1,721,043 research outputs found
Costs associated with emergency care and hospitalization for severe hypoglycemia
No full textBackground and aims: We aimed to determine the direct economic cost of the management of severe hypoglycemia among people with diabetes in Italy. Methods and results: Data of cases with an acceptance diagnosis of hypoglycemia between January 2011 and June 2012 were collected in 46 Emergency Departments (EDs). Emergency care costs were computed by estimating the average cost per ambulance service, ED visit and short-term (<24 h) observation period. Hospitalization expenditure was estimated using the average cost reimbursed by the Italian healthcare system for hospital admission per patient with diabetes in a specific hospital ward. We retrieved 3516 hypoglycemic episodes occurring in subjects with diabetes. Half the cases (51.8%) required referral to EDs by means of the emergency ambulance services. A total of 1751 cases (49.8%) received an ED visit followed by discharge; 604 cases (17.2%) received a short-term observation period; 1161 (33.1%) were hospitalized. Unit costs for emergency care management were estimated at €205 for an ambulance call, €23 for an ED visit, and €220 for a short-term observation. The mean hospitalization cost was estimated at €5317; the average cost per each severe hypoglycemic event totaled €1911. From a base case assumption, the total direct cost of severe hypoglycemia in patients with diabetes in Italy was estimated to be approximately €23 million per year. Conclusion: Severe hypoglycemia in patients with diabetes constitutes a remarkable economic burden for national healthcare systems. Measures for preventing hypoglycemia are mandatory in diabetes management programs considering the impact on patients and on health spending
sj-docx-1-tag-10.1177_17562848231177153 – Supplemental material for Iron deficiency anemia impacts disease progression and healthcare resource consumption in patients with inflammatory bowel disease: a real-world evidence study
No full textSupplemental material, sj-docx-1-tag-10.1177_17562848231177153 for Iron deficiency anemia impacts disease progression and healthcare resource consumption in patients with inflammatory bowel disease: a real-world evidence study by Gionata Fiorino, Jean-Frederic Colombel, Kostas Katsanos, Fermín Mearin, Jürgen Stein, Margherita Andretta, Stefania Antonacci, Loredana Arenare, Rita Citraro, Stefania Dell’Orco, Luca Degli Esposti, Antonio Ramirez de Arellano Serna, Neige Morin and Ioannis E. Koutroubakis in Therapeutic Advances in Gastroenterology</p
Availability of computerised reminders in primary care doesn’t reduce heart-failure repeated hospitalisations
No full textComputerised reminders can be a support for clinical improvement. We verified their effect on heart-failure (HF) re-hospitalisation rate.
Methods and Results: A software (Millewin®) widely used in Italian general practice enbedded an automatic reminder to help general practitioners (GPs) to
identify HF patients and to prescribe them with recommended drugs. This reminder system was already activated in the first 2004 release, but required
voluntary activation in the successive releases. We had no possibility to know who decided to keep using the reminders. We examined the 2004-2009 HF
hospitalisations in Puglia, a Southern Italian Region with a population of over 4000000, and with high HF hospitalisation rate compared with the Italian
mean7. We compared the hospitalisations for patients cared for by GPs who used Millewin® in 2004 to those of the patients cared for by GPs who never
used Millewin®. Data were provided by the local Health Authority, and were extracted from the administrative database. Users of Millewin® cared for 4969
patients (mean age 76 y, sd 12; 48,6% men), the non-users cared for 48781 patients (mean age 76 y, sd 11; 50% men ): no significant difference as far as
age and gender are concerned. We examined 17810 patients with > 2 hospitalisation. No difference in re-hospitalisations was observed.
Conclusions: Availability of computerised automatic reminders aimed to improve detection of HF patients and prescription of recommended drugs doesn’t
decrease repeated hospitalisation; these tools should be probably part of a more complex strategy, such as a long-term audit.
KEYWORDS: Computerised reminder; heart failure; hospitalisatio
Antihypertensive therapy among newly treated patients: An analysis of adherence and cost of treatment over years
No full textAdherence to antihypertensive medications and health outcomes among newly treated hypertensive patients
No full text
Pharmacoeconomic Burden of Undertreating Hypertension
No full textMany studies have shown the importance of antihypertensive drug therapy as a factor in reducing the risk of cardiovascular morbidity and mortality, and in containing the cost of managing hypertension and its complications. Nevertheless, the evidence in clinical practice indicates about half of hypertensive patients do not receive pharmacological treatment and about half of treated patients do not achieve blood pressure level control. Undertreating hypertension is the leading cause of failure in drug therapy effectiveness and cost effectiveness. The pharmacoeconomic burden of undertreating hypertension can be defined as the clinical (number of cardiovascular events) and economic (costs of managing cardiovascular events) consequences that would have been avoided by adequate control of blood pressure levels. In the last few years, the increase in this burden and the restriction of budget constraints has raised the awareness of healthcare providers with regards to the need to achieve better performance and to improve disease management of hypertension. This review aims to present the current situation regarding the pharmacoeconomic burden of undertreating hypertension by identifying the key issues of this medical condition, defining and measuring the extent of undertreatment, defining and measuring costs associated with undertreatment, and discussing some fundamental aspects of disease management for hypertension. The pharmacoeconomic burden of undertreating hypertension appears to be an extremely important phenomenon for which there is currently only very limited adequate research. The present dearth of appropriate data can be largely attributed to the lack of epidemiological studies in clinical practice. Future studies are necessary for a more precise quantification of the therapeutic and economic impact of undertreating arterial hypertension in clinical practice (appropriateness studies) and for more precise selection of antihypertensive drugs on the basis of the different cost-effectiveness profiles detected inEconomic-implications, Hypertension
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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