Economic Evaluation of Total Knee Replacement Compared with Non-Surgical Management for Knee Osteoarthritis in India.

Objective: This study is an economic evaluation of total knee replacement (TKR) in comparison with non-surgical management in India.

Methods: Cost-utility analysis and budget impact analysis (BIA) were conducted on individuals aged ≥ 50 years with osteoarthritis of the knee (OA knee) Kellgren-Lawrence grades 2 and 3 using a provider's perspective. Three scenarios were considered, varying the age at which TKR is administered while assuming a 20-year lifespan for the implant.

Costs and models used in the economic analysis of Total Knee Replacement (TKR): A systematic review.

Objectives: The main objective of this review is to summarize the evidence on the core modelling specifications and methodology on the cost-effectiveness of TKR compared to non-surgical management. Another objective of this study is to synthesize evidence of TKR cost and compare it across countries using purchasing power parity (PPP).

Methodology: The electronic databases used for this review were MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), HTAIn repository, Cost effectiveness Analysis (CEA) registry, and Google Scholar.

Why are they "unreached"? Macro and Meso determinants of health care access in hard to reach areas of Odisha, India.

Background: Reaching hard to reach populations is key to reduce health inequities. Despite targeted interventions, status of crucial public health indicators like neonatal and maternal mortality is still far from optimal. Complex interplay of social determinants can influence both communities and health care workers to effectively access each other.

Profile of comorbidity and multimorbidity among women attending antenatal clinics: An exploratory cross-sectional study from Odisha, India.

Background: Multimorbidity is being recognized as a crucial maternal health challenge in India. However, pregnancy remains an exclusion criterion in most multimorbidity estimation studies resulting in a deficient understanding of the problem in this population. The present study aims to estimate the prevalence of multimorbidity, identify its correlates, and assess healthcare utilization and expenditure outcomes among women availing of antenatal care clinics.

Disability Weights Estimates From India in 2018: Measurements From Community Members From Two Distinct States of India.

Background: India is undergoing a rapid demographic and epidemiologic transition. Thus demanding prioritization of diseases based on burden estimation is befitting our cultural diversity. Disability weights (DWs) by Global burden of disease (GBD) studies may not be representative.

Profile of multimorbidity in outpatients attending public healthcare settings: A descriptive cross-sectional study from Odisha, India.

Background: Multimorbidity, the co-occurrence of two or more long-term conditions (LTC) in individuals, is associated with greater healthcare utilization, expenditure, and premature mortality, thus positing a challenge for patients and healthcare providers. Given its sparsely available epidemiological evidence, we aimed to describe the profile of multimorbidity in a representative sample of public healthcare outpatients in India.

Methods: A facility-based cross-sectional study was conducted from 1 July to 31 December 2015 in Odisha, India.

Managing diabetes mellitus with comorbidities in primary healthcare facilities in urban settings: a qualitative study among physicians in Odisha, India.

Aim: To explore the perceived barriers and facilitators in the management of the patients having diabetes with comorbidities by primary care physicians.

Methods: A qualitative In-Depth Interview study was conducted among the primary care physicians at seventeen urban primary health care centres at Bhubaneswar city of Odisha, India. The digitally recorded interviews were transcribed verbatim and translated into English.

Impact of comorbidity on health-related quality of life among type 2 diabetic patients in primary care.

Background: Health-related quality of life (HRQL) is an important outcome for chronic diseases such as diabetes mellitus that is associated with complications, comorbidities, and lifelong care.

Objectives: The present study aims to explore the impact of comorbidities on the different dimensions of HRQL among type 2 diabetic patients attending primary care.

Methods: A total of 912 type 2 diabetic patients attending primary care centers in India were assessed using a predesigned and pretested questionnaire - Diabetes Comorbidity Evaluation Tool in Primary Care.

Describing the Development of a Health State Valuation Protocol to Obtain Community-Derived Disability Weights.

For the prioritization of the allocation of national resources, estimating the burden of disease studies play a critical role. Hence the first Global Burden of Disease study conducted in the 1990s was done for this particular estimation. By the means of introducing disability-adjusted life year (DALY) metric, the burden of various diseases was calculated using disability weights (DWs)-a component of DALY.

Risk factors for dengue outbreaks in Odisha, India: A case-control study.

Background: Environmental and climatic risk factors of dengue outbreak has been studied in detail. However, the socio-epidemiological association with the disease is least explored. The study aims to identify the social and ecological factors associated with emerging dengue in Odisha, India.

Distribution of and associated factors for dengue burden in the state of Odisha, India during 2010-2016.

This study is aimed to estimate the epidemiological burden of dengue in Odisha, India using the disability adjusted life year (DALY) methods and to explore the associated factors in the year 2010-2016. During the period of 2010-2016, 27 772 cases (68.4% male) were reported in the state.

Has the Public Health System Provided Adequate Financial Risk Protection for Child Birth Conditions - Evidences From an Eastern Indian State.

Over the years, national and sub-national governments have introduced several initiatives to improve access to maternal and child health services in India. However, financial barriers have posed major constraints. Based upon the data of National Family Health Survey (NFHS) round 4 for Odisha state, our paper examines the out-of-pocket expenditure (OOPE) borne by households for accessing maternal and child healthcare services in a low resource setting of India.

'Health Promoting School' Model in Prevention of Vector-Borne Diseases in Odisha: A Pilot Intervention.

We tested 'Health-Promoting School model' for vector-borne diseases (VBDs) through behavioural changes among students in India for better control of the diseases in the community. A total of 1098 students from eight co-ed schools (four controls and four interventions) of Odisha participated in the study. Intervention was 12 h of class room teaching and activities on mosquito dynamics, source identification, prevention and management of VBDs.

Health system preparedness in noncommunicable diseases: Findings from two states Odisha and Kerala in India.

Introduction: "Non-communicable diseases (NCDs) are the raging reality of today's world and have moved up the priority list of most countries worldwide including India. The government of India has launched programs such as National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular disease, and Stroke, but little is known about preparedness of health system to address NCDs.

Methods: A qualitative study was conducted in the states of Odisha and Kerala to document the government stakeholder perspectives of health system preparedness for NCDs.

Does public health system provide adequate financial risk protection to its clients? Out of pocket expenditure on inpatient care at secondary level public health institutions: Causes and determinants in an eastern Indian state.

Unlabelled: This study is undertaken to estimate the out of pocket expenditure (OOPE) for various diseases and its determinants at secondary level public health facilities in Odisha.

Methods: A cross-sectional survey was conducted among the inpatients utilising secondary level public health facilities in the 2 districts of Odisha. More than 80% of the inpatients were selected conveniently, and data on OOPE and socioeconomic status of patients were collected.

Barriers and enablers to adoption of intrauterine device as a contraceptive method: A multi-stakeholder perspective.

Background: Promoting family planning practices aid considerably in attaining Millennium Development Goals by various mechanisms. Despite concerted health system efforts, adoption of especially reversible contraceptive methods such as intrauterine devices (IUDs) has remained negatively skewed in India, which is the pioneer country to implement Family Planning programme way back in 1952. Although few studies in India have looked into the reasons for its nonacceptance, literature from Odisha was scant and hence the study was undertaken.

Out-of-Pocket health expenditure and sources of financing for delivery, postpartum, and neonatal health in urban slums of Bhubaneswar, Odisha, India.

Background: Out-of-pocket expenditure (OOPE) is an obstacle in the path of getting universal health coverage in India.

Objective: This study aimed to explore the OOPE, sources of funding, and experience of catastrophic expenditure (CE) for healthcare related to delivery, postpartum, and neonatal morbidity.

Methods: A community-based, cross-sectional survey was conducted among a sample of 240 recently delivered women from the slums of Bhubaneswar, Odisha.

Prevalence, Pattern, and Correlates of Alcohol Misuse among Male Patients Attending Rural Primary Care in India.

Background: There are limited data available on how the problem of alcohol use is detected in primary care setting in India. Particularly in Odisha, it has not been investigated yet. This study was conducted to determine the prevalence of drinking, drinking patterns, and quitting behavior among the male patients visiting a primary health-care facility in a district of Odisha.

Development of an international comorbidity education framework.

Context: The increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions.

Aim: Our aims were to evaluate current teaching and learning about comorbidity care amongst the global population of healthcare students from different disciplines and to develop an International Comorbidity Education Framework (ICEF) for incorporating comorbidity concepts into health education.

Diabetes Mellitus among Newly Diagnosed Tuberculosis Patients in Tribal Odisha: An Exploratory Study.

Introduction: The association between Diabetes Mellitus (DM) and Tuberculosis (TB) poses a strong public health challenge. Tribal ethnics possess a different propensity towards infectious and haematological diseases which may influence the inter-relationship of DM and TB and thus merit separate attention.

Aim: To investigate the prevalence of diabetes in newly diagnosed pulmonary TB patients of tribal ethnicity in Odisha.

Teaching of geriatric health in India: Mapping the terrain.

India is currently undergoing a rapid demographic transition along with a dramatic upsurge in the number of elderly adults. Creating a cadre of specialized health care professionals in geriatric medicine is clearly vital to address the health care needs of this growing population. The authors undertook a mapping of the available academic programs in geriatric health in India and examined their content, duration, architecture, and student intake.

Family medicine education in India: A panoramic view.

Introduction: In the recent years, there has been renewed interest in strengthening primary care for improved health services delivery. Family medicine with its holistic principles is an effective approach for building primary care workforce in resource constraint settings. Even though this discipline is well established and mainstreamed in Western countries, the same is yet to occur in low- and middle-income nations.

Report from a symposium on catalyzing primary and secondary prevention of cancer in India.

Purpose: Oral, breast, and cervical cancers are amenable to early detection and account for a third of India's cancer burden. We convened a symposium of diverse stakeholders to identify gaps in evidence, policy, and advocacy for the primary and secondary prevention of these cancers and recommendations to accelerate these efforts.

Methods: Indian and global experts from government, academia, private sector (health care, media), donor organizations, and civil society (including cancer survivors and patient advocates) presented and discussed challenges and solutions related to strategic communication and implementation of prevention, early detection, and treatment linkages.