Electronic versus Paper-Based Data Collection for Conducting Health-Care Research: A Cost-Comparison Analysis

Background: Containing expenditure and efficient resource use is essential to limit the increasing costs of health research. Electronic data collection (EDC) is thought to reduce the costs compared to paper-based data collection (PDC). Objectives: As economic evidence in this area is scanty, especially in low- and middle-income countries, the objectives of the study are to perform an economic evaluation and compare the cost between EDC and PDC. Methods: A cost-comparison study was conducted to compare between EDC and PDC from the institutional perspective for the year 2018, based on a community?based survey. Step?down cost accounting was adopted with a bottom?up approach for cost estimation. Total and unit costs were estimated with the base case comparison between EDC and PDC while using SPSS software (e?SPSS and p?SPSS, respectively). We conducted scenario analyses based on the usage of different software, R and STATA for both EDC and PDC (e-R, p-R, e-STATA, and p-STATA, respectively). One-way and probabilistic sensitivity analysis (PSA) was performed to examine the robustness of the observed results. Results: In the base-case analysis, total costs of EDC and PDC were ?72,617 ($1060.9) and 87,717 ($1281.5), respectively, with estimated cost reduction of ?15,100 ($220.6). In other scenarios, the estimated cost reduction for e?R, e-STATA, p-R, p-STATA was ??274 ($4.0), 98 ($1.4), 14826 ($216.6), and 15,002 ($219.2), respectively, when compared to EDC?SPSS. On one-way and PSA, the results of the cost-comparison analysis were robust. Conclusion: EDC minimizes institutional cost for conducting health research. This finding will help researchers in efficiently planning for the budget for their research.

Cost estimation of medical services for COVID-19 epidemic in Wuhan city / 中华医院管理杂志

Objective:To simulate the cost of medical services for COVID-19 epidemic in Wuhan city from the social perspective, as references and suggestions in case of possible public health emergencies in China in the future.Methods:By such means as policy documents and literature review, interview survey and Delphi method, a cost estimation model was built and confirmed to simulate the cost of medical services for COVID-19 in Wuhan, from December 27, 2019 to April 26, 2020.Results:The total cost of medical services during the COVID-19 epidemic in Wuhan was 8 152 670 867 yuan. 721 800 387 yuan(8.85%) of the medical cost was covered by medical insurance; the medical cost covered by sources other than medical insurance was 434 813 725 yuan(5.34%); the cost of additional measures related to medical service was estimated to be 6 996 056 755 yuan(85.81%).Conclusions:The total cost of medical services during the COVID-19 epidemic in Wuhan was gigantic. The cost estimation results can provide the government with basic information, decision-making basis and suggestions regarding epidemic control.

Status Quo of Cost Estimation and Systematic Review in Pharmacy Intravenous Admixture Services in China / 中国药房

OBJECTIVE： To systematically evaluate the status quo of cost estimation in pharmacy intravenous admixture services （PIVAS）， and to provide cost basis for the construction of PIVAS in China. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， CNKI， CSJD and Wanfang database from database establishment to Jan. 2019， the studies about the status quo of cost estimation in PIVAS of China were included. The descriptive analysis was conducted for content and method of cost estimation， infection to hospital. RESULTS： A total of 17 literatures were included， involving 8 before and after control studies， 6 experience sharing studies and 3 reviews. Existing reports showed that the estimation contents and methods of PIVAS cost were roughly the same. The cost included manpower， medical and health materials， fixed asset purchase， depreciation， repair costs， medicine cost and indirect costs. At the same time， the infection to hospital were reported， such as in manpower adopting， formulating detailed management measures and systems， concurrent allocation of the same kind of drugs， shortening infusion preparation and replacement time， in order to save manpower cost. CONCLUSIONS： PIVAS cost calculation method is roughly the same in some hospitals， but there is no uniform standard. It is necessary to further improve the PIVAS cost measurement standard and provide a basis for the construction and development of PIVAS in China.

Systematic Evaluation of Current Status of Charges in PIVAS of China / 中国药房

OBJECTIVE： To systematically evaluate current status of charges in pharmacy intravenous admixture services （PIVAS）， and to provide reference for the formulation of China’s pharmacy intravenous admixture services （PIVAS） charging standards. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， CNKI， VIP， Wanfang database and related goverment websets， the literatures about current status evaluation of charges in PIVAS of China were collected during the establishment of database to Jan. 2019. Cost estimation， charge standard， influential factors and other indicators were collected， and the results were presented by descriptive analysis. RESULTS： A total of 5 literatures were included， all of which were reviewed. According to the existing literatures， except for Shandong， Guangdong and Yunnan provinces， there were no regional charge standards in other provinces （districts and cities）. The cost estimation methods of PIVAS in these three provinces were basically the same. The cost could be obtained by adding up the business fees， labor fees， fees of medical instruments purchase and use， indirect fees etc. Dispensing charges in PIVAS were 3-5 yuan per piece for general drug， 5 yuan per piece for antibiotics and 8-12 yuan per piece for cancer chemotherapeutics， 20-35 yuan per piece for TPN. The charging level was mainly affected by local prices， PIVAS scale， hardware investment， management and other factors. CONCLUSIONS： There is no unified charging standard for PIVAS in most provinces （districts， cities） of China. The cost estimation methods of the hospitals from the included literatures are basically the same. It is necessary to construct national PIVAS charging standard and cost estimation method， which could provide a basis for formulating the price of medical and health services.

Study on Cost Estimation of Free Family Planning Technical Services / 中国卫生经济

Objective:To calculate the average full cost and average direct cost of the 13 items of free family planning technical services,and provide references for the settlement standard of free family planning technical service project during the period of "two children policy".Methods:Questionnaire survey,ladder allocation method and time coefficient distribution method.Results:Among the 13 items of free family planning technical service,the highest cost was the tubal recanalization(full cost wasl 719.38 yuan,direct cost was 1 381.36 yuan),followed by tubal ligation and the cost of the operation(full cost was 974.76 yuan,direct cost was 786.75 yuan),the lowest was the contraceptive ring and pregnancy situation(full cost was 37.62 yuan,direct cost was 30.37 yuan);free family planning technical service items constituted the details,laboratory tests costed the most time and the number of participants in the operation was the largest.The current settlement standard of Sichuan compensated the actual cost of less than one-third.Conclusion:Maternal and child health institutions should improve efficiency,control too much inspection,strengthen cost management.The government should promptly adjust the relevant settlement standards to make up the actual costs.

Estimating the burden of dengue in the Philippines using a dynamic transmission model

@#<p style="text-align: justify;"><b>OBJECTIVE:</b> This study aimed to describe dengue burden in the Philippines. Specifically, health and economic costs of the disease were estimated.</p><p style="text-align: justify;"><b>METHODS:</b> A published serotype-specific and age-stratified dengue dynamic transmission model was populated with Philippine-specific dengue epidemiology and cost data. Data were gathered from literature and record reviews. Dengue experts were consulted to validate the model parameters. Sensitivity analyses were performed to test the uncertainty of input parameters on model outcomes.</p><p style="text-align: justify;"><strong>RESULTS:</strong> By 2016 to 2020, it is estimated that annually, average hospitalized cases will amount to 401,191 and ambulatory cases will amount to 239,497; resulting to USD 139 million (PhP 5.9 billion) and USD 19 million (PhP 827 million) worth of aggregate costs shouldered by the public payer for hospitalized and ambulatory cases, respectively. Average annual productivity losses may amount to USD 19 million (PhP 821 million) and DALY lost is expected to be 50,622.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The cost of dengue is high especially since the Philippines is an endemic country. Thus, there is a need to optimize government interventions such as vector control and vaccination that aim to prevent dengue infections.</p>

Research progress of cost estimation of community basic public health service in China / 中国卫生政策研究

Objective:To summarize the cost of basic community public health service in Chinese community for the period 2009 to 2016 and to provide suggestions for the formulation of the compensatory policy and work in-struction in each region.Methods: The literature search conducted on Chinese literature database(including CNKI, VIP, Wan Fang) from the period of 2009 to 2016.The literature was analyzed with the help of NoteExpress managing Literatures,and the relevant papers and their references were comparatively analyzed by using Microsoft excel 2007. Results:There were a total of 817 relevant articles,of which,48 were included in this study and 19 with detailed re-search results.For the 48 articles,41.7% adopted full costing method and 20.8% used activity-based costing meth-od,54.2% using six-item screener. More research of cost estimation applied to current evaluation of public health service in community,the results of cost estimation showed that the cost of basic community public health service per capita was significantly different among the studies in the period of 2009to2011 (20.9 RMB to 95 RMB).The man-power cost was the main cost of basic community public health service(between 56.59% and 74.9%).Conclusions:Further exploration and research on the cost estimation of national basic community public health service in China re-quires to be performed,and the cost estimation methods are supposed to improve in practice.

Itrio 90 como radionúclido para terapia / Ytrium 90 as a radionuclide for therapy

El 90Y es un emisor beta puro con período de semidesintegración de 64.1 horas y 2.28 MeV de energía, características apropiadas para su uso como radionúclido terapéutico. Radiofármacos de 90Y han sido efectivos en el tratamiento de diferentes enfermedades como sinovitis crónica, cáncer de hígado, dolor por metástasis óseas y tumores de origen neuroendocrino. Mención aparte merecen los resultados en el tratamiento de los linfomas no-Hodgkin, que combinan la especificidad de un anticuerpo monoclonal por el antígeno CD20 y la energía beta pura del 90Y. Aunque el período de semidesintegración del 90Y permite su transportación, se comercializa a precios elevados para una utilización sistemática o a gran escala. El hecho de que se pueda obtener a través de un generador radisotópico, basado en el equilibrio secular que se establece con el 90Sr, hace que su producción local sea atractiva, pues reduciría significativamente los costos y facilitaría su disponibilidad. En este trabajo se exponen las vías para obtener 90Y, aspectos relacionados con la calidad del producto final, sus principales aplicaciones y los resultados obtenidos en el Centro de Isótopos.

90Y is a pure beta emitter with a half-life of 64.1h and 2.28 MeV of energy, suitable properties for its use as a therapeutic radionuclide. Radiopharmaceuticals based on 90Y have been effectively used in the treatment of different diseases such as chronic synovitis, liver cancer, pain caused by bone metastases and neuroendocrine tumors. The results in the treatment of no-Hodgkin lymphoma, that combine the specificity of a monoclonal antibody for CD20 antigen and the pure beta energy of 90Y, deserve a particular distinction. Although the half-life of 90Y makes possible its transportation, it is sold at high prices for a systematic or large-scale use. The fact that 90Y can be produced through a radionuclide generator system, based on the secular equilibrium of 90Sr decaying to 90Y, is very attractive for developing a local production because the cost could be significantly reduced and 90Y availability could be guaranteed. The present work shows the ways to obtain 90Y, the aspects related to the quality of final product, the main applications and the results achieved by the Isotope Centre in this area.

Estimation of Optimal Educational Cost per Medical Student / 한국의학교육

PURPOSE: This study aims to estimate the optimal educational cost per medical student. METHODS: A private medical college in Seoul was targeted by the study, and its 2006 learning environment and data from the 2003~2006 budget and settlement were carefully analyzed. Through interviews with 3 medical professors and 2 experts in the economics of education, the study attempted to establish the educational cost estimation model, which yields an empirically computed estimate of the optimal cost per student in medical college. RESULTS: The estimation model was based primarily upon the educational cost which consisted of direct educational costs (47.25%), support costs (36.44%), fixed asset purchases (11.18%) and costs for student affairs (5.14%). These results indicate that the optimal cost per student is approximately 20,367,000 won each semester; thus, training a doctor costs 162,936,000 won over 4 years. Consequently, we inferred that the tuition levels of a local medical college or professional medical graduate school cover one quarter or one-half of the per- student cost. CONCLUSION: The findings of this study do not necessarily imply an increase in medical college tuition; the estimation of the per-student cost for training to be a doctor is one matter, and the issue of who should bear this burden is another. For further study, we should consider the college type and its location for general application of the estimation method, in addition to living expenses and opportunity costs.

Concentrated Disinfectant Supply of Regional Medical Appliances and Its Cost Estimation / 中华医院感染学杂志

OBJECTIVE To estimate the cost of concentrated disinfectant supply of medical appliances,so as to provide the primary basis for improving the concentrated disinfectant supply model,along with regional integration.METHODS Using contrasting methodologies,the cost level before and after the concentrated disinfectant supply with regional integration was compared,and the individual cost and total cost were analyzed.RESULTS Material and human resource cost was the core of total cost.Concentration management of regional medical appliances disinfection supply could significantly reduce costs.CONCLUSIONS Integrated management of concentrated disinfectant supply could reduce cost and economize expenses.Actually,this model is worth promoting.

Cost-Benefit Analysis Methods For Assessing Air Pollution Control Programs in Urban Environments --- A Review

The most common method of evaluating beneficial impacts of environmental policies is cost-benefit analysis (CBA). In the present review, CBA methods for air pollution impacts are reviewed. Three types of air pollution effects are identified, including health, productivity, and amenity. Market valuation, stated preference methods, and revealed preference methods are identified for valuing benefits. Three types of costs are described, including private sector costs, societal costs, and governmental regulatory costs. A benefits valuation approach based on Freeman’s principals is described. A costs valuation approach based on U.S. Environmental Protection Agency and Dixon et al. principals is described. Limitations associated with estimates of benefits and costs are summarized. Input assumptions and results are compared for several existing air pollution control analyses. The importance of CBA in environmental policy studies is discussed. Our conceptual approaches should be useful in analyses of urban air pollution impacts and air pollution prevention policies.

Research on the cost estimation of community medical aid programs for the urban poor / 中华医院管理杂志

Objective To estimate the cost of community medical aid programs for the urban poor in Shenyang, Chengdu, Xining and Yinchuan so as to provide the primary basis for improving the compensation mechanisms for such programs. Methods A survey was made on the cost consumption of six major categories in the course of health service delivery and the amount of various community health services actually delivered by the pilot community health service institutions in 2003. The cost of each service program was estimated and then the cost of medical aid programs for the urban poor was estimated. Results The per capita cost of the medical aid programs for the poor in the cities was less than 5 yuan and the total cost of the medical aid programs accounted mostly for 0.05‰ or so of the financial expenditure of each of the cities. Conclusion The government ought to make rational compensation for community medical aid programs, the cost of which is low. Setting up community health service based mechanisms of medical aid for the poor conforms to the actual condition of our country.