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[Cost-effectiveness analysis of ocriplasmin in the treatment of vitreomacular traction in Italy] 【意大利头孢拉西明治疗玻璃体黄斑牵拉的成本-效果分析】
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-12-23 DOI: 10.7175/FE.V16I4.1221
Lucia S D'Angiolella, Riccardo Miglietta, F. Bandello, S. Rizzo, L. Mantovani
BACKGROUND: Vitreomacular traction (VMT) caused by vitreomacular adhesion (VMA), is a pathological condition when the vitreous humor has an abnormally strong attachment to the central part of the retina. Ocriplasmin recently approved for the treatment of VMT, including when associated with macular hole (MH) of diameter less than or equal to 400 microns, is a recombinant truncated form of the human serine protease plasmin with retained enzymatic activity, administered by intravitreal injection. We estimated long-term benefits and costs associated with the resolution of traction, following treatment with ocriplasmin versus Standard of Care (SoC), from National Health Service (NHS) perspective. METHODS: A lifetime Markov model has been adopted for Italy in order to estimate costs and outcomes, gained for patients with VMT, with and without MH, treated with ocriplasmin. Health effects have been expressed as Life Years (LY) and Quality adjusted LY gained (QALY), and estimated based on time spent in Visual Acuity (VA) states, defined by best and worst seeing eye, disutility impact associated with surgical interventions, adverse events and metamorphopsia. Deterministic and probabilistic analysis have also been conducted. RESULTS: Over a lifetime ocriplasmin versus SoC generated incremental benefits in terms of QALYs and overall treatment costs in each patients subgroups. Patients with VMT and VMT+MH treated with ocriplasmin had an incremental survival benefits of 0.1123 and 0.0772 QALYs respectively. Therefore, it is expected to come at an incremental cost of 1,873 € and 2,185 € for VMT and VMT+MH patients respectively. The associated ICER is 16,683 € and 28,294 € per QALY gained. Both sensitivity analyses for each of the subgroups confirmed the robustness of the model results. CONCLUSION: Compared to SoC, ocriplasmin is a cost effective therapy option in the treatment of VMT, including when associated with MH. [Article in Italian]
背景:由玻璃体黄斑粘连(VMA)引起的玻璃体黄斑牵拉(VMT)是一种玻璃体与视网膜中心部分有异常强烈附着的病理状态。奥克拉西敏最近被批准用于治疗VMT,包括与直径小于或等于400微米的黄斑孔(MH)相关的情况,是一种重组人丝氨酸蛋白酶纤溶酶的截短形式,具有保留的酶活性,通过玻璃体内注射给药。我们从国家卫生服务(NHS)的角度估计了与奥克里普拉敏治疗与标准护理(SoC)治疗后牵引解决相关的长期收益和成本。方法:意大利采用了终身马尔可夫模型,以估计使用俄克里白蛋白治疗的VMT患者的成本和结果,无论是否有MH。健康影响以生命年(LY)和质量调整后的生命年(QALY)表示,并根据在视力(VA)状态中花费的时间进行估计,由最佳和最差视力定义,与手术干预相关的不利影响,不良事件和变形。还进行了确定性和概率分析。结果:在每个患者亚组中,终生使用奥克里普兰与SoC相比,在qaly和总治疗成本方面产生了增量益处。VMT和VMT+MH患者接受奥克里普拉敏治疗的增量生存获益分别为0.1123和0.0772 QALYs。因此,VMT和VMT+MH患者的增量成本预计分别为1873欧元和2185欧元。相关的ICER为16,683欧元,每个获得的QALY为28,294欧元。每个亚组的敏感性分析都证实了模型结果的稳健性。结论:与SoC相比,奥克里普兰敏是治疗VMT的一种经济有效的治疗选择,包括与MH相关的治疗。
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引用次数: 1
The regulatory and Health Technology processes in Europe and drug market access. The case of cystic fibrosis 欧洲的监管和卫生技术进程以及药品市场准入。囊性纤维化病例
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-12-23 DOI: 10.7175/FE.V16I4.1207
M. Martinez, P. Serrano, A. S. Santamera
In order to reach the European market, a new drug needs to receive a positive evaluation regarding its quality, safety and efficacy by regulatory health authorities and also obtain a positive HTA appraisal regarding its cost-effectiveness by HTA bodies. Regulators and HTA bodies are collaborating in several projects at European level in order to harmonize the scientific requirements of both evaluations to the maximum extent possible. The comparison of the regulatory evaluation performed by EMA for Kalydeco and the HTA appraisals issued by several EU bodies exemplifies the dilemma between scientific evidence and local economic considerations and the difficulties in the achievement of harmonization and therefore equity in the access to drugs.
为了进入欧洲市场,新药需要获得监管卫生部门对其质量、安全性和有效性的积极评价,并获得HTA机构对其成本效益的积极评价。管制机构和卫生管理局机构正在欧洲一级的若干项目中进行合作,以便尽可能协调这两种评价的科学要求。EMA对Kalydeco进行的监管评估与几个欧盟机构发布的HTA评估的比较,举例说明了科学证据和当地经济考虑之间的困境,以及实现药品可及性的协调和公平的困难。
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引用次数: 1
Comparison between traditional and goal directed perfusion in cardiopulmonary by-pass. Adaptation of a differential cost analysis 传统灌注与目标定向灌注在心肺旁路中的比较。适应差异成本分析
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-10-12 DOI: 10.7175/fe.v16i1S.1201
M. Povero, L. Pradelli
BACKGROUND: A previous patient-level discrete event simulation (DES) model was developed to perform an economic evaluation of GDP strategy with respect to TP in US. Aim of this supplement is provide results of the adaptations of the differential cost analysis to Belgium, Canada, France, Germany, Italy, and UK. METHODS: A Discrete Event Simulation model was developed to compare TP and GDP strategy in patients undergoing CPB. National perspective was adopted to calculate costs associated to each event while GDP strategy was exploited the introduction of Sorin Heartlink (HL) Card/GDP Card and Sorin Connect (electronic data management system). RESULTS: GDP reduces the total cost with respect to traditional perfusion; furthermore the cost of GDP strategy (Sorin GDPTM Monitor and Sorin ConnectTM) is completely offset by the saving in hospital stay. CONCLUSION: GDP seems to improve significantly the main outcomes related to CPB surgery, when compared to TP techniques. Additional costs due to perform GDP strategy have no impact on the total cost since completely offset by the savings in hospital cost.
背景:先前的患者水平离散事件模拟(DES)模型被开发出来,以执行GDP战略的经济评估。本补充的目的是向比利时、加拿大、法国、德国、意大利和英国提供差异成本分析的调整结果。方法:建立离散事件模拟模型,比较CPB患者的TP和GDP策略。采用国家视角来计算与每个事件相关的成本,同时利用国内生产总值战略,引入Sorin Heartlink卡/GDP卡和Sorin Connect(电子数据管理系统)。结果:与传统灌注相比,GDP降低了总成本;此外,国内生产总值战略的成本(Sorin GDP监测和Sorin ConnectTM)完全被住院时间的节省所抵消。结论:与TP技术相比,GDP似乎显著改善了CPB手术相关的主要结果。由于执行国内生产总值战略而产生的额外成本对总成本没有影响,因为医院成本的节省完全抵消了这些成本。
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引用次数: 1
Cost of illness of advanced ovarian carcinoma in Italy: results of an empirical, single-centre study 在意大利晚期卵巢癌疾病的成本:一项经验,单中心研究的结果
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-09-30 DOI: 10.7175/FE.V16I3.1181
C. Lazzaro, F. Plotti, S. Capriglione, M. Ferrario, R. Angioli
AIM: To perform an empirical, single-centre, retrospective and secondary cost of illness (COI) study of advanced ovarian carcinoma (AOC) in Italy. METHODS: Demographic, clinical, health care and non-health care resource consumption data concerning a convenience sample of subsequent patients in 1st line of treatment (100 patients), 2nd line of treatment A (surgery + chemotherapy; 30 patients) and 2nd line of treatment B (chemotherapy only; 20 patients) were obtained from a database created in 2011 by the Obstetrics and Ginecology Unit at Campus Biomedico teaching hospital, Rome. Patients were followed-up for 2 years. Resources were valued according to the above mentioned database and literature, following the societal viewpoint. Costs are expressed in Euro (€) 2014 and reported as mean and standard deviation (SD). RESULTS: One-year COI for 1st line of treatment reaches € 44,999.7 (SD: €28,757.3), € 55,410.8 (SD: € 32,454.6) and €46,895.6 (SD: € 28,407.4) for 2nd line of treatment A and B, respectively. Regardless the line of treatment, COI is mainly driven by cost borne by patient and her family. Due to the high costs of relapse the mean COI per patient after 2 years from the diagnosis of AOC equals € 81,869.4 (SD: € 30,660.9), or 182% of the COI for the 1st line of treatment. CONCLUSIONS: Despite some limitations, our results show that increasing progression-free survival could well reduce the COI for AOC in Italy.
目的:执行经验,单中心,回顾性和二次疾病成本(COI)研究晚期卵巢癌(AOC)在意大利。方法:采用方便样本,收集随访患者的人口学、临床、卫生保健和非卫生保健资源消耗数据,包括一线治疗(100例)、二线a治疗(手术+化疗;30例患者)和二线治疗B(仅化疗;20名患者)的数据来自罗马Campus Biomedico教学医院产科和Ginecology部门于2011年创建的数据库。患者随访2年。根据上述数据库和文献,遵循社会观点,对资源进行估值。成本以2014年欧元(€)表示,并以平均值和标准差(SD)报告。结果:一线治疗的1年COI分别达到44,999.7欧元(SD: 28,757.3欧元),二线治疗A和B的55,410.8欧元(SD: 32,454.6欧元)和46,895.6欧元(SD: 28,407.4欧元)。无论何种治疗方式,COI主要由患者及其家庭承担的费用驱动。由于复发的高成本,每位患者在诊断为AOC后2年的平均COI为81,869.4欧元(标准差:30,660.9欧元),或一线治疗COI的182%。结论:尽管存在一些局限性,但我们的研究结果表明,增加无进展生存期可以很好地降低意大利AOC的COI。
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引用次数: 1
Comparison between traditional and goal directed perfusion in cardiopulmonary by-pass. A differential cost analysis in US 传统灌注与目标定向灌注在心肺旁路中的比较。美国的差异成本分析
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-09-30 DOI: 10.7175/FE.V16I3.1200
M. Povero, L. Pradelli
OBJECTIVES: High oxygen delivery (DO2) during cardiopulmonary bypass (CPB) is associated with better renal outcome in cardiac surgery. Traditional perfusion (TP) techniques, targeted on body surface area and CPB temperature, achieves high DO2 in about 50% of the cases while a goal directed perfusion (GDP) approach can lead to more than 90% of cases achieving high DO2 with a consequent reduction in Acute Kidney Injury (AKI) rate of about 40%. Aim of this study is to perform an economic evaluation of GDP strategy with respect to TP in US. METHODS: A Discrete Event Simulation model was developed to compare TP and GDP strategy in patients undergoing CPB. The patient’s pathways from operation to discharging from hospital was simulated: AKI incidence, in-hospital mortality, hospital length of stay, transfusions were correlated to probability to achieve high DO2 target using published correlations. National perspective was adopted to calculate costs associated to each event while GDP strategy was exploited the introduction of Sorin Heartlink (HL) Card/GDP Card and Sorin Connect (electronic data management system). RESULTS: GDP strategy saved more than 3 days in hospital and 11% of AKI episodes. The cost-saving is $ 3,137 (95% CI: 1,122-4,951); the cost of HL Card/GDP Card+Connect ($ 180, 95% CI: 113-249) is more than offset by savings in hospital stay that result the main driver in cost ($ 3,222, 95% CI: 1,235-4,950). Deterministic sensitivity analysis shows that the total savings are mainly influenced by nadir haematocrit during CPB and hospital LOS/cost per day both in ICU and in ward. CONCLUSIONS: GDP seems to improve significantly the main outcomes related to CPB surgery, when compared to TP techniques. Additional costs due to perform GDP strategy have no impact on the total cost since completely offset by the savings in hospital cost.
目的:体外循环(CPB)期间的高氧输送(DO2)与心脏手术中更好的肾脏预后相关。传统的灌注(TP)技术,以体表面积和CPB温度为目标,在约50%的病例中实现高DO2,而目标定向灌注(GDP)方法可使90%以上的病例实现高DO2,从而使急性肾损伤(AKI)发生率降低约40%。本研究的目的是对美国国内生产总值战略进行经济评估。方法:建立离散事件模拟模型,比较CPB患者的TP和GDP策略。模拟患者从手术到出院的过程:AKI发生率、住院死亡率、住院时间、输血量与达到高DO2目标的概率相关。采用国家视角来计算与每个事件相关的成本,同时利用国内生产总值战略,引入Sorin Heartlink卡/GDP卡和Sorin Connect(电子数据管理系统)。结果:GDP策略可节省3天以上住院时间,减少11%的AKI发作。节省成本为3137美元(95% CI: 1,122-4,951);HL卡/GDP卡+Connect的成本(180美元,95%置信区间:113-249)被住院费用节省所抵消(3,222美元,95%置信区间:1,235-4,950)。确定性敏感性分析表明,总节省主要受CPB期间最低红细胞压积和ICU和病房每天医院LOS/成本的影响。结论:与TP技术相比,GDP似乎显著改善了CPB手术相关的主要结果。由于执行国内生产总值战略而产生的额外成本对总成本没有影响,因为医院成本的节省完全抵消了这些成本。
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引用次数: 5
Using Patient-Reported Outcomes to Include the Patient in Research, Care, and Quality 使用患者报告的结果将患者纳入研究、护理和质量
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-09-30 DOI: 10.7175/FE.V16I3.1203
P. Gaur, N. Jeswani, N. Ganesan
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引用次数: 0
Cost analysis of inappropriate treatments for suspected dermatomycoses 疑似皮肤真菌病不适当治疗的成本分析
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-06-30 DOI: 10.7175/fe.v16i2.1172
E. Fiammenghi, A. Patalano, V. Conte, G. Calabrò
Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1) to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2) to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II”) in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination) were defined as inappropriate: (1) cortisone in a patient with at least one positive site; (2) antifungals in (a) patients with all negative sites or (b) ineffective antifungal treatment (in terms of drug chosen, dose or duration) in those with all positive sites; or (3) antibiotics; (4) antivirals or (5) antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease with respect to the total consumption of drugs at the time of access to the Mycology Laboratory of € 34,781. Thus, our cost analysis shows that it is important to obtain a reduction of costs for pathologies that need to be confirmed by examinations before starting treatment.
据估计,浅表真菌病影响到世界20-25%以上的人口,并且多年来呈持续增长趋势。大多数到我诊所就诊的疑似皮肤真菌病患者均已接受过药物治疗,未做过真菌学检查,许多患者的临床表现发生了变化。事实上,一些药物,如类固醇、抗病毒药物、抗生素和抗组胺药不能消除真菌感染,但它们也会引起非典型的临床表现。治疗不当的后果包括延误诊断、延长愈合时间和额外费用。本研究的目的是:(1)评估由国民健康服务和患者持续的不适当治疗导致的费用增加的发生率;(2)强调在开始治疗前进行真菌学评估的重要性,以提高诊断的准确性。2013年9月至2014年2月,我们对意大利那不勒斯我们中心(大学医院“Federico II”)的765例疑似真菌学感染患者进行了观察性回顾性和前瞻性研究。以下治疗(单独或联合)被定义为不合适:(1)至少有一个阳性部位的患者使用可的松;(2) (a)所有阴性位点患者的抗真菌药物或(b)所有阳性位点患者的抗真菌治疗无效(就药物选择、剂量或持续时间而言);(3)抗生素;(4)抗病毒药物或(5)抗组胺药,≥1个阳性部位。在评估访问之前,有550名患者正在使用药物。与先前不适当治疗相关的可避免成本总额为121,417欧元,占总治疗成本的74%。253/550例患者在访视后也接受了药物治疗。对于这些患者,在真菌学检测后规定的治疗费用为42,952欧元,在进入真菌学实验室时的药物总消费量为34,781欧元,因此有所减少。因此,我们的成本分析表明,降低需要在开始治疗前通过检查确认的病理的成本是很重要的。
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引用次数: 1
Patient reported outcomes to support drug development decision making 患者报告的结果支持药物开发决策
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-06-30 DOI: 10.7175/FE.V16I2.1187
A. Nixon, D. Wild, W. Muehlhausen
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引用次数: 1
Low-protein diet for chronic kidney disease in the Caserta Local Health Unit: the SaniARP Initiative 低蛋白饮食治疗慢性肾病在卡塞塔地方卫生单位:SaniARP倡议
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-06-30 DOI: 10.7175/FE.V16I2.1176
C. Troncone, E. Menditto, V. Orlando, D. Valiante, G. Farina, M. Tari
INTRODUCTION: In clinical practice, the interest in the use of low-protein food for patients suffering from chronic kidney disease has increased. Currently, these products are not yet contemplated in the essential levels of assistance but the Italian regions deliver, low-protein food discretionally using their own funds. The Campania Region, in 2010, interrupted the distribution of these products. With the exception of Caserta which took up distribution again in 2013. OBJECTIVE: The aim of this paper is to describe an initiative put in place by Caserta which has decided to invest in prevention. MATERIALS AND METHODS: A treatment plan for the distribution designed by a team of in-house nephrologists and data are recorded using Saniarp, a web-based platform. RESULTS: In the observation period patients with a prescription of low-protein food products were 869. The mean age was 61 years. The average cost patient / month for the nutritional treatment was 59 Euro. The average cost patient / month for any type of drug was 632 Euro. In particular, 48 Euro for EPO, 277 Euro for Chelate Agents, 16 Euro for antihypertensive therapy. DISCUSSION AND CONCLUSIONS: The policy put in place by the LHU Caserta improved care of kidney patients. The results available to date are still incomplete and do not enable us to clearly assess the benefits both in clinical and economic terms which can be produced by a low-protein diet in kidney patients. In the perspective of third party payers to budget this expense it appears entirely sustainable especially in view of the fact that this dietary treatment might delay the onset of dialysis therapy and lead to lower comorbidity for the patient.
在临床实践中,对慢性肾病患者使用低蛋白食物的兴趣有所增加。目前,这些产品还没有考虑到必要的援助水平,但意大利地区使用自己的资金谨慎地提供低蛋白食品。2010年,坎帕尼亚地区中断了这些产品的分销。除了卡塞塔(Caserta),它在2013年再次开始分销。目的:本文的目的是描述由卡塞塔已经决定投资于预防的举措。材料和方法:由内部肾病学家团队设计的分配治疗计划和使用基于网络的平台Saniarp记录数据。结果:观察期内服用低蛋白食品处方的患者869例。平均年龄61岁。营养治疗的平均费用为59欧元/月。任何一种药物的平均费用为每月632欧元。其中,EPO为48欧元,螯合剂为277欧元,降压药为16欧元。讨论与结论:LHU Caserta实施的政策改善了肾病患者的护理。到目前为止,现有的结果仍然不完整,不能使我们清楚地评估低蛋白饮食对肾病患者在临床和经济方面的益处。从第三方付款人的角度来预算这笔费用,这似乎是完全可持续的,特别是考虑到这种饮食治疗可能会延迟透析治疗的开始,并降低患者的合并症。
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引用次数: 1
Process reengineering: the experience of electrophisiology center of the Local Health Unit of Viterbo 流程再造:维泰博地方卫生单位电生理中心的经验
IF 0.5 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2015-06-30 DOI: 10.7175/FE.V16I2.1189
Mario Malavasi, S. Dari
Farmeconomia. Health economics and therapeutic pathways 2015; 16(2) © SEEd All rights reserved professionali, professionisti amministrativi addetti al controllo di gestione, alla contabilità analitica e all’analisi statistica e dei costi, con lo scopo di individuare e reingegnerizzare i processi di sala operatoria [4,5]. Le procedure studiate sono state due: impianto di pacemaker (PM) o defibrillatore impiantabile (ICD) e sostituzione di PM o ICD. È stato messo a confronto il primo semestre 2012, utilizzando i dati inseriti nel registro operatorio cartaceo, con il secondo semestre 2014, prendendo le informazioni inserite nel software di gestione del registro operatorio. Nello specifico sono stati individuati in entrambi i casi tre tipologie di tempi procedurali: preoperatorio (dall’ingresso nel blocco operatorio all’incisione della cute), operatorio (dall’incisione alla sutura della cute) e postoperatorio (dalla sutura all’uscita dal blocco operatorio) [2]. Lo scenario individuato è stato rielaborato grazie ai software Windows Acces ed Excell ed i risultati sono stati espressi come media ponderata e rapporto percentuale tra metodologia tradizionale e innovativa. Come illustrato in Tabella I, relativamente all’impianto di PM/ICD, il tempo preoperatorio è passato da 31 minuti della procedura tradizionale a 23 minuti, con una riduzione del 35% e quello postoperatorio da 22 a 14 minuti con una riduzione del 57%: complessivamente il paziente in media è stato in sala La reingegnerizzazione dei processi in sanità La reingegnerizzazione dei processi è un metodo di analisi nato nella realtà privata, per prevedere un ripensamento delle procedure aziendali al fine di ottimizzarle in termini di costi e tempi. Negli ultimi anni è divenuto sempre più uno strumento in uso nella Pubblica Amministrazione prendendo il nome di Public Organization Reengineering [1]. Questo nasce prevalentemente quale strumento operativo per proporre progetti efficaci, ottenendo risultati che migliorino la qualità dei servizi erogati [2]. La reingegnerizzazione dei processi dell’Elettrofisiologia dell’ASL di Viterbo ha avuto inizio nel secondo semestre del 2012, con una sperimentazione che è andata a regime nel 2013 e che a tutt’oggi è un quotidiano strumento operativo [3]. Obiettivo di questo brief report è confrontare la gestione tradizionale con quella informatizzata attraverso l’utilizzo del software di gestione del registro operatorio che accoglie dati personali e sensibili del paziente, nonché tempistica di Sala Operatoria. A due anni consolidati si può veramente parlare di ottimizzazione dei tempi?
Farmeconomia。卫生经济与治疗途径2015;16(2)©SEEd All rights reserved专业,专业人员行政管理控制、会计和统计分析和成本,目的是查明和,手术室过程[4,5]。研究了两种方法:植入起搏器(PM)或植入除颤器(ICD)和更换PM或ICD。将2012年上半年的数据与2014年下半年的数据进行比较,将数据输入操作日志管理软件。具体地说,在这两种情况下都确定了三种程序时间:术前(从进入块到皮肤切口)、手术前(从切口到皮肤缝合)和术后(从缝合到离开块[2]。使用Windows accs和Excell软件重新开发了所发现的场景,并将结果表示为传统方法和创新方法之间的加权平均值和百分比比率。如表一所示,对于PM/ICD装置,术前时间从传统手术的31分钟减少到23分钟,减少35%,术后时间从22分钟减少到14分钟,减少57%:总的来说,病人平均是在房间里的审判业务过程的卫生是北约在私营实体的分析方法,来重新思考企业程序作出规定,以优化成本和时间。近年来,它越来越多地成为一种公共行政工具,被称为公共组织改造[1]。这主要是作为一种业务工具来提出有效的项目,并产生提高所提供服务质量的结果[2]。Viterbo asl电生学过程的逆向工程始于2012年下半年,该实验于2013年投入使用,至今仍是一种日常操作工具。本简要报告的目的是通过使用包含患者个人和敏感数据以及手术室时间表的操作日志管理软件,将传统管理与计算机管理进行比较。在两年的时间里,我们真的能谈论时间的优化吗?
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引用次数: 0
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