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Energy Losses in Transformers01:21

Energy Losses in Transformers

In an ideal transformer, it is assumed that there are no energy losses, and, hence, all the power at the primary winding is transferred to the secondary winding. However, in reality,  the transformers always have some energy losses, and, hence, the output power obtained at the secondary winding is less than the input power at the primary winding due to energy losses.
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A Prospective Multicenter Analysis of Mobile Stroke Unit Cost-Effectiveness.

Suja S Rajan1, Jose-Miguel Yamal2, Mengxi Wang2

  • 1Department of Management, Policy and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX.

Annals of Neurology
|December 3, 2024
PubMed
Summary

Mobile stroke units (MSUs) show borderline cost-effectiveness for all ischemic stroke patients initially. However, MSUs become highly cost-effective for patients without prior disability, considering lifetime costs and stroke-related expenses.

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Area of Science:

  • Neurology
  • Health Economics
  • Emergency Medical Services

Background:

  • Ischemic stroke presents a significant disease and financial burden.
  • Timely administration of thrombolytics is crucial for effective stroke management.
  • Evaluating novel approaches like Mobile Stroke Units (MSUs) for stroke treatment is critical.

Purpose of the Study:

  • To evaluate the cost-effectiveness of Mobile Stroke Units (MSUs) compared to standard Emergency Medical Services (EMS) for expediting tissue plasminogen activator (tPA) administration.
  • To analyze one-year and lifetime cost-effectiveness using the Incremental Cost-Effectiveness Ratio (ICER) method.

Main Methods:

  • A prospective, multicenter, alternating-week, cluster-controlled trial comparing MSU and EMS.
  • Quality-adjusted life years (QALYs) estimated via EQ-5D-5L data served as the primary effectiveness measure.
  • Cost analysis based on Medicare reimbursements, including calculations excluding pre-existing disability and limited to stroke-related costs.

Main Results:

  • First-year ICERs were $238,873/QALY for all tPA-eligible patients and $61,199/QALY for those without pre-existing disability.
  • Lifetime ICERs were $94,710/QALY for all patients and $31,259/QALY for those without pre-existing disability.
  • ICERs decreased when restricted to stroke-related costs and were influenced by annual patient treatment volume per MSU.

Conclusions:

  • MSUs demonstrate borderline cost-effectiveness for all tPA-eligible patients within the first year, considering total costs.
  • MSUs are cost-effective to highly cost-effective for patients without pre-existing disability, over a lifetime horizon, and when focusing on stroke-related costs.
  • The cost-effectiveness of MSUs is significantly dependent on patient volume and specific cost parameters.