Sergio I. Prada

Level-I Trauma Center Effects on Return-to-Work Outcomes

Background: Injury is the leading cause of death for persons aged 1-44 years in the United States. Injuries have a substantial economic cost. For that reason, regional systems of trauma care in which the more acutely injured patients are transported to Level-I (L-I) trauma centers (TCs) has been widely advocated. However, the cost of TC care is high, raising questions about the value of such an approach. Objectives: To study L-I TC effectiveness and study return-to-work (RTW) outcomes. Research Design: Using data from National Study on the Costs and Outcomes of Trauma, the authors address the issue of selection bias by comparing naive estimates to matching techniques, as well as to nonlinear instrumental variable models (2SRI) and bivariate probit estimators. Subjects: Individuals ages 18-64 who were mainly working before traumatic injury. Patients selected for the study were treated at 69 hospitals located in 12 states in the United States. N = 1790. Measures: Treatment is binary indicator on whether treated at L-I TC. Outcome is binary indicator on whether returned to work within 3 months after injury. Covariates include: demographics, pre-injury characteristics (job, health and insurance status), injury descriptors, other income sources, etc. Results: Across all models that control for unobserved factors, the authors find that L-I TC treatment is positively associated with RTW within 3 months after injury. The estimated average marginal effect of treatment on the probability of RTW ranges from 23 to 38 percentage points. Conclusions: Benefits of L-I TC care extend beyond mortality and morbidity.

Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis

Background Oral miltefosine has been shown to be non-inferior to first-line, injectable meglumine antimoniate (MA) for the treatment of cutaneous leishmaniasis (CL) in children. Miltefosine may be administered via in-home caregiver Directly Observed Therapy (cDOT), while patients must travel to clinics to receive MA. We performed a cost-effectiveness analysis comparing miltefosine by cDOT versus MA for pediatric CL in southwest Colombia. Methodology/Principle findings We developed a Monte Carlo model comparing the cost-per-cure of miltefosine by cDOT compared to MA from patient, government payer, and societal perspectives (societal = sum of patient and government payer perspective costs). Drug effectiveness and adverse events were estimated from clinical trials. Healthcare utilization and costs of travel were obtained from surveys of providers and published sources. The primary outcome was cost-per-cure reported in 2015 USD. Treatment efficacy, costs, and adherence were varied in sensitivity analysis to assess robustness of results. Treatment with miltefosine resulted in substantially lower cost-per-cure from a societal and patient perspective, and slightly higher cost-per-cure from a government payer perspective compared to MA. Mean societal cost-per-cure were

Level-I trauma centre treatment effects on return to work in teaching hospitals

531 (SD±

Disseminating Public Data as Public Use Files: What Makes a Successful Initiative?

239) for MA and

Young Latino Children Obesity: The Importance of Socioeconomic Status, Home Language, TV Watching, and Physical Activity

188 (SD±

Actual expense associated with patients with Alzheimer's disease in Colombia

100) for miltefosine, a mean cost-per-cure difference of +

Photo Detection Cameras and Road Accidents. Evidence for the City of Cali

343. Mean cost-per-cure from a patient perspective were

Barrier to Access or Cost Share? Coinsurance and Dental-Care Utilization in Colombia.

442 (SD ±

Escenarios posibles para el Sistema General de Seguridad Social en Salud (SGSSS) (Alternative Scenarios for the Colombian Healthcare System)

233) for MA and

Quantifying the effect of a cancer diagnosis on Medicare payments and use according to new Public Use Files.

30 (SD±