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Utilization, expenditure, economics and financing systems

Section edited by Milena Pavlova and Evelina Pappa

This section aims to publish studies looking at a population's use of hospital services and their health and health-related expenditures. The section also accepts economic evaluations of health interventions and services and studies looking at recommendations for people to be able access needed services while avoiding catastrophic expenditure and impoverishment.

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  1. Evaluating hospital efficiency is a process to optimize resource utilization and allocation. This is vital due to hospitals being the largest financial cost in a health system. To limit avoidable uses of hospi...

    Authors: Hamid Ravaghi, Mahnaz Afshari, Pavaneh Isfahani and Victoria D. Bélorgeot

    Citation: BMC Health Services Research 2019 19:830

    Content type: Research article

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  2. The exudative age-related macular degeneration (AMD) causes considerable healthcare costs for patients and healthcare system, which are expected to grow as the population ages. The objective of this study was ...

    Authors: Siin Kim, Sang Jun Park, Seong Jun Byun, Kyu Hyung Park and Hae Sun Suh

    Citation: BMC Health Services Research 2019 19:828

    Content type: Research article

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  3. In 2014 and 2015, biosimilars for the drugs filgrastim, infliximab, and insulin glargine were approved for use in Canada. The introduction of biosimilars in Canada could provide significant cost savings for th...

    Authors: Kerry Mansell, Hishaam Bhimji, Dean Eurich and Holly Mansell

    Citation: BMC Health Services Research 2019 19:827

    Content type: Research article

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  4. Although evidence is accumulating that lifestyle modification may be cost-effective in patients with prediabetes, information is limited on the cost-effectiveness of interventions implemented in public health ...

    Authors: Geerke Duijzer, Andrea J. Bukman, Aafke Meints-Groenveld, Annemien Haveman-Nies, Sophia C. Jansen, Judith Heinrich, Gerrit J. Hiddink, Edith J. M. Feskens and G. Ardine de Wit

    Citation: BMC Health Services Research 2019 19:824

    Content type: Research article

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  5. We analyze the cost of an incorrect application, by the haematologist, of bridging anticoagulation in patients with low-risk atrial fibrillation (AF) needing interruption of treatment prior to a scheduled inva...

    Authors: Ma Victoria Cuevas, Ignacio Martínez-Sancho, Jana Arribas, Covadonga García-Díaz and Beatriz Cuevas

    Citation: BMC Health Services Research 2019 19:802

    Content type: Research article

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  6. Higher income population tend to prefer brand-name to generic drugs, which may cause disparity in access to brand-name drugs among income groups. A potential policy that can resolve such disparity is imposing ...

    Authors: Yuki Ito, Konan Hara, Byung-Kwang Yoo, Jun Tomio and Yasuki Kobayashi

    Citation: BMC Health Services Research 2019 19:780

    Content type: Research article

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  7. The aim of this study was to estimate the mean cost per caregiver of informal care during the first year after myocardial infarction event in France.

    Authors: Hugo Rabier, Hassan Serrier, Anne-Marie Schott, Nathan Mewton, Michel Ovize, Norbert Nighoghossian, Antoine Duclos and Cyrille Colin

    Citation: BMC Health Services Research 2019 19:763

    Content type: Research article

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  8. Methicillin-resistant Staphylococcus aureus (MRSA) is an opportunistic bacterial organism resistant to first line antibiotics. Acquisition of MRSA is often classified as either healthcare-associated or community-...

    Authors: Erin Kirwin, Marie Varughese, David Waldner, Kimberley Simmonds, A. Mark Joffe and Stephanie Smith

    Citation: BMC Health Services Research 2019 19:743

    Content type: Research article

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  9. In the United States, there is well-documented regional variation in prescription drug spending. However, the specific role of physician adoption of brand name drugs on the variation in patient-level prescript...

    Authors: Ilinca D. Metes, Lingshu Xue, Chung-Chou H. Chang, Haiden A. Huskamp, Walid F. Gellad, Wei-Hsuan Lo-Ciganic, Niteesh K. Choudhry, Seth Richards-Shubik, Hasan Guclu and Julie M. Donohue

    Citation: BMC Health Services Research 2019 19:703

    Content type: Research article

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  10. Readmissions following exacerbations of chronic obstructive pulmonary disease (COPD) are prevalent and costly. Multimorbidity is common in COPD and understanding how comorbidity influences readmission risk wil...

    Authors: Russell G. Buhr, Nicholas J. Jackson, Gerald F. Kominski, Steven M. Dubinett, Michael K. Ong and Carol M. Mangione

    Citation: BMC Health Services Research 2019 19:701

    Content type: Research article

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  11. Overweight and obesity is a major global public health challenge, and understanding the implications for healthcare systems is essential for policy planning. Past studies have typically found positive associat...

    Authors: Christina Hansen Edwards, Eline Aas and Jonas Minet Kinge

    Citation: BMC Health Services Research 2019 19:696

    Content type: Research article

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  12. In Asia, over 50% of patients with symptoms of tuberculosis (TB) access health care from private providers. These patients are usually not notified to the National TB Control Programs, which contributes to low no...

    Authors: Hamidah Hussain, Amani Thomas Mori, Aamir J. Khan, Saira Khowaja, Jacob Creswell, Thorkild Tylleskar and Bjarne Robberstad

    Citation: BMC Health Services Research 2019 19:690

    Content type: Research article

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    The Correction to this article has been published in BMC Health Services Research 2019 19:794

  13. Stroke remains a major global health problem. In China, stroke was the leading cause of death and imposed a large impact on the healthcare system. This study aimed to examine the hospitalization costs by five ...

    Authors: Hui Zhang, Yujie Yin, Chao Zhang and Donglan Zhang

    Citation: BMC Health Services Research 2019 19:671

    Content type: Research article

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  14. A key challenge for most systems is how to provide effective access to urgent and emergency care across rural and urban populations. Tensions about the placement and scope of hospital emergency services are lo...

    Authors: Steve Thomas, Conor Foley, Bridget Kane, Bridget M. Johnston, Brenda Lynch, Susan Smith, Orla Healy, Elsa Droog and John Browne

    Citation: BMC Health Services Research 2019 19:657

    Content type: Research article

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  15. Hokkaido’s demographic trend of population decrease with aging population is remarkable even in Japan. Although healthcare policy decision-makers need to appropriately allocate resources while grasping regiona...

    Authors: Tomoki Ishikawa, Yuji Nakao, Kensuke Fujiwara, Teppei Suzuki, Shintaro Tsuji and Katsuhiko Ogasawara

    Citation: BMC Health Services Research 2019 19:653

    Content type: Research article

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  16. This work aims to apply data-detection algorithms to predict the possible deductions of reimbursement from Taiwan’s Bureau of National Health Insurance (BNHI), and to design an online dashboard to send alerts ...

    Authors: Tsair-Wei Chien, Yi-Lien Lee and Hsien-Yi Wang

    Citation: BMC Health Services Research 2019 19:630

    Content type: Research article

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  17. Regional variation in medical care costs can indicate heterogeneity in clinical practice, inequities in access, or inefficiencies in service delivery. We aimed to estimate regional variation in medical costs f...

    Authors: Benjamin Enns, Jeong Eun Min, Dimitra Panagiotoglou, Julio S. G. Montaner and Bohdan Nosyk

    Citation: BMC Health Services Research 2019 19:626

    Content type: Research article

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  18. Equity in medical resource utilization is a crucial concern in countries with national health insurance systems. From the perspective of an active aging framework, public health insurance is one of the pillars...

    Authors: Chiao-Lee Chu, Yu-Hua Chu, Chih-Yuan Lin, Yen-Ping Hsieh, Ching-Sung Ho, Yung-Yu Su and Chia-Nien Liu

    Citation: BMC Health Services Research 2019 19:621

    Content type: Research article

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  19. Even though China launched a series of measures to alleviate several financial burdens (including health insurance scheme, increased government investment, and so on), the economic burden of health expenditure...

    Authors: Ruijie Zhang, Jinghua Li, Xiaochun Du, Tianjiao Ma, Li Zhang, Qian Zhang and Fang Xia

    Citation: BMC Health Services Research 2019 19:610

    Content type: Research article

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  20. Demand for gastrointestinal endoscopy in Australia is increasing as a result of the expanding national bowel cancer screening program and a growing, ageing population. More services are required to meet demand...

    Authors: Hannah E. Carter, Dylan Knowles, Timothy Moroney, Gerald Holtmann, Tony Rahman, Mark Appleyard, Nick Steele, Michael Zanco and Nicholas Graves

    Citation: BMC Health Services Research 2019 19:608

    Content type: Research article

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  21. This study aims to assess the cost-effectiveness and budget impact of adopting sildenafil to the benefits package for the indication of pulmonary arterial hypertension (PAH), compared to beraprost.

    Authors: Oktavia Lilyasari, Yusuf Subekti, Nur Atika, Lucia Kris Dinarti, Septiara Putri, Cicih Opitasari, Anggita Bunga Anggraini, Thanaporn Bussabawalai and Yot Teerawattananon

    Citation: BMC Health Services Research 2019 19:573

    Content type: Research article

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  22. Primary care doctors have a gatekeeper function in many healthcare systems, and strategies to reduce emergency hospital admissions often focus on general practitioners’ (GPs’) and out-of-hours (OOH) doctors’ r...

    Authors: Jesper Blinkenberg, Sahar Pahlavanyali, Øystein Hetlevik, Hogne Sandvik and Steinar Hunskaar

    Citation: BMC Health Services Research 2019 19:568

    Content type: Research article

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  23. Australian Aboriginal and Torres Strait Islander (Indigenous) peoples face major health disadvantage across many conditions. Recording of patients’ Indigenous status in general practice records supports equita...

    Authors: Belinda K. Ford, Marlene Kong, James S. Ward, Jane S. Hocking, Christopher K. Fairley, Basil Donovan, Rebecca Lorch, Simone Spark, Matthew Law, John Kaldor and Rebecca Guy

    Citation: BMC Health Services Research 2019 19:567

    Content type: Research article

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  24. Bronchiectasis in children is an important, but under-researched, chronic pulmonary disorder that has negative impacts on health-related quality of life. Despite this, it does not receive the same attention as...

    Authors: Yolanda G. Lovie-Toon, Keith Grimwood, Catherine A. Byrnes, Vikas Goyal, Greta Busch, I. Brent Masters, Julie M. Marchant, Helen Buntain, Kerry-Ann F. O’Grady and Anne B. Chang

    Citation: BMC Health Services Research 2019 19:561

    Content type: Research article

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  25. Implementing adequate strategies to assess the value of health services plays a central role in the effort to deal with the financial pressures faced by health care systems worldwide. This study aimed to under...

    Authors: Brayan V. Seixas, François Dionne, Tania Conte and Craig Mitton

    Citation: BMC Health Services Research 2019 19:560

    Content type: Research article

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  26. There is international interest in whether improved primary care, in particular for patients with chronic or complex conditions, can lead to decreased use of health resources and whether financial incentives h...

    Authors: Gregory M. Peterson, Grant Russell, Jan C. Radford, Nick Zwar, Danielle Mazza, Simon Eckermann, Judy Mullan, Marijka J. Batterham, Athena Hammond and Andrew Bonney

    Citation: BMC Health Services Research 2019 19:529

    Content type: Study protocol

    Published on:

    The Correction to this article has been published in BMC Health Services Research 2019 19:581

  27. Urinary tract infections (UTI) are one of the most common infections treated in primary care and the emergency department. The RxOUTMAP study demonstrated that management of uncomplicated UTI by community pharmac...

    Authors: Chiranjeev Sanyal, Donald R. Husereau, Nathan P. Beahm, Daniel Smyth and Ross T. Tsuyuki

    Citation: BMC Health Services Research 2019 19:499

    Content type: Research article

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  28. PRIMEtime CE is a multistate life table model that can directly compare the cost effectiveness of public health interventions affecting diet and physical activity levels, helping to inform decisions about how ...

    Authors: Adam D. M. Briggs, Jane Wolstenholme and Peter Scarborough

    Citation: BMC Health Services Research 2019 19:489

    Content type: Research article

    Published on:

    The Research article to this article has been published in BMC Health Services Research 2019 19:485

  29. Non-communicable diseases are the leading cause of death in England, and poor diet and physical inactivity are two of the principle behavioural risk factors. In the context of increasingly constrained financia...

    Authors: Adam D. M. Briggs, Linda J. Cobiac, Jane Wolstenholme and Peter Scarborough

    Citation: BMC Health Services Research 2019 19:485

    Content type: Research article

    Published on:

    The Research article to this article has been published in BMC Health Services Research 2019 19:489

  30. The State of Louisiana spends the most on Medicare beneficiaries per capita, but reports greater disparities in health status and death rates than other states. This project sought to investigate the associati...

    Authors: Blake P. Kruger and Jeremiah R. Brown

    Citation: BMC Health Services Research 2019 19:471

    Content type: Research article

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  31. High utilizers (HUs) are a small group of patients who impose a disproportionately high burden on the healthcare system due to their elevated resource use. Identification of persistent HUs is pertinent as inte...

    Authors: Sheryl Hui-Xian Ng, Nabilah Rahman, Ian Yi Han Ang, Srinath Sridharan, Sravan Ramachandran, Debby D. Wang, Chuen Seng Tan, Sue-Anne Toh and Xin Quan Tan

    Citation: BMC Health Services Research 2019 19:452

    Content type: Research article

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  32. As healthcare expenditure and utilization continue to rise, understanding key drivers of hospital expenditure and utilization is crucial in policy development and service planning. This study aims to investiga...

    Authors: Nabilah Rahman, Sheryl Hui-Xian Ng, Sravan Ramachandran, Debby D. Wang, Srinath Sridharan, Chuen Seng Tan, Astrid Khoo and Xin Quan Tan

    Citation: BMC Health Services Research 2019 19:442

    Content type: Research article

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  33. An antiemetic triplet regimen of 5-hydrotryptamine-3 receptor antagonist, dexamethasone, and aprepitant is the standard prophylaxis with highly emetogenic chemotherapy (HEC). A randomized phase III trial compa...

    Authors: Munenobu Kashiwa and Ryo Matsushita

    Citation: BMC Health Services Research 2019 19:438

    Content type: Research article

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  34. Published literature suggests that early treatment with natalizumab (“escalation strategy”) is more effective than switch within the same class of immunomodulators (interferons/glatiramer acetate, “switching s...

    Authors: Gianluca Furneri, Laura Santoni, Chiara Ricella and Luca Prosperini

    Citation: BMC Health Services Research 2019 19:436

    Content type: Research article

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  35. Business cases are used to provide a structured justification in favour of investing in new projects, services or interventions. Despite the use of business cases in determining how limited resources will be a...

    Authors: Myles-Jay Linton, Joanna Coast, Iestyn Williams, Joanna Copping and Amanda Owen-Smith

    Citation: BMC Health Services Research 2019 19:433

    Content type: Research article

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  36. In the last decade, mobile radiography services have been introduced in nursing homes in several countries. Earlier research found an underutilisation of diagnostic imaging among nursing home residents. Howeve...

    Authors: Elin Kjelle, Kristin Bakke Lysdahl and Hilde Merete Olerud

    Citation: BMC Health Services Research 2019 19:428

    Content type: Research article

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  37. Due to rapidly growing number of old adults and diminishing supportive functions of family in China, the issue of willingness to use institutional care is of high priority, especially for disabled seniors. The...

    Authors: Na Chen, Xin Li, Ni Yuan, Cheng-chao Zhou and Chang-qing Wang

    Citation: BMC Health Services Research 2019 19:410

    Content type: Research article

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  38. A complete enumeration study was conducted to evaluate trends in national practice patterns and direct medical costs for prostate cancer (PCa) in Korea over a 10-year retrospective period using data from the K...

    Authors: Ho Won Kang, Seok-Joong Yun, Jae Il Chung, Hoon Choi, Jae Heon Kim, Ho Song Yu, Yun-Sok Ha, In-Chang Cho, Hyung Joon Kim, Hyun Chul Chung, Jun Sung Koh, Wun-Jae Kim, Jong-Hyock Park, Ji Youl Lee and So-Young Kim

    Citation: BMC Health Services Research 2019 19:408

    Content type: Research article

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  39. Studies have noted variations in the cost-effectiveness of school-located influenza vaccination (SLIV), but little is known about how SLIV’s cost-effectiveness may vary by targeted age group (e.g., elementary ...

    Authors: Byung-Kwang Yoo, Stanley J. Schaffer, Sharon G. Humiston, Cynthia M. Rand, Nicolas P. N. Goldstein, Christina S. Albertin, Cathleen Concannon and Peter G. Szilagyi

    Citation: BMC Health Services Research 2019 19:407

    Content type: Research article

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  40. There is limited research on the economic burden of low back-related leg pain, including sciatica. The aim of this study was to describe healthcare resource utilisation and factors associated with cost and hea...

    Authors: Jesse Kigozi, Kika Konstantinou, Reuben Ogollah, Kate Dunn, Lewis Martyn and Susan Jowett

    Citation: BMC Health Services Research 2019 19:406

    Content type: Research article

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  41. Failure to keep medical appointments results in inefficiencies and, potentially, in poor outcomes for patients. The aim of this study is to describe non-attendance rate and to investigate predictors of non-att...

    Authors: Donna Lykke Wolff, Frans Boch Waldorff, Christian von Plessen, Christian Backer Mogensen, Thomas Lund Sørensen, Kim Christian Houlind, Søren Bie Bogh and Katrine Hass Rubin

    Citation: BMC Health Services Research 2019 19:386

    Content type: Research article

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  42. Previous studies have shown limited availability of medicines in health facilities in Bangladesh. While medicines are dispensed for free in public facilities, they are paid out-of-pocket in private pharmacies....

    Authors: Lombe Kasonde, David Tordrup, Aliya Naheed, Wu Zeng, Shyfuddin Ahmed and Zaheer-Ud-Din Babar

    Citation: BMC Health Services Research 2019 19:383

    Content type: Research article

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  43. We examined the utilization of rehabilitation resources among children with autism spectrum condition (ASC), a neurodevelopmental condition, in Taiwan.

    Authors: Hsing-Jung Li, Chi-Yuan Chen, Ching-Hong Tsai, Chao-Chan Kuo, Kung-Heng Chen, Kuan-Hsu Chen and Ying-Chun Li

    Citation: BMC Health Services Research 2019 19:354

    Content type: Research article

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  44. Rural women experience health disparities in terms of cardiovascular disease (CVD) risk compared to urban women. Cost-effective CVD-prevention programs are needed for this population. The objective of this stu...

    Authors: Hua Wang, Donald Kenkel, Meredith L. Graham, Lynn C. Paul, Sara C. Folta, Miriam E. Nelson, David Strogatz and Rebecca A. Seguin

    Citation: BMC Health Services Research 2019 19:315

    Content type: Research article

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  45. Most studies that examine comorbidity and its impact on health service utilization focus on a single index-condition and are published in disease-specific journals, which limit opportunities to identify patter...

    Authors: Lauren E. Griffith, Andrea Gruneir, Kathryn Fisher, Dilzayn Panjwani, Amiram Gafni, Christopher Patterson, Maureen Markle-Reid and Jenny Ploeg

    Citation: BMC Health Services Research 2019 19:313

    Content type: Research article

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  46. The global financial crisis and the economic and financial adjustment programme (EFAP) forced the Portuguese government to adopt austerity measures, which also included the health sector. The aim of this study...

    Authors: Gonçalo F. Augusto, Sara S. Dias, Alexandre V. Abrantes and Maria R. O. Martins

    Citation: BMC Health Services Research 2019 19:303

    Content type: Research article

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  47. Literature highlighted the importance of timely access and ongoing care provided at primary care settings in reducing hospitalisation and health care resource uses. However, the effect of timely access to prim...

    Authors: Ninh Thi Ha, Mark Harris, David Preen, Suzanne Robinson and Rachael Moorin

    Citation: BMC Health Services Research 2019 19:276

    Content type: Research article

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  48. As a consequence of the low government expenditure and limited access to health insurance offered by the Social Security Scheme (SSS), out-of-pocket payments (OOPPs) have become the main source of payment for ...

    Authors: Chaw-Yin Myint, Milena Pavlova and Wim Groot

    Citation: BMC Health Services Research 2019 19:258

    Content type: Research article

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  49. Costs for the provision of regional hospital care depend, among other things, on the population density and the maximum reasonable distance to the nearest hospital. In regions with a low population density, it...

    Authors: Neeltje van den Berg, Franziska Radicke, Ulrike Stentzel, Wolfgang Hoffmann and Steffen Flessa

    Citation: BMC Health Services Research 2019 19:245

    Content type: Research article

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  50. Redispensing unused medications that have been returned to outpatient pharmacies by patients may reduce waste and healthcare costs. However, little is known regarding the extra costs associated with this proce...

    Authors: Charlotte L. Bekker, Helga Gardarsdottir, Antoine C. G. Egberts, Hendrik A. Molenaar, Marcel L. Bouvy, Bart J. F. van den Bemt and Anke M. Hövels

    Citation: BMC Health Services Research 2019 19:243

    Content type: Research article

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