scholarly journals Economic evaluation of the cost of different methods of retesting chlamydia positive individuals in England

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024828
Author(s):  
Katharine J Looker ◽  
Erna Buitendam ◽  
Sarah C Woodhall ◽  
Emma Hollis ◽  
Koh-Jun Ong ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Patient Choice ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Cost Estimates ◽  
Adjusted Cost ◽  
Audit Data ◽  
Message Service ◽  
The Cost ◽  
Recall Methods

ObjectivesThe National Chlamydia Screening Programme (NCSP) in England opportunistically screens eligible individuals for chlamydia infection. Retesting is recommended three3 months after treatment following a positive test result, but no guidance is given on how local areas should recall individuals for retesting. Here , we compare cost estimates for different recall methods to inform the optimal delivery of retesting programmes.DesignEconomic evaluation.SettingEngland.MethodsWe estimated the cost of chlamydia retesting for each of the six most commonly used recall methods in 2014 based on existing cost estimates of a chlamydia screen. Proportions accepting retesting, opting for retesting by post, returning postal testing kits and retesting positive were informed by 2014 NCSP audit data. Health professionals ‘sense-checked’ the costs.Primary and secondary outcomesCost and adjusted cost per chlamydia retest; cost and adjusted cost per chlamydia retest positive.ResultsWe estimated the cost of the chlamydia retest pathway, including treatment/follow-up call, to be between £45 and £70 per completed test. At the lower end, this compared favourably to the cost of a clinic-based screen. Cost per retest positive was £389–£607. After adjusting for incomplete uptake, and non-return of postal kits, the cost rose to £109–£289 per completed test (cost per retest positive: £946–£2,506). The most economical method in terms of adjusted cost per retest was no active recall as gains in retest rates with active recall did not outweigh the higher cost. Nurse-led client contact by phone was particularly uneconomical, as was sending out postal testing kits automatically.ConclusionsRetesting without active recall is more economical than more intensive methods such as recalling by phone and automatically sending out postal kits. If sending a short message service (SMS) could be automated, this could be the most economical way of delivering retesting. However, patient choice and local accessibility of services should be taken into consideration in planning.

scholarly journals Cost-Effectiveness of an Exercise Programme that Provided Group or Individual Training to Reduce the Fall Risk in Healthy Community-Dwelling People Aged 65–80: A Secondary Data Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 714
Author(s):  
Isaac Aranda-Reneo ◽  
Laura Albornos-Muñoz ◽  
Manuel Rich-Ruiz ◽  
María Ángeles Cidoncha-Moreno ◽  
Ángeles Pastor-López ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Older People ◽  
Incremental Cost ◽  
Fall Risk ◽  
Community Dwelling ◽  
Effective Measure ◽  
The Individual ◽  
The Cost ◽  
Individual Training

Research has demonstrated that some exercise programs are effective for reducing fall rates in community-dwelling older people; however, the literature is limited in providing clear recommendations of individual or group training as a result of economic evaluation. The objective of this study was to assess the cost-effectiveness of the Otago Exercise Program (OEP) for reducing the fall risk in healthy, non-institutionalized older people. An economic evaluation of a multicenter, blinded, randomized, non-inferiority clinical trial was performed on 498 patients aged over 65 in primary care. Participants were randomly allocated to the treatment or control arms, and group or individual training. The program was delivered in primary healthcare settings and comprised five initial sessions, ongoing encouragement and support to exercise at home, and a reinforcement session after six months. Our hypothesis was that the patients who received the intervention would achieve better health outcomes and therefore need lower healthcare resources during the follow-up, thus, lower healthcare costs. The primary outcome was the incremental cost-effectiveness ratio, which used the timed up and go test results as an effective measure for preventing falls. The secondary outcomes included differently validated tools that assessed the fall risk. The cost per patient was USD 51.28 lower for the group than the individual sessions in the control group, and the fall risk was 10% lower when exercises had a group delivery. The OEP program delivered in a group manner was superior to the individual method. We observed slight differences in the incremental cost estimations when using different tools to assess the risk of fall, but all of them indicated the dominance of the intervention group. The OEP group sessions were more cost-effective than the individual sessions, and the fall risk was 10% lower.

Economic Evaluation of a Ninngen-Dokku (Medical Checkup)

1993 ◽  
Vol 32 (03) ◽  
pp. 199-202
Author(s):  
T. Shimizu ◽  
T. Suzuki
Keyword(s):  
Economic Evaluation ◽  
Economic Analysis ◽  
Medical Treatment ◽  
Medical Checkup ◽  
Dry Dock ◽  
The Cost ◽  
Mass Health ◽  
Medical Judgment

Abstract:An economic evaluation of a medical checkup center (Ninngendokku, “human dry dock”) was conducted from two perspectives: the cost for cancer checkup, and the cost for medical treatment after a diagnosis was obtained. We studied the cost of diagnosing cancer, compared with the cost required when cancer of an individual organ was detected through mass health testing, and studied the economics of a Ninngendokku according to Kawai’s method of medical judgment. Assuming that the cost of death is more than the cost of saving the lives of persons who undergo the Ninngen-dokku, the Ninngen-dokku will be affordable. In the group undergoing the Ninngen-dokku compared with the group which did not, the estimated cost of medical treatment was reduced. The Ninngendokku carries advantages that cannot be quantified in financial terms; therefore, a multi-layered economic analysis of the Ninngen-dokku was required.

scholarly journals 3031 Facilitators and Barriers in Screening Sexually Active Female Adolescents for Chlamydia Infection in the Suburban Practice Setting

2019 ◽  
Vol 3 (s1) ◽  
pp. 144-144
Author(s):  
Ashaunta Tumblin Anderson ◽  
Barbara Frankowski ◽  
Paul J. Chung ◽  
Judith Shaw
Keyword(s):  
Best Practices ◽  
Female Adolescents ◽  
Chlamydia Infection ◽  
Pediatric Care ◽  
Chlamydia Screening ◽  
Practice Setting ◽  
Sexually Active ◽  
Structured Interviews ◽  
Policy And Practice ◽  
Pediatric Providers

OBJECTIVES/SPECIFIC AIMS: 1) Describe strategies pediatric providers perceive improve chlamydia screening of sexually active female adolescents (SA), and 2) describe barriers to regular screening of SA for chlamydia METHODS/STUDY POPULATION: Using qualitative methods, 14 general pediatric providers across 7 clinical sites in Vermont were interviewed to ascertain best practices and remaining challenges. Semi-structured interviews lasting 30-45 minutes were audiotaped and transcribed. Chlamydia screening rates provided by BCBS-VT were used to categorize participant responses across three performance tiers, data were coded, and themes identified within these tiers. RESULTS/ANTICIPATED RESULTS: Facilitators: When asked to describe facilitators of chlamydia screening, providers in the top tier of chlamydia screening emphasized the importance of adequate insurance to cover the cost of testing. Providers in the middle performance tier cited use of pre-visit questionnaires, and those in the bottom performance tier identified no best practices. Other strategies included improving physician confidence and awareness, establishing practice- and individual-level routines, and providing strong leadership and communication of local screening rates. Barriers: Across the 3 performance tiers, the most common challenges to consistent chlamydia screening were threats to patient confidentiality, cost of the screening test, and requirement for patient disclosure of sexual activity. Less commonly, providers were concerned that adolescent patients were not reliable to obtain screens off-site, or fill treatment prescriptions without the help of a parent. DISCUSSION/SIGNIFICANCE OF IMPACT: The need for systematic, confidential, and inexpensive means for screening SA for chlamydia was highlighted in both the best practices and challenges described by providers of pediatric care in the suburban practice setting. Policy and practice interventions may target these needs to improve the reproductive health of female adolescents.

Comparing two definitions of ethnicity for identifying young persons at risk for chlamydia

2011 ◽  
Vol 140 (5) ◽  
pp. 951-958 ◽  
Author(s):  
A. HAASNOOT ◽  
F. D. H. KOEDIJK ◽  
E. L. M. OP DE COUL ◽  
H. M. GÖTZ ◽  
M. A. B. VAN DER SANDE ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Ethnic Disparities ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Country Of Birth ◽  
Regression Modelling ◽  
Explained Variation ◽  
The Difference ◽  
Using Data ◽  
Logistic Regression Modelling

SUMMARYEthnic disparities in chlamydia infections in The Netherlands were assessed, in order to compare two definitions of ethnicity: ethnicity based on country of birth and self-defined ethnicity. Chlamydia positivity in persons aged 16–29 years was investigated using data from the first round of the Chlamydia Screening Implementation (CSI, 2008–2009) and surveillance data from STI centres (2009). Logistic regression modelling showed that being an immigrant was associated with chlamydia positivity in both CSI [adjusted odds ratio (aOR) 2·3, 95% confidence interval (CI) 2·0–2·6] and STI centres (aOR 1·4, 95% CI 1·3–1·5). In both settings, 60% of immigrants defined themselves as Dutch. Despite the difference, classification by self-defined ethnicity resulted in similar associations between (non-Dutch) ethnicity and chlamydia positivity. However, ethnicity based on country of birth explained variation in chlamydia positivity better, and is objective and constant over time and therefore more useful for identifying young persons at higher risk for chlamydia infection.

Power of Knowledge

2015 ◽  
Vol 55 (8) ◽  
pp. 717-723
Author(s):  
Rachel S. Sagor ◽  
Jeremy Golding ◽  
Margaret M. Giorgio ◽  
Diane R. Blake
Keyword(s):  
Knowledge Score ◽  
Educational Interventions ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
University Campus ◽  
Intervention Participant ◽  
Media Type ◽  
Positive Effects ◽  
Stage Of Readiness ◽  
To Receive

We compared ( a) the effectiveness of print versus digital educational media for communicating information about Chlamydia trachomatis to adolescents and young adults and ( b) the influence of media type on readiness for Chlamydia screening. Young men and women (n = 103), aged 15 to 24 years, were recruited from a youth center and university campus and randomized to receive the print or digital Chlamydia educational intervention. Participant mean knowledge score improved postintervention, but there was no association with type of intervention medium. Nearly two-thirds (61%) of sexually active participants endorsed an increased postintervention stage of readiness for screening; however, there was no association with type of intervention medium. Learning about Chlamydia infection may have positive effects on willingness to be screened. Further study is needed to evaluate the efficacy of educational interventions for increasing actual screening rates.

Theoretical and methodological approaches to the calculation of planned costs for maintenance of service vehicles of the road works customer

2021 ◽  
Vol 2021 (23) ◽  
pp. 20-30
Author(s):  
Taras Pechonchyk ◽  
◽  
Vitaliy Ivanchenko ◽  
Keyword(s):  
Customer Service ◽  
Planning Process ◽  
Spare Parts ◽  
Cost Estimates ◽  
The Road ◽  
Fleet Composition ◽  
Cost Planning ◽  
Methodological Approaches ◽  
The Cost ◽  
Service Vehicles

AbstractIntroduction. Effective management of road indstry is particularly important in conditions of limited funding, as it is not possible to provide adequate funding of the economic entity that has the functions of a customer service. The cost of the customer service maintenance depends directly on the compliance with applicable regulations for these works cost determination. One of the aspects that form a considerable part of the costs of customer service is the maintenance of service vehicles.Problem Statement. Road services in the regions (hereinafter RSR) are the recipients and managers of the funds from the State Budget of Ukraine that are directed for the development and maintenance of public roads of state importance, being as well the asset holders of these roads. To perform their functions, the RSR have vehicles on their balance, the use of which involves a number of costs, including fuel and lubricants, repair, maintenance, replacement of tires, etc. The most important of the steps involved in setting the costs of vehicle maintenance is the process of cost planning. Planning has to be based on the structure of the vehicle fleet (own or leased), functional responsibilities and scope of road works.Planning is carried out for vehicles on the balance of the RSR, as well as for leased vehicles. In the case of leasing, the costs mentioned above are added by the vehicles leasing costs. These costs must be forecasted, justified and performed within the approved cost estimates of the customer service expenses.Purpose. The purpose of the article is to highlight the theoretical and methodological approaches to the calculation of planned costs for the maintenance of service vehicles of the road works customer.Materials and methods. Dialectical methods of knowledge, such as analysis and synthesis of fleet composition characteristics and approaches to cost planning methods, as well as induction, were used in writing the article to explore some aspects of the process of calculating the planned cost of maintenance of the road works customer's service vehicles.Results. The study highlights and describes the main approaches to the calculation of planned costs for the maintenance of service vehicles of the road works customer. The methodology of calculation of planned costs for the maintenance of service vehicles is explored.Conclusions. The introduction of a clear methodology and analytical toolkit for calculating all necessary expenditure items for the maintenance of the road works customer's vehicles in the cost planning process will establish the implementation of a clear mechanism for calculating the planned costs of maintenance of the road works customer's vehicles. It will also provide an automated information-analytical complex for planning of cost estimates, with information entry and reporting in standard forms and possibility of prompt response to changes in fleet composition, needs for spare parts, repairs or other expenses for the maintenance of service vehicles and making changes in cost estimates.Keywords: motor vehicles, costs, cost planning, customer service, maintenance of service vehicles

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