scholarly journals Rheumatology - A Qualitative Review of Community and Hospital Based Delivery Models

2019 ◽  
pp. 3-5
Author(s):  
Hannah Jethwa ◽  
Sonya Abraham
Keyword(s):  
Healthcare Providers ◽  
Cost Effective ◽  
Models Of Care ◽  
Community Based ◽  
Qualitative Review ◽  
Delivery Models

Over recent years the increasing pressures on hospital based services has raised the question as to whether more clinical facilities can be provided in the community. Accordingly, commissioning groups have focused much of their energy towards research into whether this shift in healthcare models is feasible, cost-effective and satisfactory to both patients and healthcare providers. Specialties which lend themselves towards the possibility of community based models of care include those that manage patients with chronic but stable diseases and Rheumatology, in particular, has been a focus of such research.

scholarly journals Cost-effectiveness of models of care quality for children affected by HIV and AIDS in Nepal

2018 ◽  
Vol 11 ◽  
pp. 19-25 ◽  
Author(s):  
PM Pradhan ◽  
G Bhatta ◽  
K Bam
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Models Of Care ◽  
Care Quality ◽  
Hiv And Aids ◽  
Income Generation ◽  
Care Model ◽  
Community Based ◽  
Care And Support ◽  
Hiv Aids

Background: With an estimated sixty four thousand people living with HIV in Nepal, there are tremendous implications for children, whose lives are greatly affected when a parent is infected. The objective of this study is to identify and assess cost effectiveness for existing models of care for children affected with HIV/AIDS Methods: The study performed cost effective analysis for types of care and support for children affected by HIV and AIDS in Nepal from a societal perspective. Types of care and support to Children affected by HIV/AIDS were assessed, Comparator minimum was estimated based on government minimum standards guideline; comparative analysis for cost effectiveness was done in terms of care quality, and overall modes of care delivery. Results: This study identified only three types of care model (comprehensive institutional model of care, home based care and support, community based care with income generation) prevalent in Nepal. Out of this three types of models of care: Community based care with income generation was assessed as the most cost effective care model in Nepal. Conclusion: Community based care with income generation imparted children with better socialization and professional skills. However, continuum of care was often missed by one model, therefore other existing models of child care were also essential to provide care and provision of safety nets for children who fail to reach the care homes should also be considered by the government. DOI: http://dx.doi.org/10.3126/hprospect.v11i0.7425 Health Prospect 2012;11:19-25

E-Voting Kepala Desa dan Modal Sosial

2019 ◽  
Vol 2 (6) ◽  
pp. 759
Author(s):  
Khaulah Afifah ◽  
Lala M Kolopaking ◽  
Zessy Ardinal Barlan
Keyword(s):  
Social Capital ◽  
Random Sampling ◽  
Qualitative Data ◽  
Sampling Technique ◽  
Cost Effective ◽  
Simple Random Sampling ◽  
Community Based ◽  
Time Saving ◽  
The Social ◽  
Voting System

Head of a village election with e-voting system is a new thing for community The success level of e-voting system can be reached by fulfil several principles in order to the implementation going effective and the result of the election can be accepted by all. The objectives of this research is to analyze the relation between the success level of e-voting system with social capital of the community. This research is carried out with the quantitative approach and supported by qualitative data. This research takes 60 respondents using simple random sampling technique. The results showed that the success level of e-voting has a correlation with the level of social capital of the community. Based on the field study, the social capital of the community is classified as high. The high social capital makes the implementation of e-voting successful and the success level is also high, because in the election ten years ago occurred a conflict. The community considers e-voting easier and more practical, cost effective and time-saving, and the results of e-voting are also reliable. A practical and fast of e-voting system can be a solution especially for “rural-urban” community who are busy or work outside the village.Keywords: E-voting, the success level of the system, social capital Pemilihan kepala desa dengan sistem e-voting merupakan hal yang baru bagi masyarakat. Keberhasilan penerapan sistem e-voting dilihat dari terpenuhinya beberapa prinsip agar penerapannya berlangsung efektif dan hasilnya dapat diterima oleh seluruh masyarakat. Penelitian ini bertujuan untuk menganalisis hubungan tingkat keberhasilan sistem e-voting dalam pemilihan kepala desa dengan tingkat modal sosial masyarakat. Bentuk penelitian ini adalah penelitian kuantitatif yang didukung oleh analisis data kualitatif. Penelitian ini mengambil enam puluh responden dengan teknik simple random sampling. Hasil penelitian menunjukkan bahwa tingkat keberhasilan e-voting memiliki hubungan dengan tingkat modal sosial masyarakat. Berdasarkan kajian di lapang, modal sosial masyarakat tergolong tinggi. Tingginya modal sosial tersebut membuat pelaksanaan e-voting berhasil dan tingkat keberhasilannya juga tergolong tinggi karena pada pemilihan sepuluh tahun silam sempat terjadi konflik. Masyarakat menganggap sistem evoting lebih mudah dan praktis, hemat dalam segi biaya dan waktu, serta hasil dari pemilihan juga dapat dipertanggungjawabkan. Sistem e-voting yang praktis dan cepat dapat menjadi solusi khususnya bagi masyarakat daerah “desa-kota” yang memiliki kesibukan atau pekerjaan di luar desa.Kata Kunci: E-voting, keberhasilan sistem, modal sosial. 

scholarly journals 139. Impact of Pharmacist Driven Outpatient Fluoroquinolone Stewardship Initiative in Community Based Setting

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S81-S81
Author(s):  
Sarah Norman ◽  
Sara Jones ◽  
Cara Acklin ◽  
Christian Cheatham
Keyword(s):  
Antimicrobial Stewardship ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Secondary Outcome ◽  
Quality Improvement Initiative ◽  
Oral Antibiotic ◽  
Ambulatory Care Setting ◽  
Community Based ◽  
Before And After ◽  
Physician Network

Abstract Background Antimicrobial stewardship initiatives and efforts have historically had a greater emphasis in the inpatient hospital setting. There is a need for outpatient stewardship, and additionally, accreditation standards are starting to require antimicrobial stewardship efforts in the ambulatory care setting. Fluoroquinolones are a target for antimicrobial stewardship based on their broad-spectrum activity, pharmacokinetics/pharmacodynamics, safety profile, downstream resistance, and risk of super infections. The objective of this study was to compare outpatient fluoroquinolone prescribing rates before and after pharmacist led initiative. Methods This was a prospective, quality improvement initiative between October 1, 2019 to June 1, 2020 at a community-based physician network across Indiana. The pharmacist initiative incorporated a live, educational presentation with intervention 1 and an informational letter to healthcare providers across the outpatient physician network with intervention 2. Data was collected from a computer-generated, prescription report. The primary outcome was fluoroquinolone prescribing rates at Central Indiana (CI) sites before and after pharmacist led interventions. Rate of fluoroquinolone prescribing was defined as total number of fluoroquinolone prescriptions per month. The secondary outcome included percentage of fluoroquinolone use at CI sites. Percentage of fluoroquinolone use was defined as monthly number of fluoroquinolones prescriptions compared to monthly number of all oral antibiotic prescriptions. Results There was a 29.8% decrease (382 vs 268 prescriptions) in outpatient fluoroquinolone prescriptions at CI sites after intervention 1 compared to same month of previous year. There was a 43.7% decrease (428 vs 241 prescriptions) in outpatient fluoroquinolone prescriptions at CI sites after intervention 2. There was an overall 2.4% decrease (4.9% vs 2.5%) in percentage of fluoroquinolone use compared to all oral antibiotics at CI sites after intervention 2 compared to same month of previous year. Conclusion These findings suggest the pharmacist led outpatient antimicrobial stewardship initiative successfully decreased fluoroquinolone prescribing rates across the network. Disclosures Christian Cheatham, PharmD, BCIDP, Antimicrobial Resistance Solutions (Shareholder)

scholarly journals Self-fill oxygen technology: benefits for patients, healthcare providers and the environment

Breathe ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Phyllis Murphie ◽  
Nick Hex ◽  
Jo Setters ◽  
Stuart Little
Keyword(s):  
Positive Impact ◽  
Healthcare Providers ◽  
Cost Savings ◽  
Cost Effective ◽  
Evidence Base ◽  
Environmental Benefits ◽  
List Type ◽  
Potential Cost ◽  
Unlimited Supply ◽  
Technology Benefits

“Non-delivery” home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers.Educational aimsProvide update for oxygen prescribers on options for home oxygen provision.Provide update on the evidence base for available self-fill oxygen technologies.Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems.

A community-based approach to evaluation of health outcomes and costs for telepsychiatry in a rural population: Preliminary results

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 155-157 ◽  
Author(s):  
Craig Kennedy ◽  
Peter Yellowlees
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Rural Areas ◽  
Pilot Trial ◽  
Public Mental Health ◽  
Cost Effective ◽  
Community Based ◽  
Public And Private ◽  
Preliminary Results ◽  
The People

A pilot trial was established to support visiting psychiatric services and local public and private practitioners through the use of videoconferencing. The purpose of the trial was to determine whether people in the community received better health-care with telemedicine. A community-based approach was used to evaluate health outcomes, costs, utilization, accessibility, quality and needs for such services in a rural community in Queensland. Over a two-year period data were collected from 124 subjects who met the criteria of having a mental health problem or mental disorder. Nine further subjects refused to participate in the study. Only 32 subjects used videoconferencing to receive mental health services. Preliminary results did not show any significant improvements in wellbeing or quality of life, although the time span was relatively short. However, the results confirmed that the people were no worse off from a consumer or a practitioner perspective from using videoconferencing. Most consumers found that videoconferencing with a psychiatrist moderately or greatly helped them in managing their treatment, with 98% of them preferring to be offered videoconferencing in combination with local services. Overall, videoconferencing is a crucial part of enhancing psychiatry services in rural areas. However, it is not necessarily cost-effective for all consumers, general practitioners, psychiatrists, or the public mental health service.

scholarly journals Cost-effectiveness of two long-lasting insecticidal nets delivery models in mass campaign in rural Mozambique

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Jorge A. H. Arroz ◽  
Baltazar Candrinho ◽  
Chandana Mendis ◽  
Melanie Lopez ◽  
Maria do Rosário O. Martins
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Universal Coverage ◽  
Cost Effectiveness Ratio ◽  
Net Benefit ◽  
Incremental Net Benefit ◽  
The Cost ◽  
And Control ◽  
Delivery Models ◽  
Long Lasting Insecticidal Nets

Abstract Objective The aim is to compare the cost-effectiveness of two long-lasting insecticidal nets (LLINs) delivery models (standard vs. new) in universal coverage (UC) campaigns in rural Mozambique. Results The total financial cost of delivering LLINs was US$ 231,237.30 and US$ 174,790.14 in the intervention (302,648 LLINs were delivered) and control districts (219,613 LLINs were delivered), respectively. The average cost-effectiveness ratio (ACER) per LLIN delivered and ACER per household (HH) achieving UC was lower in the intervention districts. The incremental cost-effectiveness ratio (ICER) per LLIN and ICER per HH reaching UC were US$ 0.68 and US$ 2.24, respectively. Both incremental net benefit (for delivered LLIN and for HHs reaching UC) were positive (intervention deemed cost-effective). Overall, the newer delivery model was the more cost-effective intervention. However, the long-term sustainability of either delivery models is far from guaranteed in Mozambique’s current economic context.

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