scholarly journals Pharmacoeconomics in Africa: needs, prospect and challenges

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Temitope Ben-Ajepe ◽  
Ifechukwu Benedict Nwogu ◽  
Damilola Quazeem Olaoye ◽  
Abdulhafeez Ayodele Mustapha ◽  
Theogene Uwizeyimana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Limited Resources ◽  
African Countries ◽  
Continuous Increase ◽  
Poverty Threshold ◽  
Therapy Choice ◽  
Medication Selection ◽  
Healthcare Interventions ◽  
The Cost

AbstractAfrica as a continent has experienced a continuous increase in the cost of healthcare as its demands increase. With many of these African countries living below the poverty threshold, Africans continue to die from preventable and curable diseases. Population increases have led to an increase in demands for healthcare, which unfortunately have been met with inequitable distribution of drugs. Hence, the outcomes from healthcare interventions are frequently not maximized. These problems notably call for some economic principles and policies to guide medication selection, procurement, or donation for population prioritization or health insurance. Pharmacoeconomics drives efficient use of scarce or limited resources to maximize healthcare benefits and reduce costs. It also brings to play tools that rate therapy choice based on the quality of life added to the patient after a choice of intervention was made over an alternative. In this paper, we commented on the needs, prospect, and challenges of pharmacoeconomics in Africa.

scholarly journals Ethical Issues Which Have Prevented the U.S. from Maximizing Quality of Life Years

2021 ◽  
Author(s):  
Sage Arbor
Keyword(s):  
Quality Of Life ◽  
Ethical Issues ◽  
Cost Transparency ◽  
Societal Norms ◽  
Life Years ◽  
Healthcare Interventions ◽  
The Cost ◽  
Quality Adjusted Life ◽  
The U.S

The cost of healthcare interventions varies greatly with age, with a significant fraction of cost being spent in the last two years of life. Treating a child can save orders of magnitude more life-years than an octogenarian treated for the same disease, such as cancer. While Quality-Adjusted Life Years (QALYs) can be used to plan a roadmap for how resources should be expended to maximize quality of life the execution of those plans often fail due to societal norms which trump the carefully measured QALYs, resulting in lowered average number and/or quality of years lived. The ethical issues concerning age, sex, lifestyle (smoking, drinking, obesity), cost transparency, and extreme examples (war, population explosion vs. collapse) will be discussed.

Unknown and Under-Researched: The Anatomy of Drinking Under Control Programs

2017 ◽  
Vol 63 (5) ◽  
pp. 277-288
Author(s):  
Harald Klingemann ◽  
Justyna Klingemann
Keyword(s):  
Quality Of Life ◽  
Harm Reduction ◽  
Evaluation Studies ◽  
Mission Statements ◽  
Community Response ◽  
Limited Resources ◽  
Admission Criteria ◽  
Control Programs ◽  
Institutional Order

Abstract. Introduction: While alcohol treatment predominantly focuses on abstinence, drug treatment objectives include a variety of outcomes related to consumption and quality of life. Consequently harm reduction programs tackling psychoactive substances are well documented and accepted by practitioners, whereas harm reduction programs tackling alcohol are under-researched and met with resistance. Method: The paper is mainly based on key-person interviews with eight program providers conducted in Switzerland in 2009 and up-dated in 2015, and the analysis of reports and mission statements to establish an inventory and description of drinking under control programs (DUCPs). A recent twin program in Amsterdam and Essen was included to exemplify conditions impeding their implementation. Firstly, a typology based on the type of alcohol management, the provided support and admission criteria is developed, complemented by a detailed description of their functioning in practice. Secondly, the case studies are analyzed in terms of factors promoting and impeding the implementation of DUCPs and efforts of legitimize them and assess their success. Results: Residential and non-residential DUCPs show high diversity and pursue individualized approaches as the detailed case descriptions exemplify. Different modalities of proactively providing and including alcohol consumption are conceptualized in a wider framework of program objectives, including among others, quality of life and harm reduction. Typically DUCPs represent an effort to achieve public or institutional order. Their implementation and success are contingent upon their location, media response, type of alcohol management and the response of other substance-oriented stake holders in the treatment system. The legitimization of DUCPs is hampered by the lack of evaluation studies. DUCPs rely mostly – also because of limited resources – on rudimentary self-evaluations and attribute little importance to data collection exercises. Conclusions: Challenges for participants are underestimated and standard evaluation methodologies tend to be incompatible with the rationale and operational objectives of DUCPs. Program-sensitive multimethod approaches enabled by sufficient financing for monitoring and accompanying research is needed to improve the practice-oriented implementation of DUCPs. Barriers for these programs include assumptions that ‘alcohol-assisted’ help abandons hope for recovery and community response to DUCPs as locally unwanted institutions (‘not in my backyard’) fuelled by stigmatization.

scholarly journals Economic assessment of a community-based care package for people with lower limb disorder caused by lymphatic filariasis, podoconiosis and leprosy in Ethiopia

2020 ◽  
Vol 114 (12) ◽  
pp. 1021-1034
Author(s):  
Natalia Hounsome ◽  
Mersha Kinfe ◽  
Maya Semrau ◽  
Oumer Ali ◽  
Abraham Tesfaye ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lymphatic Filariasis ◽  
Lower Limb ◽  
Life Quality ◽  
Psychosocial Care ◽  
Northwest Ethiopia ◽  
World Health ◽  
Care Package ◽  
The Cost

Abstract We conducted an implementation research study to integrate a holistic package of physical health, mental health and psychosocial care for podoconiosis, lymphatic filariasis and leprosy into routine healthcare in Gusha cluster, Guagusa Shikudad district, northwest Ethiopia. The healthcare package included training patients in lower limb hygiene and skin care and provision of shoes, hygiene supplies and medication. The implementation activities included training events, workshops, awareness raising, self-help groups, supportive supervision, staff secondments and advisory board meetings. The cost of implementing the care package in Gusha cluster, with a population of 30 558 people, was 802 655 Ethiopian birr (ETB) (£48 159) and the cost of delivering care to 235 participants was 204 388 ETB (£12 263), or 870 ETB (£52) per person. There was a 35% decrease in the mean disability scores (measured using the World Health Organization Disability Assessment Schedule 2.0) and a 45% improvement in the dermatology-specific quality of life (measured using the Dermatology Life Quality Index) at the 3-month follow-up compared with baseline. There were reductions in the number of days with symptoms, days off usual activities/work and days with reduced activity due to illness, all of which were statistically significant. Our pilot suggests that integration of the care package into routine healthcare in Ethiopia may be effective in improving health-related quality of life and disability and reducing time out of economic activity due to illness.

scholarly journals The cost, survival, and quality‐of‐life implications of guideline‐discordant imaging for prostate cancer

2021 ◽  
Author(s):  
Aaron N. Winn ◽  
Matthew Kelly ◽  
Shannon Ciprut ◽  
Dawn Walter ◽  
Heather T. Gold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
The Cost

Cost effectiveness in palliative care setting

2018 ◽  
Vol 21 (2) ◽  
pp. 62-71
Author(s):  
Henry O’Lawrence ◽  
Rohan Chowlkar
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Hospice Care ◽  
Home Health ◽  
Data Set ◽  
Content Type ◽  
Care Services ◽  
The Cost

Purpose The purpose of this paper is to determine the cost effectiveness of palliative care on patients in a home health and hospice setting. Secondary data set was utilized to test the hypotheses of this study. Home health care and hospice care services have the potential to avert hospital admissions in patients requiring palliative care, which significantly affects medicare spending. With the aging population, it has become evident that demand of palliative care will increase four-fold. It was determined that current spending on end-of-life care is radically emptying medicare funds and fiscally weakening numerous families who have patients under palliative care during life-threatening illnesses. The study found that a majority of people registering for palliative and hospice care settings are above the age group of 55 years old. Design/methodology/approach Different variables like length of stay, mode of payment and disease diagnosis were used to filter the available data set. Secondary data were utilized to test the hypothesis of this study. There are very few studies on hospice and palliative care services and no study focuses on the cost associated with this care. Since a very large number of the USA, population is turning 65 and over, it is very important to analyze the cost of care for palliative and hospice care. For the purpose of this analysis, data were utilized from the National Home and Hospice Care Survey (NHHCS), which has been conducted periodically by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Descriptive statistics, χ2 tests and t-tests were used to test for statistical significance at the p<0.05 level. Findings The Statistical Package for Social Sciences (SPSS) was utilized for this result. H1 predicted that patients in the age group of 65 years and up have the highest utilization of home and hospice care. This study examined various demographic variables in hospice and home health care which may help to evaluate the cost of care and the modes of payments. This section of the result presents the descriptive analysis of dependent, independent and covariate variables that provide the overall national estimates on differences in use of home and hospice care in various age groups and sex. Research limitations/implications The data set used was from the 2007 NHHCS survey, no data have been collected thereafter, and therefore, gap in data analysis may give inaccurate findings. To compensate for this gap in the data set, recent studies were reviewed which analyzed cost in palliative care in the USA. There has been a lack of evidence to prove the cost savings and improved quality of life in palliative/hospice care. There is a need for new research on the various cost factors affecting palliative care services as well as considering the quality of life. Although, it is evident that palliative care treatment is less expensive as compared to the regular care, since it eliminates the direct hospitalization cost, but there is inadequate research to prove that it improves the quality of life. A detailed research is required considering the additional cost incurred in palliative/hospice care services and a cost-benefit analysis of the same. Practical implications While various studies reporting information applicable to the expenses and effect of family caregiving toward the end-of-life were distinguished, none of the previous research discussed this issue as their central focus. Most studies addressed more extensive financial effect of palliative and end-of-life care, including expenses borne by the patients themselves, the medicinal services framework and safety net providers or beneficent/willful suppliers. This shows a significant hole in the current writing. Social implications With the aging population, it has become evident that demand of palliative/hospice care will increase four-fold. The NHHCS have stopped keeping track of the palliative care requirements after 2007, which has a negative impact on the growing needs. Cost analysis can only be performed by analyzing existing data. This review has recognized a huge niche in the evidence base with respect to the cost cares of giving care and supporting a relative inside a palliative/hospice care setting. Originality/value The study exhibited that cost diminishments in aggressive medications can take care of the expenses of palliative/hospice care services. The issue of evaluating result in such a physically measurable way is complicated by the impalpable nature of large portions of the individual components of outcome. Although physical and mental well-being can be evaluated to a certain degree, it is significantly more difficult to gauge in a quantifiable way, the social and profound measurements of care that help fundamentally to general quality of care.

Advances in critical care for the older patient

2013 ◽  
Vol 23 (2) ◽  
pp. 118-130 ◽  
Author(s):  
Diane Monkhouse
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Critical Illness ◽  
General Population ◽  
Acute Illness ◽  
Limited Resources ◽  
Care Practice ◽  
Older Patient ◽  
Life Sustaining Treatment

SummaryAs the proportion of elderly people in the general population increases, so does the number admitted to critical care. In caring for an older patient, the intensivist has to balance the complexities of an acute illness, pre-existing co-morbidities and patient preference for life-sustaining treatment with the chances of survival, quality of life after critical illness and rationing of expensive, limited resources. This remains one of the most challenging areas of critical care practice.

scholarly journals Análisis de las actitudes hacia la actividad minera en la comunidad de Combayo, región Cajamarca

2019 ◽  
pp. 91-97
Keyword(s):  
Quality Of Life ◽  
Cognitive Dissonance ◽  
Negative Attitude ◽  
Mining Activity ◽  
Psychological Wellbeing ◽  
Calidad De Vida ◽  
Physical Wellbeing ◽  
The Cost ◽  
Bienestar Psicologico

Análisis de las actitudes hacia la actividad minera en la comunidad de Combayo, región Cajamarca Analysis of attitudes towards the mining activity in Combayo’s community, Cajamarca Region Jorge L. Vásquez pacheco Universidad Inca Garcilaso de la Vega Empresa de Servicios Organizacionales, Educativos y Comunitarios Green planet DOI: https://doi.org/10.33017/RevECIPeru2010.0026/ RESUMEN Estudio de tipo descriptivo que aplica la metodología transversal mediante una escala original de actitudes, tipo Likert, compuesta inicialmente de 32 reactivos, reducidos a 29 ítems tras el análisis estadístico por medio de la correlación item-test. Dicha escala obtuvo un coeficiente Alfa de Cronbach de ,938, determinando así su consistencia y su validez para el propósito del presente estudio. Los participantes fueron 120 pobladores oriundos de la comunidad de Combayo, región Cajamarca, cuyas edades fluctuaban entre 18 a 60 años (hombres y mujeres), elegidos al azar. No se dio preferencia a uno u otro sexo y todas las dudas fueron resueltas de manera personalizada. Asimismo, tras la aplicación del instrumento se realizaron entrevistas breves a un subgrupo (30) elegido de manera aleatoria con el fin de complementar y contrastar la información obtenida y conocer así si el comunero de Combayo fundamenta la posición que asume. Se obtuvieron cinco factores: calidad de vida, desarrollo comunal, prospección comunal, bienestar psicológico y bienestar físico, cuyos indicadores han permitido establecer los niveles de aprobación respecto a la actividad minera, con los siguientes resultados: para el 80%, la actividad minera es desfavorable; para el 14%, la actividad minera es favorable; mientras que para el 6%, la influencia de la actividad minera le resulta neutral. Se concluye que a pesar de la actitud desfavorable hacia la actividad minera en su comunidad, los pobladores la aceptan a nivel conductual, pues mediante las entrevistas se pudo conocer que en general percibían que dicha actividad podía contribuir a su bienestar pero a costa de su calidad de vida (primer factor), siendo mayor la consideración (puntajes de las medias aritméticas) que tienen respecto al desarrollo de su comunidad (segundo factor), la prospección comunal (tercer factor), el bienestar psicológico (cuarto factor) y el bienestar físico (quinto factor). Sin embargo, dicha consideración disminuye respecto a factores contribuyentes a mejorar su calidad de vida. De esta expresión se puede notar que los comuneros de Combayo tienen mayor interés por la obtención de resultados a corto plazo y de satisfacción inmediata respecto a los beneficios que esperan obtener del desarrollo de actividades mineras en su comunidad, lo cual evidencia la presencia de una disonancia cognitiva en dicha comunidad, puesto que estarían reconociendo sus necesidades y también el costo de satisfacer las mismas. Descriptores: actitud, actividad minera, comunidad, disonancia cognitiva. ABSTRACT This is a descriptive study that applies a cross research methodology through the application of an original scale of attitudes, likert like, composed originally of 32 reagents, reduced to 29 items after the statistical analysis through the item-test correlation. The scale obtained a cronbach alpha coefficient of, 938 thereby determining the consistency and validity for the purpose of this study. The participants were 120 people natives from the combayo’s community, region cajamarca, ranging in age from 18 to 60 years (men and women) selected randomly. no preference was given to any gender and all doubts were resolved in an individual manner. also, after application of the instrument brief interviews were conducted with a subgroup (30) randomly chosen in order to complement and contrast the information obtained, thus disclosing whether the villager from combayo has a basis for the position taken. We looked into five factors: Quality of life, community development, community prospecting, psychological wellbeing, and physical wellbeing. Where indicators serve to establish approval levels on mining, with the following results: For 80% of the subjects mining is unfavorable, for 14% of the subjects mining is favorable, and for 6% of the subjects the influence of mining is neutral. We conclude that despite the negative attitude towards mining in this community, residents accept it since they generally perceived that this activity could contribute to their welfare but at the cost of their quality of life (First Factor), but it is of their greater consideration (scores of arithmetic mean) the development of their community (second factor), the communal prospects (third factor), the psychological wellbeing (fourth factor), and physical wellbeing (Fifth Factor). nevertheless, such consideration falls on contributing to improve their quality of life. one can see that the commoners of combayo are more interested in obtaining short-term results and immediate satisfaction regarding the benefits expected from the development of mining activities in their community, which shows the presence of cognitive dissonance in that community since they would be recognizing their needs and also the cost of meeting them. Keywords: attitude, mining activity, community, cognitive dissonance.

Injuries and the Cost of Falls Among Older Adults—How Pharmacists Can Help

2009 ◽  
Vol 22 (3) ◽  
pp. 344-345 ◽  
Author(s):  
Donald Limona
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Older Adults ◽  
Medical Expenditures ◽  
Public Health Issue ◽  
Considerable Morbidity ◽  
The Cost ◽  
Serious Injuries ◽  
Care Costs

Fall-related injuries are a serious public health issue among older adults. In addition to having a significant impact on our economy, these injuries are associated with considerable morbidity. Each year, 1 out of every 3 adults aged 65 and older fall; of these adults, 10% to 20% sustain serious injuries such as fractures or head traumas. Such injuries account for about 6% of medical expenditures for adults 65 years and older. Pharmacist interventions can prevent falls, thereby improving the quality of life of these older adults, preserving their independence, and significantly reducing health care costs.

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