The cost of measures to fight poverty and to improve health and education

Investing in Health Wisely: The Role of Needs-based Technology Assessment

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300009107 ◽

1995 ◽

Vol 11 (4) ◽

pp. 673-684 ◽

Cited By ~ 4

Author(s):

Dean T. Jamison ◽

Helen Saxenian ◽

Yves Bergevin

Keyword(s):

Public Health ◽

Technology Assessment ◽

Universal Access ◽

Policy Formulation ◽

Disability Adjusted Life ◽

Life Years ◽

National Public Health ◽

The Cost ◽

Improve Health

AbstractCountries worldwide spend huge sums on health—about $1,700 billion a year, or roughly 8% of global income. But the World Development Report 1993: Investing in Health shows that these monies could be spent much more wisely, in the process doing a great deal to help the world's 1 billion poor. Essential national public health and clinical packages are proposed based on assessment of the burden of disease (measured in disability adjusted life years) and the cost-effectiveness of interventions. Governments can play a central role in improving the health of their citizens: they can foster an environment that enables households to improve health and they can also improve their own spending on health, targeting it to support universal access to essential national public health and clinical packages based on the above methods. This is a good example of the concept of needs-based technology assessment, combining the disciplines of epidemiology, economics, and policy formulation. When applied, it should lead to improved effectiveness, efficiency, and equity.

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Improving Mammography Rates Among the Hispanic Population: An Evidence-Based Project Utilizing a Promotora Intervention

10.46409/sr.falg6532 ◽

2021 ◽

Author(s):

◽

Dawn Mirowski

Keyword(s):

Breast Cancer ◽

Early Stage ◽

Hispanic Women ◽

Effective Means ◽

Breast Cancer Mortality ◽

Hispanic Population ◽

Practice Problem ◽

Clinically Significant ◽

The Cost ◽

Improve Health

Practice Problem: Breast cancer is the leading cause of death in Hispanic women in the U.S., with mammography being the most effective means of reducing breast cancer mortality. Promotoras have been shown to improve health promotion, including mammography, among the Hispanic population. PICOT: The PICOT question that guided this project was: In Hispanic women 40 years or older (P), how does the use of a promotora intervention (I), compared to no promotora intervention (C), affect mammography rates (O) within an 8-week period (T)? Evidence: Twenty-one studies that met the inclusion criteria supported the use of promotoras to improve mammography rates. Interventions included education and counseling, navigation assistance, providing a link to resources, and facilitating interaction with providers. Intervention: A promotora was assigned to contact patients with a mammogram order to provide education, counseling, and other assistance needed. Outcome: The intervention improved compliance with mammography rates by 37% over baseline. The results are clinically significant as the cost of the promotora intervention is minimal compared to the benefits of an early-stage diagnosis. Conclusion: The implementation of this project was consistent with the research evidence supporting a promotora intervention to improve mammography rates in the Hispanic population.

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039 Estimating the health and economic burden of investigating tumefactive demyelination compared to conventional multiple sclerosis

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-anzan.36 ◽

2019 ◽

Vol 90 (e7) ◽

pp. A13.3-A14

Author(s):

Matthew Silsby ◽

Pedro S Lopez ◽

Judy Spies ◽

Stephen Reddel ◽

Jane Frith ◽

...

Keyword(s):

Multiple Sclerosis ◽

Brain Biopsy ◽

Adverse Outcomes ◽

Diagnostic Challenge ◽

Mcdonald Criteria ◽

Relapsing Remitting ◽

Demyelinating Lesions ◽

The Cost ◽

The Brain ◽

Improve Health

IntroductionTumefactive demyelinating lesions, defined as demyelinating lesions > 2cm in diameter, occur most commonly in association with multiple sclerosis (MS), and can pose a diagnostic challenge. The aim of this study was to estimate the cost and morbidity associated with the diagnostic investigation of patients with tumefactive demyelination (TD) compared to patients with conventional relapsing-remitting MS.MethodsRetrospective review of patients seen between 2013–2018 in clinics at the Brain and Mind Centre, Sydney; a centre with tertiary referral expertise in MS. Records were searched for the terms ‘tumefactive’ and ‘pseudotumour’. All patients diagnosed with TD were included and paired with a patient of similar age diagnosed in the same year with MS according to 2010 McDonald criteria.ResultsThere were 31 patients with TD and 31 patients with conventional relapsing remitting MS. The estimated cost of investigating TD was more than 7.5 times higher per patient than in MS ($18,300 AUD vs $2,418 AUD, p<0.001). Brain biopsy was performed in 6/31 TD patients and 0/31 MS patients and was the cause of more adverse outcomes in the TD versus MS group. More patients in the TD group were admitted to hospital (22/31 vs 10/31) and ICU admissions only occurred in the TD group (10/22 vs 0/10).ConclusionThe cost and adverse outcomes associated with investigating TD are higher than in conventional MS. Improvements in the diagnosis of TD have the potential to improve health and economic outcomes.

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Development, Functioning, and Effectiveness of a Preoperative Risk Assessment Clinic

Health Services Insights ◽

10.4137/hsi.s40540 ◽

2016 ◽

Vol 9s1 ◽

pp. HSI.S40540

Author(s):

Hassan Tariq ◽

Rafeeq Ahmed ◽

Salil Kulkarni ◽

Sana Hanif ◽

Omesh Toolsie ◽

...

Keyword(s):

Preoperative Assessment ◽

Cost Of Care ◽

Preoperative Risk ◽

Patient Centered ◽

Assessment Clinic ◽

Preoperative Risk Assessment ◽

Perioperative Surgical Home ◽

The Cost ◽

Evidence Based Guidelines ◽

Improve Health

Lee first described the concept of preoperative assessment testing (PAT) clinic in 1949. An efficiently run clinic is associated with increased cost-effectiveness by lowering preoperative admission time and thus reducing the length of stay and the associated costs. The setup of the PAT clinic should be based on the needs, culture, and resources of the institution. Various models for the setup of PAT clinic have been described, including the concept of a perioperative surgical home, which is a patient-centered model designed to improve health and the delivery of health care and to reduce the cost of care. Although there are several constraints in the development of PAT clinics, with increasing awareness about the usefulness of pre-operative risk assessments, growing bodies of literature, and evidence-based guidelines, these clinics are becoming a medical necessity for the improvement of perioperative care.

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Improving General Practitioner Access to Physiotherapy: A Review of the Economic Evidence

Health Services Management Research ◽

10.1177/095148489701000403 ◽

1997 ◽

Vol 10 (4) ◽

pp. 225-230 ◽

Cited By ~ 4

Author(s):

M. Hensher

Keyword(s):

Primary Care ◽

General Practitioner ◽

Alternative Methods ◽

Direct Access ◽

Organizational Models ◽

Improve Health Status ◽

Patient Groups ◽

The Uk ◽

The Cost ◽

Improve Health

The provision of physiotherapy via general practitioner (GP) ‘direct access’ arrangements or in primary care itself has become increasingly common in the UK. Evidence on the economics and the cost-effectiveness of alternative methods of organizing access to physiotherapy services is reviewed, and the likely impacts of different organizational models are discussed. GP direct access physiotherapy and primary care provision appear to have a lower average cost than consultant access physiotherapy models, while GP direct access appears to minimize health care resource use per patient. Primary care physiotherapy provision appears to minimize the costs to patients of seeking care, and appears to generate a greater demand for service than other models. The extent to which physiotherapy provision in primary care can substitute for physiotherapy and other resources in the hospital sector is discussed, as is the extent to which patients may benefit from receiving physiotherapy in primary care. It is argued that continued expansion of access to physiotherapy should be critically appraised, and its ability to improve health status compared with that achievable in alternative patient groups who might benefit from physiotherapy in hospital or rehabilitation settings.

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The IBM-PC in electron microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100165525 ◽

1996 ◽

Vol 54 ◽

pp. 612-613

Author(s):

James F. Mancuso

Keyword(s):

Head Start ◽

Image Acquisition ◽

Cost Effective ◽

Financial Applications ◽

Number Of Factors ◽

Instrument Control ◽

The Cost ◽

Training And Support ◽

Control Image ◽

Ibm Pc

IBM PC compatible computers are widely used in microscopy for applications ranging from control to image acquisition and analysis. The choice of IBM-PC based systems over competing computer platforms can be based on technical merit alone or on a number of factors relating to economics, availability of peripherals, management dictum, or simple personal preference.IBM-PC got a strong “head start” by first dominating clerical, document processing and financial applications. The use of these computers spilled into the laboratory where the DOS based IBM-PC replaced mini-computers. Compared to minicomputer, the PC provided a more for cost-effective platform for applications in numerical analysis, engineering and design, instrument control, image acquisition and image processing. In addition, the sitewide use of a common PC platform could reduce the cost of training and support services relative to cases where many different computer platforms were used. This could be especially true for the microscopists who must use computers in both the laboratory and the office.

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New Feasible Concepts of Aberration Correction for Realizing High-Resolution Electron Microscopes

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100179762 ◽

1990 ◽

Vol 48 (1) ◽

pp. 202-203

Author(s):

H. Rose

Keyword(s):

Spherical Aberration ◽

Wave Length ◽

Electron Wave ◽

Optical Lens ◽

Resolution Electron ◽

Rotationally Symmetric ◽

Electron Microscopes ◽

The Cost ◽

Imaging Performance ◽

Acceleration Voltage

The imaging performance of the light optical lens systems has reached such a degree of perfection that nowadays numerical apertures of about 1 can be utilized. Compared to this state of development the objective lenses of electron microscopes are rather poor allowing at most usable apertures somewhat smaller than 10-2 . This severe shortcoming is due to the unavoidable axial chromatic and spherical aberration of rotationally symmetric electron lenses employed so far in all electron microscopes.The resolution of such electron microscopes can only be improved by increasing the accelerating voltage which shortens the electron wave length. Unfortunately, this procedure is rather ineffective because the achievable gain in resolution is only proportional to λ1/4 for a fixed magnetic field strength determined by the magnetic saturation of the pole pieces. Moreover, increasing the acceleration voltage results in deleterious knock-on processes and in extreme difficulties to stabilize the high voltage. Last not least the cost increase exponentially with voltage.

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