Cost-Effectiveness and Return-on-Investment of the Dynamic Work Intervention Compared With Usual Practice to Reduce Sedentary Behavior

Abstract Background Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the incremental cost per healthcare worker death averted, and 2) the incremental cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results Kenya would need to invest $3.12 million (95% CI: 2.65–3.59) to adequately protect healthcare workers against COVID-19. This investment would avert 416 (IQR: 330–517) and 30,041 (IQR: 7243 – 102,480) healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a healthcare system ROI of $170.64 million (IQR: 138–209) – equivalent to an 11.04 times return. Conclusion Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

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The social and economic benefit of health literacy interventions in the WHO EURO region

European Journal of Public Health ◽

10.1093/eurpub/ckz186.390 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Cited By ~ 1

Author(s):

A Stielke ◽

M Dyakova ◽

K Ashton ◽

T van Dam

Keyword(s):

Health Promotion ◽

Cost Effectiveness ◽

Health Literacy ◽

Health Systems ◽

Return On Investment ◽

Grey Literature ◽

Literacy Interventions ◽

Social Return On Investment ◽

Mesh Terms ◽

The Social

Abstract Background Health literacy (HL) allows people to make informed decisions regarding their health, enabling them to understand health promotion activities and to self-manage their disease or complication without requiring support from healthcare services. HL has the potential to support sustainability in health systems by decreasing healthcare spendings stemming from lowered disease occurrence and progression, it can also impact on the rest of peoples’ lives and their surroundings by allowing them to be more independent. This study researched the evidence for return on investment and the social return on investment for health literacy interventions within the WHO EURO region. Methods A narrative literature review on published peer-reviewed reviews and grey literature was conducted by use of keywords and MeSH terms. Google, Google Scholar and PubMed were used find literature. The search on PubMed was restricted to reviews, published within the last 10 years (2009-2019), in English. Results In total, 450 publications were screened 12 publications that analysed the economic or social aspect of HL interventions were identified. Five discussed the cost-effectiveness of health literacy, three the return on investment (ROI) and the remaining three the social return on investment (SROI) of HL. Types of HL interventions ranged from health promotion campaigns, web-based HL programs, prevention systems to education-based interventions. Cost-effectiveness differed between studies and fields. Evidence for ROI was found, the return ratios ranged from 0.62 to 27.4. Findings show SROI between 4.41 and 7.25, indicating additional value of social benefit next to improved health. Conclusions A link between cost-effectiveness and HL interventions was established and ROI and SROI showed positive ratios. Further research is required in order to investigate whether HL interventions consistently achieve a positive returns. Key messages A link between health literacy interventions and positive investment returns has been established. Health literacy interventions show potential for sustainable development of health systems.

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Protocol for economic evaluation alongside the SHINE (Supporting Healthy Image, Nutrition and Exercise) cluster randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-038050 ◽

2020 ◽

Vol 10 (8) ◽

pp. e038050

Author(s):

Victoria Brown ◽

Joanne Williams ◽

Lisa McGivern ◽

Susan Sawyer ◽

Liliana Orellana ◽

...

Keyword(s):

Body Image ◽

Economic Evaluation ◽

Cost Effectiveness ◽

Incremental Cost ◽

Randomised Control Trial ◽

Usual Practice ◽

Cluster Randomised ◽

Life Years ◽

The Difference ◽

Intervention Costs

IntroductionLimited evidence exists on the cost-effectiveness of interventions to prevent obesity and promote healthy body image in adolescents. The SHINE (Supporting Healthy Image, Nutrition and Exercise) study is a cluster randomised control trial (cRCT) aiming to deliver universal education about healthy nutrition and physical activity to adolescents, as well as targeted advice to young people with body image concerns who are at risk of developing disordered eating behaviours. This paper describes the methods for the economic evaluation of the SHINE cRCT, to determine whether the intervention is cost-effective as an obesity prevention measure.Methods and analysisA public payer perspective will be adopted, with intervention costs collected prospectively. Within-trial cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) will quantify the incremental costs and health gains of the intervention as compared with usual practice (ie, teacher-delivered curriculum). CEA will present results as cost per body mass index unit saved. CUA will present results as cost per quality-adjusted life year gained. A modelled CUA will extend the target population, time horizon and decision context to provide valuable information to policymakers on the potential for incremental cost offsets attributable to disease prevention arising from intervention. Intervention costs and effects will be extrapolated to the population of Australian adolescents in Grade 7 of secondary school (approximate age 13 years) and modelled over the cohort’s lifetime. Modelled CUA results will be presented as health-adjusted life years saved and healthcare cost-savings of diseases averted. Incremental cost-effectiveness ratios will be calculated as the difference in costs between the intervention and comparator divided by the difference in benefit. Semi-structured interviews with key intervention stakeholders will explore the potential impact of scalability on cost-effectiveness. These data will be thematically analysed to inform sensitivity analysis of the base case economic evaluation, such that cost-effectiveness evidence is reflective of the potential for scalability.Ethics and disseminationEthics approval was obtained from the Deakin University Human Research Ethics Committee (#2017–269) and the Victorian Department of Education and Training (#2018_003630). Study findings will be disseminated through peer-reviewed academic papers and participating schools will receive annual reports over the 3 years of data collection.Trial registration numberACTRN 12618000330246; Pre-results.

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Examining the Cost-effectiveness of Personal Protective Equipment for Formal Healthcare Workers in Kenya during the COVID-19 Pandemic

10.21203/rs.3.rs-479486/v1 ◽

2021 ◽

Author(s):

Jacob Kazungu ◽

Kenneth Munge ◽

Kalin Werner ◽

Nicholas Risko ◽

Andres Vecino Ortiz ◽

...

Keyword(s):

Cost Effectiveness ◽

Healthcare Worker ◽

Personal Protective Equipment ◽

Return On Investment ◽

Healthcare Workers ◽

Health Economic Evaluation ◽

Response Strategy ◽

Decision Analytic Model ◽

Protective Equipment ◽

The Cost

Abstract Background: Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods: We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the cost per healthcare worker death averted, and 2) the cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results: Kenya would need to invest $3.12 million to adequately protect healthcare workers against COVID-19. This investment would avert 416 and 30,041 healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a societal ROI of $170.64 million – equivalent to an 11.04 times return. Conclusion: Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

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Cost-effectiveness and return on investment of protecting health workers in low- and middle-income countries during the COVID-19 pandemic

10.1101/2020.06.22.20137257 ◽

2020 ◽

Author(s):

Nicholas Risko ◽

Kalin Werner ◽

O. Agatha Offorjebe ◽

Andres I. Vecino-Ortiz ◽

Lee A. Wallis ◽

...

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Health Care Workers ◽

Return On Investment ◽

World Health ◽

Decision Analytic Model ◽

Middle Income ◽

Middle Income Countries ◽

Care Workers ◽

Low And Middle Income

AbstractBackgroundIn this paper, we predict the health and economic consequences of immediate investment in personal protective equipment (PPE) for health care workers (HCWs) in low- and middle-income countries (LMICs).MethodsTo account for health consequences, we estimated mortality for health care workers (HCW), and present a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model with Bayesian multivariate sensitivity analysis and Monte Carlo simulation. Inputs were used from the World Health Organization Essential Supplies Forecasting Tool and the Imperial College of London epidemiologic model.ResultsAn investment of $9.6 billion USD would adequately protect HCWs in all LMICs. This intervention saves 2,299,543 lives across LMICs, costing $59 USD per HCW case averted and $4,309 USD per HCW life saved. The societal ROI is $755.3 billion USD, the equivalent of a 7,932% return. Regional and national estimates are also presented. In scenarios where PPE remains scarce, 70-100% of HCWs will get infected, irrespective of nationwide social distancing policies. Maintaining HCW infection rates below 10% and mortality below 1% requires inclusion of a PPE scale-up strategy as part of the pandemic response.DiscussionIn conclusion, wide-scale procurement and distribution of PPE for LMICs is an essential strategy to prevent widespread HCW morbidity and mortality. It is cost-effective and yields a large downstream return on investment.

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Cost-Effectiveness and Return on Investment of Continuous Lateral Rotation Therapy to Prevent Ventilator-Associated Pneumonia and Pressure Injuries in the Critical Care Setting

Value in Health ◽

10.1016/j.jval.2018.04.1130 ◽

2018 ◽

Vol 21 ◽

pp. S167-S168

Author(s):

SY Kang ◽

MJ DiStefano ◽

F Yehia ◽

WV Padula

Keyword(s):

Critical Care ◽

Cost Effectiveness ◽

Return On Investment ◽

Care Setting ◽

Critical Care Setting ◽

Ventilator Associated Pneumonia ◽

Continuous Lateral Rotation ◽

Lateral Rotation

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Cost-effectiveness of targeted thrombolytic therapy for stroke patients using multi-modal CT compared to usual practice

PLoS ONE ◽

10.1371/journal.pone.0206203 ◽

2018 ◽

Vol 13 (10) ◽

pp. e0206203 ◽

Cited By ~ 1

Author(s):

Penny Reeves ◽

Kim Edmunds ◽

Christopher Levi ◽

Longting Lin ◽

Xin Cheng ◽

...

Keyword(s):

Cost Effectiveness ◽

Thrombolytic Therapy ◽

Stroke Patients ◽

Usual Practice

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Assessing the potential return on investment of the proposed UK NHS diabetes prevention programme in different population subgroups: an economic evaluation

BMJ Open ◽

10.1136/bmjopen-2016-014953 ◽

2017 ◽

Vol 7 (8) ◽

pp. e014953 ◽

Cited By ~ 9

Author(s):

Chloe Thomas ◽

Susi Sadler ◽

Penny Breeze ◽

Hazel Squires ◽

Michael Gillett ◽

...

Keyword(s):

Socioeconomic Status ◽

Cost Effectiveness ◽

Cost Saving ◽

Low Socioeconomic Status ◽

Return On Investment ◽

Diabetes Prevention ◽

Cost Effective ◽

Baseline Hba1c ◽

Low Socioeconomic ◽

Diabetes Prevention Programme

ObjectivesTo evaluate potential return on investment of the National Health Service Diabetes Prevention Programme (NHS DPP) in England and estimate which population subgroups are likely to benefit most in terms of cost-effectiveness, cost-savings and health benefits.DesignEconomic analysis using the School for Public Health Research Diabetes Prevention Model.SettingEngland 2015–2016.PopulationAdults aged ≥16 with high risk of type 2 diabetes (HbA1c 6%–6.4%). Population subgroups defined by age, sex, ethnicity, socioeconomic deprivation, baseline body mass index, baseline HbA1c and working status.InterventionsThe proposed NHS DPP: an intensive lifestyle intervention focusing on dietary advice, physical activity and weight loss. Comparator: no diabetes prevention intervention.Main outcome measuresIncremental costs, savings and return on investment, quality-adjusted life-years (QALYs), diabetes cases, cardiovascular cases and net monetary benefit from an NHS perspective.ResultsIntervention costs will be recouped through NHS savings within 12 years, with net NHS saving of £1.28 over 20 years for each £1 invested. Per 100 000 DPP interventions given, 3552 QALYs are gained. The DPP is most cost-effective and cost-saving in obese individuals, those with baseline HbA1c 6.2%–6.4% and those aged 40–74. QALY gains are lower in minority ethnic and low socioeconomic status subgroups. Probabilistic sensitivity analysis suggests that there is 97% probability that the DPP will be cost-effective within 20 years. NHS savings are highly sensitive to intervention cost, effectiveness and duration of effect.ConclusionsThe DPP is likely to be cost-effective and cost-saving under current assumptions. Prioritising obese individuals could create the most value for money and obtain the greatest health benefits per individual targeted. Low socioeconomic status or ethnic minority groups may gain fewer QALYs per intervention, so targeting strategies should ensure the DPP does not contribute to widening health inequalities. Further evidence is needed around the differential responsiveness of population subgroups to the DPP.

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