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Sample records for health economic assessment

  1. Limits on use of health economic assessments for rare diseases.

    PubMed

    Hyry, H I; Stern, A D; Cox, T M; Roos, J C P

    2014-03-01

    Funding of expensive treatments for rare (orphan) diseases is contentious. These agents fare poorly on 'efficiency' or health economic measures, such as the quality-adjusted life years, because of high cost and frequently poor gains in quality of life and survival. We show that cost-effectiveness assessments are flawed, and have only a limited role to play in reimbursement decisions for orphan drugs and beyond. PMID:24453281

  2. Particulate matter in urban areas: health-based economic assessment.

    PubMed

    El-Fadel, M; Massoud, M

    2000-08-10

    The interest in the association between human health and air pollution has grown substantially in recent years. Based on epidemiological studies in several countries, there is conclusive evidence of a link between particulate air pollution and adverse health effects. Considering that particulate matter may be the most serious pollutant in urban areas and that pollution-related illness results in financial and non-financial welfare losses, the main objective of this study is to assess the economic benefits of reducing particulate air pollution in Lebanese urban areas. Accordingly, the extent and value of health benefits due to decreasing levels of particulate in the air are predicted. Health impacts are expressed in both physical and monetary terms for saved statistical lives, and productivity due to different types of morbidity endpoints. Finally, the study concludes with a range of policy options available to mitigate particulate air pollution in urban areas. PMID:10989923

  3. Current process and future path for health economic assessment of pharmaceuticals in France.

    PubMed

    Toumi, Mondher; Rémuzat, Cécile; El Hammi, Emna; Millier, Aurélie; Aballéa, Samuel; Chouaid, Christos; Falissard, Bruno

    2015-01-01

    The Social Security Funding Law for 2012 introduced the Economic and Public Health Assessment Committee (Commission Evaluation Economique et de Santé Publique, or CEESP) in the Social Security Code as a specialised committee affiliated with the Haute Autorité de Santé in charge of providing recommendations and health economic opinions. This article provides an in-depth description of the CEESP's structure and working methods, and analyses the impact of health economic assessment on market access of drugs in France. It also points out the areas of uncertainty and the conflicting rules following the introduction of the health economic assessment in France. The authors also provide their personal opinion on the likely future of health economic assessment of drugs in France, including the possible merge of the CEESP and the Transparency Committee, the implementation of a French threshold, and the extension of health economic assessment to a larger number of products. PMID:27123173

  4. Current process and future path for health economic assessment of pharmaceuticals in France

    PubMed Central

    Toumi, Mondher; Rémuzat, Cécile; El Hammi, Emna; Millier, Aurélie; Aballéa, Samuel; Chouaid, Christos; Falissard, Bruno

    2015-01-01

    The Social Security Funding Law for 2012 introduced the Economic and Public Health Assessment Committee (Commission Evaluation Economique et de Santé Publique, or CEESP) in the Social Security Code as a specialised committee affiliated with the Haute Autorité de Santé in charge of providing recommendations and health economic opinions. This article provides an in-depth description of the CEESP's structure and working methods, and analyses the impact of health economic assessment on market access of drugs in France. It also points out the areas of uncertainty and the conflicting rules following the introduction of the health economic assessment in France. The authors also provide their personal opinion on the likely future of health economic assessment of drugs in France, including the possible merge of the CEESP and the Transparency Committee, the implementation of a French threshold, and the extension of health economic assessment to a larger number of products. PMID:27123173

  5. Health Economics of Dengue: A Systematic Literature Review and Expert Panel's Assessment

    PubMed Central

    Beatty, Mark E.; Beutels, Philippe; Meltzer, Martin I.; Shepard, Donald S.; Hombach, Joachim; Hutubessy, Raymond; Dessis, Damien; Coudeville, Laurent; Dervaux, Benoit; Wichmann, Ole; Margolis, Harold S.; Kuritsky, Joel N.

    2011-01-01

    Dengue vaccines are currently in development and policymakers need appropriate economic studies to determine their potential financial and public health impact. We searched five databases (PubMed, EMBASE, LILAC, EconLit, and WHOLIS) to identify health economics studies of dengue. Forty-three manuscripts were identified that provided primary data: 32 report economic burden of dengue and nine are comparative economic analyses assessing various interventions. The remaining two were a willingness-to-pay study and a policymaker survey. An expert panel reviewed the existing dengue economic literature and recommended future research to fill information gaps. Although dengue is an important vector-borne disease, the economic literature is relatively sparse and results have often been conflicting because of use of inconsistent assumptions. Health economic research specific to dengue is urgently needed to ensure informed decision making on the various options for controlling and preventing this disease. PMID:21363989

  6. Health economics of dengue: a systematic literature review and expert panel's assessment.

    PubMed

    Beatty, Mark E; Beutels, Philippe; Meltzer, Martin I; Shepard, Donald S; Hombach, Joachim; Hutubessy, Raymond; Dessis, Damien; Coudeville, Laurent; Dervaux, Benoit; Wichmann, Ole; Margolis, Harold S; Kuritsky, Joel N

    2011-03-01

    Dengue vaccines are currently in development and policymakers need appropriate economic studies to determine their potential financial and public health impact. We searched five databases (PubMed, EMBASE, LILAC, EconLit, and WHOLIS) to identify health economics studies of dengue. Forty-three manuscripts were identified that provided primary data: 32 report economic burden of dengue and nine are comparative economic analyses assessing various interventions. The remaining two were a willingness-to-pay study and a policymaker survey. An expert panel reviewed the existing dengue economic literature and recommended future research to fill information gaps. Although dengue is an important vector-borne disease, the economic literature is relatively sparse and results have often been conflicting because of use of inconsistent assumptions. Health economic research specific to dengue is urgently needed to ensure informed decision making on the various options for controlling and preventing this disease. PMID:21363989

  7. Integrated Assessment of Health-related Economic Impacts of U.S. Air Pollution Policy

    NASA Astrophysics Data System (ADS)

    Saari, R. K.; Rausch, S.; Selin, N. E.

    2012-12-01

    We examine the environmental impacts, health-related economic benefits, and distributional effects of new US regulations to reduce smog from power plants, namely: the Cross-State Air Pollution Rule. Using integrated assessment methods, linking atmospheric and economic models, we assess the magnitude of economy-wide effects and distributional consequences that are not captured by traditional regulatory impact assessment methods. We study the Cross-State Air Pollution Rule, a modified allowance trading scheme that caps emissions of nitrogen oxides and sulfur dioxide from power plants in the eastern United States and thus reduces ozone and particulate matter pollution. We use results from the regulatory regional air quality model, CAMx (the Comprehensive Air Quality Model with extensions), and epidemiologic studies in BenMAP (Environmental Benefits Mapping and Analysis Program), to quantify differences in morbidities and mortalities due to this policy. To assess the economy-wide and distributional consequences of these health impacts, we apply a recently developed economic and policy model, the US Regional Energy and Environmental Policy Model (USREP), a multi-region, multi-sector, multi-household, recursive dynamic computable general equilibrium economic model of the US that provides a detailed representation of the energy sector, and the ability to represent energy and environmental policies. We add to USREP a representation of air pollution impacts, including the estimation and valuation of health outcomes and their effects on health services, welfare, and factor markets. We find that the economic welfare benefits of the Rule are underestimated by traditional methods, which omit economy-wide impacts. We also quantify the distribution of benefits, which have varying effects across US regions, income groups, and pollutants, and we identify factors influencing this distribution, including the geographic variation of pollution and population as well as underlying

  8. Economic Assessment of Zoonoses Surveillance in a 'One Health' Context: A Conceptual Framework.

    PubMed

    Babo Martins, S; Rushton, J; Stärk, K D C

    2016-08-01

    Collaboration between animal and public health sectors has been highlighted as a means to improve the management of zoonotic threats. This includes surveillance systems for zoonoses, where enhanced cross-sectoral integration and sharing of information are seen as key to improved public health outcomes. Yet, there is a lack of evidence on the economic returns of such collaboration, particularly in the development and implementation of surveillance programmes. The economic assessment of surveillance in this context needs to be underpinned by the understanding of the links between zoonotic disease surveillance in animal populations and the wider public health disease mitigation process and how these relations impact on the costs and benefits of the surveillance activities. This study presents a conceptual framework of these links as a basis for the economic assessment of cross-sectoral zoonoses surveillance with the aim of supporting the prioritization of resource allocation to surveillance. In the proposed framework, monetary, non-monetary and intermediate or intangible cost components and benefit streams of three conceptually distinct stages of zoonotic disease mitigation are identified. In each stage, as the final disease mitigation objective varies so does the use of surveillance information generated in the animal populations for public health decision-making. Consequently, the associated cost components and benefit streams also change. Building on the proposed framework and taking into account these links, practical steps for its application are presented and future challenges are discussed. PMID:26607752

  9. Do health economic evaluations using observational data provide reliable assessment of treatment effects?

    PubMed Central

    2013-01-01

    Economic evaluation in modern health care systems is seen as a transparent scientific framework that can be used to advance progress towards improvements in population health at the best possible value. Despite the perceived superiority that trial-based studies have in terms of internal validity, economic evaluations often employ observational data. In this review, the interface between econometrics and economic evaluation is explored, with emphasis placed on highlighting methodological issues relating to the evaluation of cost-effectiveness within a bivariate framework. Studies that satisfied the eligibility criteria exemplified the use of matching, regression analysis, propensity scores, instrumental variables, as well as difference-in-differences approaches. All studies were reviewed and critically appraised using a structured template. The findings suggest that although state-of-the-art econometric methods have the potential to provide evidence on the causal effects of clinical and policy interventions, their application in economic evaluation is subject to a number of limitations. These range from no credible assessment of key assumptions and scarce evidence regarding the relative performance of different methods, to lack of reporting of important study elements, such as a summary outcome measure and its associated sampling uncertainty. Further research is required to better understand the ways in which observational data should be analysed in the context of the economic evaluation framework. PMID:24229445

  10. Health impacts and economic losses assessment of the 2013 severe haze event in Beijing area.

    PubMed

    Gao, Meng; Guttikunda, Sarath K; Carmichael, Gregory R; Wang, Yuesi; Liu, Zirui; Stanier, Charles O; Saide, Pablo E; Yu, Man

    2015-04-01

    Haze is a serious air pollution problem in China, especially in Beijing and surrounding areas, affecting visibility, public health and regional climate. In this study, the Weather Research and Forecasting-Chemistry (WRF-Chem) model was used to simulate PM2.5 (particulate matters with aerodynamic diameter≤2.5 μm) concentrations during the 2013 severe haze event in Beijing, and health impacts and health-related economic losses were calculated based on model results. Compared with surface monitoring data, the model results reflected pollution concentrations accurately (correlation coefficients between simulated and measured PM2.5 were 0.7, 0.4, 0.5 and 0.6 in Beijing, Tianjin, Xianghe and Xinglong stations, respectively). Health impacts assessments show that the PM2.5 concentrations in January might cause 690 (95% confidence interval (CI): (490, 890)) premature deaths, 45,350 (95% CI: (21,640, 57,860)) acute bronchitis and 23,720 (95% CI: (17,090, 29,710)) asthma cases in Beijing area. Results of the economic losses assessments suggest that the haze in January 2013 might lead to 253.8 (95% CI: (170.2, 331.2)) million US$ losses, accounting for 0.08% (95% CI: (0.05%, 0.1%)) of the total 2013 annual gross domestic product (GDP) of Beijing. PMID:25585158

  11. The Economics of Health.

    ERIC Educational Resources Information Center

    Cairns, John

    1978-01-01

    Discusses the relationship of economics to health, health services, and supply and demand of health care. Examines alternative mechanisms by which health resources can be allocated and considers who should make decisions about rationing medical care. (DB)

  12. Quality of life, resource utilisation and health economics assessment in advanced neuroendocrine tumours: a systematic review.

    PubMed

    Chau, I; Casciano, R; Willet, J; Wang, X; Yao, J C

    2013-11-01

    Neuroendocrine tumours (NET) are often diagnosed at an advanced stage when the prognosis is poor for patients, who often experience diminished quality of life (QoL). As new treatments for NET become available, it is important to characterise the associated outcomes, costs and QoL. A comprehensive search was performed to systematically review available data in advanced NET regarding cost of illness/resource utilisation, economic studies/health technology assessment and QoL. Four rounds of sequential review narrowed the search results to 22 relevant studies. Most focused on surgical procedures and diagnostic tools and contained limited information on the costs and consequences of medical therapies. Multiple tools are used to assess health-related QoL in NET, but few analyses have been conducted to assess the comparative impact of available treatment alternatives on QoL. Limitations include English language and the focus on advanced NET; ongoing terminology and classification changes prevented pooled statistical analyses. This systematic review suggests a lack of comparative economic and outcomes data associated with NET treatments. Further research on disease costs, resource utilisation and QoL for patients with advanced NET is warranted. PMID:23895457

  13. Quality of life, resource utilisation and health economics assessment in advanced neuroendocrine tumours: a systematic review

    PubMed Central

    Chau, I; Casciano, R; Willet, J; Wang, X; Yao, JC

    2013-01-01

    Neuroendocrine tumours (NET) are often diagnosed at an advanced stage when the prognosis is poor for patients, who often experience diminished quality of life (QoL). As new treatments for NET become available, it is important to characterise the associated outcomes, costs and QoL. A comprehensive search was performed to systematically review available data in advanced NET regarding cost of illness/resource utilisation, economic studies/health technology assessment and QoL. Four rounds of sequential review narrowed the search results to 22 relevant studies. Most focused on surgical procedures and diagnostic tools and contained limited information on the costs and consequences of medical therapies. Multiple tools are used to assess health-related QoL in NET, but few analyses have been conducted to assess the comparative impact of available treatment alternatives on QoL. Limitations include English language and the focus on advanced NET; ongoing terminology and classification changes prevented pooled statistical analyses. This systematic review suggests a lack of comparative economic and outcomes data associated with NET treatments. Further research on disease costs, resource utilisation and QoL for patients with advanced NET is warranted. PMID:23895457

  14. Government use licenses in Thailand: an assessment of the health and economic impacts

    PubMed Central

    2011-01-01

    Background Between 2006 and 2008, Thailand's Ministry of Public Health (MOPH) granted government use licenses for seven patented drugs in order to improve access to these essential treatments. The decision to grant the government use licenses was contentious both within and beyond the country. In particular, concerns were highlighted that the negative consequences might outweigh the expected benefits of the policy. This study conducted assessments of the health and economic implications of these government use licenses. Methods The health and health-related economic impacts were quantified in terms of i) Quality Adjusted Life Years (QALYs) gained and ii) increased productivity in US dollars (USD) as a result of the increased access to drugs. The study adopted a five-year timeframe for the assessment, commencing from the time of the grant of the government use licenses. Empirical evidence gathered from national databases was used to assess the changes in volume of exports after US Generalized System of Preferences (GSP) withdrawal and level of foreign direct investment (FDI). Results As a result of the granting of the government use licenses, an additional 84,158 patients were estimated to have received access to the seven drugs over five years. Health gains from the use of the seven drugs compared to their best alternative accounted for 12,493 QALYs gained, which translates into quantifiable incremental benefits to society of USD132.4 million. The government use license on efavirenze was found to have the greatest benefit. In respect of the country's economy, the study found that Thailand's overall exports increased overtime, although exports of the three US GSP withdrawal products to the US did decline. There was also found to be no relationship between the government use licenses and the level of foreign investment over the period 2002 to 2008. Conclusions The public health benefits of the government use licenses were generally positive. Specifically, the policy

  15. A framework for assessing health system resilience in an economic crisis: Ireland as a test case

    PubMed Central

    2013-01-01

    Background The financial crisis that hit the global economy in 2007 was unprecedented in the post war era. In general the crisis has created a difficult environment for health systems globally. The purpose of this paper is to develop a framework for assessing the resilience of health systems in terms of how they have adjusted to economic crisis. Resilience can be understood as the capacity of a system to absorb change but continue to retain essentially the same identity and function. The Irish health system is used as a case study to assess the usefulness of this framework. Methods The authors identify three forms of resilience: financial, adaptive and transformatory. Indicators of performance are presented to allow for testing of the framework and measurement of system performance. Both quantitative and qualitative methods were used to yield data for the Irish case study. Quantitative data were collected from government documents and sources to understand the depth of the recession and the different dimensions of the response. Semi-structured interviews were conducted with key decision makers to understand the reasons for decisions made. Results In the Irish case there is mixed evidence on resilience. Health funding was initially protected but was then followed by deep cuts as the crisis deepened. There is strong evidence for adaptive resilience, with the health system showing efficiency gains from the recession. Nevertheless, easy efficiencies have been made and continued austerity will mean cuts in entitlements and services. The prospects for building and maintaining transformatory resilience are unsure. While the direction of reform is clear, and has been preserved to date, it is not certain whether it will remain manageable given continued austerity, some loss of sovereignty and capacity limitations. Conclusions The three aspects of resilience proved a useful categorisation of performance measurement though there is overlap between them. Transformatory

  16. Quantifying Groundwater Quality at a Regional Scale: Establishing a Foundation for Economic and Health Assessments

    NASA Astrophysics Data System (ADS)

    Belitz, K.

    2015-12-01

    -metric exceeds 50,000 people in 10 study areas. On a statewide basis, the population metric is 2 million people (18% of 11 million equivalent-people). The proposed assessment approach is independent of scale, allows for consistent comparison across regions, and provides a foundation for subsequent economic or health assessments.

  17. Assessment of resident's exposure level and health economic costs of PM10 in Beijing from 2008 to 2012.

    PubMed

    Hou, Qing; An, Xingqin; Tao, Yan; Sun, Zhaobin

    2016-09-01

    Epidemiological studies have asserted a negative association between atmospheric particulates and human health, especially particulate matter (PM10), which can cause a noticeable damage to human health. In recent years, PM10 has become the primary pollutant in major cities in China. It is crucial to evaluate the health impacts of PM10 to make pollution control policies and protect public health. For health-based assessments, human exposure evaluation is a key step, which is related to offering an exact exposure date for assessment. Using high-density PM10 and population data based on the Geographic Information System (GIS), this study estimated the impact of PM10 on human exposure levels and combined the exposure-response function with the health-economic loss relationship to assess the effect of PM10 on human health in Beijing from 2008 to 2012 quantitatively. The results showed that the population distribution was highly centralized in urban areas, especially inside the fifth ring road. A high proportion, 63.4% of the population, was exposed to the range of 120 to 130μg/m(3). Approximately 44.1% of that population was located inside the fifth ring road, and approximately 55.9% of it was located outside of the fifth ring road. The spatial distribution of the economic cost associated with PM10 from 2008 to 2012 was uneven, being highly centralized in urban areas, especially inside the fifth ring road, similar to the population densities. The economic cost increased from 2008 to 2012, similar to GDP. The proportion of economic cost to Beijing's GDP decreased from 2008 to 2012. The average economic cost of 5years inside the fifth ring road was 4.55billion US$; that of the outside was 4.95billion US$. The proportions of average economic losses compared with GDP inside and outside of the fifth ring road changed slightly in the period from 2008 to 2012. PMID:27155078

  18. Postmodern health economics.

    PubMed

    Mannion, R; Small, N

    1999-01-01

    Postmodernism and health economics are both concerned with questions about choices and values, risk and uncertainty. Postmodernists seek to respond to such questions in the context of a world of uncoordinated and often contradictory chances, a world devoid of clear-cut standards. Health economics seeks to respond using the constructs of modernity, including the application of reason to generate better order. In this article we present two sorts of voice. First we introduce postmodernism and those seeking to contribute to economics from a postmodern perspective. Second, we consider critics of a prevalent neo-classicism within health economics both from outside that paradigm and from those more closely associated with it. It is increasingly evident that (health) economics, as presently constituted, is failing both in its descriptive powers and its prescriptive possibilities. Postmodernism offers not just an alternative theoretical approach but the possibility of both expanding the scope of health economics and grounding it more appropriately in the everyday experience of those engaging with health systems. PMID:10724554

  19. Health economics and orthopaedics.

    PubMed

    Maniadakis, N; Gray, A

    2000-01-01

    It is becoming widely accepted that research which considers only the outcome and not the costs associated with new technologies in health care, is of limited value in making decisions about the use of scarce resources. Economic evaluation is becoming a standard feature of clinical research but many published economic evaluations fall short of best practice in their methodology. We have described the essential features of economic evaluation, using published studies in orthopaedics, in order to try to improve the ability of orthopaedic surgeons to read, understand and appraise such studies critically, and to encourage them to consider including economic evaluation in future investigations. PMID:10697306

  20. Assessing the incremental effects of combining economic and health interventions: the IMAGE study in South Africa

    PubMed Central

    Ferrari, Giulia; Abramsky, Tanya; Watts, Charlotte; Hargreaves, James; Morison, Linda; Phetla, Godfrey; Porter, John; Pronyk, Paul

    2009-01-01

    Abstract Objective To explore whether adding a gender and HIV training programme to microfinance initiatives can lead to health and social benefits beyond those achieved by microfinance alone. Methods Cross-sectional data were derived from three randomly selected matched clusters in rural South Africa: (i) four villages with 2-year exposure to the Intervention with Microfinance for AIDS and Gender Equity (IMAGE), a combined microfinance–health training intervention; (ii) four villages with 2-year exposure to microfinance services alone; and (iii) four control villages not targeted by any intervention. Adjusted risk ratios (aRRs) employing village-level summaries compared associations between groups in relation to indicators of economic well-being, empowerment, intimate partner violence (IPV) and HIV risk behaviour. The magnitude and consistency of aRRs allowed for an estimate of incremental effects. Findings A total of 1409 participants were enrolled, all female, with a median age of 45. After 2 years, both the microfinance-only group and the IMAGE group showed economic improvements relative to the control group. However, only the IMAGE group demonstrated consistent associations across all domains with regard to women’s empowerment, intimate partner violence and HIV risk behaviour. Conclusion The addition of a training component to group-based microfinance programmes may be critical for achieving broader health benefits. Donor agencies should encourage intersectoral partnerships that can foster synergy and broaden the health and social effects of economic interventions such as microfinance. PMID:20072767

  1. Economic Evaluation of Health IT.

    PubMed

    Luzi, Daniela; Pecoraro, Fabrizio; Tamburis, Oscar

    2016-01-01

    Economic evaluation in health care supports decision makers in prioritizing interventions and maximizing the available limited resources for social benefits. Health Information Technology (health IT) constitutes a promising strategy to improve the quality and delivery of health care. However, to determine whether the appropriate health IT solution has been selected in a specific health context, its impact on the clinical and organizational process, on costs, on user satisfaction as well as on patient outcomes, a rigorous and multidimensional evaluation analysis is necessary. Starting from the principles of evaluation introduced since the mid-1980s within the Health Technology Assessment (HTA) guidelines, this contribution provides an overview of the main challenging issues related to the complex task of performing an economic evaluation of health IT. A set of necessary key principles to deliver a proper design and implementation of a multidimensional economic evaluation study is described, focusing in particular on the classification of costs and outcomes as well as on the type of economic analysis to be performed. A case study is eventually described to show how the key principles introduced are applied. PMID:27198101

  2. [Cancer and health economics].

    PubMed

    Koinuma, N

    1996-01-01

    Health economics on cancer medicine is a supportive tool of cancer care and is becoming one of the essential weapons against cancer. Its principal roles are to enhance the quality and efficacy and to secure the finance necessary to the cancer care. The economic aspects of cancer medicine and the methods of economic evaluation are overviewed with emphasis on cost-benefit, cost-effectiveness and cost-utility analysis. The operational and interpretational checkpoints are introduced, and the problems and prospects of the practical use of the methods on clinical settings such as cancer chemotherapy are discussed. PMID:8546457

  3. Assessment of alcohol use in health professionals during the economic crisis.

    PubMed

    Saridi, Maria; Karra, Aphrodite; Kourakos, Michael; Souliotis, Kyriakos

    The aim of this study was to investigate the use of alcohol in health professionals during the economic crisis in Greece. The sample included 579 health professionals. Despite the fact that alcohol consumption was low and women held more negative views on the effectiveness of its use compared to men, they consumed more than men both in quantity (mean 1.57 vs 1.46, p=0.291) and in frequency (mean 1.98 vs 1.73, p=0.132). Employees with a higher level of education expressed more opposition to the use of alcohol than those with a basic level of education (93.5% vs 66.7%, p=0.004). There was a significant positive correlation between the amount of alcohol consumed after a stressful event and the frequency with which this amount of alcohol consumption occurred in workers. PMID:27081734

  4. Using Integrated Assessment Models to Estimate the Economic Damages from Temperature Related Human Health Effects in the US

    NASA Astrophysics Data System (ADS)

    Gilmore, E.; Calvin, K. V.; Puett, R.; Sapkota, A.; Schwarber, A.

    2014-12-01

    Climate change is projected to increase risks to human health. One pathway that may be particularly difficult to manage is adverse human health impacts (e.g. premature mortality and morbidity) from increases in mean temperatures and changing patterns of temperature extremes. Modeling how these health risks evolve over decadal time-scales is challenging as the severity of the impacts depends on changes in climate as well as socioeconomic conditions. Here, we show estimates of health damages as well as both direct and indirect economic damages that span climate and socioeconomic dimensions for each US state to 2050. We achieve this objective by extending the integrated assessment model (IAM), Global Change Assessment Model (GCAM-USA). First, we quantify the change in premature mortality. We identify a range of exposure-response relationships for temperature related mortality through a critical review of the literature. We then implement these relationships in the GCAM by coupling them with projections of future temperature patterns and population estimates. Second, we monetize the effect of these adverse health effects, including both direct and indirect economic costs through labor force participation and productivity along a range of possible economic pathways. Finally, we evaluate how uncertainty in the parameters and assumptions affects the range of possible estimates. We conclude that the model is sensitive to assumptions regarding exposure-response relationship and population growth. The economic damages, however, are driven by the estimates of income and GDP growth as well as the potential for adaptation measures, namely the use and effectiveness of air conditioning.

  5. Prognostic Health Monitoring System: Component Selection Based on Risk Criteria and Economic Benefit Assessment

    SciTech Connect

    Binh T. Pham; Vivek Agarwal; Nancy J Lybeck; Magdy S Tawfik

    2012-05-01

    Prognostic health monitoring (PHM) is a proactive approach to monitor the ability of structures, systems, and components (SSCs) to withstand structural, thermal, and chemical loadings over the SSCs planned service lifespans. The current efforts to extend the operational license lifetime of the aging fleet of U.S. nuclear power plants from 40 to 60 years and beyond can benefit from a systematic application of PHM technology. Implementing a PHM system would strengthen the safety of nuclear power plants, reduce plant outage time, and reduce operation and maintenance costs. However, a nuclear power plant has thousands of SSCs, so implementing a PHM system that covers all SSCs requires careful planning and prioritization. This paper therefore focuses on a component selection that is based on the analysis of a component's failure probability, risk, and cost. Ultimately, the decision on component selection depend on the overall economical benefits arising from safety and operational considerations associated with implementing the PHM system.

  6. Assessing health and economic outcomes of interventions to reduce pregnancy-related mortality in Nigeria

    PubMed Central

    2012-01-01

    Background Women in Nigeria face some of the highest maternal mortality risks in the world. We explore the benefits and cost-effectiveness of individual and integrated packages of interventions to prevent pregnancy-related deaths. Methods We adapt a previously validated maternal mortality model to Nigeria. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to Southwest and Northeast zones using survey-based data. Strategies consisted of improving coverage of effective interventions, and could include improved logistics. Results Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality, was cost saving in the Southwest zone and cost-effective elsewhere, and prevented nearly 1 in 5 abortion-related deaths. However, with a singular focus on family planning and safe abortion, mortality reduction would plateau below MDG 5. Strategies that could prevent 4 out of 5 maternal deaths included an integrated and stepwise approach that includes increased skilled deliveries, facility births, access to antenatal/postpartum care, improved recognition of referral need, transport, and availability quality of EmOC in addition to family planning and safe abortion. The economic benefits of these strategies ranged from being cost-saving to having incremental cost-effectiveness ratios less than $500 per YLS, well below Nigeria’s per capita GDP. Conclusions Early intensive efforts to improve family planning and control of fertility choices, accompanied by a stepwise effort to scale-up capacity for integrated maternal health services over several years, will save lives and provide equal or greater value than many public health interventions we consider among the most cost-effective (e.g., childhood immunization). PMID:22978519

  7. SEASAT economic assessment

    NASA Technical Reports Server (NTRS)

    Hicks, K.; Steele, W.

    1974-01-01

    The SEASAT program will provide scientific and economic benefits from global remote sensing of the ocean's dynamic and physical characteristics. The program as presently envisioned consists of: (1) SEASAT A; (2) SEASAT B; and (3) Operational SEASAT. This economic assessment was to identify, rationalize, quantify and validate the economic benefits evolving from SEASAT. These benefits will arise from improvements in the operating efficiency of systems that interface with the ocean. SEASAT data will be combined with data from other ocean and atmospheric sampling systems and then processed through analytical models of the interaction between oceans and atmosphere to yield accurate global measurements and global long range forecasts of ocean conditions and weather.

  8. Economics and health: beyond financing.

    PubMed

    Horwitz, A

    1988-01-01

    World Bank publications have a large influence on the decisions of governments. This article analyzes the publication "Financing Health Services in Developing Countries: An Agenda for Reform" part of the World Bank Policy Studies series. This study assesses only peripheral reasons for the lack of public and private financial investments in health services. It does not include the result of economic recession, budget cutbacks, and poverty on financing systems. There has been excessive expenditure on luxury in health institutions which takes considerable finances from disease prevention and health promotion services. There is low demand for private services because of the high cost, but public health services sometimes lack tools and money necessary for adequate care. The study does not address the relationship between needs and demand and the supply of health services. It outlines "4 Policy Reforms" in which the aims are to increase to cost of curative services and to use the additional money for prevention. The World Bank favors using private sector services but does not seem to view decentralization of health care as important. Social security systems have been in place in Latin America for 63 years. These systems are funded by wage earners and do not cover lower income rural citizens. Chile was the 1st country to adopt compulsory insurance in 1924 for catastrophes and diseases. The Chilean National Health Service combines institutional and community resources to provide quality health care. Social insurance and other prepayment systems are the rational approaches for financing health care in the Americas. These systems should be based on contributions by the State, employers, and urban and rural workers. There is a need for fund redistribution from institutional curative care to community preventative care. Health care costs should reflect income proportionally. The World Bank contributes vital analysis to the problem of health service financing. Hopefully

  9. European Conference on Health Economics.

    PubMed

    Malmivaara, Antti

    2010-12-01

    The biennial European Conference on Health Economics was held in Finland this year, at the Finlandia Hall in the centre of Helsinki. The European conferences rotate among European countries and fall between the biennial world congresses organized by the International Health Economics Association (iHEA). A record attendance of approximately 800 delegates from 50 countries around the world were present at the Helsinki conference. The theme of the conference was 'Connecting Health and Economics'. All major topics of health economics were covered in the sessions. For the first time, social care economics was included in the agenda of the European Conference as a session of its own. PMID:21155696

  10. A cardiovascular disease policy model: part 2—preparing for economic evaluation and to assess health inequalities

    PubMed Central

    Lawson, K D; Lewsey, J D; Ford, I; Fox, K; Ritchie, L D; Tunstall-Pedoe, H; Watt, G C M; Woodward, M; Kent, S; Neilson, M; Briggs, A H

    2016-01-01

    Objectives This is the second of the two papers introducing a cardiovascular disease (CVD) policy model. The first paper described the structure and statistical underpinning of the state-transition model, demonstrating how life expectancy estimates are generated for individuals defined by ASSIGN risk factors. This second paper describes how the model is prepared to undertake economic evaluation. Design To generate quality-adjusted life expectancy (QALE), the Scottish Health Survey was used to estimate background morbidity (health utilities) and the impact of CVD events (utility decrements). The SF-6D algorithm generated utilities and decrements were modelled using ordinary least squares (OLS). To generate lifetime hospital costs, the Scottish Heart Health Extended Cohort (SHHEC) was linked to the Scottish morbidity and death records (SMR) to cost each continuous inpatient stay (CIS). OLS and restricted cubic splines estimated annual costs before and after each of the first four events. A Kaplan-Meier sample average (KMSA) estimator was then used to weight expected health-related quality of life and costs by the probability of survival. Results The policy model predicts the change in QALE and lifetime hospital costs as a result of an intervention(s) modifying risk factors. Cost-effectiveness analysis and a full uncertainty analysis can be undertaken, including probabilistic sensitivity analysis. Notably, the impacts according to socioeconomic deprivation status can be made. Conclusions The policy model can conduct cost-effectiveness analysis and decision analysis to inform approaches to primary prevention, including individually targeted and population interventions, and to assess impacts on health inequalities. PMID:27335653

  11. [Economic assessment of the epidemiological profile change: information for health care reforms].

    PubMed

    Arredondo, A

    1997-02-01

    Taking into account the information needed to implement the reform process of the health sector, we present the results of an analysis of costs and the financial consequences of the epidemiological change of four tracer diseases in Mexico, two chronic (diabetes and hypertension) and two infectious diseases (pneumonias and diarrheas). The hospital cost-case management of diabetes expected for 1998 represents the same amount of hospital and ambulatory case management of diarrheas and pneumonias for the same year. The internal competition for resource allocations that is expected, among other factors, is one of the results that permits the argument that changes in the epidemiological profile generate relevant financial consequences in the planning and implementing of structural reforms of the health systems, particularly with regards to the patterns of resource allocation for specific health programs. PMID:9430948

  12. Study Guide in Health Economics.

    ERIC Educational Resources Information Center

    Dawson, George; Jablon, Bert

    Prepared to assist students at Empire State College in developing learning contracts for the study of the economics of health care delivery, this study guide discusses various aspects of the topic, suggests student projects, and provides an extensive bibliography. First, introductory material discusses the relationship of economics to health care…

  13. Health economic assessment of universal immunization of toddlers against Hepatitis A Virus (HAV) in Mexico.

    PubMed

    Carlos, Fernando; Gómez, Jorge Alberto; Anaya, Pablo; Romano-Mazzotti, Luis

    2016-01-01

    Hepatitis A virus (HAV) has shifted from high to intermediate endemicity in Mexico, which may increase the risk of clinically significant HAV infections in older children, adolescents and adults. The objective of this study was to evaluate the cost-utility of single-dose or 2-dose universal infant HAV vaccination strategy in Mexico, compared with no vaccination. A previously published dynamic model estimated the expected number of HAV cases with each strategy, and a decision model was used to estimate the costs and quality-adjusted life-years (QALYs) expected with each strategy. The time horizon was 25 years (2012-2036) and the base case analysis was conducted from the perspective of the Mexican public health system. Costs and QALYs after the first year were discounted at 5% annually. Input data were taken from national databases and published sources where available. The single-dose HAV vaccination strategy had an incremental cost-utility ratio (ICUR) of Mexican peso (MXN) 2,270 per QALY gained, compared with no vaccination. The two-dose strategy had an ICUR of MXN 14,961/QALY compared with no vaccination, and an ICUR of MXN 78,280/QALY compared with the single-dose strategy. The estimated ICURs were below the threshold of 1 x Mexican gross domestic product per capita. When indirect costs were included (societal perspective), the single-dose HAV vaccination strategy would be expected to improve health outcomes and to be cost-saving. This analysis indicates that routine vaccination of toddlers against HAV would be cost-effective in Mexico using either a single-dose or a 2-dose vaccination strategy. GSK study identifier: HO-12-12877. PMID:26503702

  14. Health economic assessment of universal immunization of toddlers against Hepatitis A Virus (HAV) in Mexico

    PubMed Central

    Carlos, Fernando; Gómez, Jorge Alberto; Anaya, Pablo; Romano-Mazzotti, Luis

    2016-01-01

    Hepatitis A virus (HAV) has shifted from high to intermediate endemicity in Mexico, which may increase the risk of clinically significant HAV infections in older children, adolescents and adults. The objective of this study was to evaluate the cost-utility of single-dose or 2-dose universal infant HAV vaccination strategy in Mexico, compared with no vaccination. A previously published dynamic model estimated the expected number of HAV cases with each strategy, and a decision model was used to estimate the costs and quality-adjusted life-years (QALYs) expected with each strategy. The time horizon was 25 years (2012–2036) and the base case analysis was conducted from the perspective of the Mexican public health system. Costs and QALYs after the first year were discounted at 5% annually. Input data were taken from national databases and published sources where available. The single-dose HAV vaccination strategy had an incremental cost-utility ratio (ICUR) of Mexican peso (MXN) 2,270 per QALY gained, compared with no vaccination. The two-dose strategy had an ICUR of MXN 14,961/QALY compared with no vaccination, and an ICUR of MXN 78,280/QALY compared with the single-dose strategy. The estimated ICURs were below the threshold of 1 x Mexican gross domestic product per capita. When indirect costs were included (societal perspective), the single-dose HAV vaccination strategy would be expected to improve health outcomes and to be cost-saving. This analysis indicates that routine vaccination of toddlers against HAV would be cost-effective in Mexico using either a single-dose or a 2-dose vaccination strategy. GSK study identifier: HO-12-12877. PMID:26503702

  15. [HEALTH ECONOMIC ANALYSIS AND FAIR DECISION MAKING].

    PubMed

    Jeantet, Marine; Lopez, Alain

    2015-09-01

    Health technology assessment consists in evaluating the incremental cost-benefit ratio of a medicine, a medical device, a vaccine, a health strategy, in comparison to alternative health technologies. This form of socio-eoonomic evaluation aims at optimizing resource allocation within the health system. By setting the terms of valid alternatives, it is useful to highlight public choices, but it cannot in itself make the decision as regards the public funding of patient's access to the considered technology. The decision to include such technology in the basket of health goods and sercices covered, the levels and conditions of the coverage, also result from budget constraints, from economic situation and from a political vision about health policy, social protection and public expenditure. Accordingly, health economic analysis must be implemented on specific and targeted topics. The decision making process, with its health, economic and ethical stakes, calls for a public procedure and debate, based on shared information and argument. Otherwise, health system regulation, confronted with radical and costly innovations in the coming years, will become harder to handle. This requires the development of health economic research teams able to contribute to this assessment exercise. PMID:26619723

  16. Health economic analysis of screening

    PubMed Central

    Krauth, Christian

    2010-01-01

    In this article health economic implications of screening are analysed. First, requirements screening programmes should fulfil are derived, and methodical standards of health economic evaluation are outlined. Using the example of newborn hearing screening, it is then examined if empirical studies meet the methodical requirements of health economic evaluation. Some deficits are realised: Health economic studies of newborn hearing screening are not randomised, most studies are even not controlled. Therefore, most studies do not present incremental, but only average cost-effectiveness ratios (i.e. cost per case identified). Furthermore, evidence on long-term outcomes of screening and early interventions is insufficient. In conclusion, there is a need for controlled trials to examine differences in identified cases, but particularly to examine long-term effects. PMID:22073088

  17. Economic Stress and Mental Health

    PubMed Central

    Butts, Hugh F.

    1979-01-01

    This paper correlates economic stress with minority status, resource allocations for mental health programs, and vulnerability to mental disability. Several hypotheses are advanced: 1. A major and recurring psychological pattern of the American national character is prowhite, antiblack paranoia. 2. Mental health fiscal allocations and programmatic determinations in ghetto, lower socioeconomic, minority-populated urban areas are predicated on political and racist considerations, the underlying motivation being to keep minorities at greater risk of mental disability. 3. Economic privation and stress increase vulnerability to mental illness, especially in a minority population for whom health, mental health, educational, and social services are grossly inadequate. 4. Poverty and economic stress combine with health systems that are unresponsive to the needs of blacks and other minorities, resulting in the perpetuation of disabilities and other conditions in blacks that are potentially preventable. 5. Health and mental health resources should be increased rather than diminished during periods of economic stress, especially in the public sector. 6. In order to provide each citizen with access to quality health and mental health care regardless of race and/or economic status, there must be enacted a national health insurance program based on tax-levy monies that will cover all aspects of health and mental health care. 7. Racism and social status will continue to be powerful determinants of the quality of service that white professionals render to black patients and to poor white patients, unless our training institutions mount a massive campaign to train appropriately and to include significant numbers of minority candidates and trainees in the effort. To date this effort is virtually nonexistent. PMID:439171

  18. Health technology assessment (HTA): a brief introduction of history and the current status in the field of cardiology under the economic crisis.

    PubMed

    Fanourgiakis, John; Kanoupakis, Emmanuel

    2015-08-01

    In a time of economic recession health technology assessment is an established aid in decision making in many countries in order to identify cost-containment policy options. Moreover, as the volume, complexity, and cost of new medical technology increases, the need for evaluating benefits, risks and costs becomes increasingly important. In recent years there has been a proliferation of health technology assessment initiatives internationally, aimed in introducing rationality in the decision-making process, informing reimbursement, providing clinical guidance on the use of medical technologies across the world in an evidence-based decision-making environment and in pricing decisions. PMID:26291523

  19. Health economic evaluation in England.

    PubMed

    Raftery, James

    2014-01-01

    The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness. PMID:25444294

  20. Probabilistic sensitivity analysis in health economics.

    PubMed

    Baio, Gianluca; Dawid, A Philip

    2015-12-01

    Health economic evaluations have recently become an important part of the clinical and medical research process and have built upon more advanced statistical decision-theoretic foundations. In some contexts, it is officially required that uncertainty about both parameters and observable variables be properly taken into account, increasingly often by means of Bayesian methods. Among these, probabilistic sensitivity analysis has assumed a predominant role. The objective of this article is to review the problem of health economic assessment from the standpoint of Bayesian statistical decision theory with particular attention to the philosophy underlying the procedures for sensitivity analysis. PMID:21930515

  1. Q methodology in health economics.

    PubMed

    Baker, Rachel; Thompson, Carl; Mannion, Russell

    2006-01-01

    The recognition that health economists need to understand the meaning of data if they are to adequately understand research findings which challenge conventional economic theory has led to the growth of qualitative modes of enquiry in health economics. The use of qualitative methods of exploration and description alongside quantitative techniques gives rise to a number of epistemological, ontological and methodological challenges: difficulties in accounting for subjectivity in choices, the need for rigour and transparency in method, and problems of disciplinary acceptability to health economists. Q methodology is introduced as a means of overcoming some of these challenges. We argue that Q offers a means of exploring subjectivity, beliefs and values while retaining the transparency, rigour and mathematical underpinnings of quantitative techniques. The various stages of Q methodological enquiry are outlined alongside potential areas of application in health economics, before discussing the strengths and limitations of the approach. We conclude that Q methodology is a useful addition to economists' methodological armoury and one that merits further consideration and evaluation in the study of health services. PMID:16378531

  2. [Health economics and antibiotic therapy].

    PubMed

    Leclercq, P; Bigdéli, M

    1995-01-01

    In the field of antibiotic therapy, particularly the methods of economic evaluation hold one's attention within the wide range of health economics' applications. Several tools allow a comparison of the outcomes of alternative strategies and thereby guide choices to the most appropriate solutions. After a brief recall of the methods classically used to evaluate health care strategy, the authors stress the importance and difficulty of fixing and applying a correct and satisfactory procedure for evaluation. An evaluation example of antibiotic therapy allows to illustrate the application of the principles confronting a field in which competition is intense and economic stakes stay large--a fact which naturally yields to seek after objective decision making criteria. The health care policies drawn by public authorities as well as the marketing strategies of the health sector trade are partly based on such evaluations. If these techniques are not intended for the practitioner in the first place, they should not be indifferent to him since they influence health authorities and thereby indirectly affect the therapeutic freedom of the physician. PMID:7481251

  3. ECONOMICS OF BIOLOGICAL ASSESSMENT

    EPA Science Inventory

    The objective of the session was to describe procedures used in the estimation of economic cost of air pollution to agriculture in the U.S. and to present some examples of those estimates. In recent years, there has been great interest in the development of monetary estimates of ...

  4. Health economics--concepts and conceptual problems.

    PubMed

    Satpathy, S K; Bansal, R D

    1982-01-01

    Awareness of the economic manifestation of health and diseases and the limited resources allocated to health care services has brought to the focus a new discipline - health economics. Cost accounting, cost benefit, cost effectiveness methods etc. are increasingly becoming an integral part of the health management and evaluation of health programmes. Various concepts and problems relating to health economics are discussed in the present paper. More efforts should be made to conduct health economic studies in hospitals and health centres by which the process of standardisation of the concepts, would be easier. Health economics should also find its due place in the medical curriculum. PMID:10310083

  5. Health economic modeling to assess short-term costs of maternal overweight, gestational diabetes, and related macrosomia – a pilot evaluation

    PubMed Central

    Lenoir-Wijnkoop, Irene; van der Beek, Eline M.; Garssen, Johan; Nuijten, Mark J. C.; Uauy, Ricardo D.

    2015-01-01

    Background: Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes mellitus (GDM) and associated with increased morbidity for mother and child in the perinatal period. Poorly controlled diabetes during pregnancy, pre- pregnancy maternal obesity and/or excessive maternal weight gain during pregnancy are associated with intermittent periods of fetal exposure to hyperglycemia and subsequent hyperinsulinemia, leading to increased birth weight (e.g., macrosomia), body adiposity, and glycogen storage in the liver. Macrosomia is associated with an increased risk of developing obesity and type 2 diabetes mellitus later in life. Objective: Provide insight in the short-term health-economic impact of maternal overweight, GDM, and related macrosomia. To this end, a health economic framework was designed. This pilot study also aims to encourage further health technology assessments, based on country- and population-specific data. Results: The estimation of the direct health-economic burden of maternal overweight, GDM and related macrosomia indicates that associated healthcare expenditures are substantial. The calculation of a budget impact of GDM, based on a conservative approach of our model, using USA costing data, indicates an annual cost of more than $1,8 billion without taking into account long-term consequences. Conclusion: Although overweight and obesity are a recognized concern worldwide, less attention has been given to the health economic consequences of these conditions in women of child-bearing age and their offspring. The presented outcomes underline the need for preventive management strategies and public health interventions on life style, diet and physical activity. Also, the predisposition in people of Asian ethnicity to develop diabetes emphasizes the

  6. Health care technology assessment

    NASA Astrophysics Data System (ADS)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  7. Development of a web-based tool for the assessment of health and economic outcomes of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA)

    PubMed Central

    2015-01-01

    Background The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) is a European Commission led policy initiative to address the challenges of demographic change in Europe. For monitoring the health and economic impact of the social and technological innovations carried out by more than 500 stakeholder's groups ('commitments') participating in the EIP on AHA, a generic and flexible web-based monitoring and assessment tool is currently being developed. Aim This paper describes the approach for developing and implementing this web-based tool, its main characteristics and capability to provide specific outcomes that are of value to the developers of an intervention, as well as a series of case studies planned before wider rollout. Methods The tool builds up from a variety of surrogate endpoints commonly used across the diverse set of EIP on AHA commitments in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs) as well as health and social care utilisation. A highly adaptable Markov model with initially three mutually exclusive health states ('baseline health', 'deteriorated health' and 'death') provides the basis for the tool which draws from an extensive database of epidemiological, economic and effectiveness data; and also allows further customisation through remote data entry enabling more accurate and context specific estimation of intervention impact. Both probabilistic sensitivity analysis and deterministic scenario analysis allow assessing the impact of parameter uncertainty on intervention outcomes. A set of case studies, ranging from the pre-market assessment of early healthcare technologies to the retrospective analysis of established care pathways, will be carried out before public rollout, which is envisaged end 2015. Conclusion Monitoring the activities carried out within the EIP on AHA requires an approach that is both flexible and consistent in the way health and

  8. The economics of health insurance.

    PubMed

    Jha, Saurabh; Baker, Tom

    2012-12-01

    Insurance plays an important role in the United States, most importantly in but not limited to medical care. The authors introduce basic economic concepts that make medical care and health insurance different from other goods and services traded in the market. They emphasize that competitive pricing in the marketplace for insurance leads, quite rationally, to risk classification, market segmentation, and market failure. The article serves as a springboard for understanding the basis of the reforms that regulate the health insurance market in the Patient Protection and Affordable Care Act. PMID:23206642

  9. A school-based strategy to assess children's environmental exposures and related health effects in economically disadvantaged urban neighborhoods.

    PubMed

    Sexton, K; Greaves, I A; Church, T R; Adgate, J L; Ramachandran, G; Tweedie, R L; Fredrickson, A; Geisser, M; Sikorski, M; Fischer, G; Jones, D; Ellringer, P

    2000-01-01

    The School Health Initiative: Environment, Learning, Disease (SHIELD) study is a novel school-based investigation of children's environmental health in economically disadvantaged urban neighborhoods of Minneapolis. This article describes the study design and summarizes lessons learned about recruiting and monitoring this historically understudied population. The SHIELD study focused on measuring children's exposures to multiple environmental stressors [volatile organic chemicals (VOCs), environmental tobacco smoke, allergens, bioaerosols, metals, pesticides, polychlorinated biphenyls (PCB), phthalates] and exploring related effects on respiratory health (e.g., lung function) and learning outcomes (e.g., standardized test scores, academic achievement). It involved intensive exposure monitoring, including environmental measurements inside and outside the children's schools and inside their homes, personal measurements with passive dosimeters worn by the children, and biological marker measurements in blood and urine. The SHIELD participants comprised a stratified random sample of 153 "index" children and 51 of their siblings enrolled in grades 2-5 at two adjacent elementary schools. The Minneapolis Public Schools (MPS) assisted with identifying, contacting, recruiting, and monitoring this population, which traditionally is difficult to study because families/children are highly mobile, speak a diversity of languages, frequently do not have a telephone, endure economic hardships, often do not trust researchers, and have a spectrum of unconventional lifestyles and living arrangements. Using a school-based approach, the overall SHIELD enrollment (response) rate was 56.7%, with a wide disparity between English-speaking (41.7%) and non-English-speaking (71.0%) families/children. Most children remained involved in the study through both monitoring sessions and exhibited an acceptable degree of compliance with study protocols, including providing blood and urine samples

  10. Economic analysis in health care research.

    PubMed

    Rizk, Diaa E E

    2008-04-01

    There is contemporary widespread acceptance in the medical community of the need to address economic perspective of healthcare, specifically whether the benefits of a proposed or existing medical intervention are sufficient to justify that particular use of scarce health resources. The use of any scarce resources whether manpower, buildings or equipment has an opportunity cost in terms of the benefits foregone by denying those resources to other competing claims. Health economics emphasizes the need to assess formally the implications of choices over the deployment of resources. A number of economic evaluation techniques such as cost-benefit analysis and cost-effectiveness analysis have thus been developed to aid this formal assessment and to help identify the most efficient allocation of resources. The methodological quality and principles of economic analyses studies recently published in the biomedical literature, however, can be further improved. The most common limitations are in the methodology or presentation of cost, incremental analyses, sensitivity analysis and discounting. The ten methodological principles that should be incorporated in studies addressing economic analyses are highlighted. Understanding the methodology of cost-benefit analysis and cost-effectiveness analysis is critical for biomedical researchers, editors, reviewers and readers from developing countries to accurately interpret the results of the growing body of these articles. PMID:19143119

  11. Health economics and health policy: experiences from New Zealand.

    PubMed

    Cumming, Jacqueline

    2015-06-01

    Health economics has had a significant impact on the New Zealand health system over the past 30 years. In this paper, I set out a framework for thinking about health economics, give some historical background to New Zealand and the New Zealand health system, and discuss examples of how health economics has influenced thinking about the organisation of the health sector and priority setting. I conclude the paper with overall observations about the role of health economics in health policy in New Zealand, also identifying where health economics has not made the contribution it could and where further influence might be beneficial. PMID:25583117

  12. Assessment of population exposure to PM10 for respiratory disease in Lanzhou (China) and its health-related economic costs based on GIS

    PubMed Central

    2013-01-01

    Background Evaluation of the adverse health effects of PM10 pollution (particulate matter less than 10 microns in diameter) is very important for protecting human health and establishing pollution control policy. Population exposure estimation is the first step in formulating exposure data for quantitative assessment of harmful PM10 pollution. Methods In this paper, we estimate PM10 concentration using a spatial interpolation method on a grid with a spatial resolution 0.01° × 0.01°. PM10 concentration data from monitoring stations are spatially interpolated, based on accurate population data in 2000 using a geographic information system. Then, an interpolated population layer is overlaid with an interpolated PM10 concentration layer, and population exposure levels are calculated. Combined with the exposure-response function between PM10 and health endpoints, economic costs of the adverse health effects of PM10 pollution are analyzed. Results The results indicate that the population in Lanzhou urban areas is distributed in a narrow and long belt, and there are relatively large population spatial gradients in the XiGu, ChengGuan and QiLiHe districts. We select threshold concentration C0 at: 0 μg m-3 (no harmful health effects), 20 μg m-3 (recommended by the World Health Organization), and 50 μg m-3 (national first class standard in China) to calculate excess morbidity cases. For these three scenarios, proportions of the economic cost of PM10 pollution-related adverse health effects relative to GDP are 0.206%, 0.194% and 0.175%, respectively. The impact of meteorological factors on PM10 concentrations in 2000 is also analyzed. Sandstorm weather in spring, inversion layers in winter, and precipitation in summer are important factors associated with change in PM10 concentration. Conclusions The population distribution by exposure level shows that the majority of people live in polluted areas. With the improvement of evaluation criteria, economic damage of

  13. HEALTH SECTOR ASSESSMENT

    EPA Science Inventory

    As part of the USGCRP's First National Assessment effort, EPA's Global Change Research Program sponsored the Health Sector Assessment. The Health Sector Assessment was co-chaired by Dr. Jonathan A. Patz, Director of the Program on the Health Effects of Global Environmental Change...

  14. Introduction to health economics and decision-making: Is economics relevant for the frontline clinician?

    PubMed

    Goeree, Ron; Diaby, Vakaramoko

    2013-12-01

    In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation. PMID:24182604

  15. Abnormal economics in the health sector.

    PubMed

    Hsaio, W C

    1995-01-01

    The implosion of centrally-planned economies has led to a widespread and uncritical belief that a free market is the best mechanism for structuring the economic and social sectors. Many international agencies have pushed this belief on the developing nations. This paper offers a critical analysis of the effectiveness of using free market principles to structure the health sector. We try to answer two questions: in what spheres can the market operate freely? In what spheres is government action required? According to economic theory, the market is only appropriate for producing and distributing private goods. This study analyzed health care and subdivides it into three categories (public, merit, and private goods) to clarify where the market has a legitimate role. Next, we analyze two of the five markets in the health sector--financing and delivery--and assess the respective roles of the market and government Competitive markets have certain prerequisites. We identify the major market failures by evaluating where these conditions are not satisfied. Next, we draw on international experience to ascertain the seriousness of those failures and the capacity of government action to correct them. Lessons are drawn for developing nations about the appropriateness of market strategies to finance and deliver health care. PMID:10156633

  16. Nutrition economics – characterising the economic and health impact of nutrition

    PubMed Central

    Lenoir-Wijnkoop, I.; Dapoigny, M.; Dubois, D.; van Ganse, E.; Gutiérrez-Ibarluzea, I.; Hutton, J.; Jones, P.; Mittendorf, T.; Poley, M. J.; Salminen, S.; Nuijten, M. J. C.

    2011-01-01

    There is a new merging of health economics and nutrition disciplines to assess the impact of diet on health and disease prevention and to characterise the health and economic aspects of specific changes in nutritional behaviour and nutrition recommendations. A rationale exists for developing the field of nutrition economics which could offer a better understanding of both nutrition, in the context of having a significant influence on health outcomes, and economics, in order to estimate the absolute and relative monetary impact of health measures. For this purpose, an expert meeting assessed questions aimed at clarifying the scope and identifying the key issues that should be taken into consideration in developing nutrition economics as a discipline that could potentially address important questions. We propose a first multidisciplinary outline for understanding the principles and particular characteristics of this emerging field. We summarise here the concepts and the observations of workshop participants and propose a basic setting for nutrition economics and health outcomes research as a novel discipline to support nutrition, health economics and health policy development in an evidence and health-benefit-based manner. PMID:20797310

  17. The impact of economic globalisation on health.

    PubMed

    Koivusalo, Meri

    2006-01-01

    The analysis of the impact of economic globalisation on health depends on how it is defined and should consider how it shapes both health and health policies. I first discuss the ways in which economic globalisation can and has been defined and then why it is important to analyse its impact both in terms of health and health policies. I then explore the ways in which economic globalisation influences health and health policies and how this relates to equity, social justice, and the role of values and social rights in societies. Finally, I argue that the process of economic globalisation provides a common challenge for all health systems across the globe and requires a broader debate on values, accountability, and policy approaches. PMID:16532301

  18. Cycling Promotion and Non-Communicable Disease Prevention: Health Impact Assessment and Economic Evaluation of Cycling to Work or School in Florence

    PubMed Central

    Taddei, Cristina; Gnesotto, Roberto; Forni, Silvia; Bonaccorsi, Guglielmo; Vannucci, Andrea; Garofalo, Giorgio

    2015-01-01

    Objective To estimate the effects of cycling promotion on major non-communicable diseases (NCDs) and costs from the public healthcare payer’s perspective. Design Health impact assessment and economic evaluation using a dynamic model over a ten-year period and according to two cycling promotion scenarios. Setting Cycling to work or school in Florence, Italy. Population All individuals aged 15 and older commuting to work or school in Florence. Main outcome measures The primary outcome measures were changes in NCD incidence and healthcare direct costs for the Tuscany Regional Health Service (SST) due to increased cycling. The secondary outcome was change in road traffic accidents. Results Increasing cycling modal share in Florence from 7.5% to about 17% (Scenario 1) or 27% (Scenario 2) could decrease the incidence of type 2 diabetes by 1.2% or 2.5%, and the incidence of acute myocardial infarction (AMI) and stroke by 0.6% or 1.2%. Within 10 years, the number of cases that can be prevented is 280 or 549 for type 2 diabetes, 51 or 100 for AMI, and 51 or 99 for stroke in Scenario 1 or Scenario 2, respectively. Average annual discounted savings for the SST are estimated to amount to €400,804 or €771,201 in Scenario 1 or Scenario 2, respectively. In Florence, due to the high use of vulnerable motorized vehicles (such as scooters, mopeds, and motorcycles), road traffic accidents are expected to decline in both our scenarios. Sensitivity analyses showed that health benefits and savings for the SST are substantial, the most sensitive parameters being the relative risk estimates of NCDs and active commuting. Conclusions Effective policies and programs to promote a modal shift towards cycling among students and workers in Florence will contribute to reducing the NCD burden and helping long-term economic sustainability of the SST. PMID:25928421

  19. Health economics education in undergraduate medical training: introducing the health economics education (HEe) website.

    PubMed

    Oppong, Raymond; Mistry, Hema; Frew, Emma

    2013-01-01

    In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and support teaching and learning in health economics for medical students. It was designed to function both as a forum for teachers of health economics to communicate and to share resources and also to provide instantaneous access to supporting literature and teaching materials on health economics. The website provides a range of free online material that can be used by both health economists and non-health economists to teach the basic principles of the discipline. The Health Economics education website is the only online education resource that exists for teaching health economics to medical undergraduate students and it provides teachers of health economics with a range of comprehensive basic and advanced teaching materials that are freely available. This article presents the website as a tool to encourage the incorporation of health economics training into the undergraduate medical curricula. PMID:24034906

  20. Applying Behavioral Economics to Public Health Policy

    PubMed Central

    Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

    2016-01-01

    Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

  1. Health Economics Research: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Dillard, Carole D.; And Others

    This annotated bibliography lists books and journal articles published since 1976 which deal with health economics and which are based on health services research supported by the National Center for Health Services Research (NCHSR). Articles prepared by NCHSR staff are listed as intramural. All other articles cite the NCHSR grant or contract…

  2. Applying economic principles to health care.

    PubMed Central

    Scott, R. D.; Solomon, S. L.; McGowan, J. E.

    2001-01-01

    Applying economic thinking to an understanding of resource use in patient care is challenging given the complexities of delivering health care in a hospital. Health-care markets lack the characteristics needed to determine a "market" price that reflects the economic value of resources used. However, resource allocation in a hospital can be analyzed by using production theory to determine efficient resource use. The information provided by hospital epidemiologists is critical to understanding health-care production processes used by a hospital and developing economic incentives to promote antibiotic effectiveness and infection control. PMID:11294724

  3. Metro Nature, Environmental Health, and Economic Value

    PubMed Central

    Robbins, Alicia S.T.

    2015-01-01

    Background Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities. Objectives We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values. Methods We reviewed the literature on urban nature-based health and well-being benefits. In this review, we provide a classification schematic and propose potential economic values associated with metro nature services. Discussion Economic valuation of benefits derived from urban green systems has largely been undertaken in the fields of environmental and natural resource economics, but studies have not typically addressed health outcomes. Urban trees, parks, gardens, open spaces, and other nearby nature elements—collectively termed metro nature—generate many positive externalities that have been largely overlooked in urban economics and policy. Here, we present a range of health benefits, including benefit context and beneficiaries. Although the understanding of these benefits is not yet consistently expressed, and although it is likely that attempts to link urban ecosystem services and economic values will not include all expressions of cultural or social value, the development of new interdisciplinary approaches that integrate environmental health and economic disciplines are greatly needed. Conclusions Metro nature provides diverse and substantial benefits to human populations in cities. In this review, we begin to address the need for development of valuation methodologies and new approaches to understanding the potential economic outcomes of these benefits. Citation Wolf KL, Robbins AS. 2015. Metro nature, environmental health, and economic value. Environ Health Perspect 123:390–398; http://dx.doi.org/10.1289/ehp.1408216 PMID:25626137

  4. The Comprehensive Health Assessment.

    ERIC Educational Resources Information Center

    Eastern Iowa Community Coll. District, Davenport.

    This report contains information from a fall 1991 health occupations assessment of 1,021 health-related employers in Eastern Iowa and the Illinois Quad Cities area. Twelve chapters present comprehensive results of all surveys; results of 10 labor market survey instruments developed for chiropractic offices, dentists' offices, emergency medical…

  5. Hypertension, a health economics perspective.

    PubMed

    Alcocer, Luis; Cueto, Liliana

    2008-06-01

    The economic aspects of hypertension are critical to modern medicine. The medical, economic, and human costs of untreated and inadequately controlled hypertension are enormous. Hypertension is distributed unequally and with iniquity in different countries and regions of the world. Treatment of hypertension requires an investment over many years to prolong disease-free quality years of life. The high prevalence and high cost of the disease impacts on the microeconomics and macroeconomics of countries and regions. The criteria used for inclusion in clinical guidelines for hypertension impact on the cost and cost/utility of diagnosis or treatment. PMID:19124418

  6. [Health economic evaluation of AIDS response].

    PubMed

    Sun, Jiangping

    2015-06-01

    During the past over 20 years of AIDS response in China, different fields from the international society and domestic sources provide significant amounts of resources for China's AIDS response. The investment, distribution and use of these resources and their effect has become the concern of the society. The health economic evaluation method is used to scientifically answer these questions, which is also the motivation of the evaluation studies. Based on several studies on health economic evaluation of AIDS response in this issue, concepts and issues related to this area are summarized. It is important for the readers to make a point of health economics evaluation, and it is also of great importance to know its limitations to provide the basis for future proper use of AIDS health economic evaluation results. PMID:26310326

  7. Global health funding and economic development

    PubMed Central

    2012-01-01

    The impact of increased national wealth, as measured by Gross Domestic Product (GDP), on public health is widely understood, however an equally important but less well-acclaimed relationship exists between improvements in health and the growth of an economy. Communicable diseases such as HIV, TB, Malaria and the Neglected Tropical Diseases (NTDs) are impacting many of the world's poorest and most vulnerable populations, and depressing economic development. Sickness and disease has decreased the size and capabilities of the workforce through impeding access to education and suppressing foreign direct investment (FDI). There is clear evidence that by investing in health improvements a significant increase in GDP per capita can be attained in four ways: Firstly, healthier populations are more economically productive; secondly, proactive healthcare leads to decrease in many of the additive healthcare costs associated with lack of care (treating opportunistic infections in the case of HIV for example); thirdly, improved health represents a real economic and developmental outcome in-and-of itself and finally, healthcare spending capitalises on the Keynesian 'economic multiplier' effect. Continued under-investment in health and health systems represent an important threat to our future global prosperity. This editorial calls for a recognition of health as a major engine of economic growth and for commensurate investment in public health, particularly in poor countries. PMID:22490207

  8. Global health funding and economic development.

    PubMed

    Martin, Greg; Grant, Alexandra; D'Agostino, Mark

    2012-01-01

    The impact of increased national wealth, as measured by Gross Domestic Product (GDP), on public health is widely understood, however an equally important but less well-acclaimed relationship exists between improvements in health and the growth of an economy. Communicable diseases such as HIV, TB, Malaria and the Neglected Tropical Diseases (NTDs) are impacting many of the world's poorest and most vulnerable populations, and depressing economic development. Sickness and disease has decreased the size and capabilities of the workforce through impeding access to education and suppressing foreign direct investment (FDI). There is clear evidence that by investing in health improvements a significant increase in GDP per capita can be attained in four ways: Firstly, healthier populations are more economically productive; secondly, proactive healthcare leads to decrease in many of the additive healthcare costs associated with lack of care (treating opportunistic infections in the case of HIV for example); thirdly, improved health represents a real economic and developmental outcome in-and-of itself and finally, healthcare spending capitalises on the Keynesian 'economic multiplier' effect. Continued under-investment in health and health systems represent an important threat to our future global prosperity. This editorial calls for a recognition of health as a major engine of economic growth and for commensurate investment in public health, particularly in poor countries. PMID:22490207

  9. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-04-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23587340

  10. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-04-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website: (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23537754

  11. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-06-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website ( www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23526140

  12. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-05-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication.The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website ( www.ispor.org/TaskForces/EconomicPubGuidelines.asp ).We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23529207

  13. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23529982

  14. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication.The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (http://www.ispor.org/TaskForces/EconomicPubGuidelines.asp).We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23531194

  15. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication.The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (http://www.ispor.org/TaskForces/EconomicPubGuidelines.asp).We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23531108

  16. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website: (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23538200

  17. Migrant Farmworkers in the Oak Orchard Health Service Area. A Descriptive Profile and Assessment of Health Care Needs and Economic Impact.

    ERIC Educational Resources Information Center

    State Univ. of New York, Buffalo. Regional Economic Assistance Center.

    Interviews with 160 solo individuals and 293 family members revealed demographic characteristics, health care status and needs, and income and spending patterns of migrant farmworkers in the Oak Orchard Community Health Center (New York) service area during 1983. Findings showed that the migrant population was estimated at 1,089 workers and…

  18. Health without wealth? Costa Rica's health system under economic crisis.

    PubMed

    Morgan, L M

    1987-01-01

    The recent history of Costa Rica's health system is reviewed, emphasizing the health-related effects of the economic crisis of the 1980s. This economic crisis has stopped and in some instances reversed the marked health improvements Costa Rica realized during the decade of the 1970s. The effects of the economic crisis emerge in 4 areas: deterioration in health status, as poverty contributed to higher disease rates; reductions in the government's ability to maintain public health and medical services; increased reliance on foreign aid to finance the health system; and growing national debate over the role of the state in health care. The result of the economic crisis was a reduction in health services and a questioning of the Costa Rican health model. This occurred following the implementation of an expensive health infrastructure and at a time when people most needed health services. During the 1941-70 period, domestic initiative can account for much of the expansion of Costa Rica's social security system, but also at this time international agencies such as the US Agency for International Development (USAID) and the Inter-American Development began to assist in the expansion of the health system. In 1971 a plan was initiated to create a nationalized health system. By 1980 the success of the health sector reorganization was evident in the statistics: marked improvements in life expectancy, infant mortality, and infectious disease mortality had surpassed the goals set by the Pan American Health Organization (PAHO) and the Ministry of Health. Costa Rica's success was a vindication of both policy goals and funding priorities, for it has been "proved" that primary health care was capable of improving health indices, particularly where the agencies had the active and conscientious support of the national government. By 1977, foreign contracts for aid had expired, and the Ministry declared that the rural health program would be supported totally by the government. The

  19. Unpaid work in health economic evaluations.

    PubMed

    Krol, Marieke; Brouwer, Werner

    2015-11-01

    Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. PMID:26421997

  20. The health effects of economic insecurity.

    PubMed Central

    Catalano, R

    1991-01-01

    BACKGROUND. Interest in the health and behavioral effects of economic insecurity appears to vary with the performance of the economy. The current recession in the United States and Western Europe and growing unemployment in Eastern Europe make it timely to analytically review the recent research concerned with the health effects of economic contraction. METHODS. The research concerned with the health and behavioral effects of economic insecurity is organized by dependent variable and method. Rules for determining which effects are supported by strong and which by weak evidence are developed and applied to the literature. RESULTS. Evidence for effects on symptoms of psychological distress, seeking help for psychological distress, and nonspecific physiological illness is strong. Evidence for effects on suicide, child abuse, adverse birth outcomes, and heart disease is characterized as weak or sufficiently controversial to warrant skepticism. CONCLUSIONS. The health effects of economic security are undoubtedly mediated by economic policies. Estimating the effect of policy alternatives on the incidence of various outcomes is, however, very difficult given the current state of the research. The effect of rising unemployment on health in Eastern Europe cannot, moreover, be estimated from existing research. Effects estimated from Western economies probably do not generalize to situations in which the meaning of economic insecurity is conditioned by profound social and political reforms. PMID:1951825

  1. Life assessments of a boiler economizer unit

    SciTech Connect

    Lichti, K.A.; Thomas, C.W.; Wilson, P.T.; Julian, W.

    1997-09-01

    An economizer which experienced pitting corrosion during a cleaning accident was subject to recurring corrosion fatigue failures. A condition assessment was undertaken to assess the risk of further failures through metallurgical assessment, extreme value pitting assessments, and on-site NDT condition assessment with on-site extreme value pitting analysis. This was followed by a fatigue life assessment in accordance with PD6493. Condition assessment work and lifetime prediction progressed from initial failure investigation through to final recommendations in a stepwise process. Each stage of the work was followed by a review of the findings and an economic assessment of the alternative options i.e. continue with assessment, full economizer replacement or partial replacement. Selective replacement of a portion of the economizer was recommended.

  2. 25 CFR 225.23 - Economic assessments.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Economic assessments. 225.23 Section 225.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS OIL AND GAS, GEOTHERMAL, AND SOLID MINERALS AGREEMENTS Minerals Agreements § 225.23 Economic assessments. The Secretary shall prepare or...

  3. 25 CFR 225.23 - Economic assessments.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Economic assessments. 225.23 Section 225.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS OIL AND GAS, GEOTHERMAL, AND SOLID MINERALS AGREEMENTS Minerals Agreements § 225.23 Economic assessments. The Secretary shall...

  4. 25 CFR 225.23 - Economic assessments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Economic assessments. 225.23 Section 225.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS OIL AND GAS, GEOTHERMAL, AND SOLID MINERALS AGREEMENTS Minerals Agreements § 225.23 Economic assessments. The Secretary shall...

  5. 25 CFR 225.23 - Economic assessments.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Economic assessments. 225.23 Section 225.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS OIL AND GAS, GEOTHERMAL, AND SOLID MINERALS AGREEMENTS Minerals Agreements § 225.23 Economic assessments. The Secretary shall...

  6. 25 CFR 225.23 - Economic assessments.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Economic assessments. 225.23 Section 225.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS OIL AND GAS, GEOTHERMAL, AND SOLID MINERALS AGREEMENTS Minerals Agreements § 225.23 Economic assessments. The Secretary shall...

  7. THE HEALTH EFFECTS OF ECONOMIC DECLINE

    PubMed Central

    Catalano, Ralph; Goldman-Mellor, Sidra; Saxton, Katherine; Margerison-Zilko, Claire; Subbaraman, Meenakshi; LeWinn, Kaja; Anderson, Elizabeth

    2013-01-01

    The recent recession and lingering high unemployment will likely lead to a burst of research studying the health effects of economic decline. We aim to inform that work by summarizing empirical research concerned with those effects. We separate the studies into groups defined by questions asked, mechanisms invoked, and outcomes studied. We conclude that although much research shows that undesirable job and financial experiences increase the risk of psychological and behavioral disorder, many other suspected associations remain poorly studied or unsupported. The intuition that mortality increases when the economy declines, for example, appears wrong. We note that the research informs public health programming by identifying risk factors, such as job loss, made more frequent by economic decline. The promise that the research would identify health costs and benefits of economic policy choices, however, remains unfulfilled and will likely remain so without stronger theory and greater methodological agreement. PMID:21054175

  8. Paradigms and research programmes: is it time to move from health care economics to health economics?

    PubMed

    Edwards, R T

    2001-10-01

    As an applied subdiscipline of economics, health economics has flourished, defining itself as the study of how scarce health care resources may be used to meet our needs. This evolutionary pathway has led to health economists adopting a very 'medical' model of health, in which the predominant production function for health is health care. This paper sets out policy challenges to health economics which have arisen in light of growing recognition by governments of the socioeconomic determinants of health and their stated commitment to tackle inequalities in health. It reviews Thomas Kuhn's theory of paradigm shift and Imre Lakatos' theory of scientific research programmes in the natural sciences, favouring the latter as an explanation of the evolution of the subdiscipline of health economics. The paper brings together four recently published visions of the future of health economics-visions that are almost exclusively focused on the production, organization and distribution of health care. In contrast to these visions, in Lakatosian terms, this paper challenges the subdiscipline's core 'positive heuristic', i.e. the set of imperatives which determines how the research programme should unfold, how it may be defended, its scope and boundaries. This paper argues that health economics will need to evolve to embrace a more socioeconomic model of health and, to this end, offers for debate an expansion of Williams' diagrammatic representation of the subdiscipline. It concludes by asking whether the magnitude and the magnetism of health care policy issues will continue to prove too strong to allow health economists, should they wish, to steer their research and educational programmes more directly towards 'health' rather than 'health care' as the relevant social want. PMID:11747046

  9. Global Health and the Global Economic Crisis

    PubMed Central

    Gill, Stephen; Bakker, Isabella

    2011-01-01

    Although the resources and knowledge for achieving improved global health exist, a new, critical paradigm on health as an aspect of human development, human security, and human rights is needed. Such a shift is required to sufficiently modify and credibly reduce the present dominance of perverse market forces on global health. New scientific discoveries can make wide-ranging contributions to improved health; however, improved global health depends on achieving greater social justice, economic redistribution, and enhanced democratization of production, caring social institutions for essential health care, education, and other public goods. As with the quest for an HIV vaccine, the challenge of improved global health requires an ambitious multidisciplinary research program. PMID:21330597

  10. Organizational economics and health care markets.

    PubMed

    Robinson, J C

    2001-04-01

    As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership. PMID:11327173

  11. Organizational economics and health care markets.

    PubMed Central

    Robinson, J C

    2001-01-01

    As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership. PMID:11327173

  12. Mycotoxins: significance to global economics and health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Mycotoxins are fungal metabolites produced my micro-fungi (molds and mildews) that have significant impacts on global economics and health. Some of these metabolites are beneficial, but most are harmful and have been associated with well-known epidemics dating back to medieval times. The terms ‘myco...

  13. [Health economics: in search of efficiency].

    PubMed

    Schlander, Michael

    2009-01-01

    Economic terms such as efficiency, optimality and social welfare carry strong positive connotations. Sometimes non-economists may overlook the substantive difference between the scientific definition of these terms and their use in common parlance. This difference will be highly relevant if and when economic statements about efficiency are presented or interpreted in a normative way, i.e., implying that efficiency equals social desirability. Any statement about efficiency rests on implicit or explicit assumptions concerning the appropriate effectiveness criterion because efficiency invariably is an instrumental or secondary objective only, subject to clarification of the primary objectives to be pursued. In the absence of an agreement on the primary objectives of a collectively funded health scheme, the pursuit of efficiency may lead to health care allocation decisions that are not in line with prevailing social value judgements. Therefore, exposition and acceptance of the specific value judgements underlying economic evaluations of health care programmes should be a prerequisite to any attempt towards their normative interpretation. As regards the implementation of cost benefit evaluation in health care, the cautious stance taken by the German Institute for Quality and Efficiency in Health Care (IQWiG) appears to be well justified in the absence of such a fundamental consensus, especially when these evaluations are meant to address issues of allocative efficiency. PMID:19476311

  14. Health and economic costs of physical inactivity.

    PubMed

    Kruk, Joanna

    2014-01-01

    Physical inactivity has reached epidemic levels in developed countries and is being recognized as a serious public health problem. Recent evidence shows a high percentages of individuals worldwide who are physically inactive, i.e. do not achieve the WHO's present recommendation of 150 minutes of moderate to vigorous intensity per week in addition to usual activities. Living in sedentary lifestyle is one of the leading causes of deaths and a high risk factor for several chronic diseases, like cancer, cardiovascular disease, diabetes type 2, and osteoporosis. This article summarizes evidence for relative risk of the civilization diseases attributable to physical inactivity and the most important conclusions available from the recent investigations computing the economic costs specific to physical inactivity. The findings provide health and economic arguments needed for people to understand the meaning of a sedentary lifestyle. This may be also useful for public health policy in the creation of programmes for prevention of physical inactivity. PMID:25292019

  15. Economics and ethics in health care

    PubMed Central

    Culyer, A.

    2001-01-01

    This editorial provides a review of the current ways in which health economics is impacting on policy and reviews some of the key ethical and value-judgmental issues that commonly arise in and as a result of the work of economists. It also briefly highlights the contributions of the authors of this special issue of the journal, all of which illustrate how economists have approached ethical issues in health service policy (both in its financing and its delivery), and some of which explore the major methodological matters that arise and go on to discuss their potential as sources of conflict or harmony with other approaches to the same questions. Key Words: Health economics • value judgments • resource allocation • ethics • QALYs PMID:11479350

  16. Techno-Economics & Life Cycle Assessment (Presentation)

    SciTech Connect

    Dutta, A.; Davis, R.

    2011-12-01

    This presentation provides an overview of the techno-economic analysis (TEA) and life cycle assessment (LCA) capabilities at the National Renewable Energy Laboratory (NREL) and describes the value of working with NREL on TEA and LCA.

  17. Economic recession and mental health: an overview.

    PubMed

    Cooper, Brian

    2011-01-01

    Effects of the current global economic downturn on population mental health will emerge in the years ahead. Judging from earlier experience of financial crises in various parts of the world, stresses associated with rising unemployment, poverty and social insecurity will lead to upward trends in many national suicide rates, as well as to less readily charted increase in the prevalence of psychiatric illness, alcohol-related disorders and illicit drug use. At the same time, mental health services are being cut back as part of government austerity programs. Budget cuts will thus affect psychiatric services adversely just when economic stressors are raising the levels of need and demand in affected populations. Proactive fiscal and social policies could, however, help to mitigate the health consequences of recession. Evidence- based preventive measures include active labor market and family support programs, regulation of alcohol prices and availability, community care for known high-risk groups, and debt relief projects. Economic mental health care could best be achieved, not by decimating services but by planning and deploying these to meet the needs of defined area populations. PMID:21968374

  18. Dutch Cycling: Quantifying the Health and Related Economic Benefits.

    PubMed

    Fishman, Elliot; Schepers, Paul; Kamphuis, Carlijn Barbara Maria

    2015-08-01

    The Netherlands is well known for their high bicycle use. We used the Health Economic Assessment Tool and life table calculations to quantify the population-level health benefits from Dutch cycling levels. Cycling prevents about 6500 deaths each year, and Dutch people have half-a-year-longer life expectancy because of cycling. These health benefits correspond to more than 3% of the Dutch gross domestic product. Our study confirmed that investments in bicycle-promoting policies (e.g., improved bicycle infrastructure and facilities) will likely yield a high cost-benefit ratio in the long term. PMID:26066942

  19. A Systematic Review on Health Resilience to Economic Crises

    PubMed Central

    Glonti, Ketevan; Gordeev, Vladimir S.; Goryakin, Yevgeniy; Reeves, Aaron; Stuckler, David; McKee, Martin; Roberts, Bayard

    2015-01-01

    Background The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises. Methods We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed. Results From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women’s mental health appeared more susceptible to crises than men’s. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours. Conclusions Despite widespread rhetoric about the importance of resilience, there was a dearth of studies

  20. Sustainable energy, economic growth and public health.

    PubMed

    Haines, A

    2001-01-01

    Dramatic economic growth over the last 50 years has been accompanied by widening inequalities world-wide in wealth and energy consumption, diminished life expectancy in some countries, and deteriorating indices of environmental sustainability including loss of bio-diversity. Raised output of carbon dioxide (CO2) and other greenhouse gases due to increased economic and industrial activity is causing progressive climate change, leading in turn to direct and indirect adverse effects on health. Emissions of greenhouse gases can be lowered by increased use of renewable energy sources, for example, wind power in the United Kingdom (UK), greater energy efficiency and other measures to promote sustainability. The experience of some developing countries shows that favourable indicators of health and development can accompany a low output of greenhouse gases. It is unclear whether contemporary political and social systems can deliver improved human development without increased use of fossil fuels and other resources. PMID:11339344

  1. Economic evaluation of implementation strategies in health care.

    PubMed

    Hoomans, Ties; Severens, Johan L

    2014-01-01

    Economic evaluations can inform decisions about the efficiency and allocation of resources to implementation strategies-strategies explicitly designed to inform care providers and patients about the best available research evidence and to enhance its use in their practices. These strategies are increasingly popular in health care, especially in light of growing concerns about quality of care and limits on resources. But such concerns have hardly motivated health authorities and other decision-makers to spend on some form of economic evaluation in their assessments of implementation strategies. This editorial addresses the importance of economic evaluation in the context of implementation science-particularly, how these analyses can be most efficiently incorporated into decision-making processes about implementation strategies. PMID:25518730

  2. [Economics of health care in Mali].

    PubMed

    Coulibaly, S O; Keita, M

    1996-01-01

    From the results obtained regarding the financing of health care in Mali, we emphasize two important points. First, there is a lack of criteria for the distribution of finding in the health care sector, resulting in a waste of resources. Secondly, there is an absence of adequate pharmaceutical policies. The field studies led in 1987 provided the following observations. The rate of occupation of the beds is very low. Also, the numerous new investments are not yet put into service because of the lack of necessary equipment of qualified personnel. In addition, this does not consider the excessive investments occurring in certain localities where neither the rate of frequentation nor the economic conditions will ever allow the use of the capacity created. Among the possible solutions for the crisis of health care funding in Mali, the following should be priority: first, to fight against the complete lack of organization of the activities at the health care centers; secondly, to fight against the waste and misappropriation of money resulting from the behavior of the medical and paramedical personnel: and thirdly, to clarify the management of the resources coming from the charges for each service. The pharmaceutical policies adopted and implemented in recent years Largely contributed to, first, the creation of competition between essential generic medications and nongeneric medications that can be replaced, and then, the destruction of the public network of drug distribution. These conditions considerably limited the distribution of essential medications; yet, this is the only manner of reducing the pharmaceutical expenses and accordingly, allowing more funding for other medical services. As the distribution network is disorganized, the only alternative for the population to obtain the medications at the lowest price was to create centers of purchasing and distribution and to multiply the number of retailers of essential medications. Extensive work has been conducted in

  3. The economic value of health care data.

    PubMed

    Harper, Ellen M

    2013-01-01

    The amount of health care data in our world has been exploding, and the ability to store, aggregate, and combine data and then use the results to perform deep analyses have become ever more important. "Big data," large pools of data that can be captured, communicated, aggregated, stored, and analyzed, are now part of every sector and function of the global economy. While most research into big data thus far has focused on the question of their volume, there is evidence that the business and economic possibilities of big data and their wider implications are important for consideration. It is even offering the possibility that health care data could become the most valuable asset over the next 5 years as "secondary use" of electronic health record data takes off. PMID:23454988

  4. Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

    PubMed Central

    Pronk, Nicolaas P.

    2014-01-01

    Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

  5. Geologic coal assessment: The interface with economics

    USGS Publications Warehouse

    Attanasi, E.D.

    2001-01-01

    Geologic resource assessments describe the location, general characteristics, and estimated volumes of resources, whether in situ or technically recoverable. Such compilations are only an initial step in economic resource evaluation. This paper identifies, by examples from the Illinois and Appalachian basins, the salient features of a geologic assessment that assure its usefulness to downstream economic analysis. Assessments should be in sufficient detail to allocate resources to production units (mines or wells). Coal assessments should include the spatial distribution of coal bed characteristics and the ability to allocate parts of the resource to specific mining technologies. For coal bed gas assessment, the production well recoveries and well deliverability characteristics must be preserved and the risk structure should be specified so dryholes and noncommercial well costs are recovered by commercially successful wells. ?? 2001 International Association for Mathematical Geology.

  6. [Assessment of the impact of socio-economic factors on the health state of the population of the Sverdlovsk region in the system of social-hygienic monitoring].

    PubMed

    Derstuganova, T M; VelichkovskiĬ, B T; Varaksin, A N; Gurvich, V B; Malykh, O L; Kochneva, N I; Iarushin, S V

    2013-01-01

    There was investigated the impact of socioeconomic factors on medical and demographic processes in working age population. For the assessment of the impact of living conditions and environmental factors on mortality rate in a population of the Sverdlovsk region factor-typological, correlation and regression analyzes were applied There was shown an availability of statistically significant correlation relationships between mortality of the population of working age and socio-economic characteristics (degree of home improvement, quality of medical care, the level of social tension, the level of the demographic load), as well as between their increments with taking into account the time shifts. The effect of the value of the purchasing power on the mortality rate of the working population has been established The purchasing power was shown to be connected with a mortality rate of working population from external causes more stronger than death from all causes. PMID:24624831

  7. Health research systems: promoting health equity or economic competitiveness?

    PubMed Central

    Loff, Bebe

    2012-01-01

    Abstract International collaborative health research is justifiably expected to help reduce global health inequities. Investment in health policy and systems research in developing countries is essential to this process but, currently, funding for international research is mainly channelled towards the development of new medical interventions. This imbalance is largely due to research legislation and policies used in high-income countries. These policies have increasingly led these countries to invest in health research aimed at boosting national economic competitiveness rather than reducing health inequities. In the United States of America and the United Kingdom of Great Britain and Northern Ireland, the regulation of research has encouraged a model that: leads to products that can be commercialized; targets health needs that can be met by profitable, high-technology products; has the licensing of new products as its endpoint; and does not entail significant research capacity strengthening in other countries. Accordingly, investment in international research is directed towards pharmaceutical trials and product development public–private partnerships for neglected diseases. This diverts funding away from research that is needed to implement existing interventions and to strengthen health systems, i.e. health policy and systems research. Governments must restructure their research laws and policies to increase this essential research in developing countries. PMID:22271965

  8. Behavioral economics and health policy: understanding Medicaid's failure.

    PubMed

    Richman, Barak D

    2005-03-01

    This Article employs a behavioral economic analysis to understand why Medicaid has failed to improve the health outcomes of its beneficiaries. It begins with a formal economic model of health care consumption and then systematically incorporates a survey of psychosocial variables to formulate explanations for persistent health disparities. This methodology suggests that consulting the literature in health psychology and intertemporal decision theory--empirical sources generally excluded from orthodox economic analysis--provides valuable material to explain certain findings in health econometrics. More significantly, the lessons from this behavioral economic approach generate useful policy considerations for Medicaid policymakers, who largely have neglected psychosocial variables in implementing a health insurance program that rests chiefly on orthodox economic assumptions. The Article's chief contributions include an expansion of the behavioral economic approach to include a host of variables in health psychology, a behavioral refinement of empirical health economics, a behavioral critique of Medicaid policy, and a menu of suggested Medicaid reforms. PMID:15868692

  9. Health technology assessment and haemophilia.

    PubMed

    Farrugia, A; O'Mahony, B; Cassar, J

    2012-03-01

    Although the funding of rare diseases such as haemophilia in developing countries remains a low priority, pressures on the funding of haemophilia treatment are also emerging in developed economies affected by the global economic downturn and the other demands on health care budgets. This is leading advisory bodies and payers alike to explore the tools of Health Technology Assessment (HTAs) in deriving recommendations for reimbursement policies. In particular, the use of cost utility analysis (CUA) in deriving costs per quality adjusted life year (QALY) for different interventions is being used to rank interventions in order of priorities relative to a threshold cost per QALY. In these exercises, rare chronic disorders such as haemophilia emerge as particularly unattractive propositions for reimbursement, as the accepted methodology of deriving a CUA. For e.g. the use of prophylaxis in haemophilia leads to a range of costs/QALY which exceed the willingness to pay thresholds of most payers. In this commentary, we review the principles utilized in a recent systematic review of the use of haemophilia products carried out in Sweden as part of an HTA. We suggest that ranking haemophilia related interventions with the standard interventions of therapeutics and public health in CUA comparisons is inappropriate. Given that haemophilia treatment is a form of blood replacement therapy, we propose that such comparisons should be made with the interventions of mainstream blood transfusion. We suggest that unequivocally effective treatments such as haemophilia therapies should be assessed differently from mainstream interventions, that new methodologies are required for these kinds of diseases and that evidence of a societal willingness to support people with rare disorders needs to be recognized when reimbursement policies are developed. PMID:22335450

  10. HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION.

    PubMed

    Tamba, B I; Azoicăi, Doina; Druguş, Daniela

    2016-01-01

    Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony. PMID:27125091

  11. Solar Heating and Cooling: An Economic Assessment.

    ERIC Educational Resources Information Center

    McGarity, Arthur E.

    This study serves as an introduction to the important economic considerations that are necessary for an assessment of the potential for solar heating and cooling in the United States. The first chapter introduces the technology that is used to tap solar energy for residential and commercial applications and illustrates the potential significance…

  12. Health and economic consequences of counterfeit drugs.

    PubMed

    Seiter, A

    2009-06-01

    "Counterfeit Drugs Kill" is the slogan the World Health Organization (WHO) uses in its anti-counterfeiting campaign. International organizations, governments of developed and developing countries, and the pharmaceutical industry created the IMPACT initiative (International Medical Products Anti-Counterfeiting Taskforce) to take on the thriving illegal industry that makes profits by selling fake drugs. However, before committing resources, policy makers want to assess the burden caused by counterfeit drugs in comparison with other health problems that compete for the limited resources available. PMID:19451909

  13. Health and economic impacts of antimicrobial resistance.

    PubMed

    Holmberg, S D; Solomon, S L; Blake, P A

    1987-01-01

    For comparison of the impacts of infections due to antimicrobial-resistant bacteria with those of infections due to antimicrobial-susceptible strains of the same bacteria, data were evaluated from 175 published and unpublished reports of investigations of nosocomial and community-acquired infections with selected bacteria. The evaluation of outcomes of hospital-acquired infections with resistant organisms was often confounded by risk factors also associated with poor outcomes. Nevertheless, for both nosocomial and community-acquired infections, the mortality, the likelihood of hospitalization, and the length of hospital stay were usually at least twice as great for patients infected with drug-resistant strains as for those infected with drug-susceptible strains of the same bacteria. Poor outcomes could be attributed both to the expected effects of ineffective antimicrobial therapy and to the unexpected occurrence of drug-resistant infections complicated by prior antimicrobial therapy for other medical problems. Although the adverse economic and health effects of drug-resistant bacterial infections can only be roughly quantified, it is concluded that antimicrobial resistance is an important health problem and an economic burden to society. PMID:3321356

  14. Economics methods in Cochrane systematic reviews of health promotion and public health related interventions

    PubMed Central

    Shemilt, Ian; Mugford, Miranda; Drummond, Michael; Eisenstein, Eric; Mallender, Jacqueline; McDaid, David; Vale, Luke; Walker, Damian

    2006-01-01

    Background Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. Methods The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Results Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. Conclusion There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as well as regular dialogue between

  15. [Approaches for assessing forest ecosystem health].

    PubMed

    Chen, Gao; Deng, Hongbing; Wang, Qingli; Dai, Limin; Hao, Zhanqing

    2003-06-01

    Assessment and indicator system become the key issues in the research on ecosystem health in 21st century. Assessing forest ecosystem health gradually attach much attention because it is an important component of terrestrial ecosystem. The definition, measurement, evaluation and its management had been discussed broadly, and some theories, assessing methods and frameworks had been proposed, which provides a new concept and a serial research approaches for dealing with the crisis of terrestrial ecosystems, even the environment problems in the world. Now, the common operational models for assessing forest ecosystem health do not exist owing to the manifold limitations. This paper discussed forest ecosystem health problem, and brought forward three preconditions for assessing forest ecosystem health: 1) a clear conceptual framework; 2) adequate data sets; 3) proper research and analysis techniques. The issues of three preconditions were discussed, and the possible approaches for the assessing research on forest ecosystem health, e.g., long-term studies and environment monitoring, space-for-time substation studies, e.g., history approaches, economics valuation and others were expariated. PMID:12974013

  16. [Economics and ethics in public health?].

    PubMed

    Blum, R

    1999-01-01

    The topic suggests a conflict between ethics and economy in medical care. It is often argued that today's welfare state in affluent societies with their social insurance systems makes it easier for the doctor to translate ethical demands into reality without being hampered by economic restrictions. Both doctors and patients took advantage of this system of medical care by mingling social guarantees for health with the doctor's income. Hence, medical expenses expanded rapidly, additionally promoted by technical progress in medicine. This entailed a proportionate increase in medical expenses in relation to personal income, especially wage income. Budgets of state authorities were streamlined or deficits became larger. This state of affairs was promoted further by mechanisms of distribution of national income in accordance with the slogan "less state, more market". While national income continued to grow, although at a slower rate, the number of jobless persons grew continually and thus also the social expenses, this was not due, as is usually assumed and pretended, to an economic crisis. Society and economy are facing a crisis of distribution of national income under conditions of technical progress as a job killer, making economic production more productive and efficient. Not taking into account the new challenge of social market economy--the German innovation in market economy creating the economic miracle after World War II--reforms of the system of medical care took place and are still continuing along market principles, particularly the latest German reform law leading to individual contracts between patients and their doctors in respect of cost charging. However, marketing principles promote economy in medicine, but they do not promote medical ethics. Further German guidelines for medical care should take stock of past experiences. There will be more competition in the "growing market of medical care" (private and public) and this will need--as economic

  17. [Health research and health technology assessment in Chile].

    PubMed

    Espinoza, Manuel Antonio; Cabieses, Báltica; Paraje, Guillermo

    2014-01-01

    Health research is considered an essential element for the improvement of population health and it has been recommended that a share of the national health budget should be allocated to develop this field. Chile has undertaken efforts in the last decades in order to improve the governmental structure created to promote the development of health research, which has increased human resources and funding opportunities. On the other hand, the sustained economic growth of Chile in the last decades suggests that the health expenditure will maintain its increasing trend in the following years. This additional funding could be used to improve coverage of current activities performed in the health system, but also to address the incorporation of new strategies. More recently, health technology assessment (HTA) has been proposed as a process to support decisions about allocation of resources based on scientific evidence. This paper examines the relationship between the development of health research and the HTA process. First, it presents a brief diagnosis of the situation of health research in Chile. Second, it reviews the conceptual basis and the methods that account for the relationship between a HTA process and the development of health research. In particular, it emphasizes the relevance of identifying information gaps where funding additional research can be considered a good use of public resources. Finally, it discusses the challenges and possible courses of action that Chile could take in order to guarantee the continuous improvement of an articulated structure for health research and HTA. PMID:24861179

  18. Overview of methods in economic analyses of behavioral interventions to promote oral health

    PubMed Central

    O’Connell, Joan M.; Griffin, Susan

    2016-01-01

    Background Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. Objective To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. Methods We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Discussion Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly. PMID:21656966

  19. Assessing health apps.

    PubMed

    2016-07-01

    A survey commissioned by the National Institute for Health and Care Excellence aims to explore the way nurses and midwives engage with mobile technologies, such as smartphones, tablets and health apps. It is seeking opinions on how these apps should be evaluated, and about online patient feedback. Results will inform NICE's plan to develop a central process for evaluating and endorsing health apps, which will enable patients, healthcare professionals and hospitals to identify the most useful. Nurses or midwives practising in the UK, and involved with direct patient care are welcome to take part in the survey. PMID:27369711

  20. FRAMEWORK FOR THE INTEGRATION OF HEALTH AND ECOLOIGCAL RISK ASSESSMENT

    EPA Science Inventory

    The World Health Organization's International Programme on Chemical Safety (IPCS), the Organization for Economic Cooperation and Development (OECD), and the U.S. Environmental Protection Agency have developed a collaborative partnership to foster integration; of assessment approa...

  1. Health impact assessment in Korea

    SciTech Connect

    Kang, Eunjeong; Lee, Youngsoo; Harris, Patrick; Koh, Kwangwook; Kim, Keonyeop

    2011-07-15

    Recently, Health Impact Assessment has gained great attention in Korea. First, the Ministry of Environment introduced HIA within existing Environment Impact Assessment. Second, the Korea Institute for Health and Social Affairs began an HIA program in 2008 in alliance with Healthy Cities. In this short report, these two different efforts are introduced and their opportunities and challenges discussed. We believe these two approaches complement each other and both need to be strengthened. We also believe that both can contribute to the development of health in policy and project development and ultimately to improvements in the Korean population's health.

  2. The impact of health economic evaluations in Sweden.

    PubMed

    Heintz, Emelie; Arnberg, Karl; Levin, Lars-Åke; Liliemark, Jan; Davidson, Thomas

    2014-01-01

    The responsibility for healthcare in Sweden is shared by the central government, county councils and municipalities. The counties and municipalities are free to make their own prioritizations within the framework of the state healthcare laws. To guide prioritization of healthcare resources in Sweden, there is consensus that cost-effectiveness constitutes one of the three principles. The objective of this paper is to describe how cost-effectiveness, and hence health economic evaluations (HEE), have a role in pricing decisions, reimbursement of pharmaceuticals as well as the overall prioritization and allocation of resources in the Swedish healthcare system. There are various organizations involved in the processes of implementing health technologies in the Swedish healthcare system, several of which consider or produce HEEs when assessing different technologies: the Dental and Pharmaceutical Benefits Agency (TLV), the county councils' group on new drug therapies (NLT), the National Board of Health and Welfare, the Swedish Council on Health Technology Assessment (SBU), regional HTA agencies and the Public Health Agency of Sweden. The only governmental agency that has official and mandatory guidelines for how to perform HEE is TLV (LFNAR 2003:2). Even though HEEs may seem to have a clear and explicit role in the decision-making processes in the Swedish healthcare system, there are various obstacles and challenges in the use and dissemination of the results. PMID:25444295

  3. Health economics and the European Heart Rhythm Association.

    PubMed

    Vardas, Panos; Boriani, Giuseppe

    2011-05-01

    The management of healthcare is becoming extremely complex in developed countries, as a result of increasing age of the population and increasing costs of care, coupled with diminishing resources due to global financial crisis. This situation threatens access to appropriate care, and a more or less explicit rationing of some types of treatment may occur in 'real world' clinical practice. This is particularly true for those treatments or interventions with a relatively high up-front cost, such as cardioverter defibrillators, devices for cardiac resynchronization therapy or ablation procedures for atrial fibrillation. The European Heart Rhythm Association (EHRA) is strongly convinced that the skills of electrophysiologists and cardiologists responsible for the management of rhythm disorders have to evolve, also embracing the knowledge of health economics, clinical epidemiology, health-care management and outcome research. These disciplines do not belong to what is considered as the conventional cultural background of physicians, but knowledge of comparative cost effectiveness and of other economic approaches nowadays appears fundamental for a dialogue with a series of stakeholders, such as policy makers, politicians, and administrators, involved in budgeting the activity of hospitals and health-care services, as well as in approaching health technology assessment. PMID:21518741

  4. [Competitiveness among health and the health sector. A new look at the health economics paradigm].

    PubMed

    Knaul, Felicia Marie; Héctor, Arreola-Ornelas; Escandón, Pablo

    2007-01-01

    Health and the health sector have a direct impact on economic growth and competitiveness. Moreover, the health sector is experiencing increasingly strong links with the economy, which reinforces the key role that health plays in the development of individuals and economies. On the one hand, in addition to its intrinsic value health constitutes an important economic good because it contributes to increasing the capacity of individuals and nations to achieve greater levels of human, economic and social development. In addition, there is a direct relationship between health as a productive sector and the economy that will become more important as world health expenditure increases and because of recent advances in the productivity of the medical sector and the technology used in providing health services. For these reasons, a better understanding of the complex relationship between health, the health sector and economic development will help to increase competitiveness and attain higher levels of growth by enabling a more efficient health system that is in turn based on a solid, fair, equitable and sufficient financial base. PMID:17585695

  5. HEALTH EFFECTS ASSESSMENT FOR ACRYLONITRILE

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  6. Health Effects Assessment for Bromomethane

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  7. Health Effects Assessment for Ammonia

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  8. Public health economics: a systematic review of guidance for the economic evaluation of public health interventions and discussion of key methodological issues

    PubMed Central

    2013-01-01

    Background If Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted. Methods Electronic databases and organisation websites were searched using a 22 year time horizon (1990–2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers. Results We identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist. Conclusions In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may

  9. HEALTH EFFECTS ASSESSMENT FOR ETHYLBENZENE

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  10. Health Effects Assessment for Naphthalene

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  11. HEALTH EFFECTS ASSESSMENT FOR BENZENE

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  12. Assessing the Economic Impacts of Weather

    NASA Astrophysics Data System (ADS)

    Lazo, J. K.

    2008-05-01

    Understanding the socio-economic impacts of weather provides a basis for prioritizing actions to mitigate and respond to weather events and understanding the value of improvements in weather forecasts. In this talk we discuss two studies of the economic impacts of weather: (1) an empirical study of the sensitivity of state-sector level economic activity to weather variability and (2) an assessment of the quality of data on storm damages in the US as primarily collected through the National Weather Service's Storm Data Program. In the first study, 24 years of state level sector economic data and historical weather observations are used to form a panel combining weather information with economic data. A translog function is estimated of sectoral sensitivity and vulnerability to weather variability. Eleven sectors are ranked based on their degree of sensitivity to weather, states more sensitive to weather impacts are identified, and the aggregate dollar amount of variation in U.S. economic activity attributable to weather variability is calculated. Estimates indicate that US economic output varies by about 3.4% due to weather variability. While considerably smaller than prior estimates, our estimate represents about 469 billion a year in 2007 dollars. In our work to update and revise damage data in the Extreme Weather Sourcebook (www.sip.ucar.edu/sourcebook), we have confronted issues concerning the depth, accuracy and consistency of storm damage data collection. This type of data has been used in many studies exploring changes in weather impacts over time but there has been little recognition of the quality of the data. In the second study reported here, we examine issues with weather induced damage data quality to prompt a dialogue about reliability of scattered and inconsistent data from multiple sources. We hope this will lead to efforts to reduce the error in reported damages and to better reporting and organization of storm damage data in the future. We advocate

  13. Economics Framework for the 2006 National Assessment of Educational Progress

    ERIC Educational Resources Information Center

    Buckles, Stephen; Melican, Claire

    2006-01-01

    This document provides a guide for the development of the 2006 National Assessment of Educational Progress (NAEP) Economics Assessment. The framework is designed to assess the outcomes of student education in and understanding of economics in grade 12 as part of NAEP. Economic literacy is defined as the ability to identify, analyze, and evaluate…

  14. Health and economic development: introduction to the symposium.

    PubMed

    Clay, Joy A; Mirvis, David M

    2008-01-01

    This symposium explores the role of health as an 'economic engine' in the lower Mississippi River Delta region of the United States. The health as an economic engine model proposes that health is an important and perhaps critical determinant of economic growth and development. This model is the reverse of the more commonly considered paradigm in which economic conditions are major determinants of health status. This reframing of the conventional pathway draws upon an existing and extensive internationally-based body of knowledge, predominantly from research done in Africa and Asia. We suggest, in this symposium, that the health as an economic engine model can also be applied within the United States, particularly in regions that are economically underdeveloped and have poor health. This reframing has significant implications for population health policy as public health advancement can be legitimately argued to be an investment rather than just an expense. Viewing health as an economic engine supports a call to community-based participatory action on the part of policy makers, researchers, and educators to further both public and private investment in health, particularly for children and the poor. PMID:18575145

  15. 10th World IHEA and ECHE Joint Congress: health economics in the age of longevity.

    PubMed

    Jakovljevic, Mihajlo B; Getzen, Thomas E; Torbica, Aleksandra; Anegawa, Tomofumi

    2014-12-01

    The 10th consecutive World Health Economics conference was organized jointly by International Health Economics Association and European Conference on Health Economics Association and took place at The Trinity College, Dublin, Ireland in July 2014. It has attracted broad participation from the global professional community devoted to health economics teaching,research and policy applications. It has provided a forum for lively discussion on hot contemporary issues such as health expenditure projections, reimbursement regulations,health technology assessment, universal insurance coverage, demand and supply of hospital services, prosperity diseases, population aging and many others. The high-profile debate fostered by this meeting is likely to inspire further methodological advances worldwide and spreading of evidence-based policy practice from OECD towards emerging markets. PMID:25301000

  16. Health Care as a Right: The Politics and Economics.

    ERIC Educational Resources Information Center

    Sirmans, Meredith F.

    In the past few years there has been an increase in the discussion of health care as a right. Although the statement that health care is a right sounds good and altruistic, it does not deal with the political or economic realities of health care, especially for blacks. The health care industry represents approximately 8% of the Gross National…

  17. Alternative futures for health economics: implications for nursing management.

    PubMed

    Mannion, Russell; Small, Neil; Thompson, Carl

    2005-09-01

    As nursing has been subject to successive waves of 'managerialism' there has been a drive on the part of government and elements within the profession to enhance the science base and promote cost-effective health care interventions. This has generated new interest in the 'economics of nursing' as efficiency and 'value for money' are viewed as necessary precondition for the provision of a high quality nursing service. As an academic subject health economics has brought an elegant set of theories to bear on the topic of health and health care. However, mainstream health economics is premised on a series of simplifying assumptions that, if applied uncritically, can induce a range of unintended and adverse consequences. This paper asks how ideas developed in one sphere (health economics) can be become influential in another (nursing management and practice) and it seeks explanations in the theories of Michel Foucault, specifically in his exploration of the reciprocal relationship between power and knowledge. How are our assumptions about what is possible and desirable shaped, how far do mechanisms of surveillance and self-subjugation extend? A range of alternative economic approaches have been developed which challenge many mainstream health economics assumptions. Some of these are better suited to the complex social environment present within health care. Nurses, nurse managers and researchers should question the assumptions of dominant economic models and explore a range of economic frameworks when planning services and evaluating their practice. PMID:16108775

  18. Public Health and Economics: A Marriage of Necessity

    PubMed Central

    Maynard, Alan

    2012-01-01

    With resources always scarce, limited resources have to be targeted at those interventions, prevention and cure, that give the greatest population health gain at least cost. Mere identification of what works in prevention is inadequate unless this evidence is supplemented with economic analysis that identifies what is cost effective. Public health without the use of economics is incomplete. PMID:25170441

  19. Symposium on Economic Change, Scarcity and Mental Health Administration.

    ERIC Educational Resources Information Center

    Feldman, Saul, ed.

    1983-01-01

    Discusses challenges to the mental health field as a result of severe economic change. The six articles deal with reindustrialization, the effect of the labor market on mental hospital and prison use, retrenchment strategies, mental health problems in energy boomtowns, and economic issues of public policy. (JAC)

  20. [The impact of health economics: a status report].

    PubMed

    Tunder, R

    2011-12-01

    "Health is not everything, but without health, everything is nothing" (cited from Arthur Schopenhauer, German philosopher, 1788-1860). The relationship between medicine and economics could not have been put more precisely. On the one hand there is the need for a maximum of medical care and on the other hand the necessity to economize with scarce financial resources. The compatibility of these two aspects inevitably leads to strains. How to approach this challenge? From medicine to economics or from economics to medicine? The present article intends to raise awareness to regard the "economization of medicine" not just as a threat, but also as an opportunity. Needs for economic action are pointed out, and insights as well as future perspectives for the explanatory contribution for health economics are given. PMID:22108908

  1. Do Social and Economic Policies Influence Health? A Review

    PubMed Central

    Joshi, Pamela; Geronimo, Kimberly; Acevedo-Garcia, Dolores

    2014-01-01

    Although social and economic policies are not considered part of health services infrastructure, such policies may influence health and disease by altering social determinants of health (SDH). We review social and economic policies in the US that have measured health outcomes among adults in four domains of SDH including housing and neighborhood, employment, family strengthening/marriage, and income supplementation. The majority of these policies target low-income populations. These social policies rarely consider health as their initial mission or outcomes. When measuring health, the programs document mental health and physical health benefits more than half the time, although some effects fade with time. We also find considerable segregation of program eligibility by gender and family composition. Policy makers should design future social policies to evaluate health outcomes using validated health measures; to target women more broadly across the socioeconomic spectrum; and to consider family caregiving responsibilities as ignoring them can have unintended health effects. PMID:25984439

  2. Public health and economic impact of dampness and mold

    SciTech Connect

    Mudarri, David; Fisk, William J.

    2007-06-01

    The public health risk and economic impact of dampness and mold exposures was assessed using current asthma as a health endpoint. Individual risk of current asthma from exposure to dampness and mold in homes from Fisk et al. (2007), and asthma risks calculated from additional studies that reported the prevalence of dampness and mold in homes were used to estimate the proportion of U.S. current asthma cases that are attributable to dampness and mold exposure at 21% (95% confidence internal 12-29%). An examination of the literature covering dampness and mold in schools, offices, and institutional buildings, which is summarized in the appendix, suggests that risks from exposure in these buildings are similar to risks from exposures in homes. Of the 21.8 million people reported to have asthma in the U.S., approximately 4.6 (2.7-6.3) million cases are estimated to be attributable to dampness and mold exposure in the home. Estimates of the national cost of asthma from two prior studies were updated to 2004 and used to estimate the economic impact of dampness and mold exposures. By applying the attributable fraction to the updated national annual cost of asthma, the national annual cost of asthma that is attributable to dampness and mold exposure in the home is estimated to be $3.5 billion ($2.1-4.8 billion). Analysis indicates that exposure to dampness and mold in buildings poses significant public health and economic risks in the U.S. These findings are compatible with public policies and programs that help control moisture and mold in buildings.

  3. Health technology assessment and thyroid surgery.

    PubMed

    Lucchini, R; Sanguinetti, A; Monacelli, M; Triola, R; Avenia, S; Conti, C; Santoprete, S; Avenia, N

    2013-01-01

    The growth of technological innovation, the request for assistance, the rising patient's expectations and the interest of the industry have led to a rise in the cost of health care systems. In this context the role of the National Health System is not to delay the development or adoption of new technologies, but rather to drive the development selecting priorities and promoting its use. Health Technology Assessment (HTA) is a multidisciplinary and multidimensional approach for analyzing the medical-clinical, social, organizational, economic, ethical and legal implications of a technology (devices, drugs, procedures) through the assessment of multiple parameters such as effectiveness, safety, costs of the social and organizational impact. A health technology assessment is a comprehensive, systematic evaluation of the prerequisites for estimating the consequences of using health technology. Main characteristic of HTA is that the problem is tackled using an approach focused on four main elements: - technology; - patient; - organization; - economy. The authors have applied the HTA method for the analysis of the ultrasonic focus dissector on thyroid surgery. They compared the cost of the surgical procedure using the ultrasonic dissector and without it in a case study of 440 patients who underwent thyroidectomy. PMID:24091174

  4. Health economics: potential applications in HIV/AIDS control in Africa.

    PubMed

    Kirigia, Joses M; Sambo, Luis G; Anikpo, Emilienne; Karisa, Eddie; Mwabu, Germano

    2005-01-01

    There is growing evidence that HIV/ AIDS has enormous negative impact on health status and economic development of individuals, households, communities and nations in the African region. Thus, there is urgent need for various disciplines to demonstrate how they can contribute in curbing the spread of this deadly disease in the African region. This paper, using an extended version of Professor Alan Williams schema as the conceptual framework, attempts to demonstrate how health economics can be used to inform policy and managerial choices related to HIV/AIDS advocacy, prevention, treatment and management. It argues that the discipline of health economics (and economics generally) is extremely valuable in: measuring health impacts of the disease and interventions; evaluating the relationships between health care-seeking behaviour of individuals and health system specific attributes; the estimation of determinants of compliance of HIV/AIDS patients with treatment regimen; establishing of health institutions efficiency in combating AIDS; guiding choices of HIV/AIDS interventions; assessing the relationships between HIV/AIDS, development, poverty, and trade; programme planning, monitoring and evaluation; and assessing health system's overall performance. The paper is a modest attempt to show how the discipline of health economics can elucidate, and help in resolving practical and conceptual issues in HIV/AIDS control in Africa. PMID:17298133

  5. Big Data and Health Economics: Strengths, Weaknesses, Opportunities and Threats.

    PubMed

    Collins, Brendan

    2016-02-01

    'Big data' is the collective name for the increasing capacity of information systems to collect and store large volumes of data, which are often unstructured and time stamped, and to analyse these data by using regression and other statistical techniques. This is a review of the potential applications of big data and health economics, using a SWOT (strengths, weaknesses, opportunities, threats) approach. In health economics, large pseudonymized databases, such as the planned care.data programme in the UK, have the potential to increase understanding of how drugs work in the real world, taking into account adherence, co-morbidities, interactions and side effects. This 'real-world evidence' has applications in individualized medicine. More routine and larger-scale cost and outcomes data collection will make health economic analyses more disease specific and population specific but may require new skill sets. There is potential for biomonitoring and lifestyle data to inform health economic analyses and public health policy. PMID:26093888

  6. Complexity and reflexivity: two important issues for economic evaluation in health care.

    PubMed

    Lessard, Chantale

    2007-04-01

    Economic evaluations are analytic techniques to assess the relative costs and consequences of health care programmes and technologies. Their role is to provide rigorous data to inform the health care decision-making process. Economic evaluation may oversimplify complex health care decisions. These analyses often ignore important health consequences, contextual elements, relationships or other relevant modifying factors, which might not be appropriate in a multi-objective, multi-stakeholder issue. One solution would be to develop a new paradigm based on the issues of perspective and context. Complexity theory may provide a useful conceptual framework for economic evaluation in health care. Complexity thinking develops an awareness of issues including uncertainty, contextual issues, multiple perspectives, broader societal involvement, and transdisciplinarity. This points the economic evaluation field towards an accountability and epistemology based on pluralism and uncertainty, requiring new forms of lay-expert engagement and roles of lay knowledge into decision-making processes. This highlights the issue of reflexivity in economic evaluation in health care. A reflexive approach would allow economic evaluators to analyze how objective structures and subjective elements influence their practices. In return, this would point increase the integrity and reliability of economic evaluations. Reflexivity provides opportunities for critically thinking about the organization and activities of the intellectual field, and perhaps the potential of moving in new, creative directions. This paper argues for economic evaluators to have a less positivist attitude towards what is useful knowledge, and to use more imagination about the data and methodologies they use. PMID:17258367

  7. Systematic review of employer-sponsored wellness strategies and their economic and health-related outcomes.

    PubMed

    Kaspin, Lisa C; Gorman, Kathleen M; Miller, Ross M

    2013-02-01

    This review determines the characteristics and health-related and economic outcomes of employer-sponsored wellness programs and identifies possible reasons for their success. PubMed, ABI/Inform, and Business Source Premier databases, and Corporate Wellness Magazine were searched. English-language articles published from 2005 to 2011 that reported characteristics of employer-sponsored wellness programs and their impact on health-related and economic outcomes among US employees were accepted. Data were abstracted, synthesized, and interpreted. Twenty references were accepted. Wellness interventions were classified into health assessments, lifestyle management, and behavioral health. Improved economic outcomes were reported (health care costs, return on investment, absenteeism, productivity, workers' compensation, utilization) as well as decreased health risks. Programs associated with favorable outcomes had several characteristics in common. First, the corporate culture encouraged wellness to improve employees' lives, not only to reduce costs. Second, employees and leadership were strongly motivated to support the wellness programs and to improve their health in general. Third, employees were motivated by a participation-friendly corporate policy and physical environment. Fourth, successful programs adapted to the changing needs of the employees. Fifth, community health organizations provided support, education, and treatment. Sixth, successful wellness programs utilized technology to facilitate health risk assessments and wellness education. Improved health-related and economic outcomes were associated with employer-sponsored wellness programs. Companies with successful programs tended to include wellness as part of their corporate culture and supported employee participation in several key ways. PMID:23113636

  8. Gross national happiness as a framework for health impact assessment

    SciTech Connect

    Pennock, Michael; Ura, Karma

    2011-01-15

    The incorporation of population health concepts and health determinants into Health Impact Assessments has created a number of challenges. The need for intersectoral collaboration has increased; the meaning of 'health' has become less clear; and the distinctions between health impacts, environmental impacts, social impacts and economic impacts have become increasingly blurred. The Bhutanese concept of Gross National Happiness may address these issues by providing an over-arching evidence-based framework which incorporates health, social, environmental and economic contributors as well as a number of other key contributors to wellbeing such as culture and governance. It has the potential to foster intersectoral collaboration by incorporating a more limited definition of health which places the health sector as one of a number of contributors to wellbeing. It also allows for the examination of the opportunity costs of health investments on wellbeing, is consistent with whole-of-government approaches to public policy and emerging models of social progress.

  9. Revolution then evolution: the advance of health economic evaluation in Australia.

    PubMed

    Lopert, Ruth; Viney, Rosalie

    2014-01-01

    All governments face immense challenges in providing affordable healthcare for their citizens, and the diffusion of novel health technologies is a key driver of growth in expenditure for many. Although important methodological and process variations exist around the world, health economic evaluation is increasingly seen as an important tool to support decision-making around the introduction of new health technologies, interventions and programmes in countries of varying stages of economic development. In Australia, the assessment of the comparative cost-effectiveness of new medicines proposed for subsidy under the country's national drug subsidy programme, the Pharmaceutical Benefits Scheme, was introduced in the late 1980s and became mandatory in 1993, making Australia the first country to introduce such a requirement nationally. Since then the use of health economic evaluation has expanded and been applied to support decision-making across a broader range of health technologies, as well as to programmes in public health. PMID:25444293

  10. Sensor based soil health assessment

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Quantification and assessment of soil health involves determining how well a soil is performing its biological, chemical, and physical functions relative to its inherent potential. Due to high cost, labor requirements, and soil disturbance, traditional laboratory analyses cannot provide high resolut...

  11. Ethics, economics, and public financing of health care

    PubMed Central

    Hurley, J.

    2001-01-01

    There is a wide variety of ethical arguments for public financing of health care that share a common structure built on a series of four logically related propositions regarding: (1) the ultimate purpose of a human life or human society; (2) the role of health and its distribution in society in advancing this ultimate purpose; (3) the role of access to or utilisation of health care in maintaining or improving the desired level and distribution of health among members of society, and (4) the role of public financing in ensuring the ethically justified access to and utilisation of health care by members of society. This paper argues that economics has much to contribute to the development of the ethical foundations for publicly financed health care. It focuses in particular on recent economic work to clarify the concepts of access and need and their role in analyses of the just distribution of health care resources, and on the importance of economic analysis of health care and health care insurance markets in demonstrating why public financing is necessary to achieve broad access to and utilisation of health care services. Key Words: Ethics • economicshealth care financing PMID:11479353

  12. [The economic-financial crisis and health in Spain. Evidence and viewpoints. SESPAS report 2014].

    PubMed

    Cortès-Franch, Imma; González López-Valcárcel, Beatriz

    2014-06-01

    The objectives of the SESPAS 2014 Report are as follows: a) to analyze the impact of the economic crisis on health and health-related behaviors, on health inequalities, and on the determinants of health in Spain; b) to describe the changes in the Spanish health system following measures to address the crisis and assess its potential impact on health; c) to review the evidence on the health impact of economic crises in other countries, as well as policy responses; and d) to suggest policy interventions alternative to those carried out to date with a population health perspective and scientific evidence in order to help mitigate the impact of the economic downturn on health and health inequalities. The report is organized in five sections: 1) the economic, financial and health crisis: causes, consequences, and contexts; 2) the impact on structural determinants of health and health inequalities; 3) the impact on health and health-related behaviors, and indicators for monitoring; 4) the impact on health systems; and 5) the impact on specific populations: children, seniors, and immigrants. There is some evidence on the relationship between the crisis and the health of the Spanish population, health inequalities, some changes in lifestyle, and variations in access to health services. The crisis has impacted many structural determinants of health, particularly among the most vulnerable population groups. Generally, policy responses on how to manage the crisis have not taken the evidence into account. The crisis may contribute to making public policy vulnerable to corporate action, thus jeopardizing the implementation of healthy policies. PMID:24863987

  13. Preliminary energy sector assessments of Jamaica. Volume II: economic assessment

    SciTech Connect

    Not Available

    1980-01-01

    Presented is an economic assessment of the specialized study areas, reviewing recommendations from the specialized studies in relation to each other and to the GOJ's 5-year Development and Energy Sector Plans. After analyzing the effects of these recommendations on Jamaica's energy situation and economy, the recommendations are integrated and prioritized in a proposed Combined Energy Program (CEP) which is recommended for immediate GOJ implementation. Highest priority items include research, testing, training, and tax structures to encourage solar hot water and agricultural drying systems; installation of small- and medium-size biogas plants; and negotiating joint port usage for a possible coal-fired electricity plant.

  14. A Framework for Including Family Health Spillovers in Economic Evaluation

    PubMed Central

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-01-01

    Health care interventions may affect the health of patients’ family networks. It has been suggested that these “health spillovers” should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the “health care perspective”). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society. PMID:26377370

  15. Economics of Mass Media Health Campaigns with Health-Related Product Distribution: A Community Guide Systematic Review

    PubMed Central

    Jacob, Verughese; Chattopadhyay, Sajal K.; Elder, Randy W.; Robinson, Maren N.; Tansil, Kristin A.; Soler, Robin E.; Labre, Magdala P.; Mercer, Shawna L.

    2015-01-01

    Context The objective of this systematic review was to determine the costs, benefits, and overall economic value of communication campaigns that included mass media and distribution of specified health-related products at reduced price or free of charge. Evidence Acquisition Economic evaluation studies from a literature search from January 1980–December 2009 were screened and abstracted following systematic economic review methods developed by The Community Guide. Data were analyzed in 2011. Evidence Synthesis The economic evidence was grouped and assessed by type of product distributed and health risk addressed. A total of 15 evaluation studies were included in the economic review, involving campaigns promoting the use of child car seats or booster seats, pedometers, condoms, recreational safety helmets, and nicotine replacement therapy (NRT). Conclusion Economic merits of the intervention could not be determined for health communication campaigns associated with use of recreational helmets, child car seats, and pedometers, primarily because available economic information and analyses were incomplete. There is some evidence that campaigns with free condom distribution to promote safer sex practices were cost-effective among high-risk populations and the cost per quit achieved in campaigns promoting tobacco cessation with NRT products may translate to a cost per quality-adjusted life year (QALY) less than $50,000. Many interventions were publicly funded trials or programs, and the failure to properly evaluate their economic cost and benefit is a serious gap in the science and practice of public health. PMID:25145619

  16. The Delineation of Economic and Health Service Areas and the Location of Health Manpower Education Programs.

    ERIC Educational Resources Information Center

    Leyes, John M.; And Others

    The research reported pertains to the interrelationships of the economic system, the health-care delivery system, and the health manpower education systems. In this research it was learned that in a part of the intermountain region predominately rural in nature, the economic and the health systems are closely related. Challenge is given to the…

  17. Economics, Work, and Mental Health: Implications for Primary Prevention.

    ERIC Educational Resources Information Center

    Cahill, Janet

    Recent research on the impact of economics on mental and physical health has raised fundamental questions about structural elements in the macro-economy and their role in creating stress. This paper reviews and integrates these sometimes conflicting findings into a cohesive model. Structural elements of our current economic system are identified…

  18. Parental Health and Children's Economic Well-Being

    ERIC Educational Resources Information Center

    Wagmiller, Robert L., Jr.; Lennon, Mary Clare; Kuang, Li

    2008-01-01

    The life course perspective emphasizes that past economic experiences and stage in the life course influence a family's ability to cope with negative life events such as poor health. However, traditional analytic approaches are not well-suited to examine how the impact of negative life events differs based on a family's past economic experiences,…

  19. Economic analysis of health care interventions.

    PubMed

    Konski, Andre

    2008-07-01

    According to US government statistics, health care expenditures approached $2 trillion in 2005 or $6,697/person, with spending expected to exceed $4.1 trillion by 2016 (http://www.cms.hhs.gov/NationalHealthExpendData/). Total Centers for Medicare and Medicaid Services spending (including Medicaid, State Children's Health Insurance Program (SCHIP), and Medicare) was $660.7 million in 2005. Despite the decline in the growth rate of health care spending growth over the past 4 years, health care spending increased 6.9% from 2004 to 2005 and was 16% of the gross domestic product (GDP) in 2005 and forecasted to be 19.6% of the GDP by 2016. Although the percentage of GDP may not concern providers of health care products or services, it has an affect on the rest of the economy. Spending on health care by employers or patients increases the cost of the products produced, making goods produced here in the United States less attractive to world markets in the age of globalization in addition to leaving less money for patients to spend on other goods and services or save. PMID:18513626

  20. [What are the economic advantages of Integrated Health Care?].

    PubMed

    Henke, K-D

    2006-01-01

    Integrated Health Care and Managed Health Care are both tools to implement broader responsibilities of health care providers for the economic efforts of their activities. While Managed Care is quite common in the United States of America, experiences with such systems are sparse in Europe and Germany. With Integrated Health Care, new types of markets will emerge: not only a market for health care services, but also for insurance contracts, and for provision of care. The paper discusses different incentives arising from different health care systems. PMID:16598562

  1. Health Literacy and Adult Basic Education Assessments

    ERIC Educational Resources Information Center

    Golbeck, Amanda L.; Ahlers-Schmidt, Carolyn R.; Paschal, Angelia M.

    2005-01-01

    Adult basic education (ABE) is an ideal venue for developing health literacy skills. Literacy and numeracy assessments used in ABE were identified and the most common were examined for health components. Only the Comprehensive Adult Student Assessment System (CASAS) included health. The two most common health literacy assessments used in general…

  2. Health economic evaluations in reimbursement decision making in the Netherlands: time to take it seriously?

    PubMed

    Franken, Margreet; Koopmanschap, Marc; Steenhoek, Adri

    2014-01-01

    Health technology assessment already informed Dutch policymaking in the early 1980s. Evidence of health economic evaluations is, however, only systematically used in drug reimbursement decision making. Outpatient drugs with an added therapeutic value and expensive specialist drugs require evidence from an economic evaluation. Due to many exemptions, however, the availability of evidence of health economic evaluations remains rather low. Although the Dutch reimbursement agency suggested a cost-effectiveness threshold range depending on the severity of the disease (i.e., €10,000 - 80,000 per Quality Adjusted Life Year), it was never confirmed nor endorsed by the Ministry of Health. It is highly questionable whether health economic evaluations currently play a role in actual Dutch reimbursement decision making. Although the requirements exist in policy procedures, recent cases show that Dutch policymakers experience great difficulties in putting restrictions on reimbursement based on evidence from health economic evaluations. The near future will show whether the need will increase to base decisions on societal value for money, and whether Dutch policymakers show the courage to take health economic evaluations seriously. PMID:25444296

  3. Liposome Bupivacaine for Postsurgical Analgesia in Adult Patients Undergoing Laparoscopic Colectomy: Results from Prospective Phase IV Sequential Cohort Studies Assessing Health Economic Outcomes☆

    PubMed Central

    Candiotti, Keith A.; Sands, Laurence R.; Lee, Edward; Bergese, Sergio D.; Harzman, Alan E.; Marcet, Jorge; Kumar, Anjali S.; Haas, Eric

    2013-01-01

    Background Opioid-based postsurgical analgesia exposes patients undergoing laparoscopic colectomy to elevated risk for gastrointestinal motility problems and other opioid-related adverse events (ORAEs). The purpose of our research was to investigate postsurgical outcomes, including opioid consumption, hospital length of stay, and ORAE risk associated with a multimodal analgesia regimen, employing a single administration of liposome bupivacaine as well as other analgesics that act by different mechanisms. Methods We analyzed combined results from 6 Phase IV, prospective, single-center studies in which patients undergoing laparoscopic colectomy received opioid-based intravenous patient-controlled analgesia (PCA) or multimodal analgesia incorporating intraoperative administration of liposome bupivacaine. As-needed rescue therapy was available to all patients. Primary outcome measures were postsurgical opioid consumption, hospital length of stay, and hospitalization costs. Secondary measures included time to first rescue opioid use, patient satisfaction with analgesia (assessed using a 5-point Likert scale), and ORAEs. Results Eighty-two patients underwent laparoscopic colectomy and did not meet intraoperative exclusion criteria (PCA n = 56; multimodal analgesia n = 26). Compared with the PCA group, the multimodal analgesia group had significantly lower mean total postsurgical opioid consumption (96 vs 32 mg, respectively; P < 0.0001) and shorter median postsurgical hospital length of stay (3.0 vs 4.0 days; P = 0.0019). Geometric mean costs were $11,234 and $13,018 in the multimodal analgesia and PCA groups, respectively (P = 0.2612). Median time to first rescue opioid use was longer in the multimodal analgesia group versus PCA group (1.1 hours vs 0.6 hours, respectively; P=0.0003). ORAEs were experienced by 41% of patients receiving intravenous opioid PCA and 8% of patients receiving multimodal analgesia (P = 0.0019). Study limitations included use of an open

  4. Fuel ethanol and agriculture: an economic assessment. Agricultural economic report

    SciTech Connect

    Grinnell, G.; Gavett, E.

    1986-08-01

    Increased fuel ethanol production through 1995 would raise net farm income, benefiting mainly corn and livestock producers. Production of additional byproduct feeds would depress the price of soybeans. Large ethanol subsidies, which are required to sustain the industry, would offset any savings in agricultural commodity programs. Increased ethanol production would also raise consumer expenditures for food. Any benefits of higher income to farmers would be more than offset by increased Government costs and consumer food expenditures. Direct cash payments to farmers would be more economical than attempting to boost farm income through ethanol subsidies.

  5. [The economic-industrial health care complex and the social and economic dimension of development].

    PubMed

    Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira; Maldonado, José

    2012-12-01

    The strategic role of health care in the national development agenda has been increasingly recognized and institutionalized. In addition to its importance as a structuring element of the Social Welfare State, health care plays a leading role in the generation of innovation - an essential element for competitiveness in knowledge society. However, health care's productive basis is still fragile, and this negatively affects both the universal provision of health care services and Brazil's competitive inclusion in the globalized environment. This situation suggests the need of a more systematic analysis of the complex relationships among productive, technological and social interests in the scope of health care. Consequently, it is necessary to produce further knowledge about the Economic-Industrial Health Care Complex due to its potential for contributing to a socially inclusive development model. This means reversing the hierarchy between economic and social interests in the sanitary field, thus minimizing the vulnerability of the Brazilian health care policy. PMID:23250391

  6. A programme for Health Impact Assessment in Brighton and Hove.

    PubMed

    Scanlon, Thomas J; Lawrence, Lydie; Blair-Stevens, Terry; Nichols, Sarah

    2006-01-01

    HIA is based on the theory of health determinants, which recognizes that well-being is determined by a wide range of economic, social and environmental factors, by heredity and medical intervention. The intended HIA procedure represents a new approach to the evaluation of all local authority policies in order to assess their potential health impacts and to improve the quality of governmental decisions, through recommendations to enhance predicted positive health impacts and minimize negative ones. PMID:17191538

  7. Community Mental Health Ideology, Dogmatism, and Political-Economic Conservatism

    ERIC Educational Resources Information Center

    Baker, Frank; Schulberg, Herbert C.

    1969-01-01

    Indications are that degree of adherence to philosophy of community mental health among area board members, as measured by the Community Mental Health Ideology Scale and the five-term form of the Political-Economic-Conservatism Scale, is significantly negatively correlated with dogmatism and conservatism. (Author/CJ)

  8. International Inequalities: Algebraic Investigations into Health and Economic Development

    ERIC Educational Resources Information Center

    Staats, Susan; Robertson, Douglas

    2009-01-01

    The Millennium Project is an international effort to improve the health, economic status, and environmental resources of the world's most vulnerable people. Using data associated with the Millennium Project, students use algebra to explore international development issues including poverty reduction and the relationship between health and economy.…

  9. The Impact of Economic Stress on Community Mental Health Services.

    ERIC Educational Resources Information Center

    Hagan, Brian J.; And Others

    1982-01-01

    Warns that community mental health services are threatened by reductions in federal support and increased numbers of clients. Reviews literature on the effect of adverse economic events on mental health. Identifies issues and answers for managing this dilemma including planning, financial diversification, and inter-agency cooperation. (Author/JAC)

  10. Meta-Evaluation of Worksite Health Promotion Economic Return Studies.

    ERIC Educational Resources Information Center

    Chapman, Larry S.

    2003-01-01

    This meta-evaluation provides a standardized look at the quality of the economic evaluation literature for multi-component worksite health promotion programs. Analysis of 42 studies suggests that the evidence is very strong for average reductions in sick leave, health plan costs, and workers' compensation and disability costs of slightly more than…

  11. Health economics of weight management: evidence and cost.

    PubMed

    Kouris-Blazos, Antigone; Wahlqvist, Mark L

    2007-01-01

    The World Health Organization estimates that around one billion people throughout the world are overweight and that over 300 million of these are obese and if current trends continue, the number of overweight persons will increase to 1.5 billion by 2015. The number of obese adults in Australia is estimated to have risen from 2.0 million in 1992/93 to 3.1 million in 2005. The prevalence of obesity has been increasing due to a convergence of factors--the rise of TV viewing, our preference for takeaway and pre-prepared foods, the trend towards more computer-bound sedentary jobs, and fewer opportunities for sport and physical exercise. Obesity is not only linked to lack of self esteem, social and work discrimination, but also to illnesses such as the metabolic syndrome and hyperinsulinaemia (which increases the risk of developing heart disease, diabetes, hypertension, fatty liver), cancer, asthma, dementia, arthritis and kidney disease. It has been estimated that the cost of obesity in Australia in 2005 was $1,721 million. Of this amount, $1,084 million were direct health costs, and $637 million indirect health costs (due to lost work productivity, absenteeism and unemployment). The prevalence cost per year for each obese adult has been estimated at $554 and the value of an obesity cure is about $6,903 per obese person. Government efforts at reducing the burden remain inadequate and a more radical approach is needed. The Australian government, for example, has made changes to Medicare so that GPs can refer people with chronic illness due to obesity to an exercise physiologist and dietitian and receive a Medicare rebate, but so far these measures are having no perceptible effect on obesity levels. There is a growing recognition that both Public Health and Clinical approaches, and Private and Public resources, need to be brought to this growing problem. Australian health economist, Paul Gross, from the Institute of Health Economics and Technology Assessment claims there

  12. Special issue: Behavioral Economics and Health Annual Symposium.

    PubMed

    2011-09-01

    The application of behavioral economics to health and health care has captured the imagination of policymakers across the political spectrum. The idea is that many people are irrational in predictable ways, and that this both contributes to unhealthy behaviors like smoking and holds one of the keys to changing those behaviors. Because health care costs continue to increase, and a substantial portion of costs are incurred because of unhealthy behaviors, employers and insurers have great interest in using financial incentives to change behaviors. However, it is in the details that complexity and controversies emerge. Who should the targets be, and what outcomes should be rewarded? How should incentives be structured, to maximize their effectiveness and minimize unintended consequences? In what situations should we be intervening to affect decisions by people who may prefer to be obese or to smoke, and in what situations should we accept their preferences? To begin to answer these questions, the Penn-CMU Roybal P30 Center on Behavioral Economics and Health held its first annual Behavioral Economics and Health Symposium on March 24-25, 2011 with support from the Robert Wood Johnson Foundation. The symposium drew more than 50 researchers, scholars, and health professionals from a variety of disciplines, including medicine, public health, economics, law, management, marketing, and psychology. They heard perspectives on behavioral economics from public and private funders, the CEO of the University of Pennsylvania Health System, and the CEO of stickK.com, a start-up company that uses online, voluntary commitment contracts to help people achieve their goals. Participants formed eight working groups to review the current state-of-the-art in a variety of clinical contexts and to consider how behavioral economics could inform a research agenda to improve health. This Issue Brief summarizes the findings of these working groups and the symposium. PMID:21949955

  13. Economic analysis of the health impacts of housing improvement studies: a systematic review

    PubMed Central

    Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

    2013-01-01

    Background Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Methods Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. Results 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid ‘balance sheet’ approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Conclusions Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy. PMID:23929616

  14. Economics, management, and public health nutrition.

    PubMed

    Dahl, T

    1977-02-01

    Research has shown that including a nutritional functional area in comprehensive health care delivery can reduce the total cost per registrant. The savings occur when nutritionists substitute for more costly medical personnel in a team-care setting. Further research has demonstrated that the cost of nutritional care is related to the performance of nutritional staff, i.e., productivity, which may be improved as much as 25 to 70% through simple managerial techniques. The implications for nutritional planning and operations are discussed. Nevertheless, the greatest potential for improving nutritional health rests with the patient himself. Thus, the future orientation in public health nutrition must be directed toward the problems of shifting the major part of the responsibility from the provider to the patient, with accompanying competence in self-care and health maintenance. A promising approach to the idea of greater patient responsibility and autonomy is the so-called Vinland Center concept. Originally developed in Norway, a center incorporating the principles is now being planned in Minnesota and is expected to begin operation in 1979. Funds for the planning effort were given to the U.S. as a Bicentennial gift from Norway. The concept is explained. PMID:402409

  15. Protecting Pakistan's health during the global economic crisis.

    PubMed

    Jooma, R; Khan, A; Khan, A A

    2012-03-01

    The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources. PMID:22574485

  16. How is health economics relevant to transplant clinicians?

    PubMed

    Wong, Germaine; Howard, Kirsten; Webster, Angela C; Morton, Rachael L; Chapman, Jeremy R; Craig, Jonathan C

    2014-07-27

    Decision making is complex and difficult in clinical practice. Clinicians are often faced with a large range of possible alternative decision options, each with their own consequences and trade-offs. Health economics methods enable informed decision making on how best to allocate limited resources that could lead to most health gains. Economic evaluation in particular is highly relevant in transplantation medicine. Transplantation is an expensive intervention, but it improves the quality of life and survival of people with chronic diseases. The balance between health care resource use and the optimal health gains is useful not only to decision-makers, but also to consumers, clinicians, and researchers. This article is an overview of the concepts of economic evaluation in the setting of transplantation and highlights the applicability of these concepts in clinical transplantation. PMID:24926827

  17. EPA guidance on mental health and economic crises in Europe.

    PubMed

    Martin-Carrasco, M; Evans-Lacko, S; Dom, G; Christodoulou, N G; Samochowiec, J; González-Fraile, E; Bienkowski, P; Gómez-Beneyto, M; Dos Santos, M J H; Wasserman, D

    2016-03-01

    This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed. PMID:26874960

  18. Economic Shocks and Public Health Protections in US Metropolitan Areas

    PubMed Central

    Hogg, Rachel A.

    2015-01-01

    Objectives. We examined public health system responses to economic shocks using longitudinal observations of public health activities implemented in US metropolitan areas from 1998 to 2012. Methods. The National Longitudinal Survey of Public Health Systems collected data on the implementation of 20 core public health activities in a nationally representative cohort of 280 metropolitan areas in 1998, 2006, and 2012. We used generalized estimating equations to estimate how local economic shocks relate to the scope of activities implemented in communities, the mix of organizations performing them, and perceptions of the effectiveness of activities. Results. Public health activities fell by nearly 5% in the average community between 2006 and 2012, with the bottom quintile of communities losing nearly 25% of their activities. Local public health delivery fell most sharply among communities experiencing the largest increases in unemployment and the largest reductions in governmental public health spending. Conclusions. Federal resources and private sector contributions failed to avert reductions in local public health protections during the recession. New financing mechanisms may be necessary to ensure equitable public health protections during economic downturns. PMID:25689201

  19. Health Economics of Nutrition Intervention in Asia: Cost of Malnutrition.

    PubMed

    Mizumoto, Kaori; Murakami, Genki; Oshidari, Kenro; Trisnantoro, Laksono; Yoshiike, Nobuo

    2015-01-01

    Asia has recorded the fastest economic growth in the world. However, some countries are still struggling with economic stagnation and poverty. Even in the emerging countries, there are economic disparities between urban and rural areas within a country. Reflecting the situations, nutritional issues in Asia came to be the antithetical situation of excess and insufficiency. The rate of overweight and obesity keeps increasing, especially in emerging countries. Meanwhile, underweight is still a critical problem in the region. Although the importance of nutrition is well recognized for social and economic development, it is difficult to identify the immediate outcome of nutrition interventions. Evidence-based decision-making is an important element of quality health care and efficiency and effectiveness are always key words. Along with enhanced attention to accountability and transparency of budget use in health services, attention to the economic evaluation of nutrition interventions has increased in recent years. In this symposium, we will review the current situation of nutritional issues and economic evaluation of nutrition interventions in Asia through experience of an international organization, the basis and trends for health care economics, and also efforts have been made in an Asian country. Discussion will be made about efficient and effective ways to evaluate projects/programmes for nutrition improvement. PMID:26598883

  20. Health Assessment Guidance Manual. Draft report

    SciTech Connect

    Not Available

    1990-07-01

    The document is directed to public health physicians, scientists, and engineers employed by The Agency for Toxic Substances and Disease Registry (ATSDR) and other State and Federal agencies who perform health assessments. It sets forth the health assessment process as defined by ATSDR and clarifies the methodologies and guidelines that will be used by ATSDR staff and agents of ATSDR in conducting these health assessments. The individual steps for performing a health assessment are discussed in Chapters 3 through 8 of the document. Chapter 9 discusses how the health assessment report should be written and the format in which it should be presented.

  1. Engaging Health Professionals in Health Economics: A Human Capital Informed Approach for Adults Learning Online

    ERIC Educational Resources Information Center

    Lieberthal, Robert D.; Leon, Juan

    2015-01-01

    The authors describe a Wikipedia-based project designed for a graduate course introducing health economics to experienced healthcare professionals. The project allows such students to successfully write articles on niche topics in rapidly evolving health economics subspecialties. These students are given the opportunity to publish their completed…

  2. Environment, health, and sustainable development: the role of economic instruments and policies.

    PubMed Central

    Warford, J. J.

    1995-01-01

    Recent years have seen considerable progress in integrating environmental concerns into the mainstream of development policy and planning. Economic instruments designed explicitly for environmental purposes may help to achieve cost-effective solutions, and generate public revenues. Macroeconomic and sectoral policies may impact heavily upon the environment, and there is much scope for policy reforms that are justified in both economic and environmental terms. Progress in this area has been much more rapid than in the case of health objectives, even though the rationale for environmental improvement is often ultimately related to human health and well-being. It is proposed that lessons from recent experience in the use of economic instruments and policies to achieve environmental objectives are highly relevant for the health sector, which should seek and encourage support for measures that requires consumer and producers of environmentally degrading products to pay for the economic and social costs of the damage resulting from their use. Policy reform at the macroeconomic or sectoral level may yield cost-effective solutions to some health problems, and may even bring about improvements in health status that involve no net cost at all. The countrywide impact of such policies indicate that health agencies, including WHO, should develop the capacity to understand how economic policies and the adjustment process impact upon human health, not only direct through the effect on incomes, but also indirectly, via changes in the natural environment. Ability to conduct rigorous health impact assessment of economic policy reform, which requires a multidisciplinary effort, is a necessary condition if health ministries are to maximize their effectiveness in influencing overall government economic policy. PMID:7614671

  3. Canadian Digestive Health Foundation Public Impact Series 4: Celiac disease in Canada. Incidence, prevalence, and direct and indirect economic impact

    PubMed Central

    Fedorak, Richard N; Switzer, Connie M; Bridges, Ron J

    2012-01-01

    The Canadian Digestive Health Foundation initiated a scientific program to assess the incidence, prevalence, mortality and economic impact of digestive disorders across Canada in 2009. The current article presents the updated findings from the study concerning celiac disease. PMID:22720277

  4. The impact of economic issues on Nigerian health sciences libraries.

    PubMed Central

    Belleh, G S; Akhigbe, O O

    1991-01-01

    Economic issues are among the most important factors affecting health sciences libraries in Nigeria. These issues are influenced by the political, cultural, geographic, and demographic characteristics of the country. Significant economic issues are the dependence of the national economy on a single commodity, large foreign debt and spiraling inflation, stringent foreign exchange control measures, and inadequate realization by authorities of the role and importance of health sciences libraries. With shrinking budgets, resources, and staff, health sciences libraries can neither grow nor afford library automation. Health sciences librarians must take initiatives for cooperative activities to increase and make the most of resources, pursue nontraditional methods of fund-raising, educate authorities about the role and importance of libraries, and develop and implement a plan for the development and growth of health sciences libraries in the country. PMID:1884083

  5. Health economics and outcomes research fellowship practices reviewed.

    PubMed

    Suh, Kangho; Gabriel, Susan; Adams, Michelle A; Arcona, Steve

    2015-01-01

    The guidelines for health economics and outcomes research (HEOR) fellowship training programs devised by the American College of Clinical Pharmacy (ACCP) and the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) suggest that continuous improvements are made to ensure that postgraduate training through didactic and professional experiences prepare fellows for HEOR research careers. The HEOR Fellowship Program at Novartis Pharmaceuticals Corporation was standardized to enhance the fellows' HEOR research understanding and align professional skill sets with the ACCP-ISPOR Fellowship Program Guidelines. Based on feedback from an internal task force comprised of HEOR employees and current and former fellows, the HEOR Fellowship Program was normatively and qualitatively assessed to evaluate the current curricular program. Fellowship program activities were instituted to ensure that the suggested minimum level requirements established by the guidelines were being met. Research opportunities enabling fellows to work hand-in-hand with other fellows and HEOR professionals were emphasized. Curricular enhancements in research methodology and professional training and development, and materials for a structured journal club focusing on specific methodological and HEOR research topics were developed. A seminar series (e.g., creating SMART Goals, StrengthsFinder 2.0) and professional courses (e.g., ISPOR short courses, statistics.com) were included to enhance the fellows' short- and long-term professional experience. Additional program attributes include an online reference library developed to enrich the current research facilities and a Statistical Analysis Software training program. Continuously assessing and updating HEOR fellowship programs keeps programs up-to-date in the latest HEOR concepts and approaches used to evaluate health care, both professionally and educationally. PMID:25178521

  6. Trial-Based Economic Evaluations in Occupational Health

    PubMed Central

    van Wier, Marieke F.; Tompa, Emile; Bongers, Paulien M.; van der Beek, Allard J.; van Tulder, Maurits W.; Bosmans, Judith E.

    2014-01-01

    To allocate available resources as efficiently as possible, decision makers need information on the relative economic merits of occupational health and safety (OHS) interventions. Economic evaluations can provide this information by comparing the costs and consequences of alternatives. Nevertheless, only a few of the studies that consider the effectiveness of OHS interventions take the extra step of considering their resource implications. Moreover, the methodological quality of those that do is generally poor. Therefore, this study aims to help occupational health researchers conduct high-quality trial-based economic evaluations by discussing the theory and methodology that underlie them, and by providing recommendations for good practice regarding their design, analysis, and reporting. This study also helps consumers of this literature with understanding and critically appraising trial-based economic evaluations of OHS interventions. PMID:24854249

  7. Economic impact of public sector spending on health care.

    PubMed

    Hy, Ronald John

    2011-01-01

    Public sector spending on health care clearly has a positive economic impact on local communities. Not only does such spending provide residents with better health care, but it is widely recognized as an investment that returns continual dividends in the form of better jobs, higher incomes, and additional state and local tax revenues. The results of a static input/output model shows that public sector spending on health care of approximately $46 billion (in 2009 dollars) in the state of Texas yields over 588,000 jobs, $74.2 billion in total output, $26.3 billion in personal income, $22 billion in employee compensation, and $1.8 billion in state and local taxes; it clearly has a considerable positive economic impact on local economies and their quest for economic development. PMID:22106548

  8. [Public health in major socio-economic crisis].

    PubMed

    Cosmacini, G

    2014-01-01

    The term "crisis" in different cultures (such as ancient Greece or China) can have a positive meaning, since it indicates a time of growth, change and opportunity. Over the centuries there have been times of severe economic and social crisis that led to the implementation of major reforms and improved population health. Nowadays, despite the new economic crisis which has also affected health care for its rising costs, health economics does not hesitate to affirm the importance of key objectives such as prevention and medical assistance. Prevention is not prediction. Prevention means "going upstream" and fixing a problem at the source; the goal is to reduce diseases' effects, causes and risk factors, thereby reducing the prevalence of costly medical conditions. PMID:25486685

  9. Mental health reform, economic globalization and the practice of citizenship.

    PubMed

    Morrow, Marina

    2004-01-01

    Drawing on research conducted in British Columbia, Ontario, and Quebec it is argued that tension exists between mental health reforms born out of concern for the well-being and care of people and those that are being driven by cost-containment and efficiency. Contributing to this tension are competing discourses about mental health and mental illness. It is argued that progressive change requires the meaningful engagement of mental health care recipients in policy decision-making processes and ongoing analysis about the interconnections between economic globalization, social welfare state restructuring and mental health reform. PMID:16138645

  10. 3rd latin american and Caribbean congress on health economics.

    PubMed

    Pérez Izquierdo, Victoria; Alvarez Muñiz, Manuel

    2009-02-01

    The 3rd Latin American and Caribbean Congress on Health Economics took place at Havana Convention Center from 28th to 31st October 2008. The conference was an excellent opportunity for the exchange of personal encounters regarding health economics and its related disciplines from the perspectives of research, teaching and management. Specialists from mostly Latin American countries attended the event. High-ranking specialists from other countries highlighted the importance and popularity of the conference. A total of 313 delegates from 23 countries were present at the congress, 160 of whom were Cuban. PMID:19371176

  11. Promoting prevention with economic arguments – The case of Finnish occupational health services

    PubMed Central

    Kankaanpää, Eila; Suhonen, Aki; Valtonen, Hannu

    2008-01-01

    Background Both social and ethical arguments have been used to support preventive occupational health services (OHS). During the 1990s it became more common to support political argumentation for occupational health and safety by converting the consequences of ill health at work into monetary units. In addition, OHS has been promoted as a profitable investment for companies, and this aspect has been used by OHS providers in their marketing. Our intention was to study whether preventive occupational health services positively influence a company's economic performance. Methods We combined the financial statements provided by Statistics Finland and employers' reimbursement applications for occupational health services (OHS) costs to the Social Insurance Institution. The data covered the years 1997, 1999 and 2001 and over 6000 companies. We applied linear regression analysis to assess whether preventive OHS had had a positive influence on the companies' economic performance after two or four years. Results Resources invested in preventive OHS were not positively related to a company's economic performance. In fact, the total cost of preventive OHS per turnover was negatively correlated to economic performance. Conclusion Even if OHS has no effect on the economic performance of companies, it may have other effects more specific to OHS. Therefore, we recommend that the evaluation of prevention in OHS should move towards outcome measures, such as sickness absence, disability pension and productivity, when applicable, both in occupational health service research and in practice at workplaces. PMID:18430218

  12. Head Start Oral Health Assessment.

    PubMed

    Reed, Rebecca; York, Jill; Dady, Nadege; Chaviano-Moran, Rosa; Jiang, Shuying; Holtzman, Joseph

    2016-05-01

    Purpose A Head Start program located in Paterson, New Jersey considered establishing a school-based dental clinic to address unmet oral health needs such as access to care and the need for restorative treatment. The purpose of this study was to establish the oral health status of Head Start children, their treatment needs, and parents' interest and willingness to utilize a school-based dental clinic. Description School-based dental care has been used to address access to care issues, particularly among children who live in underserved areas. A 21 item survey was used to correlate the results of an oral exam performed on the Head Start children and the parents' preferences, beliefs and access patterns. Fisher's exact test and Chi squared test were used to study the association among variable with significance levels set at 0.05. Assessment The oral exam revealed a high caries rate amongst all of the children. Parental responses indicated strong support for the establishment of a school-based clinic and identified the need for further parental education. Having a regular source of care was found to be unrelated to treatment needs. Conclusion Further education of the parents regarding the child's oral health is critical to the success and viability of this school-based clinic. PMID:27017227

  13. Genome sequencing: a systematic review of health economic evidence

    PubMed Central

    2013-01-01

    Recently the sequencing of the human genome has become a major biological and clinical research field. However, the public health impact of this new technology with focus on the financial effect is not yet to be foreseen. To provide an overview of the current health economic evidence for genome sequencing, we conducted a thorough systematic review of the literature from 17 databases. In addition, we conducted a hand search. Starting with 5 520 records we ultimately included five full-text publications and one internet source, all focused on cost calculations. The results were very heterogeneous and, therefore, difficult to compare. Furthermore, because the methodology of the publications was quite poor, the reliability and validity of the results were questionable. The real costs for the whole sequencing workflow, including data management and analysis, remain unknown. Overall, our review indicates that the current health economic evidence for genome sequencing is quite poor. Therefore, we listed aspects that needed to be considered when conducting health economic analyses of genome sequencing. Thereby, specifics regarding the overall aim, technology, population, indication, comparator, alternatives after sequencing, outcomes, probabilities, and costs with respect to genome sequencing are discussed. For further research, at the outset, a comprehensive cost calculation of genome sequencing is needed, because all further health economic studies rely on valid cost data. The results will serve as an input parameter for budget-impact analyses or cost-effectiveness analyses. PMID:24330507

  14. Investing in children's health: what are the economic benefits?

    PubMed Central

    Belli, Paolo C.; Bustreo, Flavia; Preker, Alexander

    2005-01-01

    This paper argues that investing in children's health is a sound economic decision for governments to take, even if the moral justifications for such programmes are not considered. The paper also outlines dimensions that are often neglected when public investment decisions are taken. The conclusion that can be drawn from the literature studying the relationship between children's health and the economy is that children's health is a potentially valuable economic investment. The literature shows that making greater investments in children's health results in better educated and more productive adults, sets in motion favourable demographic changes, and shows that safeguarding health during childhood is more important than at any other age because poor health during children's early years is likely to permanently impair them over the course of their life. In addition, the literature confirms that more attention should be paid to poor health as a mechanism for the intergenerational transmission of poverty. Children born into poor families have poorer health as children, receive lower investments in human capital, and have poorer health as adults. As a result, they will earn lower wages as adults, which will affect the next generation of children who will thus be born into poorer families. PMID:16283055

  15. Animal Genetic Resource Trade Flows: Economic Assessment

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Throughout human history, livestock producers have relied on a vibrant international exchange of genetic resources to achieve improvements in the quality and productivity of their animals. In recent years, however, some observers have argued that changes in the legal, technological, and economic env...

  16. [Health technology assessment agencies in the xxi century].

    PubMed

    Argimon, Josep Maria

    2015-11-01

    The origins of the health technology assessment (HTA) agencies date back to the 70s in the United States; in the European context, the current Agency for Quality and Health Assessment of Catalonia was among the pioneers in 1991. Epidemiological, social, technological and economic changes of recent years have led to the incorporation, by the agencies, of new functions, activities and projects that can offer better services (information and knowledge) to the various players in the healthcare system (patients, professionals, providers, insurers and policy-makers) in order to increase healthcare quality and preserve the sustainability of the health system. PMID:26711062

  17. Economic Evaluation of Environmental Health Interventions to Support Decision Making

    PubMed Central

    Hutton, Guy

    2008-01-01

    Environmental burden of disease represents one quarter of overall disease burden, hence necessitating greater attention from decision makers both inside and outside the health sector. Economic evaluation techniques such as cost-effectiveness analysis and cost-benefit analysis provide key information to health decision makers on the efficiency of environmental health interventions, assisting them in choosing interventions which give the greatest social return on limited public budgets and private resources. The aim of this article is to review economic evaluation studies in three environmental health areas—water, sanitation, hygiene (WSH), vector control, and air pollution—and to critically examine the policy relevance and scientific quality of the studies for selecting and funding public programmers. A keyword search of Medline from 1990–2008 revealed 32 studies, and gathering of articles from other sources revealed a further 18 studies, giving a total of 50 economic evaluation studies (13 WSH interventions, 16 vector control and 21 air pollution). Overall, the economic evidence base on environmental health interventions remains relatively weak—too few studies per intervention, of variable scientific quality and from diverse locations which limits generalisability of findings. Importantly, there still exists a disconnect between economic research, decision making and programmer implementation. This can be explained by the lack of translation of research findings into accessible documentation for policy makers and limited relevance of research findings, and the often low importance of economic evidence in budgeting decisions. These findings underline the importance of involving policy makers in the defining of research agendas and commissioning of research, and improving the awareness of researchers of the policy environment into which their research feeds. PMID:21572840

  18. Health protection in times of economic crisis: challenges and opportunities for Europe.

    PubMed

    McDaid, David; Quaglio, Gianluca; Correia de Campos, António; Dario, Claudio; Van Woensel, Lieve; Karapiperis, Theodoros; Reeves, Aaron

    2013-11-01

    STOA, the European Parliament's technology assessment body, and the European Observatory on Health Systems and Policies recently organised a workshop on the impacts of the economic crisis on European health systems. Evidence of the impact of the recent financial crisis on health outcomes is only just beginning to emerge. Data suggests that this latest recession has led to more frequent poor health status, rising incidence of some communicable diseases, and higher suicide rates. Further, available data are likely to underestimate the broader mental health crisis linked to increased rates of stress, anxiety, and depression among the economically vulnerable. Not only does recession affect factors that determine health, but it also affects the financial capacity to respond. Many European governments have reduced public expenditure on health services during the financial crisis, while introducing or increasing user charges. The recession has driven structural reforms, and has affected the priority given to public policies that could be used to help protect population health. The current economic climate, while challenging, presents an opportunity for reforming and restructuring health promotion actions and taking a long-term perspective. PMID:23986120

  19. Community Health Needs Assessment: Potential for Population Health Improvement.

    PubMed

    Pennel, Cara L; McLeroy, Kenneth R; Burdine, James N; Matarrita-Cascante, David; Wang, Jia

    2016-06-01

    Derived from various health care policies and initiatives, the concept of population health has been newly adopted by health care and medicine. In particular, it has been suggested that the Patient Protection and Affordable Care Act provision that requires nonprofit hospitals to conduct a community health needs assessment (CHNA) and implement strategies to address health priorities has the potential to improve population health. A mixed methods study design was used to examine the potential for population health improvements to occur through the Internal Revenue Service (IRS)-mandated nonprofit hospital CHNA and planning processes. Methods involved a 2-phased approach composed of (1) content analysis of 95 CHNA/implementation strategies reports and (2) interviews with key informants, consultants, and community stakeholders involved in CHNA and planning processes. Although this is a great opportunity for the nonprofit hospital assessment and planning processes to influence population health outcomes, the findings from the first 3-year assessment and planning cycle (2011-2013) suggest this is unlikely. As nonprofit hospitals begin the second 3-year assessment and planning cycle, this article offers recommendations to increase the potential for nonprofit hospitals to improve population health. These recommendations include clarifying the purpose of IRS CHNA regulations, engaging community stakeholders in collaborative assessment and planning, understanding disease etiology and identifying and addressing broader determinants of health, adopting a public health assessment and planning model, and emphasizing population health improvement. (Population Health Management 2016;19:178-186). PMID:26440370

  20. Utilization review. Health economics and cost-effective resource management.

    PubMed

    Rosenstein, A H

    1991-01-01

    In an effort to reduce their health care burden, health care payors have turned to utilization controls and restructured health care payment systems to control health care costs. While health care payors are interested in economic restraints, health care providers are being placed at increasing levels of financial risk, and they struggle to maintain high quality services. Quality of care must remain our number one priority, but it is essential to achieve this goal in a cost-efficient manner. Cost-efficiencies are gained through the development of a comprehensive physician education program that encourages information exchange, physician input, and the implementation of positive alternatives that lead to efficiencies in resource management. PMID:1824449

  1. Mapping coal quality parameters for economic assessments

    SciTech Connect

    Hohn, M.E.; Smith, C.J.; Ashton, K.C.; McColloch, G.H. Jr.

    1988-08-01

    This study recommends mapping procedures for a data base of coal quality parameters. The West Virginia Geological and Economic Survey has developed a data base that includes about 10,000 analyses of coal samples representing most seams in West Virginia. Coverage is irregular and widely spaced; minimal sample spacing is generally greater than 1 mi. Geologists use this data base to answer public and industry requests for maps that show areas meeting coal quality specifications.

  2. Methodology for the economic assessment of PACS

    NASA Astrophysics Data System (ADS)

    Langlotz, Curtis P.; Even-Shoshan, Orit; Seshadri, Sridhar B.; Brikman, Inna; Kishore, Sheel; Kundel, Harold L.; Schwartz, J. Sanford

    1994-05-01

    Most economic studies of Picture Archiving and Communications Systems (PACS) to date, including our own, have focused on the perspective of the radiology department and its direct costs. However, many researchers have suggested additional cost savings that may accrue to the medical center as a whole through increased operational capacity, fewer lost images, rapid simultaneous access to images, and other decreases in resource utilization. We describe here a new economic analysis framework we have developed to estimate these potential additional savings. Our framework is comprised of two parallel measurement methods. The first method estimates the cost of care actually delivered through online capture of charge entries from the hospital's billing computer and from the clinical practices' billing database. Multiple regression analyses will be used to model cost of care, length of stay, and other estimates of resource utilization. The second method is the measurement of actual resource utilization, such as technologist time, frequency and duration of film searches, and equipment utilization rates. The costs associated with changes in resource use will be estimated using wage rates and other standard economic methods. Our working hypothesis is that, after controlling for the underlying clinical and demographic differences among patients, patients imaged using a PACS will have shorter lengths of stay, shorter exam performance times, and decreased costs of care. We expect our analysis framework to explain and resolve some of the conflicting views of the cost-effectiveness of PACS.

  3. [Controversial issues in economic evaluation (I): perspective and costs of Health Care interventions].

    PubMed

    Oliva, Juan; Brosa, Max; Espín, Jaime; Figueras, Montserrat; Trapero, Marta

    2015-01-01

    Economic evaluation of health care interventions has experienced a strong growth over the past decade and is increasingly present as a support tool in the decisions making process on public funding of health services and pricing in European countries. A necessary element using them is that agents that perform economic evaluations have minimum rules with agreement on methodological aspects. Although there are methodological issues in which there is a high degree of consensus, there are others in which there is no such degree of agreement being closest to the normative field or have experienced significant methodological advances in recent years. In this first article of a series of three, we will discuss on the perspective of analysis and assessment of costs in economic evaluation of health interventions using the technique Metaplan. Finally, research lines are proposed to overcome the identified discrepancies. PMID:25946581

  4. [Controversial Issues in Economic Evaluation (III): health Care Interventions in Special Situations].

    PubMed

    Espín Balbino, Jaime; Brosa Riestra, Max; Oliva Moreno, Juan; Trapero-Bertran, Marta

    2015-01-01

    The development of the economic evaluation of health care interventions has become a support tool in making decisions on pricing and reimbursement of new health interventions. The increasingly extensive application of these techniques has led to the identification of particular situations in which, for various reasons, it may be reasonable to take into account special considerations when applying the general principles of economic evaluation. In this article, which closes a series of three, we will discuss, using the Metaplan technique, about the economic evaluation of health interventions in special situations such as rare diseases and end of life treatments, as well as consideration of externalities in assessments, finally pointing out some research areas to solve the main problems identified in these fields. PMID:26388338

  5. Prioritizing risk factors to identify preventive interventions for economic assessment

    PubMed Central

    Blakely, Tony; Foster, Rachel H; Hadorn, David; Vos, Theo

    2012-01-01

    Abstract Objective To explore a risk factor approach for identifying preventive interventions that require more in-depth economic assessment, including cost-effectiveness analyses. Methods A three-step approach was employed to: (i) identify the risk factors that contribute most substantially to disability-adjusted life years (DALYs); (ii) re-rank these risk factors based on the availability of effective preventive interventions warranting further cost-effectiveness analysis (and in some instances on evidence from existing cost-effectiveness analyses); and (iii) re-rank these risk factors in accordance with their relative contribution to health inequalities. Health inequalities between the Māori and non-Māori populations in New Zealand were used by way of illustration. Findings Seven of the top 10 risk factors prioritized for research on preventive interventions in New Zealand were also among the 10 risk factors most highly ranked as contributing to DALYs in high-income countries of the World Health Organization’s Western Pacific Region. The final list of priority risk factors included tobacco use; alcohol use; high blood pressure; high blood cholesterol; overweight/obesity, and physical inactivity. All of these factors contributed to health inequalities. Effective interventions for preventing all of them are available, and for each risk factor there is at least one documented cost-saving preventive intervention. Conclusion The straightforward approach to prioritizing risk factors described in this paper may be applicable in many countries, and even in those countries that lack the capacity to perform additional cost-effectiveness analyses, this approach will still make it possible to determine which cost-effective interventions should be implemented in the short run. PMID:22423159

  6. Assessment of the Undergraduate Economics Major: A National Survey

    ERIC Educational Resources Information Center

    Myers, Steven C.; Nelson, Michael A.; Stratton, Richard W.

    2011-01-01

    Economics departments are faced with growing demands to document what their graduates have learned on completion of the undergraduate major. The results of a national survey of economics department chairs in the United States reveal that nearly two-thirds of the departments have a formal assessment plan. There is substantial agreement on the most…

  7. Assessing Health Professional Education: Workshop Summary

    ERIC Educational Resources Information Center

    Cuff, Patricia A.

    2014-01-01

    "Assessing Health Professional Education" is the summary of a workshop hosted by the Institute of Medicine's Global Forum on Innovation in Health Professional Education to explore assessment of health professional education. At the event, Forum members shared personal experiences and learned from patients, students, educators, and…

  8. CONSUMER ASSESSMENT OF HEALTH PLANS SURVEY (CAHPS)

    EPA Science Inventory

    This 5-year project has been used for consumers to identify the best health care plans and services for their needs. The goals of the Consumer Assessment of Health Plans (CAHPS?) are to (1) develop and test questionnaires that assess health plans and services, (2) produce easily ...

  9. Current Challenges in Health Economic Modeling of Cancer Therapies: A Research Inquiry

    PubMed Central

    Miller, Jeffrey D.; Foley, Kathleen A.; Russell, Mason W.

    2014-01-01

    Background The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology. Objectives We sought to explore some of the contentious issues associated with the development and use of oncology economic models as informative tools in current healthcare decision-making. Our objective was to draw attention to these complex pharmacoeconomic concerns and to promote discussion within the oncology and health economics research communities. Methods Using our combined expertise in health economics research and economic modeling, we structured our inquiry around the following 4 questions: (1) Are economic models adequately addressing questions relevant to oncology decision makers; (2) What are the methodologic limitations of oncology economic models; (3) What guidelines are followed for developing oncology economic models; and (4) Is the evolution of oncology economic modeling keeping pace with treatment innovation? Within the context of each of these questions, we discuss issues related to the technical limitations of oncology modeling, the availability of adequate data for developing models, and the problems with how modeling analyses and results are presented and interpreted. Discussion There is general acceptance that economic models are good, essential tools for decision-making, but the practice of oncology and its rapidly evolving technologies present unique challenges that make assessing and demonstrating value especially complex. There is wide latitude for improvement in oncology modeling methodologies and how model results are presented

  10. Interview: Health technology assessment in Asia: an emerging trend.

    PubMed

    Yang, Bong-min

    2012-05-01

    Bong-min Yang, PhD (in economics), is Professor and former Dean of the School of Public Health at the Seoul National University, South Korea. Professor Yang has led research and written many papers in health economics and healthcare systems in Korea and Asia. His recent research and publications focus on the field of economic evaluation and outcomes research. He played a key role in the introduction of a formal health technology assessment system within Korean healthcare. He is currently serving as Executive Director, Institute of Health and Environment, Seoul National University. In addition to his research and publications, Professor Yang is Associate Editor for Journal of Comparative Effectiveness Research, is co-editor-in-chief for Value in Health Regional Issues, and is currently chair of the Management Advisory Board of Value in Health and a member of the editorial board of the Journal of Medical Economics. He has been a policy consultant to China, Japan, Indonesia, Hong Kong, Malaysia, Taiwan, Thailand and India. He has also worked as a short-term consultant at the WHO, ADB, UNDP and the World Bank. For the Korean government, he served as Chairperson of the Health Insurance Reform Committee, and Chairperson of the Drug Pricing and Reimbursement Committee. He is currently serving as Chair of the International Society of Pharmacoeconomics and Outcomes Research-Asia Consortium, and a member of the Board of Directors of the International Society of Pharmacoeconomics and Outcomes Research. PMID:24237405

  11. Economic Evaluation of Mental Health Interventions: A Guide to Costing Approaches.

    PubMed

    Shearer, James; McCrone, Paul; Romeo, Renee

    2016-07-01

    Costing approaches in the economic evaluation of mental health interventions are complicated by the broad societal impacts of mental health, and the multidisciplinary nature of mental health interventions. This paper aims to provide a practical guide to costing approaches across a wide range of care inputs and illness consequences relevant to the treatment of mental health. The resources needed to deliver mental health interventions are highly variable and depend on treatment settings (institutional, community), treatment providers (medical, non-medical) and formats (individual, group, electronic). Establishing the most appropriate perspective is crucial when assessing the costs associated with a particular mental health problem or when evaluating interventions to treat them. We identify five key cost categories (social care, informal care, production losses, crime and education) impacted by mental health and discuss contemporary issues in resource use measurement and valuation, including data sources and resource use instruments. PMID:26922076

  12. LNG vehicle technology, economics, and safety assessment

    NASA Astrophysics Data System (ADS)

    Powars, Charles A.; Moyer, Carl B.; Lowell, Douglas D.

    1994-02-01

    Liquid natural gas (LNG) is an attractive transportation fuel because of its high heating value and energy density (i.e., Btu/lb. and Btu/gal.), clean burning characteristics, relatively low cost ($/Btu), and domestic availability. This research evaluated LNG vehicle and refueling system technology, economics, and safety. Prior and current LNG vehicle projects were studied to identify needed technology improvements. Life-cycle cost analyses considered various LNG vehicle and fuel supply options. Safety records, standards, and analysis methods were reviewed. The LNG market niche is centrally fueled heavy-duty fleet vehicles with high fuel consumption. For these applications, fuel cost savings can amortize equipment capital costs.

  13. Health economics, equity, and efficiency: are we almost there?

    PubMed

    Ferraz, Marcos Bosi

    2015-01-01

    Health care is a highly complex, dynamic, and creative sector of the economy. While health economics has to continue its efforts to improve its methods and tools to better inform decisions, the application needs to be aligned with the insights and models of other social sciences disciplines. Decisions may be guided by four concept models based on ethical and distributive justice: libertarian, communitarian, egalitarian, and utilitarian. The societal agreement on one model or a defined mix of models is critical to avoid inequity and unfair decisions in a public and/or private insurance-based health care system. The excess use of methods and tools without fully defining the basic goals and philosophical principles of the health care system and without evaluating the fitness of these measures to reaching these goals may not contribute to an efficient improvement of population health. PMID:25709481

  14. Arthritis Patient Education: How Economic Evaluations Can Inform Health Policy.

    ERIC Educational Resources Information Center

    Clarke, Ann E.

    1997-01-01

    A cost-effectiveness evaluation of an Arthritis Self-Management Program assessed direct and indirect costs through self-reporting of health services use. Diminished productivity and effectiveness were measured through a visual analog scale and the health status dimensions of the Canadian Medical Outcomes Study short form. (JOW)

  15. Integrating Ecosystem Services Into Health Impact Assessment

    EPA Science Inventory

    Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

  16. [Clinical and health economic challenges of personalized medicine].

    PubMed

    Brüggenjürgen, B; Kornbluth, L; Ferrara, J V; Willich, S N

    2012-05-01

    Healthcare systems across the globe are currently challenged by aging populations, increases in chronic diseases and the difficult task of managing a healthcare budget. In this health economic climate, personalized medicine promises not only an improvement in healthcare delivery but also the possibility of more cost-effective therapies. It is important to remember, however, that personalized medicine has the potential to both increase and decrease costs. Each targeted therapy must be evaluated individually. However, standard clinical trial design is not suitable for personalized therapies. Therefore, both scientists and regulatory authorities will need to accept innovative study designs in order to validate personalized therapies. Hence correct economic evaluations are difficult to carry out due to lack of clear clinical evidence, longitudinal accounting and experience with patient/clinician behavior in the context of personalized medicine. In terms of reimbursement, payers, pharmaceutical companies and companion diagnostic manufacturers will also need to explore creative risk-sharing concepts. Germany is no exception to the challenges that face personalized medicine and for personalized medicine to really become the future of medicine many health economic challenges first need to be overcome. The health economic implications of personalized medicine remain unclear but it is certain that the expansion of targeted therapies in current healthcare systems will create a host of challenges. PMID:22526860

  17. Health effects of risk-assessment categories

    SciTech Connect

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

  18. Health insurance and outcomes: comprehensive assessment of health system outputs.

    PubMed

    Perkins, N A

    1991-01-01

    Outcomes analysis in health care has historically meant the examination of clinical results of inpatient hospitalization. In response to climbing health care and health insurance costs, the organization of health care providers, the location of service delivery and reimbursement mechanisms have changed. As the health care industry changes, so too must the definition of outcomes. This article presents a conceptual framework for the analysis of health outcomes as health industry outputs, with an emphasis on the ways in which such outputs are being assessed and improved. PMID:10116955

  19. From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis.

    PubMed

    Burke, Sara Ann; Normand, Charles; Barry, Sarah; Thomas, Steve

    2016-03-01

    Ireland experienced one of the most severe economic crises of any OECD country. In 2011, a new government came to power amidst unprecedented health budget cuts. Despite a retrenchment in the ability of health resources to meet growing need, the government promised a universal, single-tiered health system, with access based solely on medical need. Key to this was introducing universal free GP care by 2015 and Universal Health Insurance from 2016 onwards. Delays in delivering universal access and a new health minister in 2014 resulted in a shift in language from 'universal health insurance' to 'universal healthcare'. During 2014 and 2015, there was an absence of clarity on what government meant by universal healthcare and divergence in policy measures from their initial intent of universalism. Despite the rhetoric of universal healthcare, years of austerity resulted in poorer access to essential healthcare and little extension of population coverage. The Irish health system is at a critical juncture in 2015, veering between a potential path to universal healthcare and a system, overwhelmed by years of austerity, which maintains the status quo. This papers assesses the gap between policy intent and practice and the difficulties in implementing major health system reform especially while emerging from an economic crisis. PMID:26777302

  20. Decision making in Germany: is health economic evaluation as a supporting tool a sleeping beauty?

    PubMed

    Gerber-Grote, Andreas; Sandmann, Frank Gerd; Zhou, Min; Ten Thoren, Corinna; Schwalm, Anja; Weigel, Carolin; Balg, Christiane; Mensch, Alexander; Mostardt, Sarah; Seidl, Astrid; Lhachimi, Stefan K

    2014-01-01

    For many years, the legal situation within the statutory health insurance (SHI) system in Germany has allowed for health economic evaluations. There are various reasons why health economic evaluations have played virtually no role in decision making until now: to begin with, a method for the evaluation of the relation between benefits and costs which needed to be in accordance with the legal requirements had to be developed, the outcome of which was the efficiency frontier approach. Subsequent health care reforms have led to changing objectives and strategies. Currently, price negotiations of newly launched drugs are based on an early benefit assessment of dossiers submitted by pharmaceutical manufacturers. Other reasons might be the presently very comfortable financial situation of the statutory health insurance system as well as a historically grown societal fear and discomfort towards what is perceived to be a rationing of medicinal products. For the time being, it remains open how long the German health care system can afford to continue neglecting the benefits of health economic evaluations for drug and non-drug interventions, and when it will be time to wake this sleeping beauty. PMID:25444297

  1. The consideration of health in strategic environmental assessment (SEA)

    SciTech Connect

    Fischer, Thomas B; Matuzzi, Marco; Nowacki, Julia

    2010-04-15

    Following the requirements of the European Directive 2001/42/EC on strategic environmental assessment (SEA) and the Protocol on Strategic Environmental Assessment (Kiev, 2003) to the Convention on Environmental Impact Assessment in a Transboundary Context (Espoo, 1991), health is one of the aspects to be considered in SEA. In this paper, results of an evaluation of eight SEAs from Austria, the Czech Republic, Germany, the Netherlands and the United Kingdom (England and Wales) regarding the consideration of health are presented. This includes SEAs for five spatial plans, as well as one SEA for each, a transport, a waste management and an economic development plan. It is found that while all SEAs cover important physical and natural aspects that are related to health, social and behavioural aspects are considered to a much smaller extent. Based on the results, facilitating factors and barriers for health inclusive SEA are identified. Overall, good baseline data can be seen as an important starting point for effective health inclusive SEA, while an effective monitoring system is crucial for effective implementation of the measures and recommendations brought forward in health inclusive SEA. Crucially, health authorities/health experts need to engage more with SEA, as this provides a key platform for cross sectoral dialogue on a range of issues. SEA presents the health sector with an opportunity to influence the policy and decision-making process to improve people's health and well-being.

  2. 75 FR 23214 - HIPAA Privacy Rule Accounting of Disclosures Under the Health Information Technology for Economic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-03

    ... Accounting of Disclosures Under the Health Information Technology for Economic and Clinical Health Act...: Request for information. SUMMARY: Section 13405(c) of the Health Information Technology for Economic and... Information Technology for Economic and Clinical Health (HITECH) Act, Public Law 111-5, 123 Stat....

  3. The NICE ADHD health technology assessment: A review and critique

    PubMed Central

    Schlander, Michael

    2008-01-01

    Background Health technology assessments (HTAs) by the National Institute for Health and Clinical Excellence (NICE) enjoy high levels of international attention. The present analysis addresses NICE's appraisal of methylphenidate, atomoxetine and dexamphetamine for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, published in March 2006. Methods A qualitative study of NICE Technology Appraisal No. 98 was done focusing on the >600-page technology assessment report, which aimed at evaluating ADHD treatment strategies by a clinical effectiveness review and an economic analysis using meta-analytical techniques and a cost-effectiveness model. Results The technology assessment was unable to differentiate between the various drugs in terms of efficacy, and its economic model was ultimately driven by cost differences. While the assessment concluded that the economic model "clearly identified an optimal treatment strategy" with first-line dexamphetamine, the NICE appraisal committee subsequently found it impossible to distinguish between the different strategies on grounds of cost-effectiveness. Analyzing the assessment reveals gaps and inconsistencies concerning data selection (ultimately relying on a small number of short-term studies only), data synthesis (pooling of heterogeneous study designs and clinical endpoints), and economic model structure (identifying double-counting of nonresponders as a likely source of bias, alongside further methodological anomalies). Conclusion Many conclusions of the NICE technology assessment rest on shaky grounds. There remains a need for a new, state-of-the-art systematic review of ADHD treatment strategies including economic evaluation, which ideally should address outcomes beyond children's health-related quality of life, such as long-term sequelae of the disorder and caregiver burden. PMID:18197978

  4. Economic evaluation and health care. What does it mean?

    PubMed Central

    Robinson, R

    1993-01-01

    Ever since the concept of value for money in health care was introduced into the NHS, economic terms and jargon have become part of our everyday lives--but do we understand what the different types of economic evaluation all mean, particularly those that sound similar to the uninitiated? This article introduces readers to the purpose of economic evaluation, and briefly explains the differences between cost-minimisation analysis (used when the outcomes of the procedures being compared are the same); cost-effectiveness analysis (used when the outcomes may vary, but can be expressed in common natural units, such as mm Hg for treatments of hypertension); cost-utility analysis (used when outcomes do vary--for example, quality of life scales); and cost-benefit analysis (used when a monetary value is being placed on services received). Further articles will deal with each one in more detail. Images p671-a p673-a PMID:8401057

  5. Development of a Health Screening Package Under the Universal Health Coverage: The Role of Health Technology Assessment.

    PubMed

    Teerawattananon, Yot; Kingkaew, Pritaporn; Koopitakkajorn, Tanunya; Youngkong, Sitaporn; Tritasavit, Nattha; Srisuwan, Patsri; Tantivess, Sripen

    2016-02-01

    This study reports the systematic development of a population-based health screening package for all Thai people under the universal health coverage (UHC). To determine major disease areas and health problems for which health screening could mitigate health burden, a consultation process was conducted in a systematic, participatory, and evidence-based manner that involved 41 stakeholders in a half-day workshop. Twelve diseases/health problems were identified during the discussion. Subsequently, health technology assessments, including systematic review and meta-analysis of health benefits as well as economic evaluations and budget impact analyses of corresponding population-based screening interventions, were completed. The results led to advice against elements of current clinical practice, such as annual chest X-rays and particular blood tests (e.g. kidney function test), and indicated that the introduction of certain new population-based health screening programs, such as for chronic hepatitis B, would provide substantial health and economic benefits to the Thais. The final results were presented to a wide group of stakeholders, including decision-makers at the Ministry of Public Health and the public health insurance schemes, to verify and validate the findings and policy recommendations. The package has been endorsed by the Thai UHC Benefit Package Committee for implementation in fiscal year 2016. PMID:26774008

  6. A Primer on Health Economic Evaluations in Thoracic Oncology.

    PubMed

    Whittington, Melanie D; Atherly, Adam J; Bocsi, Gregary T; Camidge, D Ross

    2016-08-01

    There is growing interest for economic evaluation in oncology to illustrate the value of multiple new diagnostic and therapeutic interventions. As these analyses have started to move from specialist publications into mainstream medical literature, the wider medical audience consuming this information may need additional education to evaluate it appropriately. Here we review standard practices in economic evaluation, illustrating the different methods with thoracic oncology examples where possible. When interpreting and conducting health economic studies, it is important to appraise the method, perspective, time horizon, modeling technique, discount rate, and sensitivity analysis. Guidance on how to do this is provided. To provide a method to evaluate this literature, a literature search was conducted in spring 2015 to identify economic evaluations published in the Journal of Thoracic Oncology. Articles were reviewed for their study design, and areas for improvement were noted. Suggested improvements include using more rigorous sensitivity analyses, adopting a standard approach to reporting results, and conducting complete economic evaluations. Researchers should design high-quality studies to ensure the validity of the results, and consumers of this research should interpret these studies critically on the basis of a full understanding of the methodologies used before considering any of the conclusions. As advancements occur on both the research and consumer sides, this literature can be further developed to promote the best use of resources for this field. PMID:27079184

  7. Economics of disaster risk, social vulnerability, and mental health resilience.

    PubMed

    Zahran, Sammy; Peek, Lori; Snodgrass, Jeffrey G; Weiler, Stephan; Hempel, Lynn

    2011-07-01

    We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44-31.14%), and by 71.88% (95% CI, 39.48-211.82%) for single females with children. Monthly time-series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02-1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03-1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two-dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata. PMID:21303401

  8. Economics and the Transformation of the Mental Health System.

    PubMed

    Glied, Sherry; Frank, Richard G

    2016-08-01

    Mental illnesses provide a difficult set of challenges to American health and social institutions. Those challenges have been a continuous concern of David Mechanic's over the course of his career. In this article we trace the development of modern economic and organizational structures that drive the delivery of mental health care in the early part of the twenty-first century. We show how the nature of mental disorders themselves and the treatment for addressing those illnesses pose fundamental difficulties to health care organizational and financing structures. We analyze the factors that have caused the dramatic changes in how American society has addressed mental illnesses over the past fifty years. Specifically, we note the central influence that mainstream health, income support, and disability programs have had in shaping mental health care. We argue that the interaction of the unique features of mental illnesses and changes in mainstream health and social policy led mental health care to evolve so differently from general medical care. PMID:27127263

  9. An Assessment of Integrated Health Management Frameworks

    SciTech Connect

    Lybeck, Nancy; Coble, Jamie B.; Tawfik, Magdy; Bond, Leonard J.

    2012-05-18

    In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging NPPs presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to better understanding and management of the challenges posed by aging NPPs. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of an NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of an NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system development tools, deployable architectures

  10. Alabama Allied Health Needs Assessment Study.

    ERIC Educational Resources Information Center

    Morris, Libby V.

    This study assessed the supply of and demand for allied health professionals in Alabama, focusing on the relationship between supply and demand in various workplace settings in the context of Alabama's demographics, current educational programs, and projected changes in health care. The health care professions included in the study were all fields…

  11. The West Virginia Health Education Assessment Project

    ERIC Educational Resources Information Center

    Tompkins, Nancy O'Hara; Kamal, Khalid M.; Chapman, Don

    2005-01-01

    Well-designed school health education should provide students with the knowledge and skills to prevent the health risk behaviors most responsible for the major causes of morbidity and mortality. This paper reports the methodology and findings of a West Virginia statewide health education assessment initiative and describes how the findings are…

  12. Microeconomic Surplus in Health Care: Applied Economic Theory in Health Care in Four European Countries

    PubMed Central

    Walzer, S.; Nuijten, M.; Wiesner, C.; Kaier, K.; Johansson, P-O.; Oertel, S.

    2013-01-01

    Introduction: In economic theory economic surplus refers to two related quantities: Consumer and producer surplus. Applying this theory to health care “convenience” could be one way how consumer benefits might manifest itself. Methods: Various areas of economic surplus were identified and subsequently screened and analyzed in Germany, Spain, The Netherlands, and the UK: Cesarean births, emergency room visits (nights or weekends), drug availability after test results, and response surplus. A targeted literature search was being conducted to identify the associated costs. Finally the economic surplus (convenience value) was calculated. Results: The economic surplus for different health care areas was being calculated. The highest economic surplus was obtained for the example of response surplus IVF-treatments in The Netherlands. Conclusion: The analyzed examples in this article support the underlying hypothesis for this research: “Value of convenience defined as the consumer surplus in health care can be shown in different health care settings.” Again, this hypothesis should be accepted as a starting point in this research area and hence further primary research is strongly recommended in order to fully proof this concept. PMID:23423475

  13. Stakeholders' Perspectives About and Priorities for Economic Evaluation of Health and Safety Programs in Healthcare.

    PubMed

    Tompa, Emile; de Boer, Henriette; Macdonald, Sara; Alamgir, Hasanat; Koehoorn, Mieke; Guzman, Jaime

    2016-04-01

    This study identified and prioritized resources and outcomes that should be considered in more comprehensive and scientifically rigorous health and safety economic evaluations according to healthcare sector stakeholders. A literature review and stakeholder interviews identified candidate resources and outcomes and then a Delphi panel ranked them. According to the panel, the top five resources were (a) health and safety staff time; (b) training workers; (c) program planning, promotion, and evaluation costs; (d) equipment purchases and upgrades; and (e) administration costs. The top five outcomes were (a) number of injuries, illnesses, and general sickness absences; (b) safety climate; (c) days lost due to injuries, illnesses, and general sickness absences; (d) job satisfaction and engagement; and (e) quality of care and patient safety. These findings emphasize stakeholders' stated priorities and are useful as a benchmark for assessing the quality of health and safety economic evaluations and the comprehensiveness of these findings. PMID:27056937

  14. The other crisis: the economics and financing of maternal, newborn and child health in Asia.

    PubMed

    Anderson, Ian; Axelson, Henrik; Tan, B-K

    2011-07-01

    The Global Financial Crisis (GFC) of 2008/2009 was the largest economic slowdown since the Great Depression. It undermined the growth and development prospects of developing countries. Several recent studies estimate the impact of economic shocks on the poor and vulnerable, especially women and children. Infant and child mortality rates are still likely to continue to decline, but at lower rates than would have been the case in the absence of the GFC. Asia faces special challenges. Despite having been the fastest growing region in the world for decades, and even before the current crisis, this region accounted for nearly 34% of global deaths of children under 5, more than 40% of maternal deaths and 60% of newborn deaths. Global development goals cannot be achieved without much faster and deeper progress in Asia. Current health financing systems in much of Asia are not well placed to respond to the needs of women and their children, or the recent global financial and economic slowdown. Public expenditure is often already too low, and high levels of out-of-pocket health expenditure are an independent cause of inequity and impoverishment for women and their children. The GFC highlights the need for reforms that will improve health outcomes for the poor, protect the vulnerable from financial distress, improve public expenditure patterns and resource allocation decisions, and so strengthen health systems. This paper aims to highlight the most recent assessments of how economic shocks, including the GFC, affect the poor in developing countries, especially vulnerable women and children in Asia. It concludes that conditional cash transfers, increasing taxation on tobacco and increasing the level, and quality, of public expenditure through well-designed investment programmes are particularly relevant in the context of an economic shock. That is because these initiatives simultaneously improve health outcomes for the poor and vulnerable, protect them from further financial

  15. [Economic crisis and mental health. SESPAS report 2014].

    PubMed

    Gili, Margalida; García Campayo, Javier; Roca, Miquel

    2014-06-01

    Studies published before the financial crisis of 2008 suggest that economic difficulties contribute to poorer mental health. The IMPACT study conducted in primary health care centers in Spain found a significant increase in common mental disorders. Between 2006 and 2010, mood disorders increased by 19%, anxiety disorders by 8% and alcohol abuse disorders by 5%. There were also gender differences, with increased alcohol dependence in women during the crisis period. The most important risk factor for this increase was unemployment. In parallel, antidepressant consumption has increased in recent years, although there has not been a significant inrease in the number of suicides. Finally, the study offers some proposals to reduce the impact of the crisis on mental health: increased community services, employment activation measures, and active policies to reduce alcohol consumption and prevent suicidal behavior, particularly among young people. PMID:24661346

  16. Economic Valuation of Health Care Services in Public Health Systems: A Study about Willingness to Pay (WTP) for Nursing Consultations

    PubMed Central

    Martín-Fernández, Jesús; del Cura-González, Mª Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Mª Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Bayona, Mª Teresa Sanz-; Gil-Lacruz, Ana Isabel

    2013-01-01

    Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of

  17. Findings from ATSDR's Health Assessments.

    ERIC Educational Resources Information Center

    Susten, Allan S.

    1992-01-01

    Summarizes findings from the Agency for Toxic Substances and Disease Registry concerning the evaluation of data about hazardous substance release into the environment. Identifies the hazardous substances, exposure, health effects, and public health impact from 951 facilities identified on the National Priorities List (NPL) by the Environmental…

  18. Children's Mental Health in Times of Economic Recession: Replication and Extension of the Family Economic Stress Model in Finland

    ERIC Educational Resources Information Center

    Solantaus, Tytti; Leinonen, Jenni; Punam Ki, Raija-Leena

    2004-01-01

    This study evaluated the applicability of the family economic stress model (FESM) in understanding the influences of economic hardship on child mental health during a nationwide economic recession in Finland. The information was gathered from 527 triads of 12-year-olds and their mothers and fathers from a population sample. The structural equation…

  19. Uncertainties associated with assessing the public health risk from Legionella

    PubMed Central

    Whiley, Harriet; Keegan, Alexandra; Fallowfield, Howard; Ross, Kirstin

    2014-01-01

    Legionella is an opportunistic pathogen of public health concern. Current regulatory and management guidelines for the control of this organism are informed by risk assessments. However, there are many unanswered questions and uncertainties regarding Legionella epidemiology, strain infectivity, infectious dose, and detection methods. This review follows the EnHealth Risk Assessment Framework, to examine the current information available regarding Legionella risk and discuss the uncertainties and assumptions. This review can be used as a tool for understanding the uncertainties associated with Legionella risk assessment. It also serves to highlight the areas of Legionella research that require future focus. Improvement of these uncertainties will provide information to enhance risk management practices for Legionella, potentially improving public health protection and reducing the economic costs by streamlining current management practices. PMID:25309526

  20. The need for health impact assessment in China: Potential benefits for public health and steps forward

    SciTech Connect

    Wu Liming; Rutherford, Shannon; Chu, Cordia

    2011-07-15

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  1. How health economic evaluation (HEE) contributes to decision-making in public health care: the case of Brazil.

    PubMed

    Elias, Flávia Tavares Silva; Araújo, Denizar Vianna

    2014-01-01

    The universal access to a health care system for the Brazilian population was established in 1990. Brazil is a country with no tradition in the production and use of health economic evaluation (HEE) to guide decision making in the public health system. It is only within the last two decades that HEEs using a microeconomic approach have appeared in the academic field. On a national level, HEE and Health Technology Assessment (HTA), in a wider sense, were first taken into account in 2003. Two policies deserve to be mentioned - (i) the regulation of medicines in the Brazilian market, and (ii) science, technology and innovation policy. The latter required the fostering of applied research to encourage the application of methods which employ systematic reviews and economic analyses of cost-effectiveness to guide the incorporation of technologies in the Brazilian health care system. The Ministry of Health has initiated the process of incorporating these new technologies on a federal level during the last ten years. In spite of the improvement of HEE methods at Brazilian universities and research institutes, these technologies have not yet reached the governmental bodies. In Brazil, the main challenge lies in the production, interpretation and application of HEE to all technologies within the access scheme(s), and there is limited capacity building. Setting priorities can be the solution for Brazil to be able to perform HEE for relevant technologies within the access scheme(s) while the universal coverage system struggles with a triple burden of disease. PMID:25444299

  2. Specific guidelines for assessing and improving the methodological quality of economic evaluations of newborn screening

    PubMed Central

    2012-01-01

    Background Economic evaluation of newborn screening poses specific methodological challenges. Amongst others, these challenges refer to the use of quality adjusted life years (QALYs) in newborns, and which costs and outcomes need to be considered in a full evaluation of newborn screening programmes. Because of the increasing scale and scope of such programmes, a better understanding of the methods of high-quality economic evaluations may be crucial for both producers/authors and consumers/reviewers of newborn screening-related economic evaluations. The aim of this study was therefore to develop specific guidelines designed to assess and improve the methodological quality of economic evaluations in newborn screening. Methods To develop the guidelines, existing guidelines for assessing the quality of economic evaluations were identified through a literature search, and were reviewed and consolidated using a deductive iterative approach. In a subsequent test phase, these guidelines were applied to various economic evaluations which acted as case studies. Results The guidelines for assessing and improving the methodological quality of economic evaluations in newborn screening are organized into 11 categories: “bibliographic details”, “study question and design”, “modelling”, “health outcomes”, “costs”, “discounting”, “presentation of results”, “sensitivity analyses”, “discussion”, “conclusions”, and “commentary”. Conclusions The application of the guidelines highlights important issues regarding newborn screening-related economic evaluations, and underscores the need for such issues to be afforded greater consideration in future economic evaluations. The variety in methodological quality detected by this study reveals the need for specific guidelines on the appropriate methods for conducting sound economic evaluations in newborn screening. PMID:22947299

  3. The relation of the new international economic order to health.

    PubMed

    Gish, O

    1983-06-01

    Despite national independence, hunger, illiteracy, the extremes of ill health, and other manifestations of poverty continue for the bulk of the population of most 3rd world countries. Additionally, the countries of the 3rd world remain heavily dependent upon economic and political decisions made in Europe and North America. It is estimated that about 2/3 of the world's people are poor, and that 1/4 live in absolute poverty or destitution. In regard to mortality, the single most striking fact is that despite the massive economic growth and technological progress of the post World War 2 period, the same basic complex of infectious, parasitic, and respiratory diseases, compounded by nutritional deficiencies, remain responsible for most of the world's deaths. From the end of World War 2 until the late 1960s the solution to 3rd world underdevelopment was seen to lie in a relatively rapid growth of national product. "Nonproductive" expenditures such as those for health were to be limited to the greatest degree possible, and in practice they always were. The 1950s and 1960s were relatively successful in terms of economic development. During this period little attention was given to the question of the distribution of this growth, both between and within countries. A most important change of this period was the rapid growth of populations, mostly because of falling infant and child mortality rates. The decline was generally argued to be because of public health measures such as the international smallpox and malaria campaigns, the increasing availability of supplies of clean water, and improved nutritonal status. By the middle and the late 1960s there was increasing disillusionment with "growthmanship" as the appropriate development model, and during the 1970s the strategy became that of meeting basic needs (BN) of the world's population. Most 3rd world countries maintain that a new international economic order (NIEO) is intimately linked to their own potential for

  4. 77 FR 14726 - Information Collection Request; Economic Assessment of Conservation Reserve Program Lands for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-13

    ... Farm Service Agency Commodity Credit Corporation Information Collection Request; Economic Assessment of... with the Economic Assessment of Conservation Reserve Program (CRP) Lands for Hunting. DATES: We will... Hyberg, Agricultural Economist, Economic and Policy Analysis Staff, Farm Service Agency,...

  5. China's "market economics in command": footwear workers' health in jeopardy.

    PubMed

    Chen, M S; Chan, A

    1999-01-01

    This study of occupational safety and health (OSH) problems in the footwear industry in China, the world's largest shoemaker, is based on four years of research in China supplemented by research in Taiwan, Australia, and the United States. With the advent of the economic reforms of the early 1980s, the Chinese state is being driven by an economic imperative under which the profit motive overrides other concerns, causing a deterioration in OSH conditions. Footwear workers are being exposed to high levels of benzene, toluene, and other toxic solvents contained in the adhesives used in the shoe-making process. Many workers have been afflicted with aplastic anemia, leukemia, and other health problems. Most of China's current permissible exposure limits to toxins are either outdated or underenforced. As a result, the Chinese state's protection of footwear workers' health is inadequate. The article aims to draw the attention of the international OSH community to the importance of setting specific exposure standards for the footwear industry worldwide. PMID:10615574

  6. Demonstrating the economic value of occupational health services.

    PubMed

    Miller, P; Rossiter, P; Nuttall, D

    2002-12-01

    Many large companies operate some form of occupational health service (OHS). More companies now require specific evaluative information to justify the continued provision of an in-house OHS. This is in the face of increased pressure to control costs, combined with an awareness that the service itself can induce activity (supplier-induced demand) and could be substituted with health care provided or even funded outside the company. The lack of routinely collected data and the conceptual difficulty in defining and measuring the outcomes of an OHS provide challenges for economic evaluation. A purely human capital approach, where people are valued by their wage rates, is likely to be insufficient, since OHSs have multiple objectives. These objectives include fulfilling statutory obligations, contributing to the creation of a culture of partnership, reduction of potential costs to the company (sickness benefit, production loss, poor performance, litigation, insurance) and providing a suitable environment for the cost-effective reduction of the social and health service costs of illness at work. Evidence is needed to quantify some of these arguments and demonstrate to decision makers the value generated by OHSs. The aim of this paper is to consider the practicality of different economic evaluation methodologies, specifically cost models, contingent valuation (willingness-to-pay) and development of OHS-specific outcome measures. In considering different approaches, we present the results of our research in two UK companies. PMID:12488519

  7. Assessment of health risks of policies

    SciTech Connect

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana; and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  8. Impact of the 2008 economic and financial crisis on child health: a systematic review.

    PubMed

    Rajmil, Luis; Fernandez de Sanmamed, María-José; Choonara, Imti; Faresjö, Tomas; Hjern, Anders; Kozyrskyj, Anita L; Lucas, Patricia J; Raat, Hein; Séguin, Louise; Spencer, Nick; Taylor-Robinson, David

    2014-06-01

    The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health outcomes on children, published since 2007 and related to the 2008 economic crisis were included. Two reviewers independently assessed studies for inclusion. Data were synthesised as a narrative review. Five hundred and six titles and abstracts were reviewed, from which 22 studies were included. The risk of bias for quantitative studies was mixed while qualitative studies showed low risk of bias. An excess of 28,000-50,000 infant deaths in 2009 was estimated in sub-Saharan African countries, and increased infant mortality in Greece was reported. Increased price of foods was related to worsening nutrition habits in disadvantaged families worldwide. An increase in violence against children was reported in the U.S., and inequalities in health-related quality of life appeared in some countries. Most studies suggest that the economic crisis has harmed children's health, and disproportionately affected the most vulnerable groups. There is an urgent need for further studies to monitor the child health effects of the global recession and to inform appropriate public policy responses. PMID:25019121

  9. Impact of the 2008 Economic and Financial Crisis on Child Health: A Systematic Review

    PubMed Central

    Rajmil, Luis; Fernandez de Sanmamed, María-José; Choonara, Imti; Faresjö, Tomas; Hjern, Anders; Kozyrskyj, Anita L.; Lucas, Patricia J.; Raat, Hein; Séguin, Louise; Spencer, Nick; Taylor-Robinson, David

    2014-01-01

    The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health outcomes on children, published since 2007 and related to the 2008 economic crisis were included. Two reviewers independently assessed studies for inclusion. Data were synthesised as a narrative review. Five hundred and six titles and abstracts were reviewed, from which 22 studies were included. The risk of bias for quantitative studies was mixed while qualitative studies showed low risk of bias. An excess of 28,000–50,000 infant deaths in 2009 was estimated in sub-Saharan African countries, and increased infant mortality in Greece was reported. Increased price of foods was related to worsening nutrition habits in disadvantaged families worldwide. An increase in violence against children was reported in the U.S., and inequalities in health-related quality of life appeared in some countries. Most studies suggest that the economic crisis has harmed children’s health, and disproportionately affected the most vulnerable groups. There is an urgent need for further studies to monitor the child health effects of the global recession and to inform appropriate public policy responses. PMID:25019121

  10. "Economics with Training Wheels": Using Blogs in Teaching and Assessing Introductory Economics

    ERIC Educational Resources Information Center

    Cameron, Michael P.

    2012-01-01

    Blogs provide a dynamic interactive medium for online discussion, consistent with communal constructivist pedagogy. The author of this article describes and evaluates a blog assignment used in the teaching and assessment of a small (40-60 students) introductory economics course. Using qualitative and quantitative data collected across four…

  11. Towards improved socio-economic assessments of ocean acidification's impacts.

    PubMed

    Hilmi, Nathalie; Allemand, Denis; Dupont, Sam; Safa, Alain; Haraldsson, Gunnar; Nunes, Paulo A L D; Moore, Chris; Hattam, Caroline; Reynaud, Stéphanie; Hall-Spencer, Jason M; Fine, Maoz; Turley, Carol; Jeffree, Ross; Orr, James; Munday, Philip L; Cooley, Sarah R

    2013-01-01

    Ocean acidification is increasingly recognized as a component of global change that could have a wide range of impacts on marine organisms, the ecosystems they live in, and the goods and services they provide humankind. Assessment of these potential socio-economic impacts requires integrated efforts between biologists, chemists, oceanographers, economists and social scientists. But because ocean acidification is a new research area, significant knowledge gaps are preventing economists from estimating its welfare impacts. For instance, economic data on the impact of ocean acidification on significant markets such as fisheries, aquaculture and tourism are very limited (if not non-existent), and non-market valuation studies on this topic are not yet available. Our paper summarizes the current understanding of future OA impacts and sets out what further information is required for economists to assess socio-economic impacts of ocean acidification. Our aim is to provide clear directions for multidisciplinary collaborative research. PMID:24391285

  12. The view of European experts regarding health economics for medical nutrition in disease-related malnutrition.

    PubMed

    Freijer, K; Lenoir-Wijnkoop, I; Russell, C A; Koopmanschap, M A; Kruizenga, H M; Lhachimi, S K; Norman, K; Nuijten, M J C; Schols, J M G A

    2015-05-01

    Health-care systems are currently facing tremendous budget constraints resulting in growing pressure on decision makers and health-care providers to obtain the maximum possible health benefits of the resources available. Choices have to be made, and health economics can help in allocating limited health-care resources among unlimited wants and needs. Attempts to achieve cost reductions often focus on severe pathologies and chronic diseases as they commonly represent high health-care expenditures. In this context, awareness of the considerable financial burden caused by disease-related malnutrition (DRM) is lacking. Possibilities of reducing costs by optimising the management of DRM through medical nutrition will mostly not even be taken into account. During a European expert meeting, the total evaluation of medical nutrition was viewed and discussed. The aim of this meeting was to gain an experts' outline of the key issues relating to the health economic assessment of the use of medical nutrition. This article provides a summary of the observations per discussed item and describes the next steps suggested. PMID:25604774

  13. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    NASA Technical Reports Server (NTRS)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

    The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

  14. Integrated economic and climate projections for impact assessment

    EPA Science Inventory

    We designed scenarios for impact assessment that explicitly address policy choices and uncertainty in climate response. Economic projections and the resulting greenhouse gas emissions for the “no climate policy” scenario and two stabilization scenarios: at 4.5 W/m2 and 3.7 W/m2 b...

  15. Comparison of Select Health Outcomes by Deployment Health Assessment Completion.

    PubMed

    Luse, Tina M; Slosek, Jean; Rennix, Christopher

    2016-02-01

    The Department of Defense (DoD) requires service members to complete regular health assessments for identification of deployment-related physical/behavioral issues and environmental/occupational exposures. Compliance among active duty Department of the Navy personnel varies; however, and the impact of incomplete assessments on generalizability of results is unclear. This study examines the differences between Navy and Marine Corps service members who completed both the Post-Deployment Health Assessment and Post-Deployment Health Reassessment (n = 9,452) as compared to service members who never attempted either form (n = 5,603) in fiscal year 2010. Deployment rosters, assessments, and clinical data were analyzed to determine certified assessment completion rates and incidence of certain health conditions in these populations. Only 38.9% of applicable personnel met the completion and certification criteria for the required assessments. Service members who did not complete the forms were distinctly different demographically and at increased risk for psychotropic drug use, post-traumatic stress disorder diagnosis, and traumatic brain injury diagnosis following deployment. The prevailing assumption that the risk of adverse health effects on operational forces can be estimated using the population that completed the required assessments is incorrect, and the true operational impact and medical burden of these conditions may be underestimated. PMID:26837080

  16. Programme costs in the economic evaluation of health interventions

    PubMed Central

    Johns, Benjamin; Baltussen, Rob; Hutubessy, Raymond

    2003-01-01

    Estimating the costs of health interventions is important to policy-makers for a number of reasons including the fact that the results can be used as a component in the assessment and improvement of their health system performance. Costs can, for example, be used to assess if scarce resources are being used efficiently or whether there is scope to reallocate them in a way that would lead to improvements in population health. As part of its WHO-CHOICE project, WHO has been developing a database on the overall costs of health interventions in different parts of the world as an input to discussions about priority setting. Programme costs, defined as costs incurred at the administrative levels outside the point of delivery of health care to beneficiaries, may comprise an important component of total costs. Cost-effectiveness analysis has sometimes omitted them if the main focus has been on personal curative interventions or on the costs of making small changes within the existing administrative set-up. However, this is not appropriate for non-personal interventions where programme costs are likely to comprise a substantial proportion of total costs, or for sectoral analysis where questions of how best to reallocate all existing health resources, including administrative resources, are being considered. This paper presents a first effort to systematically estimate programme costs for many health interventions in different regions of the world. The approach includes the quantification of resource inputs, choice of resource prices, and accounts for different levels of population coverage. By using an ingredients approach, and making tools available on the World Wide Web, analysts can adapt the programme costs reported here to their local settings. We report results for a selected number of health interventions and show that programme costs vary considerably across interventions and across regions, and that they can contribute substantially to the overall costs of

  17. Some Insights on Grassland Health Assessment Based on Remote Sensing

    PubMed Central

    Xu, Dandan; Guo, Xulin

    2015-01-01

    Grassland ecosystem is one of the largest ecosystems, which naturally occurs on all continents excluding Antarctica and provides both ecological and economic functions. The deterioration of natural grassland has been attracting many grassland researchers to monitor the grassland condition and dynamics for decades. Remote sensing techniques, which are advanced in dealing with the scale constraints of ecological research and provide temporal information, become a powerful approach of grassland ecosystem monitoring. So far, grassland health monitoring studies have mostly focused on different areas, for example, productivity evaluation, classification, vegetation dynamics, livestock carrying capacity, grazing intensity, natural disaster detecting, fire, climate change, coverage assessment and soil erosion. However, the grassland ecosystem is a complex system which is formed by soil, vegetation, wildlife and atmosphere. Thus, it is time to consider the grassland ecosystem as an entity synthetically and establish an integrated grassland health monitoring system to combine different aspects of the complex grassland ecosystem. In this review, current grassland health monitoring methods, including rangeland health assessment, ecosystem health assessment and grassland monitoring by remote sensing from different aspects, are discussed along with the future directions of grassland health assessment. PMID:25643060

  18. Some insights on grassland health assessment based on remote sensing.

    PubMed

    Xu, Dandan; Guo, Xulin

    2015-01-01

    Grassland ecosystem is one of the largest ecosystems, which naturally occurs on all continents excluding Antarctica and provides both ecological and economic functions. The deterioration of natural grassland has been attracting many grassland researchers to monitor the grassland condition and dynamics for decades. Remote sensing techniques, which are advanced in dealing with the scale constraints of ecological research and provide temporal information, become a powerful approach of grassland ecosystem monitoring. So far, grassland health monitoring studies have mostly focused on different areas, for example, productivity evaluation, classification, vegetation dynamics, livestock carrying capacity, grazing intensity, natural disaster detecting, fire, climate change, coverage assessment and soil erosion. However, the grassland ecosystem is a complex system which is formed by soil, vegetation, wildlife and atmosphere. Thus, it is time to consider the grassland ecosystem as an entity synthetically and establish an integrated grassland health monitoring system to combine different aspects of the complex grassland ecosystem. In this review, current grassland health monitoring methods, including rangeland health assessment, ecosystem health assessment and grassland monitoring by remote sensing from different aspects, are discussed along with the future directions of grassland health assessment. PMID:25643060

  19. Mobile economics and pricing of health care services.

    PubMed

    Huttin, Christine C

    2012-01-01

    This paper presents tools and concepts to analyze the business environment of the biopharmaceutical industry. It was presented at MEDETEL 2010. Emerging paradigms appear in that industry and new ways to value life science technologies are developed especially using mobile economics analysis. At a time, mobile computing technologies revolutionize the field of health care, this paper contributes to show how the value chain concept can be useful to analyze the value system in a mobile computing environment. It is also a milestone for the designs of future technology platforms and of health care infrastructure, in order to retain enough value between innovators, new and traditionnal players from life science, IT and other new comers, in a fragmented global competitive environment. PMID:23079949

  20. A comparison of HAS & NICE guidelines for the economic evaluation of health technologies in the context of their respective national health care systems and cultural environments

    PubMed Central

    Massetti, Marc; Aballéa, Samuel; Videau, Yann; Rémuzat, Cécile; Roïz, Julie; Toumi, Mondher

    2015-01-01

    Background Health technology assessment (HTA) has been reinforced in France, notably with the introduction of economic evaluation in the pricing process for the most innovative and expensive treatments. Similarly to the National Institute for Clinical Excellence (NICE) in England, the National Authority for Health (HAS), which is responsible for economic evaluation of new health technologies in France, has published recommendations on the methods of economic evaluation. Since economic assessment represents a major element of HTA in England, exploring the differences between these methodological guidelines might help to comprehend both the shape and the role economic assessment is intended to have in the French health care system. Methods Methodological guidelines for economic evaluation in France and England have been compared topic-by-topic in order to bring out key differences in the recommended methods for economic evaluation. Results The analysis of both guidelines has revealed multiple similarities between France and England, although a number of differences were also noted regarding the elected methodology of analysis, the comparison of studies’ outcomes with cost-effectiveness thresholds, the study population to consider, the quality of life valuation methods, the perspective on costs, the types of resources considered and their valuation, the discount rates to apply in order to reflect the present value of interventions, etc. To account for these differences, modifications will be required in order to adapt economic models from one country to the other. Conclusions Changes in HTA assessment methods occur in response to different challenges determined by the different philosophical and cultural considerations surrounding health and welfare as well as the political considerations regarding the role of public policies and the importance of their evaluation. PMID:27123190

  1. Multigene assays and molecular markers in breast cancer: systematic review of health economic analyses.

    PubMed

    Rouzier, Roman; Pronzato, Paolo; Chéreau, Elisabeth; Carlson, Josh; Hunt, Barnaby; Valentine, William J

    2013-06-01

    Breast cancer is the most common female cancer and is associated with a significant clinical and economic burden. Multigene assays and molecular markers represent an opportunity to direct chemotherapy only to patients likely to have significant benefit. This systematic review examines published health economic analyses to assess the support for adjuvant therapy decision making. Literature searches of PubMed, the Cochrane Library, and congress databases were carried out to identify economic evaluations of multigene assays and molecular markers published between 2002 and 2012. After screening and data extraction, study quality was assessed using the Quality of Health Economic Studies instrument. The review identified 29 publications that reported evaluations of two assays: Oncotype DX(®) and MammaPrint. Studies of both tests provided evidence that their routine use was cost saving or cost-effective versus conventional approaches. Benefits were driven by optimal allocation of adjuvant chemotherapy and reduction in chemotherapy utilization. Findings were sensitive to variation in the frequency of chemotherapy prescription, chemotherapy costs, and patients' risk profiles. Evidence suggests that multigene assays are likely cost saving or cost-effective relative to current approaches to adjuvant therapy. They should benefit decision making in early-stage breast cancer in a variety of settings worldwide. PMID:23722312

  2. Health-income inequality: the effects of the Icelandic economic collapse

    PubMed Central

    2014-01-01

    Introduction Health-income inequality has been the focus of many studies. The relationship between economic conditions and health has also been widely studied. However, not much is known about how changes in aggregate economic conditions relate to health-income inequality. Nevertheless, such knowledge would have both scientific and practical value as substantial public expenditures are used to decrease such inequalities and opportunities to do so may differ over the business cycle. For this reason we examine the effect of the Icelandic economic collapse in 2008 on health-income inequality. Methods The data used come from a health and lifestyle survey carried out by the Public Health Institute of Iceland in 2007 and 2009. A stratified random sample of 9,807 individuals 18–79 years old received questionnaires and a total of 42.1% answered in both years. As measures of health-income inequality, health-income concentration indices are calculated and decomposed into individual-level determinants. Self-assessed health is used as the health measure in the analyses, but three different measures of income are used: individual income, household income, and equivalized household income. Results In both years there is evidence of health-income inequality favoring the better off. However, changes are apparent between years. For males health-income inequality increases after the crisis while it remains fairly stable for females or slightly decreases. The decomposition analyses show that income itself and disability constitute the most substantial determinants of inequality. The largest increases in contributions between years for males come from being a student, having low education and being obese, as well as age and income but those changes are sensitive to the income measure used. Conclusions Changes in health and income over the business cycle can differ across socioeconomic strata, resulting in cyclicality of income-related health distributions. As substantial fiscal

  3. Integrating Sexual Minority Health Issues into a Health Assessment Class.

    PubMed

    Bosse, Jordon D; Nesteby, J Aleah; Randall, Carla E

    2015-01-01

    The health needs of the lesbian, gay, bisexual, and transgender (LGBT) population are traditionally overlooked by the health care community and are rendered invisible by most nursing school curricula. Initial contact with a nurse during a health history and assessment can have an impact on whether the person will feel comfortable disclosing his or her identity, returning for services, or following plans of care. Because the first interaction with a nurse can be critical, the health assessment course is an appropriate place in the curriculum to discuss the needs of the LGBT community. This article includes a discussion of unique health risks to the LGBT population, benefits, and challenges of incorporating these issues into the classroom and recommendations for including the care of this population into a health assessment nursing course. Specific communication techniques are provided that may be helpful during history taking and physical examination with a patient who is LGBT. Guidance regarding physical examination of the transgender patient is also included. These suggestions will be helpful to nurse faculty who teach health assessment, nursing students, educators who design and implement professional development and continuing education for established nurses, preceptors in the clinical setting, and any nurse who is unfamiliar with the needs and concerns specific to the LGBT population. PMID:26653044

  4. Health Risk Assessments for Alumina Refineries

    PubMed Central

    Coffey, Patrick S.

    2014-01-01

    Objective: To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Methods: Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. Results: The acute hazard index can exceed 1 close to refineries, but it is typically less than 1 at neighboring residential locations. The chronic hazard index is typically substantially less than 1. The incremental carcinogenic risk is typically less than 10−6. Conclusions: The risks of acute health effects are adequately controlled, and the risks of chronic health effects and incremental carcinogenic risks are negligible around referenced alumina refineries. PMID:24806721

  5. HEALTH EFFECTS ASSESSMENT FOR VANADIUM AND COMPOUNDS

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  6. HEALTH EFFECTS ASSESSMENT FOR TIN AND COMPOUNDS

    EPA Science Inventory

    The report summarizes and evaluates information relevant to a preliminary interim assessment of adverse health effects associated with specific chemicals or compounds. The Office of Emergency and Remedial Response (Superfund) uses these documents in preparing cost-benefit analyse...

  7. Office for prevention and health services assessment

    NASA Astrophysics Data System (ADS)

    Wright, James A.

    1994-12-01

    The Air Force Surgeon General has established the Office for Prevention and Health Care ASsessment (OPHSA) to become the center of excellence for preventive services and health care assessment in the U.S. Air Force and the Department of Defense. OPHSA using the principles of total quality management and integrated teams will evaluate, compare, and modify preventive services delivery guidelines to preserve the fighting force by preventing illness and injuries in military populations. OPHSA will evaluate and formulate health care delivery guidelines to improve health care access and delivery to military patient populations. OPHSA will develop data to determine the health status and health needs to beneficiary populations so medical managers can deliver medical care in the most cost effective manner. OPHSA is located at Brooks Air Force Base in San Antonio, Texas. OPHSA will have thirty seven active duty military, civil service, and contract employees and should be fully functional by the end of 1995.

  8. Economic evaluation and the postponement of health care costs.

    PubMed

    van Baal, Pieter H M; Feenstra, Talitha L; Polder, Johan J; Hoogenveen, Rudolf T; Brouwer, Werner B F

    2011-04-01

    The inclusion of medical costs in life years gained in economic evaluations of health care technologies has long been controversial. Arguments in favour of the inclusion of such costs are gaining support, which shifts the question from whether to how to include these costs. This paper elaborates on the issue how to include cost in life years gained in cost effectiveness analysis given the current practice of economic evaluations in which costs of related diseases are included. We combine insights from the theoretical literature on the inclusion of unrelated medical costs in life years gained with insights from the so-called 'red herring' literature. It is argued that for most interventions it would be incorrect to simply add all medical costs in life years gained to an ICER, even when these are corrected for postponement of the expensive last year of life. This is the case since some of the postponement mechanism is already captured in the unadjusted ICER by modelling the costs of related diseases. Using the example of smoking cessation, we illustrate the differences and similarities between different approaches. The paper concludes with a discussion about the proper way to account for medical costs in life years gained in economic evaluations. PMID:21210494

  9. Economic implications of workplace health promotion programs: review of the literature.

    PubMed

    Warner, K E; Wickizer, T M; Wolfe, R A; Schildroth, J E; Samuelson, M H

    1988-02-01

    The conventional wisdom holds that workplace health promotion (HP) programs yield financial dividends, often generating cost savings. To examine the intellectual and empirical basis for this belief, we reviewed the literature on the economics of workplace HP programs. In general, in the literature published through early 1986, the claims of HP programs' profitability are based on anecdotal evidence or analyses seriously flawed in terms of assumptions, data, or methodology. Furthermore, certain aspects of the economics of HP programs have been virtually ignored. The dearth of sound evidence on the economic merits of workplace HP should not be interpreted as a negative assessment of the potential of such programs, however. Rather, it recommends a healthy skepticism in reading the literature and development of a new research-based body of understanding. PMID:3127557

  10. [Health economics, medical ethics, and evidence-based medicine].

    PubMed

    Stelmach, Włodzimierz; Bryła, Marek; Stelmach, Iwona; Denys, Andrzej

    2002-12-01

    The paper is based on the assumption that the management on different levels of decision-making requires not only strictly medical knowledge, but also the competence to make use of the acquisitions of health economics as well as certain knowledge of the principles of medical ethics and research methods applied in the evidence-based medicine. So far the relevant scientific literature lacks any attempts to analyse the common and separate features of the three fields mentioned above. Therefore, this paper aims at filling this gap. The objective is going to be met by acquainting the reader with the historical development of the three disciplines. Emphasis will be put on the existing definitions and scope of the health economics, medical ethics and evidence-based medicine. The concluding remarks contain the authors' conviction that this paper will contribute to make the medical environment more interested in the presented issues and thus constitute the first step to work out solutions which could be applied in clinical practice in the future. PMID:12666439

  11. Standard cost lists for health economic evaluation in Thailand.

    PubMed

    Riewpaiboon, Arthorn

    2014-05-01

    This analysis was undertaken to generate a set of standard costs for medical services and those incurred by patient receiving treatment, for use in health economic evaluations. Medical service unit cost data were derived from a survey of 3,091 hospital medical services in five hospitals, disaggregated by type of hospital (district or provincial/regional) and analyzed using the relative value unit method. Patient-borne ambulatory cost values were derived from data gathered through 905 patient interviews that took place in six health centers, three district hospitals, and three provincial/regional hospitals. The survey gathered data on costs a rising from the distance travelled to access the medical service, the time spent in the healthcare facility, as well as travel and meal costs. The analysis generated a set of standard cost data for Thailand that will make conducting economic evaluations more accurate, faster and more convenient, as well as allowing better comparability between studies. This is the first standard cost menu that has been developed specifically for Thailand, and as such should be revised and refined in the future. Some areas that would benefit from revision are suggested. PMID:24964710

  12. An Assessment of Environmental Health Needs

    NASA Technical Reports Server (NTRS)

    Macatangay, Ariel V.

    2013-01-01

    Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. In manned spacecraft, environmental health risks are mitigated by a multi-disciplinary effort, employing several measures including active and passive controls, by establishing environmental standards (SMACs, SWEGs, microbial and acoustics limits), and through environmental monitoring. Human Health and Performance (HHP) scientists and Environmental Control and Life Support (ECLS) engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. ECLS engineers use environmental monitoring data to monitor and confirm the health of ECLS systems, whereas HHP scientists use the data to manage the health of the human system. Because risks can vary between missions and change over time, environmental monitoring is critical. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in environmental health knowledge and technology, required to address those risks, were identified for various types of exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of the roadmap development and findings are presented in this paper.

  13. Content Assessment of Selected College Health Textbooks.

    ERIC Educational Resources Information Center

    Huetteman, Julie Doidge

    Six college health textbooks published between 1980 and 1987 were analyzed to determine the extent of coverage of 10 selected content areas from "Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention." Content areas assessed included: motor vehicle accidents, alcohol and drug misuse, teenage pregnancy, sexually…

  14. HEALTH EFFECTS ASSESSMENT FOR GLYCOL ETHERS

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  15. HEALTH EFFECTS ASSESSMENT FOR TRIVALENT CHROMIUM

    EPA Science Inventory

    The document represents a brief, quantitatively oriented scientific summary of health effects data. It was developed by the Environmental Criteria and Assessment Office to assist the Office of Emergency and Remedial Response in establishing chemical-specific health-related goals ...

  16. RETHINKING HUMAN HEALTH IMPACT ASSESSMENT. (R825758)

    EPA Science Inventory

    Most EIA programs around the world require the consideration of human health impacts. Yet relatively few EIA documents adequately address those impacts. This article examines how, why, and to what extent health impacts are analyzed in environmental impact assessments in the U.S. ...

  17. Accounting for uncertainty in health economic decision models by using model averaging.

    PubMed

    Jackson, Christopher H; Thompson, Simon G; Sharples, Linda D

    2009-04-01

    Health economic decision models are subject to considerable uncertainty, much of which arises from choices between several plausible model structures, e.g. choices of covariates in a regression model. Such structural uncertainty is rarely accounted for formally in decision models but can be addressed by model averaging. We discuss the most common methods of averaging models and the principles underlying them. We apply them to a comparison of two surgical techniques for repairing abdominal aortic aneurysms. In model averaging, competing models are usually either weighted by using an asymptotically consistent model assessment criterion, such as the Bayesian information criterion, or a measure of predictive ability, such as Akaike's information criterion. We argue that the predictive approach is more suitable when modelling the complex underlying processes of interest in health economics, such as individual disease progression and response to treatment. PMID:19381329

  18. Systematic literature review to evaluate and characterize the health economics and outcomes research studies in India

    PubMed Central

    Mishra, Divya; Nair, Sunita R.

    2015-01-01

    Aim: This systematic literature review was conducted to identify, evaluate, and characterize the variety, quality, and intent of the health economics and outcomes research studies being conducted in India. Materials and Methods: Studies published in English language between 1999 and 2012 were retrieved from Embase and PubMed databases using relevant search strategies. Two researchers independently reviewed the studies as per Cochrane methodology; information on the type of research and the outcomes were extracted. Quality of reporting was assessed for model-based health economic studies using a published 100-point Quality of Health Economic Studies (QHES) instrument. Results: Of 546 studies screened, 132 were included in the review. The broad study categories were cost-effectiveness analyses [(CEA) 54 studies], cost analyses (19 studies), and burden of illness [(BOI) 18 studies]. The outcomes evaluated were direct and indirect costs, and incremental cost-effectiveness ratio (ICER), quality-adjusted life years (QALYs), and disability-adjusted life years (DALYs). Direct medical costs assessed cost of medicines, monitoring costs, consultation and hospital charges, along with direct non-medical costs (travel and food for patients and care givers). Loss of productivity and loss of income of patients and care givers were identified as the components of indirect cost. Overall, 33 studies assessed the quality of life (QoL), and the WHO Quality of Life-BREF (WHOQOL-BREF) was the most commonly used instrument. Quality assessment for modeling studies showed that most studies were of high quality [mean (range) QHES score to be 75.5 (34-93)]. Conclusions: This review identified various patterns of pharmacoeconomic studies and good-quality CEA studies. However, there is a need for better assessment of utilization of healthcare resources in India. PMID:25657899

  19. Economic assessment of managing processionary moth in pine forests: a case-study in Portugal.

    PubMed

    Gatto, Paola; Zocca, Alessia; Battisti, Andrea; Barrento, Maria João; Branco, Manuela; Paiva, Maria Rosa

    2009-02-01

    This paper assesses the private and social profitability of current strategies for managing processionary moth (Thaumetopoea pityocampa) in Portuguese pine forests, looking at economic and environmental costs and benefits. Costs include the expenses for forest treatment and the social costs of threats to human health (dermatitis amongst others); benefits are assessed in terms of both revenue and social benefits such as carbon fixation and recreation. The evaluation was done using Cost Benefit Analysis (CBA) as an analytical framework. While this tool is currently applied to forest and environmental assessment and specific applications to pest management strategies are to be found in agricultural economics, rather few attempts have been made in the field of forest pest management. In order to assess and compare with--without options, a case-study was analysed for the Setúbal Peninsula, south of Lisbon, an area where extensive stands of maritime pine (Pinus pinaster) grow. The exercise has shown that CBA can be a valuable tool for assessing the economic and social profitability of pest management. The results demonstrate that the loss of revenues in the no-management option is not sufficient to make pest management profitable for private forest owners in the short-term. Conversely, a social profit is gained as pest management minimizes health risks for humans and avoids possible recreational losses. PMID:18336989

  20. Global health and development: conceptualizing health between economic growth and environmental sustainability.

    PubMed

    Borowy, Iris

    2013-07-01

    After World War II, health was firmly integrated into the discourse about national development. Transition theories portrayed health improvements as part of an overall development pattern based on economic growth as modeled by the recent history of industrialization in high-income countries. In the 1970s, an increasing awareness of the environmental degradation caused by industrialization challenged the conventional model of development. Gradually, it became clear that health improvements depended on poverty-reduction strategies including industrialization. Industrialization, in turn, risked aggravating environmental degradation with its negative effects on public health. Thus, public health in low-income countries threatened to suffer from lack of economic development as well as from the results of global economic development. Similarly, demands of developing countries risked being trapped between calls for global wealth redistribution, a political impossibility, and calls for unrestricted material development, which, in a world of finite land, water, air, energy, and resources, increasingly looked like a physical impossibility, too. Various international bodies, including the WHO, the Brundtland Commission, and the World Bank, tried to capture the problem and solution strategies in development theories. Broadly conceived, two models have emerged: a "localist model," which analyzes national health data and advocates growth policies with a strong focus on poverty reduction, and a "globalist" model, based on global health data, which calls for growth optimization, rather than maximization. Both models have focused on different types of health burdens and have received support from different institutions. In a nutshell, the health discourse epitomized a larger controversy regarding competing visions of development. PMID:22467707

  1. Climate Change, Air Pollution, and the Economics of Health Impacts

    NASA Astrophysics Data System (ADS)

    Reilly, J.; Yang, T.; Paltsev, S.; Wang, C.; Prinn, R.; Sarofim, M.

    2003-12-01

    Climate change and air pollution are intricately linked. The distinction between greenhouse substances and other air pollutants is resolved at least for the time being in the context of international negotiations on climate policy through the identification of CO2, CH4, N2O, SF6 and the per- and hydro- fluorocarbons as substances targeted for control. Many of the traditional air pollutant emissions including for example CO, NMVOCs, NOx, SO2, aerosols, and NH3 also directly or indirectly affect the radiative balance of the atmosphere. Among both sets of gases are precursors of and contributors to pollutants such as tropopospheric ozone, itself a strong greenhouse gas, particulate matter, and other pollutants that affect human health. Fossil fuel combustion, production, or transportation is a significant source for many of these substances. Climate policy can thus affect traditional air pollution or air pollution policy can affect climate. Health effects of acute or chronic exposure to air pollution include increased asthma, lung cancer, heart disease and bronchitis among others. These, in turn, redirect resources in the economy toward medical expenditures or result in lost labor or non-labor time with consequent effects on economic activity, itself producing a potential feedback on emissions levels. Study of these effects ultimately requires a fully coupled earth system model. Toward that end we develop an approach for introducing air pollution health impacts into the Emissions Prediction and Policy Analysis (EPPA) model, a component of the MIT Integrated Global Systems Model (IGSM) a coupled economics-chemistry-atmosphere-ocean-terrestrial biosphere model of earth systems including an air pollution model resolving the urban scale. This preliminary examination allows us to consider how climate policy affects air pollution and consequent health effects, and to study the potential impacts of air pollution policy on climate. The novel contribution is the effort to

  2. Building Economic Security Today: making the health-wealth connection in Contra Costa county's maternal and child health programs.

    PubMed

    Parthasarathy, Padmini; Dailey, Dawn E; Young, Maria-Elena D; Lam, Carrie; Pies, Cheri

    2014-02-01

    In recent years, maternal and child health professionals have been seeking approaches to integrating the Life Course Perspective and social determinants of health into their work. In this article, we describe how community input, staff feedback, and evidence from the field that the connection between wealth and health should be addressed compelled the Contra Costa Family, Maternal and Child Health (FMCH) Programs Life Course Initiative to launch Building Economic Security Today (BEST). BEST utilizes innovative strategies to reduce inequities in health outcomes for low-income Contra Costa families by improving their financial security and stability. FMCH Programs' Women, Infants, and Children Program (WIC) conducted BEST financial education classes, and its Medically Vulnerable Infant Program (MVIP) instituted BEST financial assessments during public health nurse home visits. Educational and referral resources were also developed and distributed to all clients. The classes at WIC increased clients' awareness of financial issues and confidence that they could improve their financial situations. WIC clients and staff also gained knowledge about financial resources in the community. MVIP's financial assessments offered clients a new and needed perspective on their financial situations, as well as support around the financial and psychological stresses of caring for a child with special health care needs. BEST offered FMCH Programs staff opportunities to engage in non-traditional, cross-sector partnerships, and gain new knowledge and skills to address a pressing social determinant of health. We learned the value of flexible timelines, maintaining a long view for creating change, and challenging the traditional paradigm of maternal and child health. PMID:23793485

  3. The Swedish Council on Technology Assessment in Health Care.

    PubMed

    Bloom, B S; Banta, H D; Gross, P F; Peña-Mohr, J; Sisk, J E; Stocking, B

    1989-01-01

    During its first year of operation (1988) the Swedish Council on Technology Assessment in Health Care focused on nine areas. Additional activities will be added as need requires and resources permit. Also, preparations for 1989 projects have begun. The nine areas include: identification of technologies needing assessment, including international comparisons; review and synthesis of the value of preoperative routines; review and synthesis of the value of gastroscopy for diagnosing stomach pain; assessment of different treatment methods for back pain; assessment of the value of vascular surgery for vascular spasms in the legs; organization of a strategy conference concerning medical technology assessment in Sweden; creation of a strategy that addresses an international review of medical technology, future technologies in health care, waiting lists for medical care--the importance of medical technology, resource utilization and organizational and educational aspects of introducing new technology in health care, and costs and medical technology; translation of foreign assessment studies, with comments; national and international cooperation. SCTA has discussed the need for assessing specific technology such as bone marrow transplantation and surgical treatment of epilepsy. SCTA's Scientific Advisory Committee has additionally considered the following subjects for future projects: medical, social, and economic consequences of alternative technologies screening for prostate, colorectal, breast, and cervical cancer; costs, indications, and medical benefit of surgery for varicose vains; and modern urology technologies, particularly those related to prostate care. PMID:10292538

  4. Economic benefit risk assessment of controlling land subsidence in Shanghai

    NASA Astrophysics Data System (ADS)

    Hua, Zuo; Tiezhu, Liu; Xinhong, Lin

    1993-08-01

    Land subsidence, a major and well-known geological hazard in Shanghai, has caused serious losses. Based on past studies, the cost and benefit of the Shanghai's land subsidence hazard control were assessed and forecasted by risk assessment. An economic benefit-risk assessment was taken in order to control completely land subsidence and make rational safety elevations of the flood control wall. The result of risk assessment shows that the present 6.9-m elevation of the floodwall is not sufficient for the standard of “occurring only once in a thousand years.∝ After 200 years, the spring tide hazardous risk losses caused by land subsidence would amount to 49.73 million yuan per year. The proportion of expense in thoroughly controlling land subsidence to the economic benefit is 1∶:41.44; to construct the flood control wall to an elevation that would prevent inundation from a flood event, to reach the standard of “occurring only once in a thousand years,∝ and to avoid tide losses, the ratio of the investment of reducing tide hazard to the economic benefit should be 1∶:53.24.

  5. Establishing Economic Effectiveness through Software Health-Management

    SciTech Connect

    Pizka, M; Panas, T

    2009-05-27

    More than two thirds of the annual software budget of large-scale organizations dealing with complex software systems is spent on the perfection, correction, and operation of existing software systems. A significant part of these running costs could be saved if the software systems that need to be constantly extende, maintained and operated were in a better technical condition. This paper proposes Software Health-Checks as a method to assess the technical condition of existing software systems and to deduce measures for improving the health of software in a structured manner. Since 2006 numerous commercial software systems with a total of 30 MLOC, implemented in various technologies, were already checked with this method. The actions suggested as a result of these Software 'Health-Checks', repeatedly yielded dramatic performance improvements, risk reductions and cost savings between 30% and 80%.

  6. The Prenatal Assessment of Fetal Health

    PubMed Central

    Parboosingh, J.; Mousseau, J.; Deacon, J.

    1979-01-01

    This article reviews the objectives, indications and methods currently used to assess fetal health in pregnancies at risk of fetoplacental dysfunction. The graphic display of clinical data encourages the physician to recognize deviations from the norm and assists in the selection of patients for assessment by the more sophisticated tests of fetoplacental function. PMID:21297709

  7. HEALTH ASSESSMENT OF 1,3-BUTADIENE

    EPA Science Inventory

    This assessment was conducted to review the new information that has become available since EPA's 1985 health assessment of 1,3-butadiene.

    1,3-Butadiene is a gas used commercially in the production of styrene-butadiene rubber, plastics, and thermoplastic resins. The major...

  8. The economics of health and climate change: key evidence for decision making

    PubMed Central

    2011-01-01

    Background In responding to the health challenges of climate change, those responsible for health policies and resource allocations need to know the resource consequences of their decisions. This article examines the availability and strength of economic evidence for policy makers to draw on in making health policy decisions. Methods Relevant literature was obtained using a Medline and INTERNET search of key terms and institutions working in health and climate change. Eighteen available economic studies are presented under three categories of economic evidence: health damage cost, health adaptation cost and health economic evaluation. Results In economic studies valuing the predicted increased mortality from climate change, the health damages represent an important fraction of overall economic losses. Similarly, when considering broader health protection measures beyond the health sector (e.g. agriculture, water supply) health considerations are central. Global adaptation cost studies carried out so far indicate health sector costs of roughly US$2-5 billion annually (mid-estimates). However, these costs are expected to be an underestimate of the true costs, due to omitted health impacts, omitted economic impacts, and the costs of health actions in other sectors. No published studies compare the costs and benefits of specific health interventions to protect health from climate change. Conclusions More economic studies are needed examining the costs and benefits of adaptation measures to inform policy making. There is an urgent need for climate change-specific health economic guidelines to ensure robust methods are used, giving comparable results. Broader advocacy and focused training of decision makers is needed to increase the uptake of economic evidence in decision making. Until further climate change-specific economic studies have been conducted, decision makers should selectively draw on published studies of the costs and benefits of environmental health

  9. Economic crisis, restrictive policies, and the population's health and health care: the Greek case.

    PubMed

    Kondilis, Elias; Giannakopoulos, Stathis; Gavana, Magda; Ierodiakonou, Ioanna; Waitzkin, Howard; Benos, Alexis

    2013-06-01

    The global economic crisis has affected the Greek economy with unprecedented severity, making Greece an important test of the relationship between socioeconomic determinants and a population's well-being. Suicide and homicide mortality rates among men increased by 22.7% and 27.6%, respectively, between 2007 and 2009, and mental disorders, substance abuse, and infectious disease morbidity showed deteriorating trends during 2010 and 2011. Utilization of public inpatient and primary care services rose by 6.2% and 21.9%, respectively, between 2010 and 2011, while the Ministry of Health's total expenditures fell by 23.7% between 2009 and 2011. In a time of economic turmoil, rising health care needs and increasing demand for public services collide with austerity and privatization policies, exposing Greece's population health to further risks. PMID:23597358

  10. Smart Sensors Assess Structural Health

    NASA Technical Reports Server (NTRS)

    2010-01-01

    NASA frequently inspects launch vehicles, fuel tanks, and other components for structural damage. To perform quick evaluation and monitoring, the Agency pursues the development of structural health monitoring systems. In 2001, Acellent Technologies Inc., of Sunnyvale, California, received Small Business Innovation Research (SBIR) funding from Marshall Space Flight Center to develop a hybrid Stanford Multi-Actuator Receiver Transduction (SMART) Layer for aerospace vehicles and structures. As a result, Acellent expanded the technology's capability and now sells it to aerospace and automotive companies; construction, energy, and utility companies; and the defense, space, transportation, and energy industries for structural condition monitoring, damage detection, crack growth monitoring, and other applications.

  11. Economic rationality and health and lifestyle choices for people with diabetes.

    PubMed

    Baker, Rachel Mairi

    2006-11-01

    Economic rationality is traditionally represented by goal-oriented, maximising behaviour, or 'instrumental rationality'. Such a consequentialist, instrumental model of choice is often implicit in a biomedical approach to health promotion and education. The research reported here assesses the relevance of a broader conceptual framework of rationality, which includes 'procedural' and 'expressive' rationality as complements to an instrumental model of rationality, in a health context. Q methodology was used to derive 'factors' underlying health and lifestyle choices, based on a factor analysis of the results of a card sorting procedure undertaken by 27 adult respondents with type 2 diabetes in Newcastle upon Tyne, UK. These factors were then compared with the rationality framework and the appropriateness of an extended model of economic rationality as a means of better understanding health and lifestyle choices was assessed. Taking a wider rational choice perspective, choices which are rendered irrational within a narrow-biomedical or strictly instrumental model, can be understood in terms of a coherent rationale, grounded in the accounts of respondents. The implications of these findings are discussed in terms of rational choice theory and diabetes management and research. PMID:16875768

  12. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 10-Point Initiative to strengthen environment, safety, and health (ES H) programs, and waste management activities at DOE production, research, and testing facilities. One of the points involved conducting dent Tiger Team Assessments of DOE operating facilities. The Office of Special independent Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are more focused, concentrating on ES H management, ES H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES H areas. This manual documents the processes to be used to perform the ES H Progress Assessments. It was developed based upon the lessons learned from Tiger Team Assessments, the two pilot Progress Assessments, and Progress Assessments that have been completed. The manual will be updated periodically to reflect lessons learned or changes in policy.

  13. Health assessment of exposure to developmental toxicants

    SciTech Connect

    Kimmel, C.A.

    1987-07-01

    In 1984, the U.S. EPA published proposed Guidelines for the Health Assessment of Suspect Developmental Toxicants. The assessment of data from studies on developmental effects of chemical exposure and the estimation of risk for humans is a difficult process. Although structure/activity relationships and data from short-term tests are often used in the risk-assessment process for assessing carcinogens, these are not useful as the first step in developmental toxicity risk assessment. Human epidemiological data are used, if available, but often the only available evidence is from animal studies. Therefore, the guidelines focus on the evaluation of data from routine animal testing studies.

  14. Neo-liberal economic practices and population health: a cross-national analysis, 1980-2004.

    PubMed

    Tracy, Melissa; Kruk, Margaret E; Harper, Christine; Galea, Sandro

    2010-04-01

    Although there has been substantial debate and research concerning the economic impact of neo-liberal practices, there is a paucity of research about the potential relation between neo-liberal economic practices and population health. We assessed the extent to which neo-liberal policies and practices are associated with population health at the national level. We collected data on 119 countries between 1980 and 2004. We measured neo-liberalism using the Fraser Institute's Economic Freedom of the World (EFW) Index, which gives an overall score as well as a score for each of five different aspects of neo-liberal economic practices: (1) size of government, (2) legal structure and security of property rights, (3) access to sound money, (4) freedom to exchange with foreigners and (5) regulation of credit, labor and business. Our measure of population health was under-five mortality. We controlled for potential mediators (income distribution, social capital and openness of political institutions) and confounders (female literacy, total population, rural population, fertility, gross domestic product per capita and time period). In longitudinal multivariable analyses, we found that the EFW index did not have an effect on child mortality but that two of its components: improved security of property rights and access to sound money were associated with lower under-five mortality (p = 0.017 and p = 0.024, respectively). When stratifying the countries by level of income, less regulation of credit, labor and business was associated with lower under-five mortality in high-income countries (p = 0.001). None of the EFW components were significantly associated with under-five mortality in low-income countries. This analysis suggests that the concept of 'neo-liberalism' is not a monolithic entity in its relation to health and that some 'neo-liberal' policies are consistent with improved population health. Further work is needed to corroborate or refute these findings. PMID:19723354

  15. A comparative assessment of the economics of plutonium disposition

    SciTech Connect

    Williams, K.A.; Miller, J.W.; Reid, R.L.

    1997-04-01

    The US Department of Energy office of Fissile Materials Disposition (DOE/MD) has been evaluating three technologies for the disposition of approximately 50 metric tons of surplus plutonium from defense-related programs: reactors, immobilization, and deep boreholes. As part of the process supporting an early CY 1997 Record of Decision (ROD), a comprehensive assessment of technical viability, cost, and schedule has been conducted by DOE/MD and its national laboratory contractors. Oak Ridge National Laboratory has managed and coordinated the life-cycle cost (LCC) assessment effort for this program. This paper discusses the economic analysis methodology and the results prior to ROD. A secondary intent of the paper is to discuss major technical and economic issues that impact cost and schedule. To evaluate the economics of these technologies on an equitable basis, a set of cost-estimating guidelines and a common cost-estimating format were utilized by all three technology teams. This paper also includes the major economic analysis assumptions and the comparative constant-dollar and discounted-dollar LCCs.

  16. Economic assessment of the construction industry: A construction-economics nexus

    NASA Astrophysics Data System (ADS)

    Barber, Herbert Marion, Jr.

    The purpose of this study was to conduct an economic assessment of the construction industry. More specifically, this study addresses ambiguities within the literature that are associated with the construction-economics nexus. The researcher 1) investigated the relationships between economic indicators and stock prices of U.S. construction equipment manufacturers, 2) investigated the relationships between energy production, consumption, and corruption, and 3) determined the economic effect electricity generation and electricity consumption has on economies of scale. The researcher used descriptive and inferential statistics in this study and determined that economists, researchers, policy-makers, and others should have predicted the 2007-08 world economic collapse 5-6 years prior to realization of the event given that construction indices and GDP grossly regressed from statistically acceptable trends as early as 2002 and perhaps 2000. Substantiating this claim, the effect of the cost of construction materials and labor, i.e. construction index, on GDP was significant for years leading up to the collapse (1970-2007). Additionally, it was determined that energy production and consumption are predictors of governmental corruption in some countries. In the Republic of Botswana, for example, the researcher determined that energy production and consumption statistically jointly effected governmental corruption. In addition to determining statistical effect, a model for predicting governmental corruption was developed based on energy production and consumption volumes. Also, the researcher found that electricity generation in the 25 largest world economies had a statistically significant effect on GDP. Electricity consumption also had an effect on GDP, as well, but not on other economic indicators. More importantly than the quantitative findings, the researcher concluded that the construction-economics nexus is far more complex than most policy-makers realize. As such

  17. Managing the physics of the economics of integrated health care.

    PubMed

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

  18. Assessment of the Economic Structure of Brazilian Agribusiness.

    PubMed

    Rodrigues Moreira, Vilmar; Kureski, Ricardo; Pereira da Veiga, Claudimar

    2016-01-01

    This paper presents an economic assessment of Brazilian agribusiness and its relationship with other economic sectors. It was found that, in 2011, agribusiness had a share of 18.45% (basic prices) and 19.77% (market prices) of Brazilian GDP. The tax burden of agribusiness (20.68%) was higher than that of other sectors (13.59%), despite agribusiness being a major contributor to the generation of foreign exchange, employment, and essential products, such as food. Brazilian agribusiness is a major employer, responsible for 29.39% of national employment. However, its average income is lower than in the other sectors of the Brazilian economy. Finally, agribusiness was found to be the biggest generator of foreign exchange, with a positive balance of trade. It was possible to conclude that agribusiness forms a strong link between agriculture and livestock, industry, and services in other economic sectors. For this reason, it can be said that the development of agribusiness is highly relevant to the process of Brazilian economic development and is therefore important to the progress of economic policies. PMID:27243040

  19. Indexes system of technological condition assessment of economic branches

    NASA Astrophysics Data System (ADS)

    Chuvashova, M. N.; Avramchikova, N. T.; Antamoshkin, A. N.

    2015-10-01

    The increased level of innovative production process, connected with the current trends, points out the necessity of economic diversification of the whole national economy as well as regional economies in order to increase competitiveness and stable development. Russian regional economies are characterized with local directive of development and innovative processes have evident local vector. Intensive development of Siberian regional economies, which depends on oil and mining industries, considerably falls behind the world indicators according to the GRP output per head. To improve the quality of economic space the authors have suggested a new scientific approach, which allows qualitative assessment inside the economic space of resource-based regions, based on principles of high technological modes development inside economic branches taking into account density, regular enterprise distribution and connectivity of commercial organizations as well as secures innovative development of regional economy and its competitiveness. In this context it is necessary to develop a modern system of indexes, characterizing the structure of economic branches in accordance with present technological modes and at the same time the dynamics of appropriate structural shifts in regional economies of this type.

  20. Assessment of the Economic Structure of Brazilian Agribusiness

    PubMed Central

    Rodrigues Moreira, Vilmar; Kureski, Ricardo; Pereira da Veiga, Claudimar

    2016-01-01

    This paper presents an economic assessment of Brazilian agribusiness and its relationship with other economic sectors. It was found that, in 2011, agribusiness had a share of 18.45% (basic prices) and 19.77% (market prices) of Brazilian GDP. The tax burden of agribusiness (20.68%) was higher than that of other sectors (13.59%), despite agribusiness being a major contributor to the generation of foreign exchange, employment, and essential products, such as food. Brazilian agribusiness is a major employer, responsible for 29.39% of national employment. However, its average income is lower than in the other sectors of the Brazilian economy. Finally, agribusiness was found to be the biggest generator of foreign exchange, with a positive balance of trade. It was possible to conclude that agribusiness forms a strong link between agriculture and livestock, industry, and services in other economic sectors. For this reason, it can be said that the development of agribusiness is highly relevant to the process of Brazilian economic development and is therefore important to the progress of economic policies. PMID:27243040

  1. Assessment of environmental and economic feasibility of Enhanced Landfill Mining.

    PubMed

    Danthurebandara, Maheshi; Van Passel, Steven; Vanderreydt, Ive; Van Acker, Karel

    2015-11-01

    This paper addresses the environmental and economic performance of Enhanced Landfill Mining (ELFM). Based on life cycle assessment and life cycle costing, a detailed model is developed and is applied to a case study, i.e. the first ELFM project in Belgium. The environmental and economic analysis is performed in order to study the valorisation of different waste types in the landfill, such as municipal solid waste, industrial waste and total waste. We found that ELFM is promising for the case study landfill as greater environmental benefits are foreseen in several impact categories compared to the landfill's current situation (the 'Do-nothing' scenario). Among the considered processes, the thermal treatment process dominates both the environmental and economic performances of ELFM. Improvements in the electrical efficiency of thermal treatment process, the calorific value of refuse derived fuel and recovery efficiencies of different waste fractions lead the performance of ELFM towards an environmentally sustainable and economically feasible direction. Although the environmental and economic profiles of ELFM will differ from case to case, the results of this analysis can be used as a benchmark for future ELFM projects. PMID:25708403

  2. Economic and environmental assessment of syrup production. Colombian case.

    PubMed

    Dávila, Javier A; Hernández, Valentina; Castro, Eulogio; Cardona, Carlos A

    2014-06-01

    This work presents a techno-economic and environmental assessment of the glucose syrups production from sugarcane bagasse, plantain husk, cassava husk, mango peel, rice husk and corncobs. According to the economic analysis, the corncob had both, the lowest production cost (2.48USD/kg syrup) and the highest yield (0.61kgofsugars/kg of wet agroindustrial waste) due to its high content in cellulose and hemicellulose. This analysis also revealed that a heat integration strategy is necessary since the utilities consumption represent an important factor in the production cost. According to the results, the pretreatment section requires more energy in the syrup production in comparison with the requirements of other sections such as production and sugar concentration. The environmental assessment revealed that the solid wastes such as furfural and hydroxymethylfurfural affected the environmental development of the process for all the agroindustrial wastes, being the rice husk the residue with the lowest environmental impact. PMID:24686375

  3. Environment, safety and health progress assessment manual

    SciTech Connect

    Not Available

    1992-12-01

    On June 27, 1989, the Secretary of Energy announced a 1O-Point Initiative to strengthen environment,safety, and health (ES H) programs, and waste management activities at involved conducting DOE production, research, and testing facilities. One of the points independent Tiger Team Assessments of DOE operating facilities. The Office of Special Projects (OSP), EH-5, in the Office of the Assistant Secretary for Environment, Safety and Health, EH-1, was assigned the responsibility to conduct the Tiger Team Assessments. Through June 1992, a total of 35 Tiger Team Assessments were completed. The Secretary directed that Corrective Action Plans be developed and implemented to address the concerns identified by the Tiger Teams. In March 1991, the Secretary approved a plan for assessments that are more focused, concentrating on ES H management, ES H corrective actions, self-assessment programs, and root-cause related issues.'' In July 1991, the Secretary approved the initiation of ES H Progress Assessments, as a followup to the Tiger Team Assessments, and in the continuing effort to institutionalize the self-assessment process and line management accountability in the ES H areas. This volume contains appendices to the Environment, Safety and Health Progress Assessment Manual.

  4. The economic consequences of reproductive health and family planning.

    PubMed

    Canning, David; Schultz, T Paul

    2012-07-14

    We consider the evidence for the effect of access to reproductive health services on the achievement of Millennium Development Goals 1, 2, and 3, which aim to eradicate extreme poverty and hunger, achieve universal primary education, and promote gender equality and empower women. At the household level, controlled trials in Matlab, Bangladesh, and Navrongo, Ghana, have shown that increasing access to family planning services reduces fertility and improves birth spacing. In the Matlab study, findings from long-term follow-up showed that women's earnings, assets, and body-mass indexes, and children's schooling and body-mass indexes, substantially improved in areas with improved access to family planning services compared with outcomes in control areas. At the macroeconomic level, reductions in fertility enhance economic growth as a result of reduced youth dependency and an increased number of women participating in paid labour. PMID:22784535

  5. The ethical implications of health sciences library economics.

    PubMed Central

    Byrd, G D

    1991-01-01

    The intersection of ethics and economics is rarely discussed in the library literature or at conferences. This may be due, in part, to what economists describe as a romantic value system, that is, the belief that resources are or should be unlimited and available for exploitation by every individual with a need. But recent changes in the national economy for libraries are forcing a realization that individualistic codes of ethics and value systems do not always result in socially desirable consequences. The problems of information management and access cannot be solved by ethical individuals acting alone. Instead, a new consensus is needed on collective ethical behaviors to ensure that health information resources are managed for the common good. PMID:1958911

  6. The Health and Economic Effects of Counterfeit Drugs

    PubMed Central

    Blackstone, Erwin A.; Fuhr, Joseph P.; Pociask, Steve

    2014-01-01

    Background Counterfeit drugs comprise an increasing percentage of the US drug market and even a larger percentage in less developed countries. Counterfeit drugs involve both lifesaving and lifestyle drugs. Objective To review the health and economic consequences of counterfeit drugs on the US public and on the healthcare system as a whole. Method This comprehensive review of the literature encompassed a search of MEDLINE/PubMed, Google Scholar, and ProQuest using the keywords “counterfeit drugs,” “counterfeit medicines,” “fake drugs,” and “fake medicines.” A search of the various FiercePharma daily newsletter series on the healthcare market was also conducted. In addition, the US Food and Drug Administration and the World Health Organization websites were reviewed for additional information. Discussion The issue of counterfeit drugs has been growing in importance in the United States, with the supply of these counterfeit drugs coming from all over the world. Innovation is important to economic growth and US competitiveness in the global marketplace, and intellectual property protections provide the ability for society to prosper from innovation. Especially important in terms of innovation in healthcare are the pharmaceutical and biopharmaceutical industries. In addition to taking income from consumers and drug companies, counterfeit drugs also pose health hazards to patients, including death. The case of bevacizumab (Avastin) is presented as one recent example. Internet pharmacies, which are often the source of counterfeit drugs, often falsely portray themselves as Canadian, to enhance their consumer acceptance. Adding to the problems are drug shortages, which facilitate access for counterfeits. A long and convoluted supply chain also facilitates counterfeits. In addition, the wholesale market involving numerous firms is a convenient target for counterfeit drugs. Trafficking in counterfeits can be extremely profitable; detection of counterfeits is

  7. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Procedures for requesting health assessments. 90.3 Section 90.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES §...

  8. 42 CFR 90.3 - Procedures for requesting health assessments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures for requesting health assessments. 90.3 Section 90.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES...

  9. Economic analysis of outreach assessment clinics in breast screening programmes.

    PubMed

    van der Pol, M M; Cairns, J A; Gilbert, F J; Hendry, P J

    1999-01-01

    A model is developed for the economic evaluation of outreach assessment clinics following screening and used to identify the cost-minimizing strategy for assessing women from three island communities in the Scottish Breast Screening Programme (SBSP). There are four options of interest depending on: whether the women are assessed on the mainland or at outreach assessment clinics; and whether all women have two view screening rather than only those being screened for the first time. The benefits of outreach assessment are assumed to be solely in terms of convenience to women and reductions in the time and travel costs of women recalled for assessment. The costs are modelled in order to compare outreach and no outreach options. The results show that for the numbers of women currently screened outreach assessment is the cost-minimizing strategy. The model provides useful guidance with respect to screening policy and is readily applied to the case of outreach assessment in mainland communities outwith major population centres and to breast and other screening programmes in other countries. PMID:10351680

  10. Contributing to the Community: The Economic Significance of Academic Health Centers and Their Role in Neighborhood Development. Report IV. Report of the Task Force on Academic Health Centers.

    ERIC Educational Resources Information Center

    Commonwealth Fund, New York, NY.

    This report is a selective analysis and assessment of quantitative data and field studies that reflect the economic role of the Academic Health Center (AHC) in the urban economy and in neighborhood revitalization. It describes the effect of a variety of cooperative efforts between local community organizations and AHCs, which usually include a…

  11. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Conduct of health assessments and health effects studies. 90.8 Section 90.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  12. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Reporting of results of health assessments and health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES...

  13. 42 CFR 90.8 - Conduct of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Conduct of health assessments and health effects studies. 90.8 Section 90.8 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND...

  14. 42 CFR 90.11 - Reporting of results of health assessments and health effects studies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Reporting of results of health assessments and health effects studies. 90.11 Section 90.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES...

  15. [Telemedicine in acute stroke care--a health economics view].

    PubMed

    Günzel, F; Theiss, S; Knüppel, P; Halberstadt, S; Rose, G; Raith, M

    2010-05-01

    Specialized stroke units offer optimal treatment of patients with an acute stroke. Unfortunately, their installation is limited by an acute lack of experienced neurologists and the small number of stroke patients in sparsely populated rural areas. This problem is increasingly being solved by the use of telemedicine, so that neurological expertise is made available to basic and regular care. It has been demonstrated by national and international pilot studies that solidly based and rapid decisions can be made by telemedicine regrading the use of thrombolysis, as the most important acute treatment, but also of other interventions. So far studies have only evaluated improvement in the quality of care achieved by networking, but not of any lasting effect on any economic benefit. Complementary to a medical evaluation, the qualitative economic assessment presented here of German and American concepts of telemetric care indicate no difference in efficacy between various ways of networking. Most noteworthy, when comparing two large American and German studies, is the difference in their priorities. While the American networks achieved targeted improvements in efficacy of care that go beyond the immediate wishes of the doctors involved, this was of only secondary importance in the German studies. Also, in contrast to several American networks, the German telemetry networks have not tended to be organized for future growth. In terms of economic benefits, decentralized organized networks offer a greater potential of efficacy than purely local ones. Furthermore, the integration of inducements into the design of business models is a fundamental factor for achieving successful and lasting existence, especially within a highly competitive market. PMID:20077382

  16. Community health assessment. The first step in community health planning.

    PubMed

    Rice, J A

    1993-01-01

    Hospitals face a paradigm shift: from planning service delivery to population-based community health planning. Comprehensive community health planning is a two-step process: assessment and action, in that order. Assessment identifies community problems and resources; action follows planning, which determines which of those problems should be addressed with which resources. This paper provides an overview of the community assessment process. The first challenge in launching a community health initiative is to identify and recruit partners drawn from the ranks of prominent community organizations, such as school boards, public health agencies, and elected officials. The best enlistment strategies are those that empower persons outside the hospital to take visible control. Defining the community is the first step in analyzing the community. It is important that everyone involved in the assessment process agree on the definition, which should take in those characteristics that make the community unique, including its social systems, environmental factors, and demographics. The next step in the process is developing a community health profile, a set of key community indicators or measures that will help you set priorities, document successes and failures, and monitor trends. There are a number of models available to consult in developing indicators, whether traditional, medically oriented determinants of health or broader parameters, such as housing and public safety. Criteria for selecting indicators include validity, stability and reliability, and responsiveness. Most indicators will be developed using secondary, or already existing, sources of data, such as census data, Medicare and Medicaid files, police records, and hospital admission and exit records. Conducting the community assessment involves putting together a list of problems to be solved and a list of available resources, both of which can be compiled using the same four-step process of gathering and

  17. Environmental economic impact assessment in China: Problems and prospects

    SciTech Connect

    Lindhjem, Henrik . E-mail: henrik.lindhjem@econ.no; Hu Tao . E-mail: hu.tao@vip.163.com; Ma Zhong . E-mail: mazhong@public.bta.net.cn; Skjelvik, John Magne . E-mail: john.skjelvik@econ.no; Song Guojun . E-mail: songgj@public3.bta.net.cn; Vennemo, Haakon . E-mail: haakon.vennemo@econ.no; Wu Jian . E-mail: zhxwj@263.net; Zhang Shiqiu . E-mail: zhangshq@pku.edu.cn

    2007-01-15

    The use of economic valuation methods to assess environmental impacts of projects and policies has grown considerably in recent years. However, environmental valuation appears to have developed independently of regulations and practice of environmental impact assessment (EIA), despite its potential benefits to the EIA process. Environmental valuation may be useful in judging significance of impacts, determining mitigation level, comparing alternatives and generally enabling a more objective analysis of tradeoffs. In China, laws and regulations require the use of environmental valuation in EIA, but current practice lags far behind. This paper assesses the problems and prospects of introducing environmental valuation into the EIA process in China. We conduct four case studies of environmental economic impact assessment (EEIA), three of which are based on environmental impact statements of construction projects (a power plant, a wastewater treatment plant and a road construction project) and one for a regional pollution problem (wastewater irrigation). The paper demonstrates the potential usefulness of environmental valuation but also discusses several challenges to the introduction and wider use of EEIA, many of which are likely to be of relevance far beyond the Chinese context. The paper closes with suggesting some initial core elements of an EEIA guideline.

  18. Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

    PubMed Central

    2013-01-01

    Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA   S-2 Introduction   S-2 Benign Prostatic Hyperplasia (BPH)   S-3 • Overview   S-3• Current BPH Treatment Paradigm   S-4• BPH Continuum of Care: Bladder Health   S-5 New Treatment Option for BPH   S-5 • The UroLift® System   S-6• Positioning of UroLift® in BPH Treatment Paradigm   S-7 New Value Proposition   S-8 • Addressing Bladder Health: Breaking the Cycle   S-8• Cost Benefit Analysis: The Big Picture   S-8 Patient and Family Engagement   S-10 Summary   S-11 PMID:22823180

  19. HEALTH AND SOCIO-ECONOMIC HAZARDS ASSOCIATED WITH KHAT CONSUMPTION

    PubMed Central

    Ageely, Hussein M. A.

    2008-01-01

    The consumption of the stimulant leaf Khat (Catha edulis Forsk) is widespread in several countries of East Africa and the Arabian Peninsula. The leaf comes from a small evergreen shrub that can grow to the size of a tree. Young buds and tender leaves are chewed to attain a state of euphoria and stimulation. Khat leaves contain cathinones, an active brain stimulant that is similar in structure and pharmacological activity to amphetamines. Like amphetamines, Khat ingestion in low doses results in decreased appetite, euphoria, increased intellectual efficiency, and hyperalertness. High doses and chronic use of Khat can cause more serious adverse neurological, psychiatric, cardiovascular, dental, gastrointestinal and genitourinary effects. Besides damaging health, Khat has adverse socio-economic consequences effects on many other aspects of life including the loss of thousands of acres of arable land and billions of hours of work. The purpose of this review is to describe briefly the adverse consequences of habitual chewing of Khat on health, and help educate the general public. The study is based on literature review that includes internet search and journals. PMID:23012161

  20. Economic Evidence on the Health Impacts of Climate Change in Europe

    PubMed Central

    Hutton, Guy; Menne, Bettina

    2014-01-01

    BACKGROUND In responding to the health impacts of climate change, economic evidence and tools inform decision makers of the efficiency of alternative health policies and interventions. In a time when sweeping budget cuts are affecting all tiers of government, economic evidence on health protection from climate change spending enables comparison with other public spending. METHODS The review included 53 countries of the World Health Organization (WHO) European Region. Literature was obtained using a Medline and Internet search of key terms in published reports and peer-reviewed literature, and from institutions working on health and climate change. Articles were included if they provided economic estimation of the health impacts of climate change or adaptation measures to protect health from climate change in the WHO European Region. Economic studies are classified under health impact cost, health adaptation cost, and health economic evaluation (comparing both costs and impacts). RESULTS A total of 40 relevant studies from Europe were identified, covering the health damage or adaptation costs related to the health effects of climate change and response measures to climate-sensitive diseases. No economic evaluation studies were identified of response measures specific to the impacts of climate change. Existing studies vary in terms of the economic outcomes measured and the methods for evaluation of health benefits. The lack of robust health impact data underlying economic studies significantly affects the availability and precision of economic studies. CONCLUSIONS Economic evidence in European countries on the costs of and response to climate-sensitive diseases is extremely limited and fragmented. Further studies are urgently needed that examine health impacts and the costs and efficiency of alternative responses to climate-sensitive health conditions, in particular extreme weather events (other than heat) and potential emerging diseases and other conditions

  1. A Systematic Review of Scope and Quality of Health Economic Evaluation Studies in Vietnam

    PubMed Central

    Maher, Rachel Marie; Nguyen, Phuong Khanh; Luu, Hoat Ngoc

    2014-01-01

    Introduction The application of health economic evaluation (HEE) evidence can play an important role in strategic planning and policy making. This study aimed to assess the scope and quality of existing research, with the goal of elucidating implications for improving the use of HEE evidence in Vietnam. Methods A comprehensive search strategy was developed to search medical online databases (Medline, Google Scholar, and Vietnam Medical Databases) to select all types of HEE studies except cost-only analyses. Two researchers assessed the quality of selected studies using the Quality of Health Economic Studies (QHES) instrument. Results We selected 26 studies, including 6 published in Vietnam. The majority of these studies focused on infectious diseases (14 studies), with HIV being the most common topic (5 studies). Most papers were cost-effectiveness studies that measured health outcomes using DALY units. Using QHES, we found that the overall quality of HEE studies published internationally was much higher (mean score 88.7+13.3) than that of those published in Vietnam (mean score 67.3+22.9). Lack of costing perspectives, reliable data sources and sensitivity analysis were the main shortcomings of the reviewed studies. Conclusion This review indicates that HEE studies published in Vietnam are limited in scope and number, as well as by several important technical errors or omissions. It is necessary to formalize the process of health economic research in Vietnam and to institutionalize the links between researchers and policy-makers. Additionally, the quality of HEE should be enhanced through education about research techniques, and the implementation of standard HEE guidelines. PMID:25122180

  2. Economic and Health Impacts Associated with a Salmonella Typhimurium Drinking Water Outbreak−Alamosa, CO, 2008

    PubMed Central

    Ailes, Elizabeth; Budge, Philip; Shankar, Manjunath; Collier, Sarah; Brinton, William; Cronquist, Alicia; Chen, Melissa; Thornton, Andrew; Beach, Michael J.; Brunkard, Joan M.

    2013-01-01

    In 2008, a large Salmonella outbreak caused by contamination of the municipal drinking water supply occurred in Alamosa, Colorado. The objectives of this assessment were to determine the full economic costs associated with the outbreak and the long-term health impacts on the community of Alamosa. We conducted a postal survey of City of Alamosa (2008 population: 8,746) households and businesses, and conducted in-depth interviews with local, state, and nongovernmental agencies, and City of Alamosa healthcare facilities and schools to assess the economic and long-term health impacts of the outbreak. Twenty-one percent of household survey respondents (n = 369/1,732) reported diarrheal illness during the outbreak. Of those, 29% (n = 108) reported experiencing potential long-term health consequences. Most households (n = 699/771, 91%) reported municipal water as their main drinking water source at home before the outbreak; afterwards, only 30% (n = 233) drank unfiltered municipal tap water. The outbreak’s estimated total cost to residents and businesses of Alamosa using a Monte Carlo simulation model (10,000 iterations) was approximately $1.5 million dollars (range: $196,677–$6,002,879), and rose to $2.6 million dollars (range: $1,123,471–$7,792,973) with the inclusion of outbreak response costs to local, state and nongovernmental agencies and City of Alamosa healthcare facilities and schools. This investigation documents the significant economic and health impacts associated with waterborne disease outbreaks and highlights the potential for loss of trust in public water systems following such outbreaks. PMID:23526942

  3. Economic Crisis, Restrictive Policies, and the Population’s Health and Health Care: The Greek Case

    PubMed Central

    Giannakopoulos, Stathis; Gavana, Magda; Ierodiakonou, Ioanna; Waitzkin, Howard; Benos, Alexis

    2013-01-01

    The global economic crisis has affected the Greek economy with unprecedented severity, making Greece an important test of the relationship between socioeconomic determinants and a population’s well-being. Suicide and homicide mortality rates among men increased by 22.7% and 27.6%, respectively, between 2007 and 2009, and mental disorders, substance abuse, and infectious disease morbidity showed deteriorating trends during 2010 and 2011. Utilization of public inpatient and primary care services rose by 6.2% and 21.9%, respectively, between 2010 and 2011, while the Ministry of Health’s total expenditures fell by 23.7% between 2009 and 2011. In a time of economic turmoil, rising health care needs and increasing demand for public services collide with austerity and privatization policies, exposing Greece’s population health to further risks. PMID:23597358

  4. A generic bio-economic farm model for environmental and economic assessment of agricultural systems.

    PubMed

    Janssen, Sander; Louhichi, Kamel; Kanellopoulos, Argyris; Zander, Peter; Flichman, Guillermo; Hengsdijk, Huib; Meuter, Eelco; Andersen, Erling; Belhouchette, Hatem; Blanco, Maria; Borkowski, Nina; Heckelei, Thomas; Hecker, Martin; Li, Hongtao; Oude Lansink, Alfons; Stokstad, Grete; Thorne, Peter; van Keulen, Herman; van Ittersum, Martin K

    2010-12-01

    Bio-economic farm models are tools to evaluate ex-post or to assess ex-ante the impact of policy and technology change on agriculture, economics and environment. Recently, various BEFMs have been developed, often for one purpose or location, but hardly any of these models are re-used later for other purposes or locations. The Farm System Simulator (FSSIM) provides a generic framework enabling the application of BEFMs under various situations and for different purposes (generating supply response functions and detailed regional or farm type assessments). FSSIM is set up as a component-based framework with components representing farmer objectives, risk, calibration, policies, current activities, alternative activities and different types of activities (e.g., annual and perennial cropping and livestock). The generic nature of FSSIM is evaluated using five criteria by examining its applications. FSSIM has been applied for different climate zones and soil types (criterion 1) and to a range of different farm types (criterion 2) with different specializations, intensities and sizes. In most applications FSSIM has been used to assess the effects of policy changes and in two applications to assess the impact of technological innovations (criterion 3). In the various applications, different data sources, level of detail (e.g., criterion 4) and model configurations have been used. FSSIM has been linked to an economic and several biophysical models (criterion 5). The model is available for applications to other conditions and research issues, and it is open to be further tested and to be extended with new components, indicators or linkages to other models. PMID:21113782

  5. A Generic Bio-Economic Farm Model for Environmental and Economic Assessment of Agricultural Systems

    PubMed Central

    Louhichi, Kamel; Kanellopoulos, Argyris; Zander, Peter; Flichman, Guillermo; Hengsdijk, Huib; Meuter, Eelco; Andersen, Erling; Belhouchette, Hatem; Blanco, Maria; Borkowski, Nina; Heckelei, Thomas; Hecker, Martin; Li, Hongtao; Oude Lansink, Alfons; Stokstad, Grete; Thorne, Peter; van Keulen, Herman; van Ittersum, Martin K.

    2010-01-01

    Bio-economic farm models are tools to evaluate ex-post or to assess ex-ante the impact of policy and technology change on agriculture, economics and environment. Recently, various BEFMs have been developed, often for one purpose or location, but hardly any of these models are re-used later for other purposes or locations. The Farm System Simulator (FSSIM) provides a generic framework enabling the application of BEFMs under various situations and for different purposes (generating supply response functions and detailed regional or farm type assessments). FSSIM is set up as a component-based framework with components representing farmer objectives, risk, calibration, policies, current activities, alternative activities and different types of activities (e.g., annual and perennial cropping and livestock). The generic nature of FSSIM is evaluated using five criteria by examining its applications. FSSIM has been applied for different climate zones and soil types (criterion 1) and to a range of different farm types (criterion 2) with different specializations, intensities and sizes. In most applications FSSIM has been used to assess the effects of policy changes and in two applications to assess the impact of technological innovations (criterion 3). In the various applications, different data sources, level of detail (e.g., criterion 4) and model configurations have been used. FSSIM has been linked to an economic and several biophysical models (criterion 5). The model is available for applications to other conditions and research issues, and it is open to be further tested and to be extended with new components, indicators or linkages to other models. PMID:21113782

  6. Using health economic models to help guide healthcare decisions.

    PubMed

    Charokopou, M

    2016-01-01

    This editorial accompanies a research article being published by Clinical Medical Research and Opinion (CMRO) journal, entitled "Methods applied in cost-effectiveness models for treatment strategies in type 2 diabetes mellitus and their use in Health Technology Assessments: a systematic review of the literature from 2008 to 2013". The importance and the contribution of this research to the scientific community are presented on the grounds of serving the decision-making process of evaluating and approving T2DM treatments for public funding. PMID:26473453

  7. Health Economic Data in Reimbursement of New Medical Technologies: Importance of the Socio-Economic Burden as a Decision-Making Criterion

    PubMed Central

    Iskrov, Georgi; Dermendzhiev, Svetlan; Miteva-Katrandzhieva, Tsonka; Stefanov, Rumen

    2016-01-01

    Background: Assessment and appraisal of new medical technologies require a balance between the interests of different stakeholders. Final decision should take into account the societal value of new therapies. Objective: This perspective paper discusses the socio-economic burden of disease as a specific reimbursement decision-making criterion and calls for the inclusion of it as a counterbalance to the cost-effectiveness and budget impact criteria. Results/Conclusions: Socio-economic burden is a decision-making criterion, accounting for diseases, for which the assessed medical technology is indicated. This indicator is usually researched through cost-of-illness studies that systematically quantify the socio-economic burden of diseases on the individual and on the society. This is a very important consideration as it illustrates direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. By measuring and comparing the socio-economic burden of different diseases to society, health authorities and payers could benefit in optimizing priority setting and resource allocation. New medical technologies, especially innovative therapies, present an excellent case study for the inclusion of socio-economic burden in reimbursement decision-making. Assessment and appraisal have been greatly concentrated so far on cost-effectiveness and budget impact, marginalizing all other considerations. In this context, data on disease burden and inclusion of explicit criterion of socio-economic burden in reimbursement decision-making may be highly beneficial. Realizing the magnitude of the lost socio-economic contribution resulting from diseases in question could be a reasonable way for policy makers to accept a higher valuation of innovative therapies. PMID:27582707

  8. Mental health assessment of rape offenders

    PubMed Central

    Sarkar, Jaydip

    2013-01-01

    There is an urgent need for development of methods of assessment and management of sex offenders (rapists, child sex offenders, other sexual offenders, and murderers) to mount a society-wide battle against the scourge of sexual offences in India. This paper provides an overview of theories, models, and assessment methods of rapists. It draws upon literature from psychiatry, psychology, criminology, probation, and ethics to provide a framework for understanding reasons behind rape, how mental health issues are implicated, what mental health professionals can do to contribute to crime management, and why this is ethically right and proper. PMID:24082243

  9. Economic growth and health progress in Italy: 30 years of National Health Service.

    PubMed

    Vannelli, Alberto; Buongiorno, Massimo; Zanardo, Michele; Basilico, Valerio; Capriata, Giulio; Rossi, Fabrizio; Pruiti, Vincenzo; Battaglia, Luigi

    2012-01-01

    On December 23 of 1978, during first Italian recession since the end of World War II, Parliament voted for Law 833 that gives birth to the Italian National Public Health Services (SSN) as the new and alternative model of health care system. It was the beginning of the match of Italian health care with the world class level of the public health care. Each crisis requires solidarity and actions. Maintaining levels of health and other social expenditures is critical to protect life and livelihood and to boost productivity. The purpose of the present study is to establish an alternative point of view to demonstrate that Gross Domestic Product, is a function of health care expenditure. The chronology of the events was created by using the laws published on "Gazzetta Ufficiale" (GU). In order to analyze the corporate effectiveness and efficiency, we have divided the SSN into its three main components, namely resources (input), services (output) and performances (outcome). Health services have certainly been pioneers and are still today standard-bearers of a challenge which has borne its fruits. According to the "Organization for Economic Co-operation and Development", SSN ranks second in the world classification of the return on the health care services in 2000. The World Health Organization has published in 2005 the same result: SSN ranks second in the world for ability and quality of the health care in relationship to the resources invested The continuous reforms of health care system introduced stability to the Italian system more than others countries. Success of SSN function rooted in the ability of system to adapt assuring mechanism of positive feed-back correction. In the future SSN, will required new set of reforms, such as redefinition of structures and mechanisms of governance, strategic plans, clinical administrations. PMID:23223322

  10. The Delineation of Economic and Health Service Areas and the Location of Health Manpower Education Programs--A Summary.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Div. of Manpower Intelligence.

    The document's research concerns are directed to the study of various dimensions of health care delivery systems and the dynamics of health manpower supply and requirements. It attempts to explore and determine the effectiveness of the economic system as a surrogate in health planning for the health care delivery system, and to estimate the…

  11. Comparison of lignin extraction processes: Economic and environmental assessment.

    PubMed

    Carvajal, Juan C; Gómez, Álvaro; Cardona, Carlos A

    2016-08-01

    This paper presents the technical-economic and environmental assessment of four lignin extraction processes from two different raw materials (sugarcane bagasse and rice husks). The processes are divided into two categories, the first processes evaluates lignin extraction with prior acid hydrolysis step, while in the second case the extraction processes are evaluated standalone for a total analysis of 16 scenarios. Profitability indicators as the net present value (NPV) and environmental indicators as the potential environmental impact (PEI) are used through a process engineering approach to understand and select the best lignin extraction process. The results show that both economically and environmentally process with sulfites and soda from rice husk presents the best results; however the quality of lignin obtained with sulfites is not suitable for high value-added products. Then, the soda is an interesting option for the extraction of lignin if high quality lignin is required for high value-added products at low costs. PMID:27174614

  12. Thermal simulation and economic assessment of unglazed transpired collector systems

    SciTech Connect

    Summers, D.N.; Mitchell, J.W.; Klein, S.A.; Beckman, W.A.

    1996-10-01

    Unglazed transpired collectors (UTCs) have recently emerged as a new solar air heating technology. They are relatively inexpensive, efficient, and particularly suited to applications in which a high outdoor air requirement must be met. A TRNSYS model has been created for UTC systems. Annual simulations are performed for several representative buildings. The statewide economic potential of UTC systems is assessed for Wisconsin. UTC systems on existing buildings are competitive with electric heating systems but not with gas or oil heating. Electric heating is not widely used in most buildings that are well-suited for UTC systems, with the exception of large apartment buildings. Therefore, there is no significant statewide economic potential for retrofit of UTC systems on existing buildings except in the residential sector. However, UTC systems are cost effective for new buildings because their low first cost allows them to compete with gas and oil heating.

  13. Economic Analysis of Delivering Primary Health Care Services through Community Health Workers in 3 North Indian States

    PubMed Central

    Prinja, Shankar; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

    2014-01-01

    Background We assessed overall annual and unit cost of delivering package of services and specific services at sub-centre level by CHWs and cost effectiveness of Government of India’s policy of introducing a second auxiliary nurse midwife (ANM) at the sub-centre compared to scenario of single ANM sub-centre. Methods We undertook an economic costing of health services delivered by CHWs, from a health system perspective. Bottom-up costing method was used to collect data on resources spent in 50 randomly selected sub-centres selected from 4 districts. Mean unit cost along with its 95% confidence intervals were estimated using bootstrap method. Multiple linear regression model was used to standardize cost and assess its determinants. Results Annually it costs INR 1.03 million (USD 19,381), or INR 187 (USD 3.5) per capita per year, to provide a package of preventive, curative and promotive services through community health workers. Unit costs for antenatal care, postnatal care, DOTS treatment and immunization were INR 525 (USD 10) per full ANC care, INR 767 (USD 14) per PNC case registered, INR 974 (USD 18) per DOTS treatment completed and INR 97 (USD 1.8) per child immunized in routine immunization respectively. A 10% increase in human resource costs results in 6% rise in per capita cost. Similarly, 10% increment in the ANC case registered per provider through-put results in a decline in unit cost ranging from 2% in the event of current capacity utilization to 3% reduction in case of full capacity utilization. Incremental cost of introducing 2nd ANM at sub-centre level per unit percent increase ANC coverage was INR 23,058 (USD 432). Conclusion Our estimates would be useful in undertaking full economic evaluations or equity analysis of CHW programs. Government of India’s policy of hiring 2nd ANM at sub-centre level is very cost effective from Indian health system perspective. PMID:24626285

  14. Health technology assessment: Off-site sterilization

    PubMed Central

    Dehnavieh, Reza; Mirshekari, Nadia; Ghasemi, Sara; Goudarzi, Reza; Haghdoost, AliAkbar; Mehrolhassani, Mohammad Hossain; Moshkani, Zahra; Noori Hekmat, Somayeh

    2016-01-01

    Background: Every year millions of dollars are expended to equip and maintain the hospital sterilization centers, and our country is not an exception of this matter. According to this, it is important to use more effective technologies and methods in health system in order to reach more effectiveness and saving in costs. This study was conducted with the aim of evaluating the technology of regional sterilization centers. Methods: This study was done in four steps. At the first step, safety and effectiveness of technology was studied via systematic study of evidence. The next step was done to evaluate the economical aspect of off-site sterilization technology using gathered data from systematic review of the texts which were related to the technology and costs of off-site and in-site hospital sterilization. Third step was conducted to collect experiences of using technology in some selected hospitals around the world. And in the last step different aspects of acceptance and use of this technology in Iran were evaluated. Results: Review of the selected articles indicated that efficacy and effectiveness of this technology is Confirmed. The results also showed that using this method is not economical in Iran. Conclusion: According to the revealed evidences and also cost analysis, due to shortage of necessary substructures and economical aspect, installing the off-site sterilization health technology in hospitals is not possible currently. But this method can be used to provide sterilization services for clinics and outpatients centers. PMID:27390714

  15. Shift work, health, the working time regulations and health assessments.

    PubMed

    Nicholson, P J; D'Auria, D A

    1999-04-01

    Shift work and night work in particular have been associated with sleep difficulties, general malaise, fatigue, peptic ulceration, ischaemic heart disease, cigarette smoking and adverse pregnancy outcome. The medical conditions previously regarded as making individuals unsuitable for shift work show wide ranging patho-physiological activity and there is no published evidence for any such condition to be regarded an absolute reason to exclude an individual from shift work. The fulfilment of the legal obligations of the Working Time Regulations 1998 is neither prescribed nor constrained in any way. It is advisable therefore to build on existing health procedures where they are in effect. Periodic health questionnaires can offer health professionals an opportunity to detect any disorder likely to be aggravated by shift work or by a combination of shift work, job demands and workplace conditions. A further purpose of the questionnaire is the assessment of ability to undertake shift work duties. However, health questionnaires are neither sensitive nor specific enough to be used to select applicants or employees for shift work, since they do not consistently predict tolerance of shift work or subsequent health problems. Whether employers should offer anything more than a simple questionnaire will depend on the culture of the company and accessibility of health services. Screening programmes affect many people relative to the few who benefit and with existing knowledge, periodic general health examinations performed in asymptomatic subjects have limited predictive or preventive value. PMID:10451593

  16. 78 FR 52761 - Proposed Information Collection; Comment Request; One Year Assessment of the Social and Economic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-26

    ... Assessment of the Social and Economic Impacts of Hurricane Sandy on New Jersey and New York Commercial and... assessment of the social and economic impacts from Hurricane Sandy to the commercial and recreational...

  17. Assessing Financial Health in Community Colleges

    ERIC Educational Resources Information Center

    Bers, Trudy H.; Head, Ronald B.

    2014-01-01

    In this age of educational accountability, there is an increasing emphasis on assessment and institutional effectiveness, not only in the academic arena but also in other aspects of community college operation, such as fiscal health and stability, revenue generation, resource allocation, facilities, workforce development, and community enrichment…

  18. HEALTH EFFECTS ASSESSMENT SUMMARY TABLES (HEAST)

    EPA Science Inventory

    The Annual Health Effects Summary Tables (HEAST) are for use at both Superfund and RCRA sites. It is maintained by the Environmental Protection Agencys Office of Superfund Remediation and Technology Innovation and provides a comprehensive listing of provisional risk assessment in...

  19. Watershed Health Assessment Tools Investigating Fisheries

    EPA Science Inventory

    WHATIF is software that integrates a number of calculators, tools, and models for assessing the health of watersheds and streams with an emphasis on fish communities. The tool set consists of hydrologic and stream geometry calculators, a fish assemblage predictor, a fish habitat ...

  20. Health-care technology assessment: a clinical perspective.

    PubMed

    Chantler, Cyril

    2004-01-01

    Health technology assessment needs to relate to contemporary questions which concern public health-care systems: how to keep people healthy, how to focus on the needs of those with chronic disabilities and integrate care between the hospital and the community, how to encourage and audit effective teamwork, and how to establish a consensus about what is effective and affordable. Clinicians have an ethical responsibility to practice efficiently and economically, for profligacy in the care of one patient may mean that another is treated inadequately. For similar reasons, clinicians need to play a full role in the management of services. Advice from health technology assessment is vital and needs to be accurate, relevant, timely, clear, and accessible. As well as being concerned about what works, we need also to eliminate from practice what does not. Regular audit and appraisal of practice against the evidence base should be useful in this respect. Alternative approaches to management, such as the provision of care as opposed to aggressive treatments, need to be evaluated, and health technology assessment needs to consider how services are delivered, not just specific treatments. PMID:15176183

  1. Economic Inequalities in Latin America at the Base of Adverse Health Indicators.

    PubMed

    Ferre, Juan Cruz

    2016-07-01

    There is increasing evidence supporting the existence of a link between income inequalities and health outcomes. The main purpose of this article is to test whether economic inequalities are associated with poor population health in Latin American countries. Multi-country data from 1970 to 2012 were used to assess this question. The results show that the Gini coefficient has a strong correlation with health outcomes. Moreover, multiple linear regression analysis using fixed effects shows that after controlling for gross national income per capita, literacy rate, and health expenditure, the Gini coefficient is independently negatively associated with health outcomes. In Latin American countries, for every percentage point increase in the Gini coefficient, the infant mortality rate grows by 0.467 deaths per 1,000 live births, holding all other variables constant. Additionally, an ordinary least squares estimation model suggests that countries that do not use International Monetary Fund loans perform better on health outcomes. These findings should alert policymakers, elected officials, and the public of the need to fight income inequalities and rethink the role of international financial institutions that dictate state policies. PMID:27287670

  2. Public health assessment--Russian Federation, 1992.

    PubMed

    1992-02-14

    On December 25, 1991, the Russian Federation became an independent republic, and on January 2, 1992, restrictions on retail prices of most commodities were removed. From January 16 through February 6, a multidisciplinary team from the U.S. Food and Humanitarian Assistance Bureau (FHA) conducted an assessment of the needs for humanitarian and technical assistance, focusing on three regions in the southern Ural Mountains-Yekaterinburg, Perm, and Cheliabinsk-and three regions in south-central Siberia-Kusbas, Tomsk, and Novosibirsk. The FHA assessment included observations of health facilities, vaccine- and drug-storage centers, and disease-control programs; review of health data at central, regional, and district epidemiology stations; and collection of food-price and income data through interviews with administrative authorities and surveys of markets and private homes. This report summarizes findings from the assessment. PMID:1734228

  3. Health impact assessment: assessing opportunities and barriers to intersectoral health improvement in an expanded European Union.

    PubMed

    Lock, Karen; McKee, Martin

    2005-05-01

    On 1 May 2004 the European Union (EU) underwent unprecedented enlargement, from 15 to 25 countries, increasing its population by 20% to over 450 million. Although EU law has limited specific competence in the area of health, its influence on other policy sectors such as agriculture, trade, and employment has wide ranging implications for health. Yet with the exception of provisions on communicable disease control and food safety, public health considerations have played little part in negotiations on EU accession. This paper argues for an intersectoral public health approach in the expanded EU. It reviews the legal basis for assessing the health impacts of policy in the EU and, using health impact assessment as a case study, it examines how well the new member states may be prepared to tackle intersectoral public health action within the constraints imposed by EU policy. PMID:15831682

  4. Thai health technology assessment guideline development.

    PubMed

    Teerawattananon, Yot; Chaikledkaew, Usa

    2008-06-01

    Health Technology Assessment (HTA) is a comprehensive form of policy research that provides information on the consequences of the application of health technology. It is used primarily to guide health care resource allocation decisions. In Thailand, there is increasing impetus to use HTA information to allow more explicit and transparent health care priority setting. A previous study indicated that serious attention needed to be given to the quality of reporting and the use of information in the analyses. These problems could be reduced by setting up standard guidelines for conducting HTA to stimulate the provision of standardized, reliable and good quality information for policy makers. Nevertheless, Thailand has not yet set up such guidelines. This may lead to low quality evaluations. Therefore, the objective of this article was to describe the rationale for guideline development, supporting principles, guideline development process, sources of information, and future challenges for HTA. PMID:19253483

  5. Biogrouting compared to jet grouting: environmental (LCA) and economical assessment.

    PubMed

    Suer, Pascal; Hallberg, Niklas; Carlsson, Christel; Bendz, David; Holm, Goran

    2009-03-01

    In order to predict consequences of replacing jet grouting with biogrouting, and identify major contributors to the cost of both technologies, a large road project in Stockholm, Sweden, was used as a case study. Jet grouting had been used to seal the contact between sheet piling and bedrock, biogrouting for the same function was computed. A comparative environmental and economical assessment was carried out using life cycle assessment (LCA). The results show that biogrouting was cheaper than jet grouting and would have had lower environmental impact. The major difference was the transport and use of heavier equipment for jet grouting. Biogrouting also used less water and produced less landfilled waste. However, the production of urea and CaCl(2) for biogrouting required much energy. PMID:19184701

  6. Health and economic implications of a tobacco-free society.

    PubMed

    Warner, K E

    1987-10-16

    Cigarette smoking causes more premature deaths than do all the following together: acquired immunodeficiency syndrome, cocaine, heroin, alcohol, fire, automobile accidents, homicide, and suicide. Attainment of a tobacco-free society ultimately would produce a national life-expectancy gain comparable with that that would accompany the complete elimination of all cancers not caused by tobacco use. In particular, each year 350,000 individuals who would have experienced tobacco-related deaths would realize a life-expectancy gain of 15 years. Reflecting their higher smoking prevalence and rates of smoking-related diseases, blacks would benefit more than whites. By altering the mix of morbid conditions and fatal diseases, the end of tobacco-related diseases would shift the need for particular medical specialties and health care facilities. The tobacco industry implies that the demise of tobacco consumption would wreak havoc with the economy. By contrast, some antitobacco activists suggest that the end of tobacco use would yield a multibillion dollar fiscal dividend. Each argument is fundamentally flawed. The economic impacts of a tobacco-free society would be modest and of far less consequence than the principal implication: a significantly enriched quality and quantity of life. PMID:3656624

  7. Assessing groundwater policy with coupled economic-groundwater hydrologic modeling

    NASA Astrophysics Data System (ADS)

    Mulligan, Kevin B.; Brown, Casey; Yang, Yi-Chen E.; Ahlfeld, David P.

    2014-03-01

    This study explores groundwater management policies and the effect of modeling assumptions on the projected performance of those policies. The study compares an optimal economic allocation for groundwater use subject to streamflow constraints, achieved by a central planner with perfect foresight, with a uniform tax on groundwater use and a uniform quota on groundwater use. The policies are compared with two modeling approaches, the Optimal Control Model (OCM) and the Multi-Agent System Simulation (MASS). The economic decision models are coupled with a physically based representation of the aquifer using a calibrated MODFLOW groundwater model. The results indicate that uniformly applied policies perform poorly when simulated with more realistic, heterogeneous, myopic, and self-interested agents. In particular, the effects of the physical heterogeneity of the basin and the agents undercut the perceived benefits of policy instruments assessed with simple, single-cell groundwater modeling. This study demonstrates the results of coupling realistic hydrogeology and human behavior models to assess groundwater management policies. The Republican River Basin, which overlies a portion of the Ogallala aquifer in the High Plains of the United States, is used as a case study for this analysis.

  8. Declining fertility and economic well-being: do education and health ride to the rescue?

    PubMed Central

    Prettner, Klaus; Bloom, David E.; Strulik, Holger

    2015-01-01

    It is widely argued that declining fertility slows the pace of economic growth in industrialized countries through its negative effect on labor supply. There are, however, theoretical arguments suggesting that the effect of falling fertility on effective labor supply can be offset by associated behavioral changes. We formalize these arguments by setting forth a dynamic consumer optimization model that incorporates endogenous fertility as well as endogenous education and health investments. The model shows that a fertility decline induces higher education and health investments that are able to compensate for declining fertility under certain circumstances. We assess the theoretical implications by investigating panel data for 118 countries over the period 1980 to 2005 and show that behavioral changes partly mitigate the negative impact of declining fertility on effective labor supply. PMID:26388677

  9. Lake ecosystem health assessment: indicators and methods.

    PubMed

    Xu, F L; Tao, S; Dawson, R W; Li, P G; Cao, J

    2001-09-01

    A set of ecological indicators including structural, functional, and system-level aspects were proposed for a lake ecosystem health assessment, according to the structural, functional, and system-level responses of lake ecosystems to chemical stresses including acidification, eutrophication and copper, oil and pesticide contamination. The structural indicators included phytoplankton cell size and biomass, zooplankton body size and biomass, species diversity, macro- and micro-zooplankton biomass, the zooplankton phytoplankton ratio, and the macrozooplankton microzooplankton ratio. The functional indicators encompassed the algal C assimilation ratio, resource use efficiency, community production, gross production/respiration (i.e. P/R) ratio, gross production standing crop biomass (i.e. P/B) ratio, and standing crop biomass unit energy flow (i.e. B/E) ratio. The ecosystem-level indicators conisisted of ecological buffer capacities, energy, and structural energy. Based on these indicators, a direct measurement method (DMM) and an ecological modeling method (EMM) for lake ecosystem health assessment were developed. The DMM procedures were designed to: (1) identify key indicators; (2) measure directly or calculate indirectly the selected indicators; and, (3) assess ecosystem health on the basis of the indicator values. The EMM procedures were designed to: (1) determine the structure and complexity of the ecological model according to the lake's ecosystem structure; (2) establish an ecological model by designing a conceptual diagram, establishing model equations, and estimating model pararmeters; (3) compare the simulated values of important state variables and process rates with actual observations; (4) calculate ecosystem health indicators using the ecological model; and, (5) assess lake ecosystem health according to the values of the ecological indicators. The results of a case study demonstrated that both methods provided similar results which corresponded with the

  10. Untapped potential of health impact assessment.

    PubMed

    Winkler, Mirko S; Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2013-04-01

    The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to "green economy" and "institutional framework" strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century's sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure. PMID:23599554

  11. Untapped potential of health impact assessment

    PubMed Central

    Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2013-01-01

    Abstract The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to “green economy” and “institutional framework” strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century’s sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure. PMID:23599554

  12. Systematic review of health state utility values for economic evaluation of colorectal cancer.

    PubMed

    Jeong, Kim; Cairns, John

    2016-12-01

    Cost-utility analyses undertaken to inform decision making regarding colorectal cancer (CRC) require a set of health state utility values (HSUVs) so that the time CRC patients spend in different health states can be aggregated into quality-adjusted life-years (QALY). This study reviews CRC-related HSUVs that could be used in economic evaluation and assesses their advantages and disadvantages with respect to valuation methods used and CRC clinical pathways. Fifty-seven potentially relevant studies were identified which collectively report 321 CRC-related HSUVs. HSUVs (even for similar health states) vary markedly and this adds to the uncertainty regarding estimates of cost-effectiveness. There are relatively few methodologically robust HSUVs that can be directly used in economic evaluations concerned with CRC. There is considerable scope to develop new HSUVs which improve on those currently available either by expanded collection of generic measures or by making greater use of condition-specific data, for example, using mapping algorithms. PMID:27541298

  13. Economic perspectives on pediatric obesity: impact on health care expenditures and cost-effectiveness of preventive interventions.

    PubMed

    John, Jürgen

    2010-01-01

    This chapter surveys two segments of the economic literature on pediatric obesity: first, research regarding the impact of childhood obesity on health care expenditure, and second, research evaluating the cost-effectiveness of programs to prevent pediatric obesity. Evidence in support of the hypothesis that obese children and adolescents have higher health care costs than their otherwise similar healthy-weight peers has been found for female adolescents. Studies trying to calculate the complete lifetime health care costs attributable to childhood obesity are missing. Only a small number of studies assessing the cost-effectiveness of preventive obesity interventions among children have been published until now. The results call for the inclusion of nutrition behavior as an intervention target. There is some evidence that childhood obesity prevention might be successful in combining health gains with cost savings. However, it is not possible to rank the interventions according to their cost-effectiveness or to assess the generalizability of their results. Cost-effectiveness increasingly will be a major consideration in public reimbursement decisions. Therefore, evaluation research has to pay more attention to the economic aspects of new health technologies. Without providing good value for money, those technologies probably will not turn from inventions to innovations in health care. Moreover, future research should address various methodological and conceptual challenges and limitations which economic evaluations of preventive interventions into childhood obesity are faced with. PMID:20664220

  14. A Systematic Review of Health Economic Analyses of Housing Improvement Interventions and Insecticide-Treated Bednets in the Home

    PubMed Central

    Pega, Frank; Wilson, Nick

    2016-01-01

    Background Housing improvements have considerable potential for improving health. So does the provision of insecticide-treated bednets for malaria prevention. Therefore we aimed to conduct updated systematic reviews of health economic analyses in both these intervention domains. Methods and findings The search strategy included economic analyses of housing improvement interventions and use of insecticide-treated bednets for community-dwelling, healthy populations (published between 1 January 2000 and 15 April 2014). We searched the Cochrane Database of Systematic Reviews, MEDLINE, PubMed, EMBASE, and three health economics databases. Thirty-five economic analyses of seven types of intervention fulfilled the inclusion criteria. Most included studies adopted a health sector perspective and were cost-effectiveness analyses using decision analytic modeling or conducted alongside trials. The overall quality of the studies was generally likely to be adequate for informing policy-making (albeit with limitations in some areas). There was fairly consistent evidence for the cost-effectiveness/favorable cost-benefit of removing indoor lead to prevent lead poisoning and sequelae, and retrofitting insulation to prevent lung disease. But the value of assessing and improving home safety and providing smoke alarms to prevent injuries was more mixed and the economic evidence was inconclusive or insufficient for: home ventilation to prevent lung disease, installing heaters to prevent lung disease and regulating tap water temperatures to prevent scalding. Few studies (n = 4) considered health equity. The 12 studies of providing insecticide-treated bednets or hammocks to prevent malaria found these interventions to be moderately to highly cost-effective. Conclusions This systematic review provides updated evidence that several housing improvement interventions (such as removing indoor lead and retrofitting insulation) and also the provision of insecticide-treated bednets are cost

  15. The Politico-Economic Challenges of Ghana’s National Health Insurance Scheme Implementation

    PubMed Central

    Fusheini, Adam

    2016-01-01

    Background: National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Methods: Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Results: Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. Conclusion: The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS

  16. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

    Rhatigan, Jennifer; Charles, John; Hayes, Judith; Wren, Kiley

    2006-01-01

    Maintenance of human health on long-duration exploration missions is a primary challenge to mission designers. Indeed, human health risks are currently the largest risk contributors to the risks of evacuation or loss of the crew on long-duration International Space Station missions. We describe a quantitative assessment of the relative probabilities of occurrence of the individual risks to human safety and efficiency during space flight to augment qualitative assessments used in this field to date. Quantitative probabilistic risk assessments will allow program managers to focus resources on those human health risks most likely to occur with undesirable consequences. Truly quantitative assessments are common, even expected, in the engineering and actuarial spheres, but that capability is just emerging in some arenas of life sciences research, such as identifying and minimize the hazards to astronauts during future space exploration missions. Our expectation is that these results can be used to inform NASA mission design trade studies in the near future with the objective of preventing the higher among the human health risks. We identify and discuss statistical techniques to provide this risk quantification based on relevant sets of astronaut biomedical data from short and long duration space flights as well as relevant analog populations. We outline critical assumptions made in the calculations and discuss the rationale for these. Our efforts to date have focussed on quantifying the probabilities of medical risks that are qualitatively perceived as relatively high risks of radiation sickness, cardiac dysrhythmias, medically significant renal stone formation due to increased calcium mobilization, decompression sickness as a result of EVA (extravehicular activity), and bone fracture due to loss of bone mineral density. We present these quantitative probabilities in order-of-magnitude comparison format so that relative risk can be gauged. We address the effects of

  17. Agricultural climate impacts assessment for economic modeling and decision support

    NASA Astrophysics Data System (ADS)

    Thomson, A. M.; Izaurralde, R. C.; Beach, R.; Zhang, X.; Zhao, K.; Monier, E.

    2013-12-01

    A range of approaches can be used in the application of climate change projections to agricultural impacts assessment. Climate projections can be used directly to drive crop models, which in turn can be used to provide inputs for agricultural economic or integrated assessment models. These model applications, and the transfer of information between models, must be guided by the state of the science. But the methodology must also account for the specific needs of stakeholders and the intended use of model results beyond pure scientific inquiry, including meeting the requirements of agencies responsible for designing and assessing policies, programs, and regulations. Here we present methodology and results of two climate impacts studies that applied climate model projections from CMIP3 and from the EPA Climate Impacts and Risk Analysis (CIRA) project in a crop model (EPIC - Environmental Policy Indicator Climate) in order to generate estimates of changes in crop productivity for use in an agricultural economic model for the United States (FASOM - Forest and Agricultural Sector Optimization Model). The FASOM model is a forward-looking dynamic model of the US forest and agricultural sector used to assess market responses to changing productivity of alternative land uses. The first study, focused on climate change impacts on the UDSA crop insurance program, was designed to use available daily climate projections from the CMIP3 archive. The decision to focus on daily data for this application limited the climate model and time period selection significantly; however for the intended purpose of assessing impacts on crop insurance payments, consideration of extreme event frequency was critical for assessing periodic crop failures. In a second, coordinated impacts study designed to assess the relative difference in climate impacts under a no-mitigation policy and different future climate mitigation scenarios, the stakeholder specifically requested an assessment of a

  18. The Costs and Benefits of SNOMED CT Implementation: An Economic Assessment Model.

    PubMed

    Thiel, Rainer; Birov, Strahil; Piesche, Klaus; Højen, Anne Randorff; Gøeg, Kirstine Rosenbeck; Dewenter, Heike; Nejad, Reza Fathollah; Thun, Sylvia; Volkert, Pim; Kufrin, Vesna Kronstein; Stroetmann, Veli

    2016-01-01

    As part of its investigations, the EU-funded ASSESS CT project developed an Economic Assessment Model for assessing SNOMED CT's and other terminologies' socio-economic impact in a systematic approach. Methodology and key elements of the model are presented: cost and benefit indicators for assessing deployment, and a cost-benefit analysis tool to collect, estimate, and evaluate data. PMID:27577421

  19. Teaching health assessment in the virtual classroom.

    PubMed

    Lashley, Mary

    2005-08-01

    Health assessment skills are vital to professional nursing practice. Health assessment has traditionally been taught using lecture, teacher-developed tests, practice and live demonstration, and interactive and computer-based learning materials. Rapid advances in information technology during the past decade have greatly expanded distance learning options in higher education. Although much nursing education now uses the Internet, there has been limited use of the Web to teach psychomotor and clinical skills. This article describes how online instruction can be integrated into a health assessment course to teach physical examination skills. The development of instructional videos that can be digitally streamed onto the Web for ready and repeated access can also enhance online learning of technical and clinical skills. Student evaluation of this Web-enhanced course revealed that online assignments enabled them to pace their learning, thereby promoting greater flexibility and independence. Students were able to master the technical skills of working online with minimal difficulty and reported that working online was no more stressful than attending class. The most helpful aspect of the online course was the instructor-developed video that was digitally streamed online. PMID:16130340

  20. Barriers in the mind: promoting an economic case for mental health in low- and middle-income countries

    PubMed Central

    MCDAID, DAVID; KNAPP, MARTIN; RAJA, SHOBA

    2008-01-01

    In recent years, policy makers in high-income countries have placed an increasing emphasis on the value of maintaining good mental health, recognizing the contribution that this makes to quality of life, whilst ever more mindful of the socio-economic consequences of poor mental health. The picture in many other parts of the world is much less encouraging; policy attention and resources are still directed largely at communicable diseases. We reflect on some of the challenges faced in these countries and outline the role that economic evidence could play in strengthening the policy case for investment in mental health. Clearly this should include assessment of the economic impact of strategies implemented outside, as well as within the health sector. The ways in which mental health services are delivered is also of critical importance. Non-governmental organizations (NGOs) have long been shown to be key stakeholders in the funding, coordination and delivery of these services in high-income countries. Their role in low- and middle-income countries, where infrastructure and policy focus on mental health are more limited, can be even more vital in overcoming some of the barriers to the development of mental health policy and practice. PMID:18560485

  1. Human health and wellbeing in environmental impact assessment in New South Wales, Australia: Auditing health impacts within environmental assessments of major projects

    SciTech Connect

    Harris, Patrick J.; Harris, Elizabeth; Thompson, Susan; Harris-Roxas, Ben; Kemp, Lynn

    2009-09-15

    Internationally the inclusion of health within environmental impact assessment (EIA) has been shown to be limited. While Australian EIA documentation has not been studied empirically to date, deficiencies in practice have been documented. This research developed an audit tool to undertake a qualitative descriptive analysis of 22 Major Project EAs in New South Wales, Australia. Results showed that health and wellbeing impacts were not considered explicitly. They were, however, included indirectly in the identification of traditional public health exposures associated with the physical environment and to a lesser extent the inclusion of social and economic impacts. However, no health data was used to inform any of the assessments, there was no reference to causal pathways between exposures or determinants and physical or mental health effects, and there was no inclusion of the differential distribution of exposures or health impacts on different populations. The results add conceptually and practically to the long standing integration debate, showing that health is in a position to add value to the EIA process as an explicit part of standard environmental, social and economic considerations. However, to overcome the consistently documented barriers to integrating health in EIA, capacity must be developed amongst EIA professionals, led by the health sector, to progress health related knowledge and tools.

  2. Time to take health economics seriously-medical education in the United Kingdom.

    PubMed

    Jain, Vageesh

    2016-02-01

    In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. With the National Health Service facing the threat of large gaps in funding, there is pressure on doctors to identify where and how savings can be made. Whilst many may be keen to learn about health economics, the teaching environment and level of student knowledge differs considerably across medical schools in the UK. There is a compelling argument to suggest that key concepts such as economic evaluation, equity and priority-setting should form part of the curriculum in UK medical schools. To address the complex nature of modern health care problems, doctors must have a perspective that combines medical expertise with economic proficiency. PMID:26744143

  3. An assessment of the regional and national socio-economic impacts of the 2007 Rift Valley fever outbreak in Kenya.

    PubMed

    Rich, Karl M; Wanyoike, Francis

    2010-08-01

    Although Rift Valley fever (RVF) has significant impacts on human health and livestock production, it can also induce significant (and often overlooked) economic losses among various stakeholders in the marketing chain. This work assesses and quantifies the multi-dimensional socio-economic impacts of the 2007 RVF outbreak in Kenya based on a rapid assessment of livestock value chains in the northeast part of the country and a national macroeconomic analysis. Although study results show negative impacts among producers in terms of food insecurity and reductions in income, we also found significant losses among other downstream actors in the value chain, including livestock traders, slaughterhouses, casual laborers, and butchers, as well as other, non-agricultural sectors. The study highlights the need for greater sensitivity and analyses that address the multitude of economic losses resulting from an animal disease to better inform policy and decision making during animal health emergencies. PMID:20682906

  4. Technology and economic assessment of lactic acid production and uses

    SciTech Connect

    Datta, R.; Tsai, S.P.

    1996-03-01

    Lactic acid has been an intermediate-volume specialty chemical (world production {approximately}50,000 tons/yr) used in a wide range of food-processing and industrial applications. Potentially, it can become a very large-volume, commodity-chemical intermediate produced from carbohydrates for feedstocks of biodegradable polymers, oxygenated chemicals, environmentally friendly ``green`` solvents, and other intermediates. In the past, efficient and economical technologies for the recovery and purification of lactic acid from fermentation broths and its conversion to the chemical or polymer intermediates had been the key technology impediments and main process cost centers. Development and deployment of novel separations technologies, such as electrodialysis with bipolar membranes, extractive and catalytic distillations, and chemical conversion, can enable low-cost production with continuous processes in large-scale operations. The emerging technologies can use environmentally sound lactic acid processes to produce environmentally useful products, with attractive process economics. These technology advances and recent product and process commercialization strategies are reviewed and assessed.

  5. Compounding conservatisms: EPA's health risk assessment methods

    SciTech Connect

    Stackelberg, K. von; Burmaster, D.E. )

    1993-03-01

    Superfund conjures up images of hazardous waste sites, which EPA is spending billions of dollars to remediate. One of the law's most worrisome effects is that it drains enormous economic resources without returning commensurate benefits. In a Sept. 1, 1991, front page article in The New York Times, experts argued that most health dangers at Superfund sites could be eliminated for a fraction of the billions that will be spent cleaning up the 1,200 high-priority sites across the country. Even EPA has suggested that the Superfund program may receive disproportionate resources, compared with other public health programs, such as radon in houses, the diminishing ozone layer and occupational diseases. Public opinion polls over the last decade consistently have mirrored the public's vast fear of hazardous waste sites, a fear as great as that held for nuclear power plants. Fear notwithstanding, the high cost of chosen remedies at given sites may have less to do with public health goals than with the method EPA uses to translate them into acceptable contaminant concentrations in soil, groundwater and other environmental media.

  6. The October 1973 NASA mission model analysis and economic assessment

    NASA Technical Reports Server (NTRS)

    1974-01-01

    Results are presented of the 1973 NASA Mission Model Analysis. The purpose was to obtain an economic assessment of using the Shuttle to accommodate the payloads and requirements as identified by the NASA Program Offices and the DoD. The 1973 Payload Model represents a baseline candidate set of future payloads which can be used as a reference base for planning purposes. The cost of implementing these payload programs utilizing the capabilities of the shuttle system is analyzed and compared with the cost of conducting the same payload effort using expendable launch vehicles. There is a net benefit of 14.1 billion dollars as a result of using the shuttle during the 12-year period as compared to using an expendable launch vehicle fleet.

  7. Actions to alleviate the mental health impact of the economic crisis

    PubMed Central

    WAHLBECK, KRISTIAN; MCDAID, DAVID

    2012-01-01

    The current global economic crisis is expected to produce adverse mental health effects that may increase suicide and alcohol-related death rates in affected countries. In nations with greater social safety nets, the health impacts of the economic downturn may be less pronounced. Research indicates that the mental health impact of the economic crisis can be offset by various policy measures. This paper aims to outline how countries can safeguard and support mental health in times of economic downturn. It indicates that good mental health cannot be achieved by the health sector alone. The determinants of mental health often lie outside of the remits of the health system, and all sectors of society have to be involved in the promotion of mental health. Accessible and responsive primary care services support people at risk and can prevent mental health consequences. Any austerity measures imposed on mental health services need to be geared to support the modernization of mental health care provision. Social welfare supports and active labour market programmes aiming at helping people retain or re-gain jobs can counteract the mental health effects of the economic crisis. Family support programmes can also make a difference. Alcohol pricing and restrictions of alcohol availability reduce alcohol harms and save lives. Support to tackle unmanageable debt will also help to reduce the mental health impact of the crisis. While the current economic crisis may have a major impact on mental health and increase mortality due to suicides and alcohol-related disorders, it is also a window of opportunity to reform mental health care and promote a mentally healthy lifestyle. PMID:23024664

  8. Public health, climate, and economic impacts of desulfurizing jet fuel.

    PubMed

    Barrett, Steven R H; Yim, Steve H L; Gilmore, Christopher K; Murray, Lee T; Kuhn, Stephen R; Tai, Amos P K; Yantosca, Robert M; Byun, Daewon W; Ngan, Fong; Li, Xiangshang; Levy, Jonathan I; Ashok, Akshay; Koo, Jamin; Wong, Hsin Min; Dessens, Olivier; Balasubramanian, Sathya; Fleming, Gregg G; Pearlson, Matthew N; Wollersheim, Christoph; Malina, Robert; Arunachalam, Saravanan; Binkowski, Francis S; Leibensperger, Eric M; Jacob, Daniel J; Hileman, James I; Waitz, Ian A

    2012-04-17

    In jurisdictions including the US and the EU ground transportation and marine fuels have recently been required to contain lower concentrations of sulfur, which has resulted in reduced atmospheric SO(x) emissions. In contrast, the maximum sulfur content of aviation fuel has remained unchanged at 3000 ppm (although sulfur levels average 600 ppm in practice). We assess the costs and benefits of a potential ultra-low sulfur (15 ppm) jet fuel standard ("ULSJ"). We estimate that global implementation of ULSJ will cost US$1-4bn per year and prevent 900-4000 air quality-related premature mortalities per year. Radiative forcing associated with reduction in atmospheric sulfate, nitrate, and ammonium loading is estimated at +3.4 mW/m(2) (equivalent to about 1/10th of the warming due to CO(2) emissions from aviation) and ULSJ increases life cycle CO(2) emissions by approximately 2%. The public health benefits are dominated by the reduction in cruise SO(x) emissions, so a key uncertainty is the atmospheric modeling of vertical transport of pollution from cruise altitudes to the ground. Comparisons of modeled and measured vertical profiles of CO, PAN, O(3), and (7)Be indicate that this uncertainty is low relative to uncertainties regarding the value of statistical life and the toxicity of fine particulate matter. PMID:22380547

  9. [Indicators to monitor the evolution of the economic crisis and its effects on health and health inequalities. SESPAS report 2014].

    PubMed

    Pérez, Glòria; Rodríguez-Sanz, Maica; Domínguez-Berjón, Felicitas; Cabeza, Elena; Borrell, Carme

    2014-06-01

    The economic crisis has adverse effects on determinants of health and health inequalities. The aim of this article was to present a set of indicators of health and its determinants to monitor the effects of the crisis in Spain. On the basis of the conceptual framework proposed by the Commission for the Reduction of Social Health Inequalities in Spain, we searched for indicators of social, economic, and political (structural and intermediate) determinants of health, as well as for health indicators, bearing in mind the axes of social inequality (gender, age, socioeconomic status, and country of origin). The indicators were mainly obtained from official data sources published on the internet. The selected indicators are periodically updated and are comparable over time and among territories (among autonomous communities and in some cases among European Union countries), and are available for age groups, gender, socio-economic status, and country of origin. However, many of these indicators are not sufficiently reactive to rapid change, which occurs in the economic crisis, and consequently require monitoring over time. Another limitation is the lack of availability of indicators for the various axes of social inequality. In conclusion, the proposed indicators allow for progress in monitoring the effects of the economic crisis on health and health inequalities in Spain. PMID:24864001

  10. Risk assessment and toxicology databases for health effects assessment

    SciTech Connect

    Lu, P.Y.; Wassom, J.S.

    1990-12-31

    Scientific and technological developments bring unprecedented stress to our environment. Society has to predict the results of potential health risks from technologically based actions that may have serious, far-reaching consequences. The potential for error in making such predictions or assessment is great and multiplies with the increasing size and complexity of the problem being studied. Because of this, the availability and use of reliable data is the key to any successful forecasting effort. Scientific research and development generate new data and information. Much of the scientific data being produced daily is stored in computers for subsequent analysis. This situation provides both an invaluable resource and an enormous challenge. With large amounts of government funds being devoted to health and environmental research programs and with maintenance of our living environment at stake, we must make maximum use of the resulting data to forecast and avert catastrophic effects. Along with the readily available. The most efficient means of obtaining the data necessary for assessing the health effects of chemicals is to utilize applications include the toxicology databases and information files developed at ORNL. To make most efficient use of the data/information that has already been prepared, attention and resources should be directed toward projects that meticulously evaluate the available data/information and create specialized peer-reviewed value-added databases. Such projects include the National Library of Medicine`s Hazardous Substances Data Bank, and the U.S. Air Force Installation Restoration Toxicology Guide. These and similar value-added toxicology databases were developed at ORNL and are being maintained and updated. These databases and supporting information files, as well as some data evaluation techniques are discussed in this paper with special focus on how they are used to assess potential health effects of environmental agents. 19 refs., 5 tabs.

  11. [The impact of the economic crisis on health systems of OECD countries].

    PubMed

    Paris, Valérie

    2014-10-01

    This paper describes measures adopted by OECD countries in the health sector in response to the economic crisis which began in 2008: increase and diversification of revenues collected for health, increases in user charges, reductions in staff, salaries and prices of health goods and services; and policies aiming to increase health systems efficiency. It then reviews the impact of these policies on health spending trends. PMID:25311027

  12. Health and economic burden of obesity in elderly individuals with asthma in the United States.

    PubMed

    Shah, Ruchit; Yang, Yi

    2015-06-01

    The health and economic burden of obesity among elderly individuals with asthma has not been adequately studied. This study assessed the association between obesity and asthma among the elderly and examined the impact of obesity on asthma-related and total health care costs among elderly individuals with asthma. This was a retrospective analysis of the 2006-2010 Medical Expenditure Panel Survey (MEPS) data. Individuals aged 65 years or older were included in the study. Individuals with asthma were identified by an International Classification of Diseases, Ninth Revision code of 493 or a Clinical Classification Code of 128. Individuals with a self-reported body mass index ≥ 30 kg/m(2) were considered to be obese. Logistic regression was used to assess the relationship between obesity and asthma. Generalized linear models with gamma distribution and log link were used to assess the relationship between obesity and asthma-related and total direct medical costs. All analyses were conducted while accounting for the complex survey design of MEPS. In all, 675 elderly individuals were identified as having asthma, 292 of whom were obese. Obese elderly individuals were more likely to suffer from asthma as compared to the nonobese (odds ratio, 1.71; 95% confidence interval [CI],1.37-2.12). Obesity was a significant predictor of asthma-related costs (β: 0.537; 95% CI: 0.18-0.89; P= 0.003) and total health care costs (β: 0.154; 95% CI: 0.08-0.23; P = 0.001) among elderly individuals with asthma after controlling for sociodemographics and comorbidities. Appropriate weight management measures should be recommended to obese elderly individuals with asthma to improve asthma control and reduce health care costs. PMID:25291085

  13. Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.

    PubMed

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country. PMID:24688306

  14. Skin Testing for Allergic Rhinitis: A Health Technology Assessment

    PubMed Central

    2016-01-01

    Background Allergic rhinitis is the most common type of allergy worldwide. The accuracy of skin testing for allergic rhinitis is still debated. This health technology assessment had two objectives: to determine the diagnostic accuracy of skin-prick and intradermal testing in patients with suspected allergic rhinitis and to estimate the costs to the Ontario health system of skin testing for allergic rhinitis. Methods We searched All Ovid MEDLINE, Embase, and Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, CRD Health Technology Assessment Database, Cochrane Central Register of Controlled Trials, and NHS Economic Evaluation Database for studies that evaluated the diagnostic accuracy of skin-prick and intradermal testing for allergic rhinitis using nasal provocation as the reference standard. For the clinical evidence review, data extraction and quality assessment were performed using the QUADAS-2 tool. We used the bivariate random-effects model for meta-analysis. For the economic evidence review, we assessed studies using a modified checklist developed by the (United Kingdom) National Institute for Health and Care Excellence. We estimated the annual cost of skin testing for allergic rhinitis in Ontario for 2015 to 2017 using provincial data on testing volumes and costs. Results We meta-analyzed seven studies with a total of 430 patients that assessed the accuracy of skin-prick testing. The pooled pair of sensitivity and specificity for skin-prick testing was 85% and 77%, respectively. We did not perform a meta-analysis for the diagnostic accuracy of intradermal testing due to the small number of studies (n = 4). Of these, two evaluated the accuracy of intradermal testing in confirming negative skin-prick testing results, with sensitivity ranging from 27% to 50% and specificity ranging from 60% to 100%. The other two studies evaluated the accuracy of intradermal testing as a stand-alone tool for diagnosing allergic rhinitis, with

  15. Systematic Review of Health Economic Analyses of Measles and Rubella Immunization Interventions.

    PubMed

    Thompson, Kimberly M; Odahowski, Cassie L

    2016-07-01

    Economic analyses for vaccine-preventable diseases provide important insights about the value of prevention. We reviewed the literature to identify all of the peer-reviewed, published economic analyses of interventions related to measles and rubella immunization options to assess the different types of analyses performed and characterize key insights. We searched PubMed, the Science Citation Index, and references from relevant articles for studies in English and found 67 analyses that reported primary data and quantitative estimates of benefit-cost or cost-effectiveness analyses for measles and/or rubella immunization interventions. We removed studies that we characterized as cost-minimization analyses from this sample because they generally provide insights that focused on more optimal strategies to achieve the same health outcome. The 67 analyses we included demonstrate the large economic benefits associated with preventing measles and rubella infections using vaccines and the benefit of combining measles and rubella antigens into a formulation that saves the costs associated with injecting the vaccines separately. Despite the importance of population immunity and dynamic viral transmission, most of the analyses used static models to estimate cases prevented and characterize benefits, although the use of dynamic models continues to increase. Many of the analyses focused on characterizing the most significant adverse outcomes (e.g., mortality for measles, congenital rubella syndrome for rubella) and/or only direct costs, and the most complete analyses present data from high-income countries. PMID:25545778

  16. [Justice in health care systems from an economic perspective].

    PubMed

    Schreyögg, J

    2004-01-01

    Due to rising health care expenditures international comparisons of health care systems are recently gaining more importance. These benchmarks can provide interesting information for improving health care systems. Many of these comparisons implicitly assume that countries have a universal understanding of justice. But this assumption is rather questionable. With regard to the existing cultural differences in the understanding of justice the transferability of elements of health care systems is not always assured. A transfer usually requires a thorough examination of the judicial systems in each country. This article analyses the influence of different judicial systems applying to health care. In this context theories of justice by Rawls, Nozick and Confucius representing the possible understanding of justice in different cultures are described and analysed with regards to their influence on health care systems. The example of financing health care shows that the three theories of justice have very different consequences for designing health care systems especially concerning the role of governments. PMID:14767785

  17. Using rangeland health assessment to inform successional management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rangeland health assessment provides qualitative information on ecosystem attributes. Successional management is a conceptual framework that allows managers to link information gathered in rangeland health assessment to ecological processes that need to be repaired to allow vegetation to change in ...

  18. The Bangladesh paradox: exceptional health achievement despite economic poverty.

    PubMed

    Chowdhury, A Mushtaque R; Bhuiya, Abbas; Chowdhury, Mahbub Elahi; Rasheed, Sabrina; Hussain, Zakir; Chen, Lincoln C

    2013-11-23

    Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health--ie, positives such as women's empowerment, widespread education, and mitigation of the effect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints. PMID:24268002

  19. 75 FR 62762 - Proposed Information Collection; Comment Request; Socio-Economic Assessment of Snapper Grouper...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ...-Economic Assessment of Snapper Grouper Fisheries in the U.S. Caribbean AGENCY: National Oceanic and... demographic, cultural, economic, and social information about the snapper-grouper fisheries in the...

  20. More Health Expenditure, Better Economic Performance? Empirical Evidence From OECD Countries.

    PubMed

    Wang, Fuhmei

    2015-01-01

    Recent economic downturns have led many countries to reduce health spending dramatically, with the World Health Organization raising concerns over the effects of this, in particular among the poor and vulnerable. With the provision of appropriate health care, the population of a country could have better health, thus strengthening the nation's human capital, which could contribute to economic growth through improved productivity. How much should countries spend on health care? This study aims to estimate the optimal health care expenditure in a growing economy. Applying the experiences of countries from the Organization for Economic Co-Operation and Development (OECD) over the period 1990 to 2009, this research introduces the method of system generalized method of moments (GMM) to derive the design of the estimators of the focal variables. Empirical evidence indicates that when the ratio of health spending to gross domestic product (GDP) is less than the optimal level of 7.55%, increases in health spending effectively lead to better economic performance. Above this, more spending does not equate to better care. The real level of health spending in OECD countries is 5.48% of GDP, with a 1.87% economic growth rate. The question which is posed by this study is a pertinent one, especially in the current context of financially constrained health systems around the world. The analytical results of this work will allow policymakers to better allocate scarce resources to achieve their macroeconomic goals. PMID:26310501

  1. Life Course Pathways of Economic Hardship and Mobility and Midlife Trajectories of Health.

    PubMed

    Willson, Andrea E; Shuey, Kim M

    2016-09-01

    We utilize over 40 years of prospective data from the Panel Study of Income Dynamics (N = 1,229) and repeated-measures latent class analysis to examine how long-term patterns of stability and change in economic hardship from childhood to adulthood are related to subsequent trajectories of midlife health. We review conceptual and methodological approaches to examining health inequality across the life course and highlight the contribution of a person-centered, disaggregated approach to modeling health and its association with long-term pathways of economic resources, including changing resources associated with mobility. Findings suggest those who experienced early mobility out of economic hardship were less likely than those in persistent economic hardship to experience a high-risk health trajectory, while experiencing later mobility did not lessen this risk. We conclude with a call for further investigation into the role of social mobility and the timing, degree, and direction of change in investigations of health inequality. PMID:27601413

  2. Applying Behavioral Economics to Public Health Policy: Illustrative Examples and Promising Directions.

    PubMed

    Matjasko, Jennifer L; Cawley, John H; Baker-Goering, Madeleine M; Yokum, David V

    2016-05-01

    Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

  3. Stateline: Link Investment in Education to Economic Health

    ERIC Educational Resources Information Center

    Christie, Kathy

    2008-01-01

    In contrast to much of this year's frightening economic news, many states are investing in initiatives to strengthen local economies. This article describes how several states are improving education and training so they match business needs and the labor pool.

  4. Prioritizing Health: A Systematic Approach to Scoping Determinants in Health Impact Assessment

    PubMed Central

    McCallum, Lindsay C.; Ollson, Christopher A.; Stefanovic, Ingrid L.

    2016-01-01

    The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of health impact assessment (HIA), the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical) for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted, including both primary and gray literature. A total of 10 HIA scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors, such as impact, public concern, and data availability, to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool. PMID:27597937

  5. Prioritizing Health: A Systematic Approach to Scoping Determinants in Health Impact Assessment.

    PubMed

    McCallum, Lindsay C; Ollson, Christopher A; Stefanovic, Ingrid L

    2016-01-01

    The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of health impact assessment (HIA), the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical) for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted, including both primary and gray literature. A total of 10 HIA scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors, such as impact, public concern, and data availability, to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool. PMID:27597937

  6. [Forest health ecological risk assessment in China].

    PubMed

    Xiao, Fengjin; Ouyang, Hua; Cheng, Shulan; Zhang, Qiang

    2004-02-01

    Forest health ecological risk assessment is an important factor in forest resources management. In this paper, we selected forest fire, forest disease-pest disasters and acid rain as main risk sources, described the risk resources by probability, intensity and distributing, and mapped each risk source. The endpoints were the damages that the risk acceptor might and these damages might cause ecosystems' organization and function changing under the uncertainty risk sources. Endpoints of forest might compose of productivity descent, reducing biodiversity, forest degrading, forest ecological function declining, furthermore, forest disappearing. We described exposure in terms of intensity, space, and time. In the exposure and hazard analysis, we used fragile index to show frangibility or resistibility (resistibility is reverse to frangibility), and analyzed the damages by different risk sources. Risk assessment and management was the integrated phase of the research. Because of the spatial heterogeneity of risk sources, all risk index were overlaid in the China map by GIS, which divided the region into 30 ecological risk sub-zones (provinces), according to risk index of each risk sub-zone, and the forest in China was divided into six levels of risk zones. In every level of risk zones, we also put forward the countermeasures for forest health ecological risk management. The result of assessment could provide scientific basis for forest management. PMID:15146655

  7. Bridge health assessment system with fatigue analysis algorithm

    NASA Astrophysics Data System (ADS)

    Wang, Xuan; Wang, M. L.; Zhao, Yang

    2005-05-01

    A modern bridge is such a complicated system that is difficult to analyze by conventional mathematic tools. A rational bridge monitoring requires a good knowledge of the actual condition of various structural components. Fatigue analysis of concrete bridges is one of the most important problems. Concrete bridges are often undergoing a fatigue deterioration, starting with cracking and ending with large holes through the web. There is a need for the development of efficient health assessment system for fatigue evaluation and prediction of the remaining life. This information has clear economical consequences, as deficient bridges must be repaired or closed. The goal of this research is to provide a practical expert system in bridge health evaluation and improve the understanding of bridge behavior during their service. Efforts to develop a functional bridge monitoring system have mainly been concentrated upon successful implementation of experienced-based machine learning. The reliability of the techniques adopted for damage assessment is also important for bridge monitoring systems. By applying the system to an in-service PC bridge, it has been verified that this fuzzy logic expert system is effective and reliable for the bridge health evaluation.

  8. Health Impact Assessment of Urban Waterway Decisions

    PubMed Central

    Korfmacher, Katrina Smith; Aviles, Katia; Cummings, B.J.; Daniell, William; Erdmann, Jared; Garrison, Valerie

    2014-01-01

    Health impact assessments (HIA) promote the consideration of health in a wide range of public decisions. Although each HIA is different, common pathways, evidence bases, and strategies for community engagement tend to emerge in certain sectors, such as urban redevelopment, natural resource extraction, or transportation planning. To date, a limited number of HIAs have been conducted on decisions affecting water resources and waterfronts. This review presents four recent HIAs of water-related decisions in the United States and Puerto Rico. Although the four cases are topically and geographically diverse, several common themes emerged from the consideration of health in water-related decisions. Water resource decisions are characterized by multiple competing uses, inter-institutional and inter-jurisdictional complexity, scientific uncertainty, long time scales for environmental change, diverse cultural and historical human values, and tradeoffs between private use and public access. These four case studies reveal challenges and opportunities of examining waterfront decisions through a “health lens”. This review analyzes these cases, common themes, and lessons learned for the future practice of HIA in the waterfront zone and beyond. PMID:25547399

  9. INTELLIGENCE AND TRANSPARENCY IN HEALTH TECHNOLOGY ASSESSMENT.

    PubMed

    Richardson, Henry S

    2016-01-01

    Current thinking about the methodology of health technology assessment (HTA) seems to be dominated by two fundamental tensions: [1] between maintaining a tight focus on quality-adjusted life-years and broadening its concern out to pay attention to a broader range of factors, and [2] between thinking of the evaluative dimensions that matter as being objectively important factors or as ones that are ultimately of merely subjective importance. In this study, I will argue that health is a tremendously important all-purpose means to enjoying basic human capabilities, but a mere means, and not an end. The ends to which health is a means are manifold, requiring all those engaged in policy making to exercise intelligence in a continuing effort to identify them and to think through how they interrelate. Retreating to the subjective here would be at odds with the basic idea of HTA, which is to focus on certain objectively describable dimensions of what matters about health and to collect empirical evidence rigorously bearing on what produces improvements along those dimensions. To proceed intelligently in doing HTA, it is important to stay open to reframing and refashioning the ends we take to apply to that arena. The only way for that to happen, as an exercise of public, democratic policy making, is for the difficult value questions that arise when ends clash not to be buried in subjective preference information, but to be front-and-center in the analysis. PMID:26956573

  10. Reflections on the development of health economics in low- and middle-income countries

    PubMed Central

    Mills, Anne

    2014-01-01

    Health economics is a relatively new discipline, though its antecedents can be traced back to William Petty FRS (1623–1687). In high-income countries, the academic discipline and scientific literature have grown rapidly since the 1960s. In low- and middle-income countries, the growth of health economics has been strongly influenced by trends in health policy, especially among the international and bilateral agencies involved in supporting health sector development. Valuable and influential research has been done in areas such as cost–benefit and cost-effectiveness analysis, financing of healthcare, healthcare provision, and health systems analysis, but there has been insufficient questioning of the relevance of theories and policy recommendations in the rich world literature to the circumstances of poorer countries. Characteristics such as a country's economic structure, strength of political and social institutions, management capacity, and dependence on external agencies, mean that theories and models cannot necessarily be transferred between settings. Recent innovations in the health economics literature on low- and middle-income countries indicate how health economics can be shaped to provide more relevant advice for policy. For this to be taken further, it is critical that such countries develop stronger capacity for health economics within their universities and research institutes, with greater local commitment of funding. PMID:25009059

  11. Assessing Hmong farmers' safety and health.

    PubMed

    de Castro, A B; Krenz, Jennifer; Neitzel, Richard L

    2014-05-01

    This pilot project investigated agricultural-related safety and health issues among Hmong refugees working on family-operated farms. Novel approaches, namely participatory rural appraisal and photovoice, were used to conduct a qualitative occupational hazard assessment with a group of Hmong farmers in Washington State. These two methods were useful in gathering participants' own perspectives about priority concerns. Several identified problems were related to musculoskeletal disorders, handling and operating heavy machinery, heat and cold stress, respiratory exposures, pest management, and socioeconomic and language concerns. Findings from this study provide insight into the work-related challenges that Hmong refugee farmers encounter and can serve as a basis for occupational health professionals to develop interventions to assist this underserved group. PMID:24806037

  12. Assessing Hmong Farmers’ Safety and Health

    PubMed Central

    de Castro, A. B.; Krenz, Jennifer; Neitzel, Richard L.

    2014-01-01

    This pilot project investigated agricultural-related safety and health issues among Hmong refugees working on family-operated farms. Novel approaches, namely participatory rural appraisal and photovoice, were used to conduct a qualitative occupational hazard assessment with a group of Hmong farmers in Washington State. These two methods were useful in gathering participants’ own perspectives about priority concerns. Several identified problems were related to musculoskeletal disorders, handling and operating heavy machinery, heat and cold stress, respiratory exposures, pest management, and socioeconomic and language concerns. Findings from this study provide insight into the work-related challenges that Hmong refugee farmers encounter and can serve as a basis for occupational health professionals to develop interventions to assist this underserved group. PMID:24806037

  13. Predictors of Self-Assessed Health among Elderly Post Hospitalization.

    ERIC Educational Resources Information Center

    Lurie, Elinore; And Others

    Self-assessment of health incorporates both objective and subjective elements into a general state with implications for health-related behavior. To examine the predictors of self-assessed health in an elderly, post-hospitalization population, 73 adults, 65 years of age or older, were asked to assess the status of the condition for which they were…

  14. Assessing Psychological Health: The Contribution of Psychological Strengths

    ERIC Educational Resources Information Center

    Macaskill, Ann; Denovan, Andrew

    2014-01-01

    Balanced assessment of mental health involves assessing well-being and strengths as well as psychopathology. The character strengths of curiosity, gratitude, hope, optimism and forgiveness are assessed in 214 new undergraduates and their relationships to mental health, subjective well-being and self-esteem explored. Scoring the mental health scale…

  15. A behavioral economic approach to assessing demand for marijuana.

    PubMed

    Collins, R Lorraine; Vincent, Paula C; Yu, Jihnhee; Liu, Liu; Epstein, Leonard H

    2014-06-01

    In the United States, marijuana is the most commonly used illicit drug. Its prevalence is growing, particularly among young adults. Behavioral economic indices of the relative reinforcing efficacy (RRE) of substances have been used to examine the appeal of licit (e.g., alcohol) and illicit (e.g., heroin) drugs. The present study is the first to use an experimental, simulated purchasing task to examine the RRE of marijuana. Young-adult (M age = 21.64 years) recreational marijuana users (N = 59) completed a computerized marijuana purchasing task designed to generate demand curves and the related RRE indices (e.g., intensity of demand-purchases at lowest price; Omax-max. spent on marijuana; Pmax-price at which marijuana expenditure is max). Participants "purchased" high-grade marijuana across 16 escalating prices that ranged from $0/free to $160/joint. They also provided 2 weeks of real-time, ecological momentary assessment reports on their marijuana use. The purchasing task generated multiple RRE indices. Consistent with research on other substances, the demand for marijuana was inelastic at lower prices but became elastic at higher prices, suggesting that increases in the price of marijuana could lessen its use. In regression analyses, the intensity of demand, Omax, and Pmax, and elasticity each accounted for significant variance in real-time marijuana use. These results provide support for the validity of a simulated marijuana purchasing task to examine marijuana's reinforcing efficacy. This study highlights the value of applying a behavioral economic framework to young-adult marijuana use and has implications for prevention, treatment, and policies to regulate marijuana use. PMID:24467370

  16. Advancing Efforts to Achieve Health Equity: Equity Metrics for Health Impact Assessment Practice

    PubMed Central

    Heller, Jonathan; Givens, Marjory L.; Yuen, Tina K.; Gould, Solange; Benkhalti Jandu, Maria; Bourcier, Emily; Choi, Tim

    2014-01-01

    Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric. PMID:25347193

  17. Environmental, health and safety assessment of photovoltaics

    NASA Technical Reports Server (NTRS)

    Rose, E. C.

    1983-01-01

    The environmental, health, and safety (E, H and S) concerns associated with the fabrication, deployment, and decommissioning of photovoltaic (PV) systems in terrestial applications are identified and assessed. Discussion is limited to crystalline silicon technologies. The primary E, H, and S concerns that arise during collector fabrication are associated with occupational exposure to materials of undetermined toxicity or to materials that are known to be hazardous, but for which process control technology may be inadequate. Stricter exposure standards are anticipated for some materials and may indicate a need for further control technology development. Minimizing electric shock hazards is a significant concern during system construction, operation and maintenance, and decommissioning.

  18. Awareness and Performance of Iranian Nurses with Regard to Health Economics: A Cross-Sectional Study

    PubMed Central

    Heydari, Abbas; Mazloom, Reza; Najar, Ali Vafaee; Bakhshi, Mahmoud

    2015-01-01

    Background: Health costs have risen everywhere, worldwide, and nurses play a pivotal role in cost savings and in contributing to the financial stability of hospitals. Aim: This study evaluated the awareness and performance of Iranian nursing staff, with regard to health economics. Materials and Methods: A total of 175 nurses who worked in three teaching hospitals in Mashhad (Iran) were selected for this descriptive cross-sectional study, and data were gathered via a 27-item questionnaire. Statistical analysis was performed using one-way analysis of variance, multiple regression analysis, and Pearson's correlation coefficient. Results: A total of 78% (n = 39) of nurses did not have a good awareness of health economics. The overall mean score for economic awareness was 5.9 ± 2.1 (possible range, 0-16), and for economic performance was 26.6 ± 4 (possible range, 0-44). There was a significant relationship between the economic awareness and performance of nurses, and nurses in higher positions had a greater awareness of health economics. Conclusions: Considering the inadequacy of the health economics awareness and performance of nurses, it is essential that efforts are made to enhance their knowledge and behavior with regard to economic issues and cost saving in all the fields of nursing, through the use of continuing education courses and workshops. PMID:26605201

  19. Mobile technology for mental health assessment

    PubMed Central

    Areàn, Patricia A.; Hoa Ly, Kien; Andersson, Gerhard

    2016-01-01

    Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional assessment and provide information about patient symptoms, behavior, and functioning in real time. Although the use of sensors and apps are widespread, several questions remain in the field regarding the reliability of off-the-shelf apps and sensors, use of these tools by consumers, and provider use of these data in clinical decision-making. PMID:27489456

  20. Mobile technology for mental health assessment.

    PubMed

    Areàn, Patricia A; Hoa Ly, Kien; Andersson, Gerhard

    2016-06-01

    Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional assessment and provide information about patient symptoms, behavior, and functioning in real time. Although the use of sensors and apps are widespread, several questions remain in the field regarding the reliability of off-the-shelf apps and sensors, use of these tools by consumers, and provider use of these data in clinical decision-making. PMID:27489456

  1. Economic Assessment of Zoonotic Diseases: An Illustrative Study of Rift Valley Fever in the United States.

    PubMed

    Pendell, D L; Lusk, J L; Marsh, T L; Coble, K H; Szmania, S C

    2016-04-01

    This study evaluates the economic consequences of a Rift Valley Fever outbreak, a virus that spreads from livestock to humans, often through mosquitoes. Developing a 'one health' economic framework, economic impacts on agricultural producers and consumers, government costs of response, costs and disruptions to non-agricultural activities in the epidemiologically impacted region, and human health costs (morbidity and mortality) are estimated. We find the agricultural firms bear most of the negative economic impacts, followed by regional non-agricultural firms, human health and government. Further, consumers of agricultural products benefit from small outbreaks due to bans on agricultural exports. PMID:25052324

  2. Health economic burden that wounds impose on the National Health Service in the UK

    PubMed Central

    Guest, Julian F; Ayoub, Nadia; McIlwraith, Tracey; Uchegbu, Ijeoma; Gerrish, Alyson; Weidlich, Diana; Vowden, Kathryn; Vowden, Peter

    2015-01-01

    Objective To estimate the prevalence of wounds managed by the UK's National Health Service (NHS) in 2012/2013 and the annual levels of healthcare resource use attributable to their management and corresponding costs. Methods This was a retrospective cohort analysis of the records of patients in The Health Improvement Network (THIN) Database. Records of 1000 adult patients who had a wound in 2012/2013 (cases) were randomly selected and matched with 1000 patients with no history of a wound (controls). Patients’ characteristics, wound-related health outcomes and all healthcare resource use were quantified and the total NHS cost of patient management was estimated at 2013/2014 prices. Results Patients’ mean age was 69.0 years and 45% were male. 76% of patients presented with a new wound in the study year and 61% of wounds healed during the study year. Nutritional deficiency (OR 0.53; p<0.001) and diabetes (OR 0.65; p<0.001) were independent risk factors for non-healing. There were an estimated 2.2 million wounds managed by the NHS in 2012/2013. Annual levels of resource use attributable to managing these wounds and associated comorbidities included 18.6 million practice nurse visits, 10.9 million community nurse visits, 7.7 million GP visits and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds and associated comorbidities was £5.3 billion. This was reduced to between £5.1 and £4.5 billion after adjusting for comorbidities. Conclusions Real world evidence highlights wound management is predominantly a nurse-led discipline. Approximately 30% of wounds lacked a differential diagnosis, indicative of practical difficulties experienced by non-specialist clinicians. Wounds impose a substantial health economic burden on the UK's NHS, comparable to that of managing obesity (£5.0 billion). Clinical and economic benefits could accrue from improved systems of care and an increased awareness of the impact that wounds impose on patients

  3. The economic consequences of health shocks: evidence from Vietnam.

    PubMed

    Wagstaff, Adam

    2007-01-01

    This paper finds that the incomes of urban households are more vulnerable to health shocks than rural households, that health shocks may precipitate increases in unearned income that partially offset reductions in earned income and large increases in medical spending even among insured households. It also finds that households spend less on food following a health shock, but more on budget items such as housing and electricity. Measures of household health shocks used include a recent death of a working-age household member, a long inpatient spell, and a recent sizeable drop in the body mass index of the household head. PMID:16905205

  4. Health care: economic impact of caring for geriatric patients.

    PubMed

    Rich, Preston B; Adams, Sasha D

    2015-02-01

    National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. PMID:25459539

  5. Health, Economic Resources and the Work Decisions of Older Men

    PubMed Central

    Bound, John; Stinebrickner, Todd; Waidmann, Timothy

    2016-01-01

    We specify a dynamic programming model that addresses the interplay among health, financial resources, and the labor market behavior of men late in their working lives. We model health as a latent variable, for which self reported disability status is an indicator, and allow self-reported disability to be endogenous to labor market behavior. We use panel data from the Health and Retirement Study. While we find large impacts of health on behavior, they are substantially smaller than in models that treat self-reports as exogenous. We also simulate the impacts of several potential reforms to the Social Security program. PMID:27158180

  6. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: JOURNAL ARTICLE

    EPA Science Inventory

    NRMRL-CIN-1351 Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. Risk Analysis 600/R/01/104, Available: on internet, www.epa.gov/ORD/NRMRL/Pubs/600R01104, [NET]. 03/07/2001 D...

  7. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: PUBLISHED REPORT

    EPA Science Inventory

    NRMRL-CIN-1351A Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. EPA/600/R-01/104 (NTIS PB2002-102119). Decision makers using environmental decision support tools are often ...

  8. Economic Benefits of Investing in Women’s Health: A Systematic Review

    PubMed Central

    Bloom, David E.

    2016-01-01

    Background Globally, the status of women’s health falls short of its potential. In addition to the deleterious ethical and human rights implications of this deficit, the negative economic impact may also be consequential, but these mechanisms are poorly understood. Building on the literature that highlights health as a driver of economic growth and poverty alleviation, we aim to systematically investigate the broader economic benefits of investing in women’s health. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we systematically reviewed health, gender, and economic literature to identify studies that investigate the impact of women’s health on micro- and macroeconomic outcomes. We developed an extensive search algorithm and conducted searches using 10 unique databases spanning the timeframe 01/01/1970 to 01/04/2013. Articles were included if they reported on economic impacts stemming from changes in women’s health (table of outcome measures included in full review, Table 1). In total, the two lead investigators independently screened 20,832 abstracts and extracted 438 records for full text review. The final review reflects the inclusion of 124 articles. Results The existing literature indicates that healthier women and their children contribute to more productive and better-educated societies. This study documents an extensive literature confirming that women’s health is tied to long-term productivity: the development and economic performance of nations depends, in part, upon how each country protects and promotes the health of women. Providing opportunities for deliberate family planning; healthy mothers before, during, and after childbirth, and the health and productivity of subsequent generations can catalyze a cycle of positive societal development. Conclusions This review highlights the untapped potential of initiatives that aim to address women’s health. Societies that prioritize women

  9. [Economic assessment, a field between clinical research and observational studies].

    PubMed

    Launois, Robert

    2003-01-01

    Health technology assessments propose to study the differential impact of health interventions in a complex care system which is characterised by the multitude of individual behaviours and the diverse nature of the institutions involved. Current systems for data collection lend themselves poorly to this rigorous analysis of efficacy of treatments in the actual situations where they are used. Randomised trials endeavour to neutralise any parasitic interference which could compromise testing for a causal relationship between the treatment administered and the result obtained. Their methodology which establishes the term ceteris paribus in the principle of good practice lends itself poorly to an analysis of individual behaviour. Observational studies are start from actual treatment situations to describe them as reliably as possible. By definition, however, these assume that the natural course of events is not deviated by any intervention. The absence of an experimental plan increases the likelihood of bias and makes it more difficult to test for causal relationships. They lend themselves poorly to testing for incremental efficacy. The two instruments to be preferred are decisional analysis and quasi-experimental studies. Decisional analysis help to avoid the problems of external validity associated with randomised clinical trials by associating parameters which are extracted from data obtained from everyday practice. Quasi-experimental studies or pragmatic trials are based on the reality of behaviour of the prescriber and his/her patients; their impact on efficacy, quality of life social costs of the disease and of treatments may be identified under normal conditions of use. PMID:12609811

  10. Gender & Economic Status Matter in Mental Health of Adolescents?

    ERIC Educational Resources Information Center

    Sharma, Namita; Dua, Radha

    2011-01-01

    Mental health is the ability to adjust oneself satisfactorily to the various strains of life. Mental health and Education are closely related to each other. Sound mental is prerequisite for the learner. In this era of severe competition to excel or to be on the top is pressurizing today's adolescents to the utmost. Besides a number of factors like…

  11. Mexico: The Socio-Economic and Cultural Environment for Health.

    ERIC Educational Resources Information Center

    Stambler, Moses

    Numerous factors influencing health status and health care in Mexico are reviewed in this paper. Part I covers socioeconomic influences including agricultural and land tenure patterns, oil production, population growth rate, and the extent of poverty. Part II discusses the political environment, emphasizing the effects of politics on strategies…

  12. Economic Effects of Legislations and Policies to Expand Mental Health and Substance Abuse Benefits in Health Insurance Plans: A Community Guide Systematic Review

    PubMed Central

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A.; Goetzel, Ron Z.; Finnie, Ramona; Thota, Anilkrishna B.

    2015-01-01

    Background Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. Aims of the Study This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. Methods The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. Results The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. Discussion and Limitations This review is unable to determine the overall economic value of policies that expand MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when

  13. Economic adjustment and the future of health services in the Third World.

    PubMed

    Ruderman, A P

    1990-01-01

    Hard economic times in the Third World in the 1980s found many countries unable to maintain previous levels of health and social services in the face of the mounting service cost of their external debt and declining export earnings. The economic adjustment policies promoted by the World Bank and International Monetary Fund on the basis of market ideology were not able alone to improve the economic status of the debtor countries and did have deleterious effects on their health services and the health status of their population. Less pressure to privatize health services, more aid from abroad for the public sector, and a reallocation of scarce government resources from military to social purposes would help to rectify the situation, although sustained long-run improvement would still depend on the external factors that determine economic prosperity, and the prognosis in this respect is uncertain. PMID:2289958

  14. Expanding the frame of understanding health disparities: from a focus on health systems to social and economic systems.

    PubMed

    Smedley, Brian D

    2006-08-01

    Policy makers are increasingly attending to the problem of racial and ethnic health disparities, but much of this focus has been on evidence of inequality in health care systems. This attention is important and laudable, but eliminating inequality in the health care system would be insufficient to eliminate racial and ethnic disparities and improve the health of all Americans. Social and economic factors, such as disadvantaged socioeconomic status, racism, discrimination, and geographic inequality shape virtually all risks for poor health. Interventions that focus solely on improving access to health care, or on reducing individual behavioral and psychosocial risks, therefore have limited potential to reduce racial and ethnic health disparities. The elimination of health disparities requires comprehensive, intensive strategies that address inequality in many sectors, including housing, education, employment, and health systems. These interventions must be targeted at many levels, including individuals and families, workplaces, schools, and communities. PMID:16878351

  15. Economic assessment of advanced flue gas desulfurization processes. Final report

    SciTech Connect

    Bierman, G. R.; May, E. H.; Mirabelli, R. E.; Pow, C. N.; Scardino, C.; Wan, E. I.

    1981-09-01

    This report presents the results of a project sponsored by the Morgantown Energy Technology Center (METC). The purpose of the study was to perform an economic and market assessment of advanced flue gas desulfurization (FGD) processes for application to coal-fired electric utility plants. The time period considered in the study is 1981 through 1990, and costs are reported in 1980 dollars. The task was divided into the following four subtasks: (1) determine the factors affecting FGD cost evaluations; (2) select FGD processes to be cost-analyzed; (3) define the future electric utility FGD system market; and (4) perform cost analyses for the selected FGD processes. The study was initiated in September 1979, and separate reports were prepared for the first two subtasks. The results of the latter two subtasks appear only in this final reprot, since the end-date of those subtasks coincided with the end-date of the overall task. The Subtask 1 report, Criteria and Methods for Performing FGD Cost Evaluations, was completed in October 1980. A slightly modified and condensed version of that report appears as appendix B to this report. The Subtask 2 report, FGD Candidate Process Selection, was completed in January 1981, and the principal outputs of that subtask appear in Appendices C and D to this report.

  16. Delivery of primary health care to persons who are socio-economically disadvantaged: does the organizational delivery model matter?

    PubMed Central

    2013-01-01

    Background As health systems evolve, it is essential to evaluate their impact on the delivery of health services to socially disadvantaged populations. We evaluated the delivery of primary health services for different socio-economic groups and assessed the performance of different organizational models in terms of equality of health care delivery in Ontario, Canada. Methods Cross sectional study of 5,361 patients receiving care from primary care practices using Capitation, Salaried or Fee-For-Service remuneration models. We assessed self-reported health status of patients, visit duration, number of visits per year, quality of health service delivery, and quality of health promotion. We used multi-level regressions to study service delivery across socio-economic groups and within each delivery model. Identified disparities were further analysed using a t-test to determine the impact of service delivery model on equity. Results Low income individuals were more likely to be women, unemployed, recent immigrants, and in poorer health. These individuals were overrepresented in the Salaried model, reported more visits/year across all models, and tended to report longer visits in the Salaried model. Measures of primary care services generally did not differ significantly between low and higher income/education individuals; when they did, the difference favoured better service delivery for at-risk groups. At-risk patients in the Salaried model were somewhat more likely to report health promotion activities than patients from Capitation and Fee-For-Service models. At-risk patients from Capitation models reported a smaller increase in the number of additional clinic visits/year than Fee-For-Service and Salaried models. At-risk patients reported better first contact accessibility than their non-at-risk counterparts in the Fee-For-Service model only. Conclusions Primary care service measures did not differ significantly across socio-economic status or primary care delivery

  17. [Developing and applying the Payback Framework to assess the socioeconomic impact of health research].

    PubMed

    Buxton, Martin J; Hanney, Steve

    2008-12-01

    There is increasing pressure for assessments of the wider socioeconomic impacts of health research. Governments are making greater demands to justify the expenditure of public money. However, there is also a belief that assessing how the wider effects or benefits of health research arise should help to inform the management and organization of health research so as to increase future impacts. Since the mid- 1990s, Buxton and Hanney at the Health Economics Research Group, Brunel University, have been developing and applying the Payback Framework to assess the impacts of health research. Together with their colleagues, these researchers have applied this model in a series of studies to assess the payback from research programs in various fields (including diabetes, arthritis and cardiovascular disease) and in various countries (including the United Kingdom, The Netherlands, Ireland, Australia and Canada). Other teams of researchers have applied the Payback Framework in, for example, Spain and Hong Kong. The Payback Framework consists of two elements, the first being the multi-dimensional categorization of the benefits of health research, which covers five main categories ranging from traditional knowledge production and research training and targeting, to impacts on policy and product development through to health and economic gains. The second element is a logic model of how best to assess these impacts. Application of this framework can be resource intensive, but has provided illustrative 'good news' stories on the payback resulting from research and has helped to inform research management. PMID:19631821

  18. [The effects of economic crises on health care].

    PubMed

    Chang, Nai-Hsin; Huang, Chiu-Ling; Yang, Yu-O

    2010-08-01

    In September 2008, financial turmoil on Wall Street led to severe losses in that country's financial derivatives market and plunged the United States into the most severe financial crisis in over a decade. The backlash of this "financial tsunami" has affected countries around the world. The world economy, facing the most critical financial crisis since the 1930s, must deal with recession, severe unemployment and general fears of worse to come, which have, in turn, spawned a range of physical, psychological and spiritual problems. In this article we study the effects of the economic crisis on healthcare from several angles, including: decreasing incomes causing changing attitudes toward seeking healthcare; decreasing numbers of people covered by medical insurance; increasing impact on the job market of untreated illnesses; changing national healthcare policies in response to economic pressures; increasing physical, psychological and social problems resulting from economic problems; and the need for the nursing profession to respond to these and other rapid changes in the healthcare landscape. Nursing staff are sometimes unaware of social problems outside their profession. This article may, therefore, provide a general reference to medical and nursing staff on the effects of the economic crisis on healthcare. PMID:20661861

  19. Health economics research into supporting carers of people with dementia: A systematic review of outcome measures

    PubMed Central

    2012-01-01

    Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence

  20. Health economics research into supporting carers of people with dementia: a systematic review of outcome measures.

    PubMed

    Jones, Carys; Edwards, Rhiannon Tudor; Hounsome, Barry

    2012-01-01

    Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence

  1. Annotation: Economic Evaluations of Child and Adolescent Mental Health Interventions--A Systematic Review

    ERIC Educational Resources Information Center

    Romeo, Renee; Byford, Sarah; Knapp, Martin

    2005-01-01

    Background: Recognition has grown over recent years of the need for economic information on the impacts of child and adolescent mental health problems and the cost-effectiveness of interventions. Methods: A range of electronic databases were examined using a predefined search strategy to identify economic studies which focused on services,…

  2. Economic evaluation of mental health interventions: an introduction to cost-utility analysis.

    PubMed

    Luyten, Jeroen; Naci, Huseyin; Knapp, Martin

    2016-05-01

    Finite resources need to be allocated over an ever-increasing range of competing health policies and interventions. Economic evaluation has been developed as a methodology to inform decision makers on the efficiency of particular resource allocations. In this paper we summarize cost-utility analysis, one of the most widely-used forms of economic evaluation in healthcare. We discuss its main elements, interpretation, limitations and relevance to the domain of mental health. PMID:27075444

  3. A Health Impact Assessment of California’s Proposed Cap-and-Trade Regulations

    PubMed Central

    English, Paul; Rudolph, Linda

    2012-01-01

    Objectives. To identify unintended health effects of California’s controversial cap-and-trade regulations and establish health-promoting policy recommendations, we performed a health impact assessment. Methods. We used literature reviews, public data, and local health surveys to qualitatively assess potential health risks and benefits related to changes in employment and income, energy costs, effects of emission offset projects, and cobenefits from the allocation of program revenue. We examined case studies from various communities to find existing social, economic, and environmental health conditions. Results. We found that policy implementation will minimally impact job creation (< 0.1% change) and that health effects from job sector shifts are unlikely. Fuel prices may increase (0%–11%), and minor negative health effects could accrue for some low-income households. Conclusions. Offset projects would likely benefit environmental health, but more research is needed. Allocating some program revenue for climate change adaptation and mitigation would have substantial health benefits. Health impact assessment is a useful tool for health agencies to engage in policy discussions that typically fall outside public health. Our results can inform emission reduction strategies and cap-and-trade policy at the federal level. PMID:22742062

  4. Economics of Global Burden of Road Traffic Injuries and Their Relationship with Health System Variables

    PubMed Central

    Dalal, Koustuv; Lin, Zhiquin; Gifford, Mervyn; Svanström, Leif

    2013-01-01

    Background: To estimate the economic loss due to road traffic injuries (RTIs) of the World Health Organization (WHO) member countries and to explore the relationship between the economic loss and relevant health system factors. Methods: Data from the World Bank and the WHO were applied to set up the databases. Disability-adjusted life year (DALY) and gross domestic product per capita were used to estimate the economic loss relating to RTIs. Regression analysis was used. Data were analyzed by IBM SPSS Statistics, Versions 20.0. Results: In 2005, the total economic loss of RTIs was estimated to be 167,752.4 million United States Dollars. High income countries (HIC) showed the greatest economic losses. The majority (96%) of the top 25 countries with the greatest DALY losses are low and middle income countries while 48% of the top 25 countries with the highest economic losses are HIC. The linear regression model indicates an inverse relationship between nurse density in the health system and economic loss due to RTI. Conclusions: RTIs cause enormous death and DALYs loss in low-middle income countries and enormous economic loss in HIC. More road traffic prevention programs should be promoted in these areas to reduce both incidence and economic burden of RTIs. PMID:24498501

  5. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

    PubMed

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning. PMID:27579254

  6. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners

    PubMed Central

    Springer, Andrew E.; Evans, Alexandra E.

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning. PMID:27579254

  7. Effects of economic crises on population health outcomes in Latin America, 1981–2010: an ecological study

    PubMed Central

    Williams, Callum; Gilbert, Barnabas James; Zeltner, Thomas; Watkins, Johnathan; Atun, Rifat; Maruthappu, Mahiben

    2016-01-01

    Objectives The relative health effects of changes in unemployment, inflation and gross domestic product (GDP) per capita on population health have not been assessed. We aimed to determine the effect of changes in these economic measures on mortality metrics across Latin America. Design Ecological study. Setting Latin America (21 countries), 1981–2010. Outcome measures Uses multivariate regression analysis to assess the effects of changes in unemployment, inflation and GDP per capita on 5 mortality indicators across 21 countries in Latin America, 1981–2010. Country-specific differences in healthcare infrastructure, population structure and population size were controlled for. Results Between 1981 and 2010, a 1% rise in unemployment was associated with statistically significant deteriorations (p<0.05) in 5 population health outcomes, with largest deteriorations in 1–5 years of age and male adult mortality rates (1.14 and 0.53 rises per 1000 deaths respectively). A 1% rise in inflation rate was associated with significant deteriorations (p<0.05) in 4 population health outcomes, with the largest deterioration in male adult mortality rate (0.0033 rise per 1000 deaths). Lag analysis showed that 5 years after rises in unemployment and inflation, significant deteriorations (p<0.05) occurred in 3 and 5 mortality metrics, respectively. A 1% rise in GDP per capita was associated with no significant deteriorations in population health outcomes either in the short or long term. β coefficient comparisons indicated that the effect of unemployment increases was substantially greater than that of changes in GDP per capita or inflation. Conclusions Rises in unemployment and inflation are associated with long-lasting deteriorations in several population health outcomes. Unemployment exerted much larger effects on health than inflation. In contrast, changes in GDP per capita had almost no association with the explored health outcomes. Contrary to neoclassical development

  8. The economic value of One Health in relation to the mitigation of zoonotic disease risks.

    PubMed

    Häsler, Barbara; Gilbert, William; Jones, Bryony Anne; Pfeiffer, Dirk Udo; Rushton, Jonathan; Otte, Martin Joachim

    2013-01-01

    The essence of One Health is an interdisciplinary approach combined with some degree of intersectoral integration that is aimed at mitigation of human and animal health risks, taking account of environmental, ecological, social and economic factors. While a large number of international stakeholders now consider the One Health approach necessary for more effective protection of the global community against health threats, there is still no systematic allocation of resources to integrated national or multinational programmes, partly due to the inertia of existing sectoral systems and the lack of convincing economic arguments in support of the approach. We propose different degrees of sectoral integration depending on system types and associated economic efficiency gains to be expected from a One Health approach. International and regional organisations have an important role in facilitating the adoption of the approach, since the costs and the benefits are often of a regional or even a global nature, such as in the case of avian influenza. PMID:24264885

  9. Relief, restoration and reform: economic upturn yields modest and uneven health returns.

    PubMed

    Hurley, Robert; Katz, Aaron; Felland, Laurie

    2008-01-01

    The sensitivity of state budgets to economic cycles contributes to fluctuations in health coverage, eligibility, benefits and provider payment levels in public programs, as well as support for safety net hospitals and community health centers (CHCs). The aftershocks of the 2001 recession on state budgets were felt well into 2004. More recently, the economic recovery allowed many states to restore cuts and, in some cases, expand health services for low-income people, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Along with bolstering support of safety net providers and raising Medicaid payments for private physicians, some states advanced even more ambitious health reform proposals. Yet across communities, safety net systems face mounting challenges of caring for more uninsured patients, and these pressures will likely increase given the current economic downturn. PMID:18396571

  10. Assessment of mercury health risks to adults from coal combustion

    SciTech Connect

    Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.

    1994-05-01

    The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

  11. 78 FR 15355 - Proposed Information Collection; Comment Request; Pilot Project Assessing Economic Benefits of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-11

    ... Project Assessing Economic Benefits of Marine Debris Removal AGENCY: National Oceanic and Atmospheric... economic benefits to beach visitors of marine debris removal. The project will use a revealed preference... economic benefits, providing information about the types of marine debris that beach visitors are...

  12. The state of health economic and pharmacoeconomic evaluation research in Zimbabwe: A review

    PubMed Central

    Gavaza, Paul; Rascati, Karen; Brown, Carolyn; Lawson, Kenneth; Mann, Teresa

    2008-01-01

    BACKGROUND: Economic evaluation of health care has developed into a substantial body of work, and its contribution to medical decision making is increasingly being recognized. OBJECTIVE: The aim of the study was to describe the characteristics and quality of health economic (including pharmacoeconomic) evaluation research studies related to Zimbabwe. METHODS: A review of the literature was conducted to identify published health economic evaluation studies related to Zimbabwe. HEED, PubMed, MEDLINE, HealthSTAR, EconLit, and PsycINFO databases and sociological and dissertation abstracts were used to search for economic analyses. The searches used the following terms alone and in combination: costs, budgets, fee, economics, health, pharmacy, pharmacy services, medicines, drugs, health economics, cost-effectiveness, cost-benefit, cost-minimization, cost utility analysis, and Zimbabwe. Only original applied economic evaluations addressing a health-related topic pertaining to Zimbabwe and published in full were included. Two reviewers independently evaluated and scored each study in the final sample using the data collection form designed for the study. RESULTS: Fifty-nine studies were identified in the database searches, 18 of which were excluded because they were not about Zimbabwe (3 studies) or were not health related (15). Of the 41 remaining studies, 8 were excluded after further review because they were not original research, 6 because they were not economic analyses, and 1 because it was not about Zimbabwe. The final 26 studies appeared in 13 different journals (based mostly [17 (65%)] outside of Zimbabwe). The mean (SD) number of authors of each study was 3.36 (2.13); most of the authors had medical/clinical training. The number of studies peaked between 1994 and 1997. Based on a 10-point scale, with 10 indicating the highest quality, the mean (SD) quality score for all studies was 5.40 (1.56); 8 of the studies (31%) were considered to be of poor quality (score

  13. The health effects of economic sanctions and embargoes: the role of health professionals. Ethics and Human Rights Committee.

    PubMed

    Morin, K; Miles, S H

    2000-01-18

    As a widely used tool of foreign policy, economic sanctions take many forms. They include mandating trade restrictions (for example, limiting imports from or exports to a sanctioned nation), freezing bank accounts, limiting international travel to and from an area, imposing additional tariffs, and exerting other pressures that are intended to slow key economic activities. Since the end of the Cold War, as the global market has expanded, many countries and the United Nations have increasingly used economic sanctions instead of military intervention to compel nations to end civil or extraterritorial war or to reduce abuse of human rights. Similarly, the United States has attempted to influence international governments' domestic policies by using other economic means, such as relating "most favored nation" trading status to a country's human rights record or prohibiting the import of goods from countries in which illegal child labor is widespread. Repercussions from these measures influence a country's economic development and, therefore, can also affect the overall welfare of a nation's population. In contrast to war's easily observable casualties, the apparently nonviolent consequences of economic intervention seem like an acceptable alternative. However, recent reports suggest that economic sanctions can seriously harm the health of persons who live in targeted nations. For this reason, the American College of Physicians-American Society of Internal Medicine has undertaken this examination of physicians' roles in addressing the health effects of economic sanctions. PMID:10644279

  14. Investigating underlying principles to guide health impact assessment

    PubMed Central

    Fakhri, Ali; Maleki, Mohammadreza; Gohari, Mahmoodreza; Harris, Patrick

    2014-01-01

    Background: Many countries conduct Health Impact Assessment (HIA) of their projects and policies to predict their positive and negative health impacts. In recent years many guides have been developed to inform HIA practice, largely reflecting local developments in HIA. These guides have often been designed for specific contexts and specific need, making the choice between guides difficult. The objective of the current study is to identify underlying principles in order to guide HIA practice in Iran. Methods: This study was conducted in three stages: 1) Studies comparing HIA guidelines were reviewed to identify criteria used for comparison seeking emphasized principles. 2) The HIA characteristics extracted from published papers were categorized in order to determine the principles that could guide HIA practice. 3) Finally, these principles were agreed by experts using nominal group technique. Results: The review of the studies comparing HIA guides demonstrated there are no clear comparison criteria for reviewing HIA guides and no study mentioned HIA principles. Investigating the HIA principles from peer-reviewed papers, we found 14 issues. These were, considering of general features in planning and conducting HIAs such as HIA stream, level, timing and type, considering of the wider socio-political and economic context, considering of economic, technical and legal aspects of HIA and capacities for HIA, rationality and comprehensiveness, using appropriate evidence, elaborating on HIA relation to other forms of Impact Assessment, considering of equity, and encouraging intersectoral and interdisciplinary cooperation, involvement of stakeholders and transparency as underlying principles to guide HIA practice. The results emphasize how critical these technical as well as tactical considerations are in the early scoping step of an HIA which plans the conduct of the HIA in reponse to local contextual issues. Conclusion: Determining the principles of HIA from peer

  15. Linking Human Health and Livestock Health: A “One-Health” Platform for Integrated Analysis of Human Health, Livestock Health, and Economic Welfare in Livestock Dependent Communities

    PubMed Central

    Thumbi, S. M.; Njenga, M. Kariuki; Marsh, Thomas L.; Noh, Susan; Otiang, Elkanah; Munyua, Peninah; Ochieng, Linus; Ogola, Eric; Yoder, Jonathan; Audi, Allan; Montgomery, Joel M.; Bigogo, Godfrey; Breiman, Robert F.; Palmer, Guy H.; McElwain, Terry F.

    2015-01-01

    Background For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status. Method We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness) and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens) are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households. Findings Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively). Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%). In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40%) and diarrhea illnesses (5%). While controlling

  16. ASSESSMENT OF BEST AVAILABLE TECHNOLOGY ECONOMICALLY ACHIEVABLE FOR SYNTHETIC RUBBER MANUFACTURING WASTEWATER

    EPA Science Inventory

    An assessment of The Best Available Technology Economically Achievable (BATEA) for treatment of synthetic rubber manufacturing wastewaters has been conducted. This assessment was based on feasibility tests with actual wastewater samples, both end-of-pipe (untreated) and after pri...

  17. Economic Assessment of the Association of Northern California Oncologists Member Practices

    PubMed Central

    Buell, Roberta; Falconer, Patricia; González, José Luis

    2011-01-01

    In late 2009 and early 2010, the Association of Northern California Oncologists conducted an economic assessment on a volunteer sample (n = 14) of northern California state oncology society member practices to measure key economic factors, diagnose economic viability, and prescribe changes to practice management to enhance practice economic viability. Recommendations for individual member practices as well as for the state oncology society were made as a result of the findings of this study. Results from follow-up interviews conducted with study practices approximately 1 year after the original assessments reveal that most recommendations were implemented and seem to have generally strengthened the economic performance of the practices. PMID:22211125

  18. Economic aspects of mental health carve-outs.

    PubMed

    Vogelsang, Ingo

    1999-03-01

    BACKGROUND: Recent empirical research has found behavioral health carve-outs in the US to reduce costs immediately and considerably, compared to indemnity insurance and HMOs. Carve-outs have quickly captured a large part of the organized market in US behavioral health. At the same time, market concentration has increased significantly. METHODS: The current paper uses concepts and results from the industrial organization and transaction cost literature to explain (i) why carve-outs hold cost advantages over other institutional arrangements, (ii) why these hold in particular for behavioral health and (iii) why this did not happen earlier. RESULTS: The main explanatory variables relate to economies of scale, the avoidance of diseconomies of scope, and the avoidance of personal relationships. The sometimes surprising lack of explicit risk-taking by carve-outs and of explicit cost-reducing incentives in carve-out contracts are more than overcome by incentives created from gaining large contracts. The specific advantages of carve-outs in behavioral health derive from a combination of lack of economies of scope with other health services, lack of economies of scale in provision of behavioral health and presence of economies of scale in management. It is conjectured that behavioral health carve-outs have benefited from biomedical innovations that changed the direction of treatments, from computerization that enables large-scale standardized management and from financial pressures on the behavioral health sector. DISCUSSION: The empirical basis for the current study is a number of case studies and the rapid penetration of mental health carve-outs in the US. Cost reductions caused by such carve-outs appear to be quite robust. Explaining cost reductions from institutional changes has to start with the question of why the old institution did not implement the same or similar changes. We have emphasized reasons why such changes were not feasible under indemnity insurance and

  19. [Citizen participation in the context of health technology assessment].

    PubMed

    Freile-Gutiérrez, Berenice

    2014-01-01

    Citizen participation is important in all economic sectors of the democratic world, as it is also in the field of health. This is due to the significant value of life and therefore enjoying this in a healthy condition. This paper seeks to provide an overview of public participation in the context of Health Technology Assessments (HTA), covering from conceptualization to practical experiences. Within the existing literature, the definitions and methodological aspects of the topic discussed are reviewed, as well as how citizen participation in HTA agencies is manifested, presenting barriers as well as enablers for public involvement. In the Chilean case, where there are no public participation experiences in the context of HTA, a review of these initiatives in the health care sector is performed. In light with the studies examined, it is concluded that there is much to advance in the concreteness of citizen participation in HTA's agencies; efforts at institutional level as well as from community organizations are needed. This review can be useful as an antecedent for countries that are considering incorporating HTA in the future. PMID:24861177

  20. Self-reported health and socio-economic inequalities in England, 1996–2009: Repeated national cross-sectional study

    PubMed Central

    Maheswaran, Hendramoorthy; Kupek, Emil; Petrou, Stavros

    2015-01-01

    Tackling social inequalities in health has been a priority for recent UK governments. We used repeated national cross-sectional data for 155,311 participants (aged ≥16 years) in the Health Survey of England to examine trends in socio-economic inequalities in self-reported health over a recent period of sustained policy focus by successive UK governments aimed at tackling social inequalities in health. Socio-economic related inequalities in self-reported health were estimated using the Registrar General's occupational classification (1996–2009), and for sensitivity analyses, the National Statistics Socio-Economic Classification (NS-SEC; 2001–2011). Multi-level regression was used to evaluate time trends in General Health Questionnaire (GHQ-12) scores and bad or very bad self-assessed health (SAH), as well as EQ-5D utility scores. The study found that the probability of reporting GHQ-12 scores ≥4 and ≥ 1 was higher in those from lower social classes, and decreased for all social classes between 1997 and 2009. For SAH, the probability of reporting bad or very bad health remained relatively constant for social class I (professional) [0.028 (95%CI: 0.026, 0.029) in 1996 compared to 0.028 (95%CI: 0.024, 0.032) in 2009], but increased in lower social classes, with the greatest increase observed amongst those in social class V (unskilled manual) [0.089 (95%CI: 0.085, 0.093) in 1996 compared to 0.155 (95%CI: 0.141, 0.168) in 2009]. EQ-5D utility scores were lower for those in lower social classes, but remained comparable across survey years. In sensitivity analyses using the NS-SEC, health outcomes improved from 2001 to 2011, with no evidence of widening socio-economic inequalities. Our findings suggest that socio-economic inequalities have persisted, with evidence of widening for some adverse self-reported health outcomes. PMID:26004207

  1. Health technology assessment in the Balkans: opportunities for a balanced drug assessment system

    PubMed Central

    Dankó, Dávid; Petrova, Guenka

    2014-01-01

    Countries in the Balkan region use pharmaco-economic data for decisions about the inclusion of new pharmaceuticals into their positive drug lists, but no predefined frameworks are used and resources for health technology assessment (HTA) are limited. The goal of this analysis is to investigate into possible development directions for the HTA system in the region, and provide some practical recommendations for a sustainable model. For this purpose, the main factors currently influencing HTA in Balkan countries are briefly presented, and possible development strategies are compared. A resource-saving balanced assessment approach is proposed. It is aligned with available resources and capabilities, and helps access to new pharmaceuticals while ensuring the transparency of decision-making processes and the stability of the pharmaceutical budget. PMID:26019605

  2. Drug delivery system innovation and Health Technology Assessment: Upgrading from Clinical to Technological Assessment.

    PubMed

    Panzitta, Michele; Bruno, Giorgio; Giovagnoli, Stefano; Mendicino, Francesca R; Ricci, Maurizio

    2015-11-30

    Health Technology Assessment (HTA) is a multidisciplinary health political instrument that evaluates the consequences, mainly clinical and economical, of a health care technology; the HTA aim is to produce and spread information on scientific and technological innovation for health political decision making process. Drug delivery systems (DDS), such as nanocarriers, are technologically complex but they have pivotal relevance in therapeutic innovation. The HTA process, as commonly applied to conventional drug evaluation, should upgrade to a full pharmaceutical assessment, considering the DDS complexity. This is useful to study more in depth the clinical outcome and to broaden its critical assessment toward pharmaceutical issues affecting the patient and not measured by the current clinical evidence approach. We draw out the expertise necessary to perform the pharmaceutical assessment and we propose a format to evaluate the DDS technological topics such as formulation and mechanism of action, physicochemical characteristics, manufacturing process. We integrated the above-mentioned three points in the Evidence Based Medicine approach, which is data source for any HTA process. In this regard, the introduction of a Pharmaceutics Expert figure in the HTA could be fundamental to grant a more detailed evaluation of medicine product characteristics and performances and to help optimizing DDS features to overcome R&D drawbacks. Some aspects of product development, such as manufacturing processes, should be part of the HTA as innovative manufacturing processes allow new products to reach more effectively patient bedside. HTA so upgraded may encourage resource allocating payers to invest in innovative technologies and providers to focus on innovative material properties and manufacturing processes, thus contributing to bring more medicines in therapy in a sustainable manner. PMID:26399633

  3. Health hazards of fire fighters: exposure assessment.

    PubMed Central

    Brandt-Rauf, P W; Fallon, L F; Tarantini, T; Idema, C; Andrews, L

    1988-01-01

    There is growing concern over the detrimental health effects to firefighters produced by exposure to combustion byproducts of burning materials. To assess the types and levels of exposure encountered by firefighters during their routine occupational duties, members of the Buffalo Fire Department were monitored during firefighting activities with personal, portable, ambient environmental sampling devices. The results indicate that firefighters are frequently exposed to significant concentrations of hazardous materials including carbon monoxide, benzene, sulphur dioxide, hydrogen cyanide, aldehydes, hydrogen chloride, dichlorofluoromethane, and particulates. Furthermore, in many cases of the worst exposure to these materials respiratory protective equipment was not used owing to the visual impression of low smoke intensity, and thus these levels represent actual direct exposure of the firefighters. Many of these materials have been implicated in the production of cardiovascular, respiratory, or neoplastic diseases, which may provide an explanation for the alleged increased risk for these illnesses among firefighters. PMID:3179235

  4. Review article: gastro-oesophageal reflux disease--the health economic implications.

    PubMed

    Mason, J; Hungin, A P S

    2005-08-01

    For the vast majority of patients with gastro-oesophageal reflux disease appropriate care involves the management of symptoms with lifestyle advice and drugs. However, there is dissension about the appropriate use of endoscopy, whether drugs should be stepped up or down according to potency, how long drugs should be used for, the role of lifestyle advice, and, related to this, the role of patients' lifestyle choices. This exploration of the economics of gastro-oesophageal reflux disease reviews its cost burden to the UK, assesses published economic models for their strengths and weaknesses and examines current recommendations for gastro-oesophageal reflux disease management from a socioeconomic perspective. Drugs prescribed predominantly for dyspepsia cost the UK National Health Service a projected pound sterling 625 million in 2004, 7% of the primary care prescribing budget. When general practitioners consultations, endoscopies, over-the-counter sales and sickness absences are included the UK cost rises to pound sterling 1.5 billion: approximately half of this cost can be ascribed to gastro-oesophageal reflux disease. Emphasis upon regular review and stepping down treatment (while maintaining adequate symptom relief) is both clinically appropriate and resource efficient. Other cost-effectiveness issues largely lack objective answers because investment in treatment for gastro-oesophageal reflux disease depends upon how much more, at the margin, society wishes to invest for further but diminishing symptom relief. PMID:16042656

  5. Economics of online structural health monitoring of wind turbines: Cost benefit analysis

    NASA Astrophysics Data System (ADS)

    Van Dam, Jeremy; Bond, Leonard J.

    2015-03-01

    Operations and maintenance (O&M) costs have an average share over the lifetime of the turbine of approximately 20%-25% of the total levelized cost per kWh of electricity produced. Online structural health monitoring (OSHM) and condition-based maintenance (CBM) of wind turbine blades has the potential to reduce O&M costs and hence reduce the overall cost of wind energy. OSHM and CBM offer the potential to improve turbine blade life cycle management, limit the number of physical inspections, and reduce the potential for missed significant defects. An OSHM system would reduce the need for physical inspections, and have inspections occur only after problem detection takes place. In the economics of wind energy, failures and unplanned outages can cause significant downtime, particularly while waiting for the manufacturing and shipping of major parts. This paper will report a review and assessment of SHM technologies and a cost benefit analysis, which will examine whether the added costs associated with an OSHM system will give an adequate return on the investment. One method in which OSHM reduces costs is, in part, by converting corrective maintenance to preventative maintenance. This paper shows that under both best and worse conditions implementing an OSHM system is cost effective in more than 50% of the trials, which have been performed. Opportunities appear to exist to improve the economic justification for implementing OSHM.

  6. Technological Change in Assessing Economics: A Cautionary Welcome

    ERIC Educational Resources Information Center

    Kennelly, Brendan; Considine, John; Flannery, Darragh

    2009-01-01

    The use of computer-based automated assignment systems in economics has expanded significantly in recent years. The most widely used system is Aplia which was developed by Paul Romer in 2000. Aplia is a computer application designed to replace traditional paper-based assignments in economics. The main features of Aplia are: (1) interactive content…

  7. Assessing the Efficacy of Gaming in Economic Education.

    ERIC Educational Resources Information Center

    Gremmen, Hans; Potters, Jan

    1997-01-01

    Presents the results of a study that measured the efficacy of an international economics simulation among undergraduates. The simulation consisted of a macroeconomics game where students develop economic policies for four hypothetical countries. A multiple choice test and posttest questionnaire suggests that classroom games are more effective than…

  8. Assessing clinical competency in the health sciences

    NASA Astrophysics Data System (ADS)

    Panzarella, Karen Joanne

    To test the success of integrated curricula in schools of health sciences, meaningful measurements of student performance are required to assess clinical competency. This research project analyzed a new performance assessment tool, the Integrated Standardized Patient Examination (ISPE), for assessing clinical competency: specifically, to assess Doctor of Physical Therapy (DPT) students' clinical competence as the ability to integrate basic science knowledge with clinical communication skills. Thirty-four DPT students performed two ISPE cases, one of a patient who sustained a stroke and the other a patient with a herniated lumbar disc. Cases were portrayed by standardized patients (SPs) in a simulated clinical setting. Each case was scored by an expert evaluator in the exam room and then by one investigator and the students themselves via videotape. The SPs scored each student on an overall encounter rubric. Written feedback was obtained from all participants in the study. Acceptable reliability was demonstrated via inter-rater agreement as well as inter-rater correlations on items that used a dichotomous scale, whereas the items requiring the use of the 4-point rubric were somewhat less reliable. For the entire scale both cases had a significant correlation between the Expert-Investigator pair of raters, for the CVA case r = .547, p < .05 and for the HD case r = .700, p < .01. The SPs scored students higher than the other raters. Students' self-assessments were most closely aligned with the investigator. Effects were apparent due to case. Content validity was gathered in the process of developing cases and patient scenarios that were used in this study. Construct validity was obtained from the survey results analyzed from the experts and students. Future studies should examine the effect of rater training upon the reliability. Criterion or predictive validity could be further studied by comparing students' performances on the ISPE with other independent estimates

  9. Assessment of secondary residues. Engineering and economic analysis. Final report

    SciTech Connect

    Leuschner, A.P.; West, C.E.; Ashare, E.

    1981-08-01

    Secondary agricultural residues are defined as those residues resulting from biomass processing to produce primary products; e.g., whey from cheese processing, vegetable processing wastes, and residues from pulp and paper processing. The analyses consist of specific case studies investigating the costs of converting liquid and/or solid residue streams to methane and/or ethanol. Several economically feasible examples were found: methane production from potato processing liquid residues, ethanol from potato processing solid residues, methane from cheese processing wastes, and methane from poultry processing liquid wastes. In facilities which operate year round, energy recovery is often feasible, whereas in seasonal operations, economic feasibility is not possible. Economic feasibility of energy production from secondary residues is strongly dependent on the current use of the solid and liquid residue. If the solid residue is sold as an animal feed, energy production is usually not economical. High solid and liquid residue disposal costs often make energy conversion economically feasible.

  10. GLOBAL CHANGE RESEARCH NEWS #5: HEALTH SECTOR ASSESSMENT

    EPA Science Inventory

    The Health Sector Assessment is one of the three levels of the assessment process that is intended to answer four questions: (1) What is the current status of the nation's health, and what are current stresses on our health? (2) How might climate change affect the country's healt...

  11. Urban traffic-related determinants of health questionnaire (UTDHQ): an instrument developed for health impact assessments

    PubMed Central

    Nadrian, Haidar; Nedjat, Saharnaz; Taghdisi, Mohammad Hossein; Shojaeizadeh, Davoud

    2014-01-01

    Background: Traffic and transport is a substantial part of a range of economic, social and environmental factors distinguished to have impact on human health. This paper is a report on a preliminary section of a Health Impact Assessment (HIA) on urban traffic and transport initiatives, being conducted in Sanandaj, Iran. In this preliminary study, the psychometric properties of Urban Traffic related Determinants of Health Questionnaire (UTDHQ) were investigated. Methods: Multistage cluster sampling was employed to recruit 476 key informants in Sanandaj from April to June 2013 to participate in the study. The development of UTDHQ began with a comprehensive review of the literature. Then face, content and construct validity as well as reliability were determined. Results: Exploratory Factor Analysis showed optimal reduced solution including 40 items and 8 factors. Three of the factors identified were Physical Environment, Social Environment, Public Services Delivery and Accessibility. UTDHQ demonstrated an appropriate validity, reliability, functionality and simplicity. Conclusion: Despite the need for further studies on UTDHQ, this study showed that it can be a practical and useful tool for conducting HIAs in order to inform decision makers and stakeholders about the health influences of their decisions and measures. PMID:25664285

  12. Who Can Afford Health Care? Evaluating the Socio-Economic Conditions and the Ability to Contribute to Health Care in a Post-Conflict Area in DR Congo

    PubMed Central

    Gerstl, Sibylle; Sauter, Justin; Kasanda, Joseph; Kinzelbach, Alfred

    2013-01-01

    Introduction The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care. Methodology Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire. Findings The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%); 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27) and 79% to the drug prices (maximum amount of US$ 1.10). Six percent opted for free consultations and 19% for free drugs. Conclusions Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care. PMID:24204819

  13. Health capabilities and diabetes self-management: the impact of economic, social, and cultural resources.

    PubMed

    Weaver, Robert R; Lemonde, Manon; Payman, Naghmeh; Goodman, William M

    2014-02-01

    While the "social determinants of health" view compels us to explore how social structures shape health outcomes, it often ignores the role individual agency plays. In contrast, approaches that focus on individual choice and personal responsibility for health often overlook the influence of social structures. Amartya Sen's "capabilities" framework and its derivative the "health capabilities" (HC) approach attempts to accommodate both points of view, acknowledging that individuals function under social conditions over which they have little control, while also acting as agents in their own health and well-being. This paper explores how economic, social, and cultural resources shape the health capability of people with diabetes, focusing specifically on dietary practices. Health capability and agency are central to dietary practices, while also being shaped by immediate and broader social conditions that can generate habits and a lifestyle that constrain dietary behaviors. From January 2011 to December 2012, we interviewed 45 people with diabetes from a primary care clinic in Ontario (Canada) to examine how their economic, social, and cultural resources combine to influence dietary practices relative to their condition. We classified respondents into low, medium, and high resource groups based on economic circumstances, and compared how economic resources, social relationships, health-related knowledge and values combine to enhance or weaken health capability and dietary management. Economic, social, and cultural resources conspired to undermine dietary management among most in the low resource group, whereas social influences significantly influenced diet among many in the medium group. High resource respondents appeared most motivated to maintain a healthy diet, and also had the social and cultural resources to enable them to do so. Understanding the influence of all three types of resources is critical for constructing ways to enhance health capability, chronic

  14. Public Health Impact and Economic Costs of Volkswagen's Lack of Compliance with the United States' Emission Standards.

    PubMed

    Hou, Lifang; Zhang, Kai; Luthin, Moira A; Baccarelli, Andrea A

    2016-01-01

    The U.S. Environmental Protection Agency (EPA) recently issued a notice of violation against Volkswagen (VW) for installing a defective device in certain models of diesel cars to circumvent emission tests for nitrogen oxides (NOx). We quantified the health and economic impacts of extra NOx emissions attributable to non-compliant vehicles in the U.S. using the EPA's Co-Benefits Risk Assessment model. We estimated that the total extra NOx emitted over one year of operation would result in 5 to 50 premature deaths, 687 to 17,526 work days with restricted activity, and economic costs of $43,479,189 to $423,268,502, based on various assumptions regarding emission scenarios and risks. This study highlights the potential impacts of VW vehicles' lack of compliance on the health and well-being of the U.S. PMID:27618076

  15. Path Toward Economic Resilience for Family Caregivers: Mitigating Household Deprivation and the Health Care Talent Shortage at the Same Time

    PubMed Central

    Simon, Melissa A.

    2013-01-01

    Rising costs and a workforce talent shortage are two of the health care industry’s most pressing challenges. In particular, serious illnesses often impose significant costs on individuals and their families, which can place families at an increased risk for multigenerational economic deprivation or even an illness–poverty trap. At the same time, family caregivers often acquire a wide variety of health care skills that neither these caregivers nor the health care industry typically use. As these skills are marketable and could be paired with many existing medical certifications, this article describes a possible “path toward economic resilience” (PER) through a program whereby family caregivers could find meaningful employment using their new skills. The proposed program would identify ideal program candidates, assess and supplement their competencies, and connect them to the health care industry. We provide a set of practical steps and recommended tools for implementation, discuss pilot data on the program’s appeal and feasibility, and raise several considerations for program development and future research. Our analysis suggests that this PER program could appeal to family caregivers and the health care industry alike, possibly helping to address two of our health care system’s most pressing challenges with one solution. PMID:23633216

  16. Learning Standards for Health, Physical Education, and Home Economics. Revised Edition.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany.

    This document contains three learning standards for health, physical education, and home economics at three levels: elementary, intermediate, and commencement. The first section consists of these three standards: (1) personal health and fitness, (2) a safe and healthy environment, and (3) resource management. The format for displaying the…

  17. The economic costs of radiation-induced health effects: Estimation and simulation

    SciTech Connect

    Nieves, L.A.; Tawil, J.J.

    1988-08-01

    This effort improves the quantitative information available for use in evaluating actions that alter health risks due to population exposure to ionizing radiation. To project the potential future costs of changes in health effects risks, Pacific Northwest Laboratory (PNL) constructed a probabilistic computer model, Health Effects Costs Model (HECOM), which utilizes the health effect incidence estimates from accident consequences models to calculate the discounted sum of the economic costs associated with population exposure to ionizing radiation. Application of HECOM to value-impact and environmental impact analyses should greatly increase the quality of the information available for regulatory decision making. Three major types of health effects present risks for any population sustaining a significant radiation exposure: acute radiation injuries (and fatalities), latent cancers, and impairments due to genetic effects. The literature pertaining to both incidence and treatment of these health effects was reviewed by PNL and provided the basis for developing economic cost estimates. The economic costs of health effects estimated by HECOM represent both the value of resources consumed in diagnosing, treating, and caring for the patient and the value of goods not produced because of illness or premature death due to the health effect. Additional costs to society, such as pain and suffering, are not included in the PNL economic cost measures since they do not divert resources from other uses, are difficult to quantify, and do not have a value observable in the marketplace. 83 refs., 3 figs., 19 tabs.

  18. Chronic Family Economic Hardship, Family Processes and Progression of Mental and Physical Health Symptoms in Adolescence

    ERIC Educational Resources Information Center

    Lee, Tae Kyoung; Wickrama, K. A. S.; Simons, Leslie Gordon

    2013-01-01

    Research has documented the relationship between family stressors such as family economic hardship and marital conflict and adolescents' mental health symptoms, especially depressive symptoms. Few studies, however, have examined the processes whereby supportive parenting lessens this effect and the progression of mental health and physical health…

  19. Forecast-based Interventions Can Reduce the Health and Economic Burden of Wildfires

    EPA Science Inventory

    We simulated public health forecast-based interventions during a wildfire smoke episode in rural North Carolina to show the potential for use of modeled smoke forecasts toward reducing the health burden and showed a significant economic benefit of reducing exposures. Daily and co...

  20. Debates, dialectic, and rhetoric: an approach to teaching radiology residents health economics, policy, and advocacy.

    PubMed

    Jha, Saurabh

    2013-06-01

    Arguing is an art and essential to the functioning of our political and legal system. Moderated debates between residents are a useful educational vehicle to teach residents health economics and health policy. Articulating the opposing arguments leads to greater mutual understanding, an appreciation of the limits of knowledge and improved advocacy. PMID:23545491

  1. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS (EPA/600/R-01/104)

    EPA Science Inventory

    Environmental decision support tools often provide information that predicts a multitude of different human health effects due to environmental stressors. Medical decision making and health economics offer many metrics that allow aggregation of these different health outcomes. Th...

  2. An Economic Assessment of Electronic Text. Report Number Six of the Electronic Text Report Series.

    ERIC Educational Resources Information Center

    Carey, John

    This report outlines economic components that will eventually contribute to large models of electronic text services in institutions of higher education, and provides a simple and practical assessment of economic issues associated with electronic text for college administrators, faculty, and planners. This assessment constitutes a layman's guide…

  3. Economic vulnerability to health shocks and coping strategies: evidence from Andhra Pradesh, India.

    PubMed

    Dhanaraj, Sowmya

    2016-07-01

    Empirical research has shown that households in developing countries are unable to sustain current levels of consumption during and after severe health crises due to substantial increase in medical expenditure and/or loss of income. Health events are also found to have an adverse impact on nutritional status and educational attainment of household members. Thus, in this study, we investigate: who are vulnerable to welfare loss from health shocks, what are the household responses to cope with the economic burden of health shocks and if policy responses like state health insurance schemes are effective in reducing the economic vulnerability. We use self-reported measures of health shocks and coping strategies from the longitudinal survey of the ongoing Young Lives project in India [Andhra Pradesh (AP)] to identify the characteristics of vulnerable groups and perform three-level random intercept logistic regression that takes into account contextual or environmental factors. What emerges is socioeconomic status of household (determined by education, wealth, occupation and caste/religious group) and its demographic characteristics like gender of the household head and proportion of elderly and disabled members matter for outcomes related to health events. Households adopt different strategies to cope with the economic costs of ill-health; borrowing is the most widely used strategy. For credit, majority of households rely on informal sources (moneylenders, friends, relatives, etc.) and have little or no access to formal sources. However, health shock to main breadwinner leads to households adopting costly strategies like reducing consumption or sending children to work. We found no evidence that the state health insurance scheme reduced the household welfare loss from health shocks and their coping strategies. The results suggest that health insurance schemes have to be complemented with access to micro-credit and social security schemes for self-employed persons

  4. Barriers to generalizability of health economic evaluations in Latin America and the Caribbean region.

    PubMed

    Augustovski, Federico; Iglesias, Cynthia; Manca, Andrea; Drummond, Michael; Rubinstein, Adolfo; Martí, Sebastián García

    2009-01-01

    Use and acceptance of health economic evaluations (HEEs) has been much greater in developed than in developing nations. Nevertheless, while developing countries lag behind in the development of HEE methods, they could benefit from the progress made in other countries and concentrate on ways in which existing methods can be used or would need to be modified to fulfill their specific needs. HEEs, as context-specific tools, are not easily generalizable from setting to setting. Existing studies regarding generalizability and transferability of HEEs have primarily been conducted in developed countries. Therefore, a legitimate question for policy makers in Latin America and the Caribbean region (LAC) is to what extent HEEs conducted in industrialized economies and in LAC are generalizable to LAC (trans-regional) and to other LAC countries (intra-regional), respectively. We conducted a systematic review, searching the NHS Economic Evaluation Database (NHS EED), Office of Health Economics Health Economic Evaluation Database (HEED), LILACS (Latin America health bibliographic database) and NEVALAT (Latin American Network on HEE) to identify HEEs published between 1980 and 2004. We included individual patient- and model-based HEEs (cost-effectiveness, cost-utility, cost-benefit and cost-consequences analyses) that involved at least one LAC country. Data were extracted by three independent reviewers using a checklist validated by regional and international experts. From 521 studies retrieved, 72 were full HEEs (39% randomized controlled trials [RCTs], 32% models, 17% non-randomized studies and 12% mixed trial-modeling approach). Over one-third of identified studies did not specifically report the type of HEE. Cost-effectiveness and cost-consequence analyses accounted for almost 80% of the studies. The three Latin American countries with the highest participation in HEE studies were Brazil, Argentina and Mexico. While we found relatively good standards of reporting the study

  5. Health education among the economically deprived of a Colombian city.

    PubMed

    Bertrand, J T; Bertrand, W E

    1979-01-01

    Vivamos Mejor (Let's Live Better) is a health education program conducted in Colombia for low-income people who needed knowledge about nutrition, preventive medicine, family planning, sex education, and child raising. A 3-3 1/2 hour lecture and slide presentation (discussion, movies, puppet shows) is held at 6 p.m. in a local school. Attendance is encouraged by nurse-auxiliary extension workers who extend written invitations in a given neighborhood. A 40-page color booklet recapping the lecture information is given to those who attend. A study was conducted to determine if this program was actually effective in the community, Siloe, compared to one which had no program. Of the 128 respondents to a questionnaire, 38.3% (49) had been invited but only 21.9% (28) had attended. The initial goal of 80% coverage was overambitious. Knowledge of health concepts, hazards, and changes in health related behaviors were affected by the lectures. Women who had been to the lecture scored higher on all topics than nonattendants from Siloe or the control group from Terron Colorado. A greater percentage of the exposed population displayed desirable health practices. Women were more likely to have had their children vaccinated, prepare fresh vegetables, use meat, if they had attended the program than the nonexposed groups. 39% of those exposed to the program were using birth control compared to 33% of the nonexposed. PMID:473920

  6. Essays on the Economics of Health and Education

    ERIC Educational Resources Information Center

    Swensen, Isaac D.

    2013-01-01

    I present empirical research considering the response of health and educational outcomes to alcohol consumption, drug abuse, and collegiate athletics. Chapter II considers the effect of legal access to alcohol on student achievement. The empirical approach identifies the effect through changes in students' performance after gaining legal access to…

  7. Changing Economics of Health Care Are Devastating Academic Medical Centers.

    ERIC Educational Resources Information Center

    van der Werf, Martin

    1999-01-01

    Once a financially healthy part of American universities, many academic health centers are struggling to survive. Many are merging with for-profit chains or declaring bankruptcy. The advance of managed care and insurance companies focusing on reducing costs appears to be affecting teaching hospitals more than community hospitals. (MSE)

  8. Economic Hardship, Parent Positive Communication and Mental Health in Urban Adolescents Seeking Outpatient Psychiatric Care

    PubMed Central

    Nichols, Sara R.; Javdani, Shabnam; Emerson, Erin; Donenberg, Geri R.

    2014-01-01

    Economic hardship and poor parenting behaviors are associated with increased risk for mental health problems in community adolescents. However, less is known about the impact of socioeconomic status (SES) and parenting behaviors on youth at elevated risk for mental health problems, such as teens seeking outpatient psychiatric care. This study examined whether family SES and parent positive communication were directly and indirectly associated with mental health symptoms six months later in urban teens seeking outpatient treatment, after accounting for baseline levels of symptoms. At baseline, adolescent participants (N = 346; 42% female; 61% African-American) ages 12 to 19 years old (M = 14.9; SD = 1.8) and their primary caregivers reported on SES and teen internalizing and externalizing symptoms and engaged in a videotaped discussion of a real-life conflict to assess parent positive communication. At 6-month follow-up, 81% (N = 279) of families were retained and teens and caregivers again reported internalizing and externalizing symptoms. Structural Equation Modeling (SEM) was used to test the hypothesized models with a sample of 338, using the full information likelihood method to adjust for missing data. For parent-reported externalizing symptoms, SEM revealed support for the indirect association of SES with follow-up externalizing symptoms via parent positive communication and externalizing symptoms at baseline. For parent reported internalizing symptoms, there was a direct association between SES and follow-up internalizing symptoms, but not an indirect effect via parent positive communication. Youth-reported symptoms were not associated with SES nor with parent positive communication. Current findings extend prior research on adolescent mental health in a diverse sample of urban youth seeking outpatient psychiatric care. These families may benefit from interventions that directly target SES-related difficulties and parent positive communication. PMID:25750502

  9. An approach for assessing the economics of sorption chillers

    SciTech Connect

    Summerer, F.; Ziegler, F.F.

    1998-10-01

    Two methods are presented to optimize sorption chillers with respect to economics. To this end, the investment that is necessary for the heat exchangers is balanced with the achievable COP. The numerical tools available today allow for an exact calculation of thermodynamic processes. However, the thermophysical property data these calculations are based on are often not reliable. Moreover, the economic data that have to be taken into account are very rough guesses in most cases. Consequently, a detailed thermodynamic calculation often is too much effort if quick economic decisions have to be made. This paper shows how, based on the main irreversibilities of the process, quite strong economic statements can be made with limited effort. For detailed engineering and optimization, however, a sound cycle calculation is required. In this respect, an economic optimization can only be performed when all relevant parameters determining the process (e.g., pump flow rates and heat exchanger areas) are varied simultaneously while keeping constant the external temperatures of heat sources and sinks. The result of this parameter variation is the chiller COP, which is dependent on the overall heat exchanger area invested in the chiller. This result can be translated into running cost vs. first cost. Consequently, an economic optimum can be found. In most cases, only chillers that perform near the optimum are economically competitive.

  10. Equity during an economic crisis: financing of the Argentine health system.

    PubMed

    Cavagnero, Eleonora; Bilger, Marcel

    2010-07-01

    This article analyses the redistributive effect caused by health financing and the distribution of healthcare utilization in Argentina before and during the severe 2001/2002 economic crisis. Both dramatically changed during this period: the redistributive effect became much more positive and utilization shifted from pro-poor to pro-rich. This clearly demonstrates that when utilization is contingent on financing, changes can occur rapidly; and that an integrated approach is required when monitoring equity. From a policy perspective, the Argentine health system appears vulnerable to economic downturns mainly due to high reliance on out-of-pocket payments and the strong link between health insurance and employment. PMID:20452070

  11. Assessing the Strengths of Mental Health Consumers: A Systematic Review

    ERIC Educational Resources Information Center

    Bird, Victoria J.; Le Boutillier, Clair; Leamy, Mary; Larsen, John; Oades, Lindsay G.; Williams, Julie; Slade, Mike

    2012-01-01

    Strengths assessments focus on the individual's talents, abilities, resources, and strengths. No systematic review of strengths assessments for use within mental health populations has been published. The aims of this study were to describe and evaluate strengths assessments for use within mental health services. A systematic review identified 12…

  12. Balancing economic freedom against social policy principles: EC competition law and national health systems.

    PubMed

    Mossialos, Elias; Lear, Julia

    2012-07-01

    EU Health policy exemplifies the philosophical tension between EC economic freedoms and social policy. EC competition law, like other internal market rules, could restrict national health policy options despite the subsidiarity principle. In particular, European health system reforms that incorporate elements of market competition may trigger the application of competition rules if non-economic gains in consumer welfare are not adequately accounted for. This article defines the policy and legal parameters of the debate between competition law and health policy. Using a sample of cases it analyses how the ECJ, national courts, and National Competition Authorities have applied competition laws to the health services sector in different circumstances and in different ways. It concludes by considering the implications of the convergence of recent trends in competition law enforcement and health system market reforms. PMID:22502932

  13. Economic assessment of nine geothermal direct use applications. Final report

    SciTech Connect

    Gordon, L.C.; Breton, T.R.

    1983-12-01

    This report provides an economic analysis of nine federally-supported geothermal direct heat applications which were part of DOE's Program Opportunity Notice (PON) program. Three of the projects analyzed were user-owned systems, and six were district heating systems. Five of the nine projects are successful from an economic standpoint and the majority of these projects are in areas where geothermal energy has long been used for heating. The results of this analysis indicate that geothermal energy projects can be economic under certain conditions, but these conditions may not be very widespread.

  14. Competing conceptualizations of decent work at the intersection of health, social and economic discourses.

    PubMed

    Di Ruggiero, Erica; Cohen, Joanna E; Cole, Donald C; Forman, Lisa

    2015-05-01

    According to the International Labour Organization (ILO), decent work is critical to economic and social progress and well-being. The ILO's Decent Work Agenda outlines four directions (creating jobs, guaranteeing rights at work, extending social protection, promoting social dialogue) (ILO, 2015). While the Agenda's existence may imply consensus about its meaning, we contend that several conceptualizations of decent work exist in the global policy arena. Different institutional perspectives must be negotiated, and political, economic, social and health considerations balanced in its pursuit. This paper reports findings from a critical discourse analysis of 10 policy texts that aimed to reveal different health, economic, and social claims about decent work and how these are shaped by the work policy agendas of the ILO, World Health Organization, and World Bank. Themes emerging from the discourse analysis include the: challenges and realities of promoting "one" agenda; complex intersection between decent work, health and health equity concepts; emphasis on economic and pro-market interests versus the social dimensions of work; and, relative emphasis on individual versus collective responsibility for decent work. To our knowledge, this is a first attempt to contrast different conceptualizations of decent work involving these institutions. Our findings suggest that decent work is a contested notion, and that more than one "agenda" is operating in the face of vested institutional interests. Broader discourses are contributing to a reframing of decent work in economic, social and/or health terms and these are impacting which dimensions of work are taken up in policy texts over others. Results show how the language of economics acts as a disciplinary and regulatory power and its role as a normalizing discourse. We call for research that deepens understanding of how a social, economic and health phenomenon like work is discursively re-interpreted through different global

  15. A scalable climate health justice assessment model

    PubMed Central

    McDonald, Yolanda J.; Grineski, Sara E.; Collins, Timothy W.; Kim, Young-An

    2014-01-01

    This paper introduces a scalable “climate health justice” model for assessing and projecting incidence, treatment costs, and sociospatial disparities for diseases with well-documented climate change linkages. The model is designed to employ low-cost secondary data, and it is rooted in a perspective that merges normative environmental justice concerns with theoretical grounding in health inequalities. Since the model employs International Classification of Diseases, Ninth Revision Clinical Modification (ICD-9-CM) disease codes, it is transferable to other contexts, appropriate for use across spatial scales, and suitable for comparative analyses. We demonstrate the utility of the model through analysis of 2008–2010 hospitalization discharge data at state and county levels in Texas (USA). We identified several disease categories (i.e., cardiovascular, gastrointestinal, heat-related, and respiratory) associated with climate change, and then selected corresponding ICD-9 codes with the highest hospitalization counts for further analyses. Selected diseases include ischemic heart disease, diarrhea, heat exhaustion/cramps/stroke/syncope, and asthma. Cardiovascular disease ranked first among the general categories of diseases for age-adjusted hospital admission rate (5286.37 per 100,000). In terms of specific selected diseases (per 100,000 population), asthma ranked first (517.51), followed by ischemic heart disease (195.20), diarrhea (75.35), and heat exhaustion/cramps/stroke/syncope (7.81). Charges associated with the selected diseases over the 3-year period amounted to US$5.6 billion. Blacks were disproportionately burdened by the selected diseases in comparison to non-Hispanic whites, while Hispanics were not. Spatial distributions of the selected disease rates revealed geographic zones of disproportionate risk. Based upon a downscaled regional climate-change projection model, we estimate a >5% increase in the incidence and treatment costs of asthma attributable to

  16. School Performance: A Matter of Health or Socio-Economic Background? Findings from the PIAMA Birth Cohort Study

    PubMed Central

    Ruijsbroek, Annemarie; Wijga, Alet H.; Gehring, Ulrike; Kerkhof, Marjan; Droomers, Mariël

    2015-01-01

    Background Performance in primary school is a determinant of children’s educational attainment and their socio-economic position and health inequalities in adulthood. We examined the relationship between five common childhood health conditions (asthma symptoms, eczema, general health, frequent respiratory infections, and overweight), health related school absence and family socio-economic status on children’s school performance. Methods We used data from 1,865 children in the Dutch PIAMA birth cohort study. School performance was measured as the teacher’s assessment of a suitable secondary school level for the child, and the child’s score on a standardized achievement test (Cito Test). Both school performance indicators were standardised using Z-scores. Childhood health was indicated by eczema, asthma symptoms, general health, frequent respiratory infections, overweight, and health related school absence. Children’s health conditions were reported repeatedly between the age of one to eleven. School absenteeism was reported at age eleven. Highest attained educational level of the mother and father indicated family socio-economic status. We used linear regression models with heteroskedasticity-robust standard errors for our analyses with adjustment for sex of the child. Results The health indicators used in our study were not associated with children’s school performance, independently from parental educational level, with the exception of asthma symptoms (-0.03 z-score / -0.04 z-score with Cito Test score after adjusting for respectively maternal and paternal education) and missing more than 5 schooldays due to illness (-0.18 z-score with Cito Test score and -0.17 z-score with school level assessment after adjustment for paternal education). The effect estimates for these health indicators were much smaller though than the effect estimates for parental education, which was strongly associated with children’s school performance. Conclusion Children

  17. The socioeconomic determinants of health: economic growth and health in the OECD countries during the last three decades.

    PubMed

    López-Casasnovas, Guillem; Soley-Bori, Marina

    2014-01-01

    In times of economic crisis, most countries face the dual challenge of fighting unemployment while restraining social expenditures and closing budget deficits. The spending cuts and lack of employment affect a large number of decisions that have a direct or indirect impact on health. This impact is likely to be unevenly distributed among different groups within the population, and therefore not only health levels may be at risk, but also their distribution. The main purpose of this paper is to explore links between unemployment, economic growth, inequality, and health. We regress a measure of health, the Health Human Development Index (HHDI), against a set of explanatory variables accounting for the countries' economic performance (GDP growth, unemployment, and income inequality), and some institutional factors related to welfare spending and the nature of the health systems for the past three decades. In addition, we explore the causes for different results obtained using an inequality-adjusted HHDI, vs. the unadjusted HHDI. We describe a panel data model, estimated by random effects, for 32 countries from 1980-2010, in five-year intervals. Our conclusion is that the high economic growth observed in the last decades, together with an increase in the levels of income inequality and/or poverty, explain the observed changes of our index, particularly when this indicator is weighted by health inequality. The remaining institutional variables (the share of social spending, health care expenditure, and the type of health systems) show the expected sign but are not statistically significant. A comment on the methodological pitfalls of the approach completes the analysis. PMID:24406664

  18. The Socioeconomic Determinants of Health: Economic Growth and Health in the OECD Countries during the Last Three Decades

    PubMed Central

    López-Casasnovas, Guillem; Soley-Bori, Marina

    2014-01-01

    In times of economic crisis, most countries face the dual challenge of fighting unemployment while restraining social expenditures and closing budget deficits. The spending cuts and lack of employment affect a large number of decisions that have a direct or indirect impact on health. This impact is likely to be unevenly distributed among different groups within the population, and therefore not only health levels may be at risk, but also their distribution. The main purpose of this paper is to explore links between unemployment, economic growth, inequality, and health. We regress a measure of health, the Health Human Development Index (HHDI), against a set of explanatory variables accounting for the countries’ economic performance (GDP growth, unemployment, and income inequality), and some institutional factors related to welfare spending and the nature of the health systems for the past three decades. In addition, we explore the causes for different results obtained using an inequality-adjusted HHDI, vs. the unadjusted HHDI. We describe a panel data model, estimated by random effects, for 32 countries from 1980–2010, in five-year intervals. Our conclusion is that the high economic growth observed in the last decades, together with an increase in the levels of income inequality and/or poverty, explain the observed changes of our index, particularly when this indicator is weighted by health inequality. The remaining institutional variables (the share of social spending, health care expenditure, and the type of health systems) show the expected sign but are not statistically significant. A comment on the methodological pitfalls of the approach completes the analysis. PMID:24406664

  19. Health Impact Assessment as a Student Service Learning Experience

    ERIC Educational Resources Information Center

    Stone, Cynthia; Greene, Marion S.

    2012-01-01

    Health Impact Assessments (HIAs) incorporate a combination of tools, methods, and procedures to evaluate the potential health effects of a proposed program, project, or policy. The university public health department, in collaboration with the county health department, and the local planning organization, developed a curriculum for a…

  20. Using Community Health Assessment to Teach and Explore Health Status Disparities

    ERIC Educational Resources Information Center

    Sullivan, Marianne; Levine, Jack

    2014-01-01

    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  1. Rangeland health assessment - The key to understanding and assessing rangeland soil health in the Northern Great Plains

    Technology Transfer Automated Retrieval System (TEKTRAN)

    As the science related to soil and rangeland health evolves, so do their protocols and assessment methodologies. Rangeland health assessments consist of evaluating how well ecological processes such as the water cycle, energy flow and nutrient cycling are functioning at a site. Soil health is the ca...

  2. The impact of economic crises on social inequalities in health: what do we know so far?

    PubMed

    Bacigalupe, Amaia; Escolar-Pujolar, Antonio

    2014-01-01

    Since 2008, Western countries are going through a deep economic crisis whose health impacts seem to be fundamentally counter-cyclical: when economic conditions worsen, so does health, and mortality tends to rise. While a growing number of studies have presented evidence on the effect of crises on the average population health, a largely neglected aspect of research is the impact of crises and the related political responses on social inequalities in health, even if the negative consequences of the crises are primarily borne by the most disadvantaged populations. This commentary will reflect on the results of the studies that have analyzed the effect of economic crises on social inequalities in health up to 2013. With some exceptions, the studies show an increase in health inequalities during crises, especially during the Southeast Asian and Japanese crises and the Soviet Union crisis, although it is not always evident for both sexes or all health or socioeconomic variables. In the Nordic countries during the nineties, a clear worsening of health equity did not occur. Results about the impacts of the current economic recession on health equity are still inconsistent. Some of the factors that could explain this variability in results are the role of welfare state policies, the diversity of time periods used in the analyses, the heterogeneity of socioeconomic and health variables considered, the changes in the socioeconomic profile of the groups under comparison in times of crises, and the type of measures used to analyze the magnitude of social inequalities in health. Social epidemiology should further collaborate with other disciplines to help produce more accurate and useful evidence about the relationship between crises and health equity. PMID:25063518

  3. Comprehensive health assessment for newly arrived refugee children in Australia.

    PubMed

    Davidson, N; Skull, S; Chaney, G; Frydenberg, A; Jones, Cheryl; Isaacs, D; Kelly, P; Lampropoulos, B; Raman, S; Silove, D; Buttery, J; Smith, M; Steel, Z; Burgner, D

    2004-01-01

    Providing appropriate and responsive care to refugees from diverse backgrounds and with unique health needs is challenging. Refugee children may present with a wide range of conditions, which may be unfamiliar to health professionals in developed countries. Additionally, refugees may experience unfamiliarity with the Australian health system and distrust of authority figures and/or medical practitioners. This article provides an overview of the priority areas in health and health management for paediatric refugee patients for paediatricians as well as other relevant health care providers caring for this group. Specific issues covered include general health assessment, infectious diseases, immunization, growth and nutrition, oral health, development and disability, mental health and child protection. Comprehensive health assessment can assist in identifying children at risk of poor health and to provide them with timely and effective care, advocacy and appropriate referral. PMID:15367154

  4. NONCARCINOGENIC EFFECTS OF CHROMIUM: UPDATE TO HEALTH ASSESSMENT DOCUMENT

    EPA Science Inventory

    This 1990 document updates the 1984 Health Assessment Document for Chromium by addressing issues regarding noncarcinogenic health effects of chromium: oxidation states and persistence of these states in the environment, sampling and analytical methodology to differentiate these o...

  5. International expert workshop on the analysis of the economic and public health impacts of air pollution: workshop summary.

    PubMed Central

    Bell, Michelle L; Davis, Devra; Cifuentes, Luis; Cohen, Aaron; Gouveia, Nelson; Grant, Lester; Green, Collin; Johnson, Todd; Rogat, Jorge; Spengler, Jack; Thurston, George

    2002-01-01

    Forty-nine experts from 18 industrial and developing countries met on 6 September 2001 in Garmisch-Partenkirchen, Germany, to discuss the economic and public health impacts of air pollution, particularly with respect to assessing the public health benefits from technologies and policies that reduce greenhouse gas (GHG) emissions. Such measures would provide immediate public health benefits, such as reduced premature mortality and chronic morbidity, through improved local air quality. These mitigation strategies also allow long-term goals--for example, reducing the buildup of GHG emissions--to be achieved alongside short-term aims, such as immediate improvements in air quality, and therefore benefits to public health. The workshop aimed to foster research partnerships by improving collaboration and communication among various agencies and researchers; providing a forum for presentations by sponsoring agencies and researchers regarding research efforts and agency activities; identifying key issues, knowledge gaps, methodological shortcomings, and research needs; and recommending activities and initiatives for research, collaboration, and communication. This workshop summary briefly describes presentations made by workshop participants and the conclusions of three separate working groups: economics, benefits transfer, and policy; indoor air quality issues and susceptible populations; and development and transfer of dose-response relationships and exposure models in developing countries. Several common themes emerged from the working group sessions and subsequent discussion. Key recommendations include the need for improved communication and extended collaboration, guidance and support for researchers, advances in methods, and resource support for data collection, assessment, and research. PMID:12417489

  6. The Difference-in-Difference Method: Assessing the Selection Bias in the Effects of Neighborhood Environment on Health

    PubMed Central

    Grafova, Irina; Freedman, Vicki; Lurie, Nicole; Kumar, Rizie; Rogowski, Jeannette

    2013-01-01

    This paper uses the difference-in-difference estimation approach to explore the self-selection bias in estimating the effect of neighborhood economic environment on self-assessed health among older adults. The results indicate that there is evidence of downward bias in the conventional estimates of the effect of neighborhood economic disadvantage on self-reported health, representing a lower bound of the true effect. PMID:23623818

  7. NETIMIS: Dynamic Simulation of Health Economics Outcomes Using Big Data.

    PubMed

    Johnson, Owen A; Hall, Peter S; Hulme, Claire

    2016-02-01

    Many healthcare organizations are now making good use of electronic health record (EHR) systems to record clinical information about their patients and the details of their healthcare. Electronic data in EHRs is generated by people engaged in complex processes within complex environments, and their human input, albeit shaped by computer systems, is compromised by many human factors. These data are potentially valuable to health economists and outcomes researchers but are sufficiently large and complex enough to be considered part of the new frontier of 'big data'. This paper describes emerging methods that draw together data mining, process modelling, activity-based costing and dynamic simulation models. Our research infrastructure includes safe links to Leeds hospital's EHRs with 3 million secondary and tertiary care patients. We created a multidisciplinary team of health economists, clinical specialists, and data and computer scientists, and developed a dynamic simulation tool called NETIMIS (Network Tools for Intervention Modelling with Intelligent Simulation; http://www.netimis.com ) suitable for visualization of both human-designed and data-mined processes which can then be used for 'what-if' analysis by stakeholders interested in costing, designing and evaluating healthcare interventions. We present two examples of model development to illustrate how dynamic simulation can be informed by big data from an EHR. We found the tool provided a focal point for multidisciplinary team work to help them iteratively and collaboratively 'deep dive' into big data. PMID:26879667

  8. Estimating productivity costs in health economic evaluations: a review of instruments and psychometric evidence.

    PubMed

    Tang, Kenneth

    2015-01-01

    Health economic evaluations (i.e. cost-effectiveness appraisal of an intervention) are useful aids for decision makers responsible for the allocation of scarce healthcare resources. The relevance of including health-related productivity costs (or benefits) in these evaluations is increasingly recognized and, as such, reliable and valid instruments to quantify productivity costs are needed. Over the years, a number of work productivity instruments have emerged in the literature, along with a growing body of psychometric evidence. The overall aim of this paper is to provide a review of available instruments with potential for estimating health-related productivity costs. This included the Health and Labor Questionnaire, Health and Work Performance Questionnaire, Health-Related Productivity Questionnaire Diary, Productivity and Disease Questionnaire, Quantity and Quality method, Stanford Presenteeism Scale 13, Valuation of Lost Productivity, Work and Health Interview, Work Limitations Questionnaire, Work Productivity and Activity Impairment Questionnaire, and Work Productivity Short Inventory. Critical discussions on the instruments' overall strengths and limitations, applicability for health economic evaluations, as well as the methodological quality of existing psychometric evidence were provided. Lastly, a set of reflective questions were proposed for users to consider when selecting an instrument for health economic evaluations. PMID:25169062

  9. Estimating the Relationship between Economic Growth and Health Expenditures in ECO Countries Using Panel Cointegration Approach.

    PubMed

    Hatam, Nahid; Tourani, Sogand; Homaie Rad, Enayatollah; Bastani, Peivand

    2016-02-01

    Increasing knowledge of people about health leads to raising the share of health expenditures in government budget continuously; although governors do not like this rise because of budget limitations. This study aimed to find the association between health expenditures and economic growth in ECO countries. We added health capital in Solow model and used the panel cointegration approach to show the importance of health expenditures in economic growth. For estimating the model, first we used Pesaran cross-sectional dependency test, after that we used Pesaran CADF unit root test, and then we used Westerlund panel cointegration test to show if there is a long-term association between variables or not. After that, we used chaw test, Breusch-Pagan test and Hausman test to find the form of the model. Finally, we used OLS estimator for panel data. Findings showed that there is a positive, strong association between health expenditures and economic growth in ECO countries. If governments increase investing in health, the total production of the country will be increased, so health expenditures are considered as an investing good. The effects of health expenditures in developing countries must be higher than those in developed countries. Such studies can help policy makers to make long-term decisions. PMID:26997596

  10. Cleaner cooking solutions to achieve health, climate, and economic cobenefits.

    PubMed

    Anenberg, Susan C; Balakrishnan, Kalpana; Jetter, James; Masera, Omar; Mehta, Sumi; Moss, Jacob; Ramanathan, Veerabhadran

    2013-05-01

    Nearly half the world's population must rely on solid fuels such as biomass (wood, charcoal, agricultural residues, and animal dung) and coal for household energy, burning them in inefficient open fires and stoves with inadequate ventilation. Household solid fuel combustion is associated with four million premature deaths annually; contributes to forest degradation, loss of habitat and biodiversity, and climate change; and hinders social and economic progress as women and children spend hours every day collecting fuel. Several recent studies, as well as key emerging national and international efforts, are making progress toward enabling wide-scale household adoption of cleaner and more efficient stoves and fuels. While significant challenges remain, these efforts offer considerable promise to save lives, improve forest sustainability, slow climate change, and empower women around the world. PMID:23551030

  11. [Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

    PubMed

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

    Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance

  12. Assessment of the Economic Potential of Microgrids for Reactive Power Supply

    SciTech Connect

    Appen, Jan von; Marnay, Chris; Stadler, Michael; Momber, Ilan; Klapp, David; Scheven, Alexander von

    2011-05-01

    As power generation from variable distributed energy resources (DER) grows, energy flows in the network are changing, increasing the requirements for ancillary services, including voltage support. With the appropriate power converter, DER can provide ancillary services such as frequency control and voltage support. This paper outlines the economic potential of DERs coordinated in a microgrid to provide reactive power and voltage support at its point of common coupling. The DER Customer Adoption Model assesses the costs of providing reactive power, given local utility rules. Depending on the installed DER, the cost minimizing solution for supplying reactive power locally is chosen. Costs include the variable cost of the additional losses and the investment cost of appropriately over-sizing converters or purchasing capacitors. A case study of a large health care building in San Francisco is used to evaluate different revenue possibilities of creating an incentive for microgrids to provide reactive power.

  13. Antidepressant pharmacotherapy: economic outcomes in a health maintenance organization.

    PubMed

    Sclar, D A; Robison, L M; Skaer, T L; Legg, R F; Nemec, N L; Galin, R S; Hughes, T E; Buesching, D P

    1994-01-01

    Recent pharmacotherapeutic advances in the treatment of depression have included the development of selective serotonin re-uptake inhibitors (SSRIs). The present study was designed to contrast direct health service expenditures for the treatment of depression among patients enrolled in a health maintenance organization (HMO) and prescribed either the SSRI fluoxetine or one of three tricyclic antidepressants (TCAs) (amitriptyline, nortriptyline, or desipramine). Information regarding health service utilization was derived from the computer archive of a network-model HMO system serving 400,000 beneficiaries. A total of 701 HMO beneficiaries were found to satisfy the study selection criteria. Multivariate regression analysis was used to discern the incremental influence of selected demographic, clinical, financial, and provider characteristics on 1 year post-period expenditures (PPE) for health care. Analysis-of-variance procedures with Duncan's multiple-range test, or chi-square analyses, revealed no significant difference across antidepressant pharmacotherapy for age, sex, 6-month prior-period expenditures for physician visits, psychiatric visits, laboratory tests, hospitalizations, or psychiatric hospital services related to the treatment of depression, or number of prescribed therapeutic agents for disease state processes other than depression. Receipt of fluoxetine was associated with a significantly (P < or = 0.05) higher rate of initial prescribing by psychiatrists, an increase in the number of prescriptions for antidepressant pharmacotherapy obtained (30-day supplies), and a reduction in the number of monthly intervals during which time antidepressant pharmacotherapy was not procured. Receipt of fluoxetine as antidepressant pharmacotherapy was associated with a significantly (P < or = 0.05) higher mean medication possession ratio (MPR) relative to amitriptyline, nortriptyline, or desipramine. Multivariate findings for patient-level data reflecting a definitive

  14. Assessment of the Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Mobile Health (mHealth) Technology

    PubMed Central

    Brown, William; Yen, Po-Yin; Rojas, Marlene; Schnall, Rebecca

    2013-01-01

    Background Over two decades of research has been conducted using mobile devices for health related behaviors yet many of these studies lack rigor. There are few evaluation frameworks for assessing the usability of mHealth, which is critical as the use of this technology proliferates. As the development of interventions using mobile technology increase, future work in this domain necessitates the use of a rigorous usability evaluation framework. Methods We used two exemplars to assess the appropriateness of the Health IT Usability Evaluation Model (Health-ITUEM) for evaluating the usability of mHealth technology. In the first exemplar, we conducted 6 focus group sessions to explore adolescents’ use of mobile technology for meeting their health Information needs. In the second exemplar, we conducted 4 focus group sessions following an Ecological Momentary Assessment study in which 60 adolescents were given a smartphone with pre-installed health-related applications (apps). Data Analysis We coded the focus group data using the 9 concepts of the Health-ITUEM: Error prevention, Completeness, Memorability, Information needs, Flexibility/Customizability, Learnability, Performance speed, Competency, Other outcomes. To develop a finer granularity of analysis, the nine concepts were broken into positive, negative, and neutral codes. A total of 27 codes were created. Two raters (R1 & R2) initially coded all text and a third rater (R3) reconciled coding discordance between raters R1 and R2. Results A total of 133 codes were applied to Exemplar 1. In Exemplar 2 there were a total of 286 codes applied to 195 excerpts. Performance speed, Other outcomes, and Information needs were among the most frequently occurring codes. Conclusion Our two exemplars demonstrated the appropriateness and usefulness of the Health-ITUEM in evaluating mobile health technology. Further assessment of this framework with other study populations should consider whether Memorability and Error prevention

  15. A new approach to criteria for health risk assessment

    SciTech Connect

    Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

    2012-01-15

    Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: Black-Right-Pointing-Pointer A more objective approach to health risk assessment is provided. Black-Right-Pointing-Pointer An objective set of criteria for the consequences for chronic and acute impacts. Black-Right-Pointing-Pointer An objective set of criteria for the consequences on the health care system. Black-Right-Pointing-Pointer An objective set of criteria for event frequency that could impact on health. Black-Right-Pointing-Pointer The approach presented is currently being trialled in Australia.

  16. [COMPREHENSIVE ASSESSMENT OF HEALTH IN BABIES OF EARLY PRESCHOOL AGE].

    PubMed

    Denisov, A P; Semenova, N V; Kun, O A; Denisova, O A

    2015-01-01

    Health of the children's population is one of the most important components of safety of the country. The incidence level in children of early age reflects an interaction of economic, ecological, social and hygienic and medico-organizational factors in society. The issue of the paper is the comprehensive assessment of health of children of the first three years of life upon indices of the morbidity rate, physical development, interrelation of given indices with the structure of the family and their social status. Indices of the physical development of boys in the all age groups exceeded the corresponding indices in girls (p < 0.05). There was also statistically significant and augmentation of indices of body weights of children along with the age (p < 0.05). The highest morbidity rate in children was established in the first year of life, the minimal one--in the third year. In the all age groups diseases of respiratory organs prevailed, at this their proportion in the total amount of diseases in the third year of life considerably exceeded the same in first and second years of life. The highest incidences of children took place in the families formed by juvenile and lonely women. Diseases of digestive organs in the second and third years of life in children from juvenile and lonely mothers were considerably enlarged on frequency (by 1,4-1,7 times), infectious and parasitic diseases (by 1,1-1,7 times) in comparison with children from full families. In the all studied types offamilies and age groups the state of health of children was worse, than in full families. There was substantiated the development of the multilevel system for the prophylaxis of losses of health in children at early preschool age. PMID:26856178

  17. Nativity and Self-Assessed Health among Pre-Retirement Age Hispanics and Non-Hispanic Whites.

    ERIC Educational Resources Information Center

    Angel, Jacqueline L.; Buckley, Cynthia J.; Finch, Brian Karl

    2001-01-01

    Examined the salience of nativity in determining how economic, social, and familial resources influenced Hispanic and non-Hispanic white adults' self-assessed health. Survey data indicated that while education, accumulated assets, and marital status benefitted physical and emotional health among immigrants and nonimmigrants, family resources and…

  18. INTEGRATION OF HUMAN HEALTH AND ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    The WHO International Programme on Chemical Safety (IPCS), the Organization for Economic Cooperation and Development (OECD), and the U.S. Environmental Protection Agency (USEPA) have developed a collaborative partnership to foster integration of assessment approaches to evaluate ...

  19. In Preparation or Response: Examining Health Care Coalitions Amid a Changing Economic and Political Landscape.

    PubMed

    Dornauer, Mark E

    2015-12-01

    The Office of the Assistant Secretary for Preparedness and Response within the US Department of Health and Human Services leads the nation in preparing for, responding to, and recovering from the adverse health effects of public health emergencies, in part through formal collaborations between hospitals, health systems, community health centers, public health departments, and community organizations via health care coalitions (HCCs). HCCs endeavor to meet the medical surge demands inherent to disasters and to improve health outcomes before, during, and after public health emergencies. Nevertheless, significant changes in health economics and policy can impact the operations, capabilities, and scope of HCCs. Specifically, hospital consolidation and the Affordable Care Act (ACA) are altering the national health care landscape, as well as the emergency preparedness sector, and are challenging HCCs to adapt to large-scale, industry-wide transformations. This article examines HCCs in the context of the developments of hospital consolidation and the ACA in order to facilitate future discourse regarding the strategy and policy of HCCs amid a changing economic and political landscape. PMID:26545191

  20. Economic evaluation of the air pollution effect on public health in China's 74 cities.

    PubMed

    Li, Li; Lei, Yalin; Pan, Dongyan; Yu, Chen; Si, Chunyan

    2016-01-01

    Air deterioration caused by pollution has harmed public health. The existing studies on the economic