RESUMO
To find the status of age of suspicion and identification availed for children with different communication disorders. This cross-sectional survey study was conducted on 2081 children aged 0.5 to 15 years (mean: 5.41; S.D.: ±3.77) who came to the speech-language diagnostic department of AYJNISHD(D), RC, Kolkata for availing rehabilitation service at the institute. The information was gathered from the parents and caregivers of the children. After detailed evaluation by the interdisciplinary team, the developed 14-item questionnaire was administered, and data were recorded and tabulated. Findings suggested that average age of suspicion of presence of communication problem is 2 years (SD: ±0.98). The suspicion rate increased with increasing age with a saturation in suspicion rate after 5 years. Consultation of a medical professional, primarily an ENT specialist was availed by 2.8 years (SD: ±1.89) of age and 32% of the doctors during the first visit assured the parents not to worry as the child would learn language with age and only 43.4% were referred for rehabilitation. Among them, 42.8% of children were found hearing loss, 24.5% found to have autism spectrum disorder, 20.66% of children were diagnosed with developmental delay, 6.4% were diagnosed with intellectual disability, 4.7% were diagnosed with late language emergence and 0.86% were diagnosed with cerebral palsy. From the findings we can conclude perceived cause of delay in identification is lack of awareness, lack of proper guidance from the primary consultants, and tendency to follow wait-and-watch policy.
RESUMO
BACKGROUND: Disease-specific costing studies can be used as input into cost-effectiveness analyses and provide important information for efficient resource allocation. However, limited data availability and limited expertise constrain such studies in low- and middle-income countries (LMICs). OBJECTIVE: To describe a step-by-step guideline for conducting disease-specific costing studies in LMICs where data availability is limited and to illustrate how the guideline was applied in a costing study of cardiovascular disease prevention care in rural Nigeria. DESIGN: The step-by-step guideline provides practical recommendations on methods and data requirements for six sequential steps: 1) definition of the study perspective, 2) characterization of the unit of analysis, 3) identification of cost items, 4) measurement of cost items, 5) valuation of cost items, and 6) uncertainty analyses.Please provide the significance of asterisk given in table body. RESULTS: We discuss the necessary tradeoffs between the accuracy of estimates and data availability constraints at each step and illustrate how a mixed methodology of accurate bottom-up micro-costing and more feasible approaches can be used to make optimal use of all available data. An illustrative example from Nigeria is provided. CONCLUSIONS: An innovative, user-friendly guideline for disease-specific costing in LMICs is presented, using a mixed methodology to account for limited data availability. The illustrative example showed that the step-by-step guideline can be used by healthcare professionals in LMICs to conduct feasible and accurate disease-specific cost analyses.
