scholarly journals Active Lives South Australia health economic analysis: an evidence base for the potential of health promotion strategies supporting physical activity guidelines to reduce public health costs while improving wellbeing

2021 ◽  
Author(s):  
Simon Eckermann ◽  
Andrew R. Willan
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Cost Saving ◽  
Health System ◽  
South Australia ◽  
Emergency Department Visits ◽  
Hospital Inpatient ◽  
System Cost ◽  
Health System Cost ◽  
Promotion Strategies

Abstract Aim The COVID-19 pandemic has threatened individual and population wellbeing and strategies to jointly address these challenges within budget constraints are required. The aim of our research is to analyse evidence from the Active Lives South Australia study to consider the potential of physical activity (PA) health promotion strategies to be health-system cost saving while addressing wellbeing challenges. Methods The Active Lives South Australia study compares adult populations who meet and do not meet physical activity (PA) guidelines (150+ minutes of weekly physical activity) with respect to their subjective wellbeing and health care utilisation. Subject and results Adults who met PA guidelines had better wellbeing across all aspects with and without adjustment for age, sex and income covariates. Analysis showed significant associations between meeting guidelines and lower probabilities of visiting and utilisation of GPs, specialist doctors, other health professionals, hospital inpatient admissions, outpatient clinic and emergency department visits, and an overall A$1760 lower cost per person annually. Controlling for age, sex and income, health expenditure for adults who met PA guidelines was significantly lower by A$1393 per person annually. That translated to A$804 million potential annual SA health system cost saving by shifting all adults to meeting PA guidelines. Conclusion There is significant potential for effective health promotion strategies to be net cost saving while addressing wellbeing challenges of COVID-19 recovery where they can shift target populations from not meeting to meeting PA guidelines.

scholarly journals Healthy Mobile Check-In Study: Barriers to exercise for women in high and low SEP suburbs in Brisbane

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J A Carroll ◽  
J Rodgers ◽  
J Lyons-Reid ◽  
R Bennett
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Family Responsibilities ◽  
Social Barriers ◽  
Low Socioeconomic ◽  
Barriers To Exercise ◽  
Promotion Strategies ◽  
The Individual ◽  
Targeted Approach ◽  
Barriers To Physical Activity

Abstract Previous studies have demonstrated that physical activity (PA) promotes health and reduces risk for non-communicable diseases. However, 55% of Australian women did not meet the recommended levels of PA in 2018-19. There remains a gap in knowledge regarding the individual, household, and neighbourhood barriers to physical activity between women from high and low socioeconomic suburbs. We conducted a mixed-methods study to ascertain subjective accounts of the socioecological reasons for different daily logistics, travel, and PA between these groups. In addition to daily mobility data collated from GIS iPhone apps, in-depth interviews were held with 16 women from the high (Ashgrove) and low (Durack) SEP suburbs in Brisbane. Interview data was analysed at the individual, social, and environmental levels to unearth resistance to PA via these thematic strata. Individual psychological barriers to being active that were unique to low SE suburbs included the 'lack of enjoyment' gained from PA. Both high and low SE suburbs reported being 'time poor'. For low SEP participants, this was driven by financial demands, and for high SEP participants, this was driven by work demands. Both groups reported being burnt out. Individual physical barriers for both groups included sore joints, injury, pelvic pain and weight. Social barriers unique to participants from a high SE suburb included 'opportunities to exercise socially', and 'mother guilt'. Both groups reported 'family responsibilities' as a social barrier. Neighbourhood changes that could increase PA in the low SEP suburb included facilities to increase walkability. Participants from the high SE suburb were largely satisfied with the state of their neighbourhood. This study provides foundational insight into improved public health strategies for increasing levels of PA amongst women in Brisbane from different SEP groups. Our findings support the idea that a combination of broad strategies and a targeted approach is needed. Key messages Women from high and low socioeconomic suburbs experience different barriers to physical activity. Health promotion strategies need to accommodate this to improve overall health and reduce inequality. Women from high and low socioeconomic suburbs face psychological, physical and social barriers to exercise. Broad health promotion strategies and a targeted approach is required to address barriers.

scholarly journals Implementing standard antenatal care interventions: health system cost at primary health facilities in Tanzania

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Amisa Tindamanyile Chamani ◽  
Amani Thomas Mori ◽  
Bjarne Robberstad
Keyword(s):  
Standard Model ◽  
Antenatal Care ◽  
Health System ◽  
Health Facilities ◽  
System Cost ◽  
Primary Health ◽  
Health System Cost ◽  
The Standard Model ◽  
Health Centres ◽  
Primary Health Facilities

Abstract Background Since 2002, Tanzania has been implementing the focused Antenatal Care (ANC) model that recommended four antenatal care visits. In 2016, the World Health Organization (WHO) reintroduced the standard ANC model with more interventions including a minimum of eight contacts. However, cost-implications of these changes to the health system are unknown, particularly in countries like Tanzania, that failed to optimally implement the simpler focused ANC model. We compared the health system cost of providing ANC under the focused and the standard models at primary health facilities in Tanzania. Methods We used a micro-costing approach to identify and quantify resources used to implement the focused ANC model at six primary health facilities in Tanzania from July 2018 to June 2019. We also used the standard ANC implementation manual to identify and quantify additional resources required. We used basic salary and allowances to value personnel time while the Medical Store Department price catalogue and local market prices were used for other resources. Costs were collected in Tanzanian shillings and converted to 2018 US$. Results The health system cost of providing ANC services at six facilities (2 health centres and 4 dispensaries) was US$185,282 under the focused model. We estimated that the cost would increase by about 90% at health centres and 97% at dispensaries to US$358,290 by introducing the standard model. Personnel cost accounted for more than one third of the total cost, and more than two additional nurses are required per facility for the standard model. The costs per pregnancy increased from about US$33 to US$63 at health centres and from about US$37 to US$72 at dispensaries. Conclusion Introduction of a standard ANC model at primary health facilities in Tanzania may double resources requirement compared to current practice. Resources availability has been one of the challenges to effective implementation of the current focused ANC model. More research is required, to consider whether the additional costs are reasonable compared to the additional value for maternal and child health.

scholarly journals Cost Analysis of Pediatric Intensive Care: A Low-Middle Income Country Perspective

2020 ◽  
Author(s):  
Amrit Kaur ◽  
Muralidharan Jayashree ◽  
Shankar Prinja ◽  
Ranjana Singh ◽  
Arun K. Baranwal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Health System ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Severe Illness ◽  
Annual Data ◽  
System Cost ◽  
Health System Cost ◽  
State Of Art

Abstract Background: Globally, Pediatric Intensive Care Unit (PICU) admissions are amongst the most expensive. This makes it important to gain insights into the cost of pediatric intensive care units. We undertook this study to calculate the health system cost and out of pocket expenditure incurred per patient during Pediatric Intensive Care Unit (PICU) stayMethods: Prospective study conducted in a state of art tertiary level PICU of a teaching and referral hospital. Bottom-up micro costing methods were used to assess the health system cost. Annual data regarding hospital resources used for PICU care was collected from January 2018 to December 2018. Data regarding out of pocket expenditure (OOP) was collected from 299 patients who were admitted from July 2017 to December 2018. The study period was divided into four intervals, each of 4 and a half months duration and data was collected for 1 month in each interval. Per patient and per bed day costs for treatment were estimated both from health system and patient’s perspective. Results: The median (inter-quartile range, IQR) length of PICU stay was 5(3–8) days. Mean ± SD PRISM score of the study cohort was 22.23 ± 7.3. Of the total patients, 55.9% (167) were ventilated. Mean cost per patient treated was US$ 2,078(₹ 144,566). Of this, health system cost and OOP expenditure per patient were US$ 1,731 (₹ 120,425) and 352 (₹ 24,535) respectively. OOP expenditure of a ventilated child was twice that of a non‐ ventilated child. Conclusions: The fixed cost of PICU care were 3.5 times more than variable costs. Major portion of cost is borne by hospital. Severe illness, longer ICU stay and ventilation were associated with increased costs. This study can be used to set the reimbursement package rates under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Tertiary care state of art intensive care in a public sector teaching hospital in India is far less expensive than developed countries.

scholarly journals Health System Cost of Post-Abortion Care (PAC): A Systematic Review

2021 ◽  
Author(s):  
Estro Dariatno Sihaloho ◽  
Ibnu Habibie ◽  
Fariza Zahra Kamilah ◽  
Yodi Christiani
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Direct Cost ◽  
Medical Cost ◽  
Cochrane Library ◽  
System Cost ◽  
Abortion Care ◽  
Post Abortion Care ◽  
Health System Cost ◽  
Post Abortion

Abstract Background: Despite the increasing trend of Post Abortion Care (PAC) needs and provision, the evidence related to its health system cost is lacking. The study aims to review the health system costs of Post-Abortion Care (PAC) per patient at a national level.Methods: A systematic review of literatures related to PAC cost published in 1994 – October 2020 was performed. Electronic databases such as PubMed, Medline, The Cochrane Library, CINAHL, and PsycINFO were used to search the literature. Following the title and abstract screening, reporting quality was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. PAC costs were extrapolated into, US dollars ($US) and international dollars ($I), both in 2019. Content analysis was also conducted to synthesize the qualitative findings.Results: Twelve studies met the inclusion criteria. All studies reported direct medical cost per patient in accessing PAC, but only three of them included indirect medical cost. All studies reported either average or range of cost. In terms of range, The highest direct cost of PAC with MVA (Medical Vacuum Aspiration) services can be found in Colombia, between $US50.58-212.47, while the lowest is in Malawi ($US15.2-139.19). The highest direct cost of PAC with D&C (Dilatation and Curettage), services was in El Salvador ($US65.22-240.75), while the lowest is in Bangladesh ($US15.71-103.85). Among two studies providing average indirect cost data, Uganda with $US105.04 is the highest average indirect medical cost, while Rwanda with $US51.44 is the lowest on the cost of indirect medical.Conclusions: Our review shows variability in cost of PAC across countries. This study depicts a clearer picture of how costly it is for women to access PAC service, although it is still seemingly underestimated. When a study compared the use of UE method between MVA and D&C, it is confirmed that MVA treatments tend to have lower costs and potentially reduce a significant cost. Therefore, by looking at both clinical and economic perspective, improving and strengthening the quality and accessibility of PAC with MVA is a priority.

scholarly journals Implementing Standard Antenatal Care Interventions: Health System Cost at Primary Health Facilities in Tanzania.

2021 ◽  
Author(s):  
Amisa Tindamanyile Chamani ◽  
Amani Thomas Mori ◽  
Bjarne Robberstad
Keyword(s):  
Standard Model ◽  
Antenatal Care ◽  
Health System ◽  
Health Facilities ◽  
System Cost ◽  
Primary Health ◽  
Health System Cost ◽  
The Standard Model ◽  
Health Centres ◽  
Primary Health Facilities

Abstract Background Since 2002, Tanzania has been implementing the focused Antenatal Care (ANC) model that recommended four antenatal care visits. In 2016, the World Health Organization (WHO) reintroduced the standard ANC model with more interventions including a minimum of eight contacts. However, cost-implications of these changes to the health system is unknown, particulary in countries like Tanzania, that failed to optimally implement the simpler focused ANC model. We compared the health system cost of providing ANC under the focused and the standard models at primary health facilities in Tanzania. Methods We used a micro-costing approach to identify and quantify resources used to implement the focused ANC model at six primary health facilities in Tanzania from July 2018 to June 2019. We also used the standard ANC implementation manual to identify and quantify additional resources required. We used basic salary and allowances to value personnel time while the Medical Store Department price catalogue and local market prices were used for other resources. Cost were collected in Tanzanian shillings and converted to 2018 US$. Results The health system cost of providing ANC services was US$185,282 under the focused model and the cost increased by about 90% at health centres and 97% at dispensaries to US$358,290 for the standard model. Personnel cost accounted for more than one third of the total cost for both models. With the standard model, costs per pregnancy increased from about US$33 to US$63 at health centres and from about US$37 to US$72 at dispensaries Conclusion Introduction of a standard ANC model at primary healthcare facilities in Tanzania will double resources use compared to current practice. While resources availability has been one of the challenge to effective implementation of the focused ANC model, more research is required, to consider whether these costs are reasonable compared to the additional value for maternal and child health.

Strategies for health promotion

2018 ◽  
pp. 83-112
Author(s):  
Colin Palfrey
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Health Promotion ◽  
Northern Ireland ◽  
Health Surveys ◽  
Political Action ◽  
Health Behaviours ◽  
Current Health ◽  
Promotion Strategies ◽  
The Uk

This chapter focuses on various strategies for health promotion in the UK. It begins with a discussion of two opposing routes to better health, known as health promotion doctrines: Approach A is a health education approach that seeks to influence individual lifestyle, while Approach B argues that health inequalities can be reduced and public health can be improved only through social change and political action. The chapter then considers the different causes of ill health, with particular emphasis on the link between health and poverty. It also examines poverty in the UK, taking into account various definitions of poverty in the twentieth and twenty-first centuries, and health surveys that provide an annual update on current health behaviours and conditions in England, Scotland, Wales and Northern Ireland. Finally, it reviews health promotion strategies pursued in the four countries, such as tackling obesity, increasing physical activity and improving diet.

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