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Open access

Joana I. Simeonova, Snejanka T. Tisheva-Gospodinova, Yoana M. Todorova, Petkana A. Hristova, Asia N. Yanakieva and Martin I. Hristov

Summary

A cross-sectional study was carried out in 2016 in the research project No 4/2016. We selected 98 patients aged 40-89 and diagnosed with hypertension. The patients were admitted to Cardiology Clinic One of the University Hospital in Pleven. The study aimed to measure and compare direct and indirect costs of hypertensive patients aged 40-89 years, who were treated with lisinopril and perindopril. We estimated the total and average costs of 50 (51.0%) patients treated with lisinopril and 48 (49.0%) treated with perindopril. Males were 46.4%, and the mean age of the sample was 65.9.0±11.2 years. Data were processed by Statistical Package for Social Science version 19.0 (SPSS.v.19.0). Total costs exceeded amount reimbursed for the clinical path (BGN 420.00) in 64.6% of the patients treated with perindopril and 48.0% of the patients treated with lisinopril. We found that treatment costs within 6-months after discharge were BGN 673.82 in patients treated with lisinopril, as compared to BGN 171.92 reimbursed by the National Health Insurance Fund (NHIF), and BGN 781.18 for those treated with perindopril, compared to BGN 216.33 reimbursed by NHIF. The NHIF reimbursement rate for antihypertensive treatment is insufficient to cover all direct costs. Increased hospital costs and out-of-pocket payments present a significant restriction on access to treatment for arterial hypertension.

Open access

Andrzej Żyluk and Piotr Janowski

Results of the Treatment of Major, Complex Hand Injuries

Complex hand injuries are associated with serious consequences including long period off-work, permanent disability, inability to return to original profession or to work at all. As these injuries are common, they create considerable economical consequences and, therefore, it is desirable their treatment would be as perfect as possible to reduce potential loss of function.

The aim of the study was analysis of the structure of complex, multi-structural hand injuries and evaluation of the outcomes of the treatment of these injuries in both medical (recovery of function) and economical (period of inability to work and costs of medical care) aspects.

Material and methods. The study presents the results of treatment of 78 patients suffered from severe, major hand injuries, involving damage of at least two of four anatomical structures within the hand or wrist (bones, tendons, arteries or nerves) as well as severe injury involving at least two digits. Functional results were assessed at a mean of 10 months after the accident. Tendons were repaired in all 42 patients, bones were fixed in 29 (69%), nerves were repaired in 21 (50%), arteries in 14 (33%) and in two patients skin defect was covered by the flap (one local and one groin flap).

Results. Total active motion of affected digits amounted 2/3 of normative active motion of the healthy digits and total grip strength approximated half of the grip strength of the unaffected hand. In patients with nerve injuries, a satisfactory recovery of sensation in the affected digits was obtained. Dexterity of the hand in daily activity was scored 30 points in DASH scale. Injury-related duration of sick leave in 31 patients worked at the time of the accident amounted 4.4 months in average (range 1-12). A total of 27 subjects (87% of worked) returned to work: 24 to their previous profession and three had to qualify for a new job. Total hospital costs of the treatment in the analysed group amounted a mean of 2600 PLN.

Conclusion. The outcomes of the treatment of major hand injuries achieved in our institution over the period of the one year were satisfactory, considering their severity and complexity. These results, in our mind, show clearly advantages coming from an existence of qualified service for hand injuries.

Open access

Igor Jokanović, Bojana Grujić, Dragana Zeljić, Žarko Grujić and Mila Svilar

Abstract

The provision and maintenance of road infrastructure is a major global business, consequently it is essential that road maintenance services are provided in the most cost effective manner. Without regular maintenance, roads can rapidly fall into disrepair, preventing realization of the longer term impacts of road improvements on development, such as increased agricultural production and growth in school enrollment, which is of particular importance for a network of local (access) roads. Inadequate local roads maintenance in Albania is proposed to be solved by implementing performance based maintenance approach for which the costing exercise is presented within the paper.

Open access

Albana Ahmeti, Artan Simaku, Iria Preza and Silva Bino

Abstract

Background: Diarrheal diseases count for a considerable proportion of morbidity, mortality and elevated use of health services and costs, especially in developing countries. In limited resource countries like Albania, it is essential to assess the costs associated with diarrhea, from health provider and social perspective, as a first step toward prioritization of interventions.

Materials and Methods: We used the 2011 information by gathering data from primary care, emergency rooms (ER) and hospitals. Average non-medical and medical costs were used. To assess the social costs of diarrhea we interviewed parents of children with diarrhea. Based on this information the total cost of diarrhea in Albania was calculated.

Results: The total mean cost per hospitalized, emergency room and outpatient diarrhea case was $228.97, $17.68 and $9.24, respectively. The total social costs per each hospitalized, ER and outpatient diarrhea case were $45.66, $15.22 and $15.22, respectively. The final burden of diarrhea, in terms of costs, in Albania was approximately $3 million in 2011.

Conclusion: The high burden of diarrhea associated costs for the Albanian health care system finances dictates the necessity to assess the costs of a potential rotavirus immunization program in order to prioritize the interventions based on scientific evidence.

Open access

Dace Āriņa, Kaspars Kļavenieks and Juris Burlakovs

Abstract

Production of refuse derived fuel from municipal solid waste in future shall play a strategic role in an integrated waste management system. The amount of landfilled biodegradable materials thus will be diminished according to provisions of the 1999 Waste Landfill Directive. The aim of this article is to evaluate cost effectiveness based on cost evaluation of the different complication of the waste pre-treatment equipment complectation and based on regenerable waste quantities in Latvia. The comparison of cost estimates is done in 3 scenarios considering potential waste quantities in Latvia: Scenario I - planned annual waste quantity is 20 kT; Scenario II - 40 kT and Scenario III - 160 kT. An increase in amount of waste and processing capacity means the decrease in costs of mechanical pre-treatment of 1 ton of waste. Thus, costs of mechanical sorting line under different scenarios with capacities of 10 t h-1, 20 t h-1 and 80 t h-1 are EUR 32 per t, EUR 24 per t and EUR 15 per t, respectively. Most feasible cost for a set of mechanical pre-treatment equipment for the capacity of 10 t h-1 is EUR 32 per t by using rotating drum screener with the following manual sorting. Mechanical pre-treatment equipment of unsorted municipal waste is economically nonbeneficial, when the use of fine (biologically degradable) fraction is not possible. As the sorting of biodegradable kitchen waste is not developed under the current waste management system in Latvia, the lines for mechanical pre-treatment of household waste would be better to install in landfills.

Open access

Alina Puțan, Oana Raluca Ivan and Attila Tamas

Abstract

Current status of the hospital units is worrying: insufficient funding, increasing the number of cases considered / treated, providing quality services at public hospital unit. In this research we have undergone an empirical research carried out in the hospital units of category III and IV, from Alba County, this sample selection aims to identify an optimal solution to exercise management control which should serve to management decisionmaking. Responsibility centers, at the level of hospital unit, establish the liability for each segment of expenditure, expenditure tracking and proper grounding even their places of training, delimitation expenditure which does not strictly dependent on the production activities that are related strictly by the process; establishing the deviations of preset expenses levels; establishing a system of rules allowing highlighting the responsibilities of each performer, introducing a system of resource allocation and tracking of the use of their by developing specific cost budget for each responsibility center. The disadvantages of decentralization based on activity centers consists in increase the consumption of resources in certain activities, unclear delimitation of cause-effect relationships that create difficulties in adopting the relevant decisions by management, etc.

Open access

Ladislav Kováč and Jana Jakubová

Abstract

The experiments aimed at the comparison of the growth and production parameters of sorghum with other field crops were established in the experimental workplaces CVRV-VÚA in Milhostov. In the course of favourable meteorological factors, the slowest initial development of vegetation height and dynamics of biomass accretion was observed in sorghum. From 15th August, however, sorghum accretion intensity significantly exceeded all the monitored field crops. The total cost of the cultivation of sorghum for silage accounted for 870.34 € ha-1 and of maize for silage 861.36 € ha-1. The difference resulted from different levels of material costs. In the experiment, the harvested amount reached 62.70 t ha-1 for sorghum silage and 54.20 t ha-1 for maize (33% moisture). At these yield and silage costs 33 € t-1, sorghum achieved a profit of 1198.76 € ha-1 without subsidy, while maize achieved a profit of 927.24 € ha-1. The yields exceeding 26.37 t ha-1 for sorghum and 26.10 t ha-1 for maize would be sufficient to achieve profits.

Open access

Jindřich Ježek, Jiří Nožička and Árpád Török

Abstract

The paper deals with the issue of sensitivity analysis and its possible use in price formation in passenger road transport. The input variables are selected on the model example. Based on the calculation, the sensitivity of the output to these input variables is determined, and the question how these inputs affect the overall result is answered.

Open access

Martina Margorínová, Mária Trojanová, Martin Decký and Eva Remišová

Abstract

Building and improving road infrastructure in Slovakia is currently influenced by the amount of state funding. Therefore, it is necessary to determine the effectiveness of each proposed solution of road project, which is based on life-cycle costs. Besides capital costs, social costs are also important, which valued the negative impacts due to road construction and operation on road users, the environment, and the population living in the affected area. Some components of social costs have shortcomings in quantifying and valuating, which need to be resolved. The one of important components which affects human health and the value of an area, and have some shortcomings are noise costs. Improvement of this component will lead to more accurate valuation of economic efficiency of roads.

Open access

Peter Mesároš, Tomáš Mandičák and Jozef Selín

Abstract

Cost management should be seen as an essential function of enterprises which perform their activities in current market environment. One of the main factors affecting the level of achieved profit and favourable market position is cost structure. The company's ability to obtain necessary and reliable information on their own cost, subsequent processing and effective cost management is crucial for achieving success. This study focuses on cost management and the use of modern methods of cost management in construction enterprises. The aim of this paper is to identify approaches to cost management in Slovak construction enterprises, based on own empirical research.