scholarly journals Cost analysis of treating cardiovascular diseases in a super-specialty hospital

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262190
Author(s):  
Atul Kumar ◽  
Vijaydeep Siddharth ◽  
Soubam Iboyaima Singh ◽  
Rajiv Narang
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Cost Analysis ◽  
Rheumatic Heart Disease ◽  
World Health ◽  
Inpatient Cost ◽  
Cardiac Care ◽  
Specialty Hospital ◽  
Cardiac Care Unit ◽  
Rheumatic Heart

Cardiovascular care is expensive; hence, economic evaluation is required to estimate resources being consumed and to ensure their optimal utilization. There is dearth of data regarding cost analysis of treating various diseases including cardiac diseases from developing countries. The study aimed to analyze resource consumption in treating cardio-vascular disease patients in a super-specialty hospital. An observational and descriptive study was carried out from April 2017 to June 2018 in the Department of Cardiology, Cardio-Thoracic (CT) Centre of All India Institute of Medical Sciences, New Delhi, India. As per World Health Organization, common cardiovascular diseases i.e. Coronary Artery Disease (CAD), Rheumatic Heart Disease (RHD), Cardiomyopathy, Congenital heart diseases, Cardiac Arrhythmias etc. were considered for cost analysis. Medical records of 100 admitted patients (Ward & Cardiac Care Unit) of cardiovascular diseases were studied till discharge and number of patient records for a particular CVD was identified using prevalence-based ratio of admitted CVD patient data. Traditional Costing and Time Driven Activity Based Costing (TDABC) methods were used for cost computation. Per bed per day cost incurred by the hospital for admitted patients in Cardiac Care Unit, adult and pediatric cardiology ward was calculated to be Indian Rupee (INR) 28,144 (US$ 434), INR 22,210 (US$ 342) and INR 18,774 (US$ 289), respectively. Inpatient cost constituted almost 70% of the total cost and equipment cost accounted for more than 50% of the inpatient cost followed by human resource cost (28%). Per patient cost of treating any CVD was computed to be INR 2,47,822 (US $ 3842). Cost of treating Rheumatic Heart Disease was the highest among all CVDs followed by Cardiomyopathy and other CVDs. Cost of treating cardiovascular diseases in India is less than what has been reported in developed countries. Findings of this study would aid policy makers considering recent radical changes and massive policy reforms ushered in by the Government of India in healthcare delivery.

scholarly journals Cost analysis of treating cardiovascular diseases in a super-specialty hospital

2021 ◽  
Author(s):  
Atul Kumar ◽  
Vijaydeep Siddharth ◽  
I B Singh ◽  
Rajiv Narang
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Cost Analysis ◽  
Rheumatic Heart Disease ◽  
Inpatient Cost ◽  
Cardiac Care ◽  
Cardiac Diseases ◽  
Specialty Hospital ◽  
Cardiac Care Unit ◽  
Rheumatic Heart

Abstract Background Cardiovascular care is expensive; hence, economic evaluation is required to estimate resources being consumed and to ensure their optimal utilization. There is dearth of data regarding cost analysis of treating various diseases including cardiac diseases from developing countries. The study aimed to analyze resource consumption in treating cardio-vascular disease patients in a super-specialty hospital.Methods An observational and descriptive study was carried out from April 2017 to June 2018 in the Department of Cardiology, Cardio-Thoracic (CT) Centre of All India Institute of Medical Sciences, New Delhi, India. As per World Health Organization, common cardiac diseases i.e. Coronary Artery Disease (CAD), Rheumatic Heart Disease (RHD), Cardiomyopathy, Congenital heart diseases, Cardiac Arrhythmias etc. were considered for cost analysis. A total of 100 admitted patients (Ward & Cardiac Care Unit) of cardiovascular diseases were enrolled in the study using prevalence-based sampling. They were followed up till discharge. Traditional Costing and Time Driven Activity Based Costing (TDABC) methods were used for cost computation.Results Per bed per day cost incurred by the hospital for admitted patients in Cardiac Care Unit, adult and pediatric cardiology ward was calculated to be INR 28,144 (US$ 434), INR 22,210 (US$ 342) and INR 18,774 (US$ 289), respectively. Inpatient cost constituted almost 70% of the total cost and equipment cost accounted for more than 50% of the inpatient cost followed by human resource cost (28%). Per patient cost of treating any cardiovascular disease was computed to be INR 2,47,822 (US $ 3842).Conclusion Cost of treating Rheumatic Heart Disease is the highest among all CVDs followed by Cardiomyopathy and other CVDs. Cost of treating cardiovascular diseases in India is less than what has been reported in developed countries. Findings of this study would aid policy makers considering recent radical changes and massive policy reforms ushered in by the Government of India in healthcare delivery.

scholarly journals The American Heart Association’s Call to Action for Reducing the Global Burden of Rheumatic Heart Disease: A Policy Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 142 (20) ◽  
Author(s):  
Andrea Beaton ◽  
Flavia B. Kamalembo ◽  
James Dale ◽  
Joseph H. Kado ◽  
Ganesan Karthikeyan ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
World Health ◽  
Policy Statement ◽  
World Health Assembly Resolution ◽  
Worker Education ◽  
Rheumatic Heart

Rheumatic heart disease (RHD) affects ≈40 million people and claims nearly 300 000 lives each year. The historic passing of a World Health Assembly resolution on RHD in 2018 now mandates a coordinated global response. The American Heart Association is committed to serving as a global champion and leader in RHD care and prevention. Here, we pledge support in 5 key areas: (1) professional healthcare worker education and training, (2) technical support for the implementation of evidence-based strategies for rheumatic fever/RHD prevention, (3) access to essential medications and technologies, (4) research, and (5) advocacy to increase global awareness, resources, and capacity for RHD control. In bolstering the efforts of the American Heart Association to combat RHD, we hope to inspire others to collaborate, communicate, and contribute.

scholarly journals The personal and clinical impact of screen-detected maternal rheumatic heart disease in Uganda: a prospective follow up study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sonia Voleti ◽  
Emmy Okello ◽  
Meghna Murali ◽  
Rachel Sarnacki ◽  
Albert Majwala ◽  
...  
Keyword(s):  
Heart Disease ◽  
Social Determinants Of Health ◽  
Rheumatic Heart Disease ◽  
Social Determinants ◽  
Determinants Of Health ◽  
World Health ◽  
Medical Decision ◽  
Rheumatic Heart

Abstract Background Pre-existing maternal cardiac disease is a significant contributor to adverse maternal, fetal, and neonatal outcomes. In 2015–2017, our team conducted the first community-based study of maternal rheumatic heart disease (RHD) in sub-Saharan Africa and identified RHD in 88% of those with pre-existing heart disease. Here we conducted a follow up investigation of women previously identified with RHD, describing clinical and echocardiographic outcomes, identifying barriers to medical adherence and evaluating the personal impact of RHD. Methods A 2 week prospective follow up was completed at sites in Central and Eastern Uganda. Participants underwent a three-step mixed methods study comprising of 1) direct structured interview targeting clinical history and medication adherence, 2) echocardiogram to evaluate left-sided heart valves, and 3) semi-structured guideline interview to elicit personal impacts of RHD. Results The team evaluated 40 (80%) of the original 51 mothers with RHD at a median post-partum time of 2.5 years after delivery (IQR 0.5). Echocardiographic data showed improvement in nine women with the remaining 31 women showing stable echocardiographic findings. Adherence to Benzathine penicillin G (BPG) prophylaxis was poor, with 70% of patients either poorly adherent or non-adherent. Three major themes emerged from interviews: 1) social determinants of health (World Health Organization, Social determinants of health, 2019) negatively affecting healthcare, 2) RHD diagnosis negatively affecting female societal wellbeing, 3) central role of spouse in medical decision making. Conclusions Screening echocardiography can identify women with pre-existing rheumatic heart disease during pregnancy, but long-term follow-up in Uganda reveals adherence to medical care following diagnosis, including BPG, is poor. Additionally, mothers diagnosed with RHD may experience unintended consequences such as social stigmatization. As identification of occult RHD is critical to prevent adverse pregnancy outcomes, further research is needed to determine how to best support women who face a new diagnosis of RHD, and to determine the role of screening echocardiography in high-risk settings.

scholarly journals Examining the Ugandan health system’s readiness to deliver rheumatic heart disease-related services

2021 ◽  
Vol 15 (2) ◽  
pp. e0009164
Author(s):  
Emma Ndagire ◽  
Yoshito Kawakatsu ◽  
Hadija Nalubwama ◽  
Jenifer Atala ◽  
Rachel Sarnacki ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Diagnostic Tests ◽  
Health Workers ◽  
District Level ◽  
Essential Medicines ◽  
World Health ◽  
World Health Assembly ◽  
The World ◽  
Rheumatic Heart

Background In 2018, the World Health Assembly mandated Member States to take action on rheumatic heart disease (RHD), which persists in countries with weak health systems. We conducted an assessment of the current state of RHD-related healthcare in Uganda. Methodology/Principal findings This was a mixed-methods, deductive simultaneous design study conducted in four districts of Uganda. Using census sampling, we surveyed health facilities in each district using an RHD survey instrument that was modeled after the WHO SARA tool. We interviewed health workers with experience managing RHD, purposively sampling to ensure a range of qualification and geographic variation. Our final sample included 402 facilities and 36 health workers. We found major gaps in knowledge of clinical guidelines and availability of diagnostic tests. Antibiotics used in RHD prevention were widely available, but cardiovascular medications were scarce. Higher levels of service readiness were found among facilities in the western region (Mbarara district) and private facilities. Level III health centers were the most prepared for delivering secondary prevention. Health worker interviews revealed that limited awareness of RHD at the district level, lack of diagnostic tests and case management registries, and absence of clearly articulated RHD policies and budget prioritization were the main barriers to providing RHD-related healthcare. Conclusions/Significance Uganda’s readiness to implement the World Health Assembly RHD Resolution is low. The forthcoming national RHD strategy must focus on decentralizing RHD diagnosis and prevention to the district level, emphasizing specialized training of the primary healthcare workforce and strengthening supply chains of diagnostics and essential medicines.

Osservazioni genetistiche su 44 casi di cardiopatie acquisite

1958 ◽  
Vol 7 (3) ◽  
pp. 397-410 ◽  
Author(s):  
L. Allori ◽  
P. Vitamia
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Rheumatic Heart

SUMMARYReport of 44 cases of rheumatic heart disease with genetics observations of transmittance of rheumatic fever and cardiovascular diseases and discussion about the relation betwen the two diseases.

Global leadership in paediatric and congenital cardiac care: “global health advocacy, lift as you rise – an interview with Liesl J. Zühlke, MBChB, MPH, PhD”

2021 ◽  
pp. 1-8
Author(s):  
Justin T. Tretter ◽  
Jeffrey P. Jacobs
Keyword(s):  
South Africa ◽  
Heart Disease ◽  
Child Health ◽  
Rheumatic Heart Disease ◽  
Cape Town ◽  
Global Leadership ◽  
Cardiac Care ◽  
University Of Cape Town ◽  
The University ◽  
Rheumatic Heart

Abstract Professor Liesl Zühlke is the focus of our fifth in a series of interviews in Cardiology in the Young entitled, “Global Leadership in Paediatric and Congenital Cardiac Care”. Professor Zühlke (nee Hendricks) was born in Cape Town, South Africa. She would attend medical school in her hometown at University of Cape Town, graduating in 1991. Professor Zühlke then went on to complete a Diploma in Child Health at College of Medicine in Cape Town followed by completion of her Paediatric and Paediatric Cardiology training in 1999 and 2007, respectively. She would subsequently complete her Masters of Public Health (Clinical Research Methods) at the University of Cape Town, completing her dissertation in 2011 on computer-assisted auscultation as a screening tool for cardiovascular disease, under the supervision of Professors Landon Myer and Bongani Mayosi. Professor Zühlke began her clinical position as a paediatric cardiologist in the Department of Paediatrics and Child Health at the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa in 2007. In this role, she has been instrumental in developing a transitional clinic at the paediatric hospital, is a team member of the combined cardio-obstetric and grown-up congenital heart disease clinics, each of which are rare in South Africa, with very few similar clinics in Africa. Professor Zühlke would continue her research training, completing her Doctorate at the University of Cape Town in 2015, with her dissertation on the outcomes of asymptomatic and symptomatic rheumatic heart disease under the supervision of Professor Bongani Mayosi and Associate Professor Mark Engel. In 2015, in affiliation with the University of Cape Town and the Department of Paediatrics and the Institute of Child Health, she established The Children’s Heart Disease Research Unit, with the goals to conduct, promote and support paediatric cardiac research on the African continent, facilitate Implementation Science and provide postgraduate supervision and training in paediatric cardiac research. In 2018, she would subsequently complete her Master of Science at the London School of Economics in Health Economics, Outcomes and Management of cardiovascular sciences. Professor Zühlke currently serves as the acting Deputy-Dean of Research at the Faculty of Health Sciences, University of Cape Town. Professor Zühlke has achieved the highest leadership positions within cardiology in South Africa, including President of the Paediatric Cardiac Society of South Africa and President of the South African Heart Association. She is internationally regarded as a leader in research related to rheumatic heart disease. Professor Zühlke’s work includes patient, family and health advocacy on a global scale, being involved in the development of policies that have been adopted by major global organisations such as the World Health Organization. In addition to her clinical and research efforts, she is highly regarded by students, colleagues and graduates as an effective teacher, mentor and advisor. This article presents our interview with Professor Zühlke, an interview that covers her experience as a thought leader in the field of Paediatric Cardiology, specifically in her work related to rheumatic heart disease, Global Health and paediatric and congenital cardiac care in resource-limited settings.

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