scholarly journals Removal of percutaneous K-wires used in paediatric fracture stabilisation under IV sedation: a cost-effective and timesaving service delivery in the COVID-19 pandemic setting

2020 ◽  
Vol 102 (6) ◽  
pp. 466-466
Author(s):  
V Thiruvasagam ◽  
C Wong ◽  
S Ahmed
Keyword(s):  
Service Delivery ◽  
Cost Effective ◽  
Paediatric Fracture ◽  
K Wires

scholarly journals Cost-effectiveness and feasibility of conditional economic incentives and motivational interviewing to improve HIV health outcomes of adolescents living with HIV in Anambra State, Nigeria

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Obinna Ikechukwu Ekwunife ◽  
Chinelo Janefrances Ofomata ◽  
Charles Ebuka Okafor ◽  
Maureen Ugonwa Anetoh ◽  
Stephen Okorafor Kalu ◽  
...  
Keyword(s):  
Viral Load ◽  
Cost Effectiveness ◽  
Service Delivery ◽  
Motivational Interviewing ◽  
Cost Effective ◽  
Economic Incentives ◽  
Additional Patient ◽  
Incentive Scheme ◽  
The Cost ◽  
The Impact

Abstract Background In sub-Saharan Africa, there is increasing mortality and morbidity of adolescents due to poor linkage, retention in HIV care and adherence to antiretroviral therapy (ART). This is a result of limited adolescent-centred service delivery interventions. This cost-effectiveness and feasibility study were piggybacked on a cluster-randomized trial that assessed the impact of an adolescent-centred service delivery intervention. The service delivery intervention examined the impact of an incentive scheme consisting of conditional economic incentives and motivational interviewing on the health outcomes of adolescents living with HIV in Nigeria. Method A cost-effectiveness analysis from the healthcare provider’s perspective was performed to assess the cost per additional patient achieving undetected viral load through the proposed intervention. The cost-effectiveness of the incentive scheme over routine care was estimated using the incremental cost-effectiveness ratio (ICER), expressed as cost/patient who achieved an undetectable viral load. We performed a univariate sensitivity analysis to examine the effect of key parameters on the ICER. An in-depth interview was conducted on the healthcare personnel in the intervention arm to explore the feasibility of implementing the service delivery intervention in HIV treatment hospitals in Nigeria. Result The ICER of the Incentive Scheme intervention compared to routine care was US$1419 per additional patient with undetectable viral load. Going by the cost-effectiveness threshold of US$1137 per quality-adjusted life-years suggested by Woods et al., 2016, the intervention was not cost-effective. The sensitivity test showed that the intervention will be cost-effective if the frequency of CD4 count and viral load tests are reduced from quarterly to triannually. Healthcare professionals reported that patients’ acceptance of the intervention was very high. Conclusion The conditional economic incentives and motivational interviewing was not cost-effective, but can become cost-effective if the frequency of HIV quality of life indicator tests are performed 1–3 times per annum. Patients’ acceptance of the intervention was very high. However, healthcare professionals believed that sustaining the intervention may be difficult unless factors such as government commitment and healthcare provider diligence are duly addressed. Trial registration This trial is registered in the WHO International Clinical Trials Registry through the WHO International Registry Network (PACTR201806003040425).

Cyberspace at the Grassroots: E-Governance and Citizen/Stakeholder Perceptions at the Local Level in Bangladesh

2021 ◽  
pp. 245513332110340
Author(s):  
Habib Zafarullah ◽  
Jannatul Ferdous
Keyword(s):  
Service Delivery ◽  
Service Providers ◽  
Social Issues ◽  
Local Level ◽  
Cost Effective ◽  
Developed Countries ◽  
Information And Communications Technology ◽  
Least Developed Countries ◽  
Governance System ◽  
Citizen Perceptions

Bangladesh has experimented with e-governance since the early 2000s and currently ranks among the top 10 least developed countries. The deployment of e-governance at the local level has provided benefits to the rural people, with local councils increasingly using information and communications technology (ICT) to expand community-based delivery systems and augment rural service delivery. One-stop cyber centres provide a range of services that are user-friendly, cost-effective and less time-consuming. This study focuses on five sub-districts to inquire about the range of services provided by the e-service centres there. It has recorded citizen perceptions and the level of their satisfaction and the observations of service providers about the e-service mechanism. It also identifies key challenges in service delivery. Citizen satisfaction was measured using 12 indicators, while the service provider observations focused on social issues, governance, resource and technical issues. The study found several issues requiring attention to consolidate the e-governance system in the country.

Building back smarter—part one: the case for more modular facilities in the NHS

2021 ◽  
Vol 27 (9) ◽  
pp. 1-9
Author(s):  
Isobel Clough
Keyword(s):  
Service Delivery ◽  
Physical Space ◽  
Cost Effective ◽  
Healthcare Services ◽  
Business Case ◽  
Care Quality ◽  
Healthcare Facilities ◽  
Building Maintenance ◽  
Cost Implications ◽  
The Cost

The NHS is facing an unprecedented backlog in both patient care and building maintenance, with severe implications for service delivery, finance and population wellbeing. This article is the first in a series discussing modular healthcare facilities as a potential solution to these issues, providing flexible and cost-effective spaces to allow services to increase capacity without sacrificing care quality. The first of three instalments, this paper will outline the problems facing the NHS estate, many of which have been exacerbated to critical levels by the COVID-19 pandemic, and what this means for service delivery. It will then make the case for modular infrastructure, outlining the potential benefits for healthcare services, staff and patients alike. Using modern methods of construction, this approach to creating physical space in healthcare can provide greater flexibility and a reduced impact on the environment. The next two articles in this series will go on to provide detailed case studies of successful modular implementation in NHS trusts, an analysis of the cost implications and guidance on the commissioning process and building a business case.

scholarly journals A Framework for Designing and Evaluating Internet Interventions to Improve Tinnitus Care

2019 ◽  
pp. 121-160
Author(s):  
Eldré W. Beukes ◽  
Gerhard Andersson ◽  
Vinaya Manchaiah ◽  
Peter M. Allen ◽  
David M. Baguley
Keyword(s):  
Service Delivery ◽  
Intervention Development ◽  
Cost Effective ◽  
Evidence Based ◽  
Service Delivery Models ◽  
Internet Interventions ◽  
Intervention Models ◽  
Related Symptom ◽  
Delivery Models ◽  
Internet Based Intervention

Tinnitus can be a debilitating hearing-related symptom. Access to evidence-based tinnitus interventions remain limited. Tele-audiology can assist by providing a clinically and cost-effective tinnitus management route. This chapter highlights how this is made possible by focusing on one form of tele-audiology, namely an internet-based intervention. Guidelines are provided for the development of such interventions. A framework outlining the various processes involved in evaluating newly developed interventions is also provided. The chapter closes by discussing factors that may facilitate or hamper the dissemination of new interventions into existing service delivery models. This well-defined outline for intervention development and evaluation can be applied and used to guide innovative intervention models by stakeholders.

scholarly journals Testing a community-based distribution approach to reproductive health service delivery in Senegal (a study of community agents in Kébémer)

2004 ◽  
Keyword(s):  
Rural Communities ◽  
Reproductive Health ◽  
Service Delivery ◽  
Social Action ◽  
Rural Areas ◽  
Cost Effective ◽  
Health Service Delivery ◽  
Reproductive Health Services ◽  
Community Based ◽  
Integrated Cost

The Division of Reproductive Health (DSR) of the Senegal Ministry of Health and Social Action, in partnership with the Population Council’s FRONTIERS in Reproductive Health program and Management Sciences for Health (MSH), conducted a study to test and compare three ways of providing reproductive health services to rural communities in the Kébémer district of Senegal in terms of their effectiveness, cost, and cost-effectiveness. FRONTIERS and MSH collaborated with the DSR to design the interventions, MSH supported the DSR in implementing the interventions, and FRONTIERS undertook the evaluation. This study, funded by USAID, responded to the recommendations of a 1999 workshop, organized by FRONTIERS and the DSR, on the community-based distribution (CBD) approach, which defined alternative CBD models appropriate for Senegal. The DSR sees the development of community-based service delivery models as essential for the future of health care in Senegal. As noted in this report, the general objective of the study was to contribute to the development of an integrated cost-effective program to increase the accessibility and availability of reproductive health information and services in rural areas of Senegal.

The MICE Project: An Innovative Service Delivery System for Visually Handicapped Children

1983 ◽  
Vol 77 (2) ◽  
pp. 52-56 ◽  
Author(s):  
Mary T. Morse
Keyword(s):  
Rural Communities ◽  
Service Delivery ◽  
Cost Effective ◽  
Service Delivery System ◽  
Treatment Needs ◽  
State Service ◽  
Handicapped Children ◽  
Service Programs ◽  
Visually Handicapped ◽  
Scattered Population

Existing federal and state service programs, based on categorical treatment needs and income eligibility, often fail to provide comprehensive, coordinated services to visually handicapped infants and children. This problem is exacerbated in rural communities, where a small, widely-scattered population requires service. A cost-effective interagency linkage is proposed for service delivery in these areas. Its development and implementation are also described.

Enterprise and care

2016 ◽  
Author(s):  
Catherine Needham ◽  
Kerry Allen ◽  
Kelly Hall
Keyword(s):  
Service Delivery ◽  
Quantitative Research ◽  
Public Services ◽  
Cost Effective ◽  
Social Enterprises ◽  
For Profit ◽  
Not For Profit ◽  
The Social ◽  
Delivery Models ◽  
Micro Enterprises

This chapter focuses on enterprise and care considering the contribution that new delivery models such as social enterprises make within public services more broadly and care in particular. The chapter also considers the ambiguity of the social enterprise label and its capacity to be claimed by a range of governance types, including the for-profit as well as the not-for-profit. The chapter then draws together the evidence on micro-enterprises into four research hypotheses that are tested in later chapters of the book, through qualitative and quantitative research. These are derived from the policy claims that are made by proponents of micro forms of service delivery: that micro-enterprises are more personalised, innovative, cost-effective and outcomes-oriented than larger organisations.

PACs

1997 ◽  
Vol 28 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Jean L. Blosser ◽  
Annette Kratcoski
Keyword(s):  
Decision Making ◽  
Service Delivery ◽  
Cost Effective ◽  
Communication Disorder ◽  
Speech Language Pathologists ◽  
Economic Trends ◽  
Team Decision ◽  
Delivery Options ◽  
Increasing Demand ◽  
Delivery Models

Changes in demographic and economic trends, as well as reforms in health care and education, have encouraged speech-language pathologists to expand the service delivery options they offer. Practitioners are searching for service delivery models that promote clients’ functional skills, are cost-effective, and reflect accountability and efficacy. There is increasing demand for models that incorporate team decision-making and participation. This article provides clinicians with a framework for decision-making and service delivery by encouraging speech-language pathologists and their colleagues to consider the unique combination of providers, activities, and contexts (PACs) necessary to meet the specific needs of each individual with a communication disorder.

scholarly journals Kirschner Wire Breakage during Removal Requiring Retrieval

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Kai Yuen Wong ◽  
Rosalind Mole ◽  
Patrick Gillespie
Keyword(s):  
Hand Function ◽  
Kirschner Wire ◽  
Cost Effective ◽  
Middle Finger ◽  
Complication Rates ◽  
Simple Method ◽  
Wire Breakage ◽  
Wire Fixation ◽  
Pin Site ◽  
K Wires

Kirschner wires (K-wires) are widely used for fixation of fractures and dislocations in the hand as they are readily available, reliable, and cost-effective. Complication rates of up to 18% have been reported. However, K-wire breakage during removal is rare. We present one such case illustrating a simple technique for retrieval. A 35-year-old male presented with a distal phalanx fracture of his right middle finger. This open fracture was treated with K-wire fixation. Postoperatively, he developed a pin site infection with associated finger swelling. The K-wire broke during removal with the proximal piece completely retained in his middle phalanx. To minimise risk of osteomyelitis, the K-wire was removed with a novel surgical technique. He had full return of hand function. Intraoperative K-wire breakage has a reported rate of 0.1%. In our case, there was no obvious cause of breakage and the patient denied postoperative trauma. On the other hand, pin site infections are much more common with reported rates of up to 7% in the hand or wrist. K-wire fixation is a simple method for bony stabilisation but can be a demanding procedure with complications often overlooked. It is important to be aware of the potential sequelae.

scholarly journals Farmers’ Perceptions of Information and Communication Technology (ICT) Use in Extension Service Delivery in Northern Region, Ghana

2019 ◽  
Vol 6 (1) ◽  
pp. 21-29
Author(s):  
Francis K. OBENG ◽  
Salifu GUMAH ◽  
Stephen Mintah
Keyword(s):  
Service Delivery ◽  
Mobile Phone ◽  
Cost Effective ◽  
Northern Region ◽  
Extension Service ◽  
Positive Effects ◽  
Use Of Time ◽  
Region Data ◽  
Information And Communication ◽  
Time And Energy

Extension methodologies for communicating technologies to farmers have evolved over the past 200 years from so-called traditional methodologies to more advanced and technology-based methodologies that enable extension staff to reach many people within the shortest possible time in a more effective and efficient way. Though traditional methods are still relevant and effective, current trends require the use of more innovative and cost-effective methodologies.  This paper examined the perceptions of farmers on the use of ICTs in Extension Service delivery in the Northern Region of Ghana. Ninety farmers were randomly sampled from 6 communities in 6 districts in the region. Data was collected using semi-structured questionnaire. A 5-point Likert scale was used to determine farmers’ perceived effects of ICT on extension delivery. Data were analysed using means, standard deviations, t-test, frequencies and percentages. The most widely used ICTs by farmers are radio, mobile phone and television. Farmers perceive the use of mobile phone to have resulted in timely delivery of information, increased interaction among farmers and between farmers and AEAs and effective use of time and energy by AEAs. The use of radio has improved adoption of technologies and enhanced farmers’ awareness of innovations. It is concluded mobile phone, radio and television are used widely in the region and have very positive effects on extension service delivery.  

Sign in / Sign up

Export Citation Format

Share Document