Biomedical subjects

Vernon J Lee

Publications and source records attributed to Vernon J Lee.

4 recordsLinked to original sources

PubMed2006

Economics of neuraminidase inhibitor stock piling for pandemic influenza, Singapore.

We compared strategies for stock piling neuraminidase inhibitors to treat and prevent influenza in Singapore. Cost-benefit and cost-effectiveness analyses, with Monte Carlo simulations, were used to determine economic outcomes. A pandemic in a population of 4.2 million would result in an estimated 525-1,775 deaths, 10,700-38,600 hospitalization days, and economic costs of 0.7 dollars to 2.2 billion Singapore dollars. The treatment-only strategy had optimal economic benefits: stock piles of antiviral agents for 40% of the population would save an estimated 418 lives and 414 million dollars, at a cost of 52.6 million dollars per shelf-life cycle of the stock pile. Prophylaxis was economically beneficial in high-risk subpopulations, which account for 78% of deaths, and in pandemics in which the death rate was >0.6%. Prophylaxis for pandemics with a 5% case-fatality rate would save 50,000 lives and 81 billion dollars. These models can help policymakers weigh the options for pandemic planning.

Antiviral Agents↗

PubMed2006

Travel characteristics and health practices among travellers at the travellers' health and vaccination clinic in Singapore.

INTRODUCTION: Singapore has a fast-growing travel industry, but few studies have been done on travel characteristics and travel health practices. This study describes the profile and healthseeking behaviour of travellers attending a travel health clinic in Singapore. MATERIALS AND METHODS: A cross-sectional survey was conducted on travellers attending the Traveller's Health and Vaccination Centre (THVC) between September and November 2002 using a standardised questionnaire. Information obtained included individual demographic and medical information, travel patterns, vaccination status and travel health practices. RESULTS: Four hundred and ninetyfive (74%) eligible travellers seen at THVC responded to the questionnaire. Their mean age was 36 years; 77% were professionals, managers, executives, and businessmen, students, and white collar workers. Asia was the main travel destination, and most travelled for leisure and resided in hotels or hostels. The median duration of travel was 16 days. Although >90% had previously travelled overseas, only 20% had previously sought pre-travel advice. Malays were significantly underrepresented (P < 0.01); and Caucasians and Eurasians were significantly more likely (P < 0.01) to have previously sought pre-travel advice compared with Chinese, Indians and Malays. Factors associated with seeking pre-travel advice included travel outside of Asia, especially Africa and South America. CONCLUSION: Singaporean travellers travel more often to cities rather than rural areas, compared with non-Asian travellers. Asia is the preferred destination, and travel outside of Asia is perceived as more risky and is associated with seeking pre-travel advice and vaccinations. Travel patterns and behaviours need to be taken into account when developing evidence-based travel medicine in Asia.

Adult↗

PubMed2005

Predictors of failed attendances in a multi-specialty outpatient centre using electronic databases.

BACKGROUND: Failure to keep outpatient medical appointments results in inefficiencies and costs. The objective of this study is to show the factors in an existing electronic database that affect failed appointments and to develop a predictive probability model to increase the effectiveness of interventions. METHODS: A retrospective study was conducted on outpatient clinic attendances at Tan Tock Seng Hospital, Singapore from 2000 to 2004. 22864 patients were randomly sampled for analysis. The outcome measure was failed outpatient appointments according to each patient's latest appointment. RESULTS: Failures comprised of 21% of all appointments and 39% when using the patients' latest appointment. Using odds ratios from the mutliple logistic regression analysis, age group (0.75 to 0.84 for groups above 40 years compared to below 20 years), race (1.48 for Malays, 1.61 for Indians compared to Chinese), days from scheduling to appointment (2.38 for more than 21 days compared to less than 7 days), previous failed appointments (1.79 for more than 60% failures and 4.38 for no previous appointments, compared with less than 20% failures), provision of cell phone number (0.10 for providing numbers compared to otherwise) and distance from hospital (1.14 for more than 14 km compared to less than 6 km) were significantly associated with failed appointments. The predicted probability model's diagnostic accuracy to predict failures is more than 80%. CONCLUSION: A few key variables have shown to adequately account for and predict failed appointments using existing electronic databases. These can be used to develop integrative technological solutions in the outpatient clinic.

Adult↗

PubMedDate not supplied

Coordination and resource maximization during disaster relief efforts.

INTRODUCTION: In the aftermath of the Earthquake and Tsunami in Southeast Asia, many relief organizations sent medical aid to affected areas. OBJECTIVE: The aim of this paper is to examine the mix of healthcare workers resulting from an influx of aid to Meulaboh, Indonesia, and how they met local healthcare needs. METHODS: Data were collected from the registration center for relief organizations in Meulaboh and daily hospital meetings on healthcare needs and available workers. RESULTS: Prior to the Tsunami, there were 14 doctors and 120 nurses in the hospital. By the third week after the Tsunami, there were 21 surgeons performing 10 surgeries daily, and >20 non-surgical doctors in the 90-bed hospital. There were <70 nurses available during the month after the Tsunami, which was insufficient for the needs of the hospital. In the town of Meulaboh, the number of doctors exceeded the number of nurses, while public health workers comprised <5% of the healthcare workers. CONCLUSION: An initial disaster-coordinating agency, formed by the United Nations (UN) in conjunction with affected countries, should link actively with relief organizations. This will optimize help in meeting local needs, and direct relief to where it is needed most.

Cross-Sectional Studies↗