Building evidence for peer-led interventions: assessing the cost of the Adolescent Asthma Action program in Australia

2015 ◽  
Vol 21 (4) ◽  
pp. 438 ◽  
Author(s):  
Michael E. Otim ◽  
Ranmalie Jayasinha ◽  
Hayley Forbes ◽  
Smita Shah
Keyword(s):  
Sensitivity Analysis ◽  
Opportunity Cost ◽  
Torres Strait Islander ◽  
Stress Test ◽  
Cost Savings ◽  
Self Management ◽  
Action Program ◽  
Torres Strait ◽  
The Cost ◽  
Asthma Cost

Asthma is the most common chronic illness among adolescents in Australia. Aboriginal and Torres Strait Islander adolescents, in particular, face substantial inequalities in asthma-related outcomes. Triple A (Adolescent Asthma Action) is a peer-led education intervention, which aims to improve asthma self-management and reduce the uptake of smoking among adolescents. The aim of this study was to determine the cost of implementing the Triple A program in Australia. Standard economic costing methods were used. It involved identifying the resources that were utilised (such as personnel and program materials), measuring them and then valuing them. We later performed sensitivity analysis so as to identify the cost drivers and a stress test to test how the intervention can perform when some inputs are lacking. Results indicate that the estimated cost of implementing the Triple A program in five schools was $41 060, assuming that the opportunity cost of all the participants and venues was accounted for. This translated to $8212 per school or $50 per target student. From sensitivity analysis and a stress test, it was identified that the cost of the intervention (in practice) was $14 per student. This appears to be a modest cost, given the burden of asthma. In conclusion, the Triple A program is an affordable intervention to implement in high schools. The potential asthma cost savings due to the program are significant. If the Triple A program is implemented nation-wide, the benefits would be substantial.

scholarly journals Self-management programs for Aboriginal and Torres Strait Islander Peoples with chronic conditions: A rapid review

2017 ◽  
Vol 15 (2) ◽  
pp. 83-123
Author(s):  
Ellie Moore ◽  
Sharon Lawn ◽  
Candice Oster ◽  
Andrea Morello
Keyword(s):  
Chronic Condition ◽  
Torres Strait Islander ◽  
Grey Literature ◽  
Rapid Review ◽  
Self Management ◽  
Rigorous Evaluation ◽  
Cultural Appropriateness ◽  
Evidence Summary ◽  
Closing The Gap ◽  
Torres Strait

Objectives Review the evidence for the effectiveness of chronic condition self-management programs applied to Aboriginal and Torres Strait Islander Peoples. Methods A rapid review methodology was followed to develop an evidence summary from peer-reviewed and grey literature. Results Only seven peer-reviewed studies were identified. The evidence indicated that group programs, particularly the Stanford Program, and structured individual chronic condition self-management programs were of good quality for Aboriginal and Torres Strait Islander Peoples, although these need to be integrated into practice in order to see the greatest benefits. The Flinders Program showed promise as a standardised program with content designed specifically with and for these populations. Numerous grey literature sources were identified, many using strong participatory approaches developed locally within Aboriginal and Torres Strait Islander Peoples. However, few of these programs have been subject to rigorous evaluation. Discussion Despite the significant focus on chronic condition self-management programs to help address the burden of disease for Aboriginal and Torres Strait Islander Peoples, few studies exist that have been properly evaluated. The Closing the Gap Principles developed by the Australian Institute of Health and Welfare offer important guidance for how to proceed to maximise engagement, cultural appropriateness and ownership of program initiatives.

Cost-Effectiveness of Venous Thromboembolism Prophylaxis after Total Hip Replacement

2002 ◽  
Vol 17 (3-4) ◽  
pp. 126-133 ◽  
Author(s):  
J. A. Caprini ◽  
J. I. Arcelus ◽  
J. C. Kudraa ◽  
L. R. Sehgal ◽  
M. Oyslender ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Hip Replacement ◽  
Cost Savings ◽  
Duplex Ultrasound ◽  
Cost Effective ◽  
Combined Approach ◽  
Thromboembolism Prophylaxis ◽  
Total Hip ◽  
The Cost

Objective: To determine the cost-effectiveness of three strategies used for the prevention of venous thromboem-bolism (VTE) in patients undergoing total hip replace-ment (THR), and to perform a sensitivity analysis comparing VTE rates based on different methods of detection. Methods: In this cost-effectiveness analysis, three strategies of prophylaxis of postoperative VTE and THR were compared: (1) low-molecular-weight heparin (LMWH); Enoxaparin, (2) warfarin and (3) a combination of warfarin, heparin (UFH), graduated stockings and sequential long-leg pneumatic compression devices. The model estimates were based on pooled data from the published literature and from personal data in our series of hip replacement patients. Expected direct costs of VTE care, including prophylaxis, diagnosis and manage-ment of thromboembolic and hemorrhagic complications, were estimated for a hypothetical cohort of 100 patients in 2001 US dollars from data available for patients hospitalized at Evanston Northwestern Health-care. A sensitivity analysis was performed with different rates of VTE based on routine venography, routine duplex ultrasound, or selective diagnosis and treatment of symptomatic patients. Results: When venography was used to diagnose VTE, the cost of warfarin or LMWH treatment was $118 422 and $104 732 per 100 patients, respectively, providing cost savings of $ 13 690 per hundred patients for LMWH. When VTE rates were based on duplex ultrasound diagnoses, LMWH resulted in cost savings of $4602 and $1345 per 100 patients compared with the use of warfarin or the combined approach, respectively. However, when the rates of VTE were based on confirmed symptomatic cases, the use of LMWH resulted in an increased cost of $4486 and $10015 per 100 patients compared with warfarin and the combined approach, respectively. Conclusions: The use of LMWH for the prevention of VTE after THR was more cost-effective than using warfarin or the combined approach, when the VTE rate was based on routine venography or duplex ultrasound. However, the combined approach was more cost-effective than the use of warfarin or LMWH alone when only patients with confirmed, symptomatic VTE were treated.

scholarly journals The Cost of Acute Respiratory Infections With Cough Among Urban Aboriginal and Torres Strait Islander Children

2018 ◽  
Vol 6 ◽  
Author(s):  
Yolanda G. Lovie-Toon ◽  
Steven M. McPhail ◽  
Yin To Au-Yeung ◽  
Kerry K. Hall ◽  
Anne B. Chang ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Respiratory Infections ◽  
Acute Respiratory Infections ◽  
Torres Strait ◽  
The Cost

Exploration-Stage Implementation Variation

2014 ◽  
Vol 222 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Stephanie Romney ◽  
Nathaniel Israel ◽  
Danijela Zlatevski
Keyword(s):  
Parent Training ◽  
Average Cost ◽  
Cost Savings ◽  
Training Group ◽  
Group Differences ◽  
Triple P ◽  
Community Based ◽  
Parent Training Program ◽  
A Site ◽  
The Cost

The present study examines the effect of agency-level implementation variation on the cost-effectiveness of an evidence-based parent training program (Positive Parenting Program: “Triple P”). Staff from six community-based agencies participated in a five-day training to prepare them to deliver a 12-week Triple P parent training group to caregivers. Prior to the training, administrators and staff from four of the agencies completed a site readiness process intended to prepare them for the implementation demands of successfully delivering the group, while the other two agencies did not complete the process. Following the delivery of each agency’s first Triple P group, the graduation rate and average cost per class graduate were calculated. The average cost-per-graduate was over seven times higher for the two agencies that had not completed the readiness process than for the four completing agencies ($7,811 vs. $1,052). The contrast in costs was due to high participant attrition in the Triple P groups delivered by the two agencies that did not complete the readiness process. The odds of Triple P participants graduating were 12.2 times greater for those in groups run by sites that had completed the readiness process. This differential attrition was not accounted for by between-group differences in participant characteristics at pretest. While the natural design of this study limits the ability to empirically test all alternative explanations, these findings indicate a striking cost savings for sites completing the readiness process and support the thoughtful application of readiness procedures in the early stages of an implementation initiative.

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