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La pseudopolyarthrite rhizomélique, qui se manifeste essentiellement par des douleurs inflammatoires des ceintures après 50 ans, peut être associée ou non à une artérite à cellules géantes crânienne ou extracrânienne qui survient sur le même terrain. Les deux pathologies touchent les deux sexes et toutes les ethnies mais sont plus fréquentes chez les femmes caucasiennes. Leur coût dépend plus des effets secondaires des corticoïdes que du coût d'achat des traitements. Ce coût est plus élevé en cas d'artérite à cellules géantes associée, surtout du fait du bilan initial plus important (exploration vasculaire) et des complications (car la corticothérapie est plus forte). Si le coût des corticoïdes est très faible, l'ajout d'un biologique prescrit pour corticodépendance l'augmente considérablement sans qu'il soit facile d'en mesurer le bénéfice eu égard au caractère très décalé dans le temps des complications de la corticothérapie. Polymyalgia rheumatica is mainly manifested by inflammatory pains of the belts after 50 years. It may or may not be associated with giant cell arteritis that may present as a cranial or extracranial arteritic pathology. Both pathologies affect both sexes and all ethnicities but are more common in Caucasian women. The cost of the disease is higher in cases of giant cell arteritis, especially because of the initial larger assessment (vascular exploration) and complications (because corticosteroid therapy is stronger). The cost of drugs is very low unless a biologic is prescribed, which then significantly increases the costs; it is uneasy to measure their benefit given the very staggered nature of the cost of complications of corticosteroid therapy. [ABSTRACT FROM AUTHOR]

Cette étude cherche à identifier les coûts de la prise en charge des prestataires de santé dans la zone de santé de Kitenda, dans la province du Kwango, en République Démocratique du Congo, les difficultés qu’ils traversent en termes d’appui des partenaires et les facteurs qui favorisent la malnutrition chez les enfants âgés de 6 à 59 mois ainsi que les conséquences qui en découlent.

Le découpage de l’activité hospitalière en branches médicale et analytique pose l’incertitude dans la manière d’apprécier les retombées de l’exploitation des établissements de production de soins et de services liés à la santé où sont soignés les malades et des blessés. Voilà pourquoi, nous cherchons, dans cette étude, à construire une réflexion sur le contraste de la mise en cause de maximisation du profit dans l’activité des soins de santé. Pour cela, nous fondons celle-ci à partir des éléments comptables pour nous permettre de mesurer leur efficacité par la connaissance des coûts significatifs comme base dans la détermination de la nature de l’out put hospitalier du fait que les subsides de l’Etat sont non seulement absents mais surtout déficitaires dans les hôpitaux publics en République Démocratique du Congo (RDC). Nous nous fondons ici sur le cas de l’hôpital provincial au Kasaï Central, afin d’extrapoler la demande sur toutes les institutions de santé du pays, dans l’analyse des indicateurs d’efficacité dans la détermination de la nature de l’out put hospitalier.

Laparoscopy was introduced in Cameroon in 1992. Minimally invasive surgery in gynaecology is becoming increasingly popular, thanks to lower hospital costs and a significant reduction in the length of hospital stay. Time off work after minimally invasive gynaecological surgery varies from 7 to 28 days. In this study, we determined the total temporary functional impairment and the cost of care associated with minimally invasive gynaecological surgery in a private hospital. We conducted a descriptive cross-sectional study with retrospective data collection from January 2021 to December 2022 at the Deo-Gracias Hospital in Emana. Records of patients operated on by laparoscopy or hysteroscopy in gynaecology were included. The data collected were entered into a database created using CS pro. Statistical analysis was performed using SPSS version 23.0 software. We enrolled 160 patients with a mean age of 35.97 ± 8.95 years. The main approach was laparoscopy (72.4%) followed by hysteroscopy (25.8%). The temporary functional deficit was 44.59 ± 18.55 days, i.e. an average hospital stay before surgery of 20.07 hours, an average hospital stay of 2.89±1.09 days and an average of 23 days off work. The average cost of surgery was estimated at 412328.77 ± 82292.46 CFA francs (1US Dollar= 580,31CFA f; 1Euro= 655,96CFA f). Minimally invasive surgery in gynaecology is becoming increasingly common, reducing the time patients spend in hospital despite the high cost of healthcare, which is still heavily borne by individuals [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Disability Studies is the property of Canadian Disability Studies Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study analyzed the structure and determined the factors affecting the cost of treatment of severe burns patients. The results showed that the average total costs for a patient was 3275.9 USD. The daily cost of hospitalization was 113.3 USD, the treatment cost for 1% burn surface area was 109.5 USD with the highest proportion for medication and consumable medical equipment (43.2%), followed by surgery and procedures (30.2%). The treatment costs increased with increasing age, burn extent and deep burn area (p < .05) and were significantly higher in the group of patients with inhalation injury, electrical burns and in non-survivors (p < .01). Multivariate regression analysis found that burn extent, deep burn area and inhalation injury independently influenced the treatment cost of burn patients. [ABSTRACT FROM AUTHOR]

The incidence of hyperuricemia （HUA） has been increased year by year， showing a trend of younger onset. Juvenile HUA patients are potentially susceptible to gout and renal damage in the future， which pose significant hidden threat to the society， family and juvenile health. At present， juvenile HUA has been rarely studied at home and abroad， and unified diagnostic and treatment criteria and guidelines are still lacking. In this article， the epidemiology， diagnostic criteria， etiological factor， relationship with related diseases and treatment of juvenile HUA were summarized and reviewed， aiming to better understand and grasp the characteristics， and guide clinical diagnosis and treatment of juvenile HUA.

L'objectif était de rapporter notre expérience de mise en place dans un centre hospitalo-universitaire de l'aScope™, aS4 C (Ambu®, Ballerup, Danemark), cystoscope souple à usage unique, ainsi que les données médicales, économiques et environnementales, comparatives aux cystoscopes réutilisables. Ce travail est basé sur les données disponibles dans la littérature concernant les cystoscopes souples à usage unique. Une recherche sur la base de données PubMed et un examen narratif des articles ont été effectués en janvier 2023. Dans un essai clinique et randomisé, l'aScope 4 a montré sa non-infériorité en comparaison à un cystoscope souple réutilisable, en termes de qualité d'image, de visibilité, de maniabilité et de faisabilité de la procédure. Dans notre expérience, les avantages médicaux à l'utilisation d'un cystoscope à usage unique sont : qualité constante de la procédure, disponibilité immédiate du matériel permettant de s'affranchir de toutes les étapes de stérilisation et casses/réparations, la portabilité du matériel permettant un sondage difficile dans les services ou en réanimation et sa disponibilité les week-ends, jours fériés et la nuit. Dans notre étude, le coût d'une cystoscopie souple était similaire entre cystoscope souple à usage unique (192 euros TTC) et réutilisable (196 euros TTC). En comparaison à une procédure de décontamination à haut niveau à l'acide peracétique, l'utilisation d'un cystoscope à usage unique permettait une réduction de l'impact environnemental de la procédure de cystoscopie souple dans notre expérience. Le marché des endoscopes à usage unique est en pleine expansion. Dans notre expérience, l'utilisation exclusive du cystoscope aScope était associée à de nombreux avantages médicaux, économiques et environnementaux. To report our experience with the aScope™, aS4 C (Ambu®, Ballerup, Denmark), a single-use flexible cystoscope and the medical, economic and environmental data, compared to reusable cystoscopes. This review is based on data available in the literature regarding single-use flexible cystoscopes. A PubMed database search and narrative review of the evidence was performed in January 2023. In a randomized clinical trial, the aScope 4 showed non-inferiority to a reusable flexible cystoscope in terms of image quality, visibility, handling and procedure feasibility. In our experience, the medical advantages of using a single-use cystoscope are: the consistent quality of the procedure, the immediate availability of the equipment avoiding all sterilization and breakage/repair steps, the portability of the equipment allowing difficult catheterization in the hospital or intensive care units and its availability on days off. The cost of a flexible cystoscopy is similar between single-use (192 euros) and reusable (196 euros) flexible cystoscopes. Compared to a high-level decontamination procedure with peracetic acid, the use of a single-use cystoscope had a lower environmental impact in our center. The market for single-use cystoscopes is growing. In our experience, the exclusive use of the aScope has been associated with numerous medical, economic and environmental benefits. [ABSTRACT FROM AUTHOR]

The incidence of hyperuricemia （HUA） has been increased year by year, showing a trend of younger onset. Juvenile HUA patients are potentially susceptible to gout and renal damage in the future, which pose significant hidden threat to the society, family and juvenile health. At present, juvenile HUA has been rarely studied at home and abroad, and unified diagnostic and treatment criteria and guidelines are still lacking. In this article, the epidemiology, diagnostic criteria, etiological factor, relationship with related diseases and treatment of juvenile HUA were summarized and reviewed, aiming to better understand and grasp the characteristics, and guide clinical diagnosis and treatment of juvenile HUA. [ABSTRACT FROM AUTHOR]

The enabling and constraining properties of networks, their effects on participants, and their subsequent social consequences have all been extensively explored in a large and growing literature. A feature of social network analysis lies in its tendency to deploy structural perspectives in explaining social outcomes. Through in-depth semi-structured interviews, this article highlights the ways in which social networks operate as a context in which individual initiative and engagement lead to the making and remaking of network attributes. An empirical examination of business networks in Chinese cities reveals the way in which the formation and maintenance of networks require the conscious contributions of members, how network norms are produced by the expressed preferences of individual members, and finally how network membership involves management of network participants. [ABSTRACT FROM AUTHOR]

Background: The expenses of multiple myeloma (MM) represent a real economic and societal burden for patients and health authorities. However, very little is known about the situation in Algeria. Therefore, the aim of this study is to evaluate the costs generated by the management of MM and its complications in Algerian patients., Materials and Methods: An observational retrospective study conducted on patients diagnosed with MM, from January 1st, 2019 to April 31st, 2023, at the Establishment Hospitalier Universitaire November 1st, Oran. A bottom-up costing methodology was used to assess the phase-specific cost and the complication burden., Results: In total, 249 qualified for the study. For autologous stem cell transplantation (ASCT) eligible patients, the mean per patient cost of treating myeloma was estimated at: induction regimen ($4072); ASCT ($2899); consolidation ($1538); and maintenance ($355.76). The mean drug cost for ASCT-ineligible patients was $1421. The use of generic bortezomib and generic melphalan has led to a reduction in expenses of $1,075,181 ($5,024 per patient; 55.35%) and $10,864 ($487 per patient; 15.07%), respectively. Another cost-saving adaptation was ASCT using non-cryopreserved (NC) stem cells. The cost of managing MM complications was $177,782 per year., Conclusion: A number of adjustments have been implemented to the management of MM over time to improve clinical efficacy and reduce costs in Algeria. However, this may have come with a startlingly high cost of complications., (Copyright © 2024 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Chronic kidney disease (CKD) is one of the non-infectious diseases that threaten patients' lives on a daily basis. Its prevalence is high, but under-reported by patients and those living with the disease, as it is silent and asymptomatic in the early stages. Kidney disease increases the risk of heart and vascular disease. These problems can manifest themselves slowly, over a long period of time. Early detection and treatment can often prevent chronic kidney disease from worsening. As kidney disease progresses, it can lead to kidney failure, requiring dialysis or a kidney transplant to stay alive. In this narrative review, we will mainly discuss different treatment option costs in different countries and how much they cost healthcare systems in countries in three different continents., (Copyright © 2024 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

• Significativité et innovation : de nombreux tests de laboratoire sont prescrits de manière inappropriée dans un contexte d'orientation en rhumatologie. • On observe un gradient des tests appropriés avec une pertinence plus faible lorsque l'orientation est émise en soins primaires et une pertinence plus forte lorsque l'orientation est initiée par un spécialiste. • Dans plus de la moitié des cas, les tests prescrits sont inutiles et engendrent des dépenses et des orientations non justifiées. La recherche d'auto-anticorps est un examen très régulièrement utilisé dans le cadre du dépistage des maladies rhumatismales. Le facteur rhumatoïde (FR) et les anticorps anti-nucléaires (ANA) ont une valeur prédictive positive très faible en pratique générale. La surutilisation des tests diagnostiques peut conduire à des orientations inutiles, augmenter l'anxiété des patients et accroître le budget consacré à la santé. Nous avions pour objectif d'évaluer les habitudes d'utilisation, la pertinence et les coûts liés aux tests de détection des ANA, ENA (antigènes nucléaires solubles), anti-dsDNA, du FR et du HLA-B27 chez des patients orientés en rhumatologie. Nous avons mené une analyse rétrospective des dossiers de patients orientés de manière consécutive pendant un an (orientations acceptées et rejetées), en s'appuyant sur les pratiques de rhumatologues hospitaliers. Les tests de détection inappropriés et les coûts inhérents à ces examens ont été analysés. Les tests ont été considérés comme justifiés lorsqu'ils répondaient à au moins un critère pour une maladie spécifique. Parmi les 638 patients consécutifs orientés en rhumatologie, les motifs les plus courants étaient : les spondylarthropathies (SpA), la polyarthrite rhumatoïde (PR) et le lupus (LES). Avant leur orientation, 61 % des patients avaient déjà été testés au moins une fois pour les ANA, avec répétition du test ANA dans un tiers des cas ; 19 % avaient passé un test ENA et 21 % un test anti-dsDNA. Dans 20 % des cas, le test ANA a été réalisé en l'absence de toute indication clinique. Dans la moitié des cas, les tests anti-ENA et anti-dsDNA ont été effectués dans un contexte de négativité des ANA. Le dépistage du FR a été demandé chez 65 % des patients et dans près d'1/3 des cas sans aucun diagnostic présomptif d'arthrite inflammatoire. Malgré les recommandations de la campagne Choosing Wisely de la SCR (Société Canadienne de Rhumatologie), au moins 50 % des tests de détection du FR, des ANA, ENA et anti-dsDNA sont prescrits de manière inappropriée. Une prescription plus sélective des tests susmentionnés pourrait conduire à une réduction significative des coûts. [ABSTRACT FROM AUTHOR]

Copyright of Diversity of Research in Health Journal / Revue de la Diversité de la Recherche en Santé is the property of Diversity of Research in Health Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The economic impact of Patient blood management (PBM) must be assessed beyond the acquisition cost of blood products alone. The estimate of indirect costs may vary depending on the organization and the elements taken into account. The transposition of data from the literature into a specific local context is therefore delicate. The objective of this work was to evaluate the overall cost of red blood cell concentrate (RBC) transfusion from a French healthcare establishment point of view. We carried out an activity based costing analysis in our hospital for the year 2018. The steps of the transfusion process and additional costs were detailed and cumulated (resource consumption, labor time, frequency) to populate the ABC model. Several scenarios were developed focusing either on RBC, all blood products or the surgical activity, and a univariate sensitivity analysis was conducted. The average total cost of transfusion, including acquisition cost, was 339,64 euros per RBC transfused. The cost of administration was 138.41 euros/RBC. Focusing only on surgical activities increased this cost (152.43 euros) while taking all blood products into account reduced it (92.49 euros). The difference in our results with the literature confirms the local variability in the cost of transfusion, which may affect the economic impact of PBM. Our study related to the specific context of a single French institution has limitations that a multicenter study would clarify in order to carry out economic modelling of transfusion optimization and alternatives and to guide the choice of PBM strategies at the national level. [ABSTRACT FROM AUTHOR]

Copyright of Biotechnologie, Agronomie, Societe et Environnement is the property of Les Presses Agronomiques de Gembloux and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To synthesise the evidence for estimating the direct and indirect patient costs of drug-sensitive and drug-resistant tuberculosis care in India.Method: PubMed, Embase, Web of Science, IndMED and Google Scholar were searched for studies conducted in India between 2000 and 2018 and published in English. The search terms were "tuberculosis" AND "costs" (cost Analysis, economics, cost of illness, health care costs, health expenditures, direct service costs, catastrophic cost) AND "India". The cost of TB care was from the patient's perspective. Data regarding costs were extracted, indexed to the year 2018 using cumulative inflation rate and converted to US dollars at the exchange rate of 2018.Results: Thirteen studies were included in this review. The mean (unweighted) total cost incurred by patients being treated for drug-sensitive TB in a public health facility was $ 235.00 (SD- 222.10), and the median of means was $ 170.60 (range - 43.70-718.40). The mean direct cost was 45.5% of the total cost. Only one study, which was conducted in a private facility, reported the mean total cost for drug-resistant TB as $ 7778.04. Catastrophic cost (total cost ≥ 20% of the total annual household income) was experienced by 7% to 32.4% of drug-sensitive TB patients and by 68% of drug-resistant TB patients.Conclusion: Despite free diagnostic and treatment services provided under the Revised National Tuberculosis Control Programme, the patient cost of tuberculosis care is high. Relevant studies vary widely in methodology and cost reporting. [ABSTRACT FROM AUTHOR]

Based on data received from pension supervisory authorities, the article reviews 85 different pension schemes in 44 jurisdictions by looking at fees and charges as well as their legal ceilings and their development since 2014. A key finding is the observed decrease in fees and caps. The article presents jurisdictions according to clusters, i.e. by groups of countries with identical or very similar items already covered by pension fees, and analyses the extent to which various cost and fee elements are covered by fees charged to members. Finally, we calculate charge ratios for each cluster to quantify the impact of fees and charges on pension savings. Occupational defined contribution pension schemes and personal plans linked to employment tend to be much more cost effective than personal schemes that have no direct employment link. [ABSTRACT FROM AUTHOR]

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Dans le contexte socioéconomique actuel marqué par plusieurs mutations,nousremarquons une remise en cause de la vision purement comptable et financière de laperformance des entreprises. Aujourd’hui, il estainsi question de noter que laperformance est abordée dans une logique plus globale qui intègre plusieurs dimensions: financières, managerielles, organisationnelles, sociales, sociétales etenvironnementales. A travers ce papier, nous avons tenté d’examiner l’effet de la qualité sur la performancedes entreprises.Ainsi, les principaux résultats auxquels nous avons abouti, montreune contribution positive et significative des démarches qualité dans la performance desentreprises. Une telle performance est atteinte à travers la combinaison de plusieursfacteurs issus de la mise en œuvredʹune démarche qualité, à savoir: la satisfaction desexigences desclientset des autres parties intéressées ; Lamobilisation de l’ensembledes collaborateurs internes et externes ; Lamaîtrise des processus de l’entreprise ;L’éliminationdes défauts sur les produits;Lamaîtrise des coûts et des délais deproduction ; L’allocationoptimale des ressources financières, techniques et humaines ;Lagestion des risques et des opportunités du système qualité ;Etla recherche continuede l’amélioration des résultats.Cela contribuera certainement et dans une grande mesureà la performance globale et durable de l’entreprise

Mass casualty burn events (MCBs) require intense and complex management. Silver-infused longer use dressings might help optimise management of burns in an MCB setting. We developed a model estimating the impact of dressing choice in the context of an MCB. The model was developed in Excel in collaboration with experienced emergency response clinicians. The model compares use of silver-infused dressings with use of traditional dressings in patients with partial thickness burns covering 30% of their body. Costs were estimated from a UK perspective as a proxy for a funded emergency response team and limited to cost of dressings, bandages, padding, analgesia and staff time. Expected patient costs and resource use were summarised over an acute 2-week intervention period and extrapolated to estimate possible time savings in a hypothetical MCB. Per patient costs were estimated at £2,002 (silver) and £1,124 (traditional) (a daily additional spend of £63). Per patient staff time was estimated at 864 minutes (silver) and 1,200 minutes (traditional) (a daily time saving of 24 minutes). Multiplying up to a possible MCB population of 20 could result in a saving equivalent to 9 staff shifts over the 2-week intervention period. The model was sensitive to type of silver dressing, frequency of dressing change and staff costs. We found increased costs through use of silver dressings but time savings that might help optimise burns management in an MCB. Exploring the balance between costs and staff time might help future MCB response preparation. [ABSTRACT FROM AUTHOR]

Introduction: the consequences of severe acute malnutrition are measured in terms of health and survival, but also of cognitive development, its productivity and the overall national economy. Its management requires enormous financial resources. The purpose of this study was to assess the effectiveness of treating severe acute malnutrition versus cost of treatment of severe acute malnutrition in children. Methods: we conducted a retrospective study of 199 children aged 0-59 months admitted to the Centre for Nutritional Recovery and Education in Kaya, Burkina Faso, from January to December 2014. The cost of treatment, the length of stay in the Centre for Nutritional Recovery and Education, daily weight gain and the speed of recovery were analyzed based on the standards calculation methods. Mann-Whitney test and Kruskall-Wallis test were used to compare the medians (0.05 threshold). Results: as expected, children aged 6-23 months were the most affected (51.8%) and acute respiratory infections were the most associated diseases (57.9%). The median length of stay in the Centre for Nutritional Recovery and Education was 9.0 (7.0-13.0) days, the mean speed of recovery was 100.0 (65.8 - 143.3) g/day and the average daily weight gain was 18.1 (11.6 - 27.7) g/kg/day. The average cost of treatment in a malnourished child is estimated to be 15 715,3 FCFA (25.2 USD). Conclusion: the cost of treatment is hardly affordable by the parents of malnourished children; hence the necessity for government and development partners interventions. [ABSTRACT FROM AUTHOR]

Objective: To provide a systematic review of economic evaluations that has been conducted for onchocerciasis interventions, to summarise current key knowledge and to identify research gaps.Method: A systematic review of the literature was conducted on the 8th of August 2018 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. No date or language stipulations were applied to the searches.Results: We identified 14 primary studies reporting the results of economic evaluations of onchocerciasis interventions, seven of which were cost-effectiveness analyses. The studies identified used a variety of different approaches to estimate the costs of the investigated interventions/programmes. Originally, the studies only quantified the benefits associated with preventing blindness. Gradually, methods improved and also captured onchocerciasis-associated skin disease. Studies found that eliminating onchocerciasis would generate billions in economic benefits. The majority of the cost-effectiveness analyses evaluated annual mass drug administration (MDA). The estimated cost per disability-adjusted life year (DALY) averted of annual MDA varies between US$3 and US$30 (cost year variable).Conclusions: The cost benefit and cost effectiveness of onchocerciasis interventions have consistently been found to be very favourable. This finding provides strong evidential support for the ongoing efforts to eliminate onchocerciasis from endemic areas. Although these results are very promising, there are several important research gaps that need to be addressed as we move towards the 2020 milestones and beyond. [ABSTRACT FROM AUTHOR]

Résumé: Objectif: Déterminer les coûts de trois types d'accouchement de la maternité du centre hospitalier provincial de Tiznit. Matériel et méthodes: Il s'agit d'une étude de type quantitative pour l'année 2016. La méthode d'analyse des coûts utilisée est la comptabilité par activités (ABC). Résultats: Les charges globales imputées à la maternité étaient de 6 269 922,31 dirhams marocains (MAD) dont 5 781 409,09 MAD (92,21 %) étaient imputées aux trois types d'accouchement étudiés. Les charges de la maternité sont constituées principalement de 53,56 % pour les ressources humaines, 16,22 % de charges liées aux produits pharmaceutiques et 11,40 % de charges administratives. Le coût de revient moyen de l'accouchement normal, de l'accouchement dystocique et de l'accouchement par césarienne était respectivement de 1 257,76 MAD, 1 258,00 MAD et 3 004,87 MAD. Conclusion: Ce type d'étude est la première du genre effectuée dans un contexte hospitalier marocain. Elle a permis de démontrer la faisabilité de cette démarche, d'une part, et, d'autre part, elle fournit aux responsables une idée beaucoup plus juste de coûts de revient des prestations offertes et des informations nécessaires pour la prise de décision. Objective: To determine the costs of the three types of delivery in the maternity department of the Tiznit Provincial Hospital Center. Material and Methods: This quantitative study analyzed costs for the year 2016 by the activity-based costing method. Results: The total maternity ward costs were 6 269 922.31 MAD, of which 5 781 409,09 MAD (92.21%) were attributed to the three types of delivery studied. Human resources accounted for 53.56% of maternity department expenses, pharmaceutical expenses for 16.22%, and administrative expenses for 11.40%. The average costs of a normal delivery were 1257,76 MAD, for a dystocic delivery 1258,00 MAD, and for cesarean delivery 3004.87 MAD. Conclusion: This type of study is the first of its kind to be conducted in a Moroccan hospital. It demonstrates the feasibility of this approach, on the one hand, and on the other it provides managers with a much more accurate idea of the cost of the services offered and the information needed for decision-making. [ABSTRACT FROM AUTHOR]

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Résumé La radiothérapie externe est un traitement efficace pour le soulagement des douleurs liées aux métastases osseuses, prescrit dans le monde entier. Bien qu'il existe des recommandations sur l'utilisation de l'irradiation palliative des métastases osseuses, les pratiques internationales divergent. En outre, les coûts engendrés par de tels traitements intéressent de plus en plus les sociétés et les praticiens. L'objectif de cet article est de mettre en lumière l'évolution progressive des pratiques au cours du temps à travers la publication des essais cliniques, les études de coûts et l'évolution des techniques de radiothérapie. Abstract External beam radiation therapy is an efficient treatment, which relieves pain associated with bone metastases, and is prescribed in worldwide. Although bone metastases palliative irradiation recommendations exist, international clinical practices remain variable. The purpose of this article is to show the clinical practices evolution though clinical trials, cost studies and techniques' progression. [ABSTRACT FROM AUTHOR]

Que l’on soit dans l’industrie ou les services, une petite entreprise ou un grand groupe, la logistique est devenue aujourd’hui une question vitale pour l’entreprise. C’est un facteur de compétitivité et un moyen de satisfaction et de fidélisation des clients dans un contexte marqué par une montée continue de leurs exigences. Au cours de ce travail de recherche, nous avons essayé de mener une réflexion sur le lien qui existe entre une bonne gestion de la chaine logistique et la satisfaction des exigences des clients en termes de qualité, coût, délai et sécurité.

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Approximately 10 000 people die from suicide annually in Bangladesh, many from pesticide poisoning. We aimed to estimate financial costs to patients and health services of treating patients with self-poisoning.Methods: Data on direct costs to families, sources of funds for treatment and family wealth were collected prospectively over a one-month period in 2016 at the tertiary Chittagong Medical College Hospital, Bangladesh. Aggregate operational costs to the government were calculated using annual budget, bed occupancy and length-of-stay data.Results: Agrochemicals were the most common substances ingested (58.8%). Median duration of stay and of illness was 2 and 5 days, respectively. Median total cost to patients was conservatively estimated at US$ 98.40, highest in agrochemical poisoning (US$ 179.50), with the greatest cost due to medicines and equipment. Misdiagnosis as organophosphorus poisoning in 17.0% of agrochemical cases resulted in increased cost to patients. Only 51.9% of patients had indicators of wealth; 78.1% borrowed money to cover costs. Conservatively estimated median healthcare costs (US$ 21.30 per patient) were markedly lower than costs to patients.Conclusions: Cost to patients of treating a case of agrochemical poisoning was approximately three times the cost of one month's essential items basket. Incorrect diagnosis at admission costs families substantial sums of money and increased length of stay; it costs the national government an estimated US$ 80 428.80 annually. Widespread access to a list of pesticides used in self-poisoning plus greater focus on training doctors to better manage different forms of agrochemical poisoning should reduce the financial burden to patients and healthcare systems. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bulletin de la Société de Pathologie Exotique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Managing forests and forest products has substantial potential to help mitigate climate change but the cost has not been extensively examined in Canada. We estimated the cost of seven forest-related mitigation strategies in Canada's 230 million hectares of managed forest, divided into 32 spatial units. For each strategy and spatial unit, we determined forest sector mitigation cost per tonne (t) using estimated impacts on forest sector greenhouse gas emissions and removals and net revenue. National cost curves showed that mitigation averaged 11.0 Mt CO2e·year-1 in 2015-2050 at costs below $50·t CO2e-1 for a strategy of increased recovery of harvested biomass, increased salvage, extraction of harvest residues for bioenergy, and increased production of longer lived products. We also examined national portfolios in which the strategy selected for each spatial unit (from among the seven examined) was chosen to maximize mitigation or minimize costs. At low levels of mitigation, portfolios chosen to minimize costs were much cheaper than those that maximized mitigation, but overall, they yielded less than half the total mitigation of the latter portfolios. Choosing strategies to maximize mitigation in 2015-2050 yielded an average of 16.5 Mt·year-1 at costs below $50·t CO2e-1. Our analysis suggests that forest-related strategies may be cost-effective choices to help achieve long-term emission reductions in Canada. [ABSTRACT FROM AUTHOR]

Résumé But de l’étude Estimer les coûts médicaux de l’infarctus du myocarde (IdM) entre l’année précédant l’IdM et l’année suivant cet évènement. Patients et méthodes Une cohorte historique de patients ayant eu un IdM en France entre 2007 et 2011 a été extraite de l’échantillon généraliste des bénéficiaires (échantillon au 1/97 e , représentatif des sujets couverts par l’Assurance maladie). Résultats Au total 1920 sujets ont été identifiés avec un IdM, 2 tiers étaient des hommes, l’âge moyen était de 67 ans, 20,6 % avaient un diabète, 37,6 % une hypercholestérolémie et 82,4 % une hypertension. Le coût annuel du point de vue sociétal était de 4548 € avant l’infarctus et de 12 679 € après. Le coût lié aux hospitalisations est passé de 1616 € avant l’IdM à € 6470 après. Le coût des soins de ville est passé de 2932 € avant l’IdM à 6208 € après. Cette augmentation a touché toutes les catégories de soins de ville : les coûts des transports ont été multipliés par 4, les coûts liés aux honoraires médicaux et aux tests de laboratoire ont triplé, le coût des médicaments a doublé et le coût des auxiliaires médicaux a augmenté, dans une moindre mesure. Le coût lié à l’hospitalisation pour l’IdM était de 5876 € et a été exclu des coûts précédents. Conclusion Le coût sociétal des consommations de soins a été multiplié par 3 sur l’année suivant un IdM, comparativement à l’année précédant cet évènement. Objective To estimate the costs of healthcare resource consumption in the year preceding and the year following a myocardial infarction (MI). Patients and methods A historical cohort of patients experiencing an MI in France between 2007 and 2011 was extracted from the échantillon généraliste de bénéficiaires , a 1/97th sample of all beneficiaries of public health insurance in France. Results A total of 1920 patients experiencing an MI were identified. Two-thirds were men and the mean age was 67 years; 20.6% had diabetes, 37.6% hypercholesterolaemia and 82.4% hypertension. From a societal perspective, the annual costs of medical consumption related to hospitalisations increased from € 4548 before the MI to € 6470 in the following year. Costs of community care rose from € 2932 to € 6208. This increase concerned all components of community healthcare: costs associated with medical transportation increased fourfold, those associated with consultations and laboratory tests tripled, medication costs doubled and costs of paramedical services also increased, but to a lesser extent. It should be noted that the cost of hospitalisation for the index MI (€ 5876) is not included in the above costs. Conclusion From a society perspective, the cost of healthcare resource consumption increased threefold in the year following an MI. [ABSTRACT FROM AUTHOR]

Objective: To estimate the national costs relating to diarrhoea and acute respiratory infections from not handwashing with soap after contact with excreta and the costs and benefits of handwashing behaviour change programmes in India and China.Methods: Data on the reduction in risk of diarrhoea and acute respiratory infection attributable to handwashing with soap were used, together with World Health Organization (WHO) estimates of disability-adjusted life years (DALYs) due to diarrhoea and acute respiratory infection, to estimate DALYs due to not handwashing in India and China. Costs and benefits of behaviour change handwashing programmes and the potential returns to investment are estimated valuing DALYs at per capita GDP for each country.Results: Annual net costs to India from not handwashing are estimated at US$ 23 billion (16-35) and to China at US$ 12 billion (7-23). Expected net returns to national behaviour change handwashing programmes would be US$ 5.6 billion (3.4-8.6) for India at US$ 23 (16-35) per DALY avoided, which represents a 92-fold return to investment, and US$ 2.64 billion (2.08-5.57) for China at US$ 22 (14-31) per DALY avoided - a 35-fold return on investment.Conclusion: Our results suggest large economic gains relating to decreases in diarrhoea and acute respiratory infection for both India and China from behaviour change programmes to increase handwashing with soap in households. [ABSTRACT FROM AUTHOR]

Résumé Objectif Évaluer les coûts d’utilisation des services de soins de santé des patients atteints de polyarthrite rhumatoïde (PR) en France et estimer la proportion de ces coûts imputables à la PR. Méthode L’EGB (« échantillon généraliste des bénéficiaires ») est un échantillon aléatoire 1/97 de la principale base de données nationale couvrant la population française. Une cohorte de patients atteints de polyarthrite rhumatoïde a été constituée avec tous les adultes qui bénéficient d’une prise en charge complète pour leur polyarthrite rhumatoïde (ICD-10 M05-06) au 1 er janvier 2009. Un groupe de témoin apparié par âge et sexe a été défini. Les dépenses de santé ont été évaluées du point de vue du payeur pour l’année 2010. Résultats La dépense de santé annuelle totale remboursée par habitant était de 6404 € en 2010, montant environ deux fois plus élevé que celui du groupe de témoin, 3095 € ( p < 0,0001). Ce surcoût est principalement dû aux soins en ambulatoire (+ 2407 € ; 72,7 %), aux médicaments (+ 1686 € ; 50,0 %) et aux soins hospitaliers (+ 903 € ; 27,3 %). Les patients traités par des biothérapies ont généré une dépense annuelle ajustée par âge par habitant trois fois plus élevée que celle des non-traités (15 757 € versus 4640 €). Conclusion Seule la moitié des dépenses médicales des patients atteints de polyarthrite rhumatoïde est imputable à leur maladie et la biothérapie est devenue un facteur important du coût. [ABSTRACT FROM AUTHOR]

Combien coûte la méthanisation agricole, quelles sont les conditions de la rentabilité ? Pour répondre à ces questions simples en apparence, il faut comprendre comment se construit le « modèle d’entreprise », c’est-à-dire décrire l’organisation de la méthanisation agricole, ses finalités et ses moyens, et la manière dont se créée la valeur ajoutée.

Pour éviter de sur-dimensionner leurs infrastructures, et les coûts qui en résultent, les gestionnaires des services d’eau potable devront améliorer leurs pratiques de prévision de la demande en eau. La Californie a dû mettre en place une prévision de cette demande d’une grande précision du fait de ressources en eau limitées. Dans quelles mesures ce modèle peut-il servir d’exemple pour la France ?

Dans notre pays, les coutumes de conception des structures sont conservées depuis des décennies avec le même rythme de politique. Nous cherchons l’économie, la construction avec le moindre coût et avec les matériaux habituellement utilisés. Malgré que le marché mondial dispose de plusieurs variétés de matériaux et des nouvelles gammes de nouveaux matériaux déposés, la recherche de l’investigation rapide sans se préoccuper pour une seconde du domaine énergétique et les gains qui peuvent être approuvés à long terme sans oublier le confort humain assuré dans l’ensemble des domaines au niveau des constructions à usage divers ‘habitations, administratifs, scolaires, hospitalier, hôtelleries, etc’. A partir de cette vision, cet article consiste à faire une estimation du coût de l’installation de l’isolant dans l’étude du prix du projet. L’isolation est effectuée sur l’ensemble des éléments constitutifs d’un bâtiment. A travers une discrétisation de la structure et le calcul de l’ensemble de déperditions thermiques dus à la conduction et la convection.

Résumé L’accès à la radiothérapie de haute qualité et de sécurité est une condition préalable pour assurer les soins d’oncologie optimale dans un environnement multidisciplinaire. En vue de soutenir la planification de la radiothérapie à long terme, les besoins réels et prévus en radiothérapie devraient être placés dans le contexte des ressources actuellement disponibles. Le présent article examine les données existantes sur les ressources de radiothérapie et les besoins, ainsi que les systèmes de remboursement en vigueur dans les différents pays européens, avec un accent particulier sur la France. Il décrit les motivations potentiellement liées aux différents systèmes de financement sur la pratique clinique et met en évidence la façon dont la connaissance du coût des radiothérapies, par indication et par technique, est essentielle pour soutenir un remboursement correct, donc l’accès à la radiothérapie. Il est espéré que ces données aideront les fédérations de radiothérapie scientifiques et professionnelles nationales à travers l’Europe dans leurs négociations avec les décideurs politiques, dans le but ultime de rendre la radiothérapie accessible à tous les patients atteints de cancer qui en ont besoin, maintenant et dans les décennies à venir. Access to high-quality and safe radiotherapy is a prerequisite to assure optimal oncology care in a multidisciplinary environment. In view of supporting long-term radiotherapy planning, actual and predicted radiotherapy needs should be put in context of the nowadays’ available resources. The present article reviews the existing data on radiotherapy resources and needs, along with the prevailing reimbursement systems in the different European countries, with a specific emphasis on France. It describes potential incentives of different financing systems on clinical practice and highlights how knowledge of the cost of radiotherapy treatments, by indication and technique, is essential to support correct reimbursement, hence access to radiotherapy. It is expected that such data will help national professional and scientific radiotherapy societies across Europe in their negotiations with policy makers, with the ultimate aim to make radiotherapy accessible to all cancer patients who need it, now and in the decades to come. [ABSTRACT FROM AUTHOR]

Copyright of Revue Valaque d'Etudes Economiques is the property of Valahia University of Targoviste and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Infertility in developing countries are mainly due to tubal injuries, making essential IVF; IVF costs but this, should be reduced to be accessible to people, and not be seen as a luxury in this part of the world but rather an psycho-social emergency. Simplifying attempts monitoring means can decrease these costs, provided that the results are not altered. Patients: The authors, through this randomized survey led in the Academic Hospital Arnaud de Villeneuve in Montpellier, compare the results of 118 patients admitted to an IVF embryo transfer program. Agonist or antagonist protocols are used for ovarian stimulation. The study patients are followed up by traditional monitoring or single day monitoring. Results: Pregnancy rates are equals in both groups: traditional and unique monitoring. Single day monitoring is twice less expensive than the traditional one. Conclusion: single day monitoring doesn't affect IVF outcome and is less expensive. [ABSTRACT FROM AUTHOR]

Objective: Information on the cost of implementing residual insecticide treatment (RIT) for Aedes control is scarce. We evaluated the incremental cost on top of intensive conventional routine activities of the Aedes control programme (ACP) in the city of Santiago de Cuba, Cuba.Methods: We conducted the cost analysis study in 2011-2012, from the perspective of the ACP. Data sources were bookkeeping records, activity registers of the Provincial ACP Centre and the accounts of an RIT implementation study in 21 clusters of on average four house blocks comprising 5180 premises.Results: The annual cost of the routine ACP activities was 19.66 US$ per household. RIT applications in rounds at 4-month intervals covering, on average, 97.2% and using 8.5 g of delthametrine annually per household, cost 3.06 US$ per household per year. Delthametrine comprised 66.5% of this cost; the additional cost for deploying RIT comprised 15.6% of the total ACP routine cost and 27% of the cost related to routine adult stage Aedes control.Conclusions: The incremental cost of implementing RIT is high. It should be weighed against the incremental effect on the burden caused by the array of pathogens transmitted by Aedes. The cost could be reduced if the insecticide became cheaper, by limiting the number of yearly applications or by targeting transmission hot spots. [ABSTRACT FROM AUTHOR]

Objective: To assess the economic burden of underweight and overweight among adults in the Asia-Pacific region.Method: Systematic review of articles published until March 2015.Results: Seventeen suitable articles were found, of which 13 assess the economic burden of overweight/obesity and estimate that it accounts for 1.5-9.9% of a country's total healthcare expenditure. Four articles on the economic burden of underweight estimate it at 2.5-3.8% of the country's total GDP. Using hospital data, and compared to normal weight individuals, four articles estimated extra healthcare costs for overweight individuals of 7-9.8% and more, and extra healthcare costs for obese individuals of 17-22.3% and higher.Conclusion: Despite methodological diversity across the studies, there is a consensus that both underweight and overweight impose a substantial financial burden on healthcare systems in the Asia-Pacific region. [ABSTRACT FROM AUTHOR]

The total cost of a 25 W average load magnetic refrigerator using commercial grade Gd is calculated using a numerical model. The price of magnetocaloric material, magnet material and cost of operation are considered, and all influence the total cost. The lowest combined total cost with a device lifetime of 15 years is found to be in the range $150–$400 depending on the price of the magnetocaloric and magnet material. The cost of the magnet is largest, followed closely by the cost of operation, while the cost of the magnetocaloric material is almost negligible. For the lowest cost device, the optimal magnetic field is about 1.4 T, the particle size is 0.23 mm, the length of the regenerator is 40–50 mm and the utilization is about 0.2, for all device lifetimes and material and magnet prices, while the operating frequency vary as function of device lifetime. The considered performance characteristics are based on the performance of a conventional A +++ refrigeration unit. In a rough lifetime cost comparison between the magnetic refrigeration device and such a unit, we find similar costs, the former being slightly cheaper, assuming the cost of the magnet can be recuperated at end of life. [ABSTRACT FROM AUTHOR]

Résumé Contexte Les accidents vasculaires cérébraux (AVC) sont en France la première cause de handicap acquis chez l'adulte, la deuxième cause de démence et la troisième cause de mortalité. Malgré cela, le coût qu'ils induisent pour la collectivité est mal connu. Objectifs L'objectif de cette étude est de faire la synthèse des données françaises récentes publiées sur le coût de la prise en charge des AVC. Méthode Une revue et une analyse critique de la littérature publiée depuis 2000 sur des données françaises ont été réalisées. Résultats La dépense annuelle totale financée par la collectivité a été de 8,6 milliards d'euros en 2007. La dépense de soins au cours de la première année représentait environ un tiers de ce montant, les dépenses de soins pour les patients prévalents un autre tiers, et les dépenses médico-sociales le dernier tiers. Les dépenses post-AVC représenteraient 65 % du coût de prise en charge. Selon les sources et la nature de l'AVC, le coût des cas incidents sur 1 an variait entre 7 839 € (AVC ischémique peu sévère) et 41 437 € (AVC hémorragique sévère). Conclusion Les AVC génèrent une dépense importante pour la collectivité, qui ne se résume pas à la prise en charge de l'évènement initial et qui va courir jusqu'au décès des patients. La prise en charge médico-sociale du handicap représente en particulier un poste important, qui reste mal connu dans le contexte français. Background In France, stroke is the first cause of acquired disability for adults, the second cause of dementia and the third cause of death. Nonetheless, their economic burden for society is insufficiently documented. Aims The aim of the study was to synthetize existing published data on the cost of stroke in France. Methods A literature review of all studies published since 2000 and related to the cost of stroke in France was performed. Results Total annual expenditures funded by social security was Billion 8.7 € in 2007. Expenditures for the first year after the event was around one-third of this amount, whereas health care expenditures for patients beyond the first year and social services represented each another third. Depending on sources and nature of the initial event, the direct medical cost for the first year ranged between € 7,839 for a mild ischemic stroke to € 41,437 for a severe haemorrhagic stroke. Conclusion The review confirms the important economic burden of stroke for the French society. This burden goes beyond the expenditures incurred for the initial event. In particular, the management of disability represents a substantial share, which is still unperfectly documented in the French context. [ABSTRACT FROM AUTHOR]

Résumé Contexte Dans l'analyse de l'efficience des anticoagulants oraux directs (AOD), l'estimation du coût complet de traitement par les antivitamines K (AVK) est un paramètre clé des modèles, puisqu'il sert de base au calcul du différentiel de coût des traitements. On sait également qu'en France, ce suivi n'est pas optimal. Or, ce coût exact est mal connu, ainsi que son efficacité, mesurée en temps passé à la cible. De ce fait, l'efficacité en vie réelle des AVK peut être moindre que celle observée dans les essais cliniques comparateurs. Objectifs On a estimé quel serait l'investissement à réaliser en France et selon quel modèle d'organisation pour améliorer le suivi des AVK et, partant, leur efficacité préventive. On a estimé ensuite quelle serait la perte d'efficacité théorique AVK si le temps passé à la cible était de 50 %, taux rapporté dans le contexte français. Méthode Dans les deux cas, la méthode utilisée est la construction d'un modèle hypothétique plausible et de données de la littérature. Résultats En organisant un suivi systématique fondé sur l'association des médecins généralistes, des infirmières libérales et des laboratoires d'analyse, le coût supplémentaire à consentir pour atteindre un temps passé à la cible proche de celui observé dans les essais cliniques des AOD serait de 48 € ou de 103 € par an selon le modèle choisi, soit un coût supérieur à celui estimé sans optimisation de traitement de 17 à 39 %. La perte d'efficacité des AVK avec un temps moyen passé à la cible de 50 % a été estimée à 16,7 %, en termes de nombre d'accidents vasculaires cérébraux (AVC) évités par an. Conclusion Dans le calcul de l'efficience des AOD, il importe de prendre en compte, non le coût observé du suivi sous AVK, sous-optimal en France, mais l'investissement qu'il faut consentir pour obtenir un temps passé à la cible thérapeutique similaire à celui des essais cliniques. À défaut, il faut corriger le taux observé dans les essais cliniques pour les patients sous AVK de la perte d'efficacité liée à un suivi sous-optimal. Background When assessing the cost-effectiveness ratio of New Oral Anticoagulants vs VKA, the total cost of managing patients with VKA is a key parameter of the result, since it determines the cost-differential between the two treatments which will apply to all patients who are treated. In France, the management of patients with VKA is not optimal, with many publications estimating that average time to target is 50%. The actual cost of managing patients with VKAs is not well known, as well as its effectiveness in terms of Time to Target. Objectives To calculate what extra cost would be need in France for patients with VKA to reach the Time to Target observed in the clinical trials comparing them to NOAC; to estimate the loss of preventive effectiveness associated to an under-optimal management leading to a Time to Target of 50%. Methods Two hypothetical models were designed, based on plausible assumptions and literature review. Results Based on a strengthened coordination between general practitioners, laboratories and nurses, the extra cost per year needed to reach Time to Target similar to what was observed in the clinical trials of NOAC, would be €48 or €103 per year, according to the different organisational solutions. This extra cost would represent a relative increase of 17% to 39% relative to present sub-optimal management. If real life Time to Target was 50%, then this would represent a relative loss of preventive effectiveness of 16.7% of VKA compared to what was observed in clinical trials. Conclusion When estimating the cost-effectiveness of NOAC compared to VKA, one should consider the extra cost to be invested to reach a level of quality of the management of VKA similar as to what was observed in trials. If not, then one should consider modelling a lower effectiveness of VKA. [ABSTRACT FROM AUTHOR]