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Tomini SM, Massou E, Crellin NE, Fulop NJ, Georghiou T, Herlitz L, Litchfield I, Ng PL, Sherlaw-Johnson C, Sidhu MS, Walton H, Morris S. A Cost Evaluation of COVID-19 Remote Home Monitoring Services in England. PHARMACOECONOMICS - OPEN 2024; 8:739-753. [PMID: 38951349 PMCID: PMC11362405 DOI: 10.1007/s41669-024-00498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/12/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Remote home monitoring services emerged as critical components of health care delivery from NHS England during the COVID-19 pandemic, aiming to provide timely interventions and reduce health care system burden. Two types of service were offered: referral by community health services to home-based care to ensure the right people were admitted to the hospital at the right time (called COVID Oximetry@home, CO@h); and referral by hospital to support patients' transition from hospital to home (called COVID-19 Virtual Ward, CVW). The information collected for the oxygen levels and other symptoms was provided via digital means (technology-enabled) or over the phone (analogue-only submission mode). This study aimed to evaluate the costs of implementing remote home monitoring for COVID-19 patients across 26 sites in England during wave 2 of the pandemic. Understanding the operational and financial implications of these services from the NHS perspective is essential for effective resource allocation and service planning. METHODS We used a bottom-up costing approach at the intervention level to describe the costs of setting up and running the services. Twenty-six implementation sites reported the numbers of patients and staff involved in the service and other resources used. Descriptive statistics and multivariable regression analysis were used to assess cost variations and quantify the relationship between the number of users and costs while adjusting for other service characteristics. RESULTS The mean cost per patient monitored was lower in the CO@h service compared with the CVW service (£527 vs £599). The mean cost per patient was lower for implementation sites using technology-enabled and analogue data submission modes compared with implementation sites using analogue-only modes for both CO@h (£515 vs £561) and CVW (£584 vs £612) services. The number of patients enrolled in the services and the service type significantly affected the mean cost per patient. CONCLUSIONS Our analysis provides a framework for evaluating the costs of similar services in the future and shows that the implementation of these services benefit from the employment of tech-enabled data submission modes.
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Affiliation(s)
- Sonila M Tomini
- Global Business School for Health, University College London, London, UK.
| | - Efthalia Massou
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Nadia E Crellin
- The Nuffield Trust, 59 New Cavendish St, London, W1G 7LP, UK
| | - Naomi J Fulop
- Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK
| | - Theo Georghiou
- The Nuffield Trust, 59 New Cavendish St, London, W1G 7LP, UK
| | - Lauren Herlitz
- NIHR Children and Families Policy Research Unit, Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - Ian Litchfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, 40 Edgbaston Park Rd, Birmingham, B15 2RT, UK
| | - Pei Li Ng
- Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK
| | | | - Manbinder S Sidhu
- Health Services Management Centre, School of Social Policy, University of Birmingham, 40 Edgbaston Park Road, Birmingham, B15 2RT, UK
| | - Holly Walton
- Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK
| | - Stephen Morris
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Abd Malek K, Ariffin F, Taher SW, Abd Aziz NA, Chew BH, Wong PF, Shariff Ghazali S, Abdullah A, Abdul Samad A, Sufian ZA, Han YW, Lai WJ, Selvaraj CS. Knowledge as a Predictor for Preparedness in Managing COVID-19 Among General Practitioners in Malaysia. Cureus 2024; 16:e63147. [PMID: 39055414 PMCID: PMC11272386 DOI: 10.7759/cureus.63147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction The COVID-19 pandemic has changed the working environment for general practitioners (GPs). GPs had to adapt quickly when care mitigation for mild COVID-19 in the community began. We assessed Malaysian GPs' knowledge and preparedness to manage COVID-19. Method A cross-sectional online survey was conducted between May and October 2022 among the GPs. Emails were sent to GPs affiliated with the main GP organizations in Malaysia, such as the Academy of Family Physicians of Malaysia (AFPM). Additionally, participation was sought through social media groups, including the Association of Malaysian Islamic Doctors, the Federation of Private Medical Practitioners' Associations Malaysia, and the Primary Care Network. Data was collected using a self-administered questionnaire on items related to knowledge and preparedness to manage COVID-19. The content was validated by six experts. Multiple logistic regression was used to determine the predictors for preparedness. Results A total of 178 GPs participated in this study. The mean age of the GPs was 41.8 (SD 12.37) years, 54.5% were males, 47.8% had a postgraduate qualification, and 68% had up to 10 years of general practice experience. Their practices are commonly solo (55.1%), located within an urban area (56.2%) and 47.2% operate 7 days a week. A majority of GPs (n = 124, 69.7%) had a good level of knowledge of COVID-19. In contrast, about a third (n = 60, 33.7%) had a good level of preparedness to manage COVID-19. GPs with a good level of knowledge of COVID-19 had 1.96 times the odds of having a good level of preparedness as compared to GPs with lower knowledge (OR = 2.11 (95% CI: 1.06, 4.18, p = 0.03)). Conclusion A good level of knowledge is a predictor for preparedness to manage COVID-19. Relevant and targeted measures to enhance knowledge for better preparedness among the GPs to respond to future pandemics are needed.
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Affiliation(s)
- Khasnur Abd Malek
- Primary Care Medicine Department, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Shah Alam, MYS
| | - Farnaza Ariffin
- Primary Care Medicine Department, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Shah Alam, MYS
| | - Sri Wahyu Taher
- Family Medicine, Klinik Kesihatan Simpang Kuala, Ministry of Health Malaysia, Alor Setar, MYS
| | - Noor Azah Abd Aziz
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Boon-How Chew
- Family Medicine, Faculty of Medicine and Health Sciences, Family Medicine Specialists Clinic, Universiti Putra Malaysia, Serdang, MYS
- Family Medicine, Hospital Sultan Abdul Aziz Shah (HSAAS) Teaching Hospital, Family Medicine Specialists Clinic, Serdang, MYS
| | - Ping Foo Wong
- Family Medicine, Klinik Kesihatan Cheras Baru, Ministry of Health Malaysia, Kuala Lumpur, MYS
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, MYS
| | - Adina Abdullah
- Department of Primary Care, University of Malaya Medical Center, University of Malaya, Petaling Jaya, MYS
| | - Azah Abdul Samad
- Family Medicine, Shah Alam Health Clinic, Ministry of Health Malaysia, Selangor, MYS
| | - Ziti Akthar Sufian
- Family Medicine, Klinik Kesihatan Seri Kembangan, Ministry of Health Malaysia, Selangor, MYS
| | | | - Wei Jie Lai
- Family Medicine, Drs. Tong, Leow, Chiam & Partners, Kuala Lumpur, MYS
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Smith J, Ellins J, Sherlaw-Johnson C, Vindrola-Padros C, Appleby J, Morris S, Sussex J, Fulop NJ. Rapid evaluation of service innovations in health and social care: key considerations. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023; 11:1-47. [PMID: 37796483 DOI: 10.3310/btnu5673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (RSET: 16/138/17; BRACE: 16/138/31).
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Affiliation(s)
- Judith Smith
- Health Services Management Centre, School of Social Policy, University of Birmingham, Edgbaston, Birmingham, UK
| | - Jo Ellins
- Health Services Management Centre, School of Social Policy, University of Birmingham, Edgbaston, Birmingham, UK
| | | | | | | | - Stephen Morris
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jon Sussex
- RAND Europe, Westbrook Centre, Cambridge, UK
| | - Naomi J Fulop
- Department of Applied Health Research, University College London, London, UK
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