scholarly journals The Economic Burden of Diarrheal Disease in a Tertiary Level Hospital, Gauteng, South Africa

2010 ◽  
Vol 202 (S1) ◽  
pp. S116-S125 ◽  
Author(s):  
Una E. MacIntyre ◽  
Francois P. R. de Villiers
Keyword(s):  
South Africa ◽  
Economic Burden ◽  
Diarrheal Disease ◽  
Tertiary Level ◽  
Level Hospital

scholarly journals Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa

2020 ◽  
pp. 300-305
Author(s):  
D Schuster ◽  
JJ Fagan ◽  
M Flint ◽  
W Basera ◽  
O Porrill ◽  
...  
Keyword(s):  
South Africa ◽  
Antibiotic Prophylaxis ◽  
Cape Town ◽  
Binary Logistic Regression ◽  
Primary Objective ◽  
Tertiary Level ◽  
Cross Sectional ◽  
Surgical Antibiotic Prophylaxis ◽  
Inappropriate Antibiotics ◽  
Level Hospital

Background: The aim of surgical antibiotic prophylaxis (SAP) is to prevent surgical site infection (SSI) by administering an appropriate antimicrobial agent perioperatively. However, SAP may be associated with adverse effects and incurs added costs. The primary objective of this prospective study is to establish whether clinicians are adhering to existing perioperative antibiotic prophylaxis guidelines in terms of indication, dosage and timing of SAP. Secondary objectives are to determine the proportion of patients receiving inappropriate antibiotics, and to evaluate correct practice concerning re-dosing and duration of SAP. Methods: A cross-sectional prospective audit of the anaesthetic records and prescription charts of surgical patients was conducted at Groote Schuur Hospital, a tertiary level teaching hospital in Cape Town, South Africa, over a period of one week. Data were collected by anaesthetists – blinded to the study objectives – and the investigators; then captured on Excel spreadsheets and compared to existing SAP guidelines. Descriptive statistics and binary logistic regression were used for analysis. Results: Of the 192 patients consented, 180 questionnaires were completed for data analysis. The median age of participants was 44.5 years (IQR: 31.5–58), with a preponderance of females (58.7%). SAP was administered in 149 cases (82.8%) and withheld in 31 (17.2%). This was appropriate in 91.9% (137/149) and 77.4% (24/31) respectively. Twelve patients (6.7%) received inappropriate antibiotics and in seven (3.9%) it was inappropriately withheld. Of the 156 patients who should have received SAP, choice of drug was correct in 121 (77.6%), dosage in 110 (70.5%) and timing in 87 (55.8%). Absolute compliance was achieved in 44.4% (80/180). Errors were mostly related to timing, re-dosing and duration of SAP. Conclusion: Anaesthetists and surgeons at Groote Schuur Hospital demonstrate variable adherence to surgical antibiotic prophylaxis guidelines. Interventions aimed at improving compliance are warranted.

scholarly journals Economic Burden of Head Injury Patients Attending a Tertiary Level Hospital in a Developing Country Like Bangladesh

2014 ◽  
Vol 30 (2) ◽  
pp. 104-111
Author(s):  
AKM Jakirul Alam ◽  
Asifur Rahman ◽  
M Moududul Haque ◽  
ATM Mosharef Hossain ◽  
Ziaul Islam
Keyword(s):  
Head Injury ◽  
Indirect Cost ◽  
Economic Burden ◽  
Average Cost ◽  
Treatment Cost ◽  
Family Income ◽  
Tertiary Level ◽  
Interview Session ◽  
Different Types ◽  
Level Hospital

Objective: Objective of the study was to estimate the economic burden of head injury (HI) patients attending a tertiary level hospital. This study also tried to determine the socio-demographic characteristics, to estimate direct and indirect cost incurred by the head injury patients and to assess economic burden by different types of accidents causing head injury. Methods:The study was a cross-sectional descriptive study carried out to estimate the economic burden of head injury patients attending a tertiary level hospital during the period from January to June 2010, conducted at the neurosurgery department of Dhaka Medical College Hospital (DMCH). All the conscious head injury patients of both sexes, treated in Neurosurgery department of DMCH, willing to participate in the study were included in the study. Convenience type of non-probability sampling technique was followed and sample size of this study was 110. Face to face interview was conducted with the patient and / or attendant for data collection and specific pre-designed semi-structured and pre-tested questionnaire was used for the interview session. After Categorizing, coding, cleaning and summarizing, all data were analyzed by the software SPSS windows program version 12.0. Result: More than half (53.6%) of the patients of this study, were in younger age group (21 to 30 years) with mean (±SD) age of 29.1(±8.36) years. Majority of the patients (69.0%) were males, Average monthly family income of the patients was Tk.14,509.09 (±5762.49). Majority (36.4%) of the patients had primary level education while 20.9% were housewives. Major incidences of different types of accidents included road traffic accident (63.6%), assault (20.0%), industrial accident (8.0%) and fall from height (8.0%). Average length of the stay of the patients in the hospital was 7.43 (±3.64) days. In respect of direct cost, average travel cost incurred by the patients was Tk.3,628.18 (±2055.56), average drug cost was Tk.1,618 (±801.51), average laboratory investigation cost was Tk.2390 (±626.47) and average cost of food was Tk.2235.45 (±1208.19). Average direct treatment cost incurred by the patients was Tk.9590.10 (±4041.13). The average duration of absent from work place was 7.07 (±3.316) days and most of the patients average daily income (self) was Tk.340.65 (±158.97). Average loss of income due to illness was Tk.2415.32(±1623.68) and average cost behind giving tips to hospital staff by the patients was Tk.221.50 (±78.34). The average indirect cost of these study patients was Tk.2001.72 (±1869.27). Overall, average treatment cost incurred by the patients was Tk.12,008.05 (±5051.95). Majority (38.0%) had a cost from Tk10001 to Tk.15000. Conclusion: The study finding can help policy makers, public health specialists, future researchers and enthusiastic individuals to formulate specific strategies for reduction of economic burden of head injury patients by providing cost-effective health care services throughout the country. Bangladesh Journal of Neuroscience 2014; Vol. 30 (2): 104-111

Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 131
Keyword(s):  
Health Care ◽  
General Hospital ◽  
Health Care Providers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Medical Services ◽  
Tertiary Level ◽  
Care Providers ◽  
Level Hospital ◽  
Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

In-Hospital Outcomes of Patients with Acute Kidney Injury Following Acute Coronary Syndrome in a Tertiary level Hospital

2019 ◽  
Vol 5 (6) ◽  
Author(s):  
MSI Tipu Chowdhury ◽  
Khaled Md. Iqbal ◽  
Zahidul Mostafa ◽  
Md. Fakhrul Islam Khaled ◽  
Sadia Sultana ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Acute Coronary Syndrome ◽  
Kidney Injury ◽  
Tertiary Level ◽  
Hospital Outcomes ◽  
Coronary Syndrome ◽  
Level Hospital

The Economic Cost of Violence Against Women and Girls in Low- and Middle-Income Countries: A Systematic Review of the Evidence

2021 ◽  
pp. 152483802110160
Author(s):  
Seema Vyas ◽  
Melissa Meinhart ◽  
Katrina Troy ◽  
Hannah Brumbaum ◽  
Catherine Poulton ◽  
...  
Keyword(s):  
South Africa ◽  
Systematic Review ◽  
Violence Against Women ◽  
Economic Burden ◽  
Data Availability ◽  
Female Genital Cutting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Women And Girls ◽  
Low And Middle Income

Evidence demonstrating the economic burden of violence against women and girls can support policy and advocacy efforts for investment in violence prevention and response programming. We undertook a systematic review of evidence on the costs of violence against women and girls in low- and middle-income countries published since 2005. In addition to understanding costs, we examined the consistency of methodological approaches applied and identified and assessed common methodological issues. Thirteen articles were identified, eight of which were from sub-Saharan Africa. Eight studies estimated costs associated with domestic or intimate partner violence, others estimated the costs of interpersonal violence, female genital cutting, and sexual assaults. Methodologies applied to estimate costs were typically based on accounting approaches. Our review found that out-of-pocket expenditures to individuals for seeking health care after an episode of violence ranged from US$29.72 (South Africa) to US$156.11 (Romania) and that lost productivity averaged from US$73.84 to US$2,151.48 (South Africa) per facility visit. Most studies that estimated provider costs of service delivery presented total programmatic costs, and there was variation in interventions, scale, and resource inputs measured which hampered comparability. Variations in methodological assumptions and data availability also made comparisons across countries and settings challenging. The limited scope of studies in measuring the multifaceted impacts of violence highlights the challenges in identifying cost metrics that extend beyond specific violence episodes. Despite the limited evidence base, our assessment leads us to conclude that the estimated costs of violence against women and girls are a fraction of its true economic burden.

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