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In-hospital drug-use optimization using the marginal utility theory

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dc.contributor.author Zgheib, Philippe W.
dc.contributor.author Zgheib, Nathalie K.
dc.contributor.author Cecchetti, Alfred A.
dc.contributor.author Parmanto, Bambang
dc.contributor.author Ahmad, Sjarif
dc.contributor.author Branch, Robert A.
dc.date.accessioned 2015-11-02T08:44:19Z
dc.date.available 2015-11-02T08:44:19Z
dc.date.copyright 2011
dc.date.issued 2015-11-02
dc.identifier.issn 1759-8885 en_US
dc.identifier.uri http://hdl.handle.net/10725/2414
dc.description.abstract Objective To use cost-utility analysis as an application of the Marginal Utility Theory whereby optimal drug use in terms of optimal drug cost and volume is estimated based on the diminishing marginal utility conditions. Methods Data were collected between 2003 and 2005 from the billing system of two large hospitals that belong to the University of Pittsburgh Medical Center. Domains of interest were stored and correlated in a multidimensional, highly structured Drug Use and Management System (DRUMS) developed by the Center for Clinical Pharmacology at the University of Pittsburgh. Optimal in-hospital drug use is achieved when there are equal marginal rates of substitution between in-hospital drug use and therapeutic outcome subject to diminishing marginal utility conditions. Key findings Patient disposition after hospitalization and length of stay appeared to be reliable indicators of patient therapeutic outcome. Drug cost and volume were over-extended in patients with a length of stay exceeding 20 days and disposition into long-term care, implying over-utilization and/or over-prescribing of drugs. All categories of length of stay and disposition were investigated; they each present a different potential for cost-utility optimization. Conclusion We recommend that entrepreneurial hospital strategists adopt knowledge systems such as DRUMS to analyse aggregate data, and use cost utility as a tool for aggregate in-hospital drug use analyses. en_US
dc.language.iso en en_US
dc.title In-hospital drug-use optimization using the marginal utility theory en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOB en_US
dc.author.idnumber 201200959 en_US
dc.author.woa N/A en_US
dc.author.department Department of Management Studies (MNGT) en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of Pharmaceutical Health Services Research en_US
dc.journal.volume 2 en_US
dc.article.pages 89–95 en_US
dc.keywords Cost utility en_US
dc.keywords Drug use en_US
dc.keywords Length of stay en_US
dc.keywords Optimization en_US
dc.keywords Patient disposition en_US
dc.keywords Therapeutic outcome en_US
dc.identifier.doi http://dx.doi.org/10.1111/j.1759-8893.2011.00039.x en_US
dc.identifier.ctation Zgheib, P. W., Zgheib, N. K., Cecchetti, A. A., Parmanto, B., Ahmad, S., & Branch, R. A. (2011). In‐hospital drug‐use optimization using the Marginal Utility Theory. Journal of Pharmaceutical Health Services Research, 2(2), 89-95. en_US
dc.author.email philippe.zgheib@lau.edu.lb
dc.identifier.url http://onlinelibrary.wiley.com/doi/10.1111/j.1759-8893.2011.00039.x/full


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