PROBLEM The Brazilian population lacks equitable access to specialized health care and diagnostic tests, especially in remote municipalities, where health professionals often feel isolated and staff turnover is high. Telehealth has the potential to improve patients' access to specialized health care, but little is known about it in terms of cost-effectiveness, access to services or user satisfa...

BACKGROUND Many patients visit the accident and emergency department (AED) on their own initiative, although their medical problem can be adequately treated by a general practitioner (GP). Objective To evaluate the cost-effectiveness of addition of a GP to the AED (new care method) in comparison with usual care (usual care method). METHODS This study followed a before/after design. Patients a...

The rate of increase in industrialization and daily human activities has resulted in a tremendous increase in the amounts of waste and wastewater containing organic and inorganic pollutants discharged to the environment. Coagulation-flocculation technology has been widely employed in water/wastewater treatment as a convenient and reliable technique for removing colloids, particles, and cell deb...

BACKGROUND Interval appendectomy after conservative treatment of appendicitis with tumor formation remains controversial. The purpose of this study was to evaluate the efficacy of interval appendectomy based on a cost-effectiveness analysis. METHODS This was a retrospective study including appendicitis patients with tumor formation who received conservative treatment at first admission to Tai...

OBJECTIVE To evaluate the effectiveness and cost utility of a universally provided early years parenting programme. DESIGN Multicentre randomised controlled trial with cost-effectiveness analysis. SETTING Early years centres in four deprived areas of South Wales. PARTICIPANTS Families with children aged between 2 and 4 years. 286 families were recruited and randomly allocated to the inter...

BACKGROUND Although store-and-forward teledermatology is increasingly becoming popular, evidence on its effects on efficiency and costs is lacking. The aim of this study, performed in addition to a clustered randomised trial, was to investigate to what extent and under which conditions store-and-forward teledermatology can reduce costs from a societal perspective. METHODS A cost minimisation ...

BACKGROUND Indian guidelines recommend routine referral for HIV testing of all tuberculosis (TB) patients in the nine states with the highest HIV prevalence, and selective referral for testing elsewhere. We assessed the clinical impact and cost-effectiveness of alternative HIV testing referral strategies among TB patients in India. METHODS AND FINDINGS We utilized a computer model of HIV and ...

BACKGROUND Hearing loss is common among older adults and has consequences for sufferers, families and society, but there is substantial unmet need for intervention. Screening could expedite intervention and improve outcomes. METHODS We use Markov models to estimate the incremental cost-effectiveness ratio (ICER) of potential screening programmes compared with current provision (GP-referral), ...

OBJECTIVE To examine the effectiveness of Integrated Care and Discharge Support for elderly patients in reducing accident and emergency department attendance, acute hospital admissions, and hospital bed days after discharge. Factors that compromise its effectiveness were investigated and cost analysis was performed. DESIGN Cohort prospective study. SETTING Integrated Care and Discharge Supp...