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Effectiveness of low-impact development for urban inundation risk mitigation under different scenarios: a case study in Shenzhen, China

Intervention variables analyzed were induction or augmentation of labour with oxytocin, epidural use, caesarean section, assisted vaginal delivery with forceps or vacuum and, finally, spontaneous vaginal delivery. These were the most common interventions with an effect on cost, and costing data readily available. As newborns admitted to the NICU are the most vulnerable and critically ill, transfers to the NICU provided a useful, albeit crude, marker to denote “healthy” versus “unhealthy” babies. Admission to NICU would capture infants who experienced other outcomes of interest such as low APGAR score at five minutes, need for resuscitation at birth or intubation (Janssen et al. 2007; Reid et al. 1989; Rosenblatt et al. 1997; Sutcliffe et al. 2012). Outcomes such as small for GA or low birth weight were not included, as they were not a direct consequence of labour and delivery, but more so of the entire pregnancy (Janssen et al. 2007; Reid et al. 1989; Sutcliffe et al. 2012; Villar et al. 2001). Maternal outcomes such as postpartum haemorrhage requiring hysterectomy and fourth-degree tears were analyzed but not included in the CEA owing to low prevalence and lack of statistically significant differences between providers.

WBDG is a gateway to up-to-date information on integrated ‘whole building’ design techniques and technologies. The goal of ‘Whole Building’ Design is to create a successful high-performance building by applying an integrated design and team approach to the project during the planning and programming phases. The pharmaceutical industry has come a long way since the first drug store reportedly opened in Baghdad in the 8thcentury. The relatively recent development of antibiotics and a plethora of drugs that can treat diseases from cancers to AIDS have had a dramatic impact on the lives of billions of people globally. The pharmaceutical industry itself grew from fairly humble origins to one estimated to represent over €614 bn globally in 2011, according to figures from the European Federation of Pharmaceutical Industries & Association . The probabilities for interventions used in the model were obtained from the retrospective cohort (including oxytocin for induction and augmentation, epidural and forceps/vacuum) and method of delivery .

  • As Paul Citron of Medtronic pointed out, early cost-effectiveness studies for implanted devices are likely to present worst-case scenarios and could cause therapies to be abandoned prematurely.
  • Although methods exist to make an approximate conversion, additional information is required which is not always readily available from the original study, namely the proportion of all costs accounted for by tradeable and by non-tradeable inputs.
  • Two investigators (A.G. and A.E.N.) independently analyzed intervention and outcome rates for each provider group to ensure data agreement and validity.
  • The delivery of high dosage Interleukin-2 usually requires intensive medical support with stringent eligibility criteria for inclusion in trials, raising the question of selection bias.
  • This is an important finding because it demonstrates the impact of human resource costs in the model.
  • Plus, low-code tools simplify implementing electronic health record systems into your platforms.

Finally, the model developed may be used for future larger research studies across multiple settings and can inform governments on funding frameworks for obstetrical care. The objective of this study was to evaluate the cost-effectiveness of obstetrical care for low-risk women by OBs, FPs and MWs during the labour and delivery period in a hospital setting. The study used intervention rates and neonatal outcome rates (avoidance of transfer to the neonatal intensive care unit ) from a Canadian hospital. In-hospital costs were calculated from the provincial Ministry of Health perspective. It is estimated that 5 to 8 percent of all stents that are deployed use IVUS, and a number of clinical studies have shown that IVUS-derived residual plaque burden is the most useful predictor of outcome following clinical interventions. Technical development has persisted despite the slow schedule of reimbursement.

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These platforms provide boilerplate code, reusable components, and pre-built templates to speed up development. In other words, you’re creating an application from building blocks instead of making it from scratch. To help you see why this technology might be right for your company, let’s break down some of the benefits of low-code and traditional development in healthcare. Healthcare low-code development is a visual approach to building applications with minimal manual programming.

Model costs were obtained from both the human resources costing and CMG+ groups described above. All statistical analyses were conducted using SAS (version 9.4) software (SAS Institute Inc. 2013). Relative risks of interventions and neonatal outcomes in FPs and MWs were compared with OBs . low-code Aapp development pitfalls A normal binomial distribution was assumed for all intervention and outcome variables. Given data limitations to further examine patient characteristics between groups, the overall conservative findings of this study support investments and better integration for MWs in the current system.

It has a subtropical maritime monsoon climate; Shenzhen is hot and rainy in summer and mild in winter, and the average annual rainfall is 1837 mm. April to September is the rainy season in Shenzhen; during this period, precipitation is concentrated and storm water overflows are frequent. There were 38 rainstorm days (95 % of the year) in 2017, and the average rainfall was 170–350 mm every month during this period. Accordingly, urban inundation was particularly serious in this period; it caused loss of life and economic losses for local residents. Adequate shelter for all people is one of the pressing challenges faced by the developing countries.

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The coupled model had the advantages of SWMM and IFMS-Urban, and could be applied to simulate urban inundation and evaluate the performance of LID practices. The much vaunted arrival of «big data» – i.e. larger volumes of data than we’ve ever been able to analyze – holds great potential for pharmaceutical companies looking for insights that may yield the new blockbuster drugs the industry so needs. In a recent article published on, strategy consultancy McKinsey observed that big data may help pharmaceutical companies «drive down costs and increase patient safety» by mining «real world data» from healthcare providers.

Available hospital management solutions were overly expensive and would take up to five years to make. Low-code for healthcare reduces strain on IT departments and lowers the overall costs of the software development life-cycle. About 84% of organizations that have implemented low-code did so precisely to cut their expenses. But many platforms are left isolated in outdated legacy systems that are incompatible with more recent technologies.

Low Cost-Effectiveness of the Development Process

Achieving the Sustainable Development Goals will require LMICs to study a broader range of health interventions, particularly in adult health. Some interventions are no longer studied, in some cases because they have become usual care, in other cases because they are no longer relevant. Updating cost-effectiveness rankings on a regular basis is potentially a valuable exercise.

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Two investigators (A.G. and A.E.N.) independently analyzed intervention and outcome rates for each provider group to ensure data agreement and validity. Different rates of intervention use between provider groups during labour and delivery could have cost implications where a fee-for-service payment scheme is used for physician services. Midwifery services are still in a nascent stage of development in the Canadian healthcare system. The scope of practice and payment scheme for this group varies across provinces and territories. In Ontario, MWs are remunerated for a course of care scheme instead of by feefor-service.

Finally, the results of the PVM are instantly sent to the maintenance personnel through an exception alert notification in order to inform the maintenance personnel to quickly rule out the failure. As the developed fault detection system hardware is more cost-effective than existing detection systems, the cost-effectiveness is favorable for mass production with market competitiveness. Sean Tunis explained that there are three main routes whereby new technology enters the Medicare program. One way is through the diagnosis-related group for inpatient care and ambulatory payment classification system for outpatient care. If there exists a DRG/APC payment category for a particular condition new technologies can be added to the Medicare program by being billed under the existing DRG/APC for the condition. The second main route for new technology to enter the Medicare program is through the Local Medical Review Policy process.

We identified cost-effectiveness estimates for 93 interventions and contexts (Figs 1–4), drawn from 149 studies. Although broad national policy changes are very important, it is more difficult to estimate their costs, and their cost-effectiveness is not readily compared with that of individual health interventions. Deriving a more appropriate threshold (e.g., using the marginal health gain with the existing health budget) requires country-specific data. China, which has one-third of the worldwide smoking population, has a substantial cancer burden, with lung cancer being the leading cause of cancer-related death. The effectiveness of lung cancer screening for mortality reduction has been confirmed, but the cost-effectiveness of diverse screening modalities remains unclear. In China, urban inundation appears to be increasing, and LID practices could be efficient strategies for urban inundation mitigation.

Low Cost-Effectiveness of the Development Process

However, the management opted for a low-code platform to reduce the time-to-market. The decision to build a low-code solution for healthcare was the right choice, seeing as the process took only four months with a tiny seven-person team. The solution allowed ATC to reduce licensing costs and simplify patient registering processes and gave access to real-time analysis of critical system data.

What output does a cost-effectiveness analysis provide?

If no context is identified, the results are expected to be generally applicable in LMICs. Luz Saúde, a leading Portuguese healthcare group, needed a tool to provide medical personnel with content management, access control, and scheduling features. The development was estimated to take over nine months with a full-scale engineering team. Advanced Technology Company , a Kuwait-based healthcare technology provider, had a legacy system with complex solutions, siloed data, and inefficient communication between departments.

Low Cost-Effectiveness of the Development Process

An aspect of cost management is a cost control practice called Value Engineering . VE is a systematic evaluation procedure directed at analyzing the function of materials, systems, processes, and building equipment for the purpose of achieving required functions at the lowest total cost of ownership. The model shows that MWs and FPs were more cost-effective than OBs in performing deliveries in low-risk obstetrical patients. Notably, MWs have demonstrated significantly lower intervention rates, which are accompanied by lower costs. The sensitivity analyses showed the MW model to be sensitive to increases in the compensation for attending the delivery. If MW compensation increases, they may no longer be the cost-effective strategy.

Retrospective cohort study methods

So, how do you keep up if you lack the time or budget to upgrade your platform? The low-code approach for healthcare app development may be your best solution to make the process faster, cheaper, and more accessible to people outside of IT. Figure 5b shows changes in the inundation area under different scenarios and at different hazard levels.

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Understanding these cost contributors can help in determining if outsourcing software development is right for you. In the example below, we compare the childhood vaccination programexternal icon to the status quo of no vaccination program. We can see that the costs of implementing the program are less than the medical and productivity costs averted. Because the intervention is cost saving, the results are not presented as a cost-effectiveness ratio.

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The issues of identification, description, and control of the configuration of individual components and the entire system as a whole are important in the development process. On the cost side, studies predominantly use market exchange rates to compare across different currencies. However an influential body of work from the WHO, the WHO-CHOICE study, used international dollars for WHO subregions rather than countries. International dollars make cross-country comparisons somewhat easier to understand by adjusting for salary differences as a component of costs. The downside is that international dollars make comparison more difficult with other studies not using international dollars. It is not simply a matter of using the US $/purchasing power parity exchange rate, since it is necessary also to have information about cost structure.

He concluded by saying that efforts have to be made to increase enrollment in clinical trials. Turning to the regulatory challenges posed by metastatic melanoma, Pazdur said that the disease is characterized by a high degree of biological heterogeneity. Survival may be influenced by prognostic factors, and therefore it is important for clinical trials to be well balanced with regard to these factors. The delivery of high dosage Interleukin-2 usually requires intensive medical support with stringent eligibility criteria for inclusion in trials, raising the question of selection bias.

It helps automate redundant processes during full-scale development, so your in-house team can focus on business-critical aspects of your project. About 50% of enterprises using low-code solutions say they provide a faster speed of delivery than other types of programming. Plus, over 84% of these companies say that the low-code approach helped them improve their time-to-market. This type of paper provides an outlook on future directions of research or possible applications.

A path to faster and more cost-effective drug development

Compared to the benchmark, the reduction rates of maximum inundation depth were 3 %, 7 %, 16 %, 22 %, 26 %, and 29 % under S 1 to S 6, respectively. The results for the 100 % PP and 100 % GR scenarios showed that PP and GR had approximately the same performance at the maximum inundation depth and that both scenarios reduced maximum inundation by 14 %. Guangming New District was selected as the first pilot area for LID practices in Shenzhen in October 2011 because of the intensity of its inundation disasters. There is a need to research the effectiveness of LID on urban inundation mitigation in this area. The expansion of impervious areas accelerates rainwater convergence on urban surfaces, resulting in increased runoff and peak flows (Hatt et al., 2004; Leopold et al., 1995; Liu et al., 2015).