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Annals of the Royal College of Surgeons... Jul 2024The National Health Service contributes 4%-5% of England and Wales' greenhouse gases and a quarter of all public sector waste. Between 20% and 33% of healthcare waste...
INTRODUCTION
The National Health Service contributes 4%-5% of England and Wales' greenhouse gases and a quarter of all public sector waste. Between 20% and 33% of healthcare waste originates from a hospital's operating room, and up to 90% of waste is sent for costly and unneeded hazardous waste processing. The goal of this study was to quantify the amount and type of waste produced during a selection of common trauma and elective orthopaedic operations, and to calculate the carbon footprint of processing the waste.
METHODS
Waste generated for both elective and trauma procedures was separated primarily into clean and contaminated, paper or plastic, and then weighed. The annual carbon footprint for each operation at each site was subsequently calculated.
RESULTS
Elective procedures can generate up to 16.5kg of plastic waste per procedure. Practices such as double-draping the patient contribute to increasing the quantity of waste. Over the procedures analysed, the mean total plastic waste at the hospital sites varied from 6 to 12kg. One hospital site undertook a pilot of switching disposable gowns for reusable ones with a subsequent reduction of 66% in the carbon footprint and a cost saving of £13,483.89.
CONCLUSIONS
This study sheds new light on the environmental impact of waste produced during trauma and elective orthopaedic procedures. Mitigating the environmental impact of the operating room requires a collective drive for a culture change to sustainability and social responsibility. Each clinician can have an impact upon the carbon footprint of their operating theatre.
Topics: Carbon Footprint; Humans; Operating Rooms; England; Medical Waste; Orthopedic Procedures; Wales; Medical Waste Disposal; State Medicine; Elective Surgical Procedures; Plastics
PubMed: 38563077
DOI: 10.1308/rcsann.2023.0052 -
Sante Publique (Vandoeuvre-les-Nancy,... 2024The management of cardiovascular pathologies has a high cost for users. (Observational Study)
Observational Study
INTRODUCTION
The management of cardiovascular pathologies has a high cost for users.
PURPOSE OF THE RESEARCH
It is therefore important to assess the costs of hospitalization to gain a better understanding of its impact on care.
RESULTS
This was a case series-type, descriptive, observational study with prospective data collection.
RESULTS
A total of 103 patients were included, with a mean age of 51 years and extremes ranging from 14 to 86 years. The average length of stay was 7.1 days. Heart failure was the most frequent pathology (61.7%). The average monthly income per patient was 101,360 CFA francs. The average total direct cost during hospitalization was 114,015 CFAF. The average direct cost of drugs and consumables was 60,553.77 CFAF. The average direct cost of paraclinical examinations was 34,360.29 CFAF. Hospitalization costs averaged 16,747.47 CFAF. Total direct costs during hospitalization were 11,737,060 CFAF, dominated by drugs and medical consumables (53.14%), followed by complementary examinations (29.86%) and non-medical expenses (17%). During the study, 13.59% of patients were discharged against medical advice. Expenses were covered by the parents in 71.84% of cases.
CONCLUSIONS
The average direct cost of hospitalization is well above the purchasing power of the majority of patients.
Topics: Humans; Middle Aged; Burkina Faso; Adult; Aged; Female; Male; Aged, 80 and over; Adolescent; Young Adult; Cardiovascular Diseases; Prospective Studies; Hospitalization; Health Care Costs
PubMed: 38906807
DOI: No ID Found -
Journal of the National Comprehensive... Apr 2024The health care industry spends more on lobbying than any other industry, with more than $700 million spent in 2022. However, health care lobbying related to cancer has...
BACKGROUND
The health care industry spends more on lobbying than any other industry, with more than $700 million spent in 2022. However, health care lobbying related to cancer has not been characterized. In this study, we sought to describe overall health sector lobbying spending and oncology-related lobbying spending across patient and clinician organizations.
METHODS
We obtained lobbying data from OpenSecrets.org and the Federal Election Commission. Overall health sector lobbying spending was categorized by OpenSecrets into 4 groups: pharmaceuticals/health products, health services/health maintenance organizations (HMOs), hospitals/nursing homes, and health professionals. We then identified and categorized 4 oncology-related lobbying groups: oncology physician professional organizations (OPPOs), prospective payment system (PPS)-exempt cancer hospitals, patient advocacy organizations, and provider networks (eg, US Oncology Network). We described temporal trends in lobbying spending from 2014 to 2022, in both overall dollar value (inflation-adjusted 2023 dollars) and in per-physician spending (using American Association of Medical Colleges [AAMC] data for number of hematologists/oncologists) using a Mann-Kendall trend test.
RESULTS
Among the overall health sector lobbying, pharmaceuticals/health products had the greatest increase in lobbying spending, with an increase from $294 million in 2014 to >$376 million in 2022 (P=.0006). In contrast, lobbying spending by health professionals did not change, remaining at $96 million (P=.35). Regarding oncology-related lobbying, OPPOs and PPS-exempt cancer hospitals had a significant increase of 170% (P=.016) and 62% (P=.009), respectively. Per-physician spending also demonstrated an increase from $60 to $134 for OPPOs and from $168 to $226 for PPS-exempt cancer hospitals. Overall, OPPO lobbying increased as a percentage of overall physician lobbying from 1.16% in 2014 to 3.76% in 2022.
CONCLUSIONS
Although overall health sector lobbying has increased, physician/health professional lobbying has remained relatively stable in recent years, spending for lobbying by OPPOs has increased. Continued efforts to understand the utility and value of lobbying in health care and across oncology are needed as the costs of care continue to increase.
Topics: Humans; Lobbying; Medical Oncology; United States; Neoplasms; Delivery of Health Care; Health Expenditures
PubMed: 38648846
DOI: 10.6004/jnccn.2023.7120 -
JAMA Nov 2023
Topics: Aged; Humans; Fees, Medical; Medicare; Physicians; United States
PubMed: 37988093
DOI: 10.1001/jama.2023.18969 -
JAMA Nov 2023
Topics: Aged; Humans; Fee Schedules; Medicare; Medicare Part B; Physicians; Relative Value Scales; United States
PubMed: 37988089
DOI: 10.1001/jama.2023.18975 -
JAMA Nov 2023
Topics: Aged; Humans; Fees, Medical; Medicare; Physicians; United States
PubMed: 37988096
DOI: 10.1001/jama.2023.18960 -
JAMA Nov 2023
Topics: Aged; Humans; Medicare; United States; Fees, Medical; Physicians
PubMed: 37988092
DOI: 10.1001/jama.2023.18972 -
JAMA Nov 2023
Topics: Aged; Humans; Medicare; United States; Fees, Medical; Physicians
PubMed: 37988094
DOI: 10.1001/jama.2023.18966 -
Journal of Child Health Care : For... Jun 2024Examining reported costs for Children with Medical Complexity (CMCs) is essential because costing and resource utilization studies influence policy and operational... (Review)
Review
Examining reported costs for Children with Medical Complexity (CMCs) is essential because costing and resource utilization studies influence policy and operational decisions. Our objectives were to (1) examine how authors identified CMCs in administrative databases, (2) compare reported costs for the CMC population in different study settings, and (3) analyze author recommendations related to reported costs. We undertook a systematic search of the following databases: Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library with a focus on CMCs as a heterogeneous group. The most common method used = 11 (41%) to identify the CMC population in administrative data was the Complex Chronic Conditions methodology. The majority of included studies reported on health care service costs = 24 (89%). Only = 3 (11%) of the studies included costs from the family perspective. Author recommendations included standardizing how costs are reported and including the family perspective when making care delivery or policy decisions. Health system administrators and policymakers must consider the limitations of reported costs when assessing local costing studies or comparing costs across jurisdictions.
Topics: Humans; Child; Health Care Costs; Chronic Disease
PubMed: 35751147
DOI: 10.1177/13674935221109683 -
Value in Health Regional Issues Jan 2024Most refugees and internally displaced people (IDP) stay in low- and middle-income settings. A substantial proportion are hosted by countries in sub-Saharan African... (Review)
Review
OBJECTIVES
Most refugees and internally displaced people (IDP) stay in low- and middle-income settings. A substantial proportion are hosted by countries in sub-Saharan African (SSA), which puts significant pressure on limited government healthcare budgets. As health economics may guide more optimal healthcare decision making, we scope the health economics literature on forcibly displaced populations in SSA to identify the nature and range of health economics evidence.
METHODS
We conducted a scoping review of peer-reviewed and gray literature in English published from 2000 to 2021. Our search terms comprised a combination of keywords related to refugees, SSA, and health economics. We followed a stepwise methodology consisting of the identification and selection of studies, extraction and charting of data.
RESULTS
We identified 29 health economics studies on refugees and IDPs in SSA covering different providers, interventions, and delivery platforms. Twenty-one articles studied the determinants of health, followed by 5 on the supply of healthcare and 2 concerned with economic evaluation and the demand for healthcare, respectively. We found an equal division of articles focusing on refugees and IDPs, as well as by settlement type. Mental health was the most frequently studied health area and Uganda was the most studied destination country.
CONCLUSIONS
The health economics literature on refugees in SSA remains limited. Our scoping review encourages future research to study a larger variety of healthcare systems and health economic topics such as economic evaluations, health financing and whole health systems to support resource allocation decisions and sustainable long-term solutions.
Topics: Humans; Refugees; Africa South of the Sahara; Delivery of Health Care; Economics, Medical; Mental Health
PubMed: 38064761
DOI: 10.1016/j.vhri.2023.10.008