scholarly journals The cost‐effectiveness of quality improvement projects: a conceptual framework, checklist and online tool for considering the costs and consequences of implementation‐based quality improvement

2015 ◽  
Vol 22 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Carl Thompson ◽  
Ryan Pulleyblank ◽  
Steve Parrott ◽  
Holly Essex
Keyword(s):  
Quality Improvement ◽  
Cost Effectiveness ◽  
Conceptual Framework ◽  
Online Tool ◽  
The Cost

scholarly journals PRO39 CONCEPTUAL FRAMEWORK FOR EVALUATING THE COST-EFFECTIVENESS OF A GENE THERAPY FOR HAEMOPHILIA B

2019 ◽  
Vol 22 ◽  
pp. S847-S848
Author(s):  
N Li ◽  
E.K. Sawyer ◽  
K. Maruszczyk ◽  
M. Slomka ◽  
T. Burke ◽  
...  
Keyword(s):  
Gene Therapy ◽  
Cost Effectiveness ◽  
Conceptual Framework ◽  
Haemophilia B ◽  
The Cost

Practical Quality Improvement Applied to Toxicology Studies

1991 ◽  
Vol 10 (3) ◽  
pp. 387-391
Author(s):  
A. W. Waddell
Keyword(s):  
Quality Assurance ◽  
Quality Improvement ◽  
Cost Effectiveness ◽  
Regulatory Compliance ◽  
Good Laboratory Practice ◽  
Quality Assurance Program ◽  
Laboratory Practice ◽  
Good Laboratory ◽  
The Cost

Elements that are required for regulatory compliance can be used as powerful resources to achieve quality improvement. One such approach, using the output from a Good Laboratory Practice quality assurance program, is described and has produced marked improvements in the conduct and reporting of toxicology studies. The cost effectiveness of quality assurance programs under such circumstances is discussed.

scholarly journals Cost-Effectiveness Analysis of A Quality Improvement Program to Reduce Cesarean Sections in Brazilian Private Hospitals: A Case Study

2020 ◽  
Author(s):  
Rosa Maria Soares Madeira Domingues ◽  
Paula Mendes Luz ◽  
Bárbara Vasques da Silva Ayres ◽  
Jacqueline Alves Torres ◽  
Maria do Carmo Leal
Keyword(s):  
Quality Improvement ◽  
Cost Effectiveness ◽  
Cesarean Section ◽  
Cesarean Sections ◽  
Model Of Care ◽  
Private Hospitals ◽  
Improvement Project ◽  
Term Births ◽  
The Cost ◽  
Childbirth Care

Abstract Background: In 2015, a quality improvement project of childbirth care called Adequate Birth Project (“Projeto Parto Adequado”- PPA) was implemented in Brazilian public and private hospitals, aiming to improve the quality of childbirth care and to reduce cesarean sections without clinical indications. The objective of this study is to conduct an economic analysis of two models of care existing in a private Brazilian hospital - the model following the recommendations of the PPA and the standard of care model - in reducing the proportion of cesarean sections. Methods: We conducted a case study in one of the private hospitals included in the PPA project. The main outcome was the proportion of cesarean section. We used total cost of hospitalization for women and newborns, from the perspective of the health care provider, during the length of the observed hospital stay. We did not apply discount rates and inflation rate adjustments due to the short time horizon. We conducted univariate sensitivity analysis using the minimum and maximum costs observed in hospitalizations and variation in the probabilities of cesarean section and of maternal and neonatal complications. Results: 238 puerperal women were included in this analysis. The PPA model of care resulted in a 56.9 percentage point reduction in the cesarean section probability (88.6% vs 31.7%, p <0.001) and an increase in the total cost of US$ 67,346.25, which an incremental cost-effectiveness ratio of US$ 1,183.59 per avoided cesarean section. Women in the PPA model of care also had a higher proportion of spontaneous and induced labor and a lower proportion of early term births. There were no maternal, fetal or neonatal deaths and no significant differences in cases of maternal and neonatal nearmiss. The cost of uncomplicated vaginal births and cesarean sections was the parameter with the greatest impact on the cost-effectiveness ratio of the PPA model of care. Conclusion: The quality improvement project of childbirth care “PPA” was cost-effective in reducing cesarean sections in women assisted in a Brazilian private hospital, without increasing severe negative maternal and neonatal outcomes and reducing the frequency of early term births.

scholarly journals A Subsidy That Is Inversely Related to the Product Price

2022 ◽  
Author(s):  
Takahiko Kiso
Keyword(s):  
Quality Improvement ◽  
Cost Effectiveness ◽  
Market Power ◽  
Government Spending ◽  
Product Price ◽  
The Cost

Abstract This study considers a new subsidy design to support the purchase or production of target products. Under the proposed design, subsidy payments are inversely related to product prices. Compared to ‘flat’ subsidies, this design reduces producers’ market power and the subsidy benefits passed on to them, improving the cost-effectiveness of government spending (by up to 50% according to simulations based on an actual subsidy programme). Additionally, this subsidy’s cost-effectiveness and incidence can be adjusted flexibly by changing the policy parameters. Finally, the subsidy design can be modified to provide larger payments to higher-quality products, thereby offsetting disincentives for quality improvement.

scholarly journals The cost effectiveness of a quality improvement program to reduce maternal and fetal mortality in a regional referral hospital in Accra, Ghana

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0180929 ◽  
Author(s):  
David M. Goodman ◽  
Rohit Ramaswamy ◽  
Marc Jeuland ◽  
Emmanuel K. Srofenyoh ◽  
Cyril M. Engmann ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cost Effectiveness ◽  
Quality Improvement Program ◽  
Referral Hospital ◽  
Fetal Mortality ◽  
Improvement Program ◽  
Regional Referral Hospital ◽  
The Cost

scholarly journals Cost-effectiveness analysis of a quality improvement program to reduce caesarean sections in Brazilian private hospitals: a case study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Rosa Maria Soares Madeira Domingues ◽  
Paula Mendes Luz ◽  
Barbara Vasques da Silva Ayres ◽  
Jacqueline Alves Torres ◽  
Maria do Carmo Leal
Keyword(s):  
Quality Improvement ◽  
Cost Effectiveness ◽  
Caesarean Section ◽  
Model Of Care ◽  
Cost Effectiveness Ratio ◽  
Private Hospitals ◽  
Effectiveness Analysis ◽  
Term Births ◽  
The Cost ◽  
Childbirth Care

Abstract Background In 2015, a quality improvement project of childbirth care called Adequate Childbirth Project (“Projeto Parto Adequado”- PPA) was implemented in Brazilian public and private hospitals, aiming to improve the quality of childbirth care and to reduce caesarean sections without clinical indications. The objective of this study is to conduct an economic analysis of two models of care existing in a private Brazilian hospital—the model following the recommendations of the PPA and the standard of care model—in reducing the proportion of caesarean sections. Methods We conducted a cost-effectiveness analysis using data from one of the private hospitals included in the PPA project. The main outcome was the proportion of caesarean section. We used total cost of hospitalization for women and newborns, from the health care sector perspective, during the length of the observed hospital stay. We did not apply discount rates and inflation rate adjustments due to the short time horizon. We conducted univariate sensitivity analysis using the minimum and maximum costs observed in hospitalizations and variation in the probabilities of caesarean section and of maternal and neonatal complications. Results 238 puerperal women were included in this analysis. The PPA model of care resulted in a 56.9 percentage point reduction in the caesarean section probability (88.6% vs 31.7%, p < 0.001) with an incremental cost-effectiveness ratio of US$1,237.40 per avoided caesarean section. Women in the PPA model of care also had a higher proportion of spontaneous and induced labor and a lower proportion of early term births. There were no maternal, fetal or neonatal deaths and no significant differences in cases of maternal and neonatal near miss. The cost of uncomplicated vaginal births and caesarean sections was the parameter with the greatest impact on the cost-effectiveness ratio of the PPA model of care. Conclusion The PPA model of care was cost-effective in reducing caesarean sections in women assisted in a Brazilian private hospital. Moreover, it reduced the frequency of early term births and did not increase the occurrence of severe negative maternal and neonatal outcomes.

scholarly journals Cost-effectiveness of community health systems strengthening: quality improvement interventions at community level to realise maternal and child health gains in Kenya

2021 ◽  
Vol 6 (3) ◽  
pp. e002452
Author(s):  
Meghan Bruce Kumar ◽  
Jason J Madan ◽  
Peter Auguste ◽  
Miriam Taegtmeyer ◽  
Lilian Otiso ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Quality Improvement Intervention ◽  
Skilled Delivery ◽  
Community Healthcare ◽  
Improvement Interventions ◽  
Quality Improvement Interventions ◽  
The Cost ◽  
Improvement Intervention

IntroductionImprovements in maternal and infant health outcomes are policy priorities in Kenya. Achieving these outcomes depends on early identification of pregnancy and quality of primary healthcare. Quality improvement interventions have been shown to contribute to increases in identification, referral and follow-up of pregnant women by community health workers. In this study, we evaluate the cost-effectiveness of using quality improvement at community level to reduce maternal and infant mortality in Kenya.MethodsWe estimated the cost-effectiveness of quality improvement compared with standard of care treatment for antenatal and delivering mothers using a decision tree model and taking a health system perspective. We used both process (antenatal initiation in first trimester and skilled delivery) and health outcomes (maternal and infant deaths averted, as well as disability-adjusted life years (DALYs)) as our effectiveness measures and actual implementation costs, discounting costs only. We conducted deterministic and probabilistic sensitivity analyses.ResultsWe found that the community quality improvement intervention was more cost-effective compared with standard community healthcare, with incremental cost per DALY averted of $249 under the deterministic analysis and 76% likelihood of cost-effectiveness under the probabilistic sensitivity analysis using a standard threshold. The deterministic estimate of incremental cost per additional skilled delivery was US$10, per additional early antenatal care presentation US$155, per maternal death averted US$5654 and per infant death averted US$37 536 (2017 dollars).ConclusionsThis analysis shows that the community quality improvement intervention was cost-effective compared with the standard community healthcare in Kenya due to improvements in antenatal care uptake and skilled delivery. It is likely that quality improvement interventions are a good investment and may also yield benefits in other health areas.

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