7 research outputs found
At the coalface and the cutting edge: general practitioners’ accounts of the rewards of engaging with HIV medicine
The interviews we conducted with GPs suggest that an engagement with HIV medicine enables clinicians to develop
strong and long-term relationships with and expertise
about the care needs of people living with HIV ‘at the
coalface’, while also feeling connected with a broader
network of medical practitioners and other professionals
concerned with and contributing to the ever-changing
world of science: ‘the cutting edge’. The general practice
HIV prescriber is being modelled here as the interface between these two worlds, offering a rewarding opportunity
for general practitioners to feel intimately connected to
both community needs and scientific change
Does Aphid Infestation Interfere with Indirect Plant Defense against Lepidopteran Caterpillars in Wild Cabbage?
Evaluation of alternate outreach models for cataract services in rural Nepal
<p>Abstract</p> <p>Background</p> <p>Bharatpur Eye Hospital in Chitwan District, a primarily agrarian setting in south-central Nepal, reduced the number of diagnostic screening and treatment (DST) camps by one half (151 to 75) in an attempt to increase both the efficiency of its outreach program and the number of people that go directly to the hospital for service. The Hospital evaluated the two program models in terms of program costs, cataract surgical utilization, hospital direct payment and patient equity.</p> <p>Methods</p> <p>The study is a prospective, before and after, study of the impact of an alternate outreach model on cataract service utilization patterns and cost per outreach camp and cost per cataract surgery at Bharatpur Eye Hospital, comparing the service years July 2006 to June 2007, with July 2007 to June 2008. Study findings were based on routinely gathered hospital and outreach administrative data.</p> <p>Results</p> <p>The total cost of the DST camps decreased by approximately US52 to 3.80 to $3.20. The number of patients who went directly to the hospital, and paid for cataract surgery, increased from 432 (17%) to 623 (25%). The total number of cataract surgical procedures at Bharatpur Eye Hospital remained very similar between the two service years (2501 and 2449, respectively). The presenting visual acuity and sex of the two cataract surgical populations were very similar (favouring women, 53 and 55% in the two years, respectively). A shift toward younger men and women occurred with a 245 (64%) increase in people age 50-59 years, and shift away from people age 70 years and older with a 236 (22%) reduction. The age and sex distribution of the direct paying patients were very similar in the two years.</p> <p>Conclusion</p> <p>The new, more concentrated, more rural DST model of service delivery reduced overall outreach program costs, cost per cataract surgery transported, while increasing direct payments to the hospital, with a significant decrease in the number of people age 70 and older in the first year.</p