ABSTRACT
The effectiveness of regional health information platform was judged by overall assessment of its data contents, data quality, data safety and beneficial results in order to promote the mutual link and mutual communi-cation between the platforms and data centers at the provincial, municipal and county levels, speed up the data sharing and professional work cooperation, and meet the different information needs of different users.
ABSTRACT
Objective To construct subsystem of picture archiving and communicating system (PACS) based on video database of ophthalmology and to evaluate on effectiveness of applying PACS system in postgraduate teaching.Methods PACS subsystem were constructed by collecting audiovisual materials of ophthalmology surgery videos,retinal photography,B-ultrasonography,OCT,UBM of patients.A total of 24 postgraduates were divided into control group (n =12) and experimental group (n=12) by random number table.Students in control group was taught by traditional cases,books and literature while those in experimental by network teaching from PACS subsystem.Two teaching methods were assessed subjectively and objectively.Objective indicators including ophthalmology examination results,operational skill ratings and paper reviewing results as well as subjective indicators including efficiency to accept the knowledge,satisfaction degree of teaching,influencing degree of papers were employed to assess the effectiveness of the two teaching methods.Independent samples t-test and twosample rank sum test were used for statistical analysis,P ＜ 0.05 was considered statistically significant.Results Students in experimental group done better in operation scores and in the assessment of the efficiency of knowledge accepting,satisfaction of teaching and papers effect than control group(P =0.000、0.000、0.000、0.003).The two groups had no significant difference in professional exam achievements and paper review scores (P =0.625、0.354).Conclusions PACS subsystem based on video database of ophthalmology are benefit for postgraduate teaching.
ABSTRACT
OBJETIVOS: Comparar custos e benefícios clínicos de três terapias adicionais à metformina (MF) para pacientes com diabetes mellitus tipo 2 (DMT2). MÉTODOS: Um modelo de simulação de eventos discretos foi construído para estimar a relação custo-utilidade (custo por QALY) da saxagliptina como uma terapia adicional à MF comparada à rosiglitazona ou pioglitazona. Um modelo de impacto orçamentário (BIM - Budget Impact Model) foi construído para simular o impacto econômico da adoção de saxagliptina no contexto do Sistema Suplementar de Saúde brasileiro. RESULTADOS: O custo de aquisição da medicação para o grupo de pacientes hipotéticos analisados, para o horizonte temporal de três anos, foi de R$ 10.850.185,00, R$ 14.836.265,00 e R$ 14.679.099,00 para saxagliptina, pioglitazona e rosiglitazona, respectivamente. Saxagliptina exibiu menores custos e maior efetividade em ambas as comparações, com economias projetadas para os três primeiros anos de -R$ 3.874,00 e -R$ 3.996,00, respectivamente. O BIM estimou uma economia cumulativa de R$ 417.958,00 com o reembolso da saxagliptina em três anos a partir da perspectiva de uma operadora de plano de saúde com 1 milhão de vidas cobertas. CONCLUSÃO: Da perspectiva da fonte pagadora privada, a projeção é de que o acréscimo de saxagliptina à MF poupe custos quando comparado ao acréscimo de rosiglitazona ou pioglitazona em pacientes com DMT2 que não atingiram a meta de hemoglobina glicada (HbA1c) com metformina em monoterapia. O BIM, para a inclusão de saxagliptina nas listas de reembolso das operadoras de planos de saúde, indicou uma economia significativa para o horizonte de 3 anos.
OBJECTIVES: To compare costs and clinical benefits of three additional therapies to metformin (MF) for patients with diabetes mellitus type 2 (DM2). METHODS: A discrete event simulation model was built to estimate the cost-utility ratio (cost per quality-adjusted life years [QALY]) of saxagliptine as an additional therapy to MF when compared to rosiglitazone or pioglitazone. A budget impact model (BIM) was built to simulate the economic impact of saxagliptine use in the context of the Brazilian private health system. RESULTS: The acquiring medication costs for the hypothetical patient group analyzed in a time frame of three years, were R$ 10,850,185, R$ 14,836,265 and R$ 14,679,099 for saxagliptine, pioglitazone and rosiglitazone, respectively. Saxagliptine showed lower costs and greater effectiveness in both comparisons, with projected savings for the first three years of R$ 3,874 and R$ 3,996, respectively. The BIM estimated cumulative savings of R$ 417,958 with the repayment of saxagliptine in three years from the perspective of a health plan with 1,000,000 covered individuals. CONCLUSION: From the perspective of private paying source, the projection is that adding saxagliptine with MF save costs when compared with the addition of rosiglitazone or pioglitazone in patients with DM2 that have not reached the HbA1c goal with metformin monotherapy. The BIM of including saxagliptine in the reimbursement lists of health plans indicated significant savings on the three-year horizon.
Subject(s)
Female , Humans , Male , Middle Aged , /drug therapy , Hypoglycemic Agents/administration & dosage , Adamantane/administration & dosage , Adamantane/analogs & derivatives , Adamantane/economics , Cost-Benefit Analysis , /economics , Dipeptides/administration & dosage , Dipeptides/economics , Drug Therapy, Combination/economics , Hypoglycemic Agents/economics , Metformin/administration & dosage , Metformin/economics , Private Sector , Thiazolidinediones/administration & dosage , Thiazolidinediones/economicsABSTRACT
Este artigo apresenta os resultados de uma pesquisa que relaciona a percepção dos usuários sobre a contribuição do Programa de Saúde da Família (PSF), na Unidade Mista de Felipe Camarão, Distrito Oeste de Natal, Rio Grande do Norte, com a evolução dos indicadores de atenção à saúde da criança menor de cinco anos, no período de 2000 a 2004. Inicialmente foi realizado um levantamento de dados sobre a política de saúde implementada, incluindo um perfil dos usuários envolvidos. Depois, uma consulta às estatísticas disponíveis, contidas em documentos oficiais do Ministério da Saúde e da Secretaria Municipal de Saúde de Natal, referentes às ações desenvolvidas na área da saúde da criança no período considerado. Por fim, aplicou-se um questionário de pesquisa social a uma amostra de famílias com crianças menores de cinco anos, cadastradas na unidade mista, para conhecer o seu grau de satisfação com os serviços recebidos. A comparação do nível de satisfação dos usuários com a evolução das estatísticas revelou que as ações de atenção à saúde da criança do PSF, no órgão público considerado, foram transformadoras de atitudes e propulsoras de mudanças sociais.
Subject(s)
Effectiveness , National Health Strategies , Consumer Behavior , BrazilABSTRACT
Objective To analysis the influence of health management intervention on blood glucose control for 2 diabetic, discusses in view of the diabetic not good life style practice the effective health management measure. Methods Reviewed the diagnosised 2 diabetic examples (1152) from March,2003 to July,2007 by healthy physical examination and the physical examination materials, including the biochemistry items like fasting blood glucose (GLU), Glucosylated hemoglobin (HbAlc) and the questionnaires about each patient's formerly body activity, the diet and the medical compliance etc. Established the standard,carried on the appraisal. According to the above, the life style relative good 283 examples (A group) and the bad 869 examples (B group) the patient will integrate the cohort, carried on the cohort study, analysised the relations between life style and diabetes controll effectiveness; At the same time, compared the biochemistry results between the non-managed (C group) and the managed (D group) after by meanse of a year strengthened health management intervention (diet, movement, medical compliance, health education etc.) on the 241 example patients. Results The GLU and HbAlc control satisfaction rate of the life style relative good group's (A group) respectively is 60. 1% and 56. 5%, obviously surpasses the life style bad group's (B group) 49.0% and 45. 5% (X2 = 10.44 and 11.05, P<1.01) ; The unscientific life style is diabetes GLU and the HbAlc control not satisfactory the dangerous fact (RR = 1.28 and 1.25) ; After carries on the life style strengthening intervention for a year (D group), the nutrition and the movement knowledge awareness rate (63.5%) is obviously higher than the before management (C group) (25.7%), the difference has statistics significance (X2=4.51, P<0.05), after and before the strengthening life style management intervention, GLU and HbAic control satisfaction rate is respectively 61.8% ,64. 3% and 58.5%, 47.8%, the difference has statistics significance (X2=7.94 and 4.18, P<0.01 and 0.05) Conclusions The life style has a close correlation with the effectiveness of 2 diabetes blood glucose control, the health management intervention can raise the patient's good life style, helps the patient to obtain satisfaction the blood glucose control effectiveness.