scholarly journals Cost-analysis and cost-effectiveness of physical activity interventions in Brazilian primary health care: a randomised feasibility study

2021 ◽  
Vol 26 (11) ◽  
pp. 5711-5726
Author(s):  
Camila Bosquiero Papini ◽  
Leonardo de Campos ◽  
Priscila Missaki Nakamura ◽  
Bruna Thaís Gomes de Brito ◽  
Eduardo Kokubun
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Cost Effectiveness ◽  
Physical Exercise ◽  
Exercise Intervention ◽  
Brief Counseling ◽  
Primary Health ◽  
The Cost

Abstract Physical exercise programs have been carried out in primary health care in Brazil and have provided good results in terms of effectiveness, their economic contribution has not been investigated yet. The aim of the study is to verify the feasibility of brief counseling physical activity intervention and to compare its economic cost and cost-effectiveness with supervised physical exercise intervention in primary care. A multi-arm parallel feasibility trial, with equal randomization [1:1:1] was conducted in Basic Health Units in Brazil. 61 participants were randomized in Brief Counseling Intervention (BCI), Supervised Physical Exercise Intervention (SPEI) and Control Group (CG). Interventions lasted one year. The BCI is more economical than the SPEI, costing around 50% less in the economic comparisons (session cost, annual cost and cost per participant annually). At leisure time, the cost to move one person to the physically active category at 12 months is estimated in R$369.00 for BCI and R$426.21 for the SPEI. The Incremental Cost-effectiveness Ratio (ICER) is R$310.32. The BCI is feasible and more economic, however, the cost effective is not that different. Thus, it is strongly recommended that the two interventions be offered at primary care in Brazil.

scholarly journals Physical activity promotion in the health care setting in Switzerland

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Care Setting ◽  
Physical Activity Promotion ◽  
Health Care Setting ◽  
Primary Health ◽  
Activity Promotion

The role of regular physical activity for population health has been clearly documented. Improvements in population levels of physical activity require long-term implementation of a combination of measures, including the evidence based approaches described in the “seven best investments for physical activity” (www.globalpa.org.uk): whole-of-school programmes, transport, urban planning, integration of physical activity promotion into primary health care systems, public education, community-wide programmes, sport for all. The health care setting has a particular role in this context, particularly in its access to physically inactive individuals. Switzerland has seen a number of successful research projects in this field, but there has been no wide adaptation of these approaches in the medical community. In recent years, a group of institutions including the Swiss College of Primary Care Medicine, the Policlinique Médicale Universitaire in Lausanne, the Ligue Vaudoise contre les Maladies Cardiovasculaires and the Institute of Social and Preventive Medicine of the University of Zurich have therefore focussed on the development of a physical activity counselling approach based on international evidence as well as on established tools, but streamlined to the specific demands of primary health care providers in Switzerland. PAPRICA (Physical Activity Promotion in Primary Care, www.paprica.ch) has been the result of these developments, and nearly 300 health professionals, most of them primary care physicians, have been successfully trained so far. PAPRICA is implemented together with the Swiss Society for Sports Medicine and a number of regional partners. The development of a national programme structure is currently under preparation. This will allow Switzerland to explore and better use the potential of physicians and other health professionals in the promotion of physical activity and in the fight against non-communicable diseases.

The cost effectiveness of lipid lowering in Swedish primary health care

1996 ◽  
Vol 240 (1) ◽  
pp. 23-29 ◽  
Author(s):  
MAGNUS JOHANNESSON ◽  
LARS BORGQUIST ◽  
BENGT JONSSON ◽  
LARS H. LINDHOLM
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cost Effectiveness ◽  
Lipid Lowering ◽  
Primary Health ◽  
The Cost

scholarly journals Cost-effectiveness of the SLIMMER diabetes prevention intervention in Dutch primary health care: economic evaluation from a randomised controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Geerke Duijzer ◽  
Andrea J. Bukman ◽  
Aafke Meints-Groenveld ◽  
Annemien Haveman-Nies ◽  
Sophia C. Jansen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Cost Effectiveness ◽  
Lifestyle Intervention ◽  
Diabetes Prevention ◽  
Cost Effective ◽  
Primary Health ◽  
The Cost

Abstract Background Although evidence is accumulating that lifestyle modification may be cost-effective in patients with prediabetes, information is limited on the cost-effectiveness of interventions implemented in public health and primary health care settings. Evidence from well-conducted pragmatic trials is needed to gain insight into the realistic cost-effectiveness of diabetes prevention interventions in real-world settings. The aim of this study is to assess the cost-effectiveness of the SLIMMER lifestyle intervention targeted at patients at high risk of developing type 2 diabetes compared with usual health care in a primary care setting in the Netherlands. Methods Three hundred and sixteen high-risk subjects were randomly assigned to the SLIMMER lifestyle intervention or to usual health care. Costs and outcome assessments were performed at the end of the intervention (12 months) and six months thereafter (18 months). Costs were assessed from a societal perspective. Patients completed questionnaires to assess health care utilisation, participant out-of-pocket costs, and productivity losses. Quality Adjusted Life Years (QALY) were calculated based on the SF-36 questionnaire. Cost-effectiveness planes and acceptability curves were generated using bootstrap analyses. Results The cost-effectiveness analysis showed that the incremental costs of the SLIMMER lifestyle intervention were €547 and that the incremental effect was 0.02 QALY, resulting in an incremental cost-effectiveness ratio (ICER) of €28,094/QALY. When cost-effectiveness was calculated from a health care perspective, the ICER decreased to €13,605/QALY, with a moderate probability of being cost-effective (56% at a willingness to pay, WTP, of €20,000/QALY and 81% at a WTP of €80,000/QALY). Conclusions The SLIMMER lifestyle intervention to prevent type 2 diabetes had a low to moderate probability of being cost-effective, depending on the perspective taken. Trial registration The SLIMMER study is retrospectively registered with ClinicalTrials.gov (Identifier NCT02094911) since March 19, 2014.

scholarly journals Efektivitas Biaya Program Pengelolaan Penyakit Kronis (Prolanis) di Puskesmas

2018 ◽  
Vol 2 (4) ◽  
pp. 622-633
Author(s):  
Ayu Pramudita Wardani ◽  
Eri Witcahyo ◽  
Sri Utami
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cost Effectiveness ◽  
Home Visit ◽  
Total Cost ◽  
First Semester ◽  
Primary Health ◽  
History Of ◽  
The Cost ◽  
Catastrophic Disease

Abstrak Biaya yang dihabiskan untuk penyakit katastropik hingga semester I tahun 2017 telah mencapai Rp 12,7 trilliun atau 24,81% dari total biaya rumah sakit. Jumlah peserta Prolanis Puskesmas Karangduren sebanyak 46 peserta dengan RPPRB sebesar 92,60% dan Patrang sebanyak 45 orang dengan RPPRB sebesar 42,96%. Tujuan penelitian ini adalah menganalisis efektivitas biaya Prolanis pada Puskesmas Karangduren dan Patrang. Jenis penelitian ini adalah deskriptif. Penelitian dilakukan pada bulan September 2017 sampai dengan Oktober 2017. Data diperoleh dengan studi dokumentasi dan wawancara pada penanggung jawab Prolanis, bagian keuangan JKN dan tata usaha. Hasil penelitian menunjukkan input Prolanis pada Puskesmas Karangduren dan Patrang yakni ketersediaan SDM dan dana untuk Prolanis yang tidak keluar, serta kegiatan home visit belum terlaksana karena tidak adanya dana untuk transport petugas dan kurangnya SDM home visit. Hanya peserta Prolanis Puskesmas Patrang dengan riwayat hipertensi telah mencapai indikator 75%. Simpulan penelitian ini adalah efektivitas biaya Prolanis Puskesmas Karangduren lebih efektif dibandingkan Puskesmas Patrang.   Abstract The cost was spent  for catastrophic disease until first semester of 2017 have reached Rp 12.7 trillion or 24.81% of the total cost hospital. The amount participants of Prolanis Karangduren  primary health care was  46 participants with RPPRB of 92.60% and  Patrang was 45 participants  with RPPRB of 42.96%. The purpose of this study was to analyze the cost effectiveness of Prolanis at Karangduren and Patrang primary health care. The study was a  descriptive design. This study was conducted from September until October 2017. Data was collected by documentation and interview of Prolanis officer, finance JKN and administration staff. The results showed Prolanis input on Karangduren and Patrang  primary health care were  the availability of human resources and the fund that do come out,, and home visit activity had not been done yet. Only Prolanis participants of Patrang primary health care with the history of hypertension has reached 75% indicator every month. The cost effectiveness Prolanis Karangduren primary health care more effective was compared to Patrang primary health care.  

scholarly journals Physical Activity Promotion Tools in the Portuguese Primary Health Care: An Implementation Research

2020 ◽  
Vol 17 (3) ◽  
pp. 815
Author(s):  
Romeu Mendes ◽  
Marlene Nunes Silva ◽  
Catarina Santos Silva ◽  
Adilson Marques ◽  
Cristina Godinho ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Assessment Tool ◽  
Physical Activity Promotion ◽  
Brief Counseling ◽  
Brief Assessment ◽  
Primary Health ◽  
Activity Promotion

Background: This paper aims to discuss how physical activity (PA) brief assessment, brief counseling, and self-monitoring tools were designed and implemented in the Portuguese National Health Service (NHS), and to report on their current use by health professionals and citizens. Methods: Three digital tools to facilitate PA promotion in primary health care (PHC) were developed: 1) a PA brief assessment tool was incorporated in the electronic health record platform “SClínico Cuidados de Saúde Primários“; 2) a brief counseling tool was developed in the software “PEM—Prescrição Eletrónica Médica” (electronic medical prescription); and 3) a “Physical Activity Card” was incorporated in an official NHS smartphone app called “MySNS Carteira”. Results: From September 2017 to June 2019, 119,386 Portuguese patients had their PA assessed in PHC. Between December 2017 and June 2019, a total of 7957 patients received brief intervention for PA by a medical doctor. Regarding the app “MySNS Carteira”, 93,320 users activated the “Physical Activity Card”, between February 2018 and December 2018. Conclusions: These tools represent key actions to promote PA among Portuguese citizens using PHC as a priority setting. Further initiatives will follow, including proper assessment of their clinical impact and training programs for health care professionals on PA promotion.

Brazilian National Household Health Survey and PCAT: the case of Mato Grosso do Sul, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
D Soranz ◽  
L J Santos ◽  
M S Paranhos ◽  
L S Malta ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Health Survey ◽  
Household Surveys ◽  
Mato Grosso ◽  
Primary Health ◽  
The World ◽  
Mato Grosso Do Sul

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.

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