Evaluating Hospital Costs in Kaunas Medical University Hospital

The purpose of the study is to evaluate hospital costs in Kaunas Medical University Hospital (KMUH). KMUH is the largest hospital in Lithuania, having 1995 in-patient beds, 26 specialised in-patient departments, 5130 employees, and providing wide range of in-patient services. Methods. Methods, used in the study include assessment of inputs and outputs, evaluation of average cost per case, estimation of cost structure, estimation of case-mix dimensions in in-patient departments and clinical categories and assessment of impact of case-mix dimensions to cost per case, using multiple regressionanalysis. Cross-sectional study designwas used in the study, evaluating mainly cases and expenses of all 26 specialised in-patient departments of KMUH per year 2002. Five cost groups have been used and defined inmonetary terms in each in-patient department: labour costs; medication costs; laboratory, radiology and anaesthesiology costs; running costs of medical equipment supply andother costs (including in-patients’ mealcosts, transportation, laundry, communication, etc. costs). Case was defined as one treatment episode in particular in-patient department. Cases were analysed using following case-mix dimensions: sex, age, absenceor presence of surgical operation, patient separation status and in-patientservice group. Results. Average costs per case vary widely among in-patient departments, ranging from 126.01 Litas (36.52 Euro) to 3451.68 Litas (999.73 Euro) per case.During the study average cost per case were also estimated in clinical profiles – surgery – 1161.0 Litas (336.24 Euro), therapy – 1312.15 Litas (380.02 Euro),obstetrics and gynaecology –685.82 Litas (198.62 Euro), newborn and child care – 893.54 Litas (258.78 Euro) and intensive care – 1292.92 Litas (374.45 Euro). Using multiple regression analysis method, costper case ineach in-patient department and clinical category according case-mix dimensions were predicted. In all in-patient departments predicted values of average costs per case according case-mix dimensions, comparing with actual values, did not differ so much. Positive contributions to predictedvalue of cost per case, shows only one variable – IA in-patient service group. In any predicted case contributions of independent variables have notbeen observedas significant (p&gt;0.05). Conclusions. Inputs (measured in the number of beds) and outputs (measured in the number of in-patientcases and the number of bed-days) are different across in-patient departments, as well as outputs (measured inthe number of treatment episodes according to case-mix dimensions). The average costs per case vary widely across in-patient departments and clinical categories. The analysis of the structure of average costs per case demonstrated striking differences in in-patient departments. In all in-patient departments the predicted values of the average costs per case according to case-mix dimensions, do not differ so much comparing with theactual observed costs per case. Positive contributions to the predicted value of the cost per case, shows only onevariable – IA in-patient service group. The results of the study have proved the evidence that clinical casestreated within the same in-patient department of the hospital are not similar. The results of studyhave showedthe failure of use of “in-patient service groups” as proxy of International Disease Classification due to numberof reasonsISBN 91-7997-101-6</p

The results of nucleic acid testing for viruses in individual donor test and its importance for the safety of blood

The aim of the study was to evaluate the results of nucleic acid testing for viruses in an individual donor test in National Blood Center; the objectives – to analyze the prevalence of infectious disease markers per 100 seronegative remunerated and non-remunerated, first-time and regular whole-blood donations and to assess the odds ratio in detecting the infectious disease markers among remunerated and non-remunerated donations. Materials and methods. All seronegative (for compulsory hepatitis B surface antigen, antibodies against hepatitis C, and antibodies against HIV-1/2 tests) whole-blood donations were tested by Procleix Ultrio (Tigris, Chiron) system at the National Blood Center in 2005–2007 in order to identify HIV-1, hepatitis C, and hepatitis B viruses. Results. There were 152229 seronegative whole-blood donations tested by nucleic acid test of viruses in individual donor tests (ID-NAT). In 152146 cases, no infectious disease marker was found, and in 83 cases (or 0.05% of all seronegative whole blood donations), infectious disease markers were determined and confirmed. The prevalences of hepatitis C virus (determined by HCV-NAT method) per 100 seronegative blood donations were as follows: 0.061 among first-time remunerated donations and 0.042 among regular remunerated donations. The prevalences of hepatitis B virus (determined by HBV-NAT method) per 100 seronegative blood donations were as follows: 0.111 among first-time remunerated donations, 0.062 among regular remunerated donations, 0.014 among first-time non-remunerated donations, and 0.005 among regular non-remunerated donations. The remunerated donations showed the higher odds ratios in determining the infectious disease marker by ID-NAT test, comparing with non-remunerated ones. Conclusions. 1. The prevalence of hepatitis B and hepatitis C viruses, determined by ID-NAT test, per 100 seronegative whole-blood donations is statistically significantly higher in remunerated donations. 2. The remunerated donations had the higher odds ratios in determining the infectious disease marker by ID-NAT test, comparing with non-remunerated ones. 3. In order to maximize the safety of blood and blood products, the continuity of promotion of non-remunerated whole-blood donations program should be ensured, and a compulsory blood donor testing for nucleic acids of viruses in an individual donor test should be introduced

Blood and its components donors’ deferrals in Lithuania between April 2019 and March 2023.

Blood and its components donors’ deferrals in Lithuania between April 2019 and March 2023.</p

The score values of prevalence comparisons of transfusion-transmitted infectious disease markers in blood and its components’ donations in Lithuania between April 2019 and March 2023.

The score values of prevalence comparisons of transfusion-transmitted infectious disease markers in blood and its components’ donations in Lithuania between April 2019 and March 2023.</p

An evaluation of the effectiveness and safety of midazolam in children undergoing dental surgery

Objective: The aim of this study was to evaluate the effectiveness and safety of oral midazolam in children undergoing dental surgery. Materials and methods: A prospective, randomized, controlled trial was conducted to assess the effectiveness and safety of midazolam in children. Patients aged 2–9 years who underwent dental surgery under general anesthesia were randomly allocated into one of the four groups: midazolam 0.2 mg/kg dose group (n = 30); midazolam 0.21–0.4 mg/kg dose group (n = 15); midazolam more than 0.41 mg/kg dose group (n = 15) or the placebo group (n = 31). The effectiveness of midazolam on sedation was assessed by the evaluation of vital signs, such as the respiratory and heart rate, oxygen saturation and the patients’ reactive behaviors, in comparison with the placebo. Results: The scores of the ratings for sleep, movement and crying, as well as patients’ reactions at the moment of separation from their parents and their collaboration with the staff were statistically significantly better among patients who received oral midazolam compared with the placebo. There were statistically significant direct correlations between the doses of midazolam and higher sleep, movement, crying and reaction scores 30 min after premedication as well as higher scores of patients upon separation from their parents. There were only a few clinically insignificant side effects. Conclusions: Oral midazolam, at a single dose from 0.2 to 0.6 mg/kg, is effective and safe, and provides the expected sedative effects in children required by premedication for dental surgery

Number of blood and blood components’ donations in Lithuania between April 2019 and March 2023.

Number of blood and blood components’ donations in Lithuania between April 2019 and March 2023.</p

Number of blood and its components’ donations according to specific dimensions in Lithuania between April 2019 and March 2023.

Number of blood and its components’ donations according to specific dimensions in Lithuania between April 2019 and March 2023.</p

The score values of proportions’ comparisons of blood and its components donors’ deferrals in Lithuania between April 2019 and March 2023.

The score values of proportions’ comparisons of blood and its components donors’ deferrals in Lithuania between April 2019 and March 2023.</p

The score values of donations proportions’ comparisons according to donor’s age and sex in different years in Lithuania between April 2019 and March 2023.

The score values of donations proportions’ comparisons according to donor’s age and sex in different years in Lithuania between April 2019 and March 2023.</p