harbingers of mortality among non-Covid patients presenting in emergency.

Abstract 01: Thirty-day Readmission Rate For Hypertensive Crisis: A Nationwide Analysis

Objective: Hypertensive crisis is a life-threatening condition that leads to poor patient outcomes if not treated urgently. We evaluate the all-cause 30-day readmission rate, resource utilization, predictors of readmission, and the most common causes for readmission in patients admitted with hypertensive crisis. Methods: Using the National Readmission Database 2018, patients ≥18 years of age admitted with the principal diagnosis of the hypertensive crisis were included in the study. The primary outcome was the all-cause 30-day readmission rate in these patients. Results: We identified 129,239 patients as index admissions. The mean age of index patients was 61±0.14 years, and females were 56.6%. The 30-day readmission rate was 10.6 % (13,768± 355). The in-hospital mortality rate was 0.2 % for index admissions and 1.5 % for readmissions. The cumulative length of stay (LOS) for all readmitted patients was 62,046± 1,802 days. The cumulative total cost of hospital services in readmitted patients was 155 ± 4.6 million USD. Age<65, lower-income, increased LOS, increased comorbidity burden, primary payer, and disposition were important predictors of readmission (Table). The most common causes of readmission were hypertensive crisis (19 %), CHF (12.4%), acute renal failure (4.4%), sepsis (2.6%), ESRD (2%), NSTEMI (2%), and stroke (1.7%) Conclusion: In conclusion, the 30-day readmission rate in patients with hypertensive crisis is high (10.6%), with hypertensive crisis and CHF as the most common causes. Resource utilization is also high, with many potential avoidable days and costs. Future strategies should address underlying factors, especially socioeconomic factors.

Effects of Staff Training on Nursing Home Residents’ End-Of-Life Care: A Randomized Controlled Trial

ObjectivesThis trial examines the effects of end-of-life training on long-term care facility (LTCF) residents' health-related quality of life (HRQoL) and use and costs of hospital services. DesignA single-blind, cluster randomized (at facility level) controlled trial (RCT). Our training intervention included 4 small-group 4-hour educational sessions on the principles of palliative and end-of-life care (advance care planning, adverse effects of hospitalizations, symptom management, communication, supporting proxies, challenging situations). Training was provided to all members of staff. Education was based on constructive learning methods and included resident cases, role-plays, and small-group discussions. Setting and participantsWe recruited 324 residents with possible need for end-of-life care due to advanced illness from 20 LTCF wards in Helsinki. MethodsPrimary outcome measures were HRQoL and hospital inpatient days per person-year during a 2-year follow-up. Secondary outcomes were number of emergency department visits and cost of all hospital services. ResultsHRQoL according to the 15-Dimensional Health-Related Quality-of-Life Instrument declined in both groups, and no difference was present in the changes between the groups (P for group .75, adjusted for age, sex, do-not-resuscitate orders, need for help, and clustering). Neither the number of hospital inpatient days (1.87 vs 0.81 per person-year) nor the number of emergency department visits differed significantly between intervention and control groups (P for group .41). The total hospital costs were similar in the intervention and control groups. Conclusions and ImplicationsOur rigorous RCT on end-of-life care training intervention demonstrated no effects on residents’ HRQoL or their use of hospitals. Unsupported training interventions alone might be insufficient to produce meaningful care quality improvements.

Health Service Costs for a Predialysis Dietetic Clinic: A Retrospective Cost Analysis Study

Effect of dietetic consultation (DC) on clinical outcomes is an under-researched component of predialysis education. Predialysis DC has been associated with a 7.5-month delay in requiring dialysis commencement, having potential cost implications for health services. Limited studies have evaluated the possible impact of predialysis DC on health service costs. This study aimed to investigate the hospital health service costs associated for patients attending a predialysis dietetic clinic. A cost analysis comparing hospital health service costs over 4years in a cohort of predialysis patients with and without DC. Retrospective study data were used (n=246) along with outpatient renal clinic visits, hospital admissions records to estimate total hospital service costs. A generalized linear model evaluated associations between total cost and the marginal effects of DC and other variables on total costs. Mean total cost for patients (outpatient visits, admissions, and dialysis) was AUD$178,913 (95% confidence interval=$158,735-$199,090) or $185/day (95% confidence interval=$12-$161). The DC group total costs/day were lower than the no-DC group with a mean difference of $51/day ($155 vs. $206; P=.03). Patients in the DC group had less admissions compared to the no-DC group (6.32 vs. 8.06; P=.02). The highest marginal costs estimated for the entire cohort were lower estimated glomerular filtration rate at admission ($123,511, P=.001), inpatient admissions ($189,333, P<.001), commencing dialysis ($581,812, P<.001), having diabetes ($94,590, P=.014), and cerebrovascular disease ($177,080, P=.01). DC advice did not influence total costs. Patients who received DC had lower total health services costs/day compared to those who did not receive DC. Marginal cost analysis indicates the cost difference to be attributed to less time on dialysis and fewer hospital admissions in this retrospective observational cohort. An assessment of dietetic staffing in predialysis renal services is warranted.

Characterization and treatment of immune thrombocytopenia in Europe: a qualitative observational study

ABSTRACT Background Immune thrombocytopenia (ITP) is a rare disease, characterized by increased platelet destruction/suboptimal platelet production, leading to thrombocytopenia and risk of severe bleeding events. Methods Interviews with 23 physicians and 12 payors, a survey with 113 physicians and validation using published data were used to define the current treatment paradigm and healthcare resource utilization and to determine the costs associated with managing acute bleeds in six European countries (Germany, Spain, France, Italy, Netherlands, UK). The study estimated a prevalence of 9 to 10 per 100,000 adults in 2020 across all six countries (disease severity split: 34% mild, 32% moderate, 33% severe (due to rounding up some values might not sum up to 100%). Results Physician feedback showed that most patients with ITP (60%) received first-line treatment or were monitored by their physician; ∼75% of patients relapsed within 3–4 months. Thrombopoietin-receptor agonists (TPO-RAs) and rituximab were used to achieve disease stabilization in patients who relapse; patients could switch to an alternative TPO-RA to control symptoms, manage side-effects or improve adherence. The costs of rescue therapies and hospital services (e.g. surgery and admissions) accounted for the majority of healthcare resources to manage bleeding events. Conclusion Physicians would welcome earlier use of TPO-RAs to help maintain long-term control of ITP bleeds and potentially reduce both hospitalization and therapy costs.

Determining the Cost of Hospital Services Using the Top-Down Costing Method

Determining the Cost of Hospital Services Using the Top-Down Costing Method

English

The study aim to determine the factors that make women deliver at home after attending antenatal care, to determine the awareness of women on risks associated with home delivery, to determine the type of birth attendants’ available during home delivery, and to explore the opinions of women on various strategies to prevent home delivery. A non- experimental cross-sectional design was used, with a target population of 960 people and systematic random sampling technique was employed to select the sample of 132 subjects out of the target population. Participation was voluntary and the principle of informed consent was ensured. Questionnaire was used as an instrument for data collection but only 121 were retrieved and analyzed, using SPSS Version 23. The findings of the study revealed that, women deliver at home due to cost of hospital services, male attendant during delivery, distance of the health facility from their home, poor attitude of health care provider and fear of surgical procedure. Also, according to the findings, the strategies of preventing home delivery includes provision of free maternal and child services, good health care provider attitude, health education on danger associated with home delivery, and adequate man power. In conclusion, majority of respondents were aware on factors that make them deliver at home. Recommendations were made that, health services should be subsidized and made available to women of child bearing ages and health education as well as improvement of community awareness on the importance of institutional delivery should be planned and implemented. Key words: Determinants, home-delivery, antenatal care.

Recorded prevalence of nasal polyps increases with age.

IntroductionNasal polyps are a multifactorial inflammatory condition of the upper airways. Nasal polyps typically affect middle-aged and elderly patients, average age at diagnosis is 40 to 60, and men are affected more commonly than women.AimTo analyse the reported prevalence of nasal polyps in the Polish population, including demographics and co-morbidities, and to estimate the costs of outpatient and hospital (inpatient) services financed by the National Health Fund.Material and methodsStatistical analysis of data extracted from the National Health Fund (NHF) registers for 2008–2018.ResultsIn 2018, the recorded prevalence of nasal polyps in Poland was 52.0/10,000 population (0.52%), amounting to 64.6/10,000 (0.65%) in men and 40.2/10,000 (0.40) in women. Nasal polyps were much more frequent in patients aged 55–59 (98.1/10000) and 75–79 years (98.7/10,000). Among men, the highest prevalence was found in the 75–79 age group (164.3/10,000 population), and among women in the 55–59 age group (75.1/10,000). In 2018, the Polish NHF spent PLN 17.2 million (equivalent to EUR 4.0 million/USD 4.7 million) on health services related to the diagnosis of nasal polyps. Hospital services accounted for 77.4% of the total cost.ConclusionsNasal polyps are more than one and a half times as prevalent in men than in women. The recorded prevalence of nasal polyps increases with age, with the rates peaking in those between 75 and 79 years old, and is more often in urban than rural areas.

Medical Tourism and its Scope in India

Indian healthcare sector is one of the fastest growing sectors. The growth of trade in health care services through medical tourism has led India as an affordable destination. Patients from foreign countries come to India for surgical purposes due to low cost and high quality of hospital services. The country has huge potential to grow up and also expected to grow at a compound annual growth rate of 17 percent from the year 2011 to 2020.