Differential Cost Analysis Research Articles

Goal Directed Perfusion (Gdp): A Differential Cost Analysis In Uk And Us.

High oxygen delivery (DO2) during cardiopulmonary bypass (CPB) is associated with better renal outcome in cardiac surgery. Traditional perfusion (TP) techniques, targeted on body surface area and CPB temperature, achieves high DO2 in about 50% of the cases while a goal directed perfusion (GDP) approach can lead to more than 90% of cases achieving high DO2 with a consequent reduction in Acute Kidney Injury (AKI) rate of about 40%. Aim of this study is to perform an economic evaluation of GDP strategy with respect to TP in UK and US. A Discrete Event Simulation model was developed to compare TP and GDP strategy in patients undergoing CPB. The patient’s pathways from operation to discharging from hospital was simulated: AKI incidence, in-hospital mortality, hospital length of stay, transfusions were correlated to probability to achieve high DO2 target using published correlations. National perspective was adopted to calculate costs associated to each event while GDP strategy was exploited considering card and data management system (DMS) cost per patient. GDP strategy saved more than 3 days in hospital and 11% of AKI episodes. The cost-saving is 2,821 £ in UK and 3,206 $ in US; the cost of card and DMS (79 £ in UK, 110 $ in US) is completely offset by savings in hospital stay that result the main driver in cost (2,886 £ in UK, 3,222 $ in US). Deterministic sensitivity analysis shows that the total savings are mainly influenced by hospital LOS, cost per day both in ICU and in ward, and nadir haematocrit during CPB. GDP seems to improve significantly the main outcomes related to CPB surgery, when compared to TP techniques. Additional costs due to perform GDP strategy have no impact on the total cost since completely offset by the savings in hospital cost.

Single-access laparoscopic rectal resection versus the multiport technique: a retrospective study with cost analysis.

Single-access laparoscopic surgery is not used routinely for the treatment of colorectal disease. The aim of this retrospective cohort study is to compare the results of single-access laparoscopic rectal resection (SALR) versus multiaccess laparoscopic rectal resection with a mean follow-up of 24 months. This retrospective cohort study enrolled 42 patients. Between January 2010 and June 2012, 21 SALRs were performed. These patients were compared with a group of 21 other patients who had undergone multiport laparoscopic rectal resection. This control group had the same exclusion criteria and patient demographics. Short-term outcomes were reassessed with a mean follow-up of 2 years. Statistical analysis included the Student t test and Fisher's exact test. Finally, we performed a differential cost analysis between the 2 procedures. Exclusion criteria, patient demographics, and indication for surgery were similar in both groups. The conversion rate was 0% in both groups. There were no intraoperative complications or deaths. Bowel recovery was similar in both groups. No interventions, readmissions, or deaths were recorded at 30 days' follow-up. At a mean follow-up of 24 months, all the patients with a preoperative diagnosis of cancer are still alive and disease free. Considering the selected 3 items, the mean cost per patient for single-access laparoscopic surgery and multiple-access laparoscopic surgery were estimated as 7213 and 7495 Euros, respectively. We think that SALR could be performed in selected patients by surgeons with high multiport laparoscopic skills. It is compulsory by law to evaluate outcomes and cost-effectiveness by using randomized controlled trials.

Performance response, carcass evaluation and economic benefit or rabbits fed sorghum offal-based diets

An eight-week feeding trial was conducted to investigate the performance, carcass quality, haematological indices and economics of production of rabbits fed dietary sorghum offal substitute for maize grain. A total of forty (40) weaned rabbits with a mean weight range of 820-850 g were randomly distributed to five treatment diets where 0, 25, 50, 75 and 100% of sorghum offal replaced maize grain in the gross feed composition to give Diets 1 (control), 2, 3, 4 and 5, respectively. Each treatment diet was replicated eight times with a rabbit taken as a replicate. The determined chemical composition of the experimental diets ranged between 17.12% and17.43% for crude protein (CP), 11.48 and 14.89% for crude fibre (CF), 5.04 and 7.74% for ether extract or fat (EE), 54.17 and 56.41% for nitrogen free extract (NFE) and 3069.35kcal/kg to 3241.17ME(kcal/kg). While the results on performance showed no significant difference (P>0.05) in feed intake by rabbits fed the five test diets, there appeared to be significant decrease (P<0.05) in the weight gain and feed conversion ratio of rabbits fed 50 to 100% sorghum offal-based diets. Carcass cuts that showed significant reduction (P<0.05) at 75 and 100% sorghum offal-based diets are the carcass weight, thigh, loin, shoulder and ribs weights. Organs such as liver, kidney, heart and pancreas weights measured were significantly higher (P<0.05) at 75 and 100% sorghum offal-based diets. Haematological profile such as Packed Cell Volume (PCV), Red Blood Cells (RBC), White Blood Cells (WBC), Mean Cell Volume (MCV) and White Blood Counts such as neutrophil and basophil showed significant difference (P<0.05) at 75% and 100% sorghum offal-based diets. The serum metabolites such as albumin, globulin, cholesterol and urea showed a similar trend of significant difference (P<0.05) at 75% and 100% sorghum offal inclusion compared to other test diets. For economic production, the study revealed an optimum inclusion of sorghum offal at 50% (24.60 g/kg in feed composition) for maize grain in rabbit concentrate feed is possible. Above this level, a loss of N23.17 and N13.16 was recorded as evidenced by the cost differential and benefit cost analysis.

CRT-149 Differential Cost Analysis of 4 French Femoral Approach Revealed Significant Savings Over Radial Approach for Diagnostic Catheterization

Approximately one million diagnostic cardiac catheterizations are performed annually. The Accountable Care Act means that cost savings measures are becoming increasingly more important. Through advances in flat panel X-ray in the cath lab, coronary arteriogram quality has significantly improved for

ANALISIS PENGGUNAAN INFORMASI AKUNTANSI DIFERENSIAL DALAM PENGAMBILAN KEPUTUSAN MEMBELI ATAU MEMBUAT SENDIRI FLA KUE SUSEN PADA DOLPHIN DONUTS BAKERY.

In running a business every company always faced with many issues. There are many kinds of issues, decison making was one of them. Many informations are needed for the management in order to chose the right decision. Differential accounting information was one of the information that the management need as basis of palnning and decisions making. Differential cost analysis was appropiate for the issue in ways for the company to increase the profit and reduce the loss, which to make the decision to make or buy the material. The purpose of this research is to find out what was the right decision that the manager could took, either to make or to buy the fla using differential accounting information with comparing the differential cost within to buy or to make the fla.The result of the analysist at Dolphin Donuts bakery from differential cost showing that differential accounting information in short-term decision indicating the company better make their own fla as the material of susen, cause the production cost was more cheaper comparing if the company buy from supplier.

Beneficial effects of fibrin glue (Quixil) versus Lichtenstein conventional technique in inguinal hernia repair: a randomized clinical trial

In inguinal hernia repair, many complications are due to mesh fixation technique. Therefore, new types of atraumatic methods of fixation have been proposed. In this article, we present the results of a prospective multicentric parallel randomized controlled trial aiming to compare two mesh fixation techniques: fibrin sealant (QUIXIL(®), Omrix Biopharmaceuticals S.A., Belgium) and Lichtenstein technique. Adult patients with primary uncomplicated inguinal hernia were randomized in two groups: fibrin sealant group (FSG) and Lichtenstein group (LTG). The two groups underwent a follow-up of 15 months. Operative time is the primary outcome. Intraoperative and postoperative outcomes were analyzed. Moreover, a differential cost analysis was performed. Patients and evaluators (with exception of the surgeon who treated the patient) were blinded. A total of 102 patients, 50 in FSG and 52 in LTG, were enrolled from January 2009 to June 2010, and two patients were lost to follow-up at the twelfth month. No significant differences in baseline and clinical characteristics were observed in the two groups. Operative time was longer in LTG (median/ interquartile range: 35 min/30-42.5 min vs. 31 min/28-35 min; effect size: 0.65/95% CI 0.50-0.91; p < 0.05). No differences in intraoperative complications were observed. No significant differences were observed in early complication rate (RR = 0.62; p > 0.05). Numbness rate was lower in the FSG at 1 week (RR = 0.43; p < 0.01) and at 1 month (RR = 0.17; p < 0.05). No significant differences were observed after 6 months. Postoperative pain was lower in the FSG at 1 week (0/0-1 vs. 1/0-2; p < 0.05) and at 1 month (0/0-0 vs. 0/0-1; p < 0.05). Pain disappeared in all patients after 6 months. Analgesic assumption rate was lower in the FSG (RR = 0.42; p < 0.05). Twenty per cent of FSG and 9.62% of LTG patients were discharged within 12 h; 78% of FSG and 90.38% of LTG patients were discharged within 24 h. The only one recurrence we observed was in FSG group. About costs, although fibrin sealant needed for one mesh fixation is about 10 times more costly than the needed sutures, the total costs of the two procedures did not change significantly. This was mainly due to reduction in operative time. The use of fibrin sealant determined a significant reduction in short-term numbness rate and postoperative pain. There was no relevant difference in total costs per patient between the two procedures.