Cost-effectiveness of three rounds of mammography breast cancer screening in Iranian women

Background: Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease

Objectives: We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer

Patients and Methods: This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years [QALY] and lifetime costs

Results: The results revealed that the incremental cost effectiveness ratio [ICER] of mammography screening in Iranian women in the first round was Int. 37,350 dollars per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int.141,641 dollars and Int. 389,148 dollars respectively

Conclusions: Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making

Optimization the number of nurses in the emergency department using linear programming technique

Introduction: Aim of current study is determination of optimal number of nurses in the emergency department of Shiraz Ali Asghar Hospital

Method: Current study is an applied study and belongs to operational research [OR] studies. The population has been studied in this research, includes records of referred patients to the emergency department of hospital in 2008. Sampling was performed in the forms of stratified [monthly] and simple for all of the records and each of months respectively. Required data collection was performed from statistics notebook and also patient's records using data collection forms. After average determination of entering patients in a day at eight period in three hours, determining the type of provided services and also the period of offering nursing services [with using time information]determine optimum number of required nurses in different periods of hospital with using of linear programming technique by lingo 8 software

Results: The minimum number of nurses needed in emergency department of Ali Asghar hospital regarding to desired services to the patients were obtained 1 and 3 nurses for each shift and a day respectively

Conclusion: According to the results the used number of nurses in the emergency department was more than optimum number. It seems that, obtained number of nurses from quantitative methods such as linear programming technique is much less than the calculated number experimentally by the directors of nursing

[ application of activity based costing system in radiology ward: a case study of Hafez hospital]

Activity Based Costing [ABC] is a method to illustrate cost of products and is capable to provide non-financial information to improve efficiency of organizations. The Aim of this study is to determine cost of radiology and sonography services and to demonstrate difference between fees and cost in public sector. We analyzed more than 100 different radiology and sonography services using work and time study to determine dedicate time and resource for each service in radiology ward of Hafez hospital. Total cost of overhead centers was allotted to services using concurrent equation method after calculation. Monte Carlo simulation method has been used to calculate confidence interval of each cost price. Estimated cost price has been showed in details that included activities description, kind, amount and cost of material, equipment and energy consumed by each service. Also we calculated building depreciation and amount of total cost allotted to each service from overhead centers such as management, accounting and so on. Fees 36678 and 42038 respectively for radiology and sonography services. Our results indicated that main components of cost were human resource [48%], overhead cost [27%], equipment depreciation cost [14%] and material cost [11%]. Due to low productivity, cost of service was higher then received fees. So, for overhead cutting, the best was is increasig service volume. Finally we must mention that for making fees move realistic and imporoving service level use of ABC system is a necessity

Cost-utility analysis of neonatal screening program, shiraz university of medical sciences, shiraz, Iran, 2010

The most important cause of infant mortality during the first month of life is related to congenital abnormalities. Nevertheless, timely diagnosis of these diseases can reduce the severity of their effects. The present study aimed to investigate the cost-effectiveness of the neonatal screening program in Pars Province, Iran. In this study, costs of executing the screening programs, treatment of the diagnosed cases, treatment of affected, non-screened individuals, quality of life, and incremental cost-effectiveness ratios were measured in two study groups. Performing the screening programs for phenylketonuria, congenital hypothyroidism, galactosemia, and favism resulted in respectively $3386, $13078, $19641, and $1088 saving per patient. Overall, the study results revealed the cost-effectiveness of execution of the neonatal screening program. Neonatal screening program is one of the health interventions which lead to long-term beneficial outcome for the patients, financial saving for the society, and improvement of the patients' quantity as well as quality of life