This study assesses the unit costs of MAT provision in Georgia from the perspective of the two service providers in-country—the Ministry of Labor, Health, and Social Affairs (MOLHSA) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM). Both MOLHSA and GFATM-funded sites offer MAT in multiple facilities throughout urban and rural Georgia. Treatment protocols and personnel requirements are centrally mandated, thus allowing for little variation per patient characteristics. While service delivery tends to be comparable across MOLHSA and GFATM sites, there is one significant difference—the ministry requires that MAT clients pay for services while GFATM offers free services. The analysis found that a majority of HIV-positive patients are enrolled in the GFATM MAT program.
The study compared average unit costs between two years (2009 and 2010) and found a minimal increase. Unit costs increased only slightly at MOLHSA facilities from 229 GEL ($133 ) per month to 236 GEL ($137) per month. At GFATM sites, the monthly per patient cost of MAT rose slightly between 2009 and 2010 from 217 GEL ($126) to 229 GEL ($133). Further, data analysis revealed that GFATM programs are only slightly less expensive than at MOLHSA facilities. An important caveat—unit cost calculations for the MOLHSA sites include patient contributions that amount to 150 GEL ($87) per month for each patient. In the case of both providers, direct costs of MAT provision far exceed indirect costs. Three inputs—personnel, drugs/medical supplies, and utilities—account for a major portion of costs associated with running MAT programs in Georgia. The most significant budget item in both MOLSHA and GFATM programs is the cost of personnel (salaries of clinical and support staff).
Dr Jennifer Dixon: Competition between providersNuffield Trust
Competition in healthcare provision in England has increased through policies introducing market mechanisms since 2002. While independent sector activity makes up a small percentage of overall NHS care, research finds competition is associated with reduced mortality, especially for heart attacks. Competition may also reduce waiting times. Primary and community care is seeing more competitive tendering, with many contracts awarded to independent providers. Further evidence is still needed on the impacts of competition and potential mergers on quality, costs and regulation of different provider models.
This document discusses compliance with narcotics guidelines for managing prescription drug abuse. It describes how managed care programs, employers, healthcare providers and insurers are susceptible to increased workers' compensation costs due to prescription drug abuse. It identifies strategies to help drug-dependent employees return to work, and describes how Washington State has addressed overuse of opioids in workers' compensation through dosing guidelines and a prescription drug monitoring program. The agenda includes discussing the problem of prescription drug abuse, efforts to prevent problems, and the cost of addiction.
This is a presentation of the results of the Global Programme to Enhance reproductive Health Commodity Security (GPRHCS), coordinated by the Commodity Security Branch (CSB) of the United Nations Population Fund (UNFPA)
The document discusses the issue of prescription drug abuse in the United States. It provides statistics showing the dramatic rise in prescription opioids dispensed between 2000-2009, as well as related increases in overdose deaths, emergency department visits, and deaths exceeding other causes like firearms or car accidents. The White House Office of National Drug Control Policy has developed a Prescription Drug Abuse Prevention Plan with four key areas of focus: education for healthcare providers, improving prescription drug monitoring programs, secure medication disposal, and enforcement efforts. The goal is a coordinated federal response to address this public health crisis.
Improving Patient Safety Outcomes: Impact of Bar-code Technologyhospira2010
This document summarizes research on the impact of bar-code medication administration (BCMA) technology in reducing medication errors. Studies show BCMA reduced dispensing errors by 36-63% and potential adverse drug events by 63%. BCMA also reduced medication administration errors in intensive care units by 19.7% to 8.7%. While BCMA's impact varied between ICUs and general wards, it reduced clinically important error types. 9% of intercepted errors using BCMA were considered moderate or severe risks. BCMA has potential to reduce errors but continued improvements are still needed given medication errors can still occur.
United Kingdom Diagnostic Imaging Market Outlook to 2018 - Ultrasound Systems...ReportsnReports
This report provides an in-depth analysis of the diagnostic imaging market in the United Kingdom from 2004-2018. It examines market revenue, volume, and average prices across 10 categories, including ultrasound systems, MRI systems, CT systems, x-ray systems, and more. The 259-page report was published in October 2012 and offers a single user license for $2,500. It draws on proprietary databases and primary/secondary research to provide insights into market size, company shares, segmentation, and profiles of key players in the UK diagnostic imaging space.
A brief picture of gonorrhoea in New Zealandtepuawaitapu
The document discusses gonorrhea trends in New Zealand. It finds that gonorrhea rates peaked in the 1970s and again in 2006. The estimated national rate has remained stable at around 67 per 100,000 people from 2008 to 2011. High-risk groups include those aged 15-24, Māori, Pacific people, and men who have sex with men. Some district health boards like Tairawhiti have rates five times the national average. Testing rates are not matching incidence rates in some areas.
Education Track, National Rx Drug Abuse Summit, April 2-4, 2013. Trends in Rx Drug Abuse presentation by Dr. Andrew Kolodny, Tess Benham and Sherry Green
Dr Jennifer Dixon: Competition between providersNuffield Trust
Competition in healthcare provision in England has increased through policies introducing market mechanisms since 2002. While independent sector activity makes up a small percentage of overall NHS care, research finds competition is associated with reduced mortality, especially for heart attacks. Competition may also reduce waiting times. Primary and community care is seeing more competitive tendering, with many contracts awarded to independent providers. Further evidence is still needed on the impacts of competition and potential mergers on quality, costs and regulation of different provider models.
This document discusses compliance with narcotics guidelines for managing prescription drug abuse. It describes how managed care programs, employers, healthcare providers and insurers are susceptible to increased workers' compensation costs due to prescription drug abuse. It identifies strategies to help drug-dependent employees return to work, and describes how Washington State has addressed overuse of opioids in workers' compensation through dosing guidelines and a prescription drug monitoring program. The agenda includes discussing the problem of prescription drug abuse, efforts to prevent problems, and the cost of addiction.
This is a presentation of the results of the Global Programme to Enhance reproductive Health Commodity Security (GPRHCS), coordinated by the Commodity Security Branch (CSB) of the United Nations Population Fund (UNFPA)
The document discusses the issue of prescription drug abuse in the United States. It provides statistics showing the dramatic rise in prescription opioids dispensed between 2000-2009, as well as related increases in overdose deaths, emergency department visits, and deaths exceeding other causes like firearms or car accidents. The White House Office of National Drug Control Policy has developed a Prescription Drug Abuse Prevention Plan with four key areas of focus: education for healthcare providers, improving prescription drug monitoring programs, secure medication disposal, and enforcement efforts. The goal is a coordinated federal response to address this public health crisis.
Improving Patient Safety Outcomes: Impact of Bar-code Technologyhospira2010
This document summarizes research on the impact of bar-code medication administration (BCMA) technology in reducing medication errors. Studies show BCMA reduced dispensing errors by 36-63% and potential adverse drug events by 63%. BCMA also reduced medication administration errors in intensive care units by 19.7% to 8.7%. While BCMA's impact varied between ICUs and general wards, it reduced clinically important error types. 9% of intercepted errors using BCMA were considered moderate or severe risks. BCMA has potential to reduce errors but continued improvements are still needed given medication errors can still occur.
United Kingdom Diagnostic Imaging Market Outlook to 2018 - Ultrasound Systems...ReportsnReports
This report provides an in-depth analysis of the diagnostic imaging market in the United Kingdom from 2004-2018. It examines market revenue, volume, and average prices across 10 categories, including ultrasound systems, MRI systems, CT systems, x-ray systems, and more. The 259-page report was published in October 2012 and offers a single user license for $2,500. It draws on proprietary databases and primary/secondary research to provide insights into market size, company shares, segmentation, and profiles of key players in the UK diagnostic imaging space.
A brief picture of gonorrhoea in New Zealandtepuawaitapu
The document discusses gonorrhea trends in New Zealand. It finds that gonorrhea rates peaked in the 1970s and again in 2006. The estimated national rate has remained stable at around 67 per 100,000 people from 2008 to 2011. High-risk groups include those aged 15-24, Māori, Pacific people, and men who have sex with men. Some district health boards like Tairawhiti have rates five times the national average. Testing rates are not matching incidence rates in some areas.
Education Track, National Rx Drug Abuse Summit, April 2-4, 2013. Trends in Rx Drug Abuse presentation by Dr. Andrew Kolodny, Tess Benham and Sherry Green
GE reported preliminary results for its first quarter of 2009. The global economic downturn continued, but GE is navigating through the recession by aggressively cutting costs, driving orders where possible, and maintaining a solid industrial cash flow. Earnings were consistent with previous guidance, with the infrastructure and media businesses flat and the Capital Finance segment reporting a profit of $1.1 billion. GE remains focused on running the company for the long term through investing in growth areas.
Nestlé India Limited's 2014 Annual Report provides information on the company's performance and activities over the past year. It discusses several key areas:
- Awards and recognitions received by various Nestlé brands in 2014 for marketing campaigns and high brand trust.
- Interviews with the Managing Director and various business unit heads where they discuss Nestlé's strategic focus on nutrition, health and wellness, and initiatives taken to promote these areas.
- Performance updates of various product categories like prepared dishes, dairy, confectionery, coffee, and nutrition initiatives, along with the company's focus on rural development, water conservation, and nutrition.
- Corporate governance details like the board of directors, annual general meeting
The Internet of Things - Industry Trends and Key PlayersCM Research
This document provides an overview of the Internet of Things (IoT) as an investment theme. It defines the IoT as connecting physical objects to the internet to collect and analyze data. It estimates the IoT market will grow significantly by 2020 and outlines the value chain and key players in device, connectivity, data and control layers. The document also reviews standards bodies competing to dominate IoT communications and provides investment themes for 2015 related to social, cloud, mobile, big data, ecosystems and more.
This document provides instructions for creating a business letter with a letterhead and table in Microsoft Word 2010. It outlines objectives like changing margins, inserting and formatting shapes and images, adding borders and symbols, and inserting tables. The document then provides step-by-step instructions for completing each objective, such as how to change margins using the Margins gallery, insert a shape and apply styles, add text wrapping to objects, and insert a table and enter data.
TheEquicom Research is an ISO certified and leading financial advisory firm which provide most accurate tips and recommendation. We provide equity tips with more than 90 % accuracy. Theequicom Research also provides tips for stock cash, bullion, stock future, nifty future, agri and option.
GeniusCon is a virtual conference that connects geniuses of all ages and backgrounds from around the world. The conference highlights the problems students saw at their schools, how they tried to change issues, and how they felt about their solutions. It thanks students for using their ideas and voices to help improve schools.
TheEquicom Research is an ISO certified and leading financial advisory firm which provide most accurate tips and recommendation. We provide equity tips with more than 90 % accuracy. Theequicom Research also provides tips for stock cash, bullion, stock future, nifty future, agri and option.
- The Sensex and Nifty indices fell by 0.71% and 0.72% respectively in Indian equity markets, in line with declines in major European indices.
- Key Indian stocks like PNB and HUL fell sharply, pulling the indices lower, while sectors like banking and metals also declined.
- Trading activity figures show FIIs were net sellers in the Indian markets for the day, while DIIs were net buyers.
Theequicom Research published most accurate analysis report for equity market. We also provide sure shot calls and advice in various segments such as equity tips, commodity tips and nifty future tips.
- The Indian equity markets closed with modest gains, as the Sensex ended up 0.16% and the Nifty gained 0.17%. European markets closed lower while US markets rose.
- Among sectoral indices, the CNX IT index saw the largest gain of 1.24%, while the Bank Nifty had the largest fall of 0.38%. Infosys and Larsen & Toubro contributed most to lifting the indices, while NTPC and SBI contributed most to dragging them lower.
- The technical outlook was for the indices to consolidate in a narrow range, with resistance at 5660-5700 for Nifty and 11540-11660 for Bank Nifty, and support at 5590
- The Sensex closed up 0.21% and the Nifty closed up 0.20% while European markets closed up between 0.49-1.34%.
- Key gainers in the Nifty were Hindalco, Siemens, Cipla and BHEL while top losers were Maruti Suzuki, Infosys, Sesa Goa and Power Grid Corporation.
- Most sectoral indices closed flat to higher with Bank Nifty up 0.47% and IT down 0.75%.
- The key Indian stock indices, Sensex and Nifty, closed up slightly, rising 0.22% and 0.31% respectively, while major European indices were also up modestly.
- Reliance Industries and ICICI Bank led gains in India on hopes of reforms and interest rate cuts, while the rupee fell to a low of 54.96 against the dollar.
- In sector news, banking, capital goods and infrastructure stocks performed well, while IT and pharma saw declines.
Theequicom Research is a leading and ISO certified financial advisory firm which provide tips and recommendation for various segments such as stock and commodity.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise stimulates the production of endorphins in the brain which elevate mood and reduce stress levels.
The Indian stock market closed higher, with the Sensex gaining 0.31% and the Nifty gaining 0.30%. Several major European markets also closed higher. In India, Reliance Industries and ITC posted better-than-expected earnings, boosting investor optimism about corporate profits. Key sectoral indices like banking, IT and metal also ended higher on the day.
An outlook on indian realty sector;Indian Reality Sector;By TheEquicomTheEquicom Advisory
This document provides an overview of the Indian real estate sector in 2012. It discusses the major sectors within real estate like commercial, residential, retail, hospitality, and special economic zones. It outlines the growth drivers and market structures for each sector. It also examines demands in major Indian cities and the impact of foreign direct investment. The document discusses major players in real estate, investment opportunities, and recent policy updates. It concludes that while 2012 saw slower growth, the long term outlook for the Indian real estate sector remains positive due to strong economic growth and urbanization trends.
- The Sensex closed down 0.09% while the Nifty closed down 0.06% as the Indian markets ended flat on negative cues from global markets.
- HCL Tech and TCS were among the top losers in the market, falling over 1% and 0.9% respectively.
- Banking stocks such as PNB and DLF saw gains while IT and FMCG sectors declined on the day.
- The Sensex dropped 1.1% and the Nifty dropped 1.19% as Asian markets also declined while European markets rose slightly.
- The RBI kept policy rates unchanged and lowered GDP forecasts, causing the market to plummet over 1% and the rupee to fall to a new low.
- Top gainers were Maruti Suzuki, Dr Reddy's Lab, IDFC, and Infosys. Top losers were Bank of Baroda, SBI, JP Associates, and Tata Motors.
- Most sectoral indices closed down over 1% except the IT sector index which rose 0.56%.
O documento apresenta os resultados de jogos realizados em 05 de junho de 2013 em Apuiarés, Ceará, em modalidades como futebol, handebol, basquete, voleibol e futsal masculino e feminino. Também lista os três primeiros colocados de uma competição de ciclismo masculino.
Universal access to art policy in place 5 july11Zahed Islam
Regional Workshop on Drug Use and HIV in Eastern Europe and Central Asia was held in Kyiv, Ukraine from July 11-15, 2011 by PEPFAR. Ukraine has over 180,000 registered HIV cases but only around 22,000 receive antiretroviral therapy (ART), and less than 1% of those are active injection drug users. New HIV laws in Ukraine passed in 1991, 1998, and 2001 guarantee certain rights for people who inject drugs including access to harm reduction services, but policies have not been fully implemented and emerging policies threaten access to services for people who inject drugs. Ensuring equal access to prevention, treatment and care services for all populations remains a challenge.
This document summarizes an evaluation of Minnesota's Community Application Agent program, which provides payments to organizations for enrolling individuals in health programs. Key findings include: 1) A small group of health organizations submit the majority of applications. 2) Most successful applicants enroll in Medical Assistance. 3) There are long waits of over 15 weeks for organizations to receive bonus payments. The evaluation suggests engaging more community groups may require higher investments and support, and outreach in rural areas poses unique challenges.
GE reported preliminary results for its first quarter of 2009. The global economic downturn continued, but GE is navigating through the recession by aggressively cutting costs, driving orders where possible, and maintaining a solid industrial cash flow. Earnings were consistent with previous guidance, with the infrastructure and media businesses flat and the Capital Finance segment reporting a profit of $1.1 billion. GE remains focused on running the company for the long term through investing in growth areas.
Nestlé India Limited's 2014 Annual Report provides information on the company's performance and activities over the past year. It discusses several key areas:
- Awards and recognitions received by various Nestlé brands in 2014 for marketing campaigns and high brand trust.
- Interviews with the Managing Director and various business unit heads where they discuss Nestlé's strategic focus on nutrition, health and wellness, and initiatives taken to promote these areas.
- Performance updates of various product categories like prepared dishes, dairy, confectionery, coffee, and nutrition initiatives, along with the company's focus on rural development, water conservation, and nutrition.
- Corporate governance details like the board of directors, annual general meeting
The Internet of Things - Industry Trends and Key PlayersCM Research
This document provides an overview of the Internet of Things (IoT) as an investment theme. It defines the IoT as connecting physical objects to the internet to collect and analyze data. It estimates the IoT market will grow significantly by 2020 and outlines the value chain and key players in device, connectivity, data and control layers. The document also reviews standards bodies competing to dominate IoT communications and provides investment themes for 2015 related to social, cloud, mobile, big data, ecosystems and more.
This document provides instructions for creating a business letter with a letterhead and table in Microsoft Word 2010. It outlines objectives like changing margins, inserting and formatting shapes and images, adding borders and symbols, and inserting tables. The document then provides step-by-step instructions for completing each objective, such as how to change margins using the Margins gallery, insert a shape and apply styles, add text wrapping to objects, and insert a table and enter data.
TheEquicom Research is an ISO certified and leading financial advisory firm which provide most accurate tips and recommendation. We provide equity tips with more than 90 % accuracy. Theequicom Research also provides tips for stock cash, bullion, stock future, nifty future, agri and option.
GeniusCon is a virtual conference that connects geniuses of all ages and backgrounds from around the world. The conference highlights the problems students saw at their schools, how they tried to change issues, and how they felt about their solutions. It thanks students for using their ideas and voices to help improve schools.
TheEquicom Research is an ISO certified and leading financial advisory firm which provide most accurate tips and recommendation. We provide equity tips with more than 90 % accuracy. Theequicom Research also provides tips for stock cash, bullion, stock future, nifty future, agri and option.
- The Sensex and Nifty indices fell by 0.71% and 0.72% respectively in Indian equity markets, in line with declines in major European indices.
- Key Indian stocks like PNB and HUL fell sharply, pulling the indices lower, while sectors like banking and metals also declined.
- Trading activity figures show FIIs were net sellers in the Indian markets for the day, while DIIs were net buyers.
Theequicom Research published most accurate analysis report for equity market. We also provide sure shot calls and advice in various segments such as equity tips, commodity tips and nifty future tips.
- The Indian equity markets closed with modest gains, as the Sensex ended up 0.16% and the Nifty gained 0.17%. European markets closed lower while US markets rose.
- Among sectoral indices, the CNX IT index saw the largest gain of 1.24%, while the Bank Nifty had the largest fall of 0.38%. Infosys and Larsen & Toubro contributed most to lifting the indices, while NTPC and SBI contributed most to dragging them lower.
- The technical outlook was for the indices to consolidate in a narrow range, with resistance at 5660-5700 for Nifty and 11540-11660 for Bank Nifty, and support at 5590
- The Sensex closed up 0.21% and the Nifty closed up 0.20% while European markets closed up between 0.49-1.34%.
- Key gainers in the Nifty were Hindalco, Siemens, Cipla and BHEL while top losers were Maruti Suzuki, Infosys, Sesa Goa and Power Grid Corporation.
- Most sectoral indices closed flat to higher with Bank Nifty up 0.47% and IT down 0.75%.
- The key Indian stock indices, Sensex and Nifty, closed up slightly, rising 0.22% and 0.31% respectively, while major European indices were also up modestly.
- Reliance Industries and ICICI Bank led gains in India on hopes of reforms and interest rate cuts, while the rupee fell to a low of 54.96 against the dollar.
- In sector news, banking, capital goods and infrastructure stocks performed well, while IT and pharma saw declines.
Theequicom Research is a leading and ISO certified financial advisory firm which provide tips and recommendation for various segments such as stock and commodity.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise stimulates the production of endorphins in the brain which elevate mood and reduce stress levels.
The Indian stock market closed higher, with the Sensex gaining 0.31% and the Nifty gaining 0.30%. Several major European markets also closed higher. In India, Reliance Industries and ITC posted better-than-expected earnings, boosting investor optimism about corporate profits. Key sectoral indices like banking, IT and metal also ended higher on the day.
An outlook on indian realty sector;Indian Reality Sector;By TheEquicomTheEquicom Advisory
This document provides an overview of the Indian real estate sector in 2012. It discusses the major sectors within real estate like commercial, residential, retail, hospitality, and special economic zones. It outlines the growth drivers and market structures for each sector. It also examines demands in major Indian cities and the impact of foreign direct investment. The document discusses major players in real estate, investment opportunities, and recent policy updates. It concludes that while 2012 saw slower growth, the long term outlook for the Indian real estate sector remains positive due to strong economic growth and urbanization trends.
- The Sensex closed down 0.09% while the Nifty closed down 0.06% as the Indian markets ended flat on negative cues from global markets.
- HCL Tech and TCS were among the top losers in the market, falling over 1% and 0.9% respectively.
- Banking stocks such as PNB and DLF saw gains while IT and FMCG sectors declined on the day.
- The Sensex dropped 1.1% and the Nifty dropped 1.19% as Asian markets also declined while European markets rose slightly.
- The RBI kept policy rates unchanged and lowered GDP forecasts, causing the market to plummet over 1% and the rupee to fall to a new low.
- Top gainers were Maruti Suzuki, Dr Reddy's Lab, IDFC, and Infosys. Top losers were Bank of Baroda, SBI, JP Associates, and Tata Motors.
- Most sectoral indices closed down over 1% except the IT sector index which rose 0.56%.
O documento apresenta os resultados de jogos realizados em 05 de junho de 2013 em Apuiarés, Ceará, em modalidades como futebol, handebol, basquete, voleibol e futsal masculino e feminino. Também lista os três primeiros colocados de uma competição de ciclismo masculino.
Universal access to art policy in place 5 july11Zahed Islam
Regional Workshop on Drug Use and HIV in Eastern Europe and Central Asia was held in Kyiv, Ukraine from July 11-15, 2011 by PEPFAR. Ukraine has over 180,000 registered HIV cases but only around 22,000 receive antiretroviral therapy (ART), and less than 1% of those are active injection drug users. New HIV laws in Ukraine passed in 1991, 1998, and 2001 guarantee certain rights for people who inject drugs including access to harm reduction services, but policies have not been fully implemented and emerging policies threaten access to services for people who inject drugs. Ensuring equal access to prevention, treatment and care services for all populations remains a challenge.
This document summarizes an evaluation of Minnesota's Community Application Agent program, which provides payments to organizations for enrolling individuals in health programs. Key findings include: 1) A small group of health organizations submit the majority of applications. 2) Most successful applicants enroll in Medical Assistance. 3) There are long waits of over 15 weeks for organizations to receive bonus payments. The evaluation suggests engaging more community groups may require higher investments and support, and outreach in rural areas poses unique challenges.
This document summarizes research on the influence of global health initiatives (GHIs) on Mozambique's public health system. It finds that while GHIs increased services for HIV, malaria, and TB, they also negatively impacted health worker performance and retention by making partner organizations more attractive. GHIs placed additional stress on weak financial and monitoring systems without sufficiently strengthening the overall health system. The document concludes that health outcomes could be improved if GHIs targeted strengthening the entire health system in a coherent manner rather than specific disease programs.
GHIs operating in Mozambique include the Global Fund, PEPFAR, President's Malaria Initiative, and others focused on specific diseases. While GHIs have increased funding and scale-up of targeted health services, their vertical nature has stressed harmonization efforts and negatively impacted health workers. Overall, GHIs could have achieved better health outcomes by jointly strengthening the overall health system in a more coherent manner.
Tanzania has made progress in integrating HIV and sexual and reproductive health services. The country developed a National Road Map Strategy in 2008 to accelerate reductions in maternal, newborn, and child deaths by integrating RH and HIV policies, programs, and services. Initial integration focused on family planning services integrated into PMTCT, VCT, and CTC. Research has informed integration efforts and the development of national guidelines. Challenges remain in fully scaling up integrated services due to funding and human resource shortages. Future directions include adopting research findings, scaling up integrated models nationwide, and expanding community-based services. The goal is improved access and quality of HIV and maternal and child health services through greater coordination.
Thailand has made progress toward developing its national eHealth system but still faces challenges. The country has high adoption of health IT by providers but fragmented systems. Experts recommend prioritizing eHealth foundations like governance, standards, and privacy laws. In response, Thailand established a National Health Information Committee and is developing standards. Moving forward, partnerships, research, and capacity building will help Thailand achieve interoperable health information exchange.
Caribbean HIV Conference. AIDS Spending PresentationAndy Fearon
The document discusses HIV expenditure tracking in the Caribbean region. It presents data on HIV spending trends in Trinidad and Tobago from 2002-2009, showing increases in total spending over time but uneven allocation to prevention versus treatment. Expenditure targeting key populations like MSM and sex workers was relatively low. Regional data on four countries is also presented, showing variations in HIV spending as a share of GDP and per capita across countries from 2008-2010.
Technology enabled behavior changes for diabetic patientsJames Rose
Technology enabled behavioral changes can improve care for diabetic patients. A patient engagement system uses algorithms to analyze patient data like A1C and lipid levels, then sends alerts and reminders to both patients and providers. This increases recommended testing compliance up to 74% and supports best practices. Studies show such systems can reduce hospital admissions, ER visits, and overall costs while improving population health metrics. Engaging patients and providers in the care process through technology results in better financial, operational and health outcomes for medical groups.
The document provides an overview of the BC PharmaCare program, which is the public drug insurance program in British Columbia. It details the program's budget, beneficiaries served, and expenditures by plan type. It also discusses trends showing increasing drug costs and examines challenges around controlling expenditures. The new Assistant Deputy Minister expresses interest in initiatives around generic drug pricing, formulary management, high-cost drugs, drug shortages, supply chain complexity, integration of drug use into primary care, and ensuring affordability, sustainability, accessibility and accountability of the program.
AACO's Annual Client Services Unit, Housing, and Quality Management PresentationOffice of HIV Planning
The document summarizes activities of the Philadelphia Department of Public Health's AIDS Activities Coordinating Office (AACO). It discusses the Client Services Unit (CSU) which provides intake, case management, and housing services. It also reviews quality management activities including monitoring performance measures for outpatient medical care and medical case management. The AACO tracks over 25 measures for both areas and provides bi-monthly feedback to improve client outcomes.
Information in the new world: Can we make cancer data count?MHP Communications
The document discusses how cancer data and information can be better utilized. It argues that both a supply side information revolution to improve data collection and quality, as well as a demand side revolution to increase use of data by commissioners, providers, and patients is needed. Examples are given of how data could help commissioners prioritize issues, providers target quality improvements, and patients make informed healthcare choices. Overall, the document advocates that while progress has been made in collecting cancer data, more must be done to translate that intelligence into actions that improve outcomes.
Assessing Linkage to Care by Linking Prescription Filling Records from an AID...CDC NPIN
1) The study assessed how well the Washington DC AIDS Drug Assistance Program (ADAP) identified clients in need of antiretroviral therapy and the rate at which they started therapy by linking ADAP prescription records to HIV laboratory results.
2) In 2010, 214 ADAP clients were identified as "at risk" based on CD4 counts <350 cells/mm3 or viral loads >1,000 copies/ml while not on antiretroviral therapy through ADAP.
3) Of the 604 total "at risk" clients identified between 2007-2010, 301 (50%) started antiretroviral therapy through ADAP, with a median time to starting therapy of 10 days.
Annual State of Clinical Development CostsTTC, llc
The document summarizes key findings from a survey and presentation on annual clinical development costs. It discusses how:
1) Drug development costs are increasing while productivity is declining, putting pressure on the traditional development model.
2) Cost management strategies being used by companies include greater use of CROs, new geographic sites, and standard of care payments to reduce sponsor costs while increasing site payments.
3) Survey findings show CRO costs have risen significantly in recent years and continue to increase, while costs are lower in new geographic sites like Eastern Europe, Asia, and Latin America.
Experiences from State Health System Development Project.pptsuvadeepde
This document summarizes key indicators and experiences from a state health system development project in West Bengal, India. It shows that the project led to significant improvements in hospital utilization rates, access for poor patients, availability of diagnostic services, and patient satisfaction levels over the period from 1997 to 2003. Some challenges remain around ensuring continued funding for recurrent costs, strengthening primary healthcare, improving staff motivation, and managing private sector quality. Overall, the project demonstrates that targeted investments in infrastructure combined with system interventions can substantially improve public healthcare efficiency and outcomes, especially for underserved groups.
Factors Associated with ART Non-adherence in Rural Achham, Nepal Bibhusan Basnet
This study evaluated factors associated with non-adherence to antiretroviral therapy (ART) among 105 HIV patients in rural Nepal. The results showed an 85.7% adherence rate based on patient reporting. Key factors associated with non-adherence included family obligations from field work (p<0.0001), long travel times to clinics (p=0.0219), depressed mood (p=0.0112), and socio-cultural stigma (p=0.006). Overall, patients had low rates of medication side effects and opportunistic infections, and high family support for HIV status. The study identifies challenges with ART access and adherence in remote rural settings.
The Economics of Health Reform: Implications for Health ProfessionalsSage Growth Partners
Context and discussion regarding the problems, implications and solutions to health care reform with a contrarian point twist. Includes discussion of The Patient Protection and Affordable Care Act, economic data, insurance data, H.R. 3590, H.R. 4872, a history of health reform. Finally, the presentation outlines the implications for business, physicians and the health care system.
1) The document analyzes tuberculosis treatment outcomes in Dharwad district, India from 2010-2011 based on records from the Revised National Tuberculosis Control Program (RNTCP).
2) It finds that while case detection has increased, sputum conversion and cure rates remain below targets, ranging from 85-88% versus the goal of over 90%.
3) Cure rates varied between tuberculosis units within the district, with Kalghatgi achieving the highest and Kundgol the lowest.
4) Overall the district's cure rate was lower than the state and national averages, indicating room for improvement in tuberculosis management and control.
Collaboration Between Health Departments PresentationCDC NPIN
This document discusses the collaboration between the LA Gay & Lesbian Center (LAGLC) and the Los Angeles County Sexually Transmitted Disease Program (STDP) over 35 years. Their collaboration has led to integrated STD/HIV testing, data sharing, and several successful collaborative projects. These projects include pooled nucleic acid amplification testing for acute HIV, patient-collected rectal swabs for screening, and a community-embedded disease intervention specialist program for partner notification. The partnership has improved epidemiological monitoring, increased screening, and enhanced partner notification outcomes.
Beyond Scaling Up: Working with patent medicine vendors in NigeriaIDS
This presentation was given at the 'Beyond Scaling Up: Pathways to Universal Access' workshop which was held at the Institute of Development Studies, Brighton on the 24-25 May, 2010. This event was co-sponsored by the Future Health Systems Research Programme Consortium and the STEPS Centre. Oladepo presented on work with patent medicine vendors of malaria drugs in Nigeria.
Similar to Assessing the Costs of Medication-Assisted Treatment for HIV Prevention in Georgia (20)
Cost-benefit analysis of Medication Assisted Treatment and Needle-Syringe Pro...Irma Kirtadze M.D.
This document summarizes a cost-benefit analysis of harm reduction interventions for people who inject drugs in Georgia. It analyzes 3 scenarios: increasing needle-syringe program (NSP) coverage to 40% of people who inject drugs; increasing both NSP to 40% and medication-assisted treatment (MAT) to 20%; and further increasing HIV treatment coverage to 90%. The results found that scenario 2 of increasing only NSP had the highest net present value over 20 years. Scenario 3 of also increasing MAT had a negative net present value, finding MAT to be less cost-effective. The analysis provides implications for harm reduction policy and financing in Georgia.
NATIONAL SURVEY ON SUBSTANCE USE IN THE GENERAL POPULATION IN GEORGIA 2015Irma Kirtadze M.D.
This presentation was produced by Addiction Research Center Alternative Georgia for the Addiction Research Development in Georgia Project funded by United States Agency for International Development (USAID) and Czech Development Agency (CzDA).
ოპიოიდებით და სტიმულატორებით გამოწვეული ზედოზირების ნიშნებიIrma Kirtadze M.D.
მოცემული პრეზენტაცია განკუთვნილია ზიანის შემცირების დარგში მომუშავე სოციალური მუსაკებსითვის, თანასწორგანმანათლებელთა სწავლებსითვის. მოიცავს ოპიოიდებით და სტიმულატორებით განპირობებული ზედოზირების შემთხვევებისთვის დამახასიათებელ ნიშნებს.
მოცემული პრეზენტაცია განკუთვნილია ზიანის შემცირების დარგში მომუშავე სოციალური მუშაკებისა და თანსწორგანმანათლებელთა სწავლებისთვის, თუ როგორ უნდა გადაარჩინონ სიცოცხლე ექიმის მოსვლამდე.
Comprehensive Women‐Centered Treatment for Substance Use in Georgia (country)...Irma Kirtadze M.D.
1) The study compared a comprehensive women-centered substance use intervention (RBT+WC) to usual care (UC) for 128 women in Georgia who injected drugs. RBT+WC consisted of 12 sessions addressing substance use, HIV risk, and health issues while UC provided information booklets and case management.
2) Participants in RBT+WC showed significant declines in self-reported use of stimulants, opioids, and alcohol from baseline to post-treatment and 3-month follow-up compared to UC. Sharing of injection equipment was rare.
3) RBT+WC represents a promising intervention for reducing drug use and HIV risk among substance-using women in Georgia.
საველე სოციალური მუშაობა ნარკოტიკების ინექციურ მომხმარებლებთან (აუთრიჩი)Irma Kirtadze M.D.
მოცემული პრეზენტაცია მოწოდებულია ნარკოიტკების ინექციურ მომხმარებლებთან მომუშავე პრესონალისთვის. მოიცავს საველე მუშაობის ე.წ. აუთრიჩის პრინციპებს, სახეებს, საქართველოში დანერგილ მიდგომებს.
სარისკო ქცევა, რისკის შეფასება დაქცევის ცვლილების ეტაპებიIrma Kirtadze M.D.
მოცემული პრეზენტაცია განკუთვნილია სარისკო ქცევის მქონე სუბ-პოპულაციებთან (ნარკოტიკების ინექციურ მომხმარებელი) მომუშავე პერსონალისთვის. მოიცავს სარისკო ქცევის განმარტებას, სხვადასხვა რისკის მიმოხილვას, ასევე რა არის საჭირო დარგში მომუშავე სპეციალისტისთვის იცოდეს ბენეფიციარისგან.
Drug use patterns among participants in a woman-focused RCT in GeorgiaIrma Kirtadze M.D.
The purpose of this poster presentation is to depict preliminary results from small-scale RCT IMEDI study and show the drug use patterns among women who use illicit substance and the rate of HIV infection.
Stigma, violence, and the lack of confidentiality: The need for comprehensi...Irma Kirtadze M.D.
Women who use drugs in Georgia face significant stigma and lack access to confidential and women-centered treatment services. Through interviews with 55 women, the study found high levels of physical, sexual, and emotional violence. Societal stigma prevents women from seeking help for substance use issues or health problems. The few existing services do not ensure privacy or have separate facilities for women. There is a need for empowering and skills-based treatment that addresses the trauma and unique needs of women to help them overcome stigma and regain independence.
Risk and stigma in seeking care and policy implicationsIrma Kirtadze M.D.
This document summarizes a study on risk, stigma, and policy implications related to seeking care among drug-using women in Georgia. Qualitative interviews found that drug-using women face high stigma due to conservative social norms and their drug use. They have low self-esteem and experience stigma both for their drug use and potential HIV status. There are also few women-focused treatment services and providers sometimes have hostile attitudes. This creates major barriers to women seeking and receiving care. The study concludes there is a need for more comprehensive, confidential, and non-judgmental women-centered treatment services, as well as efforts to empower women to reduce these risks and barriers.
Understanding changing patterns of drug use in georgiaIrma Kirtadze M.D.
This document summarizes a presentation given in Piza, Italy on understanding changing patterns of drug use in Georgia and their implications. It provides background information on Georgia including drug use statistics showing a shift from traditional opioids to homemade stimulants and opioids. It describes features of Georgia's drug scene, how trends are shaped by socioeconomic factors, and associated health harms like HIV. The response has been inadequate treatment and disproportionate spending on enforcement versus healthcare. Major policy reforms are needed including developing a national drug strategy with healthcare professional engagement.
A formative study of drug-using women in Georgia: Setting the Stage for an RCTIrma Kirtadze M.D.
The study is assessing of development of an efficacious comprehensive women-centered drug treatment model. Thus, the proposed study will proceed by meeting four sequential aims.
Aim 1. Explore drug use (e.g., types and patterns), HIV and HCV injection and sexual risk behaviors, comorbid conditions (e.g., interpersonal violence, comorbid psychiatric disorders), and treatment barriers and experiences (e.g., gender discrimination) among IDU Georgian women.
Aim 2. Identify from treatment providers their practices and perceptions regarding IDU women in the current Georgian drug treatment system.
Aim 3. Adapt and pretest both a drug abuse treatment approach of Reinforcement-Based Treatment (RBT) that integrates the evidence-based Women’s Co-Op HIV prevention, and a case management approach for IDU Georgian women.
Aim 4. In a small-scale randomized trial, determine the feasibility and initial efficacy of our Georgian RBT model relative to a case management model in terms of their respective impacts on the frequency of unprotected sexual acts and syringe sharing at post-treatment and 3-month post-treatment follow-up.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central19various
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
3. Background
● One of the first countries to adopt
Christianity, in the early 4th century, remains
strongly Georgian Orthodox
● From 1921 to 1991, the Georgian Soviet
Socialist Republic was one of the 15 soviet
republics of the USSR
● Suffered from civil war and economic crisis
during the 1990s
● Rose Revolution of 2003, at which time the
new government introduced democratic and
economic reforms
● It covers a territory of 69,700 square
kilometers
● Its current population is almost 4.5 million
3
4. Study Goal
Evaluate costs of MAT programs
in Georgia to improve budgeting
and planning related to MAT
programs
4
5. Study Objectives
• Estimate unit costs of MAT
provision for one patient (per
month)
• Optimize current capacity to
include more PWIDs
5
6. Background
MSM MTCT Other
3% 2% 2%
• PWID population
approximately 40,000
• Estimated number of
HIV+ people in
Georgia - 4000 PWID
Hetero- 56%
• Injecting drug use sexual
identified as primary 37%
cause of transmission
Source: AIDS and Clinical Immunology Research Centre
(2011).
6
7. Program Characteristics
GFATM
- Start year 2005
- 5 sites in total
- Free for clients
MAT
providers MOHLSA
- Start year 2008
- 11 sites in total
- 150 GEL/pm/patient
7
9. Program Characteristics (3)
• MAT treatment protocol/personnel
centrally-mandated and identical for all
service providers
– Key treatment parameters include
• Daily methadone dosage
• STI testing (HIV, Hepatitis B/C)
• Individual psychotherapy
• Group counseling
9
10. Program Characteristics (4)
• Staffing at MAT sites is regulated by
Georgian law:
– 3 medical doctors
– 1 psychologist
– 1 social worker
– 1 head of department/chief doctor/
coordinator
– 1-3 nurses
– Other support staff (data entry specialist,
consultants, toxicologist, pharmacist and etc.)
10
11. Study Details
• Study design – samples from each provider
– MOHLSA – 7 of 11 sites (sites chosen to ensure
representation from small and large population
centers)
– GFATM – 4 of 5 sites (excluded prison site)
• Study period
– Qualitative data collected on treatment
parameters – March, April and May 2011
– Financial program data – 2009, 2010
11
12. Study Details (2)
• Collected cost and quantity data on:
• Personnel
• Drugs and supplies
• Furniture and equipment
• Land and buildings
• Consumables
• Utilities
12
13. Results
MAT Dosages Across Sites
Below 60 mg Above 60 mg
% of patients within each dose range
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
13
14. Distribution of HIV+ patients
800
1.5%
700
Total Number of Patients
600
1.1%
500
400 12.2%
12.7% 98.5%
300 98.9%
200
87.8%
87.3%
100
0
GF 2009 GF 2010 MOLHSA 2009 MOLHSA 2010
HIV Negative HIV Positive 14
15. Increase in Average # Patients
800
700
600
500
400
300
200
100
0
GF—MAT MOLHSA—MAT
15
16. Unit cost for 1 month treatment
2010 $
GFATM
Average number of PWID in 1
364
month
Unit cost for one month 229 GEL $133
MOHLSA
Average number of PWID in 1
689
month
Unit cost for one month 236 GEL $137
16
17. Cost Drivers
Share of direct and indirect costs in MAT facilities
250
21.1% 20.9%
200 23.2%
24.6%
Unit Cost (GEL)
150
100
78.9% 79.1% 76.8%
75.4%
50
0
MoLHSA 2009 MoLHSA 2010 GF 2009 GF 2010
Direct Costs Indirect Costs 17
18. Key cost drivers
MOLHSA—2010 Drugs and
GFATM—2010
Bank/
medical Rental cost
Drugs and 5% Utilities insurance
Rental cost supplies fees
medical 13%
5% 21% 0.44%
supplies
Utilities
28%
14%
Stationary Bank/ Non
office insurance Stationary medical
supply 0% office supply equipment
0% 1% 5%
Non
medical
Regional equipment
monitoring 2% Regional
0% Salaries of monitoring
clinical & 0.41%
support
Salaries of
staff clinical &
51% support staff
55% 18
19. Economies of Scale
GFATM Shida GFATM
Kartli Batumi
Narcological Narcological MoLHSA MOLHSA
Center Center Division 3 Division 6
Average
patients
per 45 117 18 142
month
Unit cost
291 GEL 161 GEL 702 GEL 122 GEL
patient/
month ($169) ($93) ($407) ($71)
19
20. Potential for Service Expansion
• 1382 maximum PWID capacity at MOLHSA sites
• 500 maximum PWID capacity at GFATM sites
(currently at capacity)
• Modelled 2 scenarios to assess potential for
expanding MAT coverage within existing facilities:
– Scenario A: Increase coverage by 15 percent until
maximum available existing capacity is reached.
– Scenario B: Graduated expansion in MAT coverage over
five years (five, seven, nine, 11 and 13 percent increases)
using existing sites until maximum available capacity is
reached. 20
21. Scenario A – 15% increase
Increase in average #
MOLHSA of patients
2010—11 MAT sites 898
2011—15% increase
1,033
2012—15% increase
1,187
2013—15% increase
1,366
21
22. Scenario A – Decreasing unit costs
1600 1366 450
1400 400
1187
Number of Patients
350
1200 1033
Unit Cost (GEL)
898 300
1000
250
800
235.8 200
600 213.21 193.58 176.5 150
400 100
200 50
0 0
2010 extrapolated 2011 2012 2013
number of patients unit cost
22
23. Scenario A – Share of direct/indirect costs
MOLHSA Direct Indirect
costs (%) costs (%)
2010—11 MAT 79.10 20.90
facilities
2011—15% increase 79.90 20.10
2012—15% increase 80.75 19.25
2013—15% increase 81.64 18.36
23
24. Scenario B – graduated increase
Graduated increase in average
MOLHSA # of patients
2010—11 MAT sites 898
2011—5% increase 943
2012—7% increase 1009
2013—9% increase 1100
2014—11% increase 1221
2015—13% increase 1379
24
25. Scenario B – Decreasing Unit Costs
1600 450
1379.2 400
1400
1220.5
350
Number of Patients
Unit Cost (GEL)
1200 1099.6
1008.8 300
1000 897.9 942.8
250
800
235.8 200
225.6 213.2
600 200.7 189.1 179.4 150
400 100
200 50
0 0
2010 2011 2012 2013 2014 2015
extrapolated
25
Number of Patients Unit cost
27. Limitations
• We were unable to include certain costs in this analysis,
primarily due to lack of data.
• Accurate patient tracking was a challenge in some
MOLHSA methadone facilities, particularly Tbilisi, where
patients may have moved from one MAT site to another.
• Finally, this analysis focused on the costs incurred by
facilities offering MAT services. As such, it does not include
the costs incurred by patients as they sought and received
services or the opportunity costs of time spent travelling to
and seeking services.
27
28. Recommendations
• Specify clear indicators for successful
treatment outcomes.
• Integration/co-location of PWID/HIV services
for better patient follow-up (currently no data
on recidivism)
• Greater autonomy for MAT sites on protocol/
personnel
28
29. Acknowledgements
USAID funded project HPI costing
• Veena Menon, Kip Beardsley, Stiven Forsythe (Futures
Group) & data collectors team : Natia Topuria, Nino
Balanchivadze, Tea Kordzade (Alternative Georgia),
Lela Sturua (NCDC)
Staff of participant MAT centers’
Authors declaring no conflict of interest
29