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Análise dos custos e complicações da cirurgia de catarata realizada por residentes; Analysis of costs and complications of cataract surgery performed by residents

Carricondo, Pedro Carlos
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 24/09/2010 PT
Relevância na Pesquisa
85.66%
INTRODUÇÃO: Os custos representam um problema crucial na formação e especialização do médico no mundo moderno. Conhecer os gastos relacionados ao ensino é importante para o planejamento financeiro das instituições de ensino. A cirurgia de catarata é um dos pontos centrais da formação do oftalmologista. O objetivo deste estudo foi comparar os custos e as complicações peroperatórias da cirurgia de catarata realizada por residentes com a cirurgia realizada por um cirurgião experiente. MÉTODOS: Neste estudo prospectivo, as cirurgias de facoemulsificação executadas por residentes durante os 3 primeiros meses de treinamento foram comparadas com cirurgias realizadas por um cirurgião experiente quanto aos custos e complicações. Foram incluídas 312 cirurgias, sendo 261 realizadas por residentes e 51 pelo cirurgião experiente. As cirurgias foram divididas, de acordo com a experiência cirúrgica do residente no momento da realização do procedimento (Grupo 1: 0 a 40 cirurgias; Grupo 2: 41 a 80 cirurgias; Grupo 3: mais de 80 cirurgias). RESULTADOS: O custo médio das cirurgias realizadas pelos residentes foi de R$ 802,74 ± 352,48 e pelo cirurgião experiente R$ 588,74 ± 44,68. No grupo 1, foram observados R$ 862,63 ± 382...

Análise e determinação de custos específicos e consequências econômico-sociais na incorporação da vacina contra meningite e doença meningocócica C conjugada na rotina do Programa Nacional de Imunização/PNI; Analysis and determination of specific costs and socioeconomic consequences in the incorporation of the vaccine against meningitis and Meningococcal Disease C conjugate in the routine national immunization program / NIP

Itria, Alexander
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 14/10/2011 PT
Relevância na Pesquisa
75.74%
As avaliações econômicas em saúde, que se propõe a estudar a alocação mais eficiente de recursos, apresentam expansão nos últimos 20 anos. Para as vacinas especificamente, há crescente surgimento das avaliações econômicas de programas de vacinação dado aumento dos preços das novas vacinas. Nesse cenário tem-se que a doença meningocócica continua sendo um agravo de extrema importância na população mundial, com características peculiares quando se consideram manifestações, morbi-mortalidade e ocorrência nas diferentes regiões. Não são suficientemente conhecidas as causas do início de uma epidemia em um dado momento e lugar, mas sabe-se que são necessários a presença concomitante de múltiplos fatores, como características do agente etiológico, do hospedeiro e do meio ambiente. Isto inclui a susceptibilidade da população, condições climáticas favoráveis, situação socioeconômica precária, tornando a prevenção primária da doença difícil, sendo necessária uma intervenção específica como as vacinas. Há diversas complicações da doença meningocócica, principalmente as sequelas, sendo as mais comuns a perda auditiva, as amputações, necrose de pele e convulsões. O Brasil, através do Programa Nacional de Imunizações / PNI...

CPITN: time and cost estimates for periodontal prevention and treatment procedures.

Dini, E. L.; Castellanos, R. A.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 53-58
ENG
Relevância na Pesquisa
85.54%
The aim of this study was to estimate the necessary time and cost for periodontal prevention and treatment in a working population from sugar and alcohol refineries in Araraquara, SP, Brazil. A stratified sample of 528 employees aged 18-64 from administrative, industrial and agricultural staffs was examined by one examiner, previously trained, according to the community periodontal index of treatment needs (CPITN). The time required for procedures and the cost was extrapolated to the total worker population. The results showed that the estimated time required for periodontal prevention/treatment was 4527 hours. Of this time, 1783 hours were required for oral hygiene instruction, 2531 for scaling, 151 for surgery and 62 for maintenance. The cost would be US $17,655 for hiring a dentist for 8 hours/day to provide oral hygiene instruction, scaling, surgery and maintenance. However, the cost would be US $9,028 for hiring a dentist for 4 hours/day to provide surgery and maintenance and a dental hygienist for 8 hours/day to provide scaling and oral hygiene instruction. Taking into account epidemiologic, technical and economic aspects, the decision relating to manpower should be this second option.

Total educational costs of an integrated nursing curriculum

Bobroff,Maria Cristina Cescatto; Gordan,Pedro A.; Garanhani,Mara Lúcia
Fonte: Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Publicador: Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2009 EN
Relevância na Pesquisa
75.76%
Innovative changes in undergraduate Nursing programs have brought about new methodologies and the need for cost evaluation. This study aims to develop a model for cost estimation, and to estimate educational costs of an integrated Nursing curriculum at a public university. This is a case study conducted in stages: model development, data collection, analysis and interpretation. The cost-construction model consisted of six steps: data collection; educational and support activity costs; four-year course educational costs; educational support costs; joint product costs and total educational costs. Findings showed a total educational cost per student/year US$ 3,788.82. Course team faculty included 97 members. The cost analysis in faculty contact hours is the most appropriate cost unit as it most consistently reflects faculty time devoted to teaching. The knowledge about educational costs provided information that may be useful for a different approach to the integrated curriculum management, with a view to putting its educational objectives in practice.

Clinical Benefits, Costs, and Cost-Effectiveness of Neonatal Intensive Care in Mexico

Profit, Jochen; Lee, Diana; Papile, LuAnn; Gutierrez, Cristina; Gonzalez-Pier, Eduardo; Zupancic, John A F; Goldie, Sue J.; Salomon, Joshua A.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
75.74%
Background: Neonatal intensive care improves survival, but is associated with high costs and disability amongst survivors. Recent health reform in Mexico launched a new subsidized insurance program, necessitating informed choices on the different interventions that might be covered by the program, including neonatal intensive care. The purpose of this study was to estimate the clinical outcomes, costs, and cost-effectiveness of neonatal intensive care in Mexico. Methods and Findings: A cost-effectiveness analysis was conducted using a decision analytic model of health and economic outcomes following preterm birth. Model parameters governing health outcomes were estimated from Mexican vital registration and hospital discharge databases, supplemented with meta-analyses and systematic reviews from the published literature. Costs were estimated on the basis of data provided by the Ministry of Health in Mexico and World Health Organization price lists, supplemented with published studies from other countries as needed. The model estimated changes in clinical outcomes, life expectancy, disability-free life expectancy, lifetime costs, disability-adjusted life years (DALYs), and incremental cost-effectiveness ratios (ICERs) for neonatal intensive care compared to no intensive care. Uncertainty around the results was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. In the base-case analysis...

Prevalence and cost of alternative medicine in Australia

MacLennan, A.; Wilson, D.; Taylor, A.
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //1996 EN
Relevância na Pesquisa
85.62%
BACKGROUND: To determine the prevalence and cost of alternative medicines and alternative practitioner use in an Australian population. METHODS: We conducted a representative population survey of persons aged 15 or older living in South Australia, which required 3004 personal interviews. We assessed the rates of use and types of alternative medicine and therapists used by this population in 1993, and correlations with other demographic and medical variables. FINDINGS: The overall use of at least one non-medically prescribed alternative medicine (excluding calcium, iron and prescribed vitamins) was 48.5%. The users were more likely to be perimenopausal females, better educated, have a higher alcohol intake, be of normal weight and more likely to be employed than non-users. 20.3% of respondents had visited at least one alternative practitioner, most commonly chiropractors (15%). The users of alternative practitioners were more likely to be younger, live in the country and be overweight. Women were more likely to consult naturopaths, iridiologists, and reflexologists than men. INTERPRETATION: Extrapolation of the costs to the Australian population gives a natural expenditure in 1993, for alternative medicines, of $621 million (Australian dollars) and for alternative therapists of $AU309 million per annum. This compares to the $AU360 million of patient contributions for all classes of pharmaceutical drugs purchased in Australia in 1992/93. The public health and economic ramifications of these huge costs are questioned in view of the paucity of sound safety and efficacy data for many of the therapies and products of the alternative medicine industry.; A.H MacLennan...

Incidence, impact on the family and cost of gastroenteritis among 4 to 6-year-old children in South Australia

Heyworth, J.; Jardine, A.; Glonek, G.; Maynard, E.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
85.65%
Background: Gastroenteritis is an important cause of morbidity in both adults and children worldwide. Although the burden of morbidity and mortality is highest in developing countries, gastroenteritis is still a significant cause of morbidity in Australia, particularly in young children. The aims of the present study were to determine the incidence of gastroenteritis among 4–6-year-old children in South Australia, to describe the impact on daily activities of the child and caregiver and estimate the cost of gastroenteritis in this population. Methods: A diary study of drinking water consumption and gastrointestinal and respiratory symptoms was undertaken among 965 rural children in South Australia over a 6-week period during February–May 1999. Data on the response to gastrointestinal episodes were collected by telephone surveys midway and at the end of the 6-week period. Costing was based on the methods of Hellard et al . Results: The incidence of community gastroenteritis among 4–6-year-old children was 5.53 episodes per child-year (95% confidence interval: 4.87–5.80). The costs associated with childhood gastroenteritis were estimated to be between $AU16 858 360 and $AU22 477 814 per annum. Conclusions: The incidence of community gastroenteritis among the 4–6-year-olds in the South Australian population is high and it costs the community a significant amount of money in terms of direct medical costs and time lost by parents and carers looking after their ill children.; Jane S Heyworth...

Cost savings from a telemedicine model of care in northern Queensland, Australia

Thaker, D.; Monypenny, R.; Olver, I.; Sabesan, S.
Fonte: Australasian Med Publ Co Ltd Publicador: Australasian Med Publ Co Ltd
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
75.74%
OBJECTIVE: To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. DESIGN: Retrospective cost–savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. PARTICIPANTS AND SETTING: Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. MAIN OUTCOME MEASURES: Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. RESULTS: There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of $442 276. The cost for project establishment was $36 000, equipment/maintenance was $143 271, and staff was $261 520. The estimated travel expense avoided was $762 394; this figure included the costs of travel for patients and escorts of $658 760, aeromedical retrievals of $52 400 and travel for specialists of $47 634...

Cost analysis of materials used in Class III, IV and V composite resin restorations

Hebling,Eduardo; Gonçalves,Rodolfo Luís; Queluz,Dagmar de Paula
Fonte: Faculdade de Odontologia de Piracicaba - UNICAMP Publicador: Faculdade de Odontologia de Piracicaba - UNICAMP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 EN
Relevância na Pesquisa
75.72%
AIM: To assess the total cost of direct and indirect materials used in Class III, IV and V composite resin direct restorations. METHODS: The calculation of costs was based on the method of variable costing system. A list of the materials was obtained by a panel of experts and based on the excellence standards established in the literature for dental team treatment. The cost considered for each material was obtained from an average of the costs found in the regional supplier market (US$1.0=R$2.12). The repetitions were obtained from Class III, IV and V cavities in artificial pre-manufactured teeth. The cavities were classified as shallow, medium and deep. The materials were quantified for each type of preparation. Seven brands of composite resins were used and weighed on a precision scale after their insertion in each cavity. The data were analyzed by descriptive statistics and non-parametric Friedman's test (α=0.05). RESULTS: The mean costs were US$7.96 (R$16.88) for Class III restoration, US$8.13 (R$17.24) for Class IV, and US$7.84 (R$16.62) for Class V. There was statistically significant difference in cost between the types of cavities and depth classification. The small cost difference among the different resin brands resulted in no statistically significant differences in the total cost of the restorations. CONCLUSIONS: The costs obtained in this survey may be used in the calculation of the final cost of restorative procedures...

Predicting mortality and cost of hematopoeitic stem-cell transplantation

Kerbauy,Fábio Rodrigues; Morelli,Leonardo Raul; Andrade,Cláudia Toledo de; Lisboa,Luis Fernando; Cendoroglo Neto,Miguel; Hamerschlak,Nelson
Fonte: Instituto Israelita de Ensino e Pesquisa Albert Einstein Publicador: Instituto Israelita de Ensino e Pesquisa Albert Einstein
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2012 EN
Relevância na Pesquisa
85.59%
OBJECTIVE: To evaluate whether the Pretransplantion Assesment of Mortality risk score is associated to transplant costs and can be used not only to predict mortality but also as a cost management tool. METHODS: We evaluated consecutively patients submitted to allogeneic (n = 27) and autologous (n = 89) hematopoietic stem cell-transplantation from 2004 to 2006 at Hospital Israelita Albert Einstein (SP), Brazil. Participants mean age at hematopoietic stem cell-transplantation was 42 (range 1 to 72) years; there were 69 males and 47 females; 30 patients had multiple myeloma; 41 had non-Hodgkin and Hodgkin's lymphomas; 22 had acute leukemia; 6 had chronic leukemia; and 17 had non-malignant disease. The Pretransplantion Assesment of Mortality risk score was applied in all patients using the available web site. RESULTS: Patients could be classified in three risk categories: high, intermediate and low, having significant difference in survival (p = 0.0162). The median cost in US dollars for each group was $ 281.000, $ 73.300 and $ 54.400 for high, intermediate and low risk, respectively. The cost of hematopoietic stem cell-transplantation significantly differed for each Pretransplantin Assesment of Mortality risk group (p = 0.008). CONCLUSION: The validation of the Pretransplantion Assesment of Mortality risk score in our patients confirmed that this system is an important tool to be used in transplantation units...

Healthcare resource utilization and costs of outpatient follow-up after liver transplantation in a university hospital in São Paulo, Brazil: cost description study

Soárez,Patricia Coelho de; Lara,Amanda Nazareth; Sartori,Ana Marli Christovam; Abdala,Edson; Haddad,Luciana Bertocco de Paiva; D'Albuquerque,Luiz Augusto Carneiro; Novaes,Hillegonda Maria Dutilh
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
Relevância na Pesquisa
75.75%
CONTEXT AND OBJECTIVE: Data on the costs of outpatient follow-up after liver transplantation are scarce in Brazil. The purpose of the present study was to estimate the direct medical costs of the outpatient follow-up after liver transplantation, from the first outpatient visit after transplantation to five years after transplantation. DESIGN AND SETTING: Cost description study conducted in a university hospital in São Paulo, Brazil. METHODS: Cost data were available for 20 adults who underwent liver transplantation due to acute liver failure (ALF) from 2005 to 2009. The data were retrospectively retrieved from medical records and the hospital accounting information system from December 2010 to January 2011. RESULTS: Mean cost per patient/year was R$ 13,569 (US$ 5,824). The first year of follow-up was the most expensive (R$ 32,546 or US$ 13,968), and medication was the main driver of total costs, accounting for 85% of the total costs over the five-year period and 71.9% of the first-year total costs. In the second year after transplantation, the mean total costs were about half of the amount of the first-year costs (R$ 15,165 or US$ 6,509). Medication was the largest contributor to the costs followed by hospitalization, over the five-year period. In the fourth year...

Total educational costs of an integrated nursing curriculum; Costos educacionales totales del currículo integrado de enfermería; Custos educacionais totais de currículo integrado de enfermagem

Bobroff, Maria Cristina Cescatto; Gordan, Pedro A.; Garanhani, Mara Lúcia
Fonte: Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto Publicador: Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf; application/pdf; application/pdf
Publicado em 01/02/2009 ENG; POR; SPA
Relevância na Pesquisa
75.76%
Innovative changes in undergraduate Nursing programs have brought about new methodologies and the need for cost evaluation. This study aims to develop a model for cost estimation, and to estimate educational costs of an integrated Nursing curriculum at a public university. This is a case study conducted in stages: model development, data collection, analysis and interpretation. The cost-construction model consisted of six steps: data collection; educational and support activity costs; four-year course educational costs; educational support costs; joint product costs and total educational costs. Findings showed a total educational cost per student/year US$ 3,788.82. Course team faculty included 97 members. The cost analysis in faculty contact hours is the most appropriate cost unit as it most consistently reflects faculty time devoted to teaching. The knowledge about educational costs provided information that may be useful for a different approach to the integrated curriculum management, with a view to putting its educational objectives in practice.; Para enfrentar los cambios innovadores en los cursos de Enfermería, fue necesario incorporar nuevas metodologías y evaluar los costos. Los objetivos de este estudio fueron construir un modelo y estimar los costos educativos del currículo integrado de Enfermería en una universidad pública...

Cost analysis of reprocessing disposable forceps used in video-assisted surgery; Análisis de los costos del reprocesamiento de pinzas de único uso, utilizadas en cirugía video-asistida; Análise dos custos do reprocessamento de pinças de uso único utilizadas em cirurgia vídeo-assistida

Psaltikidis, Eliane Molina; Graziano, Kazuko Uchikawa; Frezatti, Fábio
Fonte: Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto Publicador: Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 01/08/2006 POR
Relevância na Pesquisa
85.68%
This study aimed to analyze the reprocessing costs of disposable forceps used in video-assisted surgery. The frequent reuse of these instruments is justified by their high cost. However, few studies have been carried out on this topic. The multiple case study method was applied in three hospitals in the State of São Paulo, using the observation and document analysis techniques. In case number one, the processing cost was R$ 9.37, R$ 6.59 for case number two and R$ 3.31 for case number three. The low cost observed should be analyzed with caution, since it was observed that quality-control plays a role in the final cost. When the quality-control measures are adopted, the reprocessing costs jumped to R$ 185.19 for case number one, R$ 595.82 for case number two and to R$ 363.10 for case number three.; El trabajo objetivó analizar los costos del reprocesamiento de pinzas de uso único utilizadas en cirugía video-asistida. Fue aplicado el método de estudio de casos múltiples, en tres instituciones hospitalarias del Estado de São Paulo, utilizando la técnica de observación y de análisis documental. El costo del reprocesamiento fue de 9,37 Reales (R$), en el caso nº 1; de R$ 6,59 en el caso nº 2 y de R$ 3,31 en el caso nº 3. El bajo costo verificado debe ser analizado con cautela...

An economic evaluation of anticipated costs and savings of a behavior change intervention to enhance medication adherence

Wiegand,Phillip N.; Wertheimer,Albert I.
Fonte: Pharmacy Practice (Internet) Publicador: Pharmacy Practice (Internet)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/06/2008 ENG
Relevância na Pesquisa
85.68%
Medication adherence across disease states is generally poor. Research has focused on various methods to improve medication adherence, but there is little conclusive evidence regarding specific methods efficacy. The Transtheoretical Model for Behavior Change has been used to modify existing addictive behaviors but not in medication adherence specifically. As a behavioral component is inherently related to medication adherence, it is thought that this model may be applicable. Objective: The purpose of this research is to evaluate the costs and savings of implementing a novel behavioral intervention against the cost of poor medication adherence to determine whether further development is realistic. Methods: The basic tools required to administer this intervention were determined through primary literature review and priced by vendors supplying such materials. Diabetes Mellitus Type 2 (DM2) was used as a vehicle to establish the cost of care for long-term complications of a chronic disease. The primary literature provided information regarding the cost of care for DM2 morbidity and outpatient annual drug therapy expenditure. The total cost of the behavioral intervention components and the cost of care for DM2 morbidity were applied to a theoretical cohort of 1000 patients. By dividing this cost across 1000 patients...

Cost of work-related injuries in insured workplaces in Lebanon

Fayad,Rim; Nuwayhid,Iman; Tamim,Hala; Kassak,Kassem; Khogali,Mustafa
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 EN
Relevância na Pesquisa
75.72%
OBJECTIVE: To estimate the medical and compensation costs of work-related injuries in insured workplaces in Lebanon and to examine cost distributions by worker and injury characteristics. METHODS: A total of 3748 claims for work injuries processed in 1998 by five major insurance companies in Lebanon were reviewed. Medical costs (related to emergency room fees, physician consultations, tests, and medications) and wage and indemnity compensation costs were identified from the claims. FINDINGS: The median cost per injury was US$ 83 (mean, US$ 198; range, US$ 0-16 401). The overall cost for all 3748 injuries was US$ 742 100 (76% of this was medical costs). Extrapolated to all injuries within insured workplaces, the overall cost was US$4.5 million a year; this increased to US$ 10 million-13 million when human value cost (pain and suffering) was accounted for. Fatal injuries (three, 0.1%) and those that caused permanent disabilities (nine, 0.2%) accounted for 10.4% of the overall costs and hospitalized injuries (245, 6.5%) for 45%. Cost per injury was highest among older workers and for injuries that involved falls and vehicle incidents. Medical, but not compensation, costs were higher among female workers. CONCLUSION: The computed costs of work injuries - a fraction of the real burden of occupational injuries in Lebanon - represent a considerable economic loss. This calls for a national policy to prevent work injuries...

Cost analysis of post-polio certification immunization policies

Sangrujee,Nalinee; Cáceres,Victor M.; Cochi,Stephen L.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2004 EN
Relevância na Pesquisa
75.79%
OBJECTIVE: An analysis was conducted to estimate the costs of different potential post-polio certification immunization policies currently under consideration, with the objective of providing this information to policy-makers. METHODS: We analysed three global policy options: continued use of oral poliovirus vaccine (OPV); OPV cessation with optional inactivated poliovirus vaccine (IPV); and OPV cessation with universal IPV. Assumptions were made on future immunization policy decisions taken by low-, middle-, and high-income countries. We estimated the financial costs of each immunization policy, the number of vaccine-associated paralytic poliomyelitis (VAPP) cases, and the global costs of maintaining an outbreak response capacity. The financial costs of each immunization policy were based on estimates of the cost of polio vaccine, its administration, and coverage projections. The costs of maintaining outbreak response capacity include those associated with developing and maintaining a vaccine stockpile in addition to laboratory and epidemiological surveillance. We used the period 2005-20 as the time frame for the analysis. FINDINGS: OPV cessation with optional IPV, at an estimated cost of US$ 20 412 million, was the least costly option. The global cost of outbreak response capacity was estimated to be US$ 1320 million during 2005-20. The policy option continued use of OPV resulted in the highest number of VAPP cases. OPV cessation with universal IPV had the highest financial costs...

Does scale matter? The costs of HIV-prevention interventions for commercial sex workers in India

Guinness,Lorna; Kumaranayake,Lilani; Rajaraman,Bhuvaneswari; Sankaranarayanan,Girija; Vannela,Gangadhar; Raghupathi,P.; George,Alex
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2005 EN
Relevância na Pesquisa
75.72%
OBJECTIVE: To explore how the scale of a project affects both the total costs and average costs of HIV prevention in India. METHODS: Economic cost data and measures of scale (coverage and service volume indicators for number of cases of sexually transmitted infections (STIs) referred, number of STIs treated, condoms distributed and contacts made with target groups) were collected from 17 interventions run by nongovernmental organizations aimed at commercial sex workers in southern India. Nonparametric methods and regression analyses were used to look at the relationship between total costs, unit costs and scale. FINDINGS: Coverage varied from 250 to 2008 sex workers. Annual costs ranged from US$ 11 274 to US$ 52 793. The median cost per sex worker reached was US$ 19.21 (range = US$ 10.00-51.00). The scale variables explain more than 50% of the variation in unit costs for all of the unit cost measures except cost per contact. Total costs and unit costs have non-linear relationships to scale. CONCLUSION: Average costs vary with the scale of the project. Estimates of resource requirements based on a constant average cost could underestimate or overestimate total costs. The results highlight the importance of improving scale-specific cost information for planning.

The costs, effects and cost-effectiveness of strategies to increase coverage of routine immunizations in low- and middle-income countries: systematic review of the grey literature

Batt,Katherine; Fox-Rushby,J.A.; Castillo-Riquelme,Marianela
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2004 EN
Relevância na Pesquisa
85.67%
Evidence-based reviews of published literature can be subject to several biases. Grey literature, however, can be of poor quality and expensive to access. Effective search strategies also vary by topic and are rarely known in advance. This paper complements a systematic review of the published literature on the costs and effects of expanding immunization services in developing countries. The quality of data on the effectiveness and cost-effectiveness of strategies to increase immunization coverage is shown to be similar across literatures, but the quality of information on costing is much lower in the grey literature. After excluding poorer quality studies from this review we found the quantity of available evidence almost doubled, particularly for more complex health-system interventions and cost or cost-effectiveness analyses. Interventions in the grey literature are more up to date and cover a different geographical spread. Consequently the conclusions of the published and grey literatures differ, although the number of papers is still too low to account for differences across types of interventions. We recommend that in future researchers consider using non-English keywords in their searches.

Cost-effectiveness of childhood hepatitis A vaccination in Argentina: a second dose is warranted

Ellis,Alejandro; Rüttimann,Ricardo W.; Jacobs,R. Jake; Meyerhoff,Allen S.; Innis,Bruce L.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2007 EN
Relevância na Pesquisa
75.72%
OBJECTIVES: To investigate the cost-effectiveness of childhood vaccination against hepatitis A in the five geographic regions of Argentina, and to determine whether adding a second dose to the current one-dose schedule would provide health gains justifying its added cost. METHODS: A Markov model was used to consider four immunization options for the 2005 birth cohort: (1) no vaccination; (2) vaccination at 12 months of age, (3) vaccinations at 12 and 72 months of age; or (4) vaccinations at 12 and 18 months of age. Hepatitis A costs and consequences were predicted over 50 years. The cost-effectiveness of first and second vaccine doses was assessed through a range of vaccine prices and assumptions regarding the duration of vaccine protection. Costs and health gains (measured in quality-adjusted life years) were adjusted to present values using a 3% annual discount rate. RESULTS: The one-dose vaccination policy is predicted to reduce each birth cohort member's 50-year probability of overt hepatitis A from 7.2% to 4.1%. A second dose would reduce the probability to between 2.0% and 2.2%. Vaccination at 12 months of age, at 12 and 72 months, or at 12 and 18 months would reduce cases among personal contacts by 82%, 87%, and 92%, respectively. The first vaccine dose would meet accepted standards of cost-effectiveness in each region...

Cost-effectiveness of pneumococcal conjugate vaccination in Latin America and the Caribbean: a regional analysis

Sinha,Anushua; Constenla,Dagna; Valencia,Juan Esteban; O'Loughlin,Rosalyn; Gomez,Elizabeth; de la Hoz,Fernando; Valenzuela,Maria Teresa; Quadros,Ciro A. de
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2008 EN
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OBJECTIVE: In Latin America and the Caribbean, routine vaccination of infants against Streptococcus pneumoniae would need substantial investment by governments and donor organizations. Policymakers need information about the projected health benefits, costs, and cost-effectiveness of vaccination when considering these investments. Our aim was to incorporate vaccine, demographic, epidemiologic, and cost data into an economic analysis of pneumococcal vaccination of infants in Latin America and the Caribbean. METHODS: We previously used a structured literature review to develop regional estimates of the incidence of disease. Cost data were collected from physician interviews and public fee schedules. We then constructed a decision analytic model to compare pneumococcal conjugate vaccination of infants with no vaccination across this region, examining only vaccine's direct effects on children. RESULTS: Pneumococcal vaccination at the rate of diphtheria-tetanus-pertussis vaccine coverage was projected to prevent 9 500 deaths per year in children aged 0 to 5 years in the region, or approximately one life saved per 1 100 infants vaccinated. These saved lives as well as averted cases of deafness, motor deficit, and seizure result in 321 000 disability-adjusted life years (DALYs) being averted annually. At vaccine prices between US$5 and US$53 per dose...