scholarly journals Virtual geriatric clinics and the COVID-19 catalyst: a rapid review

2020 ◽  
Vol 49 (6) ◽  
pp. 907-914 ◽  
Author(s):  
Robert P Murphy ◽  
Karen A Dennehy ◽  
Maria M Costello ◽  
Evelyn P Murphy ◽  
Conor S Judge ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Clinical Benefit ◽  
Outpatient Service ◽  
Added Value ◽  
Rapid Review ◽  
Model Of Care ◽  
Health Crisis ◽  
Acute Hospitalisation ◽  
Geriatric Clinic ◽  
Clinical Benefits

Abstract Background During the current COVID-19 health crisis virtual geriatric clinics have become increasingly utilised to complete outpatient consultations, although concerns exist about feasibility of such virtual consultations for older people. The aim of this rapid review is to describe the satisfaction, clinic productivity, clinical benefit, and costs associated with the virtual geriatric clinic model of care. Methods A rapid review of PubMed, MEDLINE and CINAHL databases was conducted up to April 2020. Two independent reviewers extracted the information. Four subdomains were focused on: satisfaction with the virtual geriatric clinic, clinic productivity, clinical benefit to patients, costs and any challenges associated with the virtual clinic process. Results Nine studies with 975 patients met our inclusion criteria. All were observational studies. Seven studies reported patients were satisfied with the virtual geriatric clinic model of care. Productivity outcomes included reports of cost-effectiveness, savings on transport, and improved waiting list metrics. Clinical benefits included successful polypharmacy reviews, and reductions in acute hospitalisation rates. Varying challenges were reported for both clinicians and patients in eight of the nine studies. Hearing impairments and difficulty with technology added to anxieties experienced by patients. Physicians missed the added value of a thorough physical examination and had concerns about confidentiality. Conclusion Virtual geriatric clinics demonstrate evidence of productivity, benefit to patients, cost effectiveness and patient satisfaction with the treatment provided. In the current suboptimal pandemic climate, virtual geriatric clinics may allow Geriatricians to continue to provide an outpatient service, despite the encountered inherent challenges.

scholarly journals Can an allied health expanded scope Treatment Access Pathway (TAP) improve health outcomes for people with persistent pain? Study protocol for a pragmatic randomised controlled trial

2019 ◽  
Author(s):  
Margaret Anne Vandermost ◽  
Michele Sterling ◽  
Karl Bagraith ◽  
Hannah Kennedy ◽  
Darren Doherty ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Allied Health ◽  
Clinical Decision Making ◽  
Persistent Pain ◽  
Self Report ◽  
Control Group ◽  
Model Of Care ◽  
Treatment Access ◽  
Health Crisis ◽  
Access Pathway

Abstract Background Persistent pain is a public health crisis. Demand for services frequently exceeds supply and many individuals miss out on timely treatment resulting in longer than recommended wait times. The Interdisciplinary Persistent Pain Centre (IPPC) (Queensland, Australia) implemented a Treatment Access Pathway (TAP), an allied health first point of contact model of care to allow patients access to empirically supported allied health treatment without Pain Specialist assessment. The primary aim of this research project is to understand the clinical and cost effectiveness of TAP in a real-world setting. Method: Participants referred to the IPPC are randomly allocated to treatment or waitlist control groups and self-report and objective physical outcome measures are collected at baseline and 6 months’ time. A total of 196 patients will be recruited for the study (treatment group, n=98 and control group, n=98) to allow a 20% attrition rate to gain 156 participants for the study. Discussion: The results of this study will determine the clinical outcomes and cost effectiveness of the TAP as a model of care to inform future clinical decision making and program development. Ethics approval was provided by the Research Governance Office at Gold Coast Hospital and Health Service (RGOGCHHS) on the 19/10/2016 (HREC/16/QGC/156).

TeleClinical Care: A randomised controlled trial of a smartphone-based model of care to support cardiac patients transitioning from hospital to the community (Preprint)

2021 ◽  
Author(s):  
Praveen Indraratna ◽  
Uzzal Biswas ◽  
James McVeigh ◽  
Andrew Mamo ◽  
Joseph Magdy ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Medication Adherence ◽  
Randomised Controlled Trial ◽  
Cardiac Rehabilitation ◽  
Usual Care ◽  
Controlled Trial ◽  
Smartphone App ◽  
Model Of Care ◽  
Intervention Cost ◽  
Randomised Controlled

BACKGROUND This is the first randomised controlled trial (RCT) of a mobile health intervention that combines telemonitoring and educational components for both acute coronary syndrome (ACS) and heart failure (HF) inpatients to prevent readmission. OBJECTIVE Objective: To evaluate the feasibility, efficacy and cost-effectiveness of a smartphone app-based model of care (TeleClinical Care – TCC) plus usual care in patients being discharged from hospital after an ACS or HF admission, in comparison to usual care alone. METHODS Methods: In this pilot, 2-centre RCT, a smartphone app-based model of care (TeleClinical Care – TCC) was applied at discharge. The primary endpoint was the incidence of unplanned 30-day readmissions. Secondary endpoints included all-cause readmissions, cardiac readmissions, cardiac rehabilitation completion, medication adherence, cost-effectiveness and user satisfaction. Intervention arm participants received the app and Bluetooth-enabled devices for measuring weight, blood pressure and physical activity daily, plus usual care. The devices automatically transmitted recordings to the patient’s smartphone and then subsequently to a central server. Abnormal readings were flagged by email to a monitoring team. Control participants received usual care. RESULTS Results: 164 hospital inpatients were randomised at the time of discharge (TCC n=81, control n = 83, mean age 61.5 years, 79% male, 78% admitted with ACS). There were 11 unplanned 30-day readmissions in both groups (P = .97). Over a mean follow-up of 193 days, the intervention was associated with a significant reduction in unplanned hospital readmissions (21 vs. 41 readmissions, P = 0.015), including cardiac readmissions (11 vs. 25, P = .025), and higher rates of cardiac rehabilitation completion (39% vs. 18%, P = .025) and medication adherence (75% vs. 50%, P = .002). The average usability rating of the app was 4.5/5. The intervention cost AUD $6,028 per cardiac readmission saved. When modelled in a mainstream clinical setting, however, enrolment of 237 patients was projected to have the same healthcare expenditure compared to usual care, and enrolment of 500 patients was projected to save approximately AUD $100,000. CONCLUSIONS Conclusion: TCC was feasible and safe for ACS and HF inpatients. The incidence of 30-day readmissions was similar, however long-term benefits were demonstrated including fewer total readmissions over 6 months, improved medication adherence and improved cardiac rehabilitation completion. CLINICALTRIAL The study was registered with the Australia New Zealand Clinical Trials Registry (ACTRN12618001547235).

The clinical benefit and cost-effectiveness of human papillomavirus vaccination for adult women in the Netherlands

Vaccine ◽  
2011 ◽  
Vol 29 (48) ◽  
pp. 8929-8936 ◽  
Author(s):  
Johannes A. Bogaards ◽  
Veerle M.H. Coupé ◽  
Chris J.L.M. Meijer ◽  
Johannes Berkhof
Keyword(s):  
Human Papillomavirus ◽  
Cost Effectiveness ◽  
The Netherlands ◽  
Clinical Benefit ◽  
Adult Women ◽  
Human Papillomavirus Vaccination

scholarly journals The Cost Effectiveness of Ecotherapy as a Healthcare Intervention, Separating the Wood from the Trees

2021 ◽  
Vol 18 (21) ◽  
pp. 11599
Author(s):  
Sebastian Hinde ◽  
Laura Bojke ◽  
Peter Coventry
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Mental Health Problems ◽  
Health Benefit ◽  
Cost Effective ◽  
Health Problems ◽  
Healthcare Intervention ◽  
Health Crisis ◽  
Patient Pathways ◽  
Common Mental Health Problems

Internationally, shifts to more urbanised populations, and resultant reductions in engagements with nature, have been a contributing factor to the mental health crisis facing many developed and developing countries. While the COVID-19 pandemic reinforced recent trends in many countries to give access to green spaces more weight in political decision making, nature-based activities as a form of intervention for those with mental health problems constitute a very small part of patient pathways of care. Nature-based interventions, such as ecotherapy, are increasingly used as therapeutic solutions for people with common mental health problems. However, there is little data about the potential costs and benefits of ecotherapy, making it difficult to offer robust assessments of its cost-effectiveness. This paper explores the capacity for ecotherapy to be cost-effective as a healthcare intervention. Using a pragmatic scoping review of the literature to understand where the potential costs and health benefit lie, we applied value of information methodology to identify what research is needed to inform future cost-effectiveness assessments. We show that there is the potential for ecotherapy for people with mild to moderate common mental health problems to be cost-effective but significant further research is required. Furthermore, nature-based interventions such as ecotherapy also confer potential social and wider returns on investment, strengthening the case for further research to better inform robust commissioning.

scholarly journals Projected Clinical Benefits and Cost-effectiveness of a Human Papillomavirus 16/18 Vaccine

2004 ◽  
Vol 96 (8) ◽  
pp. 604-615 ◽  
Author(s):  
S. J. Goldie ◽  
M. Kohli ◽  
D. Grima ◽  
M. C. Weinstein ◽  
T. C. Wright ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cost Effectiveness ◽  
Human Papillomavirus 16 ◽  
Clinical Benefits

scholarly journals Cost-Effectiveness of Lifestyle-Related Interventions for the Primary Prevention of Breast Cancer: A Rapid Review

2020 ◽  
Vol 6 ◽  
Author(s):  
Martine Bellanger ◽  
Katharine Barry ◽  
Juwel Rana ◽  
Jean-Philippe Regnaux
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Primary Prevention ◽  
Rapid Review ◽  
Prevention Of Breast Cancer

Introduction of emerging medical devices on the market: A new procedure in Belgium

2007 ◽  
Vol 23 (4) ◽  
pp. 449-454 ◽  
Author(s):  
Imgard Vinck ◽  
Mattias Neyt ◽  
Nancy Thiry ◽  
Marleen Louagie ◽  
Dirk Ramaekers
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Insurance ◽  
Cost Effectiveness ◽  
Medical Devices ◽  
Clinical Effectiveness ◽  
Added Value ◽  
Scientific Evaluation ◽  
Medical Technologies ◽  
Organizational Issues

When new medical technologies enter the market, there is often uncertainty about the added value for the patient and for society, hampering well-considered decision making about reimbursement. Current Belgian legislation already offered opportunities for the managed uptake of possibly innovative emerging implants. However, it has also some shortcomings such as the lack of a clear research design, rendering the scientific evaluation of clinical effectiveness, cost-effectiveness, and patient or organizational issues more difficult. Against this background, a new procedure was elaborated by the Belgian health insurance institute and the Belgian Health Care Knowledge Centre.

scholarly journals Clinical Benefits, Costs, and Cost-Effectiveness of Neonatal Intensive Care in Mexico

PLoS Medicine ◽  
2010 ◽  
Vol 7 (12) ◽  
pp. e1000379 ◽  
Author(s):  
Jochen Profit ◽  
Diana Lee ◽  
John A. Zupancic ◽  
LuAnn Papile ◽  
Cristina Gutierrez ◽  
...  
Keyword(s):  
Intensive Care ◽  
Cost Effectiveness ◽  
Neonatal Intensive Care ◽  
Clinical Benefits

Utility and cost–effectiveness of 3D-printed materials for clinical use

2019 ◽  
Vol 3 (4) ◽  
pp. 209-218 ◽  
Author(s):  
Julian Vitali ◽  
Matthew Cheng ◽  
Michael Wagels
Keyword(s):  
Cost Effectiveness ◽  
3D Printing ◽  
Relevant Literature ◽  
Clinical Use ◽  
Surgical Guides ◽  
Rigorous Testing ◽  
Clinical Benefits ◽  
3D Printed ◽  
Surgical Adjunct ◽  
Printed Materials

This review summarizes the utility of 3D-printing as a surgical adjunct, reviewing the cost–effectiveness. The relevant literature was analyzed outlining the utility and/or cost–effectiveness of 3D-printing for clinical use. Compared with existing methods, the evidence suggests an advantage of using 3D-printing as a technology in the treatment of complex clinical cases. However, in high frequency cases, the additional preoperative expenses are not justified. Considerable evidence of its clinical benefits exists for the application of 3D-printed anatomical models and teaching tools. However, the evidence supporting 3D-printing’s use as surgical guides or implantable devices is less clear. Furthermore, caution must exist when using these devices in the clinical setting due to a paucity of rigorous testing, global regulation and long-term data.

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