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1.
Rev. panam. salud p£blica ; 24(5): 304-313, Nov. 2008. ilus
Artigo em Inglês | MedCarib | ID: med-17411

RESUMO

OBJECTIVE. In Latin America and the Caribbean, routine vaccination of infants against Streptococcus pneumoniae would need substantial investment by governments and donor organizations. Policymakers need information about the projected health benefits, costs, and cost-effectiveness of vaccination when considering these investments. Our aim was to incorporate vaccine, demographic, epidemiologic, and cost data into an economic analysis of pneumococcal vaccination of infants in Latin America and the Caribbean. METHODS. We previously used a structured literature review to develop regional estimates of the incidence of disease. Cost data were collected from physician interviews and public fee schedules. We then constructed a decision analytic model to compare pneumococcal conjugate vaccination of infants with no vaccination across this region, examining only vaccine’s direct effects on children. RESULTS. Pneumococcal vaccination at the rate of diphtheria-tetanus-pertussis vaccine coverage was projected to prevent 9 500 deaths per year in children aged 0 to 5 years in the region, or approximately one life saved per 1 100 infants vaccinated. These saved lives as well as averted cases of deafness, motor deficit, and seizure result in 321 000 disability-adjusted lifeyears (DALYs) being averted annually. At vaccine prices between US$5 and US$53 per dose, the cost per DALY averted from a societal perspective would range from US$154 to US$5 252. CONCLUSION. Pneumococcal conjugate vaccine was highly cost-effective up to $40 per dose. Introduction of pneumococcal vaccine in the Latin American and Caribbean region is projected to reduce childhood mortality and to be highly cost-effective across a range of possible costs.


Assuntos
Recém-Nascido , Lactente , Criança , Humanos , Streptococcus pneumoniae/efeitos dos fármacos , Vacinas Pneumocócicas/economia , Custos e Análise de Custo/estatística & dados numéricos
2.
Rev. panam. salud p£blica ; 24(5): 304-313, Nov. 2008. tab, ilus, graf
Artigo em Inglês | MedCarib | ID: med-17457

RESUMO

OBJECTIVE: In Latin America and the Caribbean, routine vaccination of infants against Streptococcus pneumoniae would need substantial investment by governments and donor organizations. Policymakers need information about the projected health benefits, costs, and cost-effectiveness of vaccination when considering these investments. Our aim was to incorporate vaccine, demographic, epidemiologic, and cost data into an economic analysis of pneumococcal vaccination of infants in Latin America and the Caribbean. METHODS: We previously used a structured literature review to develop regional estimates of the incidence of disease. Cost data were collected from physician interviews and public fee schedules. We then constructed a decision analytic model to compare pneumococcal conjugate vaccination of infants with no vaccination across this region, examining only vaccine's direct effects on children. RESULTS: Pneumococcal vaccination at the rate of diphtheria-tetanus-pertussis vaccine coverage was projected to prevent 9500 deaths per year in children aged 0 to 5 years in the region, or approximately one life saved per 1 100 infants vaccinated. These saved lives as well as averted cases of deafness, motor deficit, and seizure result in 321000 disability-adjusted life years (DALYs) being averted annually. At vaccine prices between US$5 and US$53 per dose, the cost per DALY averted from a societal perspective would range from US$154 to US$5252. CONCLUSION: Pneumococcal conjugate vaccine was highly cost-effective up to $40 per dose. Introduction of pneumococcal vaccine in the Latin American and Caribbean region is projected to reduce childhood mortality and to be highly cost-effective across a range of possible costs.


Assuntos
Humanos , Streptococcus pneumoniae , Vacinas Pneumocócicas , Custos e Análise de Custo , Árvores de Decisões , Otite Média , Pneumonia , Sepse , Meningite , América Latina , Região do Caribe
3.
Rev. panam. salud p£blica ; 21(4): 192-203, April 2007. tab, gra
Artigo em Inglês | MedCarib | ID: med-17336

RESUMO

OBJECTIVES: To estimate the health and economic burden of rotavirus gastroenteritis in hospital and outpatient settings in eight Latin American and Caribbean countries (Argentina, Brazil, Chile, Dominican Republic, Honduras, Mexico, Panama, and Venezuela). METHODS: An economic model was constructed using epidemiological data from published articles, national health administration studies, and country-specific cost estimates. For each of the eight countries, the model estimated the rotavirus outcomes for the 2003 birth cohort during the first five years of life. The main outcome measures included health care costs, transporation cost, lost wages, and disease burden expressed in disability-adjusted life years. Estimates were discounted at a rate of 3 percent. Sensitivity analyses evaluated the impact of specific variables on the medical cost of treating rotavirus. RESULTS: For every 1000 children born during 2003 in the eight Latin American and Caribbean countries studied here, we estimated that rotavirus gastroenteritis would result in an average of 246 outpatient visits, 24 hospitalizations, 0.6 deaths, and US$7971 in direct medical costs during their first five years of life. The incidence of rotavirus-associated outpatient visits and the cost of outpatient visits were predicted to have the largest impact on the total medical cost per child. CONCLUSIONS: Rotavirus gastroenteritis is likely to result in substantial disease and economic burden to health systems in Latin America and Caribbean countries, and the foreseeable burden to health systems in Latin America and Caribbean countries, and the foreseeable burden should be important an consideration in evaluating the cost-effectiveness of vaccination (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Gastroenterite , Infecções por Rotavirus/economia , Rotavirus , Gastroenterite/economia , América Latina , Custos e Análise de Custo/economia , Custos e Análise de Custo/estatística & dados numéricos , Efeitos Psicossociais da Doença , Região do Caribe
5.
West Indian med. j ; 49(suppl.4): 16-7, Nov. 9, 2000.
Artigo em Inglês | MedCarib | ID: med-390

RESUMO

OBJECTIVE: The aim was to determine the efficacy of the rapid Papanicolaou staining method (RPSM) in fine needle aspiration (FNA) cytology of breast lesions. METHODS: In a prospective study performed between May 1999 and June 2000, FNA specimens were obtained from patients attending the surgical out-patient and breast imaging services of the UHWI for the assessment of breast leisons. One-half of the slides from each specimen were stained by the RPSM, which reduces routine staining time by 80 percent (rapPaps), and the other half stained by the routine Papanicolaou method (routPaps). Specimens that were inadequate based on rapid assessment were immediately repeated. For each group of slides the smear quality, cytologic diagnoses and results of any related biopsy specimens were documented. The concordance between the cytology diagnoses and between the cytologic and histologic diagnoses was determined. RESULTS: One hundred specimens were obtained from 90 patients (M:F = 1:8; average age 42.3 years). RapPaps averaged 2.9 slides per case and routPaps 3.4; 71 percent and 77 percent of rapPaps and routPaps, respectively, had adequate cellular material, and 84 percent and 85 percent of these groups, respectively, displayed satisfactory cellular preservation. There was 83 percent, 52 percent and 56 percent concordance between rapid and routine cytologic diagnoses, rapid and histologic diagnoses, and routine and histology diagnoses, respectively. Non-concordance was due to lack of cellular material in 14/17 (82 percent), 12/23 (52 percent) and 10/21 (48 percent) cases, respectively. Of the remainder, 6 cases represented major diagnostic discrepancies in which atypical cytologic smears were confirmed to be benign lesions on histology. CONCLUSION: These findings show that staining FNA specimens by the rapid Papanicolaou method allows for accurate cytology evaluation of breast leisons at UHWI. The handling of cytologic specimens by this method can be an important cost- and time- saving strategy in the management of patients presenting to the out-patient services. (Au)


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Esfregaço Vaginal/métodos , Biópsia por Agulha/estatística & dados numéricos , Mama/citologia , Jamaica , Estudos Prospectivos , Coloração e Rotulagem/métodos , Custos e Análise de Custo
6.
West Indian med. j ; 49(Suppl 2): 20, Apr. 2000.
Artigo em Inglês | MedCarib | ID: med-1001

RESUMO

OBJECTIVE: The purpose of this study was to assess the health service cost of haemodialysis delivered by the Queen Elizabeth Hospital, Barbados. DESIGN AND METHODS: A cost analysis was performed from the viewpoint of the study hospital using the treatment protocols based on current practice. These incorporated procedures to establish dialysis access sites (surgical set up) and dialysis maintenance. Cost and patient data were collected for the period April 1, 1998 to March 31, 1999. Sixty-four patients were studied. Analyzed costs included personnel, drug expenditure, supplies (dialysis and non-dialysis related), inpatient costs, laboratory and other ancillary services, and indirect or overhead costs such as plant, housekeeping, laundry and administration. RESULTS: The final cost per patient year was $37,930.04 in the first year of dialysis and included surgical set-up, and $34,059.08 in the subsequent years (excluding inpatient admissions and treatments for complications). The total cost of dialysis provision for the year excluding surgical set up was $2,178,561.09. The cost per visit was estimated to be $286.95. Direct costs (determined by patient utilization and physician and nurse directives) amounted to 81.8 percent of total cost. The main expenditure sections were dialysis-related supplies, labour and overheads. Cost savings incurred as a result of strict modification of treatment guidelines were estimated. By altering the number of dialysis visits per week and introducing other cost saving measures, such as dialyzer re-use, a savings of $852,176.32 was observed with a full potential savings of $902,218.63. An incremental cost analysis of a service expansion (scenario 1) indicated that the cost savings would be sufficient to provide an additional 3,328 dialysis treatments or visits per year, incorporating 4 additional dialysis machines. CONCLUSIONS: These findings are important in the light of constrained economic resources. However, the outcomes associated with the observed costs must be explored in order to assess the "true value" or cost effectiveness of the current dialysis practice. Therefore, this analysis is but one component of an overall study to review the renal dialysis services in Barbados for the purpose of informing plans for expansion and optimization of services.(Au)


Assuntos
Humanos , Unidades Hospitalares de Hemodiálise/economia , Custos e Análise de Custo , Barbados , Estudo de Avaliação , Pesquisa sobre Serviços de Saúde
7.
West Indian med. j ; 49(Suppl 2): 20, Apr. 2000.
Artigo em Inglês | MedCarib | ID: med-1002

RESUMO

OBJECTIVES: To determine the cost of treating acute asthma at the Queen Elizabeth Hospital (QEH) and to identify ways of reducing these costs. DESIGN AND METHODS: Case notes of all patients presenting to the Asthma Bay of the QEH during a two-week period in March 1999, were reviewed. Data, extracted included gender, arrival time, number of nebulizations, dosage of oral prednisolone and inhalers prescribed. A questionnaire was completed by a sample of these patients regarding use of inhalers, follow-up care and time lost from work and school. RESULTS: A total of 303 cases were reviewed and 75 patients completed questionnaires. The majority of asthmatics received oral prednisolone (74 percent) and/or three nebulizations (42 percent). The cost of treating each patient was determined to be approximately US $22.00, including medical and nursing salary costs. The annual cost to the QEH was estimated to be US $214,000 including the costs of admitting patients. Indirect costs included the time lost from work or school in 86 percent of patients and in 56 percent of parents taking time off to look after their sick children. The questionnaire survey revealed that 63 percent of patients with "preventer" medications were not using them and only 38 percent received follow-up care. Seventy-four percent of these patients had repeated asthmatic attacks during the preceding 3 months with 11 percent having more than six attacks. CONCLUSIONS: A significant amount of money is spent on asthma care at the QEH. However, improper understanding and use of medication coupled with lack of continuity of care lead to poor control and frequent attacks. These findings justify the need for an asthma clinic for these patients.(Au)


Assuntos
Feminino , Humanos , Masculino , Asma/economia , Asma/terapia , Custos e Análise de Custo , Barbados , Prednisolona/uso terapêutico , Coleta de Dados , Inquéritos e Questionários , Pesquisa sobre Serviços de Saúde
8.
West Indian med. j ; 49(Suppl 2): 19, Apr. 2000.
Artigo em Inglês | MedCarib | ID: med-1003

RESUMO

OBJECTIVE: To determine the annual cost of treating asthma in Barbados over a ten-year period. METHODS: The Barbados Drug Service is the central procurement agent for drugs on the Barbados National Formulary. Information on the costs of the various asthma medications, and the number of prescriptions written for these drugs, were obtained from the Barbados Drug Service records. The prescriptions written for asthma medications between 1986 and 1997 were analysed and the annual cost of the various categories of asthma calculated. RESULTS: The annual drug cost of treating asthma in Barbados increased from $293,111 in 1987 to $1,268,348 in 1996, a four-fold increase over ten years. There was a rapid rise in the cost of anti-inflammatory drugs during the study period, from $48,628 or 16.5 percent of total drug cost in 1986 to $503,092 or 39.6 percent of total drug cost in 1997. The cost of inhaled beta-2-agonists over the same period increased from $131,154 or 44.7 percent of the total drug cost in 1997. However, the cost of oral beta-2-agonists decreased over the ten-year period, reflecting the increased use of the inhaled form of the medication. With the increasing number of acute asthmatics seen in the Accident and Emergency Department at the Queen Elizabeth Hospital, the cost of nebulization solutions increased eight-fold, from $8,361 in 1986 to $69,172 in 1997. CONCLUSIONS: Asthma has been an increasing burden on the medical resources of Barbados over the past decade. The drug costs of treating asthma have increased significantly over the 10-year period 1986 to 1997 and accounted for 5.8 percent of the annual budget of the Barbados Drug Service in 1997.(Au)


Assuntos
Humanos , Asma/economia , Asma/terapia , Custos e Análise de Custo , Coleta de Dados/economia , Pesquisa sobre Serviços de Saúde
9.
West Indian med. j ; 48(3): 141-2, Sept. 1999. tab, gra
Artigo em Inglês | MedCarib | ID: med-1496

RESUMO

Trauma accounted for 37 percent of 22,311 patients seen in the Accident and Emergency Unit (A&E) at the University Hospital of the West Indies (UHWI) during 1996. Thirty-nine percent of injuries were intentional and 18 percent were due to motor vehicle accidents. Knives, machetes and rocks accounted for 75 percent of the injuries compared with 5 percent for gunshot wounds. Passengers were injured in about 40 percent of motor vehicle accidents and pedestrians in 19 percent. The admission rate was 16 percent and the orthopaedic clinic received 75 percent of the patients referred to specialist clinics. Victims of motor vehicle accidents made up a greater proportion of admissions (24 percent) than those of unintentional violence (13 percent). The average cost of caring for each patient in the A&E Unit was US$70 resulting in an annual cost of US$578,000.(AU)


Assuntos
Adulto , Criança , Pré-Escolar , Lactente , Pessoa de Meia-Idade , Idoso , Humanos , Adolescente , Ferimentos e Lesões/etiologia , Ferimentos por Arma de Fogo , Acidentes de Trânsito/tendências , Jamaica , Violência , Acidentes , Acidentes de Trânsito , Queimaduras , Custos de Cuidados de Saúde , Custos e Análise de Custo
10.
Hastings Cent Rep ; 29(4): 23-7, July-Aug. 1999.
Artigo em Inglês | MedCarib | ID: med-1312

RESUMO

In the Caribbean as as in many other areas costly biomedical resources and personnel are limited, and more and more people are turning to alternative medicine and folk practitioners for health care. To meet the goal of providing health care for all, research on nonbiomedical therapies is needed, along with legal recognition of folk practitioners to establish standards of practice.(Au)


Assuntos
Humanos , Terapias Complementares , Prioridades em Saúde , Medicina , Medicina Tradicional , Terapias Complementares/legislação & jurisprudência , Terapias Complementares/normas , Orçamentos , Região do Caribe , Custos e Análise de Custo , Países em Desenvolvimento , Ética Médica , Previsões , Mão de Obra em Saúde , Prioridades em Saúde/economia , Prioridades em Saúde/tendências , Recursos em Saúde/economia , Recursos em Saúde/provisão & distribuição , Medicina Herbária
11.
Diabet Med ; 12(12): 1077-85, Dec. 1995.
Artigo em Inglês | MedCarib | ID: med-2994

RESUMO

Many middle-income countries are experiencing an increase in diabetes mellitus but patterns of morbidity and resource use from diabetes in developing countries have not been well described. We evaluated hospital admission with diabetes among different ethnic groups in Trinidad. We compiled a register of all patients with diabetes admitted to adult medical, general surgical, and ophthalmology wards at Port of Spain Hospital, Trinidad. During 26 weeks, 1447 patients with diabetes had 1722 admissions. Annual admission rates, standardized to the world population, for the catchment population aged 30-64 years were 1031 (95 percent CI 928 to 1134) per 100,000 in men and 1354 (1240 to 1468) per 100,000 in women. Compared with the total population, admission rates were 33 percent higher in the Indian origin population and 47 percent lower in those of mixed ethnicity. The age-standardized rate of amputation with diabetes in the general population aged 30-60 years was 54 (37 to 71) per 100,000. The hospital admission fatality rate was 8.9 percent (95 percent CI 7.6 percent to 10.2 percent). Mortality was associated with increasing age, admission with hyperglycaemia, elevated serum creatinine, cardiac failure or stroke and with lower-limb amputation during admission. Diabetes accounted for 13.6 percent of hospital admissions and 23 percent of hospital bed occupancy. Admissions associated with disorders of blood glucose control or foot problems accounted for 52 percent of diabetic hospital bed occupancy. The annual cost of admissions with diabetes was conservatively estimated at TT10.66 million (UK 1.24 million pounds). In this community diabetes admission rates were high and varied according to the prevalence of diabetes. Admissions, fatalities and resource use were associated with acute and chronic complications of diabetes. Investing in better quality preventive clinical care for diabetes might provide an economically advantageous policy for countries like Trinidad and Tobago. (AU)


Assuntos
Adulto , Idoso , Feminino , Masculino , Pessoa de Meia-Idade , Humanos , Diabetes Mellitus/economia , Diabetes Mellitus/mortalidade , Admissão do Paciente/economia , África/etnologia , Fatores Etários , Amputação Cirúrgica/economia , Glicemia/metabolismo , Causas de Morte , Custos e Análise de Custo , Etnicidade , Mortalidade Hospitalar , Hiperglicemia , Fatores Sexuais , Fatores Socioeconômicos , Trinidad e Tobago , Índia/etnologia
12.
West Indian med. j ; 44(3): 81-4, Sept. 1995.
Artigo em Inglês | MedCarib | ID: med-5888

RESUMO

A pharmacoeconomic study of 15 antibiotics available in Barbados was performed. The antibiotics studied were amoxycillin/clavulanate, ampicillin/sulbactam, cefazolin, cefotaxime, ceftazidime, ceftriaxone, clindamycin, cloxacillin, cotrimoxazole, gentamicin, imipenem, metronidazole, piperacillin/tazobactam, and vancomycin. The costs of use of these compound were calculated for a five-day course using a formula comprising eight categories: antibiotic purchase cost, maintenance of intravenous access, drug delivery cost, drug monitoring cost, dose readjustment, general monitoring cost, 'sharps' disposal cost and adverse effects. The cost of adverse effects were not included in this study due to lack of accurate data. The total cost of antibiotic use (in U.S. dollars) ranged from $42.52 to $463.73 per five-day course. Generic compound were less expensive ($45.52-$98.23) than brand-name compounds ($106.18 - $463.73). Antibiotic purchase costs accounted for proportions of total costs ranging from 7 to 93 percent. Non-drug costs represented a much greater proportion of total costs of generic compounds. For most compound the non-drug costs were related to the frequency of dosing, but for gentamicin the non-drug costs were relatively higher because of the need for monitoring of serum gentamicin levels. Efficacy and freedom from side-effects will remain the most important determinants in the choice of antibiotic therapy. However, pharmacoeconomic analyses can provide prescribers with the information required to make cost-effective choices for treatment of their patients (AU)


Assuntos
Antibacterianos/economia , Farmacoeconomia , Infecções Bacterianas/tratamento farmacológico , Custos de Medicamentos , Honorários Farmacêuticos , Barbados , Eficácia , Infusões Intravenosas/economia , Custos e Análise de Custo , Antibacterianos/uso terapêutico
13.
Kingston; Oct. 1993. ix,81 p. tab.
Tese em Inglês | MedCarib | ID: med-8265

RESUMO

Every year since the last decade a mean of 347.5 Jamaicans die as a result of road traffic accidents. Annually those injured amount to approximately 2,780 persons. For every one death due to road traffic accidents there are at least eight injured persons. The aim of this study was to determine the resource consumption of persons sustaining injuries from road traffic accidents. The public health implications were examined with respect to spectrum of injury, demographic data and resource allocation. A simple random sample of 200 victims of road traffic accidents from the population of patients seen in 1992 at the Kingston Public Hospital was selected. The results revealed that men were more frequently injured than women. The most frequent age grouping was that between 15 and 44 years this accounted for 75 percent of the sample. Of the group classified, pedestrians (40 percent), passengers (25 percent), were the most vulnerable road users. They received the largest range of injuries and were the most severly injured. Injuries to the extremities, external injuries and injury to the head and neck were most frequent. Among drivers facial injuries were significant, 75 percent of this group received injuries to the face. One in every three persons treated in casualty required admission to hospital. Of those treated in ambulatory care 25 percent require the costly service of the hospital's out patients' depatment. In casualty department a total of 483 medical intervensions were needed to treat 200 patients incurring a total cost to the government for basic resources utilized at J$74,470.89. The mean length of hospital stay was 32 days at a mean cost of J$29,105.23. Based on the type and frequency of injuries received, the results indicate that which should be done in the area of prevention (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Acidentes de Trânsito/economia , Acidentes de Trânsito/estatística & dados numéricos , Jamaica , Custos e Análise de Custo
14.
Bull Pan Am Health Organ ; 27(4): 331-6, 1993.
Artigo em Inglês | MedCarib | ID: med-7783

RESUMO

During the first half of 1992 the threat of cholera to Trindad and Tobago prompted a strong health education effort by public authorities and the private sector. To help assess the private sector effort, the cost of cholera-related advertisements and private announcements placed in the country's two leading newspapers during January-June 1992 were received. The review indicated that an estimated TT$ 540 660 was spent on these ads and announcements, that they contributed strongly to keeping cholera prevention continuously in the public eye, and that most of the messages published were accurate, specific, and safe. The strength and success of the private contribution to cholera prevention in this case suggests that similar approaches could be applied to other health problems and to the cholera problem outside Trinidad and Tobago. Overall, the lesson appears to be that if one can find congruence between private sector motives and public health interests, then the potential prospects for a successful partnership are great (AU)


Assuntos
Cólera/prevenção & controle , Setor Privado , Publicidade/economia , Cólera/economia , Surtos de Doenças/economia , Surtos de Doenças/prevenção & controle , Educação em Saúde/economia , Trinidad e Tobago , Custos e Análise de Custo
17.
In. Levett, Paul N; Fraser, Henry S; Hoyos, Michael D. Medicine and therapeutics update 1990: proceedings of Continuing Medical Education symposia in Barbados, November 1988 & June 1989. St. Michael, University of the West Indies, (Cave Hill). Faculty of Medical Sciences, 1990. p.80-2.
Monografia em Inglês | MedCarib | ID: med-15005

RESUMO

An increasing number of new and expensive antibiotics on the market makes it imperative that costs be contained and an attempt made to rationalise use without comprising patient care. Prerequisites of any containment programme are education of health and medical personnel and a good communication system to provide timely reports on culture and sensitivity results to personnel concerned


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/antagonistas & inibidores , Antibacterianos/diagnóstico , Antibacterianos/farmacocinética , Antibacterianos/provisão & distribuição , Antibacterianos/uso terapêutico , Antibacterianos/toxicidade , Custos e Análise de Custo/economia , Atenção à Saúde/economia
18.
Kingston; s.n; 1989. vii,78 p. maps, tab.
Tese em Inglês | MedCarib | ID: med-13625

RESUMO

A shift in focus of health towards "Health for all by the year 2000" made it imperative that health services are cost-effective and cost-efficient. This study compared the elderly with other adults using the University Hospital of the West Indies in 1988. This provided data on the distribution of health service and its cost between the groups. A sample of 224 clients were selected and matched for age groups and sex. Many gave addresses far from the hospital and lack of confidence in local facilities may be contributing to this pattern. Among the sample, frequency of marriage increased with age, but being married did not seem to reduce length of stay in hospital as expected. The mean cost for treating the elderly was generally higher than for other adults. In health services for the elderly the mean cost was $696.43 while for other adults $571.42. The mean cost of investigations for the elderly was $73.00 almost double that of other adults $42.00. With medication, young adults had a higher mean cost $64.00 over $22.00 for the elderly. This was significantly reduced when three atypical controls were removed and became $19.00 for cases and $17.00 for controls. Many young adults had conditions related to infections and were treated with expensive antibiotics, while the elderly may have had medication and only needed revision of dosage reducing the cost of their prescriptions (AU)


Assuntos
Humanos , Adulto , Serviços de Saúde/economia , Idoso , Jamaica , Custos e Análise de Custo/estatística & dados numéricos , Tempo de Internação/tendências , Serviços de Saúde/estatística & dados numéricos
20.
Bull Narcot;37(4): 37-49, Oct.-Dec. 1985.
em Inglês | MedCarib | ID: med-10971

RESUMO

In 1984 cannabis derivatives, in particular marijuana, hashish and liquid hashish, continued to be the most readily available drugs of abuse in Canada. Marijuana originating in Colombia decreased on the illicit marijuana market in Canada from an estimated 45 percent in 1983 to 30 percent in 1984, but it remained the largest source of marijuana supply. Marijuana originating in Thialand remained at approximately the same level (20 percent) in 1984 as in 1983, while marijuana of Jamaican origin increased its share in the illicit market from 10 percent in 1983 to 20 percent in 1984. Approximately 10 percent of marijuana on the illicit market originated in Canada, 10 percent in Mexico, and 10 per cent in the United States of America. In 1984 an estimated 85 percent of hashish on the illicit market in Canada originated in Lebanon (55 percent in 1983), 10 percent in India or Pakistan (31 percent in 1983) and 5 percent in Jamaica (2 percent in 1983). Illicit shipments in tonnes of hashish originating in Lebanon made this the dominant source of supply of the drug. Liquid hashish originating in Jamaica shared 88 percent of the illicit market of this drug in Canada during 1984, while 10 percent of the drug originated in Lebanon and 2 percent in Canada. In 1984 an estimated 40 percent of smuggled marijuana entered the illicit market in Canada by air and approximately the same by sea, while 20 percent was smuggled over land. During the same year, hashish was smuggled into Canada primarily by sea, while air accounted for 5 percent and land for 1 per cent only. Liquid hashish, in contrast, entered Canada primarily by air, and only 9 percent by land and 1 percent by sea (AU)


Assuntos
Humanos , Abuso de Maconha , Canadá , Cannabis , Colômbia , Custos e Análise de Custo , Índia , Jamaica , Líbano , México , Paquistão , Drogas Ilícitas , Tailândia , Estados Unidos
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