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Dublin Core
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2021 Special Edition 1 - Low Resource Settings
Text
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Citation List Month
2021 Special Edition 1 - Low Resource Settings
URL Address
<a href="http://doi.org/10.1155/2020/6432476" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1155/2020/6432476</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Reaching the Unreached: Providing Quality Care to HIV-Infected Children through Telemedicine-An Innovative Pilot Initiative from Maharashtra, India
Publisher
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International Journal of Pediatrics
Date
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2020
Subject
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Low resource setting; HIV
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Manglani M; Gabhale Y; Lala MM; Balakrishnan S; Bhuyan K; Rewari BB; Setia MS
Description
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BACKGROUND: The National AIDS Control Organization (NACO) of India created the Regional Pediatric Antiretroviral Therapy (ART) Center; this was subsequently upgraded to seven Pediatric Centers of Excellence (PCoEs) to strengthen the quality of treatment and care of children living with HIV/AIDS (CLHAs). In October 2013, the pediatric HIV telemedicine initiative, an e-decentralized (care provided by local healthcare providers and support provided by a central agency through telemedicine facilities) model of expert pediatric HIV care and referral services, was established as a pilot project at the Pediatric Center of Excellence for HIV Care in Maharashtra. We designed the present study to compare management, compliance to ART, and mortality in children in the ART centers linked to the PCoE through telemedicine versus those that are not linked to the PCoE. METHODS: It was a retrospective cross-sectional study of secondary data from CLHAs from October 2013 through August 2015 in the ART centers to document the intermediate outcomes and to determine if the initiative has improved the quality of care for the CLHAs enrolled in the linked ART centers with nonlinked ART centers. The centers in which the telemedicine sessions were conducted regularly were called linked-regular centers and in whom it was conducted irregularly (less than the median of 12 videoconference cases), it was called a linked-irregular center. Data from 2803 children in 31 linked (1365 in irregular and 1438 in regular centers) and 2608 children in 28 nonlinked centers were analyzed. The outcomes in children in the pre-ART group (ART naïve) were (1) alive on pre-ART, (2) lost to follow-up on pre-ART, (3) death during the pre-ART period, (4) eligible but not initiated on ART, and (5) missing baseline and latest CD4 counts. The outcomes of children on ART were (1) alive on ART, (2) lost to follow-up on ART, (3) death on ART, and (4) missing baseline and latest CD4 counts. RESULTS: We found that a higher proportion of children in the linked-regular centers (79% vs. 70%, p < 0.001) and linked-irregular centers (76% vs. 70%, p = 0.04) was alive compared with that in the nonlinked centers in the pre-ART group. In this group, the proportion of children with missing baseline CD4 counts and latest CD4 counts was significantly low in linked (regular centers) centers. In the ART group, we found that a higher proportion of children in the linked-regular centers was alive compared with that in the linked-irregular centers (77% vs. 69%, p < 0.001); the proportion was not significantly different in nonlinked centers (77% vs. 78%, p = 0.56). In this group, the proportion of missing baseline CD4 counts was significantly lower in the linked-regular centers (3% vs 13%, p<0.001) and linked-irregular centers (1% vs. 13%, p < 0.001) compared with that in the nonlinked centers. Furthermore, the latest CD4 counts were missing in a significantly lower proportion of children in the linked-regular centers compared with those in the linked-irregular centers (6% vs. 18%, p < 0.001) and nonlinked centers (6% vs. 18%, p < 0.001). CONCLUSION: Our study shows that the centers linked through telemedicine performed better in terms of patient care and treatment, with a lesser loss to follow-up and lesser deaths in CLHA. Overall, this pilot project of telemedicine for pediatric HIV has been proven to be acceptable, feasible, and effective in improving the quality of care for children living with HIV across the state of Maharashtra.
Identifier
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<a href="http://doi.org/10.1155/2020/6432476" target="_blank" rel="noreferrer noopener">10.1155/2020/6432476</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
2021 Special Edition 1 - Low Resource Settings
Balakrishnan S
Bhuyan K
Gabhale Y
Hiv
International Journal of Pediatrics
Lala MM
Low resource setting
Manglani M
Rewari BB
Setia MS
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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May 2020 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
May 2020 List
URL Address
<a href="http://ijp.mums.ac.ir/article_14832.html" target="_blank" rel="noreferrer noopener">http://ijp.mums.ac.ir/article_14832.html</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Evaluating the Cost-Effectiveness of Home-Based Palliative Care for Children with Special Health Care Needs: A Review Study
Publisher
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International Journal of Pediatrics
Date
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2020
Subject
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chronic disease; cost effectiveness; home care services; pediatric palliative care
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Eshaghian-dorcheh A; Zandi M; Rasouli M; Tahmasebi M; Esmaielzadeh F
Description
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Introduction: Due to the increased survival of children with chronic and complex diseases, transferring a part of care provision to home and harnessing the family’s potential with the aim of shortening the length of stay and returning the child to the safe and familiar atmosphere of the family can affect the health system and the family. This study aimed to evaluate the cost-effectiveness of home-based palliative care for children with complex health care needs based on the literature review.Methods: After selecting the keywords related to the research question, by examining MeSH, EMTREE and the experts’ opinions mentioned in articles, searching the databases PubMed/Medline, Embase, Scopus and Web of Science were done through a combination of them. Results: Of the 1739 retrieved studies, 11 studies met the inclusion criteria, which were investigated in three groups of methodological features, economic outcomes and indirect outcomes. The reviewed studies were of medium to high quality. Eight were cohort studies one pre-post study, and 2 economic evaluation studies. Studies showed that the decrease in the costs of home-based palliative care for the children in need of special health care, although little, was the result of either reduced hospital stay or the decreased number of hospitalizations.Conclusion: In order to set up pediatric palliative care services in Iran, considering the cultural atmosphere and the limited resources of the health system, attention should be paid to the cost effectiveness of care settings and the provided services, and measures should be taken in order to improve the situation of the children with special care needs, based on social conditions.
Rights
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
Chronic Disease
cost effectiveness
Eshaghian-dorcheh A
Esmaielzadeh F
home care services
International Journal of Pediatrics
May 2020 List
Pediatric Palliative Care
Rasouli M
Tahmasebi M
Zandi M