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Pilot Programme (pilot + programme)
Selected AbstractsEconomic analysis for clinical practice , the case of 31 national consensus guidelines in the NetherlandsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2007Louis W. Niessen MD Abstract Rationale, aims and objective, Evidence on the cost-effectiveness of health interventions in the development of practice guidelines has become of interest in many countries. Challenges are the quality of economic data, the use of cost-effectiveness criteria, and the consensus process. Our paper aims to assess the quality and use of economic information in the formulation of consensus guidelines in a Dutch pilot programme and to recommend improvements. Methods, ,Retrospective qualitative review of economic evaluations and formulated recommendations, using a checklist based on international standards. Results, The national programme to support the development of guidelines with economic analysis in multidisciplinary consensus groups run from 1998 to 2002. It has included 31 medical guidelines, addressing 23 conditions across seven International Classification of Diseases (ICD)-disease groups. Experts in health technology assessment have participated in the guidelines groups. Economic information in all guidelines varies by all criteria in the level of evidence used. Information on quality-adjusted life years gained is limited as is statistical analysis in most studies. Highest cost-effectiveness ratios reported are between ,20 000 and ,30 000. However, there is no uniformity in the definitions of acceptable cost-effectiveness ratios. Conclusions, Economic recommendations can be included in guidelines. Interaction between clinicians and health economists promotes a balance between medical and economic arguments. Among panellists there appears to be agreement on the level of the cost-effectiveness ratios that is acceptable. It is recommended that economic analysis is used to strengthen the evidence-base of guidelines. An evidence-grading system should include the quality of economic evaluation. Roles of policymakers and providers need to be defined. [source] A pre-employment programme for overseas-trained doctors entering the Australian workforce, 1997,99MEDICAL EDUCATION, Issue 7 2002Elizabeth A Sullivan Objectives Overseas-trained doctors (OTDs) have limited access and formal interaction with the Australian health care system prior to joining the Australian medical workforce. A pre-employment programme was designed to familiarize OTDs with the Australian health care system. Method All OTDs who had passed their Australian Medical Council (AMC) exams and were applying for a pre-registration year in New South Wales were invited to participate in the voluntary, free programme. A 4-week full-time programme was developed consisting of core group teaching and a hospital attachment. The curriculum included communication, health and workplace skills; and sessions on culture shock and the role of junior doctors. A pilot programme was run in 1997. The programme was repeated in 1998 and 1999. The OTDs' confidence regarding the general duties of internship, and attitudes towards hospital workplace skills were examined. Results The 66 OTDs reported greater understanding of staff and communication issues and familiarization with the hospital environment. They reported a more realistic understanding of the role of a junior doctor, the need for separation of workplace and personal responsibilities and knowledge of pathways for future professional development. The course structure, with a focus on hospital attachments, establishment of a peer network, and workplace familiarization facilitated entry into the hospital workforce. Conclusion The pre-employment programme enabled the OTDs to have a more equitable entry into the public hospital system, resulting in a more integrated, confident and functional workforce. [source] Sourcing Iron Age softstone artefacts in southeastern Arabia: results from a programme of analysis using Inductively Coupled Plasma-Mass Spectrometry/Optical Emission Spectrometry (ICP-MS/OES)ARABIAN ARCHAEOLOGY AND EPIGRAPHY, Issue 2 2005Peter Magee Iron Age softstone vessels manufactured in southeastern Arabia are widely distributed across that region and in lesser amounts throughout Western Asia. Results from a pilot programme of analysis using Inductively Coupled Plasma Mass Spectrometry/Optical Emission Spectrometry on vessel fragments from two southeast Arabian sites are presented. These results indicate the existence of geochemically distinct groups that are separated by both transition metals and rare earth elements. While this indicates the potential for the application of the provenance postulate in softstone analysis, these promising results need to be further tested by an expanded programme of analysis which includes quarry fragments. [source] UK interventions to control medicines wastage: a critical reviewINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2010Katherine Gwenda White Abstract Objective The objective is to evaluate the scope of medicines wastage in the UK, assigning a value to the costs at both a national and individual patient level to assess the cost-effectiveness of the pharmacy interventions that have been introduced to curb wastage. Methods Publicly available information was assessed in a desk-based systematic review using online search engines and publication databases. Data on community prescribing trends and costs in England from 1997 to 2008 from the Department of Health, and published reports from Primary Care Trusts (PCTs) comprise the core information that has been analysed. Key findings The commonly used upper wastage estimate of 10% is likely to be overstated, because it pre-dates major measures to curb wastage and over-prescribing. In pilot programmes, medicines use reviews have achieved cost savings of up to 20%. Awareness campaigns aimed at patients appear to be effective. Twenty-eight-day repeat prescribing has resulted in year-on-year reductions on the quantity of medication issued per prescription item to reach an average prescription length of 40 days in 2008. The increasing availability of generic medications has seen significant reductions in net ingredient costs. Nearly two-thirds of prescriptions are now issued as generics, with an average net ingredient cost of £3.83. Pharmacy charges to dispense a prescription item in 2008 averaged £1.81, so that pharmacy charges make up around one-third of the cost of most prescription items dispensed. If all 842.5 million prescription items issued by the NHS in England in 2008 had been 28-day repeat-dispensing items, this would have added a projected £700 million to the actual pharmacy costs of around £1.5 billion. Conclusions Unnecessary spending on pharmacy charges has the potential to outstrip the estimated cost of medicines wastage in the UK. The cost-effectiveness of restricted prescription lengths for the cheaper, mostly generic medications merits an urgent re-examination. [source] | ||||||||||