scholarly journals Metabolic Syndrome in Rural Community

2016 ◽  
Vol 22 (2) ◽  
Author(s):  
Mehmood Alam Pasha
Keyword(s):  
Metabolic Syndrome ◽  
Rural Communities ◽  
World Health ◽  
Diabetic Patients ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Proper Definition ◽  
Definition Of ◽  
Health Organization ◽  
Quality Adjusted Life

According to our observation, prevalence of metabolic syndrome is rising in urban populations as well as rural communities. However, this rising problem is largely being ignored and according to preliminary results quality adjusted life years can be increased by preventing Metabolic Syndrome. The first attempt to give a proper definition of Metabolic Syndrome was done by World Health Organization (WHO) in 1998.1 According to WHO criteria metabolic syndrome consists of diabetes mellitus along with any two of the following: BP greater than 140/90 mm Hg, hypertriglyceridemia, decreased HDL, central obesity and microalbumenemia.2 Metabolic syndrome is a major use of morbidity in diabetic patients and medical establishments.

QALY: An Ethical Issue that Dare Not Speak its Name

2007 ◽  
Vol 14 (1) ◽  
pp. 72-82 ◽  
Author(s):  
Peter Hirskyj
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Potential Effect ◽  
Quality Adjusted Life Years ◽  
The Public ◽  
Alternative Formula ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Definition Of ◽  
Quality Adjusted Life

The current British Government's policy towards resource allocation for health care has been informed by the commissioned Wanless Report. This makes a case for the use of quality adjusted life years (QALYs) to form a rationale for resourcing health care and has implications for the staff and patients who work in and use the health service. This article offers a definition of the term ‘QALY’ and considers some of the strengths and weaknesses of this approach to resource distribution. An account is also given of an alternative formula, the DALY (disability adjusted life years), which can address some of the problems that are associated with QALYs. The values of the public, patients and nurses are identified and linked to the potential effect of a QALY formula. The implications of QALY use are applied to the health care of patients and a discussion is offered with regard to whether this method of resource allocation can be considered as just.

Adherence to Antitumor Necrosis Factor Use Recommendations in Spondyloarthritis: Measurement and Effect in the DESIR Cohort

2017 ◽  
Vol 44 (10) ◽  
pp. 1436-1444 ◽  
Author(s):  
Stephanie Harvard ◽  
Daphne Guh ◽  
Nick Bansback ◽  
Pascal Richette ◽  
Alain Saraux ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Linear Regression ◽  
Regression Models ◽  
Linear Regression Models ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Definition Of ◽  
Main Definition ◽  
Necrosis Factor ◽  
Quality Adjusted Life

Objective.To evaluate a classification system to define adherence to axial spondyloarthritis (axSpA) anti-tumor necrosis factor (anti-TNF) use recommendations and examine the effect of adherence on outcomes in the DESIR cohort (Devenir des Spondylarthropathies Indifférenciées Récentes).Methods.Using alternate definitions of adherence, patients were classified as adherent “timely” anti-TNF users, nonadherent “late” anti-TNF users, adherent nonusers (“no anti-TNF need”), non-adherent nonusers (“unmet anti-TNF need”). Multivariate models were fitted to examine the effect of adherence on quality-adjusted life-years (QALY), total costs, and nonbiologic costs 1 year following an index date. Generalized linear regression models assuming a γ-distribution with log link were used for costs outcomes and linear regression models for QALY outcomes.Results.Using the main definition of adherence, there were no significant differences between late anti-TNF users and timely anti-TNF users in total costs (RR 0.86, 95% CI 0.54–1.36, p = 0.516) or nonbiologic costs (RR 0.72, 95% CI 0.44–1.18, p = 0.187). However, in the sensitivity analysis, late anti-TNF users had significantly increased nonbiologic costs compared with timely users (RR 1.58, 95% CI 1.06–2.36, p = 0.026). In the main analysis, there were no significant differences in QALY between timely anti-TNF users and late anti-TNF users, or between timely users and patients with unmet anti-TNF need. In the sensitivity analysis, patients with unmet anti-TNF need had significantly lower QALY than timely anti-TNF users (−0.04, 95% CI −0.07 to −0.01, p = 0.016).Conclusion.The effect of adherence to anti-TNF recommendations on outcomes was sensitive to the definition of adherence used, highlighting the need to validate methods to measure adherence.

Identifying Public Health Problems

2018 ◽  
Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday
Keyword(s):  
Public Health ◽  
Health Problems ◽  
Health Priorities ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Study Designs ◽  
Quality Adjusted Life

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

Defining Preterm Birth and Stillbirth in the Western Pacific: A Systematic Review

2021 ◽  
pp. 101053952110260
Author(s):  
Mairead Connolly ◽  
Laura Phung ◽  
Elise Farrington ◽  
Michelle J. L. Scoullar ◽  
Alyce N. Wilson ◽  
...  
Keyword(s):  
Preterm Birth ◽  
National Level ◽  
Health Indicators ◽  
Western Pacific ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.

Medicare’s Hospital Value-Based Purchasing Program Values Quality over QALYs

2021 ◽  
pp. 0272989X2110171
Author(s):  
Edward C. Norton ◽  
Jun Li ◽  
Anup Das ◽  
Andrew M. Ryan ◽  
Lena M. Chen
Keyword(s):  
Quality Of Care ◽  
Pay For Performance ◽  
Health Interventions ◽  
Quality Adjusted Life Years ◽  
Value Based Purchasing ◽  
Quality Performance ◽  
Life Years ◽  
Policy Adjustments ◽  
Quality Adjusted Life

Medicare’s Hospital Value-Based Purchasing Program (HVBP) is the first national pay-for-performance program to combine measures of quality of care with a measure of episode spending. We estimated the implicit tradeoffs between mortality reduction and spending reduction. To earn points in HVBP, a hospital can either lower mortality or reduce spending, creating a tradeoff between the 2 measures. We analyzed the quality performance and earned points of 2814 hospitals using publicly available data. We then quantified the tradeoffs between spending and mortality in terms of quality-adjusted life-years (QALYs). If incentives in the program were balanced, then the tradeoff between spending and QALYs should be comparable with those of high-value health interventions, roughly $50,000 to $200,000 per QALY. Instead, the tradeoff in HVBP was about $1.2 million per QALY. HVBP overvalues improvements in quality of care relative to spending reductions. We propose 2 possible policy adjustments that could improve incentives for hospitals to deliver high-value care.

Sign in / Sign up

Export Citation Format

Share Document