culated. Per patient per month (PPPM) utilization rates were calculated based on inpatient, outpatient and prescription data, and costs were estimated using Medicare reimbursement rates and Average Wholesale Price. RESULTS: A total of 5741 patients met the inclusion criteria. At least one HF re-hospitalization was observed in 25% of patients, representing Ն85% of all-cause hospitalizations. Mean HF hospital length of stay was 6.7 days at IH and 7.2 days at fourth HF re-hospitalization. IH was most costly ($12,426) relative to the mean cost per subsequent HF re-hospitalization ($9,832). HF re-hospitalization rates peaked at 0.062 PPPM 3-6 months post IH. All-cause and HF-related outpatient visit rates peaked at 4.1 and 0.65 visits PPPM, respectively, within three months after IH. Mean outpatient visit cost ranged from $668 (0-3 months) to $224 (18-24 months post IH). Total pharmacy costs varied from $593 PPPM (baseline period) to $848 PPPM (0-3 months post IH); of these, cardiovascular drugs accounted for about one third ranging from $162 (baseline) to $221 PPPM (0-3 months post IH). CONCLUSIONS: Treating elderly chronic HF patients is resource intensive and costly. Utilization and cost peak in the first three months post IH. New interventions to improve health outcomes in the elderly HF population hold the potential to decrease post IH resource utilization and save costs.OBJECTIVES: Patients undergoing total knee or hip replacement are at high risk of experiencing venous thromboembolism (VTE) -deep vein thrombosis (DVT) and pulmonary embolism (PE), therefore, the aim of this study was to estimate resource utilization and associated costs of VTE following TKR under SUS perspective. METHODS: Data analysis was conducted through a review of a government administrative claims database (DATASUS). A cohort of patients who underwent TKR surgery in the public healthcare system was defined (1/2010 -9/2010) and followed for 6 months after surgery. Data regarding total hospitalization costs were compared for patients who didn't present complications with patients who presented VTE events. RESULTS: A total of 4736 patients were identified between January 2010 to September 2010 with average age of 65,6 years (SD 10,3), being 72.1% female. Mean hospitalization costs per patient were $BRL4,036 (SD 2,063) for the population analyzed. VTE episodes were experienced by 42 patients (0,89%, 32 cases of DVT and 10 of PE) and were associated with higher hospitalizations costs than patients without any complication: $BRL3,919 (SD 1,811), $BRL4,581 (SD 2,362) and $BRL7,715 (SD 6,777) for patients without complication, DVT and PE respectively. CONCLUSIONS: Patients experiencing VTE following TKR surgery represents a significant economic burden for the Brazilian public health care system. Our study suggests that a patient who presents PE following TKR surgery can cost twice more than a patient without complications.
Objectives: To investigate what aspects of real-world (RW)/health-economic (HE) studies and manuscripts most commonly receive positive feedback from peer reviewers. MethOds: Data were derived from industry-sponsored RW/HE manuscript submissions for which a complete submission history was available in our company's project administration records as described previously (Hartog TE et al., ISPOR 2015). Following initial review of submission letters, a preliminary classification of positive feedback was made and 11 categories were specified. Positive feedback from peer reviewers was stratified into these categories independently by 4 researchers and collated into a final consensus score. One letter could contain feedback that matched multiple categories. Results: Our dataset included 77 manuscripts, 140 submissions attempts, and 126 complete decision letters. Many decision letters included positive feedback (79/126; 63%). The most frequent positive comments were that "the topic or study is important, useful, or interesting" (35.4%), "the manuscript is well written" (19.7%), and "the study has rigorous methodology" (16.2%). Other comments included that "the manuscript adds to/confirms the literature or aids scientific understanding" (7.1%), "is useful for clinical practice" (7.1%), "is unique or innovative" (4.0%), that "the limitations are appropriately addressed" (3.0%), "the references used are recent or relevant" (2.5%), "the figures/tables are clear and well-presented" (2.0%), "the manuscript fills a gap in the literature" (1.5%), or other remarks (e.g. "well done", 1.5%). cOnclusiOns: Based on our analysis, peer reviewers are looking for RW/HE manuscripts that are interesting, well written, and derived from well-conducted studies. These findings should be confirmed by a larger study of non-industry-sponsored, non-agency-supported manuscripts but do support our previous research indicating that reviewers' concerns about methodology and lack of novelty are common reasons for rejection. Our research could help authors to focus their efforts during the preparation of manuscripts and thereby improve their chances of a favorable journal response.
Brazil has a huge structure for attending oncology, while the public SUS, is still smaller in structure for a larger population (152 Millions) the private structure is bigger for a much smaller population with private health insurance (45 Millions). From this, it is important to expand the discussion of what SUS expects from the health insurance policies.
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