Impact of group purchasing in cooperative of hospital in Colombia, using a price index from 1999 to 2012
The application of price indices is useful to analyze the behavior of prices as an important component in patients' access to essential medications over a period of time. The present work analyzed the variation in the prices of 303 medications sold by a cooperative of hospitals in central Colombia between 1999 and 2010 by applying inflation-adjusted price indices and Laspeyres-Paasche quantities by ABC groups and principal therapeuticals in the first and second ATC (anatomic, therapeutical, chemical) level, taking 1999 as the starting year. The medications of type A and B, as well as those belonging to the first four therapeutical groups in the first ATC level in cost and for seven groups in the second ATC level, registered a drop between 40 and 53% (P < 0.05) in the applied price indices. In addition, all the ABC and ATC groups showed increases between 9 and 12 times (P < 0.01) when applying the indices on units sold. The estimated net saving in 2010 at prices of 1999, went above $ 16.9 billion COP. This impact on prices has helped to expand the coverage in essential medications supplied to the public hospitals which are afterwards administered to the patients of this region of Colombia.
The role of prices in drug expenditure analysis
The objective of this article is to develop and apply several types of price indexes to the analysis of pharmaceutical expenditure to improve the way traditional indexes adjust for innovation in drug supply. The Laspeyres and Paasche indexes in the fixed and linked modalities were used. Price is defined as average expenditure at consumer price per daily defined dose (DDD). The empirical application is restricted to two therapeutic groups, antipsychotics and antidepressants, and to the pharmaceutical expenditure of the Catalan Health Service in the period 1991–1999. The indexes can be computed from the information currently recorded in the administrative procedures of health care insurers, or from sample information provided by regular market surveys. The proposed method allows for controlling the effect of several factors on average pharmaceutical price changes, specifically, the introduction of new drugs that show some degree of therapeutic innovation.ResumenEl objetivo de este trabajo es desarrollar índices de precios de medicamentos que permitan separar el efecto de distintos factores, especialmente la comercialización de nuevos medicamentos que suponen distintos grados de innovación terapéutica, sobre los incrementos de precios y sobre el gasto. Se han utilizado los índices de Laspeyres y de Paasche en sus versiones fija y encadenada, tomando como precio el gasto medio a PVP (Precio de Venta al Público) por DDD (Dosis Diaria Definida). La aplicación empírica se circunscribe a dos grupos terapéuticos, antipsicóticos y antidepresivos, y al ámbito de la prestación farmacéutica del Servei Català de la Salut en el periodo 1991–1999. Esta metodología puede ser aplicada de forma rutinaria y automática a cualquier grupo terapéutico o a la totalidad de los mismos, utilizando la información que recogen habitualmente las administraciones sanitarias en el proceso de facturación de los medicamentos o la información muestral sobre consumo y gasto de algunos estudios de mercado.
Hedy: A Gradual Language for Programming Education
One of the aspects of programming that learners often struggle with is the syntax of programming languages: remembering the right commands to use and combining those into a working program. Prior research demonstrated that students submit source code with syntax errors in 73% of cases and even the best students do so in 50% of cases. An analysis of 37 million compilations by 250.000 students found that the most common error was a syntax error, which occurred in almost 800.000 compilations. It was also found that Java and Perl are not easier to understand than a programming language with randomly generated keywords, stressing the difficulties that novices face in understanding syntax. This paper presents Hedy: a new way of teaching the syntax of a programming language to novices, inspired by educational methods by which punctuation is taught to children. Hedy starts as a simple programming language without any syntactic elements such as brackets, colons or indentation. The rules slowly and gradually change until the novices are programming in Python. Hedy is evaluated on 9714 programs.