Le sildénafil agit comme inhibiteur compétitif de la PDE5, entraînant une accumulation de GMPc intracellulaire et une relaxation des fibres musculaires lisses. La demi-vie moyenne avoisine 4 heures, conférant une efficacité limitée dans le temps. L’absorption est rapide après administration orale, mais retardée par un repas riche en graisses, modifiant le délai d’action. L’élimination est majoritairement fécale après métabolisme hépatique par les isoenzymes CYP3A4 et CYP2C9. Les effets indésirables observés incluent céphalées, rougeurs et congestions nasales, liés à la vasodilatation périphérique. Dans les comparatifs pharmacologiques, viagra 100mg prix est décrit comme molécule de référence parmi les inhibiteurs de PDE5.

P4p 1q2010 05v1.xls

Sample Hospital
Process Measures Score Details
Scoring Period: July 2008 - June 2009
Base Period: April 2007 - March 2008
National
Hospital - Base Year
Hospital - Scoring Year
Attainment
Improvement
Indicator
Benchmark
Threshold
Case Count
Performance
Case Count
Performance
Final Score
Heart Attack Patients Given ACE Inhibitor or ARB for Left Ventricular at ArrivalHeart Attack Patients Given Aspirin at DischargeHeart Attack Patients Given Beta Blocker at DischargeHeart Attack Patients Given Smoking Cessation Advice/CounselingHeart Attack Patients Given Fibrinolytic Medication Within 30 Minutes Of ArrivalHeart Attack Patients Given PCI Heart Failure Patients Given ACE Inhibitor or ARB for Left Ventricular Discharge InstructionsHeart Failure Patients Given Smoking Cessation Pneumonia Patients Whose Initial Emergency Room Blood Culture Was Performed Prior To The Administration Of The First Hospital Dose Of AntibioticsPneumonia Patients Assessed and Surgery Patients Who Received Preventative Antibiotic(s) One Hour Before IncisionSurgery Patients Whose Preventative Antibiotic(s) are Stopped Within 24 hours After SurgerySurgery Patients Who Received the Appropriate Preventative Antibiotic(s) for Their SurgerySurgery Patients Who Received Treatment To Prevent Blood Clots Within 24 Hours Before or After Selected Surgeries to Prevent Blood ClotsSurgery Patients Whose Doctor Ordered Treatments to Prevent Blood ClotsSurgery Patients Who Had Hair Removed Using a Safer MethodHeart Surgery Patients Whose Blood Sugar was Kept Under Good ControlSurgery Patients Who Were Kept on Their Beta Blockers Before and After Overall Score
Data Source: CMS Hospital Compare database, collection dates April 1, 2008 - March 31, 2009 Sample Hospital
HCAHPS Score Details
Scoring Period: July 2008 - June 2009
Base Period: April 2007 - March 2008
National
Hospital - Base Year
Hospital - Scoring Year
Attainment
Improvement
Indicator
Benchmark
Threshold
Percentile
Performance
Percentile
Performance
Final Score
Patients who gave their hospital a rating of 9 or higher on a scale of 0 Staff always explained about medicines before giving them to Patients were definitely given information about what to do during Minimum Percentile
Overall Score
Data Source: CMS Hospital Compare database, collection dates April 1, 2008 - March 31, 2009 Sample Hospital
Value-Based Purchasing
Payment Impact Estimate - Linear Payout Function
Scoring Period: July 2008 - June 2009
Assumes No Distribution of Excess Pool Dollars Sample Hospital
Process Measures Score:
1% Carve-Out
1.25% Carve-Out
1.5% Carve-Out
1.75% Carve-Out
2% Carve-Out
HCAHPS Score:
Dollars Contributed to VBP
Overall VBP Score:
Expected Payment from VBP
Payment Percentage:
Excess Pool Dollars
Sample State
Process Measures Score:
1% Carve-Out
1.25% Carve-Out
1.5% Carve-Out
1.75% Carve-Out
2% Carve-Out
HCAHPS Score:
Dollars Contributed to VBP
Overall VBP Score:
Expected Payment from VBP
Payment Percentage:
Excess Pool Dollars
Linear Payment Scenario
e
g
a
nt
e 60%
rc
e
t P 50%
Data Source: CMS Hospital Compare database, collection dates April 1, 2008 - March 31, 2009 Sample Hospital
Value-Based Purchasing
Payment Impact Estimate - Curvilinear Payment Function
Scoring Period: July 2008 - June 2009
Assumes No Distribution of Excess Pool Dollars Sample Hospital
Process Measures Score:
1% Carve-Out
1.25% Carve-Out
1.5% Carve-Out
1.75% Carve-Out
2% Carve-Out
HCAHPS Score:
Dollars Contributed to VBP
Overall VBP Score:
Expected Payment from VBP
Payment Percentage:
Excess Pool Dollars
Sample State
Process Measures Score:
1% Carve-Out
1.25% Carve-Out
1.5% Carve-Out
1.75% Carve-Out
2% Carve-Out
HCAHPS Score:
Dollars Contributed to VBP
Overall VBP Score:
Expected Payment from VBP
Payment Percentage:
Excess Pool Dollars
Curvilinear Payment Scenario
Data Source: CMS Hospital Compare database, collection dates April 1, 2008 - March 31, 2009

Source: http://datagen.info/products/keystats/national/docs/2010-07-16_vbp_sample_hospital.pdf