An economic evaluation of a telehealth network in British Columbia

2007 ◽  
Vol 13 (5) ◽  
pp. 251-256 ◽  
Author(s):  
Joseph Schaafsma ◽  
Stefan V Pantazi ◽  
Jochen R Moehr ◽  
Christine R Anglin ◽  
Nicole A Grimm
Keyword(s):  
British Columbia ◽  
Economic Evaluation ◽  
Travel Time ◽  
Opportunity Cost ◽  
Operating Cost ◽  
Cost Effective ◽  
Health Care Facilities ◽  
Travel Costs ◽  
Utilization Data ◽  
The Cost

We carried out an economic evaluation of the northernmost five sites of the British Columbia telehealth network. The videoconferencing network links health-care facilities in 12 communities with Vancouver, for clinical consultations, administrative meetings and educational sessions. The economic evaluation was based on the netcost criterion (i.e. cost of telehealth minus travel costs avoided). Cost and utilization data were obtained from client interviews and log data compiled between September 2001 and January 2003. The results showed that the subnetwork of five sites was not only cost reducing, but also cost-effective. Travel costs for administrative meetings were reduced by $724,457/annum and were greater than the annual fixed and variable costs of all the telehealth sessions ($553,740). A sensitivity analysis was conducted on six parameters: amortization period, opportunity cost of capital, operating cost of a telehealth session (by type of session), number of telehealth sessions, travel time and the opportunity cost of travel time. The study suggests that the cost-effectiveness of telehealth to remote areas will increase over time as the cost of equipment continues to fall, as network connections become cheaper and as utilization rates rise.

scholarly journals Economic Evaluation of Home Care for Stroke Patients Compared to Hospital Care: A Systematic Review

Health Scope ◽  
2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Maryam Khoramrooz ◽  
Asra Asgharzadeh ◽  
Saeide Alidoost ◽  
Zeynab Foroughi ◽  
Saber Azami ◽  
...  
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Home Care ◽  
Hospital Care ◽  
Cost Effective ◽  
Stroke Patients ◽  
Life Years ◽  
Effective Option ◽  
The Cost

Context: Stroke is one of the main causes of premature death and disability, imposing significant costs on the healthcare system, especially due to expensive hospital care. Home care service is one of the interventions used in the last two decades to reduce the cost of services provided for stroke patients in different countries. Objectives: The present study aimed to systematically review studies related to the economic evaluation of home care compared to hospital care for stroke patients. Data Sources: A search was conducted between January 1990 and January 2021. PubMed, Scopus, Web of Science, and Embase databases were searched systematically. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to select the studies. Data Extraction: To evaluate the quality of studies included in this systematic review, Drummond’s ten-item checklist was used. Results: Five economic evaluation studies were included in this review. The included studies reported different results regarding the effect of home care on improving different indicators and the cost-effectiveness ratio of home care to hospital care. Most previous studies reported that home care is a more cost-effective option for improving many indicators, such as physical function and quality-adjusted life years (QALY), and for reducing mortality and institutionalization, compared to hospital care. Conclusions: Home care is a more cost-effective option than hospital care for stroke patients with regard to some indicators, such as the Barthel index for Activities of Daily Living, Modified Rankin Scale (mRS), quality of life, mortality, and institutionalization. However, there are some exemptions to this conclusion. Due to limitations, such as heterogeneity of interventions in the existing studies, different levels of patients’ disabilities, different perspectives toward economic evaluation, and differences in the healthcare systems of countries, further research is needed according to the context of each country based on clinical trials.

scholarly journals Cost-Effectiveness Analysis of a Large-Scale Crèche Intervention to Prevent Child Drowning in Rural Bangladesh

2021 ◽  
Author(s):  
Y. Natalia Alfonso ◽  
Adnan A Hyder ◽  
Olakunle Alonge ◽  
Shumona Sharmin Salam ◽  
Kamran Baset ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Societal Perspective ◽  
Large Scale ◽  
Operating Cost ◽  
Cost Effective ◽  
Economic Benefits ◽  
Program Cost ◽  
Rural Bangladesh ◽  
Life Years ◽  
The Cost

Abstract Drowning is the leading cause of death among children 12-59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche intervention in preventing child drowning. Estimates of the effectiveness of the crèches was based on prior studies and the program cost was assessed using monthly program expenditures captured prospectively throughout the study period from two different implementing agencies. The study evaluated the cost-effectiveness from both a program and societal perspective. Results showed that from the program perspective the annual operating cost of a crèche was $416.35 (95%C.I.: $222 to $576), the annual cost per child was $16 (95%C.I.: $9 to $22) and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,803 (95%C.I.: $9,051 to $27,625). From the societal perspective (including parents time valued) the ICER per life saved was -$176,62 (95%C.I.: -$347,091 to -$67,684)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $2,020, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Based on the evidence, the creche intervention has great potential for reducing child drowning at a cost that is reasonable.

scholarly journals Cost-effectiveness of negative-pressure wound therapy in adults with severe open fractures of the lower limb: evidence from the WOLLF randomized controlled trial

2019 ◽  
Vol 101-B (11) ◽  
pp. 1392-1401 ◽  
Author(s):  
S. Petrou ◽  
B. Parker ◽  
J. Masters ◽  
J. Achten ◽  
J. Bruce ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Lower Limb ◽  
Negative Pressure Wound Therapy ◽  
Cost Effective ◽  
Open Fractures ◽  
Wound Management ◽  
Wound Therapy ◽  
Subgroup Analyses ◽  
The Cost

Aims The aim of this study was to estimate the cost-effectiveness of negative-pressure wound therapy (NPWT) in comparison with standard wound management after initial surgical wound debridement in adults with severe open fractures of the lower limb. Patients and Methods An economic evaluation was conducted from the perspective of the United Kingdom NHS and Personal Social Services, based on evidence from the 460 participants in the Wound Management of Open Lower Limb Fractures (WOLLF) trial. Economic outcomes were collected prospectively over the 12-month follow-up period using trial case report forms and participant-completed questionnaires. Bivariate regression of costs (given in £, 2014 to 2015 prices) and quality-adjusted life-years (QALYs), with multiple imputation of missing data, was conducted to estimate the incremental cost per QALY gained associated with NPWT dressings. Sensitivity and subgroup analyses were undertaken to assess the impacts of uncertainty and heterogeneity, respectively, surrounding aspects of the economic evaluation. Results The base case analysis produced an incremental cost-effectiveness ratio of £267 910 per QALY gained, reflecting higher costs on average (£678; 95% confidence interval (CI) -£1082 to £2438) and only marginally higher QALYS (0.002; 95% CI -0.054 to 0.059) in the NPWT group. The probability that NPWT is cost-effective in this patient population did not exceed 27% regardless of the value of the cost-effectiveness threshold. This result remained robust to several sensitivity and subgroup analyses. Conclusion This trial-based economic evaluation suggests that NPWT is unlikely to be a cost-effective strategy for improving outcomes in adult patients with severe open fractures of the lower limb. Cite this article: Bone Joint J 2019;101-B:1392–1401.

scholarly journals Early intervention in psychosis: health economic evaluation using the net benefit approach in a real-world setting

2019 ◽  
Vol 217 (3) ◽  
pp. 484-490 ◽  
Author(s):  
Caragh Behan ◽  
Brendan Kennelly ◽  
Eric Roche ◽  
Laoise Renwick ◽  
Sarah Masterson ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Early Intervention ◽  
Complex Intervention ◽  
Real World ◽  
Health Sector ◽  
Cost Effective ◽  
Net Benefit ◽  
Real World Setting ◽  
The Cost ◽  
Early Intervention In Psychosis

BackgroundEarly intervention in psychosis is a complex intervention, usually delivered in a specialist stand-alone setting, which aims to improve outcomes for people with psychosis. Previous studies have been criticised because the control used did not accurately reflect actual practice.AimsTo evaluate the cost-effectiveness of early intervention by estimating the incremental net benefit (INB) of an early-intervention programme, delivered in a real-world setting. INB measures the difference in monetary terms between alternative interventions.MethodTwo contemporaneous incidence-based cohorts presenting with first-episode psychosis, aged 18–65 years, were compared. Costs and outcomes were measured over 1 year. The main outcome was avoidance of a relapse that required admission to hospital or home-based treatment.ResultsFrom the health sector perspective, the probability that early intervention was cost-effective was 0.77. The INB was €2465 per person (95% CI − €4418 to €9347) when society placed a value of €6000, the cost of an in-patient relapse, on preventing a relapse requiring admission or home care. Following adjustment, the probability that early intervention was cost-effective was 1, and the INB to the health sector was €3105 per person (95% CI −€8453 to €14 663). From a societal perspective, the adjusted probability that early intervention was cost-effective was 1, and the INB was €19 928 per person (95% CI − €2075 to €41 931).ConclusionsEarly intervention has a modest INB from the health sector perspective and a large INB from the societal perspective. The perspective chosen is critical when presenting results of an economic evaluation of a complex intervention.

Cost-effective species conservation: an application to Huemul (Hippocamelus bisulcus) in Chile

2007 ◽  
Vol 12 (4) ◽  
pp. 535-551 ◽  
Author(s):  
CARLOS ADRIÁN SALDARRIAGA ISAZA ◽  
WALTER GÓMEZ BOFILL ◽  
HUGO SALGADO CABRERA
Keyword(s):  
Opportunity Cost ◽  
Species Conservation ◽  
Cost Effective ◽  
Land Allocation ◽  
Economic Activities ◽  
Time Period ◽  
Hippocamelus Bisulcus ◽  
Protection Area ◽  
The Cost ◽  
Production Possibilities Frontier

In this paper we study the cost-effective allocation of the land in the Cordilleran Protection Area (CPA), Region VIII, Chile, for the conservation of a highly threatened species: the Huemul (Hippocamelus bisulcus). Using a production possibilities frontier (PPF) approach, a linear programming optimization model for a ten-year time period is proposed. Our model takes into account both the preferences of the species for different habitats and the opportunity cost of the land. We evaluate different possibilities of land allocation and identify cost-effective alternatives in the provision of both conservation and income.The results confirm the hypothesis that both the population of Huemul and income from economic activities can be increased compared with current levels. Therefore the current allocation of the land in the CPA is not cost-effective.

scholarly journals Cost of pruning Douglas-fir in coastal British Columbia

1994 ◽  
Vol 70 (1) ◽  
pp. 80-83
Author(s):  
S. A. Y. Omule ◽  
D. E. Paul ◽  
L. M. Darling
Keyword(s):  
British Columbia ◽  
Key Words ◽  
Travel Time ◽  
Douglas Fir ◽  
Time Study ◽  
Average Spacing ◽  
The Cost ◽  
Coastal British Columbia

Artificial pruning can increase the quantity of high-value clear lumber harvested from Douglas-fir, but the pruning cost per tree is relatively high. To prune a young Douglas-fir to 6 metres in one lift and two lifts took, respectively, 9.5 and 10.1 minutes in 14- and 18-year old stands with average spacing between trees of about 3 metres on flat or 0-30% south-facing slopes in coastal British Columbia. The associated costs were $2.09 and $2.22. This included minor travel time between trees, but excluded the cost of travelling to the site, selecting and marking trees to be pruned, and purchasing and maintaining the pruning equipment. Differences in pruning time between one-lift pruning and two-lift pruning, in one or two passes, were small. A D-handled saw was preferred to the more strenuous snap-cut pruner with ratchet-style pinions, based on observations on a pruning time-study of 5 operators. Key words: pruning saw, snap-cut pruner, pruning time, one-lift pruning, two-lift pruning

AN ECONOMIC EVALUATION OF CONTROL METHODS FOR DIFFUSE AND SPOTTED KNAPWEED IN WESTERN CANADA

1979 ◽  
Vol 59 (2) ◽  
pp. 375-382 ◽  
Author(s):  
P. HARRIS ◽  
R. CRANSTON
Keyword(s):  
Biological Control ◽  
British Columbia ◽  
Economic Evaluation ◽  
Cost Effective ◽  
The Other ◽  
Western Canada ◽  
Spotted Knapweed ◽  
Control Methods ◽  
Effective Solution ◽  
Introduced Weeds

Diffuse and spotted knapweed are introduced weeds that threaten to spread throughout the uncultivated drylands of Western Canada. By 1972 approximately 30 000 ha, mostly in British Columbia, were infested, with forage reductions of up to 88%. Presently the infestation may be increasing by 10% a year and it is estimated that 8.4–10.7 million ha are susceptible to invasion by one or the other species in Western Canada. This would be disastrous to both ranching and wildlife in the region. The economics of various options for control are discussed. Biological control, which is likely to require the introduction of six agents and cost a total of $1.8 million, is the most cost-effective solution. However, until it can be fully implemented (10–20 yr) new infestations can be spot-treated with picloram. It is also economic to convert dense stands to tame pasture after killing the knapweed with picloram at 0.5 kg/ha although the knapweed is likely to begin reinvasion after 4 yr.

scholarly journals Rural Electrification of Somalia Using WT-PV-DG-Battery Hybrid System

2021 ◽  
Author(s):  
Swathi Kumar ◽  
Richard Blanchard
Keyword(s):  
Hybrid System ◽  
Operating Cost ◽  
Cost Effective ◽  
Sub Saharan Africa ◽  
Diesel Generator ◽  
African Countries ◽  
Diesel Generators ◽  
Sub Saharan ◽  
The Cost ◽  
Wind Resource

Around 14% of the global population does not have access to electricity. About 95% of those are living in rural Sub-Saharan Africa. Often in these regions, diesel generators are the only source of electricity. The operating cost of these diesel generators is high. However, solar and wind energy are available in most of African countries. This study presents the analysis of designing an off-grid hybrid system with a wind turbine, PV, diesel generator, and battery to power a hospital, school, and 200 household village in four locations across Somalia. The research investigated the availability of wind-solar resources in selected locations. Designing of the system and economic-technical calculations were performed using HOMER. The selection of the optimum design was based on the Cost of Electricity and Net Present Cost. The results show that for Kabaal and Ceel Buur, a WT-PV-DG-Battery is the optimal system as the wind resource in these regions is high. For Saakov and Baki, a PV-DG-Battery system proves to be optimum as the wind resource is limited here. The study also evaluated the control strategy and proved that combined dispatch was the most cost-effective for these locations. The study concluded that hybrid systems are more economical than diesel systems.

scholarly journals Economic Evaluation of Oral Alendronate Therapy for Osteoporosis in Chinese Postmenopausal Women: The Impact of Medication Compliance and Persistence

2020 ◽  
Vol 11 ◽  
Author(s):  
Ruxu You ◽  
Zijie Liu
Keyword(s):  
Sensitivity Analysis ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Postmenopausal Women ◽  
Medication Compliance ◽  
Cost Effective ◽  
Full Compliance ◽  
Chinese Postmenopausal Women ◽  
The Cost ◽  
The Impact

Objective: Prevalence of osteoporosis in Chinese postmenopausal women has significantly increased over the past decade and oral bisphosphonates are the most potent antiresorptive drugs. The purpose of the present research was to evaluate the cost-effectiveness of oral alendronate for individuals with osteoporosis. We also assessed the impact of medication compliance and persistence on economic outcomes of alendronate and potential economic evaluations of persistence-enhancing interventions.Methods: We constructed an individual-level state-transition model to project health outcomes and costs of oral alendronate for Chinese postmenopausal osteoporotic women. The impact of medication compliance and persistence on economic evaluation was addressed in various scenario analyses. Model inputs were derived from clinical trials and published sources, where available. Deterministic and probabilistic sensitivity analyses were conducted to explore the impact of uncertainties and assumptions on the cost-effectiveness results.Results: Compared with no treatment, alendronate treatment was associated with an additional 0.052 QALYs (quality-adjusted life-years) at an additional cost of USD 738, which yielded an incremental cost-effectiveness ratio (ICER) of USD 14,192.308/QALY. The ICER for the different scenarios (full compliance, full persistence, and both full persistence and full compliance) was USD 4,933.333/QALY, USD 3,006.849/QALY, and USD 2,049.822/QALY, respectively. One-way sensitivity analysis showed the ICER was most sensitive to variations in time horizon and residual effect. Probabilistic sensitivity analysis demonstrated that, at a willingness to pay of USD 29,340/QALY, the probability that oral alendronate therapy will be cost-effective is approximately 80%.Conclusion: The findings support the view that oral alendronate is cost-effective for the treatment of osteoporotic fractures in Chinese postmenopausal women. Medication persistence is found to have a greater impact on cost-effectiveness than compliance and interventions to improve persistence to be an efficient use of resources.

scholarly journals Overhead Pedestrian Crossings – Economic Evaluation through Vehicle Operating Cost and Travel Time Savings

OUSL Journal ◽  
2015 ◽  
Vol 7 (0) ◽  
pp. 77
Author(s):  
K. S. Weerasekera ◽  
K. M. G. N. S. Kumara ◽  
V. K. M. Pinnagoda
Keyword(s):  
Economic Evaluation ◽  
Travel Time ◽  
Operating Cost ◽  
Travel Time Savings ◽  
Time Savings
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