scholarly journals Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Joris Hamm ◽  
Petra Van Bodegraven ◽  
Martin Bac ◽  
Jakobus M. Louw
Keyword(s):  
South Africa ◽  
Cost Effectiveness ◽  
Rural Areas ◽  
Healthcare Workers ◽  
Medical Practitioner ◽  
Literature Study ◽  
Medical Practitioners ◽  
Training Support ◽  
The Cost

Background: The National Department of Health of South Africa decided to start a programme to train mid-level healthcare workers, called clinical associates, as one of the measures to increase healthcare workers at district level in rural areas. Unfortunately, very little is known about the cost effectiveness of clinical associates.Aims: To determine, on a provincial level, the cost effectiveness of training and employing clinical associates and medical practitioners compared to the standard strategy of training and employing only more medical practitioners.Methods: A literature study was performed to answer several sub questions regarding the costs and effectiveness of clinical associates. The results were used to present a case study.Results: The total cost for a province to pay for the full training of a clinical associate is R 300 850. The average employment cost per year is R196 329 and for medical practitioners these costs are R 730 985 and R 559 397, respectively.Effectiveness: Clinical associates are likely to free up the time of a medical practitioner by 50–76%. They can provide the same quality of care as higher level workers, provided that they receive adequate training, support and supervision. Furthermore, they seem more willing to work in rural areas compared to medical practitioners.Conclusions: The case study showed that training and employing clinical associates is potentially a cost-effective strategy for a province to meet the increasing demand for rural healthcare workers. This strategy will only succeed when clinical associates receive adequate training, support and supervision and if the province keeps investing in them.

Evaluating the cost-effectiveness of invasive alien plant clearing: A case study from South Africa

2012 ◽  
Vol 155 ◽  
pp. 128-135 ◽  
Author(s):  
Matthew M. McConnachie ◽  
Richard M. Cowling ◽  
Brian W. van Wilgen ◽  
Dominic A. McConnachie
Keyword(s):  
South Africa ◽  
Cost Effectiveness ◽  
Alien Plant ◽  
Invasive Alien Plant ◽  
The Cost

scholarly journals Development of unmanned aerial vehicle (UAV) networks delivering early defibrillation for out-of-hospital cardiac arrests (OHCA) in areas lacking timely access to emergency medical services (EMS) in Germany: a comparative economic study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043791
Author(s):  
Jan Bauer ◽  
Dieter Moormann ◽  
Reinhard Strametz ◽  
David A Groneberg
Keyword(s):  
Cost Effectiveness ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Medical Services ◽  
Secondary Outcome ◽  
Annual Average ◽  
Emergency Medical ◽  
Life Years ◽  
Timely Access ◽  
The Cost

ObjectivesThis study wants to assess the cost-effectiveness of unmanned aerial vehicles (UAV) equipped with automated external defibrillators (AED) in out-of-hospital cardiac arrests (OHCA). Especially in rural areas with longer response times of emergency medical services (EMS) early lay defibrillation could lead to a significant higher survival in OHCA.Participants3296 emergency medical stations in Germany.SettingRural areas in Germany.Primary and secondary outcome measuresThree UAV networks providing 80%, 90% or 100% coverage for rural areas lacking timely access to EMS (ie, time-to-defibrillation: >10 min) were developed using a location allocation analysis. For each UAV network, primary outcome was the cost-effectiveness using the incremental cost-effectiveness ratio (ICER) calculated by the ratio of financial costs to additional life years gained compared with current EMS.ResultsCurrent EMS with 3926 emergency stations was able to gain 1224 life years on annual average in the study area. The UAV network providing 100% coverage consisted of 1933 UAV with average annual costs of €43.5 million and 1845 additional life years gained on annual average (ICER: €23 568). The UAV network providing 90% coverage consisted of 1074 UAV with average annual costs of €24.2 million and 1661 additional life years gained on annual average (ICER: €14 548). The UAV network providing 80% coverage consisted of 798 UAV with average annual costs of €18.0 million and 1477 additional life years gained on annual average (ICER: €12 158).ConclusionThese results reveal the relevant life-saving potential of all modelled UAV networks. Furthermore, all analysed UAV networks could be deemed cost-effective. However, real-life applications are needed to validate the findings.

Comparison of Alternative Methods to Assess the Cost-Effectiveness of Tumor-Agnostic Therapies: A Triangulation Approach Using Larotrectinib as a Case Study

2021 ◽  
Author(s):  
Andrew Briggs ◽  
Beth Wehler ◽  
Jennifer G. Gaultney ◽  
Alex Upton ◽  
Antoine Italiano ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Alternative Methods ◽  
The Cost

scholarly journals Proposing a Paradigm Shift in Rural Electrification Investments in Sub-Saharan Africa through Agriculture

2020 ◽  
Vol 12 (8) ◽  
pp. 3096 ◽  
Author(s):  
George Kyriakarakos ◽  
Athanasios T. Balafoutis ◽  
Dionysis Bochtis
Keyword(s):  
Rural Areas ◽  
Business Models ◽  
Sub Saharan Africa ◽  
Rural Electrification ◽  
Agricultural Cooperatives ◽  
New Approach ◽  
Sub Saharan ◽  
The Cost ◽  
Cross Subsidization

Almost one billion people in the world still do not have access to electricity. Most of them live in rural areas of the developing world. Access to electricity in the rural areas of Sub-Saharan Africa is only 28%, roughly 600 million people. The financing of rural electrification is challenging and, in order to accomplish higher private sector investments, new innovative business models have to be developed. In this paper, a new approach in the financing of microgrid electrification activities is proposed and investigated. In this approach, agriculture related businesses take the lead in the electrification activities of the surrounding communities. It is shown that the high cost of rural electrification can be met through the increased value of locally produced products, and cross-subsidization can take place in order to decrease the cost of household electrification. The approach is implemented in a case study in Rwanda, through which the possibility of local agricultural cooperatives leading electrification activities is demonstrated.

Assessment of Accuracy of Suicide Mortality Surveillance Data in South Africa

Crisis ◽  
2007 ◽  
Vol 28 (2) ◽  
pp. 74-81 ◽  
Author(s):  
Stephanie Burrows ◽  
Lucie Laflamme
Keyword(s):  
South Africa ◽  
Surveillance System ◽  
Accurate Determination ◽  
Medical Practitioner ◽  
Epidemiological Data ◽  
Careful Examination ◽  
Suicide Mortality ◽  
Injury Death ◽  
Predictive Values ◽  
Medical Practitioners

Abstract. Although it is not a legal requirement in South Africa, medical practitioners determine the manner of injury death for a surveillance system that is currently the only source of epidemiological data on suicide. This study assessed the accuracy of suicide data as recorded in the system using the docket produced from standard medico-legal investigation procedures as the gold standard. It was conducted in one of three cities where the surveillance system had full coverage for the year 2000. In the medico-legal system, one-third of cases could not be tracked, had not been finalized, or had unclear outcomes. For the remaining cases, the sensitivity, specificity, and positive and negative predictive values were generally high, varying somewhat across sex and race groups. Poisoning, jumping, and railway suicides were more likely than other methods to be misclassified, and were more common among females and Whites. The study provides encouraging results regarding the use of medical practitioner expertise for the accurate determination of suicide deaths. However, suicides may still be underestimated in this process given the challenge of tracing disguised suicides and without the careful examination of potential misclassifications of true suicides as unintentional deaths.

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