Diagnosis-Related Groups payment reform and hospital cost control.

BACKGROUND: This study explores the influence of Diagnosis-Related Groups (DRG) payment reform on hospital cost control and offers pertinent cost management strategies for public hospitals. It situates the research by elucidating the significance of the DRG payment method and comparing its advantages and drawbacks with the traditional 'pay per project' model. OBJECTIVE: The primary aim is to assess the impact of DRG payment reform on hospital cost control and propose effective cost management strategies for public hospitals. The objective is to provide insights into DRG payment implications and attempt practical recommendations for its implementation in the public healthcare sector. METHODS: Employing a comprehensive approach, the study analyzes DRG payment, delineates advantages and drawbacks, and proposes cost management strategies. Methods include staff training, an information management platform, disease analysis, and optimized cost accounting. The study highlights the potential for improved medical diagnosis and treatment through industry-finance integration. RESULTS: Findings reveal advantages and limitations of DRG payment, emphasizing strategies for optimizing hospital operations. Enhanced medical diagnosis and treatment procedures through industry-finance integration contribute to overall cost control effectiveness. CONCLUSION: The study serves as a practical guide for implementing DRG payment reforms, offering valuable insights for policymakers and healthcare professionals in navigating the complexities of cost control in public healthcare.

Assessment and characterization of solid and hazardous waste from inorganic chemical industry: Potential for energy recovery and environmental sustainability.

Rapid global urbanization and economic growth have significantly increased solid waste volumes, with hazardous waste posing substantial health and environmental risks. Co-processing strategies for industrial solid and hazardous waste as alternative fuels highlight the importance of integrated waste management for energy and material recovery. This study identifies and characterizes solid and hazardous industrial wastes with high calorific values from various industrial processes at Nirma Industries Limited. Nine types of combustible industrial wastes were analyzed: discarded containers (W1), plastic waste (W2), spent ion exchange resins from RO plants (W3), sludge from effluent treatment in soap plants (W4), glycerine foot from soap plants (W5), rock wool puff material (W6), fiber-reinforced plastic waste (W7), spent activated carbon (W8), and spent cartridges from reverse osmosis plants (W9). Physical characterization, proximate and ultimate analysis, heavy metal concentration evaluation, and thermogravimetric analysis were conducted to assess their properties, revealing high calorific values exceeding 2500 kcal/kg. Notably, W1 and W2 exhibited the highest calorific values (∼10,870 kcal/kg), followed by W6 and W8 (∼6000 kcal/kg) and W9 (∼8727 kcal/kg). Safe heavy metal levels are safe, and high calorific values support the prospects of energy recovery and economic and environmental benefits, reducing landfill reliance and enhancing sustainable waste management.

Impact of Institutional Practices and Surgical Complexity on Sarcoma Surgery Costs: Driving Efficiency in Value-Based Healthcare.

BACKGROUND: Sarcomas present a unique challenge within healthcare systems due to their rarity and complex treatment requirements. This study explores the economic impact of sarcoma surgeries across three Swiss tertiary healthcare institutions, utilizing a consistent surgical approach by a single surgeon to eliminate variability in surgical expertise as a confounding factor. METHODS: By analyzing data from 356 surgeries recorded in a real-world-time data warehouse, this study assesses surgical and hospital costs relative to institutional characteristics and surgical complexity. RESULTS: Our findings reveal significant cost variations driven more by institutional resource management and pricing strategies than by surgical techniques. Surgical and total hospitalization costs were analyzed in relation to tumor dignity and complexity scores, showing that higher complexity and malignancy significantly increase costs. Interestingly, it was found that surgical costs accounted for only one-third of the total hospitalization costs, highlighting the substantial impact of non-surgical factors on the overall cost of care. CONCLUSIONS: The study underscores the need for standardized cost assessment practices and highlights the potential of predictive models in enhancing resource allocation and surgical planning. By advocating for value-based healthcare models and standardized treatment guidelines, this research contributes to more equitable and sustainable healthcare delivery for sarcoma patients. These insights affirm the necessity of including a full spectrum of care costs in value-based models to truly optimize healthcare delivery. These insights prompt a reevaluation of current policies and encourage further research across diverse geographical settings to refine cost management strategies in sarcoma treatment.

Efficacy of post-operative X-rays after operatively treated ankle fractures: What is their role?

OBJECTIVE: The utility of routine post-operative imaging in clinically asymptomatic patients is unclear. We sought to determine how frequently X-rays following operatively treated ankle fractures result in a change in management. DESIGN: Retrospective cohort study conducted with hospital electronic health record SETTING: Single level 1 trauma center in major urban city. PATIENTS/PARTICIPANTS: 193 patients with operatively treated ankle fractures at our institution between January 2020 and December 2021. MAIN OUTCOME MEASURES: Patient radiographs were categorized as surveillance X-rays and clinically indicated X-rays. Changes in management were defined as alteration in follow-up, deviation from standard post-operative protocols, or revision surgery. A logistic regression was performed looking at factors predicting whether an X-ray changes management. A cost analysis was also performed looking at the financial implications of asymptomatic surveillance of ankle fractures. RESULTS: 438 post-operative X-rays were found and included in analysis. Of these, 391 were considered surveillance X-rays and 47 clinically indicated. 23 X-rays were determined to have resulted in changes in management (18 clinically indicated, 5 taken in asymptomatic patients). The number of management changing X-rays was significantly higher in the clinically indicated group (p < 0.0001). The only factor associated with whether an X-ray changed management was whether the patient was symptomatic at the visit (p < 0.0001). Asymptomatic surveillance X-rays cost our institution 21,825.62 USD per year. CONCLUSIONS: Radiographs in clinically asymptomatic patients with operatively managed ankle fractures have a low likelihood of changing management. Such imaging represents costs to the healthcare system, increased time for patients during clinic visits, and radiation exposure. The use of screening radiographic studies remains commonplace because the risk of delayed diagnosis is great, and the goal of any surgeon should be the swift identification of complications in order to minimize patient morbidity. Future surveillance protocols should consider the findings of this and other studies on the use of screening radiographs and strike a careful balance between minimizing unnecessary imaging, maximizing early complication detection, and ensuring a personalized approach towards patient-level factors to optimize care and efficiency for both patient and health system. LEVEL OF EVIDENCE: Level III.

Trends in Management and Cost Burden of Facial Fractures: A 14-Year Analysis.

OBJECTIVE: To discuss patient demographics and management and better understand the economic impact associated with the treatment of facial fractures at a major metropolitan level 1 trauma center. STUDY DESIGN: Retrospective chart review. METHODS: We identified 5088 facial fractures in 2479 patients who presented from 2008 to 2022. Patient demographics, mechanism of injury, associated injuries, treatment information, and hospital charges were collected and analyzed to determine factors associated with surgical management and increased cost burden. RESULTS: Our 14-year experience identified 1628 males and 851 females with a mean age of 45.7 years. Orbital fractures were most common (41.2%), followed by maxilla fractures (20.8%). The most common mechanism was fall (43.0%). Surgical management was recommended for 41% of patients. The odds of surgical management was significantly lower in female patients, patients age 65 and older, and patients who presented after the onset of the COVID-19 pandemic. The odds of surgical management was significantly higher for patients who had a mandible fracture or greater than 1 fracture. The average cost of management was highest for naso-orbito-ethmoidal fractures ($37,997.74 ± 52,850.88), followed by LeFort and frontal fractures ($29.814.41 ± 42,155.73 and $27,613.44 ± 39.178.53, respectively). The highest contributor to the total average cost of management was intensive care unit-related costs for every fracture type, except for mandible fractures for which the highest contributor was operating room (OR)-related costs. CONCLUSIONS: This study represents one of the largest comprehensive databases of facial fractures and one of the first to provide a descriptive cost analysis of facial trauma management. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:3120-3126, 2024.

Optimized pathways for operations management in public hospitals under the DIP payment system / 现代医院

As the comprehensive reform of public hospitals enters a more challenging phase,the conventional extensive operation management no longer fulfills the requirements of high-quality development.This article investigates the current challen-ges in hospital operation management under the DIP payment system,proposes an optimized pathway as well as an outline for practical implementation.The proposed pathway suggests implementing a closed-loop resource allocation strategy integrating budg-et and performance based on disease groups and scores,establishing a cost management mechanism for enhancing resource effi-ciency,and development of a performance distribution system for stimulating self-management motivation among personnel.Addi-tionally,the article suggests the establishment of a Management Information System,aiming to provide practical references for en-hancing operational management capabilities in public hospitals under the DIP payment mode.

Application of Good Engineering Practice in rabies vaccine engineering projects / 中国生物制品学杂志

@#Good Engineering Practice(GEP)is an engineering practice specifically designed for pharmaceutical engineering projects,aimed at ensuring product quality,patient safety,and Good Manufacturing Practice of Medical Products(GMP).Based on the existing management system,biopharmaceutical engineering,and international engineering project management models of Changchun Institute of Biological Products Co.,Ltd.(referred to as CCIBP),as well as combined with the characteristics of GEP technology,this paper summarizes the construction of GEP system of CCIBP and its application in rabies vaccine engineering projects starting with the key control points such as User Requirement Specification(URS),plan,design,change,quality,and handover,so as to provide technical support and theoretical references for vaccine engineering projects in risk management,organization and control,cost management,innovation and continuous improvement.

The Application of Time Driven Activity Based Costing Method in Cost Control in Public Hospitals-Taking the Ultrasound Department of a Hospital as an Example / 中国医院管理

Public hospitals stand in need of strengthening cost control and improving operational efficiency to balance public welfare and economic benefits.Taking practice and exploration of ultrasound department as an exam-ple,it integrates the advantages of TDABC with cost management.Take the merits of time driver and activity driver,realizes direct cost accounting under the clinical pathway,strengthen capacity management capabilities un-der the integration of industry and finance,with a view to providing a powerful cost control tool for public hospitals to sensibly respond to pricing reform and reasonably make operational decisions.

ACTIVITY-BASED COSTING: A PRACTICAL MODEL OF COST CALCULATION IN PSYCHIATRIC HOSPITALS.

OBJECTIVE: The aim: This paper is an analytical and descriptive study of the use of the Activity Based Costing (ABC) system in mental healthcare institutions for the allo¬cation of overhead costs of auxiliary units that provide non-medical services. The realistic estimates obtained using this costing system will help improve the allocation of resources, especially in the conditions of increased number of patients, and to control overhead costs, ensuring the reduction of non-productive expenses, increasing the efficiency and effectiveness of the mental health and psychosocial support institution. PATIENTS AND METHODS: Materials and methods: The study describes and uses ABC as a system and method for calculating inpatient care costs in 2022. The cost of medical services will be calculated as the sum of direct and overhead costs. Overhead costs into inpatient care consist of medical support units overhead costs and non-medical support units overhead costs. Overhead costs in non-medical support units were allocated to the cost of services within the cost centers:hospital departments that specialize in the treatment of specific mental health conditions. Expert opinion regarding the alignment of the cost allocation base with the factors identified for the allocation of each group of overhead costs in the mental health and psychosocial support facility was taken into account . RESULTS: Results: Calculations showed the impracticality of using a single tariff for psychiatric care medical services for adults and children in inpatient conditions, since there are cost centers, namely, clinical departments of health care institutions, which consume a larger amount of resources. In particular, these are the departments providing the treatment of psychotic disorders caused by taking psychoactive substances, as well as schizophrenic, organic disorders, including symptomatic, mental disorders). Accordingly, the tariff for such medical services should be higher. CONCLUSION: Conclusions: ABC is applicable in mental health care institutions and can help to efficiently cost processes, and thereby overcome a key challenge: to overesti¬mation or underestimation of costs into a medical services. Cost assignment through ABC generated more accurate cost estimates, which suggests that model of cost calculation ABC is more able to address complexity in mental health care institutions. ABC should be gradually incorporated into an estimated approach to costing leads, to progressively bring reliable cost-accounting practices to mental health care institutions.

A mathematical model to investigate the interactive effects of important economic factors on the behaviors of retailers.

Cost management is a key step to the success of any logistics system and supply chain management. Inventory costs are an important part of logistics costs which are highly affected by economic factors such as demand growth rate (DGR), interest rate ( i r ), and inflation rate ( e ). Analyzing the interactive effects of these economic factors plays a key role in preventing failures of logistics systems This study aims to develop a novel mathematical model and investigate the interactive effects of these factors on the behavior of retailers in Iran. To the best of our knowledge, this is the first time that the sale price is defined as a function of time and inflation rate where the demand rate is built up with a linear function of time. Different scenarios and sub-scenarios are then taken into consideration based on different combinations of factors and assumptions. As the main findings of the study, it is revealed that if e ≤ 18 % or i r ≥ 40.52 % , holding costs are much higher than buying costs, and retailers are reluctant to invest in inventories. Given that DGR is independent of the inflation rate, and also if e ≥ 20.45 % or i r ≤ 31.9 % , then DGR fluctuations have no impact on the total cost. Hence, in this case, buying costs are much higher than holding costs, and retailers are eager to invest in inventories instead of bank deposits. Furthermore, it is concluded that decision-makers can use the interest rate as leverage to set the probability of shortages and hoardings. Finally, some useful future research directions are discussed based on the main limitations of the study.

Approximation to the Consumption of Healthcare Resources and the Economic Cost of SARS-CoV-2 Patient Management: A Retrospective Study.

Spain has become one of the countries most affected by coronavirus disease 2019 (COVID-19), with the highest testing rates, and one of the worst-performing countries in the fight against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. There are no studies related to the consumption of health resources and the economic cost of the SARS-CoV-2 virus. We present a retrospective analysis of 9,811 (Primary Care and Hospital) patients which aimed to estimate public health expenditure by the consumption of health resources due to COVID-19. According to the results, the gender distribution of patients has a similar rate in both groups, with slightly higher rates in women. Similarly, age is the same in both groups, with a median of 62 years in the case of hospitalizations and 61 years in the case of primary care; using a weighted average of these rates and costs, we can estimate that the average cost of care per patient infected with the SARS-CoV-2 virus, regardless of the course is €2373.24. We conclude that a patient with COVID-19 without hospitalization costs €729.79, while the expenses of a hospitalized patient are between €4294.36 and €14440.68, if there is ICU admission.

Practice of medical technology performance reform in a large public hospital based on resource-based relative value scale theory / 中华医院管理杂志

With the deepening of the comprehensive reform process of public hospitals and the further refinement of high-quality development requirements, the reform of compensation system of public hospitals has also begun. Taking a hospital as an example, the authors deeply analyzed the four-dimensional performance appraisal scheme of medical technology departments based on resource-based relative value scale concept, with workload assessment as the foundation, multi-dimensional cost assessment as the emphasis, work efficiency as the spur and work quality as the foundation, and introduced the process of implementing the distribution scheme guided by knowledge value to the secondary distribution of departments. The performance appraisal scheme could scientifically reflect the work value of medical staff in medical and technical departments, strengthen the department′s awareness of cost control, improve the efficiency and quality of the department′s work, significantly motivate the medical and technical staff, and deepen the modern management of hospitals.

Cutaneous melanoma: cost of illness under Brazilian health system perspectives.

BACKGROUND: The landscape of cutaneous melanoma (CM) diagnosis, staging, prognosis, and treatment has undergone fundamental changes in the past decade. While the benefits of new health resources are recognized, there is a distinct lack of accurate cost-of-illness information to aid healthcare decision makers. METHODS: The cost-of-illness study for CM was conducted from the perspective of two health systems in Brazil: the public health system (Unified Health System, SUS) and the private health system (Health Management Organization, HMO). The study considered the direct medical cost in a bottom-up analysis, using melanoma incidence, knowledge of the disease's progression, and the overall survival rates. The executional costs for the complete healthcare delivery cycle were investigated considering different disease stages and possible clinical course variations. The structural cost was assessed qualitatively considering the health value chain in Brazil. RESULTS: CM represents a critical financial burden in Brazil, and the cost of illness varied according to the health system and by stage at diagnosis. HMO patient costs are approximately 10-fold and 90-fold more than a SUS patient in the early-stage and advanced disease, respectively. Overall, spending on advanced disease patients can be up to 34-fold (SUS) or 270-fold (HMO) higher than that required for the early-stage disease. Given the massive amount of resources spent by the SUS and HMO, significant efforts must be made to improve the health value chain to deliver the right mix of medical care goods and services using available resources. CONCLUSION: The cost-of-illness study for CM has the potential to inform policymakers and decision-makers regarding the economic burden that melanoma impose on a society in terms of the use of health care services, assisting them in making projections of future health care costs and resource allocation decisions. We believe that cost-of-illness analysis from a strategic perspective could be of help in assessing executional costs and be used to support the change in structural costs required for long-term strategies related to the health value chain.

Research on Time-Driven Activity-Based Management System of Public Hospitals.

OBJECTIVE: To provide references for effective implementing cost management for public hospitals through establishing time-driven activity-based management (TDABM) system. The TDABM system was established from hospital cost accounting, budget, control, and performance. RESULTS: The established TDABM system could improve the precision of hospital cost accounting, improve medical staff's working efficiency, realize the whole process of cost management, and enhance the competitiveness of the hospital. CONCLUSION: The activity of implementing TDABM in public hospitals had practical significance.

Designing a novel hybrid healthcare teleconsultation network: a benchtop study of telepathology in Iran and a systematic review.

BACKGROUND: Growing demand for medical services has increased patient waiting time due to the limited number or unbalanced distribution of healthcare centers. Healthcare teleconsultation networks are one of the potentially powerful systems to overcome this problem. Medical pathology can hugely benefit from teleconsultation networks because having second opinions is precious for many cases; however, resource planning (i.e., assignment and distribution of pathology consultation requests) is challenging due to bulky medical images of patients. This results in high setup and operational costs. The aim of this study is to design an optimal teleconsultation network for pathology labs under the supervision of medical sciences universities in Tehran, Iran. METHODS: To avoid the setup cost, we first propose a modified hybrid peer-to-peer (P2P) overlay architecture for our telepathology network, using Iran's National Healthcare Information Network (SHAMS) as the underlying infrastructure. Then we apply optimization techniques to solve the request assignment and distribution problems in the network. Finally, we present a novel mathematical model with the objective of minimizing the variable operational costs of the system. RESULTS: The efficiency of the proposed method was evaluated by a set of practical-sized network instances simulated based on the characteristics of SHAMS. The results show that the presented model and architecture can obtain optimal solutions for network instances up to 350 nodes, which covers our target network. CONCLUSIONS: We believe that the proposed method can be beneficial for designing large-scale medical teleconsultation networks by adjusting the constraints according to the rules and conditions of each country. Our findings showed that teleconsultation networks in countries with strong information technology (IT) infrastructures are under the influence of consultation fees, while in countries with weak IT infrastructure, the transmission costs are more critical. To the best of our knowledge, no research has so far addressed resource planning in medical teleconsultation networks using optimization techniques. Besides, the target network, i.e., pathology labs under the supervision of medical sciences universities in Tehran and the SHAMS network, are discussed for the first time in this work.

A micro-costing study: comparing a standard intravenous patient-controlled analgesia system with a novel sublingual patient-controlled analgesia system.

BACKGROUND: Judicious spending in healthcare is of paramount importance, particularly when introducing new devices or interventions. These products or interventions need to be economically efficient both directly and indirectly. An accepted method of cost estimation is micro-costing. Micro-costing involves direct enumeration and costing of every input consumed in the treatment of a particular patient when using new device, medicine or intervention. In our study, we investigated the cost of using a novel sublingual (SL) patient-controlled analgesia (PCA) device and compared it with our conventional intravenous (IV) PCA device. METHODS: A previous study performed in our institution produced a cost per use of IV PCA device at €97. This compared with a previous European study published in this journal in 2010 which showed a similar figure of €96 per use of IV PCA device. In our comparative study, we used a case record form (CRF) to incorporate a cost to all consumables used, staff time and equipment used to both the SL PCA and the IV PCA. RESULTS: A total of 60 patients of similar demographic were included in our study. The cost of an IV PCA episode was €97.89 and €182.32 for an SL PCA episode. Standl et al. (2010) showed that the average cost of an IV PCA episode was €96.40 with 78% of this being made up of staff time. SL PCA was more efficacious in certain patient groups and in certain surgical groups. CONCLUSION: After performance of a micro-costing study, the less costly IV PCA episode was statistically significant compared with a SL PCA episode. However, the associated staff costs were less with a SL PCA episode. We performed a micro-costing study on a novel sublingual PCA device and compared it with a conventional intravenous PCA device. All resources were included and compared.

Determinants of cost inefficiency in poultry production: evidence from small-scale broiler farms in the Ashanti Region of Ghana.

This paper examines the extent of cost inefficiency at 120 small-scale broiler farms in the Ashanti Region of Ghana by the use of stochastic frontier cost function, which incorporates cost inefficiency effects. Furthermore, farm-specific determinants that help explain why cost inefficiencies are different across broiler farms are identified. The findings confirm the presence of cost inefficiencies in small-scale broiler production in the area studied. Specifically, the results suggest that the broiler farms in question have the potential to reduce their production costs by 13.6% by being more efficient in cost management. The findings further indicate that experience in broiler production, an increase in farm size, veterinary contacts, use of self-prepared quality broiler feed, and membership in the Poultry Farmers' Association (PFA) all help minimize cost inefficiency. On the other hand, the findings show that cost inefficiency appears to worsen with an increase in the market age of a farm's broiler birds.

Contribuição para análise dos custos no tratamento da água utilizando programação linear fuzzy: um modelo para o gerenciamento do abastecimento do município de Campos (RJ) / Contribution to cost analysis in water treatment using fuzzy linear programming: a model for the supply management in the city of Campos, Rio de Janeiro, Brazil

RESUMO A água é um dos recursos naturais essenciais à sobrevivência humana, porém tem sofrido com problemas como sobrecarga de utilização, em âmbito global; distribuição desigual; e escassez, o que contribui negativamente com a disponibilidade do recurso, evidenciando, assim, a crise da água. ­Nesse cenário, surge então a necessidade de se gerenciar de maneira eficaz esse recurso que é tão importante e que apresenta fortes componentes de incertezas. Um importante objeto do gerenciamento é o tratamento químico pelo qual a água bruta passa para se tornar tratada e, então, adequada para o consumo - este processo corresponde ao segundo maior custo nas estações de tratamento de água, atrás apenas de despesas envolvendo recursos humanos, materiais e serviços. Sendo assim, o presente trabalho propõe um modelo de programação linear que incorpora a lógica fuzzy, uma ferramenta eficiente em modelos com incertezas, para auxiliar no gerenciamento de abastecimento de água, considerando os custos com produtos químicos usados no tratamento desse recurso no município de Campos dos Goytacazes. Este modelo foi resolvido utilizando o ambiente Rstudio e apresentou uma redução dos custos em 9,8% em relação ao modelo de programação linear padrão preparado para o sistema. Conclui-se, então, que o trabalho desenvolvido serve de ponto de partida para uma análise mais minuciosa sobre o impacto dos custos de alocação de água tratada no município e contribui positivamente para a racionalização da água bruta.

ABSTRACT Water is one of the essential natural resources for human survival, but it has undergone problems such as: use overload at global level; unequally distribution; and scarcity that contributes negatively to the availability of the resource, thus evidencing a water crisis. Thus, there is a need to effectively manage this important resource, which presents strong components of uncertainties. An important management object is the chemical treatment through which raw water passes in order to be treated and then appropriate for consumption, because it corresponds to the second largest cost in water treatment plants, only after expenses involving human resources, materials, and services. Thus, the present work proposes a linear programming model that incorporates the fuzzy logic, which is an efficient tool in models with uncertainties to assist in any water supply management, considering costs with chemicals used in the treatment of this resource in the city of Campos dos Goytacazes, Brazil. This model was solved using the Rstudio environment and presented a 9.8% cost reduction compared with the standard linear programming model prepared for the system. In conclusion, the developed work serves as a starting point for a more detailed analysis of the impact of the costs of treated water allocation in the municipality and contributes positively to the raw water rationalization.

Cost Management Analysis of Public Hospitals Under Comprehensive Budget Management / 中国医院管理

Cost management is an indispensable part of the economic management of public hospitals,but there are still some problems in the cost control of public hospitals in China.The work of budget management and cost accounting just stays on the surface.Hospitals are running on a large scale and spending too much to make waste.Rules and regulations are incomplete.Staff awareness of cost control is indifferent.The internal audit supervision mechanism is incomplete.Establishing comprehensive budget management is helpful for hospital managers to make decisions,which can effectively improve the cost consciousness of all staff in hospitals,and reduce the management cost of hospital.The goal of cost control should be clearly defined in public hospitals.Hospitals should improve the rules and regulations of cost control.The capital structure of the hospital and the efficiency of fund utilization should be improved.The management of human cost should be taken into account and the idea of cost control should be established.Internal audit supervision should be strengthened.

Treatment plan comparison in acute and chronic respiratory tract diseases: an observational study of doxophylline vs. theophylline.

BACKGROUND: The main objective of this article is to estimate the global cost related to the use of the two drugs (associated drugs, specialist visits, hospital admissions, plasma drug monitoring). METHODS: The drug prescriptions were extracted from the Information System of the Pharmaceutical Prescriptions of the Marche Region for each ATC code in the years 2008-2012 and the number of patients per year and other outcomes measure were obtained. RESULTS: 13,574 patients were treated with theophylline and 19,426 patients with doxophylline. The number of patients treated was approximately 5,000 per year. Co-prescription with other drugs, use of corticosteroids, mean number of visits and hospital admissions (per 100 patients) were lower for doxophylline vs theophylline (1.55vs5.50, 0.3vs0.7, 2.05vs3.73 and 1.57vs3.3 respectively). The annual mean cost per patient was €187.4 for those treated with doxophylline and €513.5 for theophylline. CONCLUSIONS: In our study, doxophylline resulted to be associated with a reduction of the overall cost.