Browsing by Subject "kustannus"
Now showing items 1-5 of 5
-
(2017)The economic burden of adverse events (AEs) is substantial and in direct relation to current increasing drug utilisation. According to previous research, the annual cost of AEs in the U.S. may be as high as 22.9 billion euros. In Europe AEs are considered to contribute to 3.6 percent of hospital admissions, have an impact on 10 percent of inpatients during their hospital admission and are responsible for less than 0.5 percent of inpatient deaths. AEs thus clearly constitute a major clinical issue. Fluoroquinolones have been in clinical use since the 1980s and are globally among the most consumed antimicrobials. Fluoroquinolones are generally well tolerated antimicrobials. The most common AEs are mild and reversible, such as diarrhea, nausea and headaches. Nevertheless, fluoroquinolones are also associated with more serious AEs, including Clostridium difficile associated diarrhea (CDAD), rate-corrected electrocardiographic prolonged QT interval, tendinitis and tendon rupture, dysglycemia, hepatic toxicity, phototoxicity, acute renal failure and serious AEs involving the central nervous system, such as seizures. Health service use and costs specifically associated with fluoroquinolone-related AEs have not been evaluated previously. The theory section of this Marter's thesis considers adverse events and fluoroquinolones. The main principles of conducting a systematic review are also discussed. The empirical section is a systematic review. The aim of this study is to identify health care use and costs associated with ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin and ofloxacin -related AEs. A literature search covering Medline, SCOPUS, Cinahl, Web of Science and Cochrane Library was performed in April 2017. Two independent reviewers systematically extracted the data and assessed the quality of the included studies. All costs were converted to 2016 euro in order to improve comparability. Of the 5,687 references found in the literature search, 19 observational studies, of which 5 were case-controlled, fulfilled the inclusion criteria. Hospitalization was an AE-related health care use outcome in 17 studies. Length of stay associated with AEs varied between <5 - 45 days. The estimated cost of an AE episode ranged between 140 and 18,252 €. CDAD was associated with the longest stays in hospital. However, a mere 10 studies reported AE-related length of stays and only 5 evaluated costs associated with AEs. Although rare, in particular serious fluoroquinolone-related AEs can have substantial economic implications, in addition to imposing potentially devastating health complications for patients. Further measures are required to prevent and reduce health service use and costs associated with fluoroquinolone-related AEs. Equally, better-quality reporting and additional published data on health service use and costs associated with AEs are essential. The strengths of this study are a comprehensive and systematic literature search and transparency of methodologies and reporting. The main weakness is the generalizability of the results.
-
(2021)The Finnish medicine reimbursement system is complex and several different conditions required by the Health Insurance Act (1224/2004) and the Social Insurance Institution of Finland (Kela) must be met in order to receive medicine reimbursement. The understanding of medicine reimbursement criteria from the perspective of medicine users has not been studied in Finland before, and little research has been done on the subject internationally. Medicine user-oriented research on the medicine reimbursement system, both in Finland and internationally, has largely focused on the financial opportunities of medicine users to purchase medicines and their opinions on the fairness of medicine reimbursements. The aim of this study was to obtain information on the understanding of medicine reimbursement criteria and the background factors affecting it, the implementation of price, generic substitution and medicine reimbursement counselling in pharmacies, seeking advice on medicine reimbursement, and the financial difficulties of buying prescription medicines. The material used in this study was from the population survey (n=1650), which examined the activation of price competition for pharmaceutical products and customers' expectations of pharmacy operations. The understanding of medicine reimbursement criteria, the price counselling provided in a pharmacy, the effect of financial challenges on the non-buying of medicines and the use of sources of advice related to the medicine reimbursement were described as frequency distributions. The effect of background factors on the understanding of medicine reimbursement criteria was compared using the chi-square test and logistic regression analysis. About a third (31%) of respondents told that they do not understand the basis on which medicine reimbursement is usually received for prescription medicines, and 13% had unclear why they had not been reimbursed for their prescription medicine in the past year. Especially younger age, low income, low medication use, depression and other mental health problems, lack of long-term illness, and insufficient medicine reimbursement counselling in a pharmacy were found to be associated with poorer understanding of medicine reimbursement. 72% of the participants in the study felt that they usually receive sufficient information about the prices of medicines and 61% about the reimbursement of medicines when buying prescription medicines from a pharmacy. Less than half (47%) of respondents felt that they have usually received sufficient information about how the amount of reimbursement for medicines is determined. Slightly over 70% of respondents said that they are usually told about the cheapest medicine available when buying a prescription medicine and/or are suggested to switch to a cheaper one. About 60% were usually told about the difference between the two interchangeable medicines. 88% of respondents would seek information about medicine reimbursement primarily from a pharmacy or pharmacy´s online services. About 3% of all respondents in the study had not bought a medicine prescribed by a doctor for financial reasons in the last six months. Based on the study, about a third of medicine users have remained unclear regarding medicine reimbursements, and not everyone feels that they have received sufficient counselling and information about medicine prices and medicine reimbursements when buying prescription medicines from a pharmacy. Counselling from a pharmacy was found to be related to understanding of medicine reimbursement criteria. Advise on the pricing, medicine reimbursement and generic substitution should continue to be actively provided to medicine users, so that the counselling meets the requirements of the law and the knowledge of the reimbursement system of medicine users can be improved. Based on the results of this study, counselling should be targeted in particular at younger, low-income and from mental health problems suffering medicine users, as well as those who are less familiar with reimbursement issues, for example due to low morbidity or medicine use.
-
(2015)New primary tillage methods have appeared alongside traditional ploughing. Objectives of primary tillage can nowadays be achieved with other methods such as by exploiting nature’s own processes or with chemical weed control. The endeavor of farmers to save time and money has caused conservation tillage to become more common. Different methods of conservation tillage and no-tillage has been replacing traditional ploughing. Conservation tillage has had various kinds of effects to achieved yields. Some international studies reported that conservation tillage had reduced yields. On the other hand, the rest of the studies point out that either the yield remained at the same level or at times, yield levels rose with reduced tillage. The aim of this study was to determine the profitability of different tillage methods. The profitability of three different primary tillage methods were compared at three farm sizes (50, 100 and 200 ha). Retail prices of farming machinery and Luke’s on-going field experiments on clay soil in Jokioinen were drawn on for data used in this study. Luke has been running no-tillage field experiments in Jokioinen since 2000. Yield data of spring barley from Jokioinen field experiment was used in this study. No-tillage was the most profitable tillage method on every farm size. The costs of no-tillage was 145?279 €/hectare lower than the costs with ploughing and 111?234 €/hectare lower than the costs with cultivation. The surplus of no-tillage was 93–226 €/hectare greater than surplus with ploughing and 69?192 €/hectare bigger than the surplus achieved with cultivation as a primary tillage. The profitability of cultivation was 16–34 €/hectare bigger than the surplus acquired through ploughing. No-tillage was more economically beneficial on a field which had less clay in its texture. The no-tillage’s surplus was 183?317 €/hectare bigger than the ploughing’s surplus and it was 161?284 €/hectare bigger than the cultivation’s surplus. Fields of similar size were used when analyzing the difference of profitability between ploughing and cultivation. This study asserts that the profitability of primary tillage method depends on machinery, weather conditions, soil type and the size of the farm. In this study, no-tillage was more profitable even though the yields produced were less than with traditional primary tillage. The profitability of the different primary tillage methods varied erratically between farms and for this reason, an unambiguous answer for profitability cannot be given.
-
(2023)Maatalousinvestointien hinnankorotuksilla on olennainen merkitys myös maahantuojayrityksen toimintaan. Osa hinnannousuista johtuu panoskustannusten kasvusta, mutta toisaalta myös yhä kehittyvästä teknologiasta. Maatalouskoneiden merkittävä teknologinen muutos lisää myös riskejä koneiden vikaantumisesta koneiden takuun voimassaollessa. Tutkimus on tehty tapaustutkimuksena tilaajayritykselle ja sen tarkoituksena on esitellä takuuta käsitteenä sekä sen taloudellista merkitystä sekä takuuprosessia yleisesti osana yrityksen strategiaa ja erityisesti sen tavoitteena on tarjota työn tilaajalle optimaaliset toimintaedellytykset takuukäsittelyä ja takuuprosessin hallintaa varten. Työssä pyritään tunnistamaan yrityksen prosesseissa olevia ongelmia ja esittää niille ratkaisuja, jotta tilaajayritys voi toimia edelleen tehokkaammin jälkimarkkinaympäristössä. On havaittavissa, että maatalouskoneiden takuun merkitys osana yrityksen markkinointistrategiaa on kasvanut merkittävästi. Tuotteiden erojen ollessa pieniä voidaan todeta, että takuu sekä jälkimarkkinan toimivuus on yksi ostopäätökseen vaikuttavista avaintekijöistä. Kun aiemmin takuujohtamista ja hallinnointia on ajateltu vain hallinnollisena työnä ja pakollisena osana toimintaa, on siitä viime vuosina tullut yhä kiinteämpi osa yritysten strategiaa. Tutkimuksen tulokset osoittavat tilaajayrityksen prosessissa olevan ongelmia, jotka aiheutuvat yrityksen sisäisistä sekä ulkoisista prosesseista. Taloudellisesta näkökulmasta katsoen merkittävin riski prosessissa on puutteellinen informaation kulku sekä henkilöstön puutteellinen osaaminen liittyen takuutapauksiin. Vastaavia puutteita havaittiin myös tilaajayrityksen sekä kolmansien osapuolten välillä. Tutkimuksen tuloksena pystyttiin luomaan yritykselle tehokkaampia toimintamalleja takuutapausten hoitoa varten esittämällä muutoksia yrityksen sisäisiin sekä ulkoisiin prosesseihin. Muutoksilla yritys pystyy pienentämään takuisiin liittyvää taloudellista riskiään tehokkaammin ja näin parantamaan osittain myös muiden osa-alueidensa toimintaa.
-
(2023)Maatalousinvestointien hinnankorotuksilla on olennainen merkitys myös maahantuojayrityksen toimintaan. Osa hinnannousuista johtuu panoskustannusten kasvusta, mutta toisaalta myös yhä kehittyvästä teknologiasta. Maatalouskoneiden merkittävä teknologinen muutos lisää myös riskejä koneiden vikaantumisesta koneiden takuun voimassaollessa. Tutkimus on tehty tapaustutkimuksena tilaajayritykselle ja sen tarkoituksena on esitellä takuuta käsitteenä sekä sen taloudellista merkitystä sekä takuuprosessia yleisesti osana yrityksen strategiaa ja erityisesti sen tavoitteena on tarjota työn tilaajalle optimaaliset toimintaedellytykset takuukäsittelyä ja takuuprosessin hallintaa varten. Työssä pyritään tunnistamaan yrityksen prosesseissa olevia ongelmia ja esittää niille ratkaisuja, jotta tilaajayritys voi toimia edelleen tehokkaammin jälkimarkkinaympäristössä. On havaittavissa, että maatalouskoneiden takuun merkitys osana yrityksen markkinointistrategiaa on kasvanut merkittävästi. Tuotteiden erojen ollessa pieniä voidaan todeta, että takuu sekä jälkimarkkinan toimivuus on yksi ostopäätökseen vaikuttavista avaintekijöistä. Kun aiemmin takuujohtamista ja hallinnointia on ajateltu vain hallinnollisena työnä ja pakollisena osana toimintaa, on siitä viime vuosina tullut yhä kiinteämpi osa yritysten strategiaa. Tutkimuksen tulokset osoittavat tilaajayrityksen prosessissa olevan ongelmia, jotka aiheutuvat yrityksen sisäisistä sekä ulkoisista prosesseista. Taloudellisesta näkökulmasta katsoen merkittävin riski prosessissa on puutteellinen informaation kulku sekä henkilöstön puutteellinen osaaminen liittyen takuutapauksiin. Vastaavia puutteita havaittiin myös tilaajayrityksen sekä kolmansien osapuolten välillä. Tutkimuksen tuloksena pystyttiin luomaan yritykselle tehokkaampia toimintamalleja takuutapausten hoitoa varten esittämällä muutoksia yrityksen sisäisiin sekä ulkoisiin prosesseihin. Muutoksilla yritys pystyy pienentämään takuisiin liittyvää taloudellista riskiään tehokkaammin ja näin parantamaan osittain myös muiden osa-alueidensa toimintaa.
Now showing items 1-5 of 5