Overall costs for managing oesophageal cancer were high and dominated by surgery costs in patients treated surgically and by chemotherapy costs in patients treated without surgery. Radiotherapy, treatment location and cancer subtype were also important. Monitoring for Barrett's oesophagus and earlier-stage detection were associated with lower management costs, but the potential net benefit from surveillance strategies needs further investigation.
BACKGROUND Early detection and response to influenza and COVID-19 outbreaks in aged care facilities (ACFs) is critical to minimising health impacts. The Sydney Local Health District (SLHD) Public Health Unit has developed and implemented a novel web-based application (app) to assist ACFs in outbreak response with integrated functions for online line listings, detection algorithms and automatic notifications to responders. The goal of the InFLUenza outbreak Communication, Advice and Reporting (FluCARE) app is to reduce time delays to notifications, which we hope will reduce the spread, duration and health impacts of an influenza or COVID-19 outbreak, as well as ease workload burdens on ACF staff. OBJECTIVE The specific aims of the study were: 1.To evaluate the acceptability and user satisfaction in the implementation and use of FluCARE in helping ACFs recognise, notify and manage influenza and COVID-19 outbreaks in their facility;2.To identify the safety of FluCARE and identify any potential adverse outcomes of using the app; and 3.To identify any perceived barriers or facilitators to the implementation and use of FluCARE from the ACF user perspective. METHODS The FluCARE app was piloted from September 2019 to December 2020 in SLHD. Associated implementation included promotion and engagement, user training, and operational policies. Participating ACF staff were invited to complete a post-training survey. Staff were also invited to complete a post pilot evaluation survey which included a user Mobile Application Rating Scale (uMARS) measuring app acceptance, utility, and barriers and facilitators to use. An issues log was also prospectively maintained to assess safety. Survey data were analysed descriptively or via content analysis where appropriate. RESULTS Thirty-one users from 27 ACFs consented and completed the surveys. FluCARE was rated 3.91/5 overall on the uMARS. The study reported that 25 of the 31 users (80%) would definitely use FluCARE for future outbreaks, and all users agreed that the app was useful for identifying influenza and COVID-19 outbreaks at their facilities. There were no reported critical issues with incorrect or missed outbreak detection. User training, particularly online training modules, and technical support were identified as key facilitators to FluCARE use. CONCLUSIONS FluCARE is an acceptable, useful and safe app to assist ACF staff with early detection and response to influenza and COVID-19 outbreaks. This study supports feasibility for ongoing implementation and efficacy evaluation, followed by scale-up into other health districts in NSW. CLINICALTRIAL N/A
Background Early detection and response to influenza and COVID-19 outbreaks in aged care facilities (ACFs) are critical to minimizing health impacts. The Sydney Local Health District (SLHD) Public Health Unit (PHU) has developed and implemented a novel web-based app with integrated functions for online line listings, detection algorithms, and automatic notifications to responders, to assist ACFs in outbreak response. The goal of the Influenza Outbreak Communication, Advice and Reporting (FluCARE) app is to reduce time delays to notifications, which we hope will reduce the spread, duration, and health impacts of an influenza or COVID-19 outbreak, as well as ease workload burdens on ACF staff. Objective The specific aims of the study were to (1) evaluate the acceptability and user satisfaction of the implementation and use of FluCARE in helping ACFs recognize, notify, and manage influenza and COVID-19 outbreaks in their facility; (2) identify the safety of FluCARE and any potential adverse outcomes of using the app; and (3) identify any perceived barriers or facilitators to the implementation and use of FluCARE from the ACF user perspective. Methods The FluCARE app was piloted from September 2019 to December 2020 in the SLHD. Associated implementation included promotion and engagement, user training, and operational policies. Participating ACF staff were invited to complete a posttraining survey. Staff were also invited to complete a postpilot evaluation survey that included the user Mobile Application Rating Scale (uMARS) measuring app acceptance, utility, and barriers and facilitators to use. An issues log was also prospectively maintained to assess safety. Survey data were analyzed descriptively or via content analysis where appropriate. Results Surveys were completed by 31 consenting users from 27 ACFs. FluCARE was rated 3.91 of 5 overall on the uMARS. Of the 31 users, 25 (80%) would definitely use FluCARE for future outbreaks, and all users agreed that the app was useful for identifying influenza and COVID-19 outbreaks at their facilities. There were no reported critical issues with incorrect or missed outbreak detection. User training, particularly online training modules, and technical support were identified as key facilitators to FluCARE use. Conclusions FluCARE is an acceptable, useful, and safe app to assist ACF staff with early detection and response to influenza and COVID-19 outbreaks. This study supports feasibility for ongoing implementation and efficacy evaluation, followed by scale-up into other health districts in New South Wales.
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