Biomedical subjects

A Haddix

Publications and source records attributed to A Haddix.

5 recordsLinked to original sources

PubMed2001

Priorities among recommended clinical preventive services.

BACKGROUND: Many recommended clinical preventive services are delivered at low rates. Decision-makers who wish to improve delivery rates, but face competing demands for finite resources, need information on the relative value of these services. This article describes the results of a systematic assessment of the value of clinical preventive services recommended for average-risk patients by the U.S. Preventive Services Task Force. METHODS: The assessment of services' value for the U.S. population was based on two dimensions: burden of disease prevented by each service and cost effectiveness. Methods were developed for measuring these criteria consistently across different types of services. A companion article describes the methods in greater detail. Each service received 1 to 5 points on each of the two dimensions, for total scores ranging from 2 to 10. Priority opportunities for improving delivery rates were determined by comparing the ranking of services with what is known of current delivery rates nationally. RESULTS: The highest ranked services (scores of 7+) with the lowest delivery rates (< or =50% nationally) are providing tobacco cessation counseling to adults, screening older adults for undetected vision impairments, offering adolescents an anti-tobacco message or advice to quit, counseling adolescents on alcohol and drug abstinence, screening adults for colorectal cancer, screening young women for chlamydial infection, screening adults for problem drinking, and vaccinating older adults against pneumococcal disease. CONCLUSIONS: Decision-makers can use the results to set their own priorities for increasing delivery of clinical preventive services. The methods provide a basis for future priority-setting efforts.

Adult↗

PubMed2001

Methods for priority setting among clinical preventive services.

Methods used to compare the value of clinical preventive services based on two criteria-clinically preventable burden (CPB) and cost effectiveness (CE)-are described. A companion article provides rankings of clinical preventive services and discusses its uses for decision-makers; this article focuses on the methods, challenges faced, and solutions. The authors considered all types of data essential to measuring CPB and CE for services recommended by the U.S. Preventive Services Task Force and developed methods essential to ensuring valid comparisons of different services' relative value.

Bias↗

PubMed1997

Partner notification to prevent pelvic inflammatory disease in women. Cost-effectiveness of two strategies.

BACKGROUND AND OBJECTIVES: Partner notification is an important strategy for prevention of Chlamydia trachomatis infection and pelvic inflammatory disease (PID). PID can be prevented by early diagnosis and treatment of the female sex partners of men infected with C. trachomatis (strategy 1) and by preventing reinfection in women through diagnosis and treatment of their male sex partners (strategy 2). STUDY DESIGN: Using a decision model, the cost-effectiveness of strategies 1 and 2 was compared to no partner notification. Outcomes were measured by cases of PID prevented and net costs expended from a health care system perspective. RESULTS: In a hypothetical cohort of 1,000 male and 1,000 female index patients, strategy 1 prevented 64 and strategy 2 prevented 20 cases of PID. Strategy 1 saved $247,000 and strategy 2 saved $33,000 over no partner notification. Sensitivity analysis showed that strategy 1 was cost-effective across a wide range of assumptions. Strategy 2 was cost-effective at baseline, but its cost-saving ability was subject to changes in the model. CONCLUSION: Partner notification of both male and female index patients is a cost-effective public health strategy for prevention of PID. In most settings, both strategies can and should be implemented.

Chlamydia Infections↗

PubMed1996

The cost of a food-borne outbreak of hepatitis A in Denver, Colo.

BACKGROUND: In 1992, a food-borne outbreak of hepatitis A associated with a catering facility in Denver, Colo, resulted in 43 secondary cases of hepatitis A and the potential exposure of approximately 5000 patrons. OBJECTIVES: To assess (1) disease control costs, including state and local health department personnel costs, provision and administration of immune globulin, and cost of extra hepatitis A serologic tests performed; (2) business losses; and (3) cost of the cases' illnesses. METHODS: Cost data were collected from hospitals, health maintenance organizations, health departments, laboratories, the caterer's insurance company, and the catering facility involved in the outbreak. RESULTS: The total costs assessed in the outbreak from a societal perspective were $809,706. Disease control costs were $689,314, which included $450,397 for 16,293 immune globulin injections and $105,699 for 2777 hours of health department personnel time. The cases' medical costs were $46,064, or 7% of the disease control costs. CONCLUSIONS: The cases' medical costs and productivity losses were only a minor component of the total cost of this outbreak. The high cost of food-borne outbreaks should be taken into account in economic analyses of the vaccination of food handlers with inactivated hepatitis A vaccine.

Colorado↗

PubMed1994

Developing a health information infrastructure for Arizona.

Network connectivity is critical in Arizona, where travel distances are great, academic programs dispersed, and health care practitioners often geographically isolated. Accordingly, the University of Arizona (UA) applied for $50,000.00 in National Library of Medicine/National Science Foundation (NLM/NSF) Connections Program funding to promote statewide collaboration in supporting UA's health sciences education and research programs by expanding network connectivity to hospitals and other health-related institutions. The proposal outlined three strategies: Each major nonuniversity teaching hospital would secure and maintain a leased communications line dedicated to network connectivity, and NSF funds would be used to buy some necessary hardward. NSF funds would be used to establish a modern bank for dial-up Internet access by rural practitioners and teaching sites. Co-principal investigators of the project would promote and support the use of this new statewide connectivity and foster its continued expansion. The proposal was based on a conservative philosophy: familiar technologies and, where possible, existing networks and equipment would be used. The proposal was approved, and NSF funds hastened creation of an expanded health information network in Arizona. Once that network was in place, participants moved quickly from managing the mechanics of connectivity to planning for a computing and communications platform with services. Private funds were obtained to help organize the Arizona Health Information Network to direct these expanded services.

Arizona↗