13 research outputs found
Alocarea resurselor către spitale pe baza costurilor standard pe grupe de diagnostic
No full textHealthcare systems are confronted with multiple challenges in the past years due to changes in the political and socio-economic international arena as well as to decreasing quality of healthcare services, decreasing population health status, lack of efficiency of the delivery system, the rigid norms and functioning of the system, lack of competition and of an active role of consumers. These have led to a growing number of healthcare facilities, with overused and outdated medical equipments, with no incentives to provide preventive care, and wide disparities between regions and socio-economic categories regarding access to and quality of hospital services.The scope of the research was to analyze actual methods of resource allocation to hospitals and to develop an improved allocation model, based on optimal costs of delivering services according to standards of actual medical practice in Romanian hospitals. The model suggests a standardization of care per types of patients (ex. Diagnostic Related Groups - DRGs) by means of developing care pathways. Once developed and implemented, care pathways may be the base for calculating the costs of „standard” care, so that they can provide a realistic image of the financial value of resources consumed in the care processes in Romanian hospitals.The model of costing care pathways offers a basis for multiple actions in the areas of financing, cost control, quality of services, adapting to international standards of care, organizational culture, patient safety and patient satisfaction. For the impact it may have on the hospital care system, the implementation of this model may be considered a bottom-up reforming of the system.Keywords: hospital financing, healthcare services costs, management accounting, care pathways, standard costs Sistemele de sănătate se confruntă cu multiple provocări în ultimii ani ca urmare a schimbărilor de pe scena politică şi socio-economică internaţională, precum şi diminuării calităţii serviciilor de sănătate, degradării stării de sănătate a populaţiei, lipsei de eficienţă a sistemului de trimiteri, rigidităţii normele şi func-ţionării sistemului, lipsei de concurenţă şi de implicare activă a consumatorilor. Acestea au condus la o creştere a numărului de unităţi sanitare, dotate cu echi-pamente medicale suprautilizate şi depăşite moral, fără existenţa unor stimulente pentru acordarea de servicii preventive, inechităţi mari între regiuni şi categorii defavorizate socio-economic în ceea ce priveşte accesul la servicii spitaliceşti şi calitatea acestora. Scopul cercetării a fost de a analiza metodele de alocare a resurselor pentru spitale şi de a dezvolta un model de alocare îmbunătăţit, în concordanţă cu standardele practicii medicale actuale din spitalele româneşti. Modelul sugerează o standardizare a îngrijirii pe tipuri de pacienţi (de ex. DRG-uri), prin mijloace de a dezvolta trasee de îngrijire. O dată dezvoltate şi implementate, aceste trasee de îngrijire pot fi bază de calcul a costurilor pentru îngrijiri "standard", astfel încât acestea să poată oferi o imagine realistă a valorii resurselor financiare consumate în procesul de îngrijiri acordate în spitalele din România. Modelul oferă o bază pentru acţiuni multiple în domeniul financiar, controlul costurilor, calitatea serviciilor, adaptarea la standardele internaţionale, cultura organizaţională, siguranţa şi satisfacţia pacientului. Pentru impactul pe care acest model l-ar putea avea asupra sistemului spitalicesc, implementarea modelului poate fi considerată o reformare de jos în sus a sistemului.Cuvinte cheie: finanţare spitale, costuri servicii medicale, contabilitate de gestiun
Impact of novel agents on patient-relevant outcomes in patients with previously untreated chronic lymphocytic leukemia who are not eligible for fludarabine-based therapy
No full textComparative Efficacy of Ibrutinib Versus Obinutuzumab + Chlorambucil in First-Line Treatment of Chronic Lymphocytic Leukemia: A Matching-Adjusted Indirect Comparison
No full textComparative Efficacy of Ibrutinib Versus Obinutuzumab + Chlorambucil in First-Line Treatment of Chronic Lymphocytic Leukemia: A Matching-Adjusted Indirect Comparison
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Real-world study of direct medical and indirect costs and time spent in healthcare in patients with chronic graft versus host disease
No full textChronic graft versus host disease (cGVHD) is a debilitating and costly complication following haemopoietic stem cell transplantation (HSCT). This study describes the economic burden associated with cGVHD. Direct costs associated with specialised healthcare utilisation (inpatient admissions and outpatient visits), as well as indirect costs associated with sickness absence-associated productivity loss were estimated in patients who underwent allogeneic HSCT in Sweden between 2006 and 2015, linking population-based health and economic registers. To capture the period of chronic GVHD, patients were included who survived > 182 days post-HSCT (start of follow-up), and cGVHD was classified based on patient treatment records to correct for any diagnosis underreporting. Patients were classified as 'non-cGVHD' if they received no immunosuppressive treatment, 'mild cGVHD' if they received only systemic corticosteroid treatment or immunosuppressive treatment, or 'moderate-severe cGVHD' if they received extracorporeal photopheresis (ECP) only, corticosteroid treatment and immunosuppressive treatment, or systemic corticosteroid treatment and ECP treatments. Patients with moderate-severe cGVHD spent more time in healthcare, had higher healthcare resource costs and higher sickness absence-related productivity loss compared to patients with non- or mild cGVHD. The cumulative total costs during the first 3 years of follow-up were EUR 14,887,599, EUR 20,544,056, and EUR 47,811,835 for non-, mild, and moderate-severe groups, respectively. The long-term costs incurred with cGVHD following HSCT continue to be very high and significantly impacted by cGVHD severity. This study adds real-world health resource and economic insight relevant for policy-makers and healthcare providers when considering the clinical challenge of balancing immunosuppression to reduce cGVHD
Front-line treatment of patients with chronic lymphocytic leukemia: a systematic review and network meta-analysis
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Aim:
A systematic literature review and network meta-analysis were conducted to determine the relative efficacy and safety of interventions for treatment-naive chronic lymphocytic leukemia patients, as comparative evidence is scarce.
Materials & methods:
Relative treatment effects of progression-free survival, overall survival and safety outcomes were estimated via network meta-analysis based on data identified via systematic literature review.
Results:
Ibrutinib was superior in all pairwise comparisons for progression-free survival (probability to be better [P] range: overall population: 69–100%; fludarabine-ineligible population: 69–100%) and overall survival (P range: overall: 89–100%; fludarabine-ineligible: 91–100%) and had the highest probability of being best for all outcomes.
Conclusion:
Ibrutinib provides superior benefit in survival and safety compared with other front-line treatments of chronic lymphocytic leukemia.
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Health Services Management, Bucharest
No full textThe main purpose of this article is to show the burden and cost of cancer, to overview the resources available for cancer treatment in European countries including Romania, and see how these relate to the countries market access for new oncology drugs. M etodology An analysis on the burden of cancer in European countries was performed using data used fro
P4‐341: QUANTIFYING THE IMPACT OF PSEUDOBULBAR AFFECT (PBA) ON HEALTH‐RELATED QUALITY OF LIFE (HRQOL) IN PATIENTS WITH ALZHEIMER'S DISEASE TREATED WITH NUEDEXTA OR CONVENTIONAL MEDICATION
No full textThe Burden of Cancer and Market Access for New Oncology Drugs in European Countries
Get PDFObiectiv: Studiul are ca obiectiv evaluarea poverii şi a costului asociat patologiei cancerului, să ofere o privire de ansamblu asupra resurselor disponibile pentru tratamentul cancerului în ţările europene, inclusiv România, precum şi evaluarea modului în care acestea sunt corelate cu accesul pe piaţă al noilor medicamente oncologice.Metodologie: O analiză a poverii cancerului în ţările europene, precum şi o comparaţie a acesteia pe tipuri de cancer pentru România a fost realizată utilizând date din cercetări de piaţă locale, precum şi date ale unui studiu descriptiv, retrospectiv, asupra bazei de date cu patologia spitalizată în România în anul 2008.Rezultate: Incidenţa cancerului în ţările europene este în creştere, pe primele trei locuri situându-se cancerul de sân, cancerul colorectal şi cancerul de prostată. Există o mare variaţie între ţările europene în ceea ce priveşte resursele alocate pentru terapia cancerului şi adaptarea tratamentului cu noile medicamente oncologice. România este printre ţările cu cea mai mică cheltuială pe cap de locuitor pentru tratamentul cancerului, în timp ce incidenţa este comparabilă cu cea din alte ţări central şi est europene. Cel mai mare volum de cazuri spitalizate sunt pentru cancerul de sân, colorectal şi de plămân. Cazurile sunt tratate prin serviciile medicale furnizate în spitalizarea continuă şi în spitalizarea de zi, totalizând un număr important de episoade de spitalizare.Concluzii: In România, datele despre complexitatea cazurilor pot fi utilizate pentru a măsura povara cancerului în termeni de evoluţie a volumului cazurilor pe tipuri de cancere, şi pe diagnostice. Costurile cu tratamentul cancerului sunt mari, însă cea mai mare parte reprezintă costuri indirecte (2/3) cum ar fi cele cu pierderile în productivitate datorate bolii, care generează o povară economică importantă pentru societate. În această perspectivă, costurile ridicate ale noilor terapii sunt, de cele mai multe ori, contrabalansate de beneficiile rezultate din prelungirea vieţii şi creşterea calităţii vieţii pacienţilor. Pe baza acestui studiu, cele mai importante probleme de analizat în viitor sunt inechitatea în accesul pacienţilor din zone diferite ale ţării, în special din zonele izolate, la îngrijirile de specialitate din spitale, precum şi accesul pe piaţă al noilor medicamente oncologice determinate de procesul decizional întârziat de rambursare a acestor terapii, în urma obţinerii autorizaţiei de punere pe piaţă. Un Registru Naţional pentru Cancer funcţional (încă în dezvoltare) precum şi resurse adiţionale disponibile pentru tratamentul în ambulator ar putea creşte accesul pacienţilor la tratament.Cuvinte cheie: evaluarea poverii, evaluarea costului, accesul pe piața medicamentelor în patologia oncologicăObjective: Aim of the study is to show the burden and cost of cancer, to overview the resources available for cancer treatment in European countries including Romania, and see how these relate to the countries market access for new oncology drugs.Methodology: An analysis of burden of cancer in European countries was performed by looking at various disease indicators from international studies, with a comparison per types of cancer for Romania based on local market research and a retrospective descriptive study on data from National Hospital database for 2008.Results: The incidence of cancer in European countries is increasing, top three cancers as number of cases are breast, colorectal and prostate cancer. There are wide variations between European countries regarding resources allocated to cancer therapy and absorption of new oncology drugs. Romania is among countries with the lowest spending for cancer treatment in EU although cancer incidence is comparable with other Eastern European countries. The most frequent types of cases hospitalized are for breast, colorectal and lung cancer. Cases are treated in day hospital and inpatient settings, and they are usually associated with intravenous chemotherapy and surgical procedures, resulting in a large number of episodes of care.Conclusions: In Romania, case-mix data can be used to show the real burden of cancer, in terms of evolution of volume of cases per types of cancer and per diagnoses. Costs of care for cancer patients are high, but most part (2/3) represent indirect costs, such as costs with loss of productivity due to disease, which generate an important economic burden for the society. In this holistic perspective, high costs of new therapies are in most of cases outweighed by future benefits from prolonging life and increased quality of life for cancer patients. Based on the analysis, important issues to be addressed in near future are the inequity in access between different regions to specialized oncologic care, and the delays in market uptake of new oncology drugs due to delayed reimbursement decisions following market authorization. Also, a functional National Cancer Registry (still under development) and additional resources for treatment in outpatient settings could improve patient access to treatment.Key words: burden of cancer, cost evaluation, market acces for new oncology drugs
