A LT H 1 7 ( 2 0 1 4 ) A 7 1 9 -A 8 1 3where the costs were allocated to the different cost-centres. Capital costs were annualised cost of capital item with life expectancy of more than 1 year and recurrent cost were all inputs consumed within a year. Total costs were then allocated to the in-patient and out-patient services based on historical financial data with a ratio of 1: 4. This was then followed by a stepwise approach of allocating the ancillary department cost centres to the clinical department cost centres. The unit cost per patient visit was calculated based on the number of visits for each department. Base year of 2010 was used to calculate the cost and patients visits. Costs were calculated from the perspective of the hospital. Results: The cost per visit to the out-patient department averaged at MYR 96.83 (USD 29.34). The cost per visit to the medical department and surgical department was MYR 138.66 (USD 42.02) and 273.39 (USD 82.84) respectively. ConClusions: The findings provide an estimate of the costs for out-patient visit. At the current minimal fee of MYR 5.00 (USD 1.5), the Ministry of Health is subsidising more than 95.0% of the health care cost for each patient. These estimates provide the policy-makers with an understanding of the cost data should they need to establish a cost basis for payment rates.
Background. Aging is a process that biological changes accumulate with time and lead to increasing susceptibility to diseases like cancer. This study is aimed at establishing an aging-related prognostic signature in colon adenocarcinoma (COAD). Methods. The transcriptome data and clinical variables of COAD patients were downloaded from TCGA database. The genes in GOBP_AGING gene set was used for prognostic evaluation by the univariate and multivariate Cox regression analyses. The model was presented by a nomogram and assessed by the Kaplan-Meier curves and calibration curves. The drug response and gene mutation were also performed to implicate the clinical significance. The GO and KEGG analyses were employed to unravel the potential functional mechanism. Results. The Gene Set Enrichment Analysis result indicates that GOBP_AGING pathway is significantly enriched in COAD samples. Four aging-related genes are finally used to construct the aging-related prognostic signature: FOXM1, PTH1R, KL, and CGAS. The COAD patients with high risk score have much shorter overall survival in both train cohort and test cohort. The nomogram is then assembled to predict 1-year, 3-year, and 5-year survival. Patients with high risk score have elevated infiltrating B cell naïve and attenuated cisplatin sensitivity. The mutation landscape shows that the TTN, FAT4, ZFHX4, APC, and OBSCN gene mutation are different between high risk score patients and low risk score patients. The differentially expressed genes between patients with high score and low score are enriched in B cell receptor signaling pathway. Conclusion. We constructed an aging-related signature in COAD patients, which can predict oncological outcome and optimize therapeutic strategy.
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