RESUMO
OBJECTIVES: to analyze the mean direct cost and peripheral venous access length outcomes using devices over needle with and without extension. METHODS: quantitative, exploratory-descriptive research. Venous punctures and length of the devices were followed. The mean direct cost was calculated by multiplying the time (timed) spent by nursing professionals by the unit cost of labor, adding to the cost of materials. RESULTS: the total mean direct cost of using devices "with extension" (US$ 9.37) was 2.9 times the cost of using devices "without extension" (US$ 4.50), US$ 7.71 and US$ 2.66, respectively. Totaling 96 hours of stay, the "device over needle with extension" showed a lower occurrence of accidental loss. CONCLUSIONS: the use of the "device over needle with extension", despite its higher mean direct cost, was more effective in favoring adequate length of peripheral venous access.
Assuntos
Cateterismo Periférico/economia , Cateterismo Periférico/normas , Avaliação de Resultados em Cuidados de Saúde/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Cateterismo Periférico/estatística & dados numéricos , Custos e Análise de Custo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas/economia , Agulhas/normas , Agulhas/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricosRESUMO
ABSTRACT Objectives: to analyze the mean direct cost and peripheral venous access length outcomes using devices over needle with and without extension. Methods: quantitative, exploratory-descriptive research. Venous punctures and length of the devices were followed. The mean direct cost was calculated by multiplying the time (timed) spent by nursing professionals by the unit cost of labor, adding to the cost of materials. Results: the total mean direct cost of using devices "with extension" (US$ 9.37) was 2.9 times the cost of using devices "without extension" (US$ 4.50), US$ 7.71 and US$ 2.66, respectively. Totaling 96 hours of stay, the "device over needle with extension" showed a lower occurrence of accidental loss. Conclusions: the use of the "device over needle with extension", despite its higher mean direct cost, was more effective in favoring adequate length of peripheral venous access.
RESUMEN Objetivos: analizar el costo directo promedio y los resultados de permanencia del acceso venoso periférico, utilizando dispositivos de aguja con y sin extensión. Métodos: investigación cuantitativa, exploratoria descriptiva. Se siguieron los pinchazos venosos y el tiempo de permanencia de los dispositivos. El costo directo promedio se calculó multiplicando el tiempo (cronometrado) dedicado por los profesionales de enfermería por el costo unitario de la mano de obra, lo que se suma al costo de los materiales. Resultados: el costo directo promedio total de usar dispositivos "extendidos" (US$ 9,37) fue 2,9 veces el costo de usar dispositivos "no extendidos" (US$ 4,50) de materiales, US$ 7.71 y US$ 2.66, respectivamente. Con un total de 96 horas de estadía, el "dispositivo de aguja extendida" mostró una menor ocurrencia de pérdida accidental. Conclusiones: a pesar del costo directo promedio más alto, el uso de un "dispositivo de aguja extendida" fue más efectivo para favorecer un tiempo de acceso venoso periférico adecuado.
RESUMO Objetivos: analisar o custo direto médio e os desfechos de permanência de acesso venoso periférico, utilizando dispositivos sobre agulha com e sem extensão. Métodos: pesquisa quantitativa, exploratório-descritiva. Acompanharam-se as punções venosas e o tempo de permanência dos dispositivos. Calculou-se o custo direto médio multiplicando-se o tempo (cronometrado) despendido por profissionais de enfermagem pelo custo unitário da mão de obra, somando-se ao custo dos materiais. Resultados: o custo direto médio total do uso de dispositivo "com extensão" (US$ 9,37) foi 2,9 vezes do que o custo do uso de dispositivo "sem extensão" (US$ 4,50), destacando-se os custos dos materiais, US$ 7,71 e US$ 2,66, respectivamente. Totalizando 96 horas de permanência, o "dispositivo sobre agulha com extensão" apresentou menor ocorrência de perda acidental. Conclusões: o uso do "dispositivo sobre agulha com extensão", apesar do maior custo direto médio, foi mais eficaz para favorecer o adequado tempo de permanência do acesso venoso periférico.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cateterismo Periférico/economia , Cateterismo Periférico/normas , Avaliação de Resultados em Cuidados de Saúde/normas , Cateterismo Periférico/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Custos e Análise de Custo , Agulhas/economia , Agulhas/normas , Agulhas/estatística & dados numéricosRESUMO
OBJECTIVE: From 2011 to 2013, the Global Fund (GF) supported needle and syringe programmes in Mexico to prevent transmission of HIV among people who inject drugs. It remains unclear how GF withdrawal affected the costs, quality and coverage of needle and syringe programme provision. DESIGN: Costing study and longitudinal cohort study. SETTING: Tijuana, Mexico. PARTICIPANTS: Personnel from a local needle and syringe programme (n=6) and people who inject drugs (n=734) participating in a longitudinal study. PRIMARY OUTCOME MEASURES: Provision of needle and syringe programme services and cost (per contact and per syringe distributed, in 2017 $USD) during GF support (2012) and after withdrawal (2015/16). An additional outcome included needle and syringe programme utilisation from a concurrent cohort of people who inject drugs during and after GF withdrawal. RESULTS: During the GF period, the needle and syringe programme distributed 55 920 syringes to 932 contacts (60 syringes/contact) across 14 geographical locations. After GF withdrew, the needle and syringe programme distributed 10 700 syringes to 2140 contacts (five syringes/contact) across three geographical locations. During the GF period, the cost per harm reduction contact was approximately 10-fold higher compared with after GF ($44.72 vs $3.81); however, the cost per syringe distributed was nearly equal ($0.75 vs $0.76) due to differences in syringes per contact and reductions in ancillary kit components. The mean log odds of accessing a needle and syringe programme in the post-GF period was significantly lower than during the GF period (p=0.02). CONCLUSIONS: Withdrawal of GF support for needle and syringe programme provision in Mexico was associated with a substantial drop in provision of sterile syringes, geographical coverage and recent clean syringe utilisation among people who inject drugs. Better planning is required to ensure harm reduction programme sustainability is at scale after donor withdrawal.
Assuntos
Programas de Troca de Agulhas/economia , Programas de Troca de Agulhas/estatística & dados numéricos , Agulhas/provisão & distribuição , Abuso de Substâncias por Via Intravenosa/epidemiologia , Seringas/provisão & distribuição , Custos e Análise de Custo , Infecções por HIV/prevenção & controle , Hepatite C/prevenção & controle , Humanos , Estudos Longitudinais , México/epidemiologia , Agulhas/economia , Seringas/economiaRESUMO
Measles, which is still killing about two million children a year in poor countries, was mostly eliminated within two to three months after the conclusion of a special, national mass vaccination campaign in which all children of a selected age group received measles vaccine subcutaneously during a period of days to months, regardless of a history of previous vaccination or measles. This strategy was tested in the Dominican Republic in 1985, in Cuba in 1986-87, and in the State of São Paulo, Brazil May 11-June 10, 1987. Subsequent control was maintained by different procedures in the three states. A simple, rapid indirect immunofluorescent test for IgM measles antibody, used in Greater São Paulo, was more efficient in confirming concurrent infection with measles virus than the hemagglutination inhibition test for IgG antibody, and only one blood specimen taken during the course of the rash was needed to confirm the etiologic diagnosis in 97.5% of 240 cases confirmed by IgM. In Greater São Paulo and Cuba, it was found that over 90% of the small number of suspect measles cases reported during the first year after the mass campaign, were not caused by measles virus. The cost of disposable syringes and needles in the State of São Paulo, where 8,565,230 children were vaccinated in 10,527 centers in 30 days, was U.S. $2,057,753 or 63% of the total. Immunization by aerosol could have vaccinated this number of children more easily and effectively in one day if each of the vaccination centers had been supplied with one plastic foot or hand pressure pump and nebulizer at a cost of only about U.S. $300,000.