Browsing by Subject "Cost"

Now showing 1 - 5 of 5
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    Open Access
    A one health framework to estimate the cost of antimicrobial resistance
    (2020-11-26) Morel, Chantal M; Alm, Richard A; Årdal, Christine; Bandera, Alessandra; Bruno, Giacomo M; Carrara, Elena; Colombo, Giorgio L; de Kraker, Marlieke E A; Essack, Sabiha; Frost, Isabel; Gonzalez-Zorn, Bruno; Goossens, Herman; Guardabassi, Luca; Harbarth, Stephan; Jørgensen, Peter S; Kanj, Souha S; Kostyanev, Tomislav; Laxminarayan, Ramanan; Leonard, Finola; Hara, Gabriel L; Mendelson, Marc; Mikulska, Malgorzata; Mutters, Nico T; Outterson, Kevin; Baňo, Jesus R; Tacconelli, Evelina; Scudeller, Luigia
    Abstract Objectives/purpose The costs attributable to antimicrobial resistance (AMR) remain theoretical and largely unspecified. Current figures fail to capture the full health and economic burden caused by AMR across human, animal, and environmental health; historically many studies have considered only direct costs associated with human infection from a hospital perspective, primarily from high-income countries. The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ON€) network has developed a framework to help guide AMR costing exercises in any part of the world as a first step towards more comprehensive analyses for comparing AMR interventions at the local level as well as more harmonized analyses for quantifying the full economic burden attributable to AMR at the global level. Methods GAP-ON€ (funded under the JPIAMR 8th call (Virtual Research Institute) is composed of 19 international networks and institutions active in the field of AMR. For this project, the Network operated by means of Delphi rounds, teleconferences and face-to-face meetings. The resulting costing framework takes a bottom-up approach to incorporate all relevant costs imposed by an AMR bacterial microbe in a patient, in an animal, or in the environment up through to the societal level. Results The framework itemizes the epidemiological data as well as the direct and indirect cost components needed to build a realistic cost picture for AMR. While the framework lists a large number of relevant pathogens for which this framework could be used to explore the costs, the framework is sufficiently generic to facilitate the costing of other resistant pathogens, including those of other aetiologies. Conclusion In order to conduct cost-effectiveness analyses to choose amongst different AMR-related interventions at local level, the costing of AMR should be done according to local epidemiological priorities and local health service norms. Yet the use of a common framework across settings allows for the results of such studies to contribute to cumulative estimates that can serve as the basis of broader policy decisions at the international level such as how to steer R&D funding and how to prioritize AMR amongst other issues. Indeed, it is only by building a realistic cost picture that we can make informed decisions on how best to tackle major health threats.
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    The cost of HIV prevention and treatment interventions in South Africa
    (2003) Geffen, Nathan; Nattrass, Nicoli; Raubenheimer, Chris
    This paper estimates the costs of introducing several AIDS-related prevention and treatment programmes in South Africa.1 Our approach combines detailed information about the costs of implementing these interventions with demographic projections of their impact. Information about prices, wages and other cost components is drawn from a range of primary and secondary sources. Johnson and Dorrington’s (2002) modelling of the demographic impact of four AIDS-related health interventions is a central input into our costing exercise. We begin the paper with an overview of the key characteristics and results of their ASSA2000 ‘Interventions Model’.2 The paper then discusses the cost components of each of these interventions. We draw attention to the additional costs not considered in our primary analysis, and to the effect of antiretroviral medicine prices on the total cost of providing highly active antiretroviral therapy (HAART) to those who need it. HAART is expensive, but the net costs to government are significantly lower than the direct costs of providing HAART. This is because people on HAART experience fewer opportunistic infections (OIs) – thereby saving the government the costs of treating those OIs. We estimate these ‘hospital costs averted’, provide a brief discussion of the savings associated with fewer orphans, and then conclude with a calculation of the cost of prevention and treatment programmes as a percentage of GNP.
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    The impact of mHealth interventions on health systems: a systematic review protocol
    (BioMed Central, 2016-11-25) Fortuin, Jill; Salie, Faatiema; Abdullahi, Leila H; Douglas, Tania S
    Background: Mobile health (mHealth) has been described as a health enabling tool that impacts positively on the health system in terms of improved access, quality and cost of health care. The proposed systematic review will examine the impact of mHealth on health systems by assessing access, quality and cost of health care as indicators. Methods: The systematic review will include literature from various sources including published and unpublished/grey literature. The databases to be searched include: PubMed, Cochrane Library, Google Scholar, NHS Health Technology Assessment Database and Web of Science. The reference lists of studies will be screened and conference proceedings searched for additional eligible reports. Literature to be included will have mHealth as the primary intervention. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion with the assistance of the third author. Discussion: The systematic review will inform policy makers, investors, health professionals, technologists and engineers about the impact of mHealth in strengthening the health system. In particular, it will focus on three metrics to determine whether mHealth strengthens the health system, namely quality of, access to and cost of health care services. Systematic review registration: PROSPERO CRD42015026070.
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    Impact of planning and building regulations on affordable housing development by the private sector in South Africa
    (2019) Ekpo, Christiana; Mooya, Manya
    This study emerged from existing literary evidence that planning and building regulations affect the supply of housing and research in this area usually takes a very descriptive route that lacks an explicit theoretical framework that can guide stakeholders for better research outcomes. The rationale is based on the context that despite the many initiatives introduced by successive post-apartheid governments to improve the housing situation in South Africa, not much has been achieved to improve the enormous housing backlogs. Affordable housing, being one of the strategic mechanisms used by the government for housing delivery is laden with problems. Many factors have been attributed to the challenges among which are land use policies and building regulations, administrative bottlenecks, budgetary constraints, and so on. To effectively manage these challenges, a more proactive private sector participation has been advocated. However, this requires that proper regulatory frameworks are put in place to ensure that developers deliver housing that meets necessary safety and quality standards and still have some return on investment. Unfortunately, legislative structures which should ideally be supportive, instead, hinder development and create barriers for private developers The study thus investigates three related questions. Firstly, what are the main planning and building regulations that impact on affordable housing by the private sector? Secondly, how do the planning and building regulations affect the total cost of affordable housing development by the private sector? Thirdly, what scope exists for the change and would, relaxing these regulations, enhance the supply of affordable housing developments by the private sector in South Africa? Corresponding to these questions is the first hypothesis which states that planning and building regulations impose a significant cost on the developers and thus deter the supply by the private sector. And secondly, relaxing some of the planning and building regulations could improve affordable housing development by the private sector. The study employed a qualitative approach to gather empirical data using household surveys and semi-structured interviews from developers and consultants on five case studies together with key informants’ interviews from government officials. With the main theoretical tools of Institution Analysis and Development, this study developed a conceptual framework that determines the main planning and building regulations that impact on affordable housing supply by the private sector. And by employing insights from New Institutional Economics tools, these regulations are treated as institutions through which development rights are obtained. The study reveals; that even though planning and building regulations are affiliated with better quality housing products, they significantly affect cost, affordability and location outcomes. That no national policy tool exists to guide affordable housing implementation processes; the current city’s policy instruments are contradictory to the propagated concepts meant to enhance housing supply. The study discovers that the government has huge land parcels for different intentions, but makes it available only to a developer whose objectives align with theirs and developers lack adequate funding and incentives to motivate them. Finally, the study reveals that even when case studies are located outside the urban core of Cape Town, dwellers are happy and satisfied with the location and careless about the system’s inefficiencies and there is no direct relation between planning and building regulations and location other than the fact that regulations contribute to the bad location of developments.
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    A scoping review examining the integration of exercise services in clinical oncology settings
    (2022-02-21) Ezenwankwo, Elochukwu F; Nnate, Daniel A; Usoro, Godspower D; Onyeso, Chimdimma P; Anieto, Ijeoma B; Ibeneme, Sam C; Albertus, Yumna; Lambert, Victoria E; Ezeukwu, Antoninus O; Abaraogu, Ukachukwu O; Shamley, Delva
    Background Addressing questions surrounding the feasibility of embedding exercise service units in clinical oncology settings is imperative for developing a sustainable exercise-oncology clinical pathway. We examined available literature and offered practical recommendations to support evidence-based practice, policymaking, and further investigations. Methods Four thousand eight hundred sixty-three unique records identified in Embase, CINAHL, MEDLINE, Web of Science Core Collection, and ProQuest (Health and Medicine) were screened for studies that recruited cancer patients, assessed the co-location of exercise service and cancer treatment units, and reported findings on service implementation. Evidence from six studies providing data from over 30 programs was integrated using narrative synthesis. Results Service implementation was relatively modest across the included studies. Exercise services were delivered by physiotherapists, exercise physiologists, and kinesiologists and funded mainly through grants and private donations, with staff salaries accruing as the major expense. Service penetration, adoption, and acceptability were generally low. However, studies recorded high clinician/patient satisfaction. Major barriers to service integration were limited funding, lack of detailed implementation plan, and low organizational buy-in. Common reasons for non-utilization, missed sessions, and dropouts were lack of interest, unwellness, hospital readmission, disease progression, and adverse skeletal events. Conclusion Implementing exercise services in clinical oncology settings seems an effective approach for increasing access to exercise-based rehabilitation for individuals on cancer treatment. While this model appears feasible for patients/clinicians, efforts are required to optimize service integration both in the short and long term. Key priorities include seeking [local] actions to address issues relating to funding and organizational buy-in. Important considerations may include developing an implementation plan to guide the implementation process, expanding the patient core management team to include staff from the exercise rehabilitation unit, and exploring the role of patient feedback in increasing clinician participation (e.g., treating oncologists and nurses) in the referral process. Future research should consider effective strategies to promote patients’ sense of self-efficacy and behavioral control and, further, the place of audit and feedback in improving exercise service delivery and overall service implementation.