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Table 5 Degree of Financial savings

From: Do clinical guidelines reduce clinician dependent costs?

Interventions studies

Degree of financial saving. {NB this is overestimated for any other denominator other than total health systems costs}

Proportion of total drug costs or total health system costs

IMCI guidelines (Tanzania)

Costs of drugs were higher by 61% compared to control districts. Cost of the intervention not included.

Total drug costs for managing outpatient illness in those aged <5 years.

 

Health system costs per child were 44% lower in intervention districts than in control districts. Cost of the intervention was included.

Total health system costs (including start up and post implementation costs) for managing outpatient illness in those aged <5 years.

Multidisciplinary clinical pathway for oxygen administration

Led to changes in oxygen prescribing behaviour but consumed more resources than standard management by 116%. Cost of the intervention was included.

Total health system costs (including start up and post implementation costs).

Multifaceted intervention to improve preventive care delivered by nurses

Costs decreased by 34%. Cost of the intervention was included.

Total health system costs (training, Supervision)

Use of commercially available electronic prescribing system with integrated clinical decision support and evidence - based message capability.

The proportion of prescriptions for high costs drugs that were the target of this intervention to prescribers was a relative 17.5% lower among the intervention group compared with the control group.

Total drug costs

Multifaceted intervention to promote early switch from intravenous to oral acetaminophen for prospective pain

Costs decrease by 57%. Cost of the intervention not included.

Total cost for acetaminophen analgesia costs

Clinical pathways for patients undergoing total laryngectony

Hospital variable costs decreased by 14.4%

Total hospital costs (both fixed and variable costs)

New antibiotics protocol involving amoxicillin as a first line agent.

Costs decrease by 28%. Cost of the intervention not included.

Total antibiotics costs

Educational intervention to decrease use of selected expensive medications

A 32% decrease in use of the more costly anticoagulant and a 20% increase in use of the less costly anticoagulant representing an estimated annual savings of $66000. Cost of the intervention not included.

Total anti-coagulant costs

Use of clinical pathway designed to manage community acquired pneumonia more efficiently than conventional therapy

Cost savings of 16%, 24% and 24% from the perspectives: healthcare, government and societal. Cost of the intervention not included.

Total consumable costs

Guidelines with one to one educational outreach visits by community pharmacists

Mean costs reduce by 6%.

Total drug costs including guideline production and dissemination; together with provision of education outreach visits

In patient diabetes management program

The reduction in length of stay for patients with diabetes has resulted in savings of more than $2 million for the year and has yielded a 467% return on investment for the hospital.

Total hospital costs

Modeling studies

Degree of financial saving

Proportion of total drug costs or total health system costs.

Malaria microscopy (change in clinical practice)

Costs of prescribed Artemether-Lumefantrine decreased by 54% while that of antibiotics increased by 5%. Therefore, the overall drug cost saving was 49%. Cost of the intervention not included.

Total Outpatient drug costs

IMCI guidelines (Kenya)

Cost of treatment reduced by an average of 42%. Cost of the intervention not included.

Total drug costs for managing outpatient illness in those aged <5 years

IMCI guidelines (Uganda)

Cost of medication reduced by 80%. Cost of the intervention not included.

Total drug costs for managing outpatient illness in those aged <5 years

IMCI guidelines (Bangladesh)

Cost of treatment reduced by 34%. Cost of the intervention not included.

Total drug costs for managing outpatient illness in those aged <5 years.