1.Assessment of the Cost Performance of Laparoscopy-Assisted Gastrectomy
Hideki KAWAMURA ; Yukifumi KONDO ; Shigenori HOMMA ; Kuniaki OKADA ; Hiroyuki ISHIZU ; Hiroyuki MASUKO ; Tsunetake HATA ; Koichi TANAKA ; Hideki YAMAGAMI ; Ryoichi YOKOTA ; Hiroshi WATARAI ; Kentaro YOKOTA ; Yoshihiko TSUNODA ; Takehiko ADACHI
Journal of the Japanese Association of Rural Medicine 2008;57(4):619-627
Background: Laparoscopy-assisted gastrectomy requires a lot of disposable products. So we compared the cost between laparoscopy-assisted gastrectomy and open surgery.Patients and methods: For comparison we used five cases each of open distal gastrectomy (ODG), laparoscopy-assisted distal gastrectomy (LADG), open total gastrectomy (OTG) and laparoscopy assisted total gastrectomy (LATG). In this study, we defined the profit of gastrectomy as below and we used the list price for all products. Profit of gastrectomy=Fee for gastrectomy-(Costs of all single use products-Demandable fee for single-use products)Results: Mean profits of ODG and LADG were 278,756.2 yen and 190,292.8 yen. The difference was 88,463.4 yen. Mean profits of OTG and LATG were 395,922.6 yen and 330,653.6 yen. The difference was 65,269 yen. Mean hospital charges, mean length of hospital stay, mean hospital charges per day of ODG, LADG, OTG and LATG were 1,390,464 yen, 21.4 days, 65,140.0 yen and 1,484,254.0 yen, 18.8 days, 80,805.4 yen and 1,956,664.0 yen, 24.4 days, 82,397.1 yen and 1,686,936.0 yen, 18.4 days, 91,894.8 yen, respectively.Conclusion: The turnover of laparoscopic gastrectomy was higher than open gastrectomy, but, the profit was lower because of high costs of disposable products. Hospital charges were not higher but the charge per day was higher because of a shorter hospital stay.
Gastrectomy
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2.Analysis of Adverse Events In Infants After Simultaneous Administration of Inactivated Vaccine
Kiyotaka OHTANI ; Noriko MATSUMOTO ; Mayu FUJIMOTO ; Hitomi INAGAKI ; Yuichiro YOKOZEKI ; Kazuteru KITSUDA ; Miho KAIDA ; Masako KITSUNEZAKI ; Shinya NAKAMURA ; Yukifumi YOKOTA
Journal of the Japanese Association of Rural Medicine 2016;64(5):798-807
In Japan, few reports have discussed adverse events and safety after simultaneous vaccination during infancy. The purpose of this study was to elucidate adverse events after simultaneous vaccination of inactivated vaccines in infants in comparison with those after single vaccination. Selected for this study were infants aged ≥2 months who received subcutaneous injections of inactivated vaccines between July 2012 and June 2013. These subjects were divided into two groups: a single-vaccination group (46 subjects) and simultaneous-vaccination group (42 subjects). The presence or absence of severe adverse events that required hospitalization was investigated. We also checked up on subject background and systemic [fever (transitional and highest body temperature)] and local (dermatological, respiratory, gastrointestinal, neurological, and other organs’ symptoms) adverse events. Questionnaires to investigate if adverse events occurred during one week after simultaneous vaccination, questionnaires were distributed to the parents of all the subjects. “We performed vaccination in 162 subjects, and the collect rate of questionnaires was 57% (97/162).” The percentage of effective answers to the questionnaire survey was 91% (88/97). Among simultaneous-vaccination group subjects, 14 (32%) received Haemophilus influenzae type b (Hib) + 7-valent pneumococcal vaccine (PCV7) and 12 (27%) received Hib + PCV7 + Diphtheria-Pertussis-Tetanus vaccine. No subject developed severe adverse events that required hospitalization. The body temperatures taken on the day following the injection in the simultaneous-vaccination group were significantly higher than those in the single-vaccination group (p=0.049). However, the incidence of other systemic and local adverse events in the simultaneous-vaccination group was not significantly different from that in the single-vaccination group. Compared with single vaccination, simultaneous vaccination of inactivated vaccines in infants resulted in a significant rise in body temperature on the day following vaccination; however, no severe adverse events occurred.