scholarly journals An Economic Evaluation of the Impact of Using Rapport-Based Interviewing Approaches With Child Sexual Abuse Suspects

2021 ◽  
Vol 12 ◽  
Author(s):  
Susan Giles ◽  
Laurence Alison ◽  
Paul Christiansen ◽  
Michael Humann ◽  
Emily Alison ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Motivational Interviewing ◽  
Cost Savings ◽  
Potential Cost ◽  
Unit Costs ◽  
Lifetime Costs ◽  
The Cost ◽  
Interviewing Technique ◽  
The Impact

Two studies examined whether rapport-based interviewing with child sexual abuse (CSA) suspects provides greater interview yield that could result in overall cost-savings to the investigation. First, multi-level modelling was applied to 35 naturalistic CSA suspect interviews to establish whether rapport-based interviewing techniques increase “yield” – defined as information of investigative value. The Observing Rapport Based Interviewing Technique (ORBIT coding manual was used to code interviews; it includes an assessment of both interpersonal adaptive and maladaptive rapport-based interviewer engagement as well as motivational interviewing (MI) strategies. The impact of these two strands (interpersonal and MI) on extracting information of investigative value (including strengthening a case for court and safeguarding) were examined. Adaptive interpersonal strategies increased case strengthening and safeguarding yield, with motivational interviewing having the largest impact on safeguarding yield. Both strategies increase the likelihood of gaining additional types of economic yield. Maladaptive interviewer strategies reduced case strengthening and different types of economic yield. In study two, literature-based economic estimates were applied to establish the potential cost benefits from following national ORBIT rapport training. Further training in adaptive and motivational interviewing could contribute cost savings between £19 and £78 million (annual unit costs) increasing to £238–£972 million (lifetime costs) for online CSA across England and Wales; and £157–£639 million (annual unit costs) increasing to £2–£8 billion (lifetime costs) for all CSA. Failure to commit training resource to this, or an alternative strategy, could mean the cost burden attributable to maladaptive interviewing (between £1 and £6 million for online CSA and £12 and £48 million for all CSA) is not successfully averted.

A Cost-Benefit Analysis of Reducing Surgical Site Infections

2018 ◽  
Vol 84 (2) ◽  
pp. 254-261
Author(s):  
Alexander Rosemurgy ◽  
Jacqueline Whitaker ◽  
Kenneth Luberice ◽  
Christian Rodriguez ◽  
Darrell Downs ◽  
...  
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Savings ◽  
Cost Benefit ◽  
Surgical Site Infections ◽  
Potential Cost ◽  
Pancreatic Resections ◽  
Before And After ◽  
Abdominal Operations ◽  
The Cost ◽  
The Impact

Surgical Site Infections (SSI) represent an onerous burden on our health-care system. This study was undertaken to determine the impact of a protocol aimed at reducing SSIs on the frequency and cost of SSIs after abdominal surgery. Beginning in 2013, 811 patients undergoing gastrointestinal operations were prospectively followed. In 2014, we initiated a protocol to reduce SSIs. SSIs were monitored before and after protocol implementation, and differences in SSI incidence and associated costs were determined. Before protocol initiation, standardized operative preparation cost was $40.85 to $126.94 per patient depending on the results of methicillin-resistant Staphylococcus aureus screen; after protocol initiation, the cost was $43.85 per patient, saving up to $83.09 per patient. With the protocol in place, SSI rate was reduced from 4.9 to 3.4 per cent (13 of 379) representing a potential prevention of eight infections that would have cost payers $166,280 ($20,785 per infection). Notably, the SSI rate after pancreatectomy was reduced by 63 per cent ( P = 0.04). With preparation and diligence, SSI rate can be meaningfully reduced and potential cost savings can be achieved. In particular, SSI rate reduction for major abdominal operations and especially pancreatic resections can be achieved. A protocol to reduce SSI is a “win-win” for all stakeholders and should be encouraged with thoughtful and active participation from all hospital disciplines.

scholarly journals Redesign of an upwind rotor for a downwind configuration: design changes and cost evaluation

2021 ◽  
Vol 6 (1) ◽  
pp. 203-220
Author(s):  
Gesine Wanke ◽  
Leonardo Bergami ◽  
Frederik Zahle ◽  
David Robert Verelst
Keyword(s):  
Cost Model ◽  
Cost Savings ◽  
Rotor Blades ◽  
Cost Evaluation ◽  
Potential Cost ◽  
Pure Material ◽  
Cost Of Energy ◽  
Design Changes ◽  
The Cost ◽  
The Impact

Abstract. Within this work, an existing model of a Suzlon S111 2.1 MW turbine is used to estimate potential cost savings when the conventional upwind rotor concept is changed into a downwind rotor concept. A design framework is used to get realistic design updates for the upwind configuration, as well as two design updates for the downwind configuration, including a pure material cost out of the rotor blades and a new planform design. A full design load basis according to the standard has been used to evaluate the impact of the redesigns on the loads. A detailed cost model with load scaling is used to estimate the impact of the design changes on the turbine costs and the cost of energy. It is shown that generally lower blade mass of up to 5 % less than the upwind redesign can be achieved with the downwind configurations. Compared to an upwind baseline, the upwind redesign shows an estimated cost of energy reduction of 2.3 %, and the downwind designs achieve a maximum reduction of 1.3 %.

scholarly journals Re-design of an upwind rotor for a downwind configuration: design changes and cost evaluation

2020 ◽  
Author(s):  
Gesine Wanke ◽  
Leonardo Bergami ◽  
Frederik Zahle ◽  
David Robert Verelst
Keyword(s):  
Cost Model ◽  
Cost Savings ◽  
Rotor Blades ◽  
Cost Evaluation ◽  
Potential Cost ◽  
Pure Material ◽  
Cost Of Energy ◽  
Design Changes ◽  
The Cost ◽  
The Impact

Abstract. Within this work, an existing model of a Suzlon S111 2.1 MW turbine is used to estimate potential cost savings when the conventional upwind rotor concept is changed into a downwind rotor concept. A design framework is used to get realistic design updates for the upwind configuration as well as two design updates for the downwind configuration, including a pure material cost-out on the rotor blades and a new planform design. A full design load basis according to the standard has been used to evaluate the impact of the redesigns on the loads. A detailed cost model with load scaling is used to estimate the impact of the design changes on the turbine costs and the cost of energy. It is shown that generally lower blade mass can be achieved with the downwind configurations of up to 5 % less than the upwind redesign. Compared to an upwind baseline, the upwind redesign shows an estimated cost of energy reduction of 2.3 % where the downwind designs achieve a maximum reduction of 1.3 %.

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

Pound Wise and Penny Foolish? Weight Loss and The Dynamics of Health Care Spending

2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch
Keyword(s):  
Weight Loss ◽  
Cost Savings ◽  
Cost Effective ◽  
Economic Consequences ◽  
Health Care Spending ◽  
Order Of Magnitude ◽  
Dynamic Measures ◽  
The Cost ◽  
The Impact ◽  
The Relationship

Current estimates of obesity costs ignore the impact of future weight loss and gain, and may either over or underestimate economic consequences of weight loss. In light of this, I construct static and dynamic measures of medical costs associated with body mass index (BMI), to be balanced against the cost of one-time interventions. This study finds that ignoring the implications of weight loss and gain over time overstates the medical-cost savings of such interventions by an order of magnitude. When the relationship between spending and age is allowed to vary, weight-loss attempts appear to be cost-effective starting and ending with middle age. Some interventions recently proven to decrease weight may also be cost-effective.

scholarly journals Cost-effectiveness and feasibility of conditional economic incentives and motivational interviewing to improve HIV health outcomes of adolescents living with HIV in Anambra State, Nigeria

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Obinna Ikechukwu Ekwunife ◽  
Chinelo Janefrances Ofomata ◽  
Charles Ebuka Okafor ◽  
Maureen Ugonwa Anetoh ◽  
Stephen Okorafor Kalu ◽  
...  
Keyword(s):  
Viral Load ◽  
Cost Effectiveness ◽  
Service Delivery ◽  
Motivational Interviewing ◽  
Cost Effective ◽  
Economic Incentives ◽  
Additional Patient ◽  
Incentive Scheme ◽  
The Cost ◽  
The Impact

Abstract Background In sub-Saharan Africa, there is increasing mortality and morbidity of adolescents due to poor linkage, retention in HIV care and adherence to antiretroviral therapy (ART). This is a result of limited adolescent-centred service delivery interventions. This cost-effectiveness and feasibility study were piggybacked on a cluster-randomized trial that assessed the impact of an adolescent-centred service delivery intervention. The service delivery intervention examined the impact of an incentive scheme consisting of conditional economic incentives and motivational interviewing on the health outcomes of adolescents living with HIV in Nigeria. Method A cost-effectiveness analysis from the healthcare provider’s perspective was performed to assess the cost per additional patient achieving undetected viral load through the proposed intervention. The cost-effectiveness of the incentive scheme over routine care was estimated using the incremental cost-effectiveness ratio (ICER), expressed as cost/patient who achieved an undetectable viral load. We performed a univariate sensitivity analysis to examine the effect of key parameters on the ICER. An in-depth interview was conducted on the healthcare personnel in the intervention arm to explore the feasibility of implementing the service delivery intervention in HIV treatment hospitals in Nigeria. Result The ICER of the Incentive Scheme intervention compared to routine care was US$1419 per additional patient with undetectable viral load. Going by the cost-effectiveness threshold of US$1137 per quality-adjusted life-years suggested by Woods et al., 2016, the intervention was not cost-effective. The sensitivity test showed that the intervention will be cost-effective if the frequency of CD4 count and viral load tests are reduced from quarterly to triannually. Healthcare professionals reported that patients’ acceptance of the intervention was very high. Conclusion The conditional economic incentives and motivational interviewing was not cost-effective, but can become cost-effective if the frequency of HIV quality of life indicator tests are performed 1–3 times per annum. Patients’ acceptance of the intervention was very high. However, healthcare professionals believed that sustaining the intervention may be difficult unless factors such as government commitment and healthcare provider diligence are duly addressed. Trial registration This trial is registered in the WHO International Clinical Trials Registry through the WHO International Registry Network (PACTR201806003040425).

Father-perpetrators of child sexual abuse who commit suicide

1990 ◽  
Vol 7 (2) ◽  
pp. 144-145 ◽  
Author(s):  
Geraldine Walford ◽  
Marie-Therese Kennedy ◽  
Morna K. C Manwell ◽  
Noel McCune
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sexually Abused ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Recent Letter ◽  
The Family ◽  
Sex Offences ◽  
The Guardian ◽  
The Impact

Two cases of fathers who committed suicide following the revelation that they had sexually abused their own or other children, are described. The importance of being alert to the possibility of suicide and suicidal acts by family members following a disclosure, is emphasised. Improved liaison and co-ordination between agencies working with these families may enable vulnerable cases to be more readily identified and consequently offered appropriate support and treatment.The revelation that the father in a family has sexually abused his own or other children often precipitates a crisis within the family. The distress suffered by the children themselves and by their mothers is well documented. (Browne and Finkelhor, Hildebrand and Forbes). Goodwin reported suicide attempts in 11 of 201 families, in which sexual abuse had been confirmed. Eight of the attempts were made by daughter-victims. In three of the five cases of mothers who attempted suicide, the abuse was intrafamilial. The impact on father perpetrators, previously a less well researched field, has been receiving more attention of late. Maisch, in a sample of 63 fathers convicted of incest reported that two fathers subsequently committed suicide. Wild has reported on six cases of suicide and three of attempted suicide by perpetrators following disclosure of child sexual abuse. The Cleveland Inquiry Report mentions one father, charged with several sex offences, who committed suicide while awaiting trial. A recent letter to The Guardian newspaper (18th February 1989) by 11 local paediatricians in that area suggests that there are now two such cases of suicide committed by alleged perpetrators.

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