The cost effectiveness of lipid lowering in Swedish primary health care

1996 ◽  
Vol 240 (1) ◽  
pp. 23-29 ◽  
Author(s):  
MAGNUS JOHANNESSON ◽  
LARS BORGQUIST ◽  
BENGT JONSSON ◽  
LARS H. LINDHOLM
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cost Effectiveness ◽  
Lipid Lowering ◽  
Primary Health ◽  
The Cost

scholarly journals Cost-effectiveness of the SLIMMER diabetes prevention intervention in Dutch primary health care: economic evaluation from a randomised controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Geerke Duijzer ◽  
Andrea J. Bukman ◽  
Aafke Meints-Groenveld ◽  
Annemien Haveman-Nies ◽  
Sophia C. Jansen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Cost Effectiveness ◽  
Lifestyle Intervention ◽  
Diabetes Prevention ◽  
Cost Effective ◽  
Primary Health ◽  
The Cost

Abstract Background 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 and primary health care settings. Evidence from well-conducted pragmatic trials is needed to gain insight into the realistic cost-effectiveness of diabetes prevention interventions in real-world settings. The aim of this study is to assess the cost-effectiveness of the SLIMMER lifestyle intervention targeted at patients at high risk of developing type 2 diabetes compared with usual health care in a primary care setting in the Netherlands. Methods Three hundred and sixteen high-risk subjects were randomly assigned to the SLIMMER lifestyle intervention or to usual health care. Costs and outcome assessments were performed at the end of the intervention (12 months) and six months thereafter (18 months). Costs were assessed from a societal perspective. Patients completed questionnaires to assess health care utilisation, participant out-of-pocket costs, and productivity losses. Quality Adjusted Life Years (QALY) were calculated based on the SF-36 questionnaire. Cost-effectiveness planes and acceptability curves were generated using bootstrap analyses. Results The cost-effectiveness analysis showed that the incremental costs of the SLIMMER lifestyle intervention were €547 and that the incremental effect was 0.02 QALY, resulting in an incremental cost-effectiveness ratio (ICER) of €28,094/QALY. When cost-effectiveness was calculated from a health care perspective, the ICER decreased to €13,605/QALY, with a moderate probability of being cost-effective (56% at a willingness to pay, WTP, of €20,000/QALY and 81% at a WTP of €80,000/QALY). Conclusions The SLIMMER lifestyle intervention to prevent type 2 diabetes had a low to moderate probability of being cost-effective, depending on the perspective taken. Trial registration The SLIMMER study is retrospectively registered with ClinicalTrials.gov (Identifier NCT02094911) since March 19, 2014.

scholarly journals Cost-analysis and cost-effectiveness of physical activity interventions in Brazilian primary health care: a randomised feasibility study

2021 ◽  
Vol 26 (11) ◽  
pp. 5711-5726
Author(s):  
Camila Bosquiero Papini ◽  
Leonardo de Campos ◽  
Priscila Missaki Nakamura ◽  
Bruna Thaís Gomes de Brito ◽  
Eduardo Kokubun
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Cost Effectiveness ◽  
Physical Exercise ◽  
Exercise Intervention ◽  
Brief Counseling ◽  
Primary Health ◽  
The Cost

Abstract Physical exercise programs have been carried out in primary health care in Brazil and have provided good results in terms of effectiveness, their economic contribution has not been investigated yet. The aim of the study is to verify the feasibility of brief counseling physical activity intervention and to compare its economic cost and cost-effectiveness with supervised physical exercise intervention in primary care. A multi-arm parallel feasibility trial, with equal randomization [1:1:1] was conducted in Basic Health Units in Brazil. 61 participants were randomized in Brief Counseling Intervention (BCI), Supervised Physical Exercise Intervention (SPEI) and Control Group (CG). Interventions lasted one year. The BCI is more economical than the SPEI, costing around 50% less in the economic comparisons (session cost, annual cost and cost per participant annually). At leisure time, the cost to move one person to the physically active category at 12 months is estimated in R$369.00 for BCI and R$426.21 for the SPEI. The Incremental Cost-effectiveness Ratio (ICER) is R$310.32. The BCI is feasible and more economic, however, the cost effective is not that different. Thus, it is strongly recommended that the two interventions be offered at primary care in Brazil.

scholarly journals Efektivitas Biaya Program Pengelolaan Penyakit Kronis (Prolanis) di Puskesmas

2018 ◽  
Vol 2 (4) ◽  
pp. 622-633
Author(s):  
Ayu Pramudita Wardani ◽  
Eri Witcahyo ◽  
Sri Utami
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cost Effectiveness ◽  
Home Visit ◽  
Total Cost ◽  
First Semester ◽  
Primary Health ◽  
History Of ◽  
The Cost ◽  
Catastrophic Disease

Abstrak Biaya yang dihabiskan untuk penyakit katastropik hingga semester I tahun 2017 telah mencapai Rp 12,7 trilliun atau 24,81% dari total biaya rumah sakit. Jumlah peserta Prolanis Puskesmas Karangduren sebanyak 46 peserta dengan RPPRB sebesar 92,60% dan Patrang sebanyak 45 orang dengan RPPRB sebesar 42,96%. Tujuan penelitian ini adalah menganalisis efektivitas biaya Prolanis pada Puskesmas Karangduren dan Patrang. Jenis penelitian ini adalah deskriptif. Penelitian dilakukan pada bulan September 2017 sampai dengan Oktober 2017. Data diperoleh dengan studi dokumentasi dan wawancara pada penanggung jawab Prolanis, bagian keuangan JKN dan tata usaha. Hasil penelitian menunjukkan input Prolanis pada Puskesmas Karangduren dan Patrang yakni ketersediaan SDM dan dana untuk Prolanis yang tidak keluar, serta kegiatan home visit belum terlaksana karena tidak adanya dana untuk transport petugas dan kurangnya SDM home visit. Hanya peserta Prolanis Puskesmas Patrang dengan riwayat hipertensi telah mencapai indikator 75%. Simpulan penelitian ini adalah efektivitas biaya Prolanis Puskesmas Karangduren lebih efektif dibandingkan Puskesmas Patrang.   Abstract The cost was spent  for catastrophic disease until first semester of 2017 have reached Rp 12.7 trillion or 24.81% of the total cost hospital. The amount participants of Prolanis Karangduren  primary health care was  46 participants with RPPRB of 92.60% and  Patrang was 45 participants  with RPPRB of 42.96%. The purpose of this study was to analyze the cost effectiveness of Prolanis at Karangduren and Patrang primary health care. The study was a  descriptive design. This study was conducted from September until October 2017. Data was collected by documentation and interview of Prolanis officer, finance JKN and administration staff. The results showed Prolanis input on Karangduren and Patrang  primary health care were  the availability of human resources and the fund that do come out,, and home visit activity had not been done yet. Only Prolanis participants of Patrang primary health care with the history of hypertension has reached 75% indicator every month. The cost effectiveness Prolanis Karangduren primary health care more effective was compared to Patrang primary health care.  

scholarly journals Point-of-Care Troponin T Testing in the Management of Patients with Chest Pain in the Swedish Primary Care

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Staffan Nilsson ◽  
Per O. Andersson ◽  
Lars Borgquist ◽  
Ewa Grodzinsky ◽  
Magnus Janzon ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chest Pain ◽  
Troponin T ◽  
Point Of Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Increased Risk ◽  
The Cost

Objective. To investigate the diagnostic accuracy and clinical benefit of point-of-care Troponin T testing (POCT-TnT) in the management of patients with chest pain. Design. Observational, prospective, cross-sectional study with followup. Setting. Three primary health care (PHC) centres using POCT-TnT and four PHC centres not using POCT-TnT in the southeast of Sweden. Patients. All patients ≥35 years old, contacting one of the primary health care centres for chest pain, dyspnoea on exertion, unexplained weakness, and/or fatigue with no other probable cause than cardiac, were included. Symptoms should have commenced or worsened during the last seven days. Main Outcome Measures. Emergency referrals, patients with acute myocardial infarctions (AMI), or unstable angina (UA) within 30 days of study enrolment. Results. 25% of the patients from PHC centres with POCT-TnT and 43% from PHC centres without POCT-TnT were emergently referred by the GP (P=0.011 ). Seven patients (5.5%) from PHC centres with POCT-TnT and six (8.8%) from PHC centres without POCT-TnT were diagnosed as AMI or UA (P=0.369). Two patients with AMI or UA from PHC centres with POCT-TnT were judged as missed cases in primary health care. Conclusion. The use of POCT-TnT may reduce emergency referrals but probably at the cost of an increased risk to miss patients with AMI or UA.

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