MyMedR

Rethinking health-care systems: a focus on chronicity

Allotey P, Reidpath DD, Yasin S, Chan CK, de-Graft Aikins A

Lancet, 2011 Feb 5;377(9764):450-1.

PMID: 21074257 DOI: 10.1016/S0140-6736(10)61856-9

Matched MeSH terms: Chronic Disease/economics*

A computer model of health status and costs in national health planning

Spohr MH, Wright NH, Herm J

Medinfo, 1995;8 Pt 2:1639.

PMID: 8591525

We developed a computer model which measures the impact of disease on a population, has the ability to track changes in disease incidence over time, and incorporates costs of disease prevention and treatment. This model was developed with data for Malaysia and used by the Ministry of Health in the development of their national health plan. The model uses the DHLL (DALY) measure which incorporates morbidity and mortality impacts of disease. The ability of the model to adjust for changes in disease incidence over a period of years allows health planners to accurately reflect demographic and development related changes in disease incidence. This model is of value to health planners because in incorporates information on population health status, costs of prevention and treatment, and changes in health status over time. It produces an evaluation of the cost effectiveness of possible interventions that can be used by health planners in making decisions on resource allocation.

Matched MeSH terms: Disease/economics

Strategy for the control of foot-and-mouth disease in Southeast Asia (SEAFMD)

Edwards JR

Dev Biol (Basel), 2004;119:423-31.

PMID: 15742655

The OIE Southeast Asia Foot-and-Mouth Disease Campaign (SEAFMD) involves the coordinated control of foot-and-mouth disease by eight of the ASEAN countries. A long term vision for SEAFMD has been developed and the core element is a progressive zoning approach to the control and eradication of FMD in the region. This paper describes the current status of FMD in Southeast Asia and progress towards achievement of OIE free zone status for FMD in parts of the Philippines and Malaysia and the initiation of the Malaysia-Thailand-Myanmar (MTM) Peninsular Campaign for FMD Freedom. In mainland Southeast Asia, the progressive zoning approach involves several sub-regional groups working in parallel to oversee the epidemiological and economic studies required to determine the feasibility of the approach. Areas involved include the Lower Mekong Basin, Upper Mekong Basin, parts of Myanmar and the Red River Delta of Vietnam. The paper describes the current usage of vaccines for FMD in Southeast Asia and provides recommendations for their supply and use in the new regional initiatives.

Matched MeSH terms: Foot-and-Mouth Disease/economics

Pattern of acute pelvic inflammatory disease in abortion-related admissions

Sinnathuray TA, Yusof K, Palan VT, Fong CK, Adeep N, Chong CH, et al.

Am J Obstet Gynecol, 1980 Dec 01;138(7 Pt 2):868-71.

PMID: 7468674

We evaluated 3,066 consecutive women admitted during 1 year to two major hospitals of Kuala Lumpur and the adjacent urban area of Malaysia. Indicators of acute pelvic inflammatory disease were more common among patients with induced abortions. PID was thought to be a major contributor to the higher costs associated with management of patients with induced abortions.

Matched MeSH terms: Pelvic Inflammatory Disease/economics

Clinical outcomes and direct costings of endoluminal clipping compared to surgery in the management of iatrogenic colonic perforation

Chan WK, Roslani AC, Law CW, Goh KL, Mahadeva S

J Dig Dis, 2013 Dec;14(12):670-5.

PMID: 23981291 DOI: 10.1111/1751-2980.12097

To compare the outcomes and costs of endoluminal clipping and surgery in the management of iatrogenic colonic perforation.

Matched MeSH terms: Iatrogenic Disease/economics*

Fulltext Cost-effectiveness analysis of ultrasonography screening for nonalcoholic fatty liver disease in metabolic syndrome patients

Phisalprapa P, Supakankunti S, Charatcharoenwitthaya P, Apisarnthanarak P, Charoensak A, Washirasaksiri C, et al.

Medicine (Baltimore), 2017 Apr;96(17):e6585.

PMID: 28445256 DOI: 10.1097/MD.0000000000006585

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) can be diagnosed early by noninvasive ultrasonography; however, the cost-effectiveness of ultrasonography screening with intensive weight reduction program in metabolic syndrome patients is not clear. This study aims to estimate economic and clinical outcomes of ultrasonography in Thailand.

METHODS: Cost-effectiveness analysis used decision tree and Markov models to estimate lifetime costs and health benefits from societal perspective, based on a cohort of 509 metabolic syndrome patients in Thailand. Data were obtained from published literatures and Thai database. Results were reported as incremental cost-effectiveness ratios (ICERs) in 2014 US dollars (USD) per quality-adjusted life year (QALY) gained with discount rate of 3%. Sensitivity analyses were performed to assess the influence of parameter uncertainty on the results.

RESULTS: The ICER of ultrasonography screening of 50-year-old metabolic syndrome patients with intensive weight reduction program was 958 USD/QALY gained when compared with no screening. The probability of being cost-effective was 67% using willingness-to-pay threshold in Thailand (4848 USD/QALY gained). Screening before 45 years was cost saving while screening at 45 to 64 years was cost-effective.

CONCLUSIONS: For patients with metabolic syndromes, ultrasonography screening for NAFLD with intensive weight reduction program is a cost-effective program in Thailand. Study can be used as part of evidence-informed decision making.

TRANSLATIONAL IMPACTS: Findings could contribute to changes of NAFLD diagnosis practice in settings where economic evidence is used as part of decision-making process. Furthermore, study design, model structure, and input parameters could also be used for future research addressing similar questions.

Matched MeSH terms: Non-alcoholic Fatty Liver Disease/economics*

Nephrology in the Oceania-South East Asia region: perspectives and challenges

Kerr PG, Tran HTB, Ha Phan HA, Liew A, Hooi LS, Johnson DW, et al.

Kidney Int, 2018 09;94(3):465-470.

PMID: 30045813 DOI: 10.1016/j.kint.2018.05.014

Matched MeSH terms: Global Burden of Disease/economics

Fulltext Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study

Lee KY, Ong TK, Low EV, Liow SY, Anchah L, Hamzah S, et al.

BMJ Open, 2017 05 28;7(5):e014307.

PMID: 28552843 DOI: 10.1136/bmjopen-2016-014307

OBJECTIVES: Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability.

DESIGN: This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014. Cost items under each unit of analysis involved in the provision of PCI service were identified, valuated and calculated to produce unit cost estimates.

SETTING: Five public cardiac centres participated. All the centres provide full-fledged cardiology services. They are also the tertiary referral centres of their respective regions.

PARTICIPANTS: The cost was calculated for elective PCI procedure in each centre. PCI conducted for urgent/emergent indication or for patients with shock and haemodynamic instability were excluded.

PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures of interest were the unit costs at the two units of analysis, namely cardiac ward admission and cardiac catheterisation utilisation, which made up the total hospitalisation cost.

RESULTS: The average hospitalisation cost ranged between RM11 471 (US$3186) and RM14 465 (US$4018). PCI consumables were the dominant cost item at all centres. The centre with daycare establishment recorded the lowest admission cost and total hospitalisation cost.

CONCLUSIONS: Comprehensive results from all centres enable comparison at the levels of cost items, unit of analysis and total costs. This generates important information on cost variations between centres, thus providing valuable guidance for service planning. Alternative procurement practices for PCI consumables may deliver cost reduction. For countries with limited data availability, costing method tailored based on country setting can be used for the purpose of economic evaluations.

REGISTRATION: Malaysian MOH Medical Research and Ethics Committee (ID: NMRR-13-1403-18234 IIR).

Study site: 5 hospitals (unnamed) of which 1 is a university teaching hospital

Matched MeSH terms: Coronary Artery Disease/economics*

Fulltext A comparison of enoxaparin with unfractionated heparins in patients with coronary heart disease in an emergency department in rural South Indian tertiary care teaching hospital

Ahmad A, Patel I, Asani H, Jagadeesan M, Parimalakrishnan S, Selvamuthukumaran S

Indian J Pharmacol, 2015 Jan-Feb;47(1):90-4.

PMID: 25821318 DOI: 10.4103/0253-7613.150360

Antithrombotic therapy with heparin plus antiplatelets reduces the rate of ischemic events in patients with coronary heart disease. Low molecular weight heparin has a more predictable anticoagulant effect than standard unfractionated heparin, is easier to administer, does not require monitoring and is associated with less ADRs. The purpose of the present study was to evaluate and compare the clinical and cost outcomes of Enoxaparin with a standard unfractionated heparin in patients with coronary heart disease.

Matched MeSH terms: Coronary Disease/economics

Fulltext Healthcare in Asia: a perspective from primary care at the gateway to a continent

Jiwa M, Othman S, Hanafi NS, Ng CJ, Khoo EM, Chia YC

Qual Prim Care, 2012;20(5):317-20.

PMID: 23113999

Malaysia has achieved reasonable health outcomes even though the country spends a modest amount of Gross Domestic Product on healthcare. However, the country is now experiencing a rising incidence of both infectious diseases and chronic lifestyle conditions that reflect growing wealth in a vibrant and successful economy. With an eye on an ageing population, reform of the health sector is a government priority. As in other many parts of the world, general practitioners are the first healthcare professional consulted by patients. The Malaysian health system is served by public and private care providers. The integration of the two sectors is a key target for reform. However, the future health of the nation will depend on leadership in the primary care sector. This leadership will need to be informed by research to integrate care providers, empower patients, bridge cultural gaps and ensure equitable access to scarce health resources.

Matched MeSH terms: Chronic Disease/economics

Taste-masked and affordable donepezil hydrochloride orally disintegrating tablet as promising solution for non-compliance in Alzheimer's disease patients

Liew KB, Tan YT, Peh KK

Drug Dev Ind Pharm, 2015 Apr;41(4):583-93.

PMID: 24495273 DOI: 10.3109/03639045.2014.884130

Manufacturing process and superdisintegrants used in orally disintegrating tablet (ODT) formulation are often time discussed. However, the effect of suitable filler for ODT formulation is not explored thoroughly.

Matched MeSH terms: Alzheimer Disease/economics

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