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Better timing for HoLEP: a retrospective analysis of patients treated with HoLEP over a 10-year period with a 1-year follow-up

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Asian Journal of Andrology 2023年第2期25卷 281-285页

作者： Yu-Cheng Tao Zi-Wei Wei Chong Liu Meng Gu Qi Chen Yan-Bo Chen Zhong Wang Urology Department Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai 200011China Urology Department Jinshan HospitalFudan UniversityShanghai 201508China

The aim of this study was to explore the optimal timing of holmium laser enucleation of the prostate(HoLEP)in patients presenting benign prostatic hyperplasia(BPH)with lower urinary tract symptoms(LUTS).A retrospective analysis was conducted based on the perioperative and postoperative outcome data of 1212 patients who underwent HoLEP in Shanghai Ninth People’s Hospital(Shanghai,China)between January 2009 and December 2018.According to the preoperative International Prostate Symptom Score(IPSS),all patients whom we analyzed were divided into Group A(IPSS of 8–18)and Group B(IPSS of 19–35).Peri-and postoperative outcome data were obtained during the 1-year follow-up.IPSS changes were the main postoperative outcomes.The postoperative IPSS,quality of life,peak urinary flow rate,postvoid residual,and overactive bladder symptom score(OABSS)improved significantly.The IPSS improved further in the group with severe LUTS symptoms,but the postoperative IPSS was still higher than that in the moderate LUTS group.OABSSs showing moderate and severe cases after follow-up were more frequent in Group B(9.1%)than in Group A(5.2%)(P<0.05).There were no significant intergroup differences in the intraoperative American Society of Anesthesiologists or hospitalization expense scores,and the medication costs,as well as the total costs,were significantly higher in Group B.In this retrospective study,HoLEP was an effective treatment for symptomatic BPH.For patients with LUTS,earlier surgery in patients with moderate severity may result in a marginally better 12-month IPSS than that in men with severe symptoms.

关键词： benign prostatic hyperplasia health economics holmium laser enucleation timing of surgery

A diagnosis-based health economic analysis of postural orthostatic tachycardia syndrome in Chinese children

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Chinese Medical Journal 2011年第20期124卷 3285-3288页

作者： LI Ya-wen DENG Wen-jun ZHANG Feng-wen DU Jun-bao JIN Hong-fang School of economics and Management Beijing University of Posts and Telecommunications Beijing 102209 China Department of Pediatrics Peking University First Hospital Beijing 100034 China

Background Postural orthostatic tachycardia syndrome （POTS） is a common clinical problem in children and adolescents. The previous diagnostic approach to POTS of children and adolescents is based on a series of tests to exclude all other causes, which is time and medical resource consuming. Recently, a new diagnostic approach has been developed. The present study was designed to statistically analyze the results of clinical investigation items and the cost for the diagnosis of POTS in children patients, and evaluate cost changes in the diagnosis of POTS. Methods A total of 315 children patients were divided into two groups according to diagnosis period, including group I diagnosed in 2002-2006 （100 cases） and group II in 2007-2010 （215 cases） and the diagnostic item-based distribution of the cost was analyzed. The diagnostic costs were compared between two groups using SPSS17.0. Results The per-capita cost of diagnosis in group I was （621.95±2.1.10） Yuan, costs of diagnostic tests （head-up tilt test standing test, etc） accounted for 8.68% and the exclusive tests for 91.32%. The per-capita cost of diagnosis in group II was （542.69±2.3.14） Yuan, diagnostic tests accounted for 10.50% and exclusive tests for 89.50%. Comparison of the total cost of diagnostic tests between the two groups showed significant differences （P〈0.05）. Conclusion The cost of POTS diagnosis has been declined in recent years, but the cost of exclusive diagnosis is still its major part.

关键词： postural orthostatic tachycardia syndrome health economics diagnosis

The Impact of Behavioural Insights on Effective Prescription of Antibiotics by Doctors: A Case Study from Latifa Hospital for Women and Children, Dubai health Authority

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health 2023年第6期15卷 517-524页

作者： Muna A. Tahlak Atif B. Fazari Fareeda Khan Raid Abukaf Lyla G. Zadeh Alawi Alsheikh Abdulaziz Istaitieh Latifa Hospital for Women and Children Dubai Health Authority Dubai UAE Mohamed Bin Rashid University Dubai UAE Mohammed Bin Rashid School of Government Dubai UAE

Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and resulting long-term antibiotics resistance. Overuse of antimicrobials is a major cause of emerging resistance to antimicrobials. There are multiple factors in the community that influence the physician’s antibiotic prescriptions. Methods: This is a systematic case-control study on antibiotics prescription for paediatric patients attending Latifa Hospital for Women and Children (LWCH), Dubai health Authority, to know the effects of behavioral interventions on rates of inappropriate antimicrobials prescription by doctors in the Paediatric Emergency Department. Results: The results of our study showed the effectiveness of behavioral insights by peer comparison in antibiotic use among paediatricians in Latifa Hospital had a statistical significance (P = 0.0038). The rate of the prescription decreased from 41% to 21%, a difference of 20%. Conclusion: The study concluded behavioural intervention is an effective measure in reducing the improper prescription of antibiotics in the hospital setting.

关键词： Behavioural Intervention Antibiotics Prescription Behavioral economics health economics Behavioural Insight

A Schematic Simulation for health Economic Feasibility Studies: Results from a Model for Cardiac Remote Monitoring

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Open Journal of Modelling and Simulation 2016年第3期4卷 118-128页

作者： Christian Elsner Guiseppe Boriani Dennis Häckl Steffen Desch Holger Thiele Medizinische Klinik II Universit&auml tsklinikum Schleswig-Holstein Campus Lübeck Lübeck Germany Cardiology Department University of Modena Modena Italy WIG2 Institut für Gesundheitsö konomie und Gesundheitssystemforschung Leipzig Germany

The market for active implants and biosensors is of high economic and medical interest. As health economic considerations get into focus in terms of business planning and reimbursement, valid and flexible economic feasibility studies get more important. Unfortunately, literature mostly provides only single economic views on specific aspects like cost savings from reduced rehabilitation in a special patient cohort. To make planning and technology value negotiation more effective and more valid, a methodology to collect relevant data from different studies and normalize it to a common set of parameters was developed for the field of cardiac monitoring in a mixed example population with an approach of simple external weight, ECG and blood-pressure measurement or implanted devices for cardiac monitoring. The target entities taken into account by the simulation model were the impacts on heart attack, stroke, heart failure and the process of implant monitoring. Simulation took place at an example population of 500 patients with specific morbidity criteria. The health economic value was calculated over a period of three years and was split into a technology effectiveness measurement in Quality-adjusted-Lifetime-Years (QALYs) and a “cost- saving-part”. QALYs were chosen as technology effectiveness parameter for a combined and weighted mortality- and morbidity-reduction. Allocating 24.000 Euro to a saved QALY, 42% of the cost would be allocated to QALYs meaning money being spent for gained lifetime-years. The remaining 58% would be the different real cost savings: a per patient gross saving of 3.308 € per year would result for that part (21% on heart attack, 3% on stroke, 68% on heart failure and 8% on implant monitoring). Up-to-date studies do not provide a simple mechanism to allow custom-tailored health economic feasibility study results in terms of other specific population mixes or outcome parameters. Target audiences for the methodology of the described simulation are payors and solution providers targeting a specif

关键词： Economic Feasibility health economics Active Implants Simulation Biosensors Technology Effectiveness

Vocational Rehabilitation after Acquired Brain Injury: A Swedish Study of Benefits and Costs

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Open Journal of Therapy and Rehabilitation 2014年第3期2卷 133-145页

作者： Kersti Samuelsson Maria Tropp Anna Lundqvist Clinical Department of Rehabilitation Medicine and Department of Medicine and health Sciences Linkoping UniversityLinkopingSweden

Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct societal costs of healthcare interventions related to vocational rehabilitation and indirect societal costs related to production loss. Method: Identified interventions in 45 patients with ABI who were discharged from a vocational rehabilitation program between 2010 and 2011 were documented, classified and translated into costs. Expenses associated with production loss were calculated by comparing sick leave production loss at first contact with the team, with sick leave production loss at discharge. health related QoL and overall health, was measured at first contact and at discharge by using the EQ5D. Results: For vocational rehabilitation interventions, mean costs were €6303/individual/month. At first contact with the team, mean production loss was estimated to be €4409/individual/month compared;at discharge to be €2446. QoL ratings increased from first contact to discharge, although estimated health did not change. At discharge, significant correlations were found between QoL ratings and estimated health and the extent of production loss

关键词： Clinical Evidence health economics Return to Work Work Training