Opportunity costs and local health service spending decisions: a qualitative study from Wales

Schaffer, S. Karlsberg; Sussex, Jon; Hughes, Dyfrig; Devlin, Nancy

doi:10.1186/s12913-016-1354-1

Cited by 20 publications

(15 citation statements)

References 10 publications

(12 reference statements)

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“…A further challenge to AWMSG is the increased need for the opportunity cost to be estimated. It is important to identify what is foregone when new cost-increasing technologies are introduced to understand the effects of HTA decisions on the healthcare system [ 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

New Medicines in Wales: The All Wales Medicines Strategy Group (AWMSG) Appraisal Process and Outcomes

et al. 2018

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BackgroundThe All Wales Medicines Strategy Group (AWMSG) develops prescribing advice and is responsible for appraising new medicines for use in Wales. In this article, we examine the medicines appraisal process in Wales, its timeliness and its impact on medicines availability in Wales, and compare its processes and recommendations with the two other UK health technology appraisal bodies [the National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC)].MethodsWe reviewed the medicines appraisals conducted by AWMSG between October 2010 and September 2015. The duration of the process and the recommendations made by AWMSG were compared with those of NICE and SMC. Only publicly available data were considered in this review.ResultsAWMSG conducted 171 single technology appraisals for 137 medicines during the study period (34 were for medicines previously appraised by AWMSG but these were for new indications). Of these, 152 appraisals were supported for use in NHS Wales (33 with restrictions) and 19 were not supported. Recommendations broadly concurred with SMC and NICE for the majority of appraisals. Compared with NICE recommendations, the median time advantage gained in Wales for those medicines that received a positive AWMSG recommendation and which were subsequently superseded by NICE advice was 10.6 months (range 3.5–48.3 months; n = 17).ConclusionThis review highlights the work carried out by AWMSG over a 5-year period, and provides evidence to support the effectiveness of the appraisal process in terms of patients in Wales gaining earlier access to medicines and efficiency through reduced duplication with NICE.

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Section: Discussionmentioning

confidence: 99%

New Medicines in Wales: The All Wales Medicines Strategy Group (AWMSG) Appraisal Process and Outcomes

et al. 2018

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“…On the other hand, the fact that materials cost accounted for a larger proportion of hospital cost suggested that the hospital should strengthen its supervision on the consumption of high-value materials. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

Research on 2041 Cases of High Inpatient Expenditure and Influence Factors during 3 Years in a Single Center

Pan

Wei

et al. 2016

Chinese Medical Journal

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Background:The study was to explore the causes of high inpatient expenditure through analyzing the distribution characteristics as well as the influence factors of high inpatient expenditure cases during 3 years within a Grade-A tertiary hospital through various aspects and multiple angles, thus identifying the major influence factors for high medical expenditure to develop further research.Methods:We retrospectively studied 2041 inpatient cases which cost more than RMB 100,000 Yuan per case in a Grade-A tertiary hospital from 2013 to 2015. We analyzed the compositions of the medical cost to evaluate the major factors that cause the high inpatient expenditure. All the data and materials were collected from medical record system, and the statistical methods included t-test, variance of analysis, and multivariate linear regression.Results:The average cost of the 2,041 cases was RMB 152,173 Yuan for medicines and materials of medical costs, which respectively accounted for 33.03% and 32.32% of the total cost; and the average length of hospital stay was 28.39 days/person. Diseases of skeletal and muscular system, circulatory system, and tumor were the top three disease categories of high inpatient expenditure, which accounted for 39.00%, 33.46%, and 18.03%, respectively. Complications, criticality of the disease, gender of the patients, the occurrence of death, and the excessive length of hospital stay all had great impacts on average medical expenditure, while age, hospital infection, and surgery showed no significant impact on average medical cost.Conclusions:The main factors for high inpatient expenditure included the inadequate use of high-value medicines and materials, lacking cost control measures within the hospital, the excessive length of hospital stay for inpatients, and the unnecessary treatment for the patients.

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“…Moreover, the core value of the evaluation is the continuous improvement of medical quality based on the patient-centered concept. [ 8 ]…”

Section: S Everal M Ajor M mentioning

confidence: 99%

Establishment of a Comprehensive Evaluation System on Medical Quality Based on Cross-examination of Departments within a Hospital

Chen

Pan

et al. 2017

Chinese Medical Journal

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Opportunity costs and local health service spending decisions: a qualitative study from Wales

Cited by 20 publications

References 10 publications

New Medicines in Wales: The All Wales Medicines Strategy Group (AWMSG) Appraisal Process and Outcomes

New Medicines in Wales: The All Wales Medicines Strategy Group (AWMSG) Appraisal Process and Outcomes

Research on 2041 Cases of High Inpatient Expenditure and Influence Factors during 3 Years in a Single Center

Establishment of a Comprehensive Evaluation System on Medical Quality Based on Cross-examination of Departments within a Hospital

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