Genotype®MTBDRplus and Xpert®MTB/RIF in the diagnosis of tuberculosis and resistant tuberculosis: cost analysis in a tertiary referral hospital

Abstract INTRODUCTION: The present study sought to assess the mean and activity based cost (ABC) of the laboratory diagnosis for tuberculosis through the application of conventional and molecular techniques-Xpert®MTB/RIF and Genotype®MTBDRplus-in a tertiary referral hospital in Brazil. METHODS: The mean cost and ABC formed the basis for the cost analysis of the TB laboratory diagnosis. RESULTS: The mean cost and ABC were US$ 4.00 and US$ 3.24, respectively, for a bacilloscopy; US$ 6.73 and US$ 5.27 for a Lowenstein-Jensen (LJ) culture; US$ 105.42 and US$ 76.56 for a drug sensitivity test (DST)-proportions method (PM) in LJ; US$ 148.45 and US$ 136.80 for a DST-BACTECTM MGITTM 960 system; US$ 11.53 and US$ 9.89 for an Xpert®MTB/RIF; and US$ 84.21 and US$ 48.38 for a Genotype®MTBDRplus. CONCLUSIONS: The mean cost and ABC proved to be good decision-making parameters in the diagnosis of TB and MDR-TB. The effective implementation of algorithms will depend on the conditions at each location.

Costos y resultados de los exámenes médicos periódicos realizados en el Instituto Nacional de Salud de los Trabajadores en el período 2008-2009 / Cost and results of periodic medical examinations performed at the National Institute for Workers' Health in the period 2008-2009

Introducción: los exámenes médicos periódicos en sus diferentes modalidades son un componente importante de la atención a la salud de los trabajadores. Objetivo: determinar los costos relacionarlos con los resultados de los exámenes médicos que se realizaron a trabajadores durante los años 2008 y 2009. Métodos: se realizó una investigación descriptiva, de corte transversal, en el área de Asistencia Médica del Instituto Nacional de Salud de los Trabajadores, para la que se utilizó la información disponible en las historias clínicas de los trabajadores examinados en el centro, la información solicitada a los centros de trabajo y dos tesis de diploma de estudiantes de Economía. Resultados: la investigación permitió calcular con precisión el costo de los exámenes médicos con la aplicación de un sistema de costo más conveniente que el que se utiliza en el sistema de salud pública, y propició al área de asistencia médica de la institución la adopción de medidas para realizar con mayor eficiencia los exámenes médicos a los trabajadores. Consideraciones finales: es necesario desarrollar nuevos estudios de costos de los exámenes médicos en el Instituto Nacional de Salud de los Trabajadores con el fin de obtener resultados contrastables y cada vez más precisos

Introduction: in their wide variety, periodic medical examinations constitute an important component of workers' health care. They should be designed and performed in keeping with the rationality and efficiency called for at the 6th Congress of the Communist Party of Cuba. Objective: determine the cost and results of the medical examinations performed on workers during the years 2008 and 2009. Methods: a descriptive cross-sectional study was conducted in the Medical Care area of the National Institute for Workers' Health, based on data from the medical records of workers examined at the center, information requested from workplaces and two diploma theses written by students of economics. Results: the study made it possible to accurately estimate the cost of medical examinations with the application of a more convenient cost system than the one used by the public health system. It also paved the way for the adoption of measures leading to greater efficiency in the performance of medical examinations. Final considerations: it is necessary to develop new studies in the National Institute for Workers' Health about costs of medical examinations, with the purpose to obtain contrastable and more precise results

Using Activity-Based Cost in Menu Engineering for Restaurant Menu Analysis / 대한지역사회영양학회지

The purposes of this study were to investigate methods of applying activity-based cost to menu engineering and to examine the feasibility. A total of 6 menu items of XYZ restaurant in Seoul were selected and the ledger of September 2005 was used for menu analysis. The menu mix percent of beef sirloin steak (61.95%) and beef tenderloin steak (17.13%) were labeled as high, whereas BBQ pork ribs (4.94%), salmon fillet (2.66%), seafood platter (5.77%), and teriyaki chicken (7.56%) showed low menu mix percent. In addition, the contribution margin for BBQ pork ribs (29,000 won), salmon fillet (25,810 won), seafood platter (22,400 won), and teriyaki chicken (22,000 won) were higher than the average contribution margin (21,957 won), and those for beef sirloin steak (21,200 won) and beef tenderloin steak (21,900 won) were lower than average. When popularity and contribution margin were applied in menu engineering, BBQ pork ribs, salmon fillet, seafood platter and teriyaki chicken were classified as puzzles and beef tenderloin steak and beef sirloin steak as plowhorses. Menu engineering using popularity and operating profit, which was calculated from activity-based cost, also gave the same results, whereas the additional label for activity cost placed BBQ pork ribs and salmon fillet in the brain teaser category. Ranking analysis on variables estimating menu profitability using Spearman's rho revealed that there were no significant correlation between variables, which means the estimation of menu item profitability could differ by methods of analysis. With these results, it was concluded that activity-based cost would help to establish more detailed marketing strategy for a restaurant.