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Biomedical subjects

R D Bowie

Publications and source records attributed to R D Bowie.

7 recordsLinked to original sources

The cost of childhood immunisation in general practice.

AIM: To estimate the cost, to general practices in the Wellington Immunisation Network, of the audit process of recalling and immunising children according to the New Zealand Immunisation Schedule. METHOD: Practices recorded all clinical and clerical time spent on immunisation as well as the materials used throughout one audit cycle. Staff time and materials were costed directly. Practice overheads were apportioned to immunisation according to the actual time spent on each of the tasks relating to immunisation relative to the total staff hours at the practice. RESULTS: The average cost of immunising a child who attended a non-capitated practice after a single reminder or recall was $15.15. The cost to the practice after taking the practice nurse subsidy and GMS into account was $8.51. The cost of immunising children who were not immunised at the first recall increased in proportion to the number of recall reminders. The annual average cost of immunisation to practices in the study exceeded the revenue obtained from the Immunisation Benefit. CONCLUSION: Overall, given the frequency of recall reminders, there was a net cost to practices for childhood immunisation after deducting the current immunisation benefit rate of $9.78 excluding GST. Thus, the practices in this study made a "loss" in carrying out childhood immunisations.

Child, Preschool↗

The private costs of HIV/AIDS.

AIM: To identify and, where possible, measure and value the private costs related to HIV/AIDS, that is, those costs that fall on the person with HIV/AIDS and the family/household/informal caregivers. METHOD: Twenty-five people living with HIV - ranging from asymptomatic seropositive people, to people with AIDS - were followed prospectively to obtain information concerning the private costs (broadly defined) incurred. The participants resided in the Auckland, Hamilton, Wellington and Christchurch areas. RESULTS: Private direct costs rise steeply as the illness progresses, from around $100 per month for asymptomatic people to around $400 per month for people with AIDS. Both indirect costs (foregone income) and intangibles (measured by a range of indicators) were also considerable. CONCLUSION: The private costs of HIV/AIDS, defined in terms of direct, indirect and intangible costs, are significant and burdensome. Costing studies which ignore them will conceal, confuse and mislead.

Adult↗

Peritoneal cytology for suspected acute appendicitis: an economic evaluation.

Suspected acute appendicitis is a common reason for surgery. Unfortunately, diagnosis is not always simple and, in recent years, considerable attention has been devoted to developing better diagnostic techniques. Peritoneal cytology is one such technique. It is simple, minimally invasive, and has been established as clinically effective. This paper reports on an economic evaluation of peritoneal cytology, carried out at Wellington Hospital, New Zealand. The analysis is based on two trials totalling 192 patients. The perspective taken initially is that of a hospital financial manager, seeking to minimise costs. In the first trial, there was a marginal increase in overall cost per person presenting with suspected acute appendicitis, from using the test. In the second, there was a reduction. In both trials there were significant health benefits--unnecessary operations were avoided, and necessary operations done more quickly. Also, the practice developed, in the second trial, of sending patients home immediately following a negative test result. This further increased savings. We then discuss the results from a broader perspective. We conclude that the additional personal benefits--less time convalescing, and lower mortality, on average--ensure that the benefits outweigh the costs of the test.

Acute Disease↗