Public Healthcare System Research Articles

New progress in laboratory detection of respiratory infectious diseases in children

Respiratory infectious disease has become ahead of all the children's diseases, with the trend of continuously increasing global incidence, antimicrobial resistance and simultaneous infection with multiple pathogens. Diagnosis of this disease is mainly based on clinical symptoms and pathogenic detection. However, there are some differences in clinical manifestations, progression and prognosis between pediatric patients and adults, which prompting clinical diagnosis mainly depending on clinical laboratory test. Therefore, fast, convenient and accurate methods are urgently needed to clarify the type of infectious pathogen and carry out differentiated treatment, and reduce the burden on families and public health-care systems in schools. This article aims to elaborate the laboratory methods of children's respiratory infectious diseases and explore the opportunities and challenges, which can provide ideas for prevention, early screening and diagnosis, prognosis and treatment monitoring.

Exploring Drivers of Healthcare Utilization among the Working and Non-Working Elderly Population: Insights from LASI

Background The elderly population of India has been growing exponentially over the past few decades, caused by a decline in fertility and an increase in life expectancy. The growth eventually has transcended the disease burden on the public healthcare system. This calls for a need to evaluate the healthcare utilization pattern of the elderly based on their socioeconomic and working condition. Methods Study used access to public and private healthcare services to measure healthcare utilization. Descriptive analysis and multivariable logistic regression were used to understand utilization patterns by working status and some selected sociodemographic parameters. All the results were reported at a 95% confidence interval. Results Using the data from the first wave of Longitudinal Ageing Study in India (LASI) with a sample of 22,680 older persons 60 years and above. The study identified that 50% of the working elderly access private services; however, 26% access public healthcare services. It was found that the working status of the elderly alone did not influence access to healthcare services, but education is also an essential indicator for utilizing healthcare services. Further, factors such as gender, marital status, religion, wealth, tobacco usage, self-rated health, ADL and IADL were significant predictors of healthcare services’ utilization for the elderly. Conclusion This study suggests that there are not many differences found among working and non-working status with healthcare utilization, although some sociodemographic indicators are associated with the utilization of healthcare services, highlighting that increasing health needs among the elderly requires strengthening the quality and appropriate public investment in health.

An examination of the ohio scales, short form, hopefulness domain, youth- and caregiver-report versions in a community care setting

The current study examined the utility of the Ohio Scales, Hopefulness Scale (OS Hopefulness Scale; Ogles et al., 2004), a free multi-informant four-item measure of hopefulness used within a large statewide public mental health care system. Collectively, the six aims of this study (done for both youth- and caregiver-report versions) examined (a) the measure’s factor structure and (b) internal consistency, (c) the relationship between youth- and caregiver-reported hopefulness, (d) the measure’s relationships with numerous domains of psychopathology (e.g., depression, anxiety, delinquency) and (e) functioning, and (f) sensitivity to change. Using a sample of 986 participants, who were ethnically diverse (30.5 % multiethnic, n = 301), 61.0 % male (n = 601), with an average age of 12.74 (SD=3.46), the study found good factor structure, acceptable internal consistency, and a significant positive association between youth-reported and caregiver-hopefulness. Additionally, significant inverse relationships were found between caregiver-reported hopefulness with youth mental health problems and youth functioning; while youth-reported hopefulness was found to be significantly inversely related to youth mental health problems but not youth functioning. Finally, significant positive changes in hopefulness and significant inverse relationships with youth functioning were also evident at three-month follow up for both youth- and caregiver-reported hopefulness. The constellation of our findings demonstrates potential for this four-item measure of hopefulness to be a useful, efficient, and cost-effective tool with ethnically diverse samples, which are substantially different from samples included in previous studies of hopefulness. Implications and suggestions for future research are discussed.

Developing Innovative Secured Protocol For M Health Application In Wireless Body Area Networks

In today's technologically advanced society, cell phones and related devices are essential for managing peoples' individual demands. This is a smart device that determines and regulates how we use our free time, communicate, shop, and engage with the outside world. It still requires a lot of fixes to be effective and strong. The development of tiny devices, or sensors, gave mHEALTH greater adaptability and a fresh perspective. The majority of currently available mobile applications are widely accessible by users, who can use them to take vital signs and evaluate their own physical state. In an effort to increase public acceptability, some mobile companies have developed health applications for smartphones. People use these programs to monitor changes in bodily parameters such as body temperature, heart rate, blood pressure, and pulse rate in order to assess their physical conditions. Using the MSE-BAN architecture, this study has created a stable mHEALTH architecture. The scheduling plan for the study project was created by taking the importance of the essential signals into account. The public health care system that has been suggested can shorten hospital stays and enable clinical staff to continuously monitor patients.

Mechanical Engineering Solutions For Healthcare Accessibility And Affordability In Public Health

The commercial outlook for the healthcare industry is bright these days, both globally and in India. The need for prosthetics, implants, and surgical equipment, among other specialised or customised medical devices, is growing daily. Investigating personalised medical gadgets is crucial to take advantage of upcoming business prospects. In order to expand this commercial opportunity in terms of customised medical devices, additive manufacturing, or AM, can be extremely important. Further investigation into the public healthcare system revealed that the laparoscopic surgical method necessitates the use of specially made, ergonomic surgical instruments. Because laparoscopic surgery is done by staring at a monitor rather than making direct touch with the organs like open surgery does, surgeons doing this sort of procedure often lack hand-eye coordination. Surgical mistakes were discovered with this surgical method. The laparoscopic surgical instrument is the only interface device, and it must be designed to improve coordination and feel responsive during the procedure.

Social prescribing in Canada: linking the Ottawa Charter for Health Promotion with health care's Quintuple Aim for a collaborative approach to health.

Social prescribing offers a practical mechanism by which public health and health care systems can work together toward a future in which well-being is prioritized, health equity is addressed and people and communities thrive. The articles in this second part of the Health Promotion and Chronic Disease Prevention in Canada special issue on social prescribing explore how social prescribing in Canada supports action on two frameworks important to public health and health care communities: the Ottawa Charter for Health Promotion, which emphasizes building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services, and the Quintuple Aim for health care improvement, which focusses on improved population health, health equity, patient experience, care team well-being and reduced costs.

Individualized pretest risk estimates to guide treatment decisions in patients with clinical high risk for psychotic disorders

IntroductionClinical high risk for psychosis (CHR) states are associated with an increased risk of transition to psychosis. However, the predictive value of CHR screening interviews is dependent on pretest risk enrichment in referred patients. This poses a major obstacle to CHR outreach campaigns since they invariably lead to risk dilution through enhanced awareness. A potential compensatory strategy is to use estimates of individual pretest risk as a ‘gatekeeper’ for specialized assessment. We aimed to test a risk stratification model previously developed in London, UK (OASIS) and to train a new predictive model for the Swiss population. MethodThe sample was composed of 513 individuals referred for CHR assessment from six Swiss early psychosis detection services. Sociodemographic variables available at referral were used as predictors whereas the outcome variable was transition to psychosis. ResultsReplication of the risk stratification model developed in OASIS resulted in poor performance (Harrel's c=0.51). Retraining resulted in moderate discrimination (Harrel's c=0.67) which significantly differentiated between different risk groups. The lowest risk group had a cumulative transition incidence of 6.4% (CI: 0–23.1%) over two years. ConclusionFailure to replicate the OASIS risk stratification model might reflect differences in the public health care systems and referral structures between Switzerland and London. Retraining resulted in a model with adequate discrimination performance. The developed model in combination with CHR assessment result, might be useful for identifying individuals with high pretest risk, who might benefit most from specialized intervention.

The Impact of the COVID-19 Pandemic on Tele-ophthalmology-Based Retinal Screening.

This study reports our experiences with systematic retinal screening in Denmark through optometrists with access to tele-ophthalmological services before, during, and after the COVID-19 pandemic. We evaluated an optometrist-based retinal screening system with a referral option for tele-ophthalmological service by a consultant ophthalmologist within the time period of August1, 2018 to September30, 2023. The optometrist collected patient history, refraction, best-corrected visual acuity, intraocular pressure, basic slit-lamp examination, 4-in-1 visual field report, and retinal imaging using color fundus 45° photography. Tele-ophthalmological services were provided by consultant ophthalmologists. Within pre-defined periods of pre-COVID-19, COVID-19, and post-COVID-19, we evaluated the rate of referrals to the tele-ophthalmological service, diagnoses made, and referrals to the public healthcare system. A total of 1,142,028 unique individuals, which corresponded to 19.1% of the entire population of Denmark, underwent screening by the optometrists; 50,612 (4.4%) of these individuals were referred to the tele-ophthalmological examination by consultant ophthalmologists. A referral for further ophthalmic examination, either at hospital or at an ophthalmic practice, was made for 10,300 individuals (20.4% of those referred for tele-ophthalmology, corresponding to 0.9% of the population screened). The referral rate from the screening to the tele-ophthalmological service increased from before COVID-19 (3.4%) to during COVID-19 (4.3%) and further after COVID-19 (6.4%). This increase coincided with an increasing prevalence of conditions seen in the tele-ophthalmological service. During a period of 5years, 19.1% of the entire population of Denmark underwent retinal screening. This provided an adjunctive health service during a period of severe strain on the public healthcare system, while limiting the number of excessive referrals to the public healthcare system. Temporal trends illustrated an increased pattern of use of a large-scale tele-ophthalmological system.

Cost-Utility Analysis of Deep Brain Stimulation for Generalized and Cervical Dystonia: A Perspective from Brazilian Healthcare

ObjectiveIn the Brazilian public national healthcare system, botulinum toxin type A has traditionally been the sole treatment option for patients with dystonia. However, as of October 2022, Deep Brain Stimulation (DBS) garnered positive recommendations for the condition. This study aims to assess the cost-effectiveness of DBS in treating adults with generalized and cervical dystonia within the Brazilian healthcare context, considering its recent inclusion. MethodsA systematic review identified randomized controlled trials (RCTs) assessing DBS efficacy in treating adults with generalized and cervical dystonia. Two cost-utility analyses compared the cost-effectiveness of DBS plus the Best Clinical Practice (BCP) to BCP alone. Markov models, which included three health states (no clinical improvement, clinical improvement, and death), employed a one-year cycle and a lifetime horizon. The study utilized both one-way and probabilistic sensitivity analyses. ResultsTwo RCTs, one for each condition, revealed superior clinical improvement with DBS when compared to sham simulation. The Incremental Cost-Utility Ratio (ICUR) was $ 1,121.66 for generalized dystonia and $4,556.50 for cervical dystonia. Effectiveness discount rates and age at surgery were identified as influential parameters. In 1,000 Monte Carlo simulations, 99.9% of the ICUR values for generalized dystonia and 74.2 % for cervical dystonia fell below the cost-effectiveness threshold in Brazil ($8,146.64 per QALY). ConclusionsFrom the perspective of the Brazilian public health system, the combination of DBS and BCP appears to be cost-effective for the treatment of both generalized and cervical dystonia when compared to BCP alone.

A comprehensive analysis of the artificial neural networks model for predicting monkeypox outbreaks

Monkeypox is a viral disease that causes outbreaks in various countries, significantly impacting public health and healthcare systems. Effective preparedness and response efforts require accurately predicting the severity of these outbreaks. Currently, there are no publicly released studies for nations like Chile and Mexico on monkeypox, leading to this study's creation. We use a neural network model with a time series dataset of monkeypox cases from multiple countries, including Argentina, Brazil, France, Germany, Chile, and Mexico. The Levenberg-Marquardt learning technique is employed to develop and validate single and two hidden layers artificial neural network models. We train various model architectures with different numbers of hidden layer neurons using the K-fold cross-validation early stopping method. Additionally, we use long short-term memory and gated recurrent unit models, commonly employed for time series data processing, to compare the performance of our artificial neural network model.

SGLT-2 Inhibitors: The Next-generation Treatment for Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) has become a worldwide concern in recent years, primarily in highly developed Western societies. T2DM causes systemic complications, such as atherosclerotic heart disease, ischemic stroke, peripheral artery disease, kidney failure, and diabetes-related maculopathy and retinopathy. The growing number of T2DM patients and the treatment of long-term T2DM-related complications pressurize and exhaust public healthcare systems. As a result, strategies for combating T2DM and developing novel drugs are critical global public health requirements. Aside from preventive measures, which are still the most effective way to prevent T2DM, novel and highly effective therapies are emerging. In the spotlight of next-generation T2DM treatment, sodium-glucose co-transporter 2 (SGLT-2) inhibitors are promoted as the most efficient perspective therapy. SGLT-2 inhibitors (SGLT2i) include phlorizin derivatives, such as canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. SGLT-2, along with SGLT-1, is a member of the SGLT family of proteins that play a role in glucose absorption via active transport mediated by Na+/K+ ATPase. SGLT-2 is only found in the kidney, specifically the proximal tubule, and is responsible for more than 90% glucose absorption. Inhibition of SGLT-2 reduces glucose absorption, and consequently increases urinary glucose excretion, decreasing blood glucose levels. Thus, the inhibition of SGLT-2 activity ultimately alleviates T2DM-related symptoms and prevents or delays systemic T2DM-associated chronic complications. This review aimed to provide a more detailed understanding of the effects of SGLT2i responsible for the acute improvement in blood glucose regulation, a prerequisite for T2DM-associated cardiovascular complications control.

High Levels of Incidental COVID-19 Infection in Emergency Urology Admissions: A Propensity Score-Matched Real World Data Analysis across Surgical Specialties.

Background: An incidental COVID-19 infection is often found in patients admitted for non-COVID-19-related conditions. This study aims to investigate the incidence of COVID-19 infections across surgical specialties including urology, general surgery, and orthopaedic surgery. Methods: This is a retrospective cohort study based on a territory-wide electronic database in Hong Kong. All emergency in-hospital admissions under the urology, general surgery, and orthopaedic surgery divisions in the public healthcare system in Hong Kong from January to September 2022 were included. All patients were routinely screened for SARS-CoV-2, based on admission protocols during the investigation period. Baseline characteristics were retrieved, with 1:1:1 propensity score matching being performed. Incidental COVID-19 rates were then compared across specialties. Results: A total of 126,034 patients were included. After propensity score matching, the baseline characteristics were well balanced, and 8535 patients in each group were analysed. Urology admission was noted to have a statistically significant higher incidence of incidental COVID-19 at 9.3%, compared to general surgery (5.4%) or orthopaedic surgery (5.6%). Amongst urology patients with incidental COVID-19 infection, 35.8% were admitted for retention of urine, 27.9% for haematuria, and 8.6% for a urinary tract infection. Conclusions: This large-scale cohort study demonstrated that incidental COVID-19 rates differ between surgical specialties, with urology having the highest proportion of incidental COVID-19 infection.

The Impact of Right to Health Under Legal Public Health Care System in India

An individual's right to health is fundamental to a decent life, hence it is important to examine the several aspects that support this right from different perspectives. Furthermore, since modern health care includes a larger social component in addition to an individualistic demand, this right must be examined in the context of the individual's personal and social life. Discrimination against members of society's most vulnerable groups women, children, the economically disadvantaged, the elderly, individuals with disabilities, including those who are mentally retarded means that people's right to health is violated. Additionally, this right is threatened by a number of other variables, including harmful working conditions and settings, natural disasters and wars, food and nutrition, housing and living situations, and forced population displacement. Therefore, in order to achieve the aim of "Health for All," this work advocated a right to health by assessing the impact of these several previously mentioned elements.

Impact of non-pharmaceutical interventions on COVID-19 incidence and deaths: cross-national natural experiment in 32 European countries

PurposeNon-pharmaceutical interventions (NPIs) have been the cornerstone of COVID-19 pandemic control, but evidence on their effectiveness varies according to the methods and approaches taken to empirical analysis.We analysed the impact of NPIs on incident SARS-CoV-2 across 32 European countries (March-December 2020) using two NPI trackers: the Corona Virus Pandemic Policy Monitor – COV-PPM, and the Oxford Covid-19 Government Response Tracker – OxCGRT.MethodsNPIs were summarized through principal component analysis into three sets, stratified by two waves (C1-C3, weeks 5–25, and C4-C6, weeks 35–52). Longitudinal, multi-level mixed-effects negative binomial regression models were fitted to estimate incidence rate ratios for cases and deaths considering different time-lags and reverse causation (i.e. changing incidence causing NPIs), stratified by waves and geographical regions (Western, Eastern, Northern, Southern, Others).ResultsDuring the first wave, restrictions on movement/mobility, public transport, public events, and public spaces (C1) and healthcare system improvements, border closures and restrictions to public institutions (C2) were associated with a reduction in SARS-CoV-2 incidence after 28 and 35-days. Mask policies (C3) were associated with a reduction in SARS-CoV-2 incidence (except after 35-days). During wave 1, C1 and C2 were associated with a decrease in deaths after 49-days and C3 after 21, 28 and 35-days. During wave 2, restrictions on movement/mobility, public transport and healthcare system improvements (C5) were also associated with a decrease in SARS-CoV-2 cases and deaths across all countries.ConclusionIn the absence of pre-existing immunity, vaccines or treatment options, our results suggest that the observed implementation of different categories of NPIs, showed varied associations with SARS-CoV-2 incidence and deaths across regions, and varied associations across waves. These relationships were consistent across components of NPIs derived from two policy trackers (CoV-PPM and OxCGRT).

Subsidiarity: outlining the advantages of AI to public health and healthcare system through public policy.

Subsidiarity: outlining the advantages of AI to public health and healthcare system through public policy.

Economic implications of step-down outpatient management for fever and neutropenia episodes in pediatric cancer patients: a cost minimization analysis

BackgroundThe management of febrile neutropenia (FN) in pediatric cancer patients has traditionally been conducted in a hospital setting. However, recent evidence has indicated that outpatient management of FN can be equally effective compared to inpatient care. Based on this evidence, we conducted a cost-minimization analysis (CMA) specifically focused on pediatric cancer patients in Mexico.MethodsA piggy-back study was conducted during the execution of a non-inferiority clinical trial that compared outpatient treatment to inpatient treatment for FN in children with cancer. A CMA was performed from a societal perspective using patient-level data. In the previous study, we observed that step-down oral outpatient management of low-risk FN was as safe and effective as inpatient intravenous management. Direct and indirect costs were collected prospectively. The costs were adjusted for inflation and converted to US dollars, with values standardized to July 2022 costs. Statistical analysis using bootstrap methods was employed to obtain robust estimations for decision-making within the Mexican public health care system.ResultsA total of 117 FN episodes were analyzed, with 60 in the outpatient group and 57 in the inpatient group; however, complete cost data were available for only 115 FN episodes. The analysis revealed an average savings of $1,087 per FN episode managed on an outpatient basis, representing a significant 92% reduction in total cost per FN episode compared to inpatient treatment. Length of hospital stay and inpatient consultations emerged as the primary cost drivers within the inpatient care group.ConclusionThis CMA demonstrates that the step-down outpatient management approach is cost-saving when compared to inpatient management of FN in pediatric cancer patients. The mean difference observed between the treatment groups provides support for decision-making within the public health care system, as outpatient management of FN allows for substantial cost savings without compromising patient health.

Twenty-year review of the bariatric programme at Te Whatu Ora Waitematā.

Obesity is a significant health issue. Te Whatu Ora Waitematā serves a population of 650,000 patients across the North Shore, Waitākere and Rodney areas. The Waitematā bariatric service at North Shore Hospital was introduced in October 2001. The aim of this study was to review the development and impact of the service over the last 20 years, and identify whether equivalent bariatric services could viably be introduced into other hospitals in Aotearoa New Zealand. A retrospective audit was conducted of the 20-year results of the Waitematā bariatric surgical service to identify the impact of technology, teaching and research on service provision. Since its inception, the Waitematā bariatric service has launched minimally invasive surgery, multiple operative options and an enhanced recovery after surgery (ERAS) protocol. Approximately 100 cases are performed per year. Of these, 3.4% of patients require admission to the intensive care unit/high dependency unit (ICU/HDU), with an average length of stay (LOS) of 0.66 days. The 1-year mortality rate is 0.39%. Eleven surgical fellows have undergone post-fellowship training with the service, which is a recognised training unit for the post-fellowship AANZGOSA/ANZMOSS programme. Bariatric surgery can be performed safely and has good long-term outcomes. The Waitematā bariatric service is dedicated to providing excellent care within the resource constraints of a public healthcare system. The high number of procedures, low requirement for ICU/HDU and low mortality rate suggest that bariatric surgery could be safely performed within a public setting in secondary and regional hospitals across the country.

Mental health apps within the healthcare system: associations with stigma and mental health literacy

BackgroundMental health apps (MHA) as a new form of self-help have gained popularity over the last years. Tentative evidence has suggested that MHA might also present a first step into the help-seeking process, because their anonymity circumvents stigma. Using MHA might also increase mental health literacy and reduce stigma through psychoeducation, which could encourage formal help-seeking. To date, it remains unclear how MHA usage relates to stigma, mental health literacy, and utilization of professional help within the public healthcare system.MethodsWe conducted a cross-sectional survey with N = 1,263 individuals from the general population (mean age 32.56 ± 11.51, 58.2% female) and employed structural equation modeling to investigate associations between stigma (against individuals with psychological disorders and against help-seeking), mental health literacy, MHA usage, and service utilization within the public healthcare system for mental health problems.ResultsMHA usage is high within the general population (40.5% of participants). Results indicate that higher stigma against help-seeking is associated with and increased likelihood of MHA usage, which in turn is positively associated with increased likelihood of service utilization. Symptoms of psychological disorder were associated with higher likelihood of service utilization, but not MHA usage.ConclusionsIt can be concluded that MHA appeal especially to individuals with higher stigma against help-seeking and therefore might provide an opportunity to reach underserviced individuals. At the current time, MHA usage appears to take place mostly in a preventative manner or as a supplement to treatment. Better integration into the public healthcare system might help to exploit both preventative and interventional benefits of MHA.

Persistent distress related to systemic racism among black veterans in the United States

BackgroundDistress related to systemic racism in the public service and healthcare systems is linked to adverse mental health sequelae in racial and ethnic minority populations. Emerging research has found that distress related to racism may impact military veterans, an increasingly racially and ethnically diverse segment of the US population who are at increased risk of mental health problems relative to non-veterans. To date, however, no known study has examined longitudinal trends in distress related to systemic racism in this population. MethodsA nationally representative sample of 2361 US military veterans completed a baseline assessment in 2020 and a 2-year follow-up in 2022. A multinomial logistic regression analysis was conducted to examine longitudinal courses and baseline predictors of systemic racism-related distress. ResultsRelative to the veterans with no racism-related distress, those who reported racism-related distress across the 2-year study period were older, more likely to be female, Black, or Hispanic, and to have completed college or higher education, and reported more lifetime traumas and stressors. Nearly 4-of-5 of Black veterans endorsed distress related to systemic racism over the 2-year study period. LimitationsUse of self-report and abbreviated measures of distress related to systemic racism. ConclusionsResults suggest that distress related to systemic racism may pose a significant emotional burden on subgroups of US veterans. They further underscore the importance of training clinicians to provide culturally-informed assessments and treatments for Black and other racial and ethnic minority veterans who bear the weight of racial discrimination.

Bleeding us dry: The financial impact of full blood examinations in the immediate postoperative period.

Full blood examinations, often referred to as FBE, are commonly ordered postoperatively, despite limited utility in many of its markers in the acute phase. It is estimated that in the 2022-2023 financial year, the Australian healthcare system billed over $13 million for full blood examinations (FBEs) to Medicare. This study aims to assess the cost of using FBE following surgery. We explore potential cost savings by using a haemoglobin examination (HE) in replace of FBE, with both tests run on identical machines, producing the same result, but at a fraction of the cost. A retrospective analysis was conducted at a single institution, including all patients who underwent minimally invasive laparoscopic pelvic surgeries between 1/7/2017 and 30/6/2019. Patient records were examined to identify patient demographics, postoperative pathology tests and interventions. Patients who received FBE in the first 24 h following surgery were identified and included in the study. Using national surgery and admission statistics, a potential cost-saving analysis will be performed. Among 519 men who underwent robotic-assisted pelvic surgery, 325 patients had routine postoperative investigations, with 323 receiving FBE and 2 receiving HE. Abnormal results were found in the majority of patients that underwent FBE. Eight patients received packed red blood cell transfusion, none of these meeting the hospital-specific criteria for transfusion protocol. Twelve patients received antibiotics, none were in response to abnormal FBE, with all patients experiencing a fever, given prophylactically or in the days following the surgery. FBE and HE are both listed on the Medicare Benefits Scheme at $16.95 and $7.85, respectively, the difference being $9.10. Extrapolating the existing data, within the first 24 h following surgery, the estimated savings were $8818, with savings increasing accumulatively with longer observation intervals following surgery. When similar savings are applied to national figures, the potential savings to the Australian Public Healthcare system likely exceeds millions. Our study revealed that over half of the patients who underwent a RARP received FBE within the first 24 h postoperatively, the vast majority of which exhibited abnormal results that were not acted upon. These findings substantiate the limited utility of FBE in the postoperative setting. Cell markers observed in FBE are predominantly subjective, but consensus exists regarding the importance of evaluating haemoglobin levels postoperatively. Considering that one in four hospital admissions involves surgical procedures, and a $9.10 price differential between FBE and HE, the potential annual economic impact of utilising routine FBEs for assessing haemoglobin levels immediately after surgery is likely to reach millions. Although having obvious flaws, these results underscore the potential accumulative cost arising from everyday clinical judgement and the importance of thoughtful consideration when ordering pathology. The routine ordering of FBE postoperatively, without properly considering its indication, incurs significant costs. This study highlights the potential cost savings by HE instead, emphasising the need for revaluation and appropriate utilisation of pathology tests in the immediate postoperative period given the physiological acute phase response expected postoperatively.