scholarly journals Low costs and opportunities for efficiency: a cost analysis of the first year of programmatic PrEP delivery in Kenya’s public sector

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn Peebles ◽  
Kenneth K. Mugwanya ◽  
Elizabeth Irungu ◽  
Josephine Odoyo ◽  
Elizabeth Wamoni ◽  
...  
Keyword(s):  
Public Sector ◽  
Care Service ◽  
Economic Cost ◽  
High Volume ◽  
First Year ◽  
Economic Costs ◽  
Ministry Of Health ◽  
Time And Motion ◽  
The Cost ◽  
Hiv 1

Abstract Background In 2017, the Kenyan Ministry of Health integrated provision of pre-exposure prophylaxis (PrEP) into public HIV-1 care clinics as a key component of the national HIV-1 prevention strategy. Estimates of the cost of PrEP provision are needed to inform the affordability and cost-effectiveness of PrEP in Kenya. Methods We conducted activity-based micro-costing from the payer perspective to estimate both the financial and economic costs of all resources and activities required to provide PrEP in Kenya’s public sector. We estimated total and unit costs in 2019 United States dollars from a combination of project expense reports, Ministry of Health training reports, clinic staff interviews, time-and-motion observations, and routinely collected data from PrEP recipient files from 25 high-volume HIV-1 care clinics. Results In the first year of programmatic PrEP delivery in 25 HIV-1 care clinics, 2,567 persons initiated PrEP and accrued 8,847 total months of PrEP coverage, accounting for 2 % of total outpatient clinic visits. The total financial cost to the Ministry of Health was $91,175, translating to an average of $10.31 per person per month. The majority (69 %) of financial costs were attributable to PrEP medication, followed by administrative supplies (17 %) and training (9 %). Economic costs were higher ($188,584 total; $21.32 per person per month) due to the inclusion of the opportunity cost of staff time re-allocated to provide PrEP and a proportional fraction of facility overhead. The vast majority (88 %) of the annual $80,811 economic cost of personnel time was incurred during activities to recruit new clients (e.g., discussion of PrEP within HIV-1 testing and counselling services), while the remaining 12 % was for activities related to both initiation and maintenance of PrEP provision (e.g., client consultations, technical advising, support groups). Conclusions Integration of PrEP provision into existing public health HIV-1 care service delivery platforms resulted in minimal additional staff burden and low incremental costs. Efforts to improve the efficiency of PrEP provision should focus on reductions in the cost of PrEP medication and extra-clinic demand creation and community sensitization to reduce personnel time dedicated to recruitment-related activities. Trial registration ClinicalTrials.gov registration NCT03052010. Retrospectively registered on February 14, 2017.

scholarly journals Occupational Stress and Its Economic Cost in Hong Kong: The Role of Positive Emotions

2020 ◽  
Vol 17 (22) ◽  
pp. 8601
Author(s):  
Oi Ling Siu ◽  
Cary L. Cooper ◽  
Lara C. Roll ◽  
Carol Lo
Keyword(s):  
Hong Kong ◽  
Occupational Stress ◽  
Positive Emotions ◽  
Job Insecurity ◽  
Economic Cost ◽  
Economic Costs ◽  
Job Stressors ◽  
Organizational Constraints ◽  
The Cost

There has been less research on the costs of occupational stress attributed to certain job stressors in Chinese contexts. This study identified and validated common job stressors and estimated the economic cost in Hong Kong. The role of positive emotions in alleviating the economic costs of job stressors was also examined. Both qualitative and quantitative approaches were adopted. The findings obtained from five focus group discussions and a survey validated five common job stressors: Job insecurity; quantitative workload; organizational constraints; interpersonal conflicts; and work/home interface. A total of 2511 employees were surveyed, with 2032 valid questionnaires returned (925 males, 1104 females, and 3 unidentified, whose ages ranged from 18 to 70 years). The economic costs were estimated by combining the costs of absenteeism, presenteeism, and medical expenses. Absenteeism mainly caused by job stressors of the work/home interface, job insecurity, and quantitative workload accounted for an annual economic cost of HK$550 million to HK$860 million. The annual economic cost due to presenteeism mainly caused by job stressors of job insecurity, interpersonal conflict, quantitative workload, and organizational constraints ranged from HK$1.373 billion to HK$2.146 billion. The cost of medical treatments associated with occupational stress was HK$2.889 billion to HK$4.083 billion. Therefore, the total annual economic cost of occupational stress was approximately HK$4.81 billion to HK$7.09 billion. Positive emotions, representing a less explored individual factor in the cost of occupational stress studies, was found to be negatively correlated with presenteeism and buffered the negative impact of job stressors on absenteeism. The theoretical contributions and practical implications of findings are discussed.

Modeling the likely economic cost of non-adherence to TB medicines in the Philippines

2020 ◽  
Vol 24 (9) ◽  
pp. 902-909
Author(s):  
D. Collins ◽  
H. Lam ◽  
H. Firdaus ◽  
J. Antipolo ◽  
P. Mangao
Keyword(s):  
Economic Impact ◽  
Economic Burden ◽  
Economic Cost ◽  
The Philippines ◽  
Economic Costs ◽  
Loss To Follow Up ◽  
The World ◽  
Mdr Tb ◽  
The Cost

SETTING: The Philippines has a population of over 90 million people and is one of the 22 highest TB burden countries in the world.OBJECTIVE: To understand the economic cost of non-adherence to TB medicines due to loss to follow up and stock-outs in the Philippines.DESIGN: Data were collected on the economic costs of non-adherence to TB medicines and a model was developed to show those costs under different scenarios.RESULTS: The model showed that as many as 1958 and 233 persons are likely to have died as a result of DS-TB and MDR-TB loss to follow up, respectively, and 588 persons are likely to have died as a result of TB medicine stock outs. The related economic impact in each case is likely have been to be as much as US$72.2 million, US$13.4 million and US$21.0 million, respectively.CONCLUSION: The economic costs of non-adherence to TB medicines due to loss to follow-up and stock-outs represent a significant economic burden for the country and it is likely that the cost of addressing these problems would be much less than this burden and, therefore, a wise investment.

The Economic Cost of Suicide in Ireland

Crisis ◽  
2007 ◽  
Vol 28 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Brendan Kennelly
Keyword(s):  
Gross National Product ◽  
Indirect Costs ◽  
Economic Cost ◽  
Economic Costs ◽  
Total Cost ◽  
Direct And Indirect Costs ◽  
Education And Health ◽  
Human Cost ◽  
Human Costs ◽  
The Cost

Abstract. Objective: To calculate the costs of suicide in Ireland. Method: The paper identifies all episodes of suicide in Ireland in 2001 and 2002, and projects the economic costs arising from these episodes over subsequent years. All prices have been converted to 2001 euros. Both direct and indirect costs were calculated. Indirect costs included both the cost of lost output and human costs. Results: The total cost of suicide is estimated at over Euro 906 million in 2001, and over Euro 835 million in 2002 (in 2001 prices). This is equivalent to a little under 1% of the gross national product in Ireland for those years. Conclusions: The results show that investment in health education and health promotion can be justified on the basis of the costs associated with suicide in Ireland. These costs fall on individuals, families, and society. The huge human cost of suffering associated with suicide can also be prevented through appropriate intervention to prevent death occurring. It is important that any suicide prevention strategy should include an evaluative framework to ensure that investment occurs in the areas most likely to generate the highest returns in term of suicides prevented and lives saved.

scholarly journals Enumerating the Economic Cost of Antimicrobial Resistance Per Antibiotic Consumed to Inform the Evaluation of Interventions Affecting their Use

2017 ◽  
Author(s):  
Poojan Shrestha ◽  
Ben S Cooper ◽  
Joanna Coast ◽  
Raymond Oppong ◽  
Nga T. T. Do ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Broad Spectrum ◽  
Correlation Coefficients ◽  
Economic Cost ◽  
The United States ◽  
Economic Evaluations ◽  
Policy Recommendations ◽  
Economic Costs ◽  
The Us ◽  
The Cost

AbstractBackground– Antimicrobial resistance (AMR) poses a colossal threat to global health and incurs high economic costs to society. Economic evaluations of antimicrobials and interventions such as diagnostics and vaccines that affect their consumption rarely include the costs of AMR, resulting in sub-optimal policy recommendations. We estimate the economic cost of AMR per antibiotic consumed, stratified by drug class and national income level.Methods– The model is comprised of three components: correlation coefficients between human antibiotic consumption and subsequent resistance; the economic costs of AMR for five key pathogens; and consumption data for antibiotic classes driving resistance in these organisms. These were used to calculate the economic cost of AMR per antibiotic consumed for different drug classes, using data from Thailand and the United States (US) to represent low/middle and high-income countries.Results– The correlation coefficients between consumption of antibiotics that drive resistance in S. aureus, E. coli, K. pneumoniae, A. baumanii, and P. aeruginosa and resistance rates were 0.37, 0.27, 0.35, 0.45, and 0.52, respectively. The total economic cost of AMR due to resistance in these five pathogens was $0.5 billion and $2.8 billion in Thailand and the US, respectively. The cost of AMR associated with the consumption of one standard unit (SU) of antibiotics ranged from $0.1 for macrolides to $0.7 for quinolones, cephalosporins and broad-spectrum penicillins in the Thai context. In the US context, the cost of AMR per SU of antibiotic consumed ranged from $0.1 for carbapenems to $0.6 for quinolones, cephalosporins and broad spectrum penicillins.Conclusion– The economic costs of AMR per antibiotic consumed were considerable, often exceeding their purchase cost. Differences between Thailand and the US were apparent, corresponding with variation in the overall burden of AMR and relative prevalence of different pathogens. Notwithstanding their limitations, use of these estimates in economic evaluations can make better-informed policy recommendations regarding interventions that affect antimicrobial consumption and those aimed specifically at reducing the burden of AMR.

Evaluation System’s Research on Textile Fiber Material Ecological Recycling

2014 ◽  
Vol 1055 ◽  
pp. 92-95
Author(s):  
Gang Wang
Keyword(s):  
Fiber Material ◽  
Economic Cost ◽  
Textile Fiber ◽  
Economic Costs ◽  
Treatment Methods ◽  
Material Recycling ◽  
Key Factor ◽  
Recycled Fiber ◽  
Fiber Materials ◽  
The Cost

This article evaluate the recycling of renewable fiber feasibility from the economic cost, the key factor is the treatment methods, reuse direction, and its economic costs. Textile fiber material recycling economic cost, mainly through analysis the cost of new textile fiber materials prices and the price of recycled fiber, of which the price of recycled fiber is the recovery of the prices of textile fibers combined with the recycling processing costs.

Study on Modifying of Polypropylene and Calcium Carbonate

2014 ◽  
Vol 1055 ◽  
pp. 27-31
Author(s):  
Ying Chen ◽  
Gang Zeng
Keyword(s):  
Calcium Carbonate ◽  
Fiber Material ◽  
Economic Cost ◽  
Textile Fiber ◽  
Economic Costs ◽  
Material Recycling ◽  
Key Factor ◽  
Recycled Fiber ◽  
Fiber Materials ◽  
The Cost

This article evaluate the recycling of renewable fiber feasibility from the economic cost, the key factor is the treatment methods, reuse direction, and its economic costs. Textile fiber material recycling economic cost, mainly through analysis the cost of new textile fiber materials prices and the price of recycled fiber, of which the price of recycled fiber is the recovery of the prices of textile fibers combined with the recycling processing costs.

Identyfikacja kosztów pogorszenia reputacji przedsiębiorstwa z perspektywy interesariuszy

2014 ◽  
pp. 10-15
Author(s):  
Danuta Szwajca ◽  
Alina Rydzewska ◽  
Tomasz Nawrocki
Keyword(s):  
Cost Analysis ◽  
Economic Costs ◽  
Crisis Situation ◽  
Modern Economy ◽  
The Cost ◽  
A Company ◽  
Crisis Situations

In the realities of modern economy even the best-managed company is not able to avoid threats and bad decisions, that can cause a crisis. Each crisis situation, that a company experiences, generates not only measurable economic costs, but also more difficult to assess and measure costs of a deteriorated reputation. These costs are the result of infringement of interests or failing to satisfy different stakeholders expectations. The aim of this article is an attempt to identify the cost of reputation deterioration in the context of the various interests of stakeholders groups. In the first part, the paper presents the effects of good and bad reputation, the reputation "contamination" path in a crisis situation and a cost analysis caused by it. The second part is empirical, where the identification of crisis situations measurable costs and reputation deterioration based on the examples of three selected companies was performed.

The Cost of Being ‘Backward’ in India: Socio-religious Discrimination in the Labour Market

2021 ◽  
pp. 097370302110296
Author(s):  
Soumyajit Chakraborty ◽  
Alok K. Bohara
Keyword(s):  
Labour Market ◽  
Economic Cost ◽  
National Sample ◽  
Sample Survey ◽  
Religious Discrimination ◽  
Capital Endowment ◽  
Scheduled Castes ◽  
Sample Survey Data ◽  
The Cost ◽  
Human Capital Endowment

Being from backward castes, classes and Muslims in India has an economic cost associated with the nature of institutional discrimination. Using the 2011–2012 National Sample Survey data, this study identifies that caste and religion still rule the modern Indian labour market. We find that discrimination is evident in the socio-religious earnings gaps. While the parametric decompositions suggest that most of these gaps are due to differential human capital endowment, the nonparametric method almost evenly attributes inequality to discrimination and endowment. The results presented in this study suggest that discrimination against Scheduled Castes and Scheduled Tribes, Muslims and Other Backward Classes should be included in policy designs to promote equity in the Indian labour market.

scholarly journals Roughing Milling with Ceramic Tools in Comparison with Sintered Carbide on Nickel-Based Alloys

Coatings ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 734
Author(s):  
Pablo Fernández-Lucio ◽  
Octavio Pereira Neto ◽  
Gaizka Gómez-Escudero ◽  
Francisco Javier Amigo Fuertes ◽  
Asier Fernández Valdivielso ◽  
...  
Keyword(s):  
Cutting Speed ◽  
High Volume ◽  
Cemented Carbide ◽  
Performance Ratio ◽  
Cost Performance ◽  
Ceramic Tools ◽  
The Cost ◽  
Engine Components ◽  
Coated Carbide ◽  
Milling Tools

Productivity in the manufacture of aircrafts components, especially engine components, must increase along with more sustainable conditions. Regarding machining, a solution is proposed to increase the cutting speed, but engines are made with very difficult-to-cut alloys. In this work, a comparison between two cutting tool materials, namely (a) cemented carbide and (b) SiAlON ceramics, for milling rough operations in Inconel® 718 in aged condition was carried out. Furthermore, both the influence of coatings in cemented carbide milling tools and the cutting speed in the ceramic tools were analysed. All tools were tested until the end of their useful life. The cost performance ratio was used to compare the productivity of the tested tools. Despite the results showing higher durability of the coated carbide tool, the ceramic tools presented a better behavior in terms of productivity at higher speed. Therefore, ceramic tools should be used for higher productivity demands, while coated carbide tools for low speed-high volume material removal.

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