scholarly journals Cost-effectiveness of interventions to reduce the risk of healthcare-acquired infections in middle-income countries: A systematic review

2019 ◽  
Vol 20 (6) ◽  
pp. 266-273
Author(s):  
Pushpa Udayangani Gamalathge ◽  
Sanjeewa Kularatna ◽  
Hannah E Carter ◽  
Sameera Senanayake ◽  
Nicholous Graves
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Developed Countries ◽  
Healthcare Systems ◽  
Quality Of Reporting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Use Of Resources ◽  
The Cost

Background: Hospital-acquired infections (HAI) contribute to prolonged hospital stays and account for a substantial economic burden to healthcare systems. Middle-income countries (MICs) experience a greater burden of HAI than developed countries. Evidence on the cost-effectiveness of interventions to reduce HAI is required to inform decision-making in these settings. Aim: To synthesise the evidence on cost-effectiveness as related to HAI interventions in MICs and to assess the quality of this evidence. Methods: A systematic review of published literature on the cost-effectiveness of interventions to reduce the incidence of HAI in MICs between 2000 and 2018 was conducted. Results: Six studies met the pre-determined inclusion criteria. The studies were from three countries: Thailand; India; and Vietnam. The evidence suggests that interventions to reduce HAI are cost-effective and, in most cases, cost-saving to healthcare systems. The quality of the reporting varied across studies. Conclusions: The implementation of HAI prevention interventions appears to be a high value use of resources in MICs. There is a need for further cost-effectiveness analyses in a wider range of MICs in order to confirm these findings. Improved standardisation and quality of reporting is required.

Cost and Cost-effectiveness of eLearning Interventions for Healthcare Workers in Low- and Middle-income Countries: a Protocol for a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Nonjabulo Gwala ◽  
Thembelihle Patricia Dlungwane ◽  
Sphamandla Nkambule ◽  
Tivani Mashamba-Thompson
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Healthcare Workers ◽  
Professional Training ◽  
Meta Analysis ◽  
Middle Income ◽  
Worker Training ◽  
Middle Income Countries ◽  
The Cost ◽  
Low And Middle Income

Abstract BackgroundIn recent years, the shift from traditional face-to-face teaching methods to eLearning methods has shown to improve professional training, particularly for the health workers in achieving necessary specialised worker training. However, there is a insufficient evidence on the costs and cost-effectiveness of designing and deploying eLearning interventions for healthcare workers in low- and middle-income countries.MethodsThe study protocol was developed and reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The Cochrane Handbook for Systematic Reviews of Interventions will be used to guide the conduct of the proposed systematic review and meta-analysis. Systematic literature searches will be conducted using the EBSCOhost platform ( Academic Search Complete, ERIC, health source: nursing/academic edition, MEDLINE with Full Text, OpenDissertations), Google Scholar, and the following databases: Web of Science, PubMed and ProQuest databases, evaluating the cost and cost-effectiveness of e-learning interventions for healthcare workers in low- and middle-income countries. The searches will be open to peer-reviewed articles published in all languages and no restriction in publication year. We will further evaluate the cost-effectiveness by determining heterogeneity in the content, if feasible we will do a meta-analysis using Meta- Easy Excel software tools. We will use OR and 95% CIs as measures of effect for dichotomous outcomes. As for continuous outcomes, we will use standardised mean differences and 95% CIs. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of the evidence across outcomes. PRISMA-P will be used to report the findings of this systematic review and meta-analysis.DiscussionThis systematic review target to deliver complete evidence of cost and the cost-effectiveness of eLearning interventions for healthcare worker training. The study will be disseminated through the publication of the manuscript and policy brief in an appropriate journal and shared with the relevant stakeholders through conference presentations, discussions and seminars.Protocol registrationPROSPERO ID: 271180

scholarly journals Cost-effectiveness of neonatal surgery for congenital anomalies in low-income and middle-income countries: a systematic review protocol

2020 ◽  
Vol 4 (1) ◽  
pp. e000755
Author(s):  
Na Eun Kim ◽  
Dominique Vervoot ◽  
Ahmad Hammouri ◽  
Cristiana Riboni ◽  
Hosni Salem ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Low Income ◽  
Congenital Anomalies ◽  
Surgical Intervention ◽  
Neonatal Surgery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Burden ◽  
The Cost

IntroductionCongenital anomalies are the fifth leading cause of death in children under 5 years old globally (591 000 deaths reported in 2016). Over 95% of deaths occur in low-income and middle-income countries (LMICs). It is estimated that two-thirds of the congenital anomaly health burden could be averted through surgical intervention and that such interventions can be cost-effective. This systematic review aims to evaluate current evidence regarding the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs.Methods and analysisA systematic literature review will be conducted in PubMed, MEDLINE, Embase, Cochrane Library, Scielo, Google Scholar, African Journals OnLine and Regional WHO’s African Index Medicus databases for articles on the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs. The following search strings will be used: (1) congenital anomalies; (2) LMICs; and (3) cost-effectiveness of surgical interventions. Articles will be uploaded to Covidence software, duplicates removed and the remaining articles screened by two independent reviewers. Cost information for interventions or procedures will be extracted by country and condition. Outcome measurements by reported unit and cost-effectiveness ratios will be extracted. Methodological quality of each article will be assessed using the Drummond checklist for economic evaluations. The Agency for Healthcare Research and Quality’s Effective Health Care Program guidance will be followed to assess the grade of the studies.Ethics and disseminationNo ethical approval is required for conducting the systematic review. There will be no direct collection of data from individuals. The finalised article will be published in a scientific journal for dissemination. The protocol has been registered with PROSPERO (International Prospective Register of Systematic Reviews).ConclusionCongenital anomalies form a large component of the global health burden that is amenable to surgical intervention. This study will systematically review the current literature on the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs.PROSPERO registration numberCRD42020172971.

scholarly journals Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: a protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027490 ◽  
Author(s):  
Giulia Rinaldi ◽  
Alexa Hijazi ◽  
Hassan Haghparast-Bidgoli
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Economic Evaluations ◽  
Quality Of Reporting ◽  
The Cost

IntroductionType 2 diabetes mellitus (T2DM) remains one of the most common chronic diseases of adulthood which creates high degrees of morbidity and mortality worldwide. The incidence of T2DM continues to rise and recently, mHealth interventions have been increasingly used in the prevention, monitoring and management of T2DM. The aim of this study is to systematically review the published evidence on cost and cost-effectiveness of mHealth interventions for T2DM, as well as assess the quality of reporting of the evidence.Methods and analysisA comprehensive review of PubMed, EMBASE, Science Direct and Web of Science of articles published until January 2019 will be conducted. Included studies will be partial or full economic evaluations which provide cost or cost-effectiveness results for mHealth interventions targeting individuals diagnosed with, or at risk of, T2DM. The quality of reporting evidence will be assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results will be presented using a flowchart following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Graphical and tabulated representations of the results will be created for both descriptive and numerical results. The cost and cost-effectiveness values will be presented as reported by the original studies as well as converted into international dollars to allow comparability. As we are predicting heterogenous results, we will conduct a narrative and interpretive analysis of the data.Ethics and disseminationNo formal approval or review of ethics is required for this systematic review as it will involve the collection and analysis of secondary data. This protocol follows the current PRISMA-P guidelines. The review will provide information on the cost and cost-effectiveness of mHealth interventions targeting T2DM. These results will be disseminated through publication and submission to conferences for presentations and posters.PROSPERO registration numberCRD42019123476

scholarly journals A systematic review of the cost-effectiveness of emergency interventions for stroke in low- and middle-income countries

2020 ◽  
Vol 10 ◽  
pp. S90-S94
Author(s):  
Euridxe Barbosa ◽  
Brito Gulela ◽  
Maria A. Taimo ◽  
Dino M. Lopes ◽  
O. Agatha Offorjebe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Middle Income ◽  
Middle Income Countries ◽  
Emergency Interventions ◽  
The Cost ◽  
Low And Middle Income

scholarly journals Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. e004213
Author(s):  
Grace McCutchan ◽  
Bahr Weiss ◽  
Harriet Quinn-Scoggins ◽  
Anh Dao ◽  
Tom Downs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Help Seeking ◽  
Middle Income ◽  
Cancer Symptoms ◽  
Middle Income Countries ◽  
Help Seeking Behaviour ◽  
Psychosocial Influences

IntroductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.MethodsMixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.ResultsOf 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.ConclusionDue to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

scholarly journals A Systematic Review of the Cost-Effectiveness of Nurse Practitioners and Clinical Nurse Specialists: What Is the Quality of the Evidence?

2014 ◽  
Vol 2014 ◽  
pp. 1-28 ◽  
Author(s):  
Faith Donald ◽  
Kelley Kilpatrick ◽  
Kim Reid ◽  
Nancy Carter ◽  
Ruth Martin-Misener ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Nurse Practitioners ◽  
Internal Validity ◽  
Risk Of Bias ◽  
Nurse Specialist ◽  
Clinical Nurse ◽  
Education Experience ◽  
The Cost

Background. Improved quality of care and control of healthcare costs are important factors influencing decisions to implement nurse practitioner (NP) and clinical nurse specialist (CNS) roles.Objective. To assess the quality of randomized controlled trials (RCTs) evaluating NP and CNS cost-effectiveness (defined broadly to also include studies measuring health resource utilization).Design. Systematic review of RCTs of NP and CNS cost-effectiveness reported between 1980 and July 2012.Results. 4,397 unique records were reviewed. We included 43 RCTs in six groupings, NP-outpatient (n=11), NP-transition (n=5), NP-inpatient (n=2), CNS-outpatient (n=11), CNS-transition (n=13), and CNS-inpatient (n=1). Internal validity was assessed using the Cochrane risk of bias tool; 18 (42%) studies were at low, 17 (39%) were at moderate, and eight (19%) at high risk of bias. Few studies included detailed descriptions of the education, experience, or role of the NPs or CNSs, affecting external validity.Conclusions. We identified 43 RCTs evaluating the cost-effectiveness of NPs and CNSs using criteria that meet current definitions of the roles. Almost half the RCTs were at low risk of bias. Incomplete reporting of study methods and lack of details about NP or CNS education, experience, and role create challenges in consolidating the evidence of the cost-effectiveness of these roles.

scholarly journals Cost-Effectiveness of Hip Arthroscopy for Treatment of Femoroacetabular Impingement Syndrome and Labral Tears: A Systematic Review

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712098753
Author(s):  
Cammille C. Go ◽  
Cynthia Kyin ◽  
Jeffrey W. Chen ◽  
Benjamin G. Domb ◽  
David R. Maldonado
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Nonoperative Treatment ◽  
Cochrane Library ◽  
System Perspective ◽  
Labral Tears ◽  
The Cost

Background: Hip arthroscopy has frequently been shown to produce successful outcomes as a treatment for femoroacetabular impingement (FAI) and labral tears. However, there is less literature on whether the favorable results of hip arthroscopy can justify the costs, especially when compared with a nonoperative treatment. Purpose: To systematically review the cost-effectiveness of hip arthroscopy for treating FAI and labral tears. Study Design: Systematic review; Level of evidence, 3. Methods: PubMed/MEDLINE, Embase, and Cochrane Library databases, and the Tufts University Cost-Effectiveness Analysis Registry were searched to identify articles that reported the cost per quality-adjusted life-year (QALY) generated by hip arthroscopy. The key terms used were “hip arthroscopy,” “cost,” “utility,” and “economic evaluation.” The threshold for cost-effectiveness was set at $50,000/QALY. The Methodological Index for Non-Randomized Studies instrument and Quality of Health Economic Studies (QHES) score were used to determine the quality of the studies. This study was prospectively registered on PROSPERO (CRD42020172991). Results: Six studies that reported the cost-effectiveness of hip arthroscopy were identified, and 5 of these studies compared hip arthroscopy to a nonoperative comparator. These studies were found to have a mean QHES score of 85.2 and a mean cohort age that ranged from 33-37 years. From both a health care system perspective and a societal perspective, 4 studies reported that hip arthroscopy was more costly but resulted in far greater gains than did nonoperative treatment. The preferred treatment strategy was most sensitive to duration of benefit, preoperative osteoarthritis, cost of the arthroscopy, and the improvement in QALYs with hip arthroscopy. Conclusion: In the majority of the studies, hip arthroscopy had a higher initial cost but provided greater gain in QALYs than did a nonoperative treatment. In certain cases, hip arthroscopy can be cost-effective given a long enough duration of benefit and appropriate patient selection. However, there is further need for literature to analyze willingness-to-pay thresholds.

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