scholarly journals Cost-Effectiveness of Osteoporosis Screening in Women Over 40-Year-Old

2021 ◽  
Author(s):  
Fereshte Keshavarzi ◽  
Elham Aflaki ◽  
Mehrdad Askarian ◽  
Nahid Hatam
Keyword(s):  
Cost Effectiveness ◽  
Screening Method ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Osteoporosis Screening ◽  
Density Reduction ◽  
Life Years ◽  
Progression Of Disease

Osteoporosis is a disease recognized by bone density reduction and is particularly common among older women, which imposes them to fractures. The evidence shows that if do no serious conflict with this issue, in the far little future, huge costs will be imposed on individuals, families, and the country. In this study, we studied the cost-effectiveness of osteoporosis screening in women over 40 years of age in Shiraz in 2016. This cross-sectional study was performed on 240 persons who were screened and 240 non-screened persons in the bone mineral density ward of Shiraz Namazi Hospital. The costs were identified and from the perspective of the insurer and the payer, which included only direct health care costs. To measure the effectiveness, the use of indicators as quality-adjusted life-years (QALY), the expected cost and effectiveness, and the Incremental cost-effectiveness ratio were calculated. The results showed that non-screening is the best strategy, given that the amount of ICER was obtained at $38484.56 and the threshold. As a result, the non-screening method compared to screening is cost-effective. The relevant authorities and proficients should prevent the progression of disease complications and consequently prevent the increase of the disease cost and improve the quality of life of the patients.

scholarly journals Cost-effectiveness Analysis of Per-abdominal and Laparoscopic Cholecystectomy

2019 ◽  
Author(s):  
Shahariar Islam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cost Effectiveness ◽  
Treatment Cost ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Total Treatment Cost ◽  
Laboratory Cost ◽  
Cross Sectional ◽  
Average Hospital ◽  
The Cost

Cholelithiasis is one of the major problems which need cholecystectomy. Laparoscopic cholecystectomy is a newer technique. But there is a need to evaluate the cost-effectiveness of per-abdominal and laparoscopic method from patients perspective. The study was performed to assess the cost-effectiveness of per-abdominal and laparoscopic cholecystectomy.
Materials and Methods:
This cross sectional study in two sample situations was conducted among 90 purposively selected cholecystectomy patients of which 60 patients underwent laparoscopic cholecystectomy (LC) and 30 patients underwent per-abdominal cholecystectomy (PAC) from three tertiary level government hospitals of Dhaka, Bangladesh at the time of their discharge through face to face interview using a semi-structured questionnaire and checklist. The study found average age 45.33(13.63) and 41.75(13.39) years in PAC and LC respectively. Average monthly income was less in the PAC group Tk.23200.00(12374.61) than LC Tk.24925.00(12166.86). Average duration of suffering from cholelithiasis was 9.50(8.68) months in PAC group and 12.43(17.49) months in LC group. Average hospital stay was 13.97(6.88) days in PAC group while it was 12.02(6.66) days in LC group. Average treatment cost was little higher Tk.21927.407795.89 in LC group than Tk.21466.306261.42 in the PAC group. Both direct cost and indirect cost were also higher in LC group (Tk.18668.305965.67 and Tk.3661.324229.85) than in PAC group (Tk.18228.004624.75 and Tk.3350.004124.58). But these differences were not statistically significant. In both groups treatment cost significantly increased with duration of hospitalization (correlation, p<0.01). Cure rate was significantly high in LC group (94.4%) than in PAC group (86.7%) (χ2, p<0.05).
This study revealed LC method is cost-effective than PAC method. Total treatment cost in LC can be reduced by minimizing hospital cost, laboratory cost and securing the income of the patients which enhance the economic load.

scholarly journals Cost-Effectiveness and Validity Assessment of Cyscope Microscope, Quantitative Buffy Coat Microscope, and Rapid Diagnostic Kit for Malaria Diagnosis among Clinic Attendees in Ibadan, Nigeria

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Abiodun Ogunniyi ◽  
Magbagbeola David Dairo ◽  
Hannah Dada-Adegbola ◽  
Ikeoluwapo O. Ajayi ◽  
Adebola Olayinka ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Predictive Value ◽  
Malaria Diagnosis ◽  
Cost Effective ◽  
Turnaround Time ◽  
Cross Sectional Study ◽  
Buffy Coat ◽  
Cross Sectional ◽  
Validity Assessment ◽  
Diagnostic Instruments

Background. Unavailability of accurate, rapid, reliable, and cost-effective malaria diagnostic instruments constitutes major a challenge to malaria elimination. We validated alternative malaria diagnostic instruments and assessed their comparative cost-effectiveness. Method. Using a cross-sectional study design, 502 patients with malaria symptoms at selected health facilities in Ibadan between January and April 2014 were recruited consecutively. We examined malaria parasites using Cyscope®, QBC, and CareStart™ and results were compared to light microscopy (LM). Validity was determined by assessing sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Costs per hour of use for instruments and turnaround time were determined. Result. Sensitivity of the instruments was 76.0% (CareStart), 95.0% (Cyscope), and 98.1% (QBC). Specificity was 96.0% (CareStart), 87.3% (Cyscope), and 85.5% (QBC). PPV were 65.2%, 67.5%, and 84.7%, while NPV were 93.6%, 98.6%, and 99.4% for CareStart, Cyscope, and QBC with Kappa values of 0.75 (CI = 0.68–0.82) for CareStart, 0.72 (CI = 0.65–0.78) for Cyscope, and 0.71 (CI = 0.64–0.77) for QBC. Average cost per hour of use was the lowest ($2.04) with the Cyscope. Turnaround time was the fastest with Cyscope (5 minutes). Conclusion. Cyscope fluorescent microscope had the shortest turnaround time and is the most cost-effective of all the malaria diagnostic instruments evaluated.

Cost Effectiveness of a Community-Based Crisis Intervention Program for People Bereaved by Suicide

Crisis ◽  
2013 ◽  
Vol 34 (6) ◽  
pp. 390-397 ◽  
Author(s):  
Tracy Comans ◽  
Victoria Visser ◽  
Paul Scuffham
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
Intervention Program ◽  
Cost Effective ◽  
Base Case ◽  
Control Group ◽  
Quality Adjusted Life Years ◽  
Cross Sectional ◽  
Life Years ◽  
Quality Adjusted Life

Background: Postvention services aim to ameliorate distress and reduce future incidences of suicide. The StandBy Response Service is one such service operating in Australia for those bereaved through suicide. Few previous studies have reported estimates or evaluations of the economic impact and outcomes associated with the implementation of bereavement/grief interventions. Aims: To estimate the cost-effectiveness of a postvention service from a societal perspective. Method: A Markov model was constructed to estimate the health outcomes, quality-adjusted life years, and associated costs such as medical costs and time off work. Data were obtained from a prospective cross-sectional study comparing previous clients of the StandBy service with a control group of people bereaved by suicide who had not had contact with StandBy. Costs and outcomes were measured at 1 year after suicide bereavement and an incremental cost-effectiveness ratio was calculated. Results: The base case found that the StandBy service dominated usual care with a cost saving from providing the StandBy service of AUS $803 and an increase in quality-adjusted life years of 0.02. Probabilistic sensitivity analysis indicates there is an 81% chance the service would be cost-effective given a range of possible scenarios. Conclusion: Postvention services are a cost-effective strategy and may even be cost-saving if all costs to society from suicide are taken into account.

scholarly journals Comparative evaluation of hysterosalpingo contrast sonography with laparoscopy for determination of tubal patency in infertility

2020 ◽  
Vol 9 (5) ◽  
pp. 2009
Author(s):  
Geetha Krishnamoorthy ◽  
Amutha Perumal ◽  
Chithra Boovaragasamy ◽  
Gnanamani Gnanasabai
Keyword(s):  
Screening Method ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Tubal Patency ◽  
Infertile Women ◽  
Additional Information ◽  
History Of

Background: Tubal factor is responsible for infertility and is found in one of three infertile women. The current research was undertaken to compare the efficacy of hysterosalpingo contrast sonography (HyCoSy) with laparoscopy and chromopertubation in infertile women.Methods: A cross-sectional study was conducted from August 2016 to March 2017 among the patients attending outpatient department with complaints of primary or secondary infertility after obtaining written and informed consent. Detailed history of the patient was taken; clinical examination and necessary investigations were done. Data analysis was carried out using SPSS version 22.Results: All the HyCoSy findings showed excellent specificity (84-100%) and the sensitivity ranged from 40-87%.Conclusions: Study conclude that HyCoSy is a good screening method for evaluating uterine cavity lesions and tubal block in infertile women being safe, sensitive, cost effective, non-invasive procedure giving additional information regarding ovarian, adnexal and peritoneal pathology.

scholarly journals Should NICE reconsider the 2016 UK guidelines on TB contact tracing? A cost-effectiveness analysis of contact investigations in London

Thorax ◽  
2018 ◽  
Vol 74 (2) ◽  
pp. 185-193 ◽  
Author(s):  
Sean M Cavany ◽  
Emilia Vynnycky ◽  
Charlotte S Anderson ◽  
Helen Maguire ◽  
Frank Sandmann ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Contact Tracing ◽  
National Guidelines ◽  
Cross Sectional ◽  
Life Years ◽  
The Uk ◽  
The Cost ◽  
Sectional Analysis ◽  
Index Cases

BackgroundIn January 2016, clinical TB guidance in the UK changed to no longer recommend screening contacts of non-pulmonary, non-laryngeal (ETB) index cases. However, no new evidence was cited for this change, and there is evidence that screening these contacts may be worthwhile. The objective of this study was to estimate the cost-effectiveness of screening contacts of adult ETB cases and adult pulmonary or laryngeal TB (PTB) cases in London, UK.MethodsWe carried out a cross-sectional analysis of data collected on TB index cases and contacts in the London TB register and an economic evaluation using a static model describing contact tracing outcomes. Incremental cost-effectiveness ratios (ICERs) were calculated using no screening as the baseline comparator. All adult TB cases (≥15 years old) in London from 2012 to 2015, and their contacts, were eligible (2465/5084 PTB and 2559/6090 ETB index cases were included).ResultsAssuming each contact with PTB infects one person/month, the ICER of screening contacts of ETB cases was £78 000/quality-adjusted life-years (QALY) (95% CI 39 000 to 140 000), and screening contacts of PTB cases was £30 000/QALY (95% CI 18 000 to 50 000). The ICER of screening contacts of ETB cases was £30 000/QALY if each contact with PTB infects 3.4 people/month. Limitations of this study include the use of self-reported symptomatic periods and lack of knowledge about onward transmission from PTB contacts.ConclusionsScreening contacts of ETB cases in London was almost certainly not cost-effective at any conventional willingness-to-pay threshold in England, supporting recent changes to National Institute for Health and Care Excellence national guidelines.

Relationship Between Nutrient Intake and Vitamin D Status in Osteoporotic Women

2007 ◽  
Vol 77 (6) ◽  
pp. 376-381 ◽  
Author(s):  
de Souza Genaro ◽  
de Paiva Pereira ◽  
de Medeiros Pinheiro ◽  
Szejnfeld ◽  
Araújo Martini
Keyword(s):  
Vitamin D ◽  
Mineral Metabolism ◽  
Sodium Intake ◽  
Serum Vitamin ◽  
Cross Sectional Study ◽  
Dietary Intakes ◽  
Mineral Density ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Dietary Records

Vitamin D is essential for maintaining calcium homeostasis and optimizing bone health. Its inadequacy is related to many factors including dietary intake. The aim of the present study was to evaluate serum 25(OH)D and its relationship with nutrient intakes in postmenopausal Brazilian women with osteoporosis. This cross-sectional study comprised 45 free-living and assisted elderly at São Paulo Hospital. Three-day dietary records were used to assess dietary intakes. Bone mineral density was measured with a dual-energy X-ray absorptiometer (DXA). Blood and urine sample were collected for analysis of biochemical markers of bone and mineral metabolism. Insufficiency of vitamin D was observed in 24.4% of the women and optimal levels (≥ 50 nmol/L) were observed in 75.6%. Parathyroid hormone was above the reference range in 51% of the participants. The mean calcium (724 mg/day) and vitamin D (4.2 μ g/day) intakes were lower than the value proposed by The Food and Nutrition Board and sodium intake was more than two-fold above the recommendation. Higher levels of serum 25(OH)D were inversely associated with sodium intake. Dietary strategies to improve serum vitamin D must focus on increasing vitamin D intake and should take a reduction of sodium intake into consideration.

OSTEOPOROSIS AND RISK FACTORS IN THE PATIENTS ON CHRONIC HEMODIALYSIS

2015 ◽  
pp. 50-58
Author(s):  
Thi Dung Nguyen ◽  
Tam Vo
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Bone Density ◽  
Region Of Interest ◽  
Cross Sectional Study ◽  
Chronic Hemodialysis ◽  
Cross Sectional ◽  
X Ray ◽  
Density Reduction

Background: The patients on hemodialysis have a significantly decreased quality of life. One of many problems which reduce the quality of life and increase the mortality in these patients is osteoporosis and osteoporosis associated fractures. Objectives: To assess the bone density of those on hemodialysis by dual energy X ray absorptiometry and to examine the risk factors of bone density reduction in these patients. Patients and Method: This is a cross-sectional study, including 93 patients on chronic hemodialysis at the department of Hemodialysis at Cho Ray Hospital. Results: Mean bone densities at the region of interest (ROI) neck, trochanter, Ward triangle, intertrochanter and total neck are 0.603 ± 0.105; 0.583 ± 0.121; 0.811 ± 0.166; 0.489 ± 0.146; 0.723 ± 0.138 g/cm2 respectively. The prevalences of osteoporosis at those ROI are 39.8%, 15.1%; 28%; 38.7%; and 26.9% respectively. The prevalences of osteopenia at those ROI are 54.8%; 46.3%; 60.2%; 45.2% and 62.7% respectively. The prevalence of osteopososis in at least one ROI is 52.7% and the prevalence of osteopenia in at least one ROI is 47.3%. There are relations between the bone density at the neck and the gender of the patient and the albuminemia. Bone density at the trochanter is influenced by gender, albuminemia, calcemia and phosphoremia. Bone density at the intertrochanter is affected by the gender. Bone density at the Ward triangle is influenced by age and albuminemia. Total neck bone density is influenced by gender, albuminemia and phosphoremia. Conclusion: Osteoporosis in patients on chronic hemodialysis is an issue that requires our attention. There are many interventionable risk factors of bone density decrease in these patients. Key words: Osteoporosis, DEXA, chronic renal failure, chronic hemodialysis

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