SETTING: In South Africa prior to 2016, the standard treatment regimen for multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) was 24 months long and required daily injectable aminoglycoside ...(IA) treatment during the first 6 months. Recent evidence supports the replacement
of IA with well-tolerated oral bedaquiline (BDQ) and a shortened 9-12 month regimen.DESIGN: Using a Markov model, we analyzed the 5-year budgetary impact and cost per successful treatment outcome of four regimens: 1) IA long-course, 2) oral long-course, 3) IA short-course,
and 4) oral short-course. We used the South African MDR/RR-TB case register (2013-2015) to assess treatment outcomes for the then-standard IA long-course. Data on the improvement in outcomes for BDQ-based regimens were based on the literature. Costs were estimated from the provider perspective
using costs incurred to provide decentralized treatment for MDR-TB at a Johannesburg hospital.RESULTS: Based on our analysis, by 2023, the cost/successful outcome for the four regimens was respectively 1) US$7374, 2) US$7860, 3) US$5149, and 4) US$4922.
The annual total cost of each regimen was US$37 million, US$43 million, US$26 million, and US$28 million.CONCLUSION: Despite the high cost of BDQ, a BDQ-based shortened regimen for the treatment of MDR/RR-TB will result in improved treatment outcomes
and cost savings for South Africa.
Structural health monitoring is recognized as a viable solution to increase aviation safety and decrease operating costs enabling a novel maintenance approach based on the actual condition of the ...airframe, mitigating operating costs induced by scheduled inspections. However, the net benefit is hardly demonstrated, and it is still unclear how the implementation of such an autonomic system can affect performance at aircraft level. To close this gap, this paper presents a systematic analysis where the impact of cost and weight of integrating permanently attached sensors—used for diagnostics- affect the main performance of the aircraft. Through a multidisciplinary aircraft analysis framework, the increment of aircraft operating empty weight is compared with the possible benefits in terms of direct operating costs to identify a breakeven point. Furthermore, the analysis allows to establish a design guideline for structural health monitoring systems returning a safer aircraft without any economic penalties. The results show that the operating costs are lower than those of the reference aircraft up to 4% increase in maximum take-off weight. Paper findings suggest to considering a condition monitoring strategy from the conceptual design stage, since it could maximize the impact of such innovative technology. However, it involves in a design of a brand-new aircraft instead of a modification of an existing one.
Micro-costing is a cost estimation method that allows for precise assessment of the economic costs of health interventions. It has been demonstrated to be particularly useful for estimating the costs ...of new interventions, for interventions with large variability across providers, and for estimating the true costs to the health system and to society. However, existing guidelines for economic evaluations do not provide sufficient detail of the methods and techniques to use when conducting micro-costing analyses. Therefore, the purpose of this study is to review the current literature on micro-costing studies of health and medical interventions, strategies, and programs to assess the variation in micro-costing methodology and the quality of existing studies. This will inform current practice in conducting and reporting micro-costing studies and lead to greater standardization in methodology in the future.
We will perform a systematic review of the current literature on micro-costing studies of health and medical interventions, strategies, and programs. Using rigorously designed search strategies, we will search Ovid MEDLINE, EconLit, BIOSIS Previews, Embase, Scopus, and the National Health Service Economic Evaluation Database (NHS EED) to identify relevant English-language articles. These searches will be supplemented by a review of the references of relevant articles identified. Two members of the review team will independently extract detailed information on the design and characteristics of each included article using a standardized data collection form. A third reviewer will be consulted to resolve discrepancies. We will use checklists that have been developed for critical appraisal of health economics studies to evaluate the quality and potential risk of bias of included studies.
This systematic review will provide useful information to help standardize the methods and techniques for conducting and reporting micro-costing studies in research, which can improve the quality and transparency of future studies and enhance comparability and interpretation of findings. In the long run, these efforts will facilitate clinical and health policy decision-making about resource allocation.
Systematic review registration: PROSPERO CRD42014007453.
Investigates the cost-effectiveness and impact in terms of health gain at a health-district level of a home safety assessment and modification (HSAM) programme aimed at reducing injurious falls in ...older people. Identifies the most uncertain model parameters that might justify further research to enhance certainty for decision-making. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We focus on analysing cost minimising production behaviour in multi-output settings. We distinguish between two approaches for modelling the use of joint inputs. The cooperative approach assumes cost ...minimisation at the aggregate firm level, while the non-cooperative approach assumes cost minimisation at the level of the individual output division. Our framework extends the existing nonparametric framework for analysing single output production. An empirical application to the English and Welsh drinking water and sewerage sector shows the practical usefulness of our framework. Specifically, we compare the empirical validity of the cooperative and non-cooperative models for describing the observed production behaviour.
Background
Enhanced recovery programs (ERPs) have been shown to improve postoperative outcomes after abdominal surgery. This study aimed to review the current literature to assess if ERPs in ...colorectal, pancreas, and liver surgery induce cost savings.
Methods
A systematic review was performed including prospective and retrospective studies comparing conventional management versus ERP in terms of costs. All kinds of ERP were considered (fast-track, ERAS
®
, or home-made protocols). Studies with no mention of a clear protocol and no reporting of protocol compliance were excluded.
Results
Thirty-seven articles out of 144 identified records were scrutinized as full articles. Final analysis included 16 studies. In colorectal surgery, two studies were prospective (1 randomized controlled trial, RCT) and six retrospective, totaling 1277 non-ERP patients and 2078 ERP patients. Three of the eight studies showed no difference in cost savings between the two groups. The meta-analysis found a mean cost reduction of USD3010 (95% CI: 5370–650,
p
= 0.01) in favor of ERP. Among the five included studies in pancreas surgery (all retrospective, 552 non-ERP vs. 348 ERP patients), the mean cost reduction in favor of the ERP group was USD7020 (95% CI: 11,600–2430,
p
= 0.003). In liver surgery, only three studies (two retrospective and 1 RCT, 180 non-ERP vs. 197 ERP patients) were found, which precluded a sound cost analysis.
Conclusions
The present systematic review suggests that ERPs in colorectal and pancreas surgery are associated with cost savings compared to conventional perioperative management. Cost data in liver surgery are scarce.
Extensive ecosystem restoration is increasingly seen as being central to conserving biodiversity
and stabilizing the climate of the Earth
. Although ambitious national and global targets have been ...set, global priority areas that account for spatial variation in benefits and costs have yet to be identified. Here we develop and apply a multicriteria optimization approach that identifies priority areas for restoration across all terrestrial biomes, and estimates their benefits and costs. We find that restoring 15% of converted lands in priority areas could avoid 60% of expected extinctions while sequestering 299 gigatonnes of CO
-30% of the total CO
increase in the atmosphere since the Industrial Revolution. The inclusion of several biomes is key to achieving multiple benefits. Cost effectiveness can increase up to 13-fold when spatial allocation is optimized using our multicriteria approach, which highlights the importance of spatial planning. Our results confirm the vast potential contributions of restoration to addressing global challenges, while underscoring the necessity of pursuing these goals synergistically.
We examine the impact of government economic policy uncertainty (GEPU) on corporate innovation and identify a cost-of-capital transmission channel. We find that GEPU increases firms’ cost of capital, ...which translates into lower innovation. As economic policy uncertainty rises, firms with more exposure to such uncertainty face a higher weighted average cost of capital and innovate less. Innovations of financially constrained firms and firms relying on external finance in a competitive environment are affected more. Our study provides novel evidence that higher economic policy uncertainty hinders innovation not only through the traditional investment irreversibility channel, but also through the cost-of-capital channel.
Infertility, a global concern affecting both sexes, is influenced by modifiable and non-modifiable risk factors. While the literature predominantly underscores the clinical- and cost-effectiveness of ...lifestyle interventions in the realm of infertility treatment, a holistic compilation analysing the economic dimensions of such interventions is lacking. This systematic review aimed to fill this gap by evaluating the economic facets of lifestyle interventions in the management of infertility. An exhaustive search was conducted within the PubMed, Embase, and Scopus databases from their inception to February 2024. The aim was to find articles related to the economic aspects of lifestyle interventions in infertility management. These included clinical studies covering economic outcomes and economic evaluations. The Drummond Checklist was used to assess the quality of the included studies. From an initial yield of 7555 articles, five studies were deemed eligible for inclusion, comprising three cost-effectiveness analyses, one prospective cohort study and a randomized controlled trial, all of which were undertaken in high-income countries (the Netherlands, Australia and Japan). These studies included patients receiving infertility treatments for conditions such as unexplained infertility, polycystic ovary syndrome, ovulation disorders, or mild male infertility, inclusive of individuals with and without obesity. The women who participated in these studies were up to 45 years of age. The findings suggested that integrating lifestyle intervention programmes tends to enhance pregnancy and live birth outcomes. These programmes encompass coaching, psychological or behavioural guidance, nutritional adjustments, exercise regimes, weight management, smoking cessation and mindfulness techniques. Moreover, these interventions are likely to be more cost-effective than standard infertility care. For couples embarking on infertility treatments, the integration of lifestyle interventions into their management strategy not only fosters clinical benefits but also represents a cost-effective alternative to conventional care, particularly within high-income settings.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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