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Recent Studies Demonstrate Ways to Improve Quality of Care and Reduce Costs

Thomas Gaziano

With a theme of “Noncommunicable Diseases: The Growing Burden,” the latest issue of Health Affairs features two studies co-led by BWH’s Thomas Gaziano, MD, of the Cardiovascular Division, and a team of authors.

The first study finds that cardiovascular disease screening by community health workers can be cost-effective in low resource countries. Understanding that a physician is not always available in low-resource settings, the authors demonstrated that community health workers can efficiently screen adults for cardiovascular disease in South Africa, Mexico and Guatemala. By using a paper-based or mobile phone-based screening tool that does not require blood testing, community health workers could conduct screenings in a cost-effective, or even cost-saving, manner in all three countries, compared to the usual clinic-based screening. “Our modeling indicated that screening by community health workers, combined with improved treatment rates, would increase the number of deaths averted from 15,000 to 110,000, compared to standard care,” write the authors.

The second study investigates the health and economic impacts of increasing prescription length for statins in South Africa, where the rates of statin use are among the lowest in the world.   “Almost five percent of the country’s total mortality has been attributed to high cholesterol levels, fueled in part by low levels of statin adherence,” write the authors.

They found that increasing prescription length from the standard 30 days to 60 or 90 days could save 1,694 or 2,553 lives per million adults, respectively. In addition, annual per patient costs related to cardiovascular disease would decrease by $152.41 and $210.29, respectively. “Increasing statin prescription length would both save resources and improve health outcomes in South Africa,” conclude the authors.

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Maru’s Efforts in Nepal Highlighted by NIH

Duncan_Maru2
Duncan Maru

Dr. Francis Collins, director of the National Institutes of Health, recently wrote a blog post highlighting Duncan Maru, MD, PhD, of the BWH Division of Global Health Equity, and his work in Nepal. In 2008, Maru co-founded Possible, a non-governmental organization that manages the health care system of Accham (a rural district of Nepal) through a public-private partnership with Nepal’s Ministry of Health and Population.

Maru has dedicated his career to developing innovative ways of delivering high-quality, low-cost care in developing areas of the world. He hopes that the work he is doing in Accham with Possible will ultimately help create a model to revitalize health care systems in Nepal and under-resourced settings around the world.

Read the blog post, “Creative Minds: Lessons from Halfway Around the Globe,” here.

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BWH Employee Organizes Aid for Dominica

Petite-Savanne-evacuees (2)On Aug. 27, the tiny nation of Dominica was devastated by a tropical storm that dropped more than 15 inches of rain on the island. Landslides and massive flooding ensued, killing more than 30 people and leaving hundreds homeless.

“This is a significant blow to any island, particularly one with about 70,000 people,” says Shirma Pierre, administrative director for BWH’s Center for Community Health and Health Equity. “The infrastructure has been crippled, and it is estimated that the storm has set Dominica’s development back 20 years.”

Pierre, who was born in Dominica and grew up there, is responding to the call for assistance along with other members of the Dominican community in Boston. The relief effort, “Boston for Dominica,” will provide assistance towards high priority needs of people in Dominica affected by the storm. The group is working with the government of Dominica to facilitate the collection and distribution of items that are deemed priority. Continue reading “BWH Employee Organizes Aid for Dominica”