scholarly journals Health economic implications of testing blood donors in South Africa for HTLV 1 & 2 infection

Vox Sanguinis ◽  
2019 ◽  
Vol 114 (5) ◽  
pp. 467-477 ◽  
Author(s):  
Marion Vermeulen ◽  
Karin Berg ◽  
Wendy Sykes ◽  
Ravi Reddy ◽  
Charlotte Ingram ◽  
...  
Keyword(s):  
South Africa ◽  
Health Economic ◽  
Blood Donors ◽  
Economic Implications

scholarly journals P105: Transforming emergency stroke care through innovation: Canadas first stroke ambulance

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S94-S94
Author(s):  
L. Morrison ◽  
S. Amlani ◽  
T. Jeerakathil ◽  
A. Shuaib ◽  
H. Kalashyan
Keyword(s):  
Health Economic ◽  
Economic Analysis ◽  
Patient Care ◽  
Tertiary Care ◽  
Added Value ◽  
Rural Setting ◽  
Stroke Patients ◽  
Health Economic Analysis ◽  
Economic Implications ◽  
Suspected Stroke

Introduction: A two-year Stroke Ambulance (SA) pilot project was implemented at the University of Alberta Hospital (UAH) in February, 2017, the first in the world to utilize this specialized technology in a rural setting. The primary objective is to evaluate clinical and economic implications of timely SA assessment and treatment of hyperacute stroke patients who present to non-stroke centres in rural Alberta and might otherwise have received delayed treatment, or not at all, due to prolonged transfer times. Methods: A steering committee and seven working groups were established, with representation from Alberta Health Services (AHS) programs impacted, to ensure comprehensive project development and implementation. The SA portable CT scanner, point of care laboratory, and videoconference system facilitate diagnosis of stroke in the field. The multidisciplinary team includes a stroke fellow, advanced & primary care paramedics, registered nurse, CT technologist, and telestroke physician. When not dispatched, the team provides stroke expertise and patient care in the emergency department (ED) and diagnostic imaging. The service model includes suspected stroke patients presenting to non-stroke centres within a 250 Km radius of Edmonton (Phase I); patients presenting to Edmonton Zone (EZ) hospitals without CT capability and/or tPA protocols (Phase 2); and expedited transport from EZ hospitals to the UAH for urgent endovascular therapy (EVT) (Phase 3). A health economic analysis will compare stroke ambulance care with standard care. Results: The SA has responded to 54 dispatches, 13 patients thrombolyzed and 3 patients receiving EVT. Median rendezvous to CT time was 10 minutes, median rendezvous to tPA time was 21 minutes, and mean time from symptom onset to tPA was 180 minutes. There were no complications. After SA imaging and assessment, 18 patients were repatriated back to their local community hospital, avoiding unnecessary admission to tertiary care. Conclusion: Our preliminary experience demonstrates that the SA offers a novel approach to performing timely evaluation and treatment of suspected stroke from non-stroke centres and may serve as an excellent triage mechanism, reducing avoidable admissions to overcapacity tertiary care EDs. The SA team provides added value to the ED with stroke expertise and patient care. A comprehensive health economic analysis will determine cost-effectiveness and whether spread is feasible.

The health economic implications of treatment with quetiapine: an audit of long-term treatment for patients with chronic schizophrenia

2001 ◽  
Vol 16 (5) ◽  
pp. 307-312 ◽  
Author(s):  
J. Lynch ◽  
J. Morrison ◽  
N. Graves ◽  
D. Meddis ◽  
M.F. Drummond ◽  
...  
Keyword(s):  
Health Economic ◽  
Case Series ◽  
Chronic Schizophrenia ◽  
Term Treatment ◽  
Revolving Door ◽  
Psychotic Symptoms ◽  
Open Label ◽  
Economic Implications ◽  
Long Term Treatment

SummaryThis retrospective, case series audit assessed the clinical and health-economic impact of long-term treatment with quetiapine (‘Seroquel’), a new atypical antipsychotic, in patients with chronic schizophrenia.The study design was of a case series format, comprising patients entered from one centre into the open-label extension of a multicentre 6-week efficacy study. Twenty-one patients (15 male, six female; mean age 39 years) were studied, of whom 17 (81%) had been rated as ‘partially responsive’ to previous antipsychotics. Data on hospitalisations and information on symptoms were collected retrospectively for the 12 months before quetiapine treatment was initiated and for the 12 months after.Quetiapine was effective in reducing psychotic symptoms with mean BPRS scores reducing significantly, from 38 to 21 (P < 0.005). Motor function was also significantly improved with mean Simpson scale scores reducing from 15 to 12 (P < 0.005). Average inpatient days were reduced by 11% in year two (97 compared with 109 days) while the overall costs of treatment, including drug costs, fell by 5% (I£20,843 to I£19,827).Four patients had been hospitalised for longer than 5 years before starting quetiapine; these chronically institutionalised patients remained in hospital, despite improved clinical outcomes (mean BPRS scores after treatment of 34, compared with 43 before), for the full 12 months of quetiapine treatment. Were the data from this audit to be re-analysed excluding these four patients then average inpatient days would have been reduced by 33% (45 to 30 days) and overall cost of treatment by 19% (I£8617 to I£7011).This audit suggests that treatment with quetiapine over this 1-year period was associated with both clinical improvements and a decreased usage of inpatient services. The reduction in hospitalisation costs would appear to compensate for the increased cost of drug treatment. Significantly, potential savings appear to be greatest for those patients with a ‘revolving door’ pattern of repeated readmission.

The Authors’ Reply to Gow et al.: “The State of Health Economic Research in South Africa”

2013 ◽  
Vol 31 (3) ◽  
pp. 255-256
Author(s):  
Paul Gavaza ◽  
Karen L. Rascati ◽  
Abiola O. Oladapo ◽  
Star Khoza
Keyword(s):  
South Africa ◽  
Health Economic ◽  
The State ◽  
Economic Research ◽  
State Of Health ◽  
Health Economic Research

scholarly journals Distribution and habitats of Bulinus tropicus, snail intermediate host of the conical fluke Calicophoron microbothrium, in South Africa

2002 ◽  
Vol 21 (4) ◽  
pp. 114-120
Author(s):  
K. N. De Kock ◽  
C. T. Wolmarans ◽  
M. Bornman ◽  
D. C. Maree
Keyword(s):  
South Africa ◽  
Intermediate Host ◽  
Geographical Distribution ◽  
Freshwater Snail ◽  
Wide Distribution ◽  
Limiting Factor ◽  
Snail Species ◽  
Rural Settlements ◽  
Economic Implications ◽  
Snail Intermediate Host

This paper focuses on the geographical distribution and the habitats of Bulinus tropicus, the snail intermediate host of the conical fluke, Calicophoron microbothrium. Bulinus tropicus is the freshwater snail species with the most extensive geographical distribution, as reflected by the collection sites of the 7 992 samples currently on record in the database of the National Freshwater Snail Collection (NFSC) of South Africa. The presence of this species was noted by collectors in a total of 14 different types of waterbodies, however, the largest number of samples was collected in dams and brooks and in habitats of which the water was described as standing, clear and fresh. The effect size was calculated for each variable separately to determine its importance in governing the distribution of this species. The data in the database were further processed and adapted to construct an integrated decision tree. This is a statistical model allowing the selection of those variables which can maximally discriminate between the frequency of occurrence of a given species and all other species in the database under specific conditions. The success of B. tropicus, as reflected by its extensive geographical distribution, can most probably be ascribed to the circumstance that population dynamic studies by various authors have shown, without any doubt, that it is highly r-selected and that it additionally has the ability to survive conditions of drought for elatively long periods. It does however, appear as if its limited tolerance to water with a relatively low conductivity could possibly be a limiting factor for its colonisation of specific areas in South Africa. As intermediate host of C. microbothrium which causes paramphistomosis in domestic stock and sometimes can lead to great losses, the wide distribution of B. tropicus has economic implications, especially for residents of informal, rural settlements whose livestock traditionally forms an integral part of their daily existence.

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