Salmaan

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.

Salmaan

Burn Relief in Malawi

BWH’s Jennifer Wall, PA-C, (at left) operates on a young burn patient with members of the surgical team.
Photo courtesy of Africa Burn Relief.

Only 2 percent of homes in Malawi, a landlocked country in Africa, include a stove. Most families cook over a fire on the ground three times a day, and every hut has a raging fire outside of it for warmth at night.

“Kids are face to face with fire all the time,” says Jennifer Wall, PA-C, a physician assistant at the Brigham and Women’s Hospital Burn Center.

Given the prevalence of fires resulting from everything from cooking to bathing to cleaning, burns are a frequent and often untreated consequence of this way of life.

Wall has made it her mission to provide resources, skills training and mentorship to local health care providers to create sustainable burn treatment and prevention models in the rural village of Nkhoma, Malawi. Continue reading “Burn Relief in Malawi”