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Biomedical subjects

S D Von Allmen

Publications and source records attributed to S D Von Allmen.

6 recordsLinked to original sources
PubMed1981

Extra charges and prolongation of stay attributable to nosocomial infections: a prospective interhospital comparison.

Using a standardized method, we estimated concurrently the prolongation of stay and extra charges attributable to nosocomial infection in three hospitals that differed in size, administrative characteristics and patients' economic status. Results showed the consequences in the three hospitals to have been similar in the degree to which nosocomial infection prolonged hospitalization (3.1 to 4.5 days) and added to the infected patients' charges ($590 to $641 in 1976 dollars). In all three hospitals, the extra charges were divided about equally between routine and ancillary charges, and a relatively small percentage of patients (10 percent) with nosocomial infection accounted for a disproportionately large share of the total extra charges--46, 65 and 38 percent in the three hospitals, respectively. The economic consequences were influenced more by site of infection than by differences among hospitals, and their magnitude emphasizes the need for continued preventive efforts.

Adult↗
PubMed1980

Estimating the extra charges and prolongation of hospitalization due to nosocomial infections: a comparison of methods.

Estimates of the economic consequences of nosocomial infections were derived by studying the same patient population with two different methods: physician's assessment and comparisons of patients with nosocomial infection and those without, matched on five characteristics. Estimates of extra days and extra routine charges obtained by the comparison were about 2 1/2 times greater than those obtained by the physician's assessment (P less than 0.0001). Even when the match of patients was exact and measures were taken to avoid confounding, patients with nosocomial infection had more discharge diagnoses recorded (P = 0.02) and experienced more episodes of pulmonary embolism, renal failure, and death in the hospital than did their counterparts. These differences suggest that, despite careful matching, the members of the pairs were not comparable in their intrinsic predisposition to prolonged hospitalization. Unless patients can be matched on this prediposition, the estimates from a comparison study will be exaggerated.

Cost-Benefit Analysis↗
PubMed1979

Congenital hypothyroidism control programs. A cost-benefit analysis.

Comprehensive screening programs to control congenital hypothyroidism (CH), a preventable form of mental retardation, are being considered by some public health agencies. The proposed programs would test neonates' blood for thyroxine and, if warranted, provide follow-up testing and therapy. The estimated cost of detecting a single case of CH is $9,300, which includes specimen collection, laboratory analysis, and retesting of border-line cases. The present value of the treatment costs of CH adds $2,500 per case, a total cost of $11,800 per case detected and child treated. The economic benefits (averted costs of institutionalization and special education and increased productivity of the affected person) are estimated to have a present value of $105,000 per case, yielding a cost-benefit ratio of 1:8.9.

Adolescent↗
PubMed1979

Epidemic dengue fever in Puerto Rico, 1977: a cost analysis.

During the period July-December 1977, a widespread epidemic of dengue fever occurred in Puerto Rico. The cost of the epidemic was calculated, using upper and lower limit incidence figures, in terms of direct costs (medical care and epidemic control measures) and indirect costs (lost production of ill workers and parents of ill children). Direct costs were estimated to range between $2.4 and $4.7 million. Indirect costs were calculated by using current (1977) employment and wage data and population extrapolations from the 1970 census, and entailed a loss to the Puerto Rico economy of from $3.7 to $10.9 million. The total cost of this epidemic, therefore, was estimated to be in a range of $6.0 to $15.6 million, of which epidemic control measures comprised 7.8--20.2%.

Adolescent↗
PubMedDate not supplied

High cost nosocomial infections.

The average charge per patient due to nosocomial infection for 215 nosocomial infections in 183 study patients was $693. These cost, however, were concentrated in very few patients; 5% of patients accounted for nearly one-third of total charges. The 10% of patients with highest nosocomial infection cost were patients on Medical or Surgical services; these services were utilized in 71% of patients with nosocomial infection and accounted for 86% of the attributable charges. Among the 22 most costly infections, 17 occurred in surgical wounds and lower respiratory tract. Although these sites accounted for 46% of the infections, they resulted in 77% of the total nosocomial infection charges. Patients with a primary diagnosis of injury had particularly costly infections. Combined analysis of these variables revealed two groups for whom nosocomial infections were especially costly: surgical patients who acquired wound infections after injuries, and medical patients with lower respiratory infections.

Cost Allocation↗