 Subjects -> PHARMACY AND PHARMACOLOGY (Total: 575 journals)
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- The Vest™ High-Frequency Chest Wall Oscillation System Compared with
Manual Chest Wall Physiotherapy for Managing Airway Clearance in Patients
with Complex Neurological Disorders: A UK-based Cost-Effectiveness
Analysis
Abstract: Background:Weakness in the muscles used to breathe and swallow can lead to difficulties with airway clearance for people with neurological disorders including neuromuscular disease and cerebral palsy. This can lead to aspiration and other respiratory problems which are the leading causes of death in patients with complex neurological disorders. The Vest™ system supports airway clearance through the use of High-Frequency Chest Wall Oscillation (HFCWO) to loosen secretions in the chest by reducing their viscosity.Objective:To assess the cost-effectiveness of the Vest™ system versus Manual Chest Wall Physiotherapy (MCWP) for airway clearance in patients with neurological disorders including neuromuscular disease and cerebral palsy.Methods:A decision-analytic Markov model was developed to estimate the cost-effectiveness of HFCWO and MCWP over 5- and 10-year time horizons. Costs were estimated from the perspective of the UK National Health Service and personal social services. The main input parameters in the model were: rates of respiratory infection, respiratory-related hospitalisation, antibiotic use for respiratory infection and cost of the Vest™ system. The input parameters were informed by existing clinical guidelines and literature. Sensitivity analyses were conducted to explore uncertainties around the input parameters.Results:Over 5- and 10-year time horizons, the Vest™ system results in more quality-adjusted life-years and lower costs per patient. The Vest™ system has a high probability of being cost-effective (>98%) at willingness-to-pay thresholds of £20,000 and £30,000. The estimated average cost saving per patient over a 5-year time horizon is £5,660 (SD = £2362). Our results show that the Vest™ system may result in approximately £6 million cost savings per 1,000 patients with complex neurological disorders in 5 years. Per 1,000 patients, 2,442 hospital admissions and 49,868 bed days could be averted with the use of the Vest™ system. Our results were generally robust to the sensitivity analyses performed.Conclusion:The Vest™ system results in fewer respiratory infection episodes and hospitalisations, and thus less National Health Service (NHS) resource use, than current practice. Therefore, it is highly likely to be a cost-saving strategy.
- GDP Growth and Health Care Expenditures Worldwide
Abstract: Background: Impact of large recessions on GDP growth is well documented and their effect on Gross Domestic Product (GDP) growth is definitive. Health care expenditure is growing everywhere in the world. The most important factors such as GDP, income per capita, health system factors, urbanization, aging, and socio-demographic factors are well determined and described.Objective:The main aim of this literature review is the summation of all factors affecting the GDP and healthcare expenditure. The second aim is presenting the bigger picture of the multifactorial connection between all impacts on healthcare expenditure. The last aim is proposing possible strategies for the development of sustainable health systems.Conclusion:Tracking the economic trend changes is necessary. Government investments in health must be as large as countries can afford due to the population aging, non-communicable disease and treatment, and pharmacological innovations. The cost-effectiveness estimates and Hierarchical task analyses are among some plausible solutions for making informed resource allocation decisions.
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Open Access journal
