Systematic review on cost-effectiveness analysis of school-based oral health promotion program.

OBJECTIVE: This study aims to assess the variance of the cost-effectiveness ratio of the school-based oral health promotion and prevention program for elementary school children. METHODS: This review protocol was registered in the international database of Prospectively Registered Systematic Reviews in Health and Social Care (PROSPERO) (No: CRD 42022326734). The search for articles conducted in March-April 2022 focuses on any kind of school-based Promotive and Preventive Program for elementary school children that have control groups, and the outcome was Incremental Cost-Effectiveness Ratio (ICER). Grey literatures are not eligible. This review used five databases (PubMed, Scopus, Web of Science, CINAHL, and Google Scholar). Two independent reviewers referred to the PICO for inclusion and exclusion criteria and carried out the systematic review process. JBI ACTUARI Guidance for Critical Appraisal of Economic Evaluation Assessment Tools was used to assess the quality of the study. RESULTS: Of the total 1,473 articles found, there were 5 articles that matched the article search criteria and were included in a systematic review. It was known that the labor cost has a large proportion of the total program cost, and cost-saving programs were found in the two milk fluoridation programs (18.59 USD and 1.7 USD/averted DMF-S), fluoride mouth rinsing program (10.86 USD), and a comprehensive program with glass ionomer cement (461,766.37 USD/averted DALYs). CONCLUSION: The fluoride programs and the comprehensive program with glass ionomer cement have the lowest cost-effectiveness ratio.

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Economic Burden of Stroke Disease: A Systematic Review.

Globally, one of the main causes of non-communicable disease as a cause of death every year is stroke. The objective of this study was to analyze the burden in consequence of stroke. This research used a systematic review method. Furthermore, a search for articles was carried out in June-July 2020. Four databases were used to search articles from 2015 to 2020. Eligible studies were identified, analyzed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were prospective cost studies, retrospective cost studies, database analysis, mathematical models, surveys, and COI studies that assess burden of stroke in primary and referral healthcare (hospital-based). The results showed that from four databases, 9270 articles were obtained, and 13 articles were qualified. A total of 9270 articles had the identified search keywords, but only 13 articles met the set criteria for inclusion. The criteria for inclusion were stroke patients, the economic burden of stroke disease based on cost of illness method, which is approximately equal to USD 1809.51-325,108.84 (direct costs 86.2%, and indirect costs 13.8%). Those that used the health expenditure method did not present the total cost; instead, only either direct or indirect cost of health expenditure were reported. For most hospital admissions due to stroke, LOS (length of stay) was the dominant cost. The high economic burden to manage stroke justifies the promotion and preventive efforts by the policymakers and motivates the practice of healthy lifestyles by the people.

Cost Effectiveness Analysis Using Disability-Adjusted Life Years for Cataract Surgery.

Cataracts are the second most prioritized eye disease in the world. Cataracts are an expensive treatment because surgery is the only method that can treat the disease. This study aims to analyze the cost effectiveness of each operating procedure. Specifically, phacoemulsification and Small Incision Cataract Surgery (SICS) with Disability-Adjusted Life Years (DALYs) as the effectiveness indicator is used. This study is an observational analytic study with a prospective framework. The sample size is 130 patients who have undergone phacoemulsification and 25 patients who have undergone SICS. The DALY for phacoemulsification at Day-7 (D-7) is 0.3204, and at Day-21 (D-21), it is 0.3204, while the DALY for SICS at D-7 is 0.3060, and at D-21, it is 0.3158. The incremental cost effectiveness ratio (ICER) for cataract surgery at D-7 is USD $1872.49, and at D-21, it is USD $5861.71, whereas the Indonesian Gross Domestic Product (GDP) is USD $4174.90. In conclusion, the phacoemulsification technique is more cost effective than the SICS technique. The ICER value is very cost effective at D-7 post-surgery compared to at D-21 post-surgery because the ICER is less than 1 GDP per capita per DALY.

Awareness of Salt Intake among Community-Dwelling Elderly at Coastal Area: The Role of Public Health Access Program.

A geographical location such as coastal area is known as risk factor hypertension relating to high exposure of salty foods. Public health access had significant effect on reducing salt intake at the community level. This study assesses salt intake in older women resident at urban coastal in Indonesia participating in the public health program. This was a cross-sectional study involving older women (56.98 ± 5.7 years) resident at urban coastal in Kenjeran, Surabaya, Indonesia. Salt intake was calculated and estimated based on 24-h urinary sodium. The mean daily salt intake was 6.16 ± 3.48 g/d; only 11.8% of subjects consumed salt intake <3 g/day. However, majority of subjects (62.8%) consume salt <6 g/d. Awareness and participation were associated significantly with low salt intake. A significant association between participation, awareness, and salt intake may suggest that participating regularly in the public health program might cause our subjects controlled excessive salt intake by limiting their salt consumption. Since daily salt intake is still significant high and hypertension is still prevalence, comprehensive strategies to reduce salt should be considered in development of sodium-reduction initiatives in this region.

Achieving cost-efficient management of drug supply via economic order quantity and minimum-maximum stock level.

BACKGROUND: A good drug inventory planning system is important for an efficient budgeting, procurement, and cost control of drugs. When stagnant drugs in the inventory are too much, wastage due to expired and spoiled drugs could occur. These will not only cause loss of income but could also jeopardize healthcare service delivery. RESEARCH DESIGN AND METHODS: This study aimed to determine the most efficient and effective management of stagnant and shortage drugs by comparing three pharmacy logistic methods; the economic order quantity (EOQ), minimum-maximum stock level (MMSL), and the traditional consumption of drug inventory, at RA Basoeni Hospital, Mojokerto. Drug inventory was analyzed to calculate the opportunity loss, opportunity cost, and proportions of both stagnant and shortage drugs. RESULTS: We found that EOQ and MMSL performed best for control of stagnant drugs and shortage drugs, respectively. Both methods had proved as effective pharmacy logistic planning. In addition, EOQ produced the lowest opportunity cost for stagnant drugs besides the lowest opportunity loss for shortage drugs. CONCLUSION: The study concluded that EOQ is the most effective and efficient method to manage stagnant and shortage drugs at hospital pharmacy.