scholarly journals Cost comparison of gynecologic procedures between the US and a developing country: An observational study

Author(s):  
Bassel Abouzeid ◽  
Georges Elhasbany ◽  
Jawad Abouzeid ◽  
souheil Hallit ◽  
Karl Jallad
Author(s):  
Bassel Abouzeid ◽  
Georges El Hasbani ◽  
Jawad Abouzeid ◽  
Souheil Halleit ◽  
Karl Jallad

2018 ◽  
Vol 63 (05) ◽  
pp. 1385-1403 ◽  
Author(s):  
KITAE SOHN ◽  
ILLOONG KWON

Trust was found to promote entrepreneurship in the US. We investigated whether this was true in a developing country, Indonesia. We failed to replicate this; this failure was true whether trust was estimated at the individual or community level or whether ordinary least squares (OLS) or two stage least squares (2SLS) was employed. We reconciled the difference between our results and those for the US by arguing that the weak enforcement of property rights in developing countries and the consequent hold-up problem make it more efficient for entrepreneurs to produce generic goods than relationship-specific goods—producing generic goods does not depend on trust.


10.2196/17425 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e17425
Author(s):  
Daniel Katz ◽  
Ronak Shah ◽  
Elizabeth Kim ◽  
Chang Park ◽  
Anjan Shah ◽  
...  

Background The incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of training are expensive, time consuming, and difficult to scale, which necessitates improvements in advanced cardiac life support (ACLS) training. Virtual reality (VR) has been proposed as an alternative or adjunct to high-fidelity simulation (HFS) in several environments. No evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills and demonstrate a cost comparison. Objective This study aimed to explore the utility of a voice-based VR ACLS team leader refresher as compared with HFS. Methods This prospective observational study performed at an academic institution consisted of 25 postgraduate year 2 residents. Participants were randomized to HFS or VR training and then crossed groups after a 2-week washout. Participants were graded on technical and nontechnical skills. Participants also completed self-assessments about the modules. Proctors were assessed for fatigue and task saturation, and cost analysis based on local economic data was performed. Results A total of 23 of 25 participants were included in the scoring analysis. Fewer participants were familiar with VR compared with HFS (9/25, 36% vs 25/25, 100%; P<.001). Self-reported satisfaction and utilization scores were similar; however, significantly more participants felt HFS provided better feedback: 99 (IQR 89-100) vs 79 (IQR 71-88); P<.001. Technical scores were higher in the HFS group; however, nontechnical scores for decision making and communication were not significantly different between modalities. VR sessions were 21 (IQR 19-24) min shorter than HFS sessions, the National Aeronautics and Space Administration task load index scores for proctors were lower in each category, and VR sessions were estimated to be US $103.68 less expensive in a single-learner, single-session model. Conclusions Utilization of a VR-based team leader refresher for ACLS skills is comparable with HFS in several areas, including learner satisfaction. The VR module was more cost-effective and was easier to proctor; however, HFS was better at delivering feedback to participants. Optimal education strategies likely contain elements of both modalities. Further studies are needed to examine the utility of VR-based environments at scale.


Author(s):  
Dalia Giedrimiene ◽  
Rachel King

CVD is a major cause of morbidity and mortality worldwide, responsible for nearly a third of all deaths. In US, 85.6 million Americans are living with CVD, including 15.5 million with coronary heart disease (CHD). Heart disease (HD) specifically is responsible for approximately one in every seven American deaths, taking 370,213 lives per year. Perhaps even more striking than CHD’s mortality is its preventability. The CDC estimates that 34% of deaths caused by HD could potentially be prevented with modifiable risk factors including hypertension, hyperlipidemia, diabetes, smoking, poor diet, and sedentary lifestyle. By comparing the mortality of CVD and CHD in the US, Europe, and the United Kingdom (UK), we aim to gain a better understanding of the CVD burden and economic cost. Methods: We conducted a literature review of the most recent epidemiological data for US, Europe, and UK to compare mortality due to CVD and CHD between these three regions. Data sources for US include the AHA and CDC. Data for Europe was obtained from the European Society of Cardiology, following the World Health Organization’s definition of 53 states as the European region. The UK is included as it was considered independently in this study. Data for the UK was published by the British Heart Foundation. Results: The comparison of data shows that high mortality is evident in all represented countries and regions with a highest percent of CVD of total deaths in Europe as compared to US (45% vs 30.8%) and CHD (20% vs 14.2%). Very similar findings according annual mortality are evident comparing US to UK for CVD (30.8% vs 28%) and for CHD (14.2% vs 13%). The treatment for CVD is increasing over time, with prescriptions and operations costs around 6.8 billion in England, the majority spend on secondary care. CDC data in US show that Americans suffer 1.5 million heart attacks and strokes each year, which contributes more than $320 billion in annual healthcare costs and lost productivity. By 2030, this cost is projected to rise to $818 billion, while lost productivity costs to $275 billion. Conclusions: Although there is some variation between Europe as a group of 53 countries compared to the US and UK, it is clear that CVD has a major impact on mortality in all three regions studied. Improved prevention of CVD, including heart disease, has the potential to save lives around the globe and to reduce economic burden.


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