OBJECTIVES: The comparative efficacy between riociguat and selexipag in patients with pulmonary arterial hypertension (PAH) has never been described in literature. Our aim was to prepare indirect treatment comparison (ITC) to evaluate the cost-effectiveness of riociguat in Czechia. METHODS: A systematic literature review identified two relevant trials with comparable endpoints to inform a Bucher ITC of relative and absolute effects. Given the comparable efficacy of riociguat and selexipag, a cost-minimization analysis (CMA) was conducted. RESULTS: A Bucher ITC provided evidence for the comparable relative efficacy of riociguat defined as the odds of unimproved functional class III 0.761 (95% CI 0.372 to 1.558; p = 0.455) compared to selexipag and a comparable absolute efficacy defined as a difference in the 6-minute walking distance of 10.560 meters (95% CI -10.692 to 31.812; p = 0.330). The CMA identified riociguat as the cost-saving therapy. CONCLUSIONS: Switching to riociguat represents the cost-saving therapy for PAH patients who were inadequately compensated with the PDE5i+ERA therapy. Consequently, riociguat has been introduced to the list of reimbursed medicines in Czechia from October 2021. Based on two global trials, we prepared the first indirect treatment comparison followed with CMA of these therapies that may improve future decision-making for PAH indications.

• Klíčová slova
• Bucher indirect comparison, cost-minimization analysis, pulmonary arterial hypertension, riociguat, selexipag, systematic review,
• MeSH
• antihypertenziva MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• plicní arteriální hypertenze * MeSH
• plicní hypertenze * farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH
• Názvy látek
• antihypertenziva MeSH
• riociguat MeSH Prohlížeč
• selexipag MeSH Prohlížeč

OBJECTIVE: Complications contribute largely to the economic gravity of diabetes mellitus (DM). How they arise and are treated differs substantially between countries. This paper assesses the total annual, direct, and indirect cost of severe hypoglycemia events (SHEs) in nine European countries: Bulgaria, Croatia, the Czech Republic, Greece, Hungary, Macedonia/the former Yugoslav Republic of Macedonia (MK), Poland, Slovenia, and Spain. METHODS: Data was collected on epidemiology, treatment structure, SHE-driven resource consumption, and unit costs. Two systematic reviews-on the SHE rates and the resources used for treatment-and data on the days-of-work lost due to SHE along with salaries and employment rates were used. The total SHE cost in each country was calculated and how the differences are driven by individual parameters was analysed. RESULTS: The annual costs of SHEs varied in absolute terms from €379,951.25 in MK up to €58,429,684.40 in Spain, or-when expressed per one drug-treated DM patient-from €5.47 in Bulgaria up to €17.74 in Spain. Indirect cost constituted between 6.01% (MK) and 26.49% (Hungary) of the total cost. The differences between countries are driven mostly by the cost of treating a single event, and this is related to general differences in prices. LIMITATIONS: The main limitation is the lack of good quality data in some parts, and the necessity to use mean-value imputations, experts' opinions, etc. Additionally, we only considered DM treatment as the SHE driver, while other elements, e.g. style of living, may contribute substantially. CONCLUSIONS: A common framework can be applied to estimate the economic burden of SHE in various countries, allowing one to identify the drivers of differences in cost. Treating DM is complex, and so no resolute conclusions ought to be drawn as to whether SHE management is better in one country than another.

• Klíčová slova
• Diabetes mellitus, cost study, direct cost, indirect cost, severe hypoglycemia,
• MeSH
• hypoglykemie ekonomika   patologie   MeSH
• lidé MeSH
• náklady a analýza nákladů * MeSH
• náklady na zdravotní péči trendy   MeSH
• osobní újma zaviněná nemocí * MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

UNLABELLED: Increasing treatment costs of HF patients affect the initiation of appropriate treatment method. Divergent approaches to measure the costs of treatment and the lack of common cost indicators impede the comparison of therapy settings. OBJECTIVES: In the context of the present meta-analysis, key cost indicators from the perspective of healthcare providers are to be identified, described, analyzed and quantified. This review helps narrowing down the cost indicators, which have the most significant economic impact on the total treatment costs of HF patients. Telemedical services are to be compared to standard therapy methods. METHODS: The identification process was based on several steps. For the quantitative synthesis, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. An additional set of criteria was defined for the following qualitative analysis. RESULTS: 5 key cost indicators were identified with significant economic impact on the treatment costs of HF patients. CONCLUSION: 95% of the reported treatment costs could be captured based on the identified cost indicators.

• Klíčová slova
• Cost comparison, cost effectiveness, economic evaluation, heart failure, telemedicine,
• MeSH
• analýza nákladů a výnosů MeSH
• chronická nemoc MeSH
• lidé MeSH
• náklady na zdravotní péči * MeSH
• srdeční selhání ekonomika   terapie   MeSH
• telemedicína MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH

The cost of salt fluoridation in a given country depends primarily on the number of salt factories and on the technical level available in the country. Equipment required may cost U.S. dollars 400,000 for large plants producing at least 20,000 tons/year providing salt for populations of several millions. Reliable batch mixers have been built locally for U.S. dollars 3000 to U.S. dollars 10,000, with one such mixer capable of producing 10 batches of one metric ton/day or 2000 to 3000 tons a year for a population of 350,000 to 500,000. Frequently 85-90% of the costs are devoted to infrastructure; in combination with salt iodization, the cost for fluoride equipment is 30-50% less. loIization is promoted by WHO, UNICEF, other international organizations and national aid agencies which can indirectly support salt fluoridation. With respect to running costs, the expense for the fluoride chemical is the major factor in small plants producing for example 6000 tons of salt, i. e U.S. dollars 0.015 to 0.03 per year and capita. The cost for personnel necessary for addition of fluoride and quality control is approximately U.S. dollars 0.008/capita/year in small plants and even less in large ones. With adequate implementation, salt fluoridation affords a cariostatic effectiveness equal to that of water fluoridation. When its cost is compared to that of water fluoridation, there may not be much difference regarding initial cost for equipment except in the case of small salt factories where local production of batch mixers may lower initial expenses substantially. Running costs for salt fluoridation are 10 to 100 times lower because the amount of fluoride chemical needed and its handling are up to 100 times less than with water fluoridation. In practice, the cost of salt fluoridation is often so low that many producers did not raise the price of fluoridated salt; this has been the case in Switzerland since 1955 and also in several countries in the Americas today.

• MeSH
• financování organizované MeSH
• fluoridace ekonomika   MeSH
• fluoridy aplikace a dávkování   ekonomika   MeSH
• investiční náklady MeSH
• kariostatické látky aplikace a dávkování   ekonomika   MeSH
• kuchyňská sůl ekonomika   MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• náklady na zdravotní péči * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Amerika MeSH
• Česká republika MeSH
• Francie MeSH
• Švýcarsko MeSH
• Názvy látek
• fluoridy MeSH
• kariostatické látky MeSH
• kuchyňská sůl MeSH

Unintentional and intentional injuries are a major cause of morbidity and mortality among children under the age of 19. The large number of premature death and disabilities due to injury and accompanying high economic cost, including public sector expenditures, emphasize the need to reduce the burden of injury. Productivity losses are greater from injury than from the three other leading causes of death--heart disease, stroke and cancer. Implementation of known injury-control interventions can substantially reduce the incidence, severity, and accompanying cost of injury. Because financial resources are limited, decision-makers need to consider the cost and effectiveness of alternative prevention strategies. Injury causes with the highest cost per injury could make a priority, especially within maternal and child health programs; as an alternative, projected total injury cost could determine program priority.

• MeSH
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• náklady a analýza nákladů * MeSH
• předškolní dítě MeSH
• rány a poranění * ekonomika   epidemiologie   prevence a kontrola   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Spojené státy americké epidemiologie   MeSH

BACKGROUND: Perioperative goal directed therapy (GDT) can substantially improve the outcomes of high risk surgical patients as shown by many clinical studies. However, the approach needs initial investment and can increase the already very high staff workload. These economic imperatives may be at least partly responsible for weak adherence to the GDT concept. A few models are available for the evaluation of GDT cost-effectiveness, but studies of real economic data based on a recent clinical trial are lacking. In order to address this we have performed a retrospective analysis of the data from the "Intraoperative fluid optimization using stroke volume variation in high risk surgical patients" trial (ISRCTN95085011). METHODS: The health-care payers perspective was used in order to evaluate the perioperative hemodynamic optimization costs. Hospital invoices from all patients included in the trial were extracted. A direct comparison between the study (GDT, N = 60) and control (N = 60) groups was performed. A cost tree was constructed and major cost drivers evaluated. RESULTS: The trial showed a significant improvement in clinical outcomes for GDT treated patients. The mean cost per patient were lower in the GDT group 2877 ± 2336€ vs. 3371 ± 3238€ in controls, but without reaching a statistical significance (p = 0.596). The mean cost of all items except for intraoperative monitoring and infusions were lower for GDT than control but due to the high variability they all failed to reach statistical significance. Those costs associated with clinical care (68 ± 177€ vs. 212 ± 593€; p = 0.023) and ward stay costs (213 ± 108€ vs. 349 ± 467€; p = 0.082) were the most important differences in favour of the GDT group. CONCLUSIONS: Intraoperative fluid optimization with the use of stroke volume variation and Vigileo/FloTrac system showed not only a substantial improvement of morbidity, but was associated with an economic benefit. The cost-savings observed in the overall costs of postoperative care trend to offset the investment needed to run the GDT strategy and intraoperative monitoring. TRIAL REGISTRATION: ISRCTN95085011.

• Klíčová slova
• Cost-effectiveness, Fluid optimization, Hemodynamic optimization,
• MeSH
• analýza nákladů a výnosů MeSH
• hemodynamika * MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• perioperační péče ekonomika   metody   MeSH
• peroperační monitorování ekonomika   metody   MeSH
• peroperační péče ekonomika   metody   MeSH
• retrospektivní studie MeSH
• tekutinová terapie ekonomika   metody   MeSH
• tepový objem * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

We developed a simple low-cost cultivation-based microfluidic device from office-laminator foil and Parafilm for the determination of specific microorganisms in water samples. The main goal was to obtain a device that would be portable and cheap compared to common laboratory techniques testing microorganisms. This device needs only 10µL of a sample and can be easily used in terrain by a non-specialist. Moreover, we dealt with some technical aspects of the device fabrication such as low-cost lamination techniques and the use of different cultivation media.

• Klíčová slova
• Cultivation, Escherichia coli, Lamination, Low-cost microfluidics,
• MeSH
• analýza moči přístrojové vybavení   MeSH
• Escherichia coli izolace a purifikace   MeSH
• laboratoř na čipu ekonomika   MeSH
• lidé MeSH
• moč mikrobiologie   MeSH
• náklady a analýza nákladů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The authors analysed the direct cost associated with treatment of IPI in 156 patients hospitalised with the diagnosis of pneumococcal meningitis at the terciary care Teaching Hospital. The total direct cost for 156 patients was 22,180,080 CZK (Czech Crowns). The average length of hospital stay for the patient with invasive pneumococcal meningitis (IPM) was 23 days. It was possible to conclude, that the direct financial expenses in 156 patients with pneumococcal meningitis would enable 88,337 people to be vaccinated. This is 6.2 % of all people in 65+ age group living in the Czech Republic, 54.8 % of all people in 65+ age group living in the Morava-Silesia Region with 1,250,800 inhabitants, or all inhabitants below 14 and above 65 years in Ostrava city (total population 312,000). The cost of pneumococcal polysacharide vaccine and its administration was 566 times lower compared to the average cost of treatment for one IPM case (Ref.21). Full Text (Free, PDF) www.bmj.sk.

• MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• náklady na zdravotní péči MeSH
• pneumokoková meningitida farmakoterapie   ekonomika   prevence a kontrola   MeSH
• pneumokokové vakcíny ekonomika   MeSH
• senioři MeSH
• vakcinace ekonomika   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• pneumokokové vakcíny MeSH

BACKGROUND: Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. METHODS: The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. RESULTS: The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. CONCLUSIONS: Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of the performed cost analysis for the hospital management. Based on the analysis results, it is possible to standardize activities and performance appraisal (Benchmarking), and provide all necessary information for hospital budgeting practices, especially Activity-Based Budgeting (ABB).

• MeSH
• dermatologie ekonomika   MeSH
• lidé MeSH
• náklady a analýza nákladů metody   statistika a číselné údaje   MeSH
• nemocnice - náklady statistika a číselné údaje   MeSH
• nemocniční oddělení ekonomika   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

The aim of this paper is to identify a break in the development trend of the time series of the number of fatal, light and heavy injuries in traffic accidents and compare the progress caused by the media campaign named "Think or you'll pay! "in the Czech Republic over the period 2000-2015. The campaign focuses on the age group of drivers under the age of 25 and the most common cause of their traffic accidents as the drivers in this age category are the most vulnerable group in road traffic. The campaign uses a method in which it tries to influence behaviour by negative action, or by causing negative emotions. The authors concentrate on the effects of mass media campaigns in the long-term development of accidents in the Czech Republic and a financial evaluation of the road safety campaign "Think or you'll pay! "by comparing the campaign costs, the cost of road fatalities, and the cost savings from the perspective of government expenditures. The secondary source data for the chart analysis and interpolation according to the criteria of analytical and mechanical balancing time series, the Chow test and Quandt Likelihood Ratio test, choosing the appropriate model trend of accidents and consequences of traffic accidents were obtained from the Czech Ministry of Transport, the database of The Losses due to Traffic Accident Rates (CZRSO) and the Czech Association of Victims of Traffic Accidents (CSODN, 2015) from period of 1990 till 2016. The impact of the media campaign "Think or you'll pay!", measured by enumerating the costs was compared with the number of fatalities in the years immediately after the campaign and the impact of the media campaign was evaluated and recognised. The conclusion and the highlights summarize the findings of research and the limits of media campaign evaluation approach.

• Klíčová slova
• Cost analysis, Road and traffic safety, Time series models, media campaign,
• MeSH
• analýza nákladů a výnosů * MeSH
• bezpečnost * MeSH
• databáze faktografické MeSH
• dopravní nehody prevence a kontrola   MeSH
• dospělí MeSH
• emoce MeSH
• hromadné sdělovací prostředky * MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• náklady a analýza nákladů MeSH
• podpora zdraví * ekonomika   MeSH
• přesvědčovací komunikace * MeSH
• rány a poranění etiologie   MeSH
• riskování MeSH
• řízení motorových vozidel * MeSH
• vládní programy MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH