scholarly journals Sustainable Financing for New Vaccines in Indonesia: Challenges and Strategies

2020 ◽  
Vol 12 (21) ◽  
pp. 9265
Author(s):  
Fonette Fonjungo ◽  
Debabrata Banerjee ◽  
Rizky Abdulah ◽  
Ajeng Diantini ◽  
Arif S. W. Kusuma ◽  
...  
Keyword(s):  
Central Government ◽  
Evaluation Studies ◽  
Cost Effective ◽  
Initial Step ◽  
Financing System ◽  
Block Grants ◽  
Effective Interventions ◽  
General Revenue ◽  
Sustainable Financing ◽  
New Vaccines

Immunization is one of the most cost-effective interventions in global health and has a crucial role in achieving 14 of the 17 sustainable development goals (SDGs). The issue of sustainable financing for new vaccines is particularly pertinent as Indonesia transitions away from extensive Gavi support towards a self-financing immunization system. As the current immunization system transitions, practical solutions must be found and applied to provide more flexibility in the budget for financing immunizations without sacrificing the current healthcare system’s needs. Despite the fact that economic evaluation studies are essential as an initial step to ensure financial readiness, the lack of reliable data is the first barrier to Indonesia’s journey toward a self-financing immunization system. To overcome this problem, standardization of data collection strategies and methodologies are required. In particular, Indonesia may have to explore other options to increase revenue for its immunization system, such as through general revenue from the central government, a sector-wide approach to financing, and a national trust fund. To deal with the tight immunization budget and its consequences, Indonesia also has to restructure its immunization system, which can be implemented through province block grants, insurance mandate and subsidy. Taking the potential of a COVID-19 vaccine into account, the Indonesian government should consider a number of costs and issues beyond the development and procurement of vaccines. The costs of delivering vaccines to the remote parts of Indonesia, implementing the necessary infrastructure, and modifying vaccine delivery are also important in this time of transition. These constraints must be addressed in the new self-financing system and other public health efforts must be increased to decrease the burden of infectious disease as Indonesia develops a stronger immunization system.

Institutional Design and Central—Local Strategies: Introducing the New Block Grants System in Norway

1989 ◽  
Vol 7 (3) ◽  
pp. 301-312 ◽  
Author(s):  
N Aarsaether
Keyword(s):  
Welfare State ◽  
Institutional Design ◽  
Central Government ◽  
Economic Incentives ◽  
Government Control ◽  
Financing System ◽  
Block Grants ◽  
Welfare Policies ◽  
National Welfare ◽  
Central Level

When special grants are replaced by block grants in a central–local financing system, central government steering of the communalized welfare sectors can no longer be based on economic incentives. In this paper the potential for central government control over welfare policies under block-grants conditions is discussed, with particular reference to the change in the Norwegian transfers system. It is argued that, given high ambitions for the welfare state at the central level, a central government may find legislation to be an insufficient means of control, and it may be more likely to search for new types of economic incentives to make the communes perform according to the priorities of the national welfare state. In doing so, however, the central government must find methods of legitimizing a partial return to old practices that do not contradict the principle of block grants.

Psychosocial Factors and Hospital Readmission Status of Older Persons with Cardiovascular Disease

1996 ◽  
Vol 27 (4) ◽  
pp. 3-10 ◽  
Author(s):  
Renée A. Middleton ◽  
E. Keith Byrd
Keyword(s):  
Cardiovascular Disease ◽  
Physical Health ◽  
Hospital Readmission ◽  
Independent Living ◽  
Cost Effective ◽  
Initial Step ◽  
Unplanned Readmission ◽  
Rehabilitation Counselor ◽  
Rehabilitation Professionals ◽  
Effective Interventions

One hundred twenty-one (121) patients 55 years and older, having cardiovascular disease, were followed for 90 days to identify factors that might be used as predictors for hospital readmission. An initial step was to determine which health status or psychosocial measures would best discriminate between two readmission groups (readmission vs. no readmission). Four factors were univariately significant: physical health, personal adjustment, happiness, and number of secondary disorders. At the end of the specified follow-up period, 71 persons (58.7%) had experienced at least one unplanned readmission. Specifically, persons reporting a positive affect about their present circumstances, and enhanced optimism about their future, were less likely to be readmitted. Further, patients who were readmitted reported worse physical health before their readmission and had a greater number of secondary disorders. It is recommended that these factors be used in a multiple discriminant predictive model in future studies to detect their potential for predicting hospital readmission. If identification of at risk characteristics for repeated admissions among predictable high cost groups can be achieved, these data can supply rehabilitation professionals with the necessary information needed for the design of comprehensive and intensive cost-effective interventions in cardiac rehabilitation. Clinical applications for the rehabilitation counselor are discussed with respect to intervention considerations and the community reintegration of the older person from the hospital to their home and other independent living settings.

scholarly journals Incremental Net Monetary Benefit of Bariatric Surgery: Systematic Review and Meta-Analysis of Cost-Effectiveness Evidences

2021 ◽  
Author(s):  
Prapaporn Noparatayaporn ◽  
Montarat Thavorncharoensap ◽  
Usa Chaikledkaew ◽  
Bhavani Shankara Bagepally ◽  
Ammarin Thakkinstian
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Cost Effectiveness ◽  
Evaluation Studies ◽  
Meta Analysis ◽  
Cost Effective ◽  
Diabetes Group ◽  
Lifetime Horizon ◽  
Middle Income ◽  
Full Economic Evaluation

AbstractThis systematic review aimed to comprehensively synthesize cost-effectiveness evidences of bariatric surgery by pooling incremental net monetary benefits (INB). Twenty-eight full economic evaluation studies comparing bariatric surgery with usual care were identified from five databases. In high-income countries (HICs), bariatric surgery was cost-effective among mixed obesity group (i.e., obesity with/without diabetes) over a 10-year time horizon (pooled INB = $53,063.69; 95% CI $42,647.96, $63,479.43) and lifetime horizon (pooled INB = $101,897.96; 95% CI $79,390.93, $124,404.99). All studies conducted among obese with diabetes reported that bariatric surgery was cost-effective. Also, the pooled INB for obesity with diabetes group over lifetime horizon in HICs was $80,826.28 (95% CI $32,500.75, $129,151.81). Nevertheless, no evidence is available in low- and middle-income countries. Graphical abstract

scholarly journals Predicting employee absenteeism for cost effective interventions

2021 ◽  
pp. 113539
Author(s):  
Natalie Lawrance ◽  
George Petrides ◽  
Marie-Anne Guerry
Keyword(s):  
Cost Effective ◽  
Effective Interventions ◽  
Employee Absenteeism

Platelet Inhibitors and Hydroxyethyl Starch: Safe and Cost-Effective Interventions in Coronary Artery Surgery

1985 ◽  
Vol 39 (5) ◽  
pp. 422-425 ◽  
Author(s):  
George L. Hicks ◽  
Lynne A. Jensen ◽  
Lisa H. Norsen ◽  
Jill R. Quinn ◽  
Scott S. Stewart ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Hydroxyethyl Starch ◽  
Cost Effective ◽  
Platelet Inhibitors ◽  
Coronary Artery Surgery ◽  
Effective Interventions

Cultivating Resilience During the COVID-19 Pandemic: A Socioecological Perspective

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ning Zhang ◽  
Shujuan Yang ◽  
Peng Jia
Keyword(s):  
Cost Effective ◽  
Future Research ◽  
Annual Review ◽  
Publication Date ◽  
Physical And Mental Health ◽  
Pandemic Preparedness ◽  
Predicting Factors ◽  
Effective Interventions ◽  
Interdisciplinary Framework ◽  
The Individual

The coronavirus disease 2019 (COVID-19) pandemic poses wide-ranging impacts on the physical and mental health of people around the world, increasing attention from both researchers and practitioners on the topic of resilience. In this article, we review previous research on resilience from the past several decades, focusing on how to cultivate resilience during emerging situations such as the COVID-19 pandemic at the individual, organizational, community, and national levels from a socioecological perspective. Although previous research has greatly enriched our understanding of the conceptualization, predicting factors, processes, and consequences of resilience from a variety of disciplines and levels, future research is needed to gain a deeper and comprehensive understanding of resilience, including developing an integrative and interdisciplinary framework for cultivating resilience, developing an understanding of resilience from a life span perspective, and developing scalable and cost-effective interventions for enhancing resilience and improving pandemic preparedness. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Prevalence of Vitamin D Deficiency and Its Relationship with Clinical Outcomes in Patients with Fibromyalgia: a Systematic Review of the Literature

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Omar M. E. Ali
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Patient Flow ◽  
Controlled Trial ◽  
Cost Effective ◽  
Therapeutic Benefit ◽  
Vitamin D Supplementation ◽  
Effective Interventions ◽  
Randomised Controlled ◽  
And Control

Abstract Fibromyalgia is a debilitating chronic condition which poses a therapeutic challenge to the clinician. With a large backlog in patient flow subsequent to the COVID-19 pandemic and rising numbers of patients with post-acute sequelae of COVID-19 (PASC) presenting with fibromyalgia-like clinical features, there is an increasingly pressing need to identify broad cost-effective interventions. Low levels of vitamin D have previously been reported in patients with fibromyalgia, though any causative link has been difficult to establish. A systematic literature review on the association between vitamin D deficiency and fibromyalgia was performed examining retrospective evidence both for and against an association between vitamin D deficiency (VDD) and fibromyalgia and evaluating the therapeutic benefit from supplementation. A group of six studies were selected based on relevance, use of controls, quality of research and citations. Four primary studies assessing the prevalence of VDD in fibromyalgia patients versus controls were evaluated with a total 3,496 subjects. Three included females only and one larger study assessed males. Two (n = 313) concluded the presence of a statistically significant association, and two (n = 161) found none. Two randomised controlled trials assessing the effect of vitamin D supplementation in a total of 80 subjects found conflicting results, with pain reduction in one and none in the other. It is likely there exists an association between VDD deficiency and fibromyalgia in a large subset of patients, although establishing primary causation is difficult. There is a need for larger randomised controlled trial designs with more effective comparison with healthy subjects and control for confounding factors. Given VDD is a major problem in the general population, we recommend supplementation be recommended by healthcare professionals to fibromyalgia patients for the purpose of maintaining bone health given their potentially increased susceptibility to developing deficiency and its sequelae.

scholarly journals Supervision and monitoring to assess quality of outreach immunization sessions in a rural area using a checklist

2020 ◽  
Vol 7 (5) ◽  
pp. 1950
Author(s):  
Ambika R. Bhaskar ◽  
Mridula Solanki
Keyword(s):  
Tertiary Care ◽  
Immunization Coverage ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Immunization Services ◽  
Timely Fashion ◽  
Assess Quality

Background: Immunization is one of the most cost-effective interventions to prevent the suffering that comes from avoidable sickness, disability and death. Outreach immunization services ensure that immunization is available to children who are unable to access a general practice in a timely fashion for their immunization events. Effective supervision and monitoring will help in improving quality and coverage of immunization.Methods: This was an observational cross-sectional study conducted in the rural field practice area of a tertiary care hospital. 50 outreach sessions held in various outdoor places including Anganwadi were supervised and monitored using checklist. 110 mothers and 20 stakeholders were interviewed. Immunization records were assessed.Results: Outreach immunization sessions were found to be of good quality. 89% children were fully immunized. ANMs and ASHAs were of the opinion that outreach session has significantly raised immunization coverage. 75.4% mothers had knowledge about services provided by outreach sessions.Conclusions: There was increase in immunization coverage due to outreach sessions. There is need for adequate supervision on safety injection practices and regular timely incentive to ASHA.

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