Most of important variables measured in medicine are in numerical forms or continuous in nature. New instruments and tests are constantly being developed for the purpose of measuring various variables, with the aim of providing cheaper, non-invasive, more convenient and safe methods. When a new method of measurement or instrument is invented, the quality of the instrument has to be assessed. Agreement and reliability are both important parameters in determining the quality of an instrument. This article will discuss some issues related to methods comparison study in medicine for the benefit of medical professional and researcher. METHOD: This is a narrative review and this article review the most common statistical methods used to assess agreement and reliability of medical instruments that measure the same continuous outcome. The two methods discussed in detail were the Bland-Altman Limits of Agreement, and Intra-class Correlation Coefficient (ICC). This article also discussed some issues related to method comparison studies including the application of inappropriate statistical methods, multiple statistical methods, and the strengths and weaknesses of each method. The importance of appropriate statistical method in the analysis of agreement and reliability in medicine is also highlighted in this article. CONCLUSION: There is no single perfect method to assess agreement and reliability; however researchers should be aware of the inappropriate methods that they should avoid when analysing data in method comparison studies. Inappropriate analysis will lead to invalid conclusions and thus validated instrument might not be accurate or reliable. Consequently this will affect the quality of care given to a patient.
Costs and Cost Analysis

Objective. This pilot study aimed to determine the epidemiologic burden of hospitalization for bronchial asthma in acute exacerbation. Methods. We used a descriptive cross-sectional study to describe the demographic profile, comorbidities and level of control of patients admitted for bronchial asthma in acute exacerbation admitted to the Philippine General Hospital from May 1 to October 31 2019. The study computed for the admission rate and compared the average cost of hospitalization (diagnostics, therapeutics and room) using direct costing to the total reimbursable cost from PhilHealth. Associations between patient characteristics (age, type of admission) and hospitalization cost were also determined. Results. We enrolled 45 patients in the study. The admission rate was 8/month. The mean cost of admission was significantly higher than the reimbursable amount from PhilHealth (Php 20,074.63 versus Php 9000) (p = 0.004). Cost of hospitalization was significantly higher in pay patients versus charity (p = 0.001 for diagnostics, p = 0.005 for treatment and p = 0.001 for room cost), in patients with poorly controlled asthma (p = 0.020 for diagnostics and p = 0.014 for room cost) and those with frequent short-acting beta-agonist (SABA) use (p = 0.001). Conclusion. Asthma remains an economic burden for the Filipino patient. Persistent SABA use, perceived asthma control of patients and increased expenses associated with an asthma exacerbation admission lead to significant out-of-pocket expenditure.
Asthma ; Costs and Cost Analysis

The purpose of this research is to suggest a model for hospital process and verily the model through analyzing the results before and after reengineering grounded on the activity -based costing. The summary of research is as follows: First, two reengineering-applicable processes for a case hospital are chosen based on the issues from the patient requirements analysis and current process analysis as well as the general characteristics of hospital operations: accounting and clinical laboratory e xami nation processes. The integration of payment-related functions principle is applied to an accounting process which includes three sub processes. while the automatic transition of laboratory output principle is applied to a clinical laboratory examination process. Second, the studs shows more than 50% reduction of activities: nine activities from nineteen by the principle of integration of payment-related functions, and nine activities from fourteen by the principle of automatic transition of laboratory output. Finally. activity-based cost analysis before and alter reengineering results in 44% cost reduction: 43.9% in payment-related subprocesses and 41.1% in a clinical laboratory examination process. Therefor this research finds an enormous gap between costs before and after reengineerring. The contributions of this research are two-fold: one is that activity-based costing methodology is practically valid for measuring the cost-performance analysis of hospital process reengineering, and another is that activity -based costing can he utilized not only an initiative of process engineering hut also as a tool for evaluating a variety of activities by a simulation technique.
Costs and Cost Analysis ; Humans ; Laboratories

Objectives: This study aims to analyze the cost of patient care among ORL-HNS patients admitted in a tertiary, teaching government hospital in a low- to middle-income country. Methods: This is a prevalence-based, prospective, bottom-up, cost-of-illness analysis among patients of the Department of Otorhinolaryngology-Head and Neck Surgery in a tertiary training government hospital admitted from July 2021 to March 2022. The value assessment method used is the human capital approach. The societal perspective is used for analysis to estimate and reflect payer (insurance providers) and patient perspectives. Results: A total of one hundred fifty seven (157) patients were admitted for elective surgery under the service of ORL-HNS consisting of 75 females and 82 males. The average total overall cost was $3,851.10 (Php 199, 870.50 ± 164, 725.60). The total direct health care cost for all patients within the study period amounted to $3,712.18 (Php 192, 662.22 ± 159, 548.60) while the direct non-health care cost was $58.60. The workforce cost (58.5%) and medication cost (18.8%) comprised the majority of in-patient expenses with a mean cost of $2,221.36 (Php 37,083.66) and $714.51 (Php 44,363.14), respectively. In this study, an average of $80.29 was lost due to illness and hospitalization (± $81.74). The total PHIC coverage pays a range from zero to 67.5% with an average coverage of only 17%. Conclusion Our analysis has shown that workforce and medication expenses are the main cost drivers for the direct healthcare costs among Otolaryngology patients admitted for elective procedures. Stakeholders, such as the otolaryngologists and hospitals should coordinate closely to create a more encompassing coverage of Philhealth to prevent patients from suffering from financial crises due to their illness.
Costs and Cost Analysis ; Otolaryngology ; Philippines

BACKGROUND: Schistosomiasis is endemic in the Philippines. Currently, the financial and economic costs of hospitalization due to schistosomiasis have not been studied or analyzed. This will be essential to the review of health benefit package of PhilHealth for schistosomiasis.

OBJECTIVES: This study estimated the cost of hospitalization due to schistosomiasis and its complications in the Philippines.

METHODS: This is a cross-sectional mixed-methods study. Nine (9) hospitals from schistosomiasis-endemic provinces were included in the study. Medical records and billing statements from year 2013 were retrieved and analyzed. Non-medical costs were calculated based on data from key informants and existing economic data in 2013.

RESULTS: A total of 1,415 hospitalized cases were collected; 94% came from government hospitals. Fifty nine percent (59%) were classified under uncomplicated schistosomiasis. Overall hospitalization costs were PhP 8,489,524.39 (USD 200,006.70), with cases of hepatic complications having the highest costs among all types of cases. Combined nonmedical costs and productivity losses for 5,005 days of hospitalization were PhP 13,019,363.75 (USD 306,726.25).

CONCLUSION: The estimated clinical cost burden and economic losses due to schistosomiasis in selected sites in the Philippines amount to PhP 21,508,888.14 (USD 506,732.95). Significant drivers of cost were the presence of schistosomiasis sequelae or complications, co-morbidities, and increasing length of stay. Estimated productivity losses and non-medical expenses of patients due to hospitalization were found to be more burdensome than the actual hospital bills. These costs stress the need for government to provide health coverage for patients diagnosed with schistosomiasis.

Objective: This paper aims to provide a better understanding of the different engagement, cost, and resource considerations in developing and implementing mHealth solutions in the Philippines during the COVID-19 pandemic. Methods: First, six participants completed a form to document the estimated costs of developing a pseudo mobile application with features to mitigate the pandemic. Second, ten key informant interviews determined the facilitators, barriers, and resource requirements in developing mHealth tools. Results: The average cost estimate to develop and roll out a mobile application with public health and epidemiology features is Php 4,018,907 (US $78,650). The analysis of the interviews resulted in 12 themes organized in three domains: 1) facilitators and barriers in developing and sustaining mHealth solutions; 2) costs of sustaining mHealth technologies; and 3) factors affecting the costs of development and maintenance of mHealth technologies. Conclusion While differences in the cost estimates are evident, it provides a ballpark figure and the different factors that implementers need to sustain and maintain an mHealth solution. This paper hopes to inform policies and practices in engaging technology solution partners and in scaling up mHealth technologies.
Telemedicine ; COVID-19 ; Costs and Cost Analysis

INTRODUCTION

Acute coronary syndrome (ACS), specifically myocardial infarction, accounted for approximately 41% of deaths due to coronary artery disease in 2013. A large number of Filipinos are affected by ACS; thus, it is important to determine its hospitalization cost. The study objectives were to (1) define the hospital care pathways for ACS; (2) determine the resources used; (3) estimate the hospitalization cost for uncomplicated ACS; and (4) determine the difference between the estimated hospitalization cost and the coverage provided by the Philippine Health Insurance Corporation (Philhealth).

A cost analysis study was done. Mixed qualitative and quantitative data collection tools consisted of consultations with local cardiologists, key informant interviews, and self-administered survey forms. Sensitivity analysis was performed through scenario analysis.

The ACS hospital care pathway was derived after consultative meetings with invasive and noninvasive cardiologists. Using this pathway, the resources used for ACS hospitalization were identified, and the total hospitalization costs were calculated. For medical treatment alone, the costs were approximately Philippine peso (₱) 67,000 to ₱90,000, whereas for medical treatment with percutaneous coronary intervention (PCI), the costs were approximately ₱265,000 to ₱425,500. In comparison, Philhealth's maximum coverage for ACS with PCI is ₱39,750.

There is variation in the ACS hospitalization cost, depending on the management strategy used and the type of hospital where a patient is confined. Medical plus reperfusion with PCI increases the cost four to five times when compared with medical treatment alone. Huge out-of-pocket expense is demonstrated because of the large discrepancy between the actual hospitalization costs to Philhealth's ACS coverage.

Hospitals are experiencing an increasing amount of financial difficulty due to government control of hospital rates since national health insurance has been implemented. The decision support system(DSS) was developed to provide cost and revenue information for the services rendered by each department in an effect to reduce costs. This information may be used to identify the causes of financial loss if cost exceeds revenue and to conduct variance analysis or portfolio analysis to improve financial situation of hospitals. The DSS was developed using a micro-mainframe interface approach where the mainframe computer collects and summarizes daily cost and revenue data and the micro computer computes the cost for each department. The significances of this paper are to determine the cost allocation basis and methods which are suitable to Korean situation and to apply DSS technology to the cost analysis.
Computers, Mainframe ; Cost Allocation ; Costs and Cost Analysis* ; National Health Programs

PURPOSE: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. METHODS: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in ‘Public Hospitals Alert’, was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. RESULTS: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as ₩29,128 The nursing cost per inpatient per day was calculated as ₩157,970, and the administration cost per patient was calculated as ₩133,710. CONCLUSION: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.
Budgets ; Cost Allocation ; Costs and Cost Analysis ; Health Care Costs ; Hospital Costs ; Hospitals, Public ; Humans ; Inpatients ; Methods ; Nursing Services ; Nursing*

BACKGROUND/AIMS: It is believed that disposable biopsy forceps are more costly than reusable biopsy forceps. In this study, we evaluated performance and cost of disposable forceps versus reusable forceps in esophagogastroduodenoscopic biopsy. METHODS: Between October 2009 and July 2010, we enrolled 200 patients undergoing esophagogastroduodenoscopic biopsy at Seoul St. Mary's Hospital. Biopsies were performed with 100 disposable or 5 reusable forceps by random assignment. Seventy-five additional patients were studied to estimate durability of reusable forceps. The assisting nurses estimated the performance of the forceps. The evaluation of costs included purchase prices and reprocessing costs. The adequacy of the sample was estimated according to the diameter of the obtained tissue. RESULTS: Performance of disposable forceps was estimated as excellent in 97.0%, good in 2.0% and adequate in 1.0%. Reusable forceps were estimated as excellent in 36.0%, good in 36.0%, adequate in 25.1% and inadequate in 2.9%. The performance of reusable forceps declined with the number of uses. The reprocessing cost of reusable forceps for one biopsy session was calculated as 8,021won. The adequacy of the sample was excellent for both forceps. CONCLUSIONS: Disposable forceps showed excellent performance. Considering the reprocessing costs of reusable forceps, usage of disposable forceps with a low price should be considered.
Biopsy ; Costs and Cost Analysis ; Disposable Equipment ; Endoscopy ; Humans ; Surgical Instruments