scholarly journals Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253063
Author(s):  
Daniel da Silva Pereira Curado ◽  
Dalila Fernandes Gomes ◽  
Thales Brendon Castano Silva ◽  
Paulo Henrique Ribeiro Fernandes Almeida ◽  
Noemia Urruth Leão Tavares ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health System ◽  
Public Health System ◽  
Antihypertensive Drugs ◽  
Circulatory System ◽  
Total Cost ◽  
Systemic Arterial Hypertension ◽  
Circulatory System Diseases ◽  
The Cost

Introduction Systemic arterial hypertension (SAH), a global public health problem and the primary risk factor for cardiovascular diseases, has a significant financial impact on health systems. In Brazil, the prevalence of SAH is 23.7%, which caused 203,000 deaths and 3.9 million DALYs in 2015. Objective To estimate the cost of SAH and circulatory system diseases attributable to SAH from the perspective of the Brazilian public health system in 2019. Methods A prevalence-based cost-of-illness was conducted using a top-down approach. The population attributable risk (PAR) was used to estimate the proportion of circulatory system diseases attributable to SAH. The direct medical costs were obtained from official Ministry of Health of Brazil records and literature parameters, including the three levels of care (primary, secondary, and tertiary). Deterministic univariate analyses were also conducted. Results The total cost of SAH and the proportion of circulatory system diseases attributable to SAH was Int$ 581,135,374.73, varying between Int$ 501,553,022.21 and Int$ 776,183,338.06. In terms only of SAH costs at all healthcare levels (Int$ 493,776,445.89), 97.3% were incurred in primary care, especially for antihypertensive drugs provided free of charge by the Brazilian public health system (Int$ 363,888,540.14). Stroke accounted for the highest cost attributable to SAH and the third highest PAR, representing 47% of the total cost of circulatory diseases attributable to SAH. Prevalence was the parameter that most affected sensitivity analyses, accounting for 36% of all the cost variation. Conclusion Our results show that the main Brazilian strategy to combat SAH was implemented in primary care, namely access to free antihypertensive drugs and multiprofessional teams, acting jointly to promote care and prevent and control SAH.

scholarly journals Delays and Unmet Need for Health Care Among Adult Primary Care Patients in a Restructured Urban Public Health System

2004 ◽  
Vol 94 (5) ◽  
pp. 783-789 ◽  
Author(s):  
Allison L. Diamant ◽  
Ron D. Hays ◽  
Leo S. Morales ◽  
Wesley Ford ◽  
Daphne Calmes ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Health System ◽  
Public Health System ◽  
Unmet Need ◽  
Primary Care Patients

scholarly journals AB1180 THE EVOLUTION OF AN FLS IN SEARCH OF EXCELLENCE: THE EXPERIENCE OF GRAN CANARIA.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1881.3-1881
Author(s):  
A. Naranjo ◽  
A. Molina ◽  
C. Sepúlveda ◽  
C. Torres ◽  
F. Santana ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health System ◽  
Fall Prevention ◽  
Public Health System ◽  
Fracture Prevention ◽  
Care Physician ◽  
Secondary Fracture ◽  
Baseline Visit ◽  
Osteoporosis Clinic

Background:The implementation of an FLS in the Spanish public health system is not an easy task since there are no official plans for the incorporation of personnel dedicated to the unitObjectives:To expose the consolidation and improvement of an FLS after its implementation as well as the problems that have arisen over time.Methods:The health program for secondary fracture prevention was implemented in 2012. Initially worked with the same staff assigned to the Rheumatology service, since 2016 we have a part-time support nurse. Patients are identified from the emergency registry and, more recently, from patients admitted for hip fracture and treated in a monographic osteoporosis clinic. The baseline visit consists of consultation with the nurse, DXA and bone metabolism analytics. Falling patients are referred to a fall prevention school. Most patients are referred to their primary care physician to start a treatment.Results:Of the 2,416 patients attended the baseline visit, 30% were forearm fractures, 27% hip, 20% humerus, 10% spine and 11% other fractures. In comparison to 2012, in 2019 the monthly average of patients has doubled, increased the number of hip and spine fractures, and increased the percentage of captured patients (Table). In spite of consolidating the unit, getting a support nurse for the admitted patients and establishing a solid alliance with primary care, it is pending the involvement of Primary Care Nurses and start first prescription at the hospital.Table.Comparison of the first year with the last year of implementation of our FLS.20122019Mean monthly number of fractures, N2242Type of fracture: forearm/hip/spine, %37/20/628/40/11Captured patients of elegible, %5777Delay in weeks until first visit to FLS, median1412Patient origin: emergency list/inpatient/outpatient, %100/0/059/31/9DXA performed, %10061Referral to fall prevention school, %026Criteria to start a treatment, %6790*Referral to the osteoporosis clinic, %377*We apply the 2019 recommendations of the Spanish Society of RheumatologyConclusion:We present the achievements made by our FLS along 8 years and the difficulties within the Spanish public health system.Disclosure of Interests:Antonio Naranjo Grant/research support from: amgen, Consultant of: UCB, Speakers bureau: AMGEN, Amparo Molina Speakers bureau: AMGEN, STADA, Cristina Sepúlveda: None declared, Candelaria Torres: None declared, Fabiola Santana: None declared, Francisco Rubiño: None declared, Rubén López: None declared, Soledad Ojeda Speakers bureau: AMGEN, LILLY, GEBRO

Assessment of Organ Acquisition Costs for an Australian Public Health System

1996 ◽  
Vol 6 (1) ◽  
pp. 39-43
Author(s):  
Gregory T Armstrong
Keyword(s):  
Public Health ◽  
Health System ◽  
Acquisition Cost ◽  
Public Health System ◽  
Indirect Costs ◽  
Cost Effective ◽  
Transport Systems ◽  
Acquisition Costs ◽  
The Cost ◽  
Organ Acquisition

Available data on the cost of organ acquisition in Australia's socialized public health systems are minimal. The purpose of this study was to determine the cost for organ acquisition by a state transplant service, and to provide (1) an assessment of acquisition costs within one Australian public health system, (2) a baseline for future cost assessments, and (3) an indication of cost-effectiveness in international terms. Between July and December 1993, 51 kidneys, 21 livers, and 15 hearts were provided for transplantation in the system. Data collected during this period were used to calculate the acquisition cost for each transplanted organ. Direct and indirect costs were included in the calculations. The distribution of costs incurred for organ acquisition were direct, 67%; indirect, 14%; and organ-specific, 19%. Of the total direct costs, aircraft charter accounted for 75%, or 50% of the total acquisition costs. The provision of an organ by a donor coordination service accounted for 20% of the total costs, or a mean of A$783 (US$563) per organ. This study provides a baseline for organ acquisition cost in the Australian healthcare system. The geographic and demographic nature of Australia imposes the largest single cost factor (ie, air charter), which highlights the need for alternative retrieval and transport systems of organs wherever possible. The acquisition costs reported in this study indicate that the system is cost-effective in international terms.

scholarly journals Effectiveness of a Physical Therapeutic Exercise Programme for Caregivers of Dependent Patients: A Pragmatic Randomised Controlled Trial from Spanish Primary Care

2020 ◽  
Vol 17 (20) ◽  
pp. 7359
Author(s):  
Federico Montero-Cuadrado ◽  
Miguel Ángel Galán-Martín ◽  
Javier Sánchez-Sánchez ◽  
Enrique Lluch ◽  
Agustín Mayo-Iscar ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Primary Care ◽  
Health System ◽  
Public Health System ◽  
Experimental Treatment ◽  
Control Group ◽  
Therapeutic Exercise ◽  
Care Programme

Female family caregivers (FFCs) constitute one of the basic supports of socio-health care for dependence in developed countries. The care provided by FFCs may impact their physical and mental health, negatively affecting their quality of life. In order to alleviate the consequences of providing care on FFCs, the Spanish Public Health System has developed the family caregiver care programme (FCCP) to be applied in primary care (PC) centres. The effectiveness of this programme is limited. To date, the addition of a physical therapeutic exercise (PTE) programme to FCCP has not been evaluated. A randomised multicentre clinical trial was carried out in two PC centres of the Spanish Public Health System. In total, 68 FFCs were recruited. The experimental group (EG) performed the usual FCCP (4 sessions, 6 h) added to a PTE programme (36 sessions in 12 weeks) whereas the control group performed the usual FCCP performed in PC. The experimental treatment improved quality of life (d = 1.17 in physical component summary), subjective burden (d = 2.38), anxiety (d = 1.52), depression (d = 1.37) and health-related physical condition (d = 2.44 in endurance). Differences between the groups (p < 0.05) were clinically relevant in favour of the EG. The experimental treatment generates high levels of satisfaction.

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