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Comparing costs of home- versus hospital-based treatment of infections in adults in a specialist cystic fibrosis center
Objectives: This study aimed to produce valid patient-based UK National Health Service (NHS) costs for adults with cystic fibrosis to identify differences between hospital- and home-based treatments for infections. Methods: A costing study was carried out in adults with cystic fibrosis (CF) in the United Kingdom, who required intravenous antibiotic treatments for respiratory infections, administered either at home or in the hospital. The perspective was that of the NHS hospital trust. Data were collected retrospectively for each patient for 1 year using clinical records. Data were collected for 116 adults with CF between 2000 and 2001, when 42,382 treatment days (454 courses) of intravenous antibiotics were administered; 213 courses with intention-to-treat at home and 241 courses with intention-to-treat in the hospital. The mean length of a course was 15.3 days. Results: Patients who had >60 percent of courses at home over 1 year had a mean cost of £13,528, compared with £22,609 for patients who had >60 percent of courses in the hospital, and a mean cost of £19,927 for patients who had an equal mix of home and hospital care (p = .0001). Conclusions: The key cost-generating events in CF respiratory infections are hospital admissions. Future studies assessing costs should concentrate on factors affecting admissions, length of stay, staff input, and alternative methods of home-care provision, rather than marginal effects, such as using different antibiotics.
Journal Article
Succeed in your medical school interview : stand out from the crowd and get into your chosen medical school
\"After completing the medical school application comes the last and often most challenging aspect of the school selection process: the interview. Notoriously hard to prepare for, it's difficult to know what questions might be asked and how to answer them.Extensively revised, How to Succeed In Your Medical School Interview de-mystifies the interview process. It provides a systematic and methodical process which enables the interviewee to mine information from examiners, while demonstrating academic ability. Full of practice questions and free downloadable podcasts of mock interviews, this book offers tips on preparation, presentation, and most importantly, what to say. The most significant addition to the book covers the multiple mini-interview system, which schools are beginning to use instead of the formal, fixed panel interview. This new system is made up of short \"stations\" ranging from 3-10 minutes, with a specific goal and a separate interviewer. The format can be a conventional interview question, a role play, linguistic skill test, writing exercise, or another challenge. The author has also added more graph-and-table data interpretation questions to the Oxbridge interview section and updated discussion material to include the current \"hot topics\" in medicine, such as e-cigarettes, medical ethics, and the US patent ban on genes. \"-- Provided by publisher.
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