Behavioral economics and diabetic eye exams.

Science.gov (United States)

Williams, Andrew M; Liu, Peggy J; Muir, Kelly W; Waxman, Evan L

2018-07-01

Diabetic retinopathy is a common microvascular complication of diabetes mellitus and is the leading cause of new blindness among working-age adults in the United States. Timely intervention to prevent vision loss is possible with early detection by regular eye examinations. Unfortunately, adherence to recommended annual diabetic eye exams is poor. Public health interventions have targeted traditional barriers to care, such as cost and transportation, with limited success. Behavioral economics provides an additional framework of concepts and tools to understand low screening rates and to promote regular diabetic eye exams for populations at risk. In particular, behavioral economics outlines biases and heuristics that affect decision-making and underlie pervasive barriers to care, such as not viewing diabetic eye exams as a priority or perceiving oneself as too healthy to need an examination. In this review, we examine the literature on the use of behavioral economics interventions to promote regular diabetic eye exams. From the results of the included studies, we outline how concepts from behavioral economics can improve eye examination rates. In particular, the default bias, present bias, and self-serving bias play a significant role in precluding regular diabetic eye examinations. Potential tools to mitigate these biases include leveraging default options, using reminder messages, providing behavioral coaching, applying commitment contracts, offering financial incentives, and personalizing health messages. When combined with traditional public health campaigns, insights from behavioral economics can improve understanding of pervasive barriers to care and offer additional strategies to promote regular preventive eye care for patients with diabetes. Copyright © 2018 Elsevier Inc. All rights reserved.

Financial incentives for healthy behavior: ethical safeguards for behavioral economics.

Science.gov (United States)

Lunze, Karsten; Paasche-Orlow, Michael K

2013-06-01

Economic incentives to promote healthy behavior are becoming increasingly common and have been suggested as an approach to decreasing healthcare costs. Ethical concerns about programs with such incentives are that they may contribute to inequities, be coercive, interfere with therapeutic relationships, undermine personal responsibility for health, and decrease social solidarity. Additionally, they may be a source of stigma or discrimination, promote dependence, and be unfair for those already engaged in targeted health behaviors or those who cannot fulfill the incentivized behaviors. Incentive programs need to incorporate appropriate safeguards to monitor these risks and support fairness in offering economic incentives to promote healthy behavior. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Behavioral economics

OpenAIRE

Camerer, Colin F.

2014-01-01

Economics, like behavioral psychology, is a science of behavior, albeit highly organized human behavior. The value of economic concepts for behavioral psychology rests on (1) their empirical validity when tested in the laboratory with individual subjects and (2) their uniqueness when compared to established behavioral concepts. Several fundamental concepts are introduced and illustrated by reference to experimental data: open and closed economies, elastic and inelastic demand, and substitutio...

Low Self-Esteem during Adolescence Predicts Poor Health, Criminal Behavior, and Limited Economic Prospects during Adulthood

Science.gov (United States)

Trzesniewski, Kali H.; Donnellan, M. Brent; Moffitt, Terrie E.; Robins, Richard W.; Poulton, Richie; Caspi, Avshalom

2006-01-01

Using prospective data from the Dunedin Multidisciplinary Health and Development Study birth cohort, the authors found that adolescents with low self-esteem had poorer mental and physical health, worse economic prospects, and higher levels of criminal behavior during adulthood, compared with adolescents with high self-esteem. The long-term…

Leveraging Behavioral Economics to Improve Heart Failure Care and Outcomes.

Science.gov (United States)

Chang, Leslie L; DeVore, Adam D; Granger, Bradi B; Eapen, Zubin J; Ariely, Dan; Hernandez, Adrian F

2017-08-22

Behavioral challenges are often present in human illness, so behavioral economics is increasingly being applied in healthcare settings to better understand why patients choose healthy or unhealthy behaviors. The application of behavioral economics to healthcare settings parallels recent shifts in policy and reimbursement structures that hold providers accountable for outcomes that are dependent on patient behaviors. Numerous studies have examined the application of behavioral economics principles to policy making and health behaviors, but there are limited data on applying these concepts to the management of chronic conditions, such as heart failure (HF). Given its increasing prevalence and high associated cost of care, HF is a paradigm case for studying novel approaches to improve health care; therefore, if we can better understand why patients with HF make the choices they do, then we may be more poised to help them manage their medications, influence daily behaviors, and encourage healthy decision making. In this article, we will give a brief explanation of the core behavioral economics concepts that apply to patients with HF. We will also examine how to craft these concepts into tools such as financial incentives and social networks that may improve the management of patients with HF. We believe that behavioral economics can help us understand barriers to change, encourage positive behaviors, and offer additional approaches to improving the outcomes of patients with HF. © 2017 American Heart Association, Inc.

Behavioral economics strategies for promoting adherence to sleep interventions.

Science.gov (United States)

Stevens, Jack

2015-10-01

Cognitive-behavioral treatment for insomnia and continuous positive airway pressure therapy for obstructive sleep apnea are among the most efficacious sleep interventions. Unfortunately, adherence levels are disappointingly low for these interventions. Behavioral economics offers a promising framework for promoting adherence, often through relatively brief and straightforward strategies. The assumptions, goals, and key strategies of behavioral economics will be introduced. These strategies include providing social norms information, changing defaults, using the compromise effect, utilizing commitment devices, and establishing lottery-based systems. Then, this review will highlight specific behavioral economic approaches to promote patient adherence for three major sleep interventions: 1) behavioral treatment for pediatric insomnia, 2) cognitive-behavioral treatment for adult insomnia, and 3) continuous positive airway pressure for obstructive sleep apnea. Next, behavioral economic strategies will be discussed as ways to improve health care provider adherence to clinical practice guidelines regarding appropriate prescribing of hypnotics and ordering sleep-promoting practices for hospitalized inpatients. Finally, possible concerns that readers may have about behavioral economics strategies, including their efficacy, feasibility, and sustainability, will be addressed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Behavioral Economics and Consumption

DEFF Research Database (Denmark)

Reisch, Lucia A.; Sunstein, Cass R.

2015-01-01

Behavioral economics explores why people sometimes fail to make rational decisions, and how their behavior departs from the predictions of standard economic models. Insights gained from studies in behavioral economics are used in consumer research and consumer policy to understand and improve ind...

Homo Oeconomicus and Behavioral Economics

Directory of Open Access Journals (Sweden)

Justyna Brzezicka

2014-12-01

Full Text Available Recent years have witnessed a growing interest in behavioral trends in both economic theory and practical applications. As a science with vast potential for explaining complex market behaviors, behavioral economics is drifting away from the classical model of homo oeconomicus deployed by mainstream economics. This paper discusses the significance and role of the homo oeconomicus model in light of behavioral economics. It analyzes the direction of changes affecting homo oeconomicus, examines the definition of anomalies within the context of behavioral economics and discusses the anomalous status of homo oeconomicus. The paper proposes a hypothesis that the attitude characterizing homo oeconomicus is unique and incidental. The presented interdisciplinary analysis relies on economics, behavioral economics, economic psychology, behavioral finance and the methodology of science to discuss the homo oeconomicus model. The paper reviews change trends in economics, which are largely propelled by advancements in behavioral economics. The key methodological tools deployed in this paper are theoretical analysis and a compilation of extensive research findings. The results were used to formulate new theories advocating the development of a modern approach to the homo oeconomicus model, recognizing its significance and the growing importance of behavioral economics.

Principles of (Behavioral) Economics

OpenAIRE

David Laibson; John A. List

2015-01-01

Behavioral economics has become an important and integrated component of modern economics. Behavioral economists embrace the core principles of economics—optimization and equilibrium—and seek to develop and extend those ideas to make them more empirically accurate. Behavioral models assume that economic actors try to pick the best feasible option and those actors sometimes make mistakes. Behavioral ideas should be incorporated throughout the first-year undergraduate course. Instructors should...

The business cycle and health behaviors.

Science.gov (United States)

Xu, Xin

2013-01-01

While it is well documented that economic expansions provide widespread and immediate financial benefits, the evidence on how an economic downturn affects individual's health behaviors is surprisingly mixed. In this paper, we take a structural approach to investigate the effects of wages and working hours on health behaviors of low-educated persons using variations in wages and hours caused by changes in local economic activity. In the empirical analysis, we adopt a two-sample instrumental variables approach to combine the data on individual health behaviors from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) with the data on individual employment from the Current Population Survey (CPS). The total sample size of the combined CPS-BRFSS data for the time period of 1984-2005 is 967,594, while that of the combined CPS-NHIS data for the time period of 1976-2001 is 364,078. We find that increases in wages caused by economic expansions are associated with greater consumption of cigarettes in the United States. We also find that increases in hours of work caused by economic expansions are associated with more cigarette consumption, but less physical activity and physician visits. More importantly, the evidence suggests that most of such effects associated with changes in hours of work can be attributed to the changes at the extensive margin of employment, meaning the changes in employment status, rather than the changes at the intensive margin, meaning changes in hours of work conditional on being employed. These findings imply that changes in employment may have heterogeneous impacts on time-intensive and less time-intensive health behaviors and also provide additional evidence on the importance of time in health production, particularly for time-intensive activities. Copyright © 2012 Elsevier Ltd. All rights reserved.

Behavioral Economic Laboratory Research in Tobacco Regulatory Science.

Science.gov (United States)

Tidey, Jennifer W; Cassidy, Rachel N; Miller, Mollie E; Smith, Tracy T

2016-10-01

Research that can provide a scientific foundation for the United States Food and Drug Administration (FDA) tobacco policy decisions is needed to inform tobacco regulatory policy. One factor that affects the impact of a tobacco product on public health is its intensity of use, which is determined, in part, by its abuse liability or reinforcing efficacy. Behavioral economic tasks have considerable utility for assessing the reinforcing efficacy of current and emerging tobacco products. This paper provides a narrative review of several behavioral economic laboratory tasks and identifies important applications to tobacco regulatory science. Behavioral economic laboratory assessments, including operant self-administration, choice tasks and purchase tasks, can be used generate behavioral economic data on the effect of price and other constraints on tobacco product consumption. These tasks could provide an expedited simulation of the effects of various tobacco control policies across populations of interest to the FDA. Tobacco regulatory research questions that can be addressed with behavioral economic tasks include assessments of the impact of product characteristics on product demand, assessments of the abuse liability of novel and potential modified risk tobacco products (MRTPs), and assessments of the impact of conventional and novel products in vulnerable populations.

Simultaneous Health Risk Behaviors in Adolescents Associated with Higher Economic Class in the Northeast of Brazil

Directory of Open Access Journals (Sweden)

Arley Santos Leão

2017-01-01

Full Text Available Design. The social, cultural, and economic context can be an important variable in the perception and adoption of risk behaviors in adolescents. Objective. The purpose of this study was to identify the prevalence of simultaneous health risk behaviors and associated socioeconomic factors in adolescents living in the metropolitan region of Aracaju, State of Sergipe, Brazil. Methods. The sample consisted of 2,207 high school students aged 13–18 years. The risk behaviors measured were “low levels of physical activity,” “excessive daily TV time,” “high consumption of alcoholic beverages on a single occasion,” “involvement in fights,” “smoking cigarettes,” “carrying firearms,” and “marijuana consumption.” Information was obtained through self-administered questionnaire. Results. Considering the results, it was observed that female adolescents and those aged up to 16 years were less likely to have two or more health risk behaviors compared to males and those aged 17 years or more, respectively. It was also found that both high- and middle-income level adolescents had higher prevalence of having two or more health risk behaviors. Conclusions. It was concluded that male adolescents older than 16 years with better socioeconomic level were more exposed to the simultaneous presence of several health risk behaviors.

Behavioral economics and regulatory analysis.

Science.gov (United States)

Robinson, Lisa A; Hammitt, James K

2011-09-01

Behavioral economics has captured the interest of scholars and the general public by demonstrating ways in which individuals make decisions that appear irrational. While increasing attention is being focused on the implications of this research for the design of risk-reducing policies, less attention has been paid to how it affects the economic valuation of policy consequences. This article considers the latter issue, reviewing the behavioral economics literature and discussing its implications for the conduct of benefit-cost analysis, particularly in the context of environmental, health, and safety regulations. We explore three concerns: using estimates of willingness to pay or willingness to accept compensation for valuation, considering the psychological aspects of risk when valuing mortality-risk reductions, and discounting future consequences. In each case, we take the perspective that analysts should avoid making judgments about whether values are "rational" or "irrational." Instead, they should make every effort to rely on well-designed studies, using ranges, sensitivity analysis, or probabilistic modeling to reflect uncertainty. More generally, behavioral research has led some to argue for a more paternalistic approach to policy analysis. We argue instead for continued focus on describing the preferences of those affected, while working to ensure that these preferences are based on knowledge and careful reflection. © 2011 Society for Risk Analysis.

Conditional Economic Incentives for Reducing HIV Risk Behaviors: Integration of Psychology and Behavioral Economics

Science.gov (United States)

Operario, Don; Kuo, Caroline C.; Sosa-Rubí, Sandra G.; Gálarraga, Omar

2014-01-01

Objective This paper reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. Methods We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories end behavioral economics can be combined into new approaches for HIV prevention. Results Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and STI prevalence, HIV testing, HIV medication adherence, and drug use. Conclusion CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PMID:24001243

Conditional economic incentives for reducing HIV risk behaviors: integration of psychology and behavioral economics.

Science.gov (United States)

Operario, Don; Kuo, Caroline; Sosa-Rubí, Sandra G; Gálarraga, Omar

2013-09-01

This article reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories and behavioral economics can be combined into new approaches for HIV prevention. Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and sexually transmitted infection (STI) prevalence, HIV testing, HIV medication adherence, and drug use. CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Modifying and developing health behavior.

Science.gov (United States)

Green, L W

1984-01-01

The literatures on both behavior modification and behavioral development have engendered innovations in public health programs, addressing problems of patient adherance to preventive and therapeutic regimens, delay in seeking diagnosis of illness symptoms, risk-taking behavior, and other aspects of lifestyle associated with health. Because most of this literature derives from psychology, there has been a distinct bias in the construction of interventions, pointing them directly at individuals, usually in a counseling or small group mode of delivery. These developments served public health well enough during a decade or so when the preoccupation was with utilization of health services and medical management of chronic diseases. With the publication of the Lalonde Report in Canada in 1974, the passage of Public Law 94-317 in 1976 in the United States, and similar initiatives in other English-speaking and European countries, the recognition of the greater complexities of lifestyle development and modification in the absence of symptoms has taken hold. Policy makers and public health workers seek a more efficient and equitable set of strategies to meet the behavioral health challenges of modern society without placing the entire weight of responsibility for behavior on the individual or on therapeutic practitioners. Concurrently, on a more global scale and in the developing countries, a concern has emerged for strategies that give individuals, families, and communities a greater role in deciding their own health priorities. The convergence of these two trends--one seeking to distribute responsibility for lifestyle more equitably and the other seeking to distribute responsibility for planning health programs more equitably --calls for policies, strategies, and interventions that will place similar emphasis on health education and organizational, economic, and environmental supports for health behavior. The combination of these elements of support for behavior calls, in

(Non-) behavioral economics: a programmatic assessment

OpenAIRE

Güth, Werner

2007-01-01

Economic theory has evolved without paying proper attention to behavioral approaches, especially to social, economic, and cognitive psychology. This has recently changed by including behavioral economics courses in many doctoral study programs. Although this new development is most welcome, the typical topics of the behavioral economics courses are not truly behavioral. More specifically, we question whether neoclassical repairs or game fitting exercises as well as more or less mechanic adapt...

Applied economics: The use of monetary incentives to modulate behavior.

Science.gov (United States)

Strang, S; Park, S Q; Strombach, T; Kenning, P

2016-01-01

According to standard economic theory higher monetary incentives will lead to higher performance and higher effort independent of task, context, or individual. In many contexts this standard economic advice is implemented. Monetary incentives are, for example, used to enhance performance at workplace or to increase health-related behavior. However, the fundamental positive impact of monetary incentives has been questioned by psychologists as well as behavioral economists during the last decade, arguing that monetary incentives can sometimes even backfire. In this chapter, studies from proponents as well as opponents of monetary incentives will be presented. Specifically, the impact of monetary incentives on performance, prosocial, and health behavior will be discussed. Furthermore, variables determining whether incentives have a positive or negative impact will be identified. © 2016 Elsevier B.V. All rights reserved.

[Family cohesion associated with oral health, socioeconomic factors and health behavior].

Science.gov (United States)

Ferreira, Luale Leão; Brandão, Gustavo Antônio Martins; Garcia, Gustavo; Batista, Marília Jesus; Costa, Ludmila da Silva Tavares; Ambrosano, Gláucia Maria Bovi; Possobon, Rosana de Fátima

2013-08-01

Overall health surveys have related family cohesion to socio-economic status and behavioral factors. The scope of this study was to investigate the association between family cohesion and socio-economic, behavioral and oral health factors. This was a, cross-sectional study with two-stage cluster sampling. The random sample consisted of 524 adolescents attending public schools in the city of Piracicaba-SP. Variables were evaluated by self-applied questionnaires and caries and periodontal disease were assessed by DMF-T and CPI indices. The adolescent's perception of family cohesion was assessed using the family adaptability and cohesion scale. Univariate and multinomial logistic regression shows that adolescents with low family cohesion were more likely than those with medium family cohesion to have low income (OR 2,28 95% CI 1,14- 4,55), presence of caries (OR 2,23 95% CI 1,21-4,09), less than two daily brushings (OR 1,91 95% CI 1,03-3,54). Adolescents with high family cohesion were more likely than those with medium family cohesion to have high income and protective behavior against the habit of smoking. Thus, the data shows that adolescent perception of family cohesion was associated with behavioral, socio-economic and oral health variables, indicating the importance of an integral approach to patient health.

Substitution of healthy for unhealthy beverages among college students. A health-concerns and behavioral-economics perspective.

Science.gov (United States)

Yang, Chao-Chin; Chiou, Wen-Bin

2010-06-01

Excessive intake of sugar-sweetened beverages by undergraduates is closely related to the increasing prevalence of obesity, making investigations of the substitution of healthy for unhealthy beverages imperative. According to the concept of price elasticity in behavioral economics, the choice of healthy over unhealthy behaviors is facilitated by increasing the cost of less-healthy alternatives or reducing the cost of healthier alternatives. Furthermore, evoking health concerns by using health claims may induce substitution of healthy for unhealthy beverages. A total of 108 18-22-year-old undergraduates participated in a laboratory experiment and were given a certain amount of money and allowed to purchase a healthy beverage and a less-healthy beverage with or without receiving health claims. Increasing the price of a type of beverage was shown to reduce purchases of that beverage type and lead to substitution with the alternative type. Moreover, the effect of price elasticity on healthy beverage substitution was more pronounced when participants' health concerns were evoked. The results suggest that lowering the cost of alternative commodities and evoking health concerns by health-related claims would foster the substitution of healthier for unhealthy beverages among college students. Copyright 2010 Elsevier Ltd. All rights reserved.

The possibility of behavioral new institutional economics

OpenAIRE

菊沢, 研宗

2011-01-01

Behavioral economics has recently been the subject of considerable research with the consequence that theories in behavioral economics and finance have complementarily developed to comprise a research field known as 'behavioral finance'. Subsequent studies seeking to integrate game theory and behavioral economics come under the 'behavioral game theory' umbrella, while those wanting to integrate contract theory and behavioral economics fall under 'behavioral contract theory'. Given such circum...

What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions.

Science.gov (United States)

Iribarren, Sarah J; Cato, Kenrick; Falzon, Louise; Stone, Patricia W

2017-01-01

Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited. In this systematic review the body of evidence related to economic evaluations of mHealth interventions is assessed and summarized. Seven electronic bibliographic databases, grey literature, and relevant references were searched. Eligibility criteria included original articles, comparison of costs and consequences of interventions (one categorized as a primary mHealth intervention or mHealth intervention as a component of other interventions), health and economic outcomes and published in English. Full economic evaluations were appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and The PRISMA guidelines were followed. Searches identified 5902 results, of which 318 were examined at full text, and 39 were included in this review. The 39 studies spanned 19 countries, most of which were conducted in upper and upper-middle income countries (34, 87.2%). Primary mHealth interventions (35, 89.7%), behavior change communication type interventions (e.g., improve attendance rates, medication adherence) (27, 69.2%), and short messaging system (SMS) as the mHealth function (e.g., used to send reminders, information, provide support, conduct surveys or collect data) (22, 56.4%) were most frequent; the most frequent disease or condition focuses were outpatient clinic attendance, cardiovascular disease, and diabetes. The average percent of CHEERS checklist items reported was 79.6% (range 47.62-100, STD 14.18) and the top quartile reported 91.3-100%. In 29 studies (74.3%), researchers reported that the mHealth intervention was cost-effective, economically beneficial, or cost saving at base case. Findings highlight a growing body of economic evidence for mHealth interventions. Although all studies included a comparison of intervention effectiveness of a health

Understanding consumer decisions using behavioral economics.

Science.gov (United States)

Zandstra, Elizabeth H; Miyapuram, Krishna P; Tobler, Philippe N

2013-01-01

Consumers make many decisions in everyday life involving finances, food, and health. It is known from behavioral economics research that people are often driven by short-term gratification, that is, people tend to choose the immediate, albeit smaller reward. But choosing the delayed reward, that is, delaying the gratification, can actually be beneficial. How can we motivate consumers to resist the "now" and invest in their future, leading to sustainable or healthy habits? We review recent developments from behavioral and neuroimaging studies that are relevant for understanding consumer decisions. Further, we present results from our field research that examined whether we can increase the perceived value of a (delayed) environmental benefit using tailored communication, that is, change the way it is framed. More specifically, we investigated whether we can boost the value of an abstract, long-term "green" claim of a product by expressing it as a concrete, short-term benefit. This is a new application area for behavioral economics. Copyright © 2013 Elsevier B.V. All rights reserved.

Presenting quality data to vulnerable groups: charts, summaries or behavioral economic nudges?

Science.gov (United States)

Elbel, Brian; Gillespie, Colleen; Raven, Maria C

2014-07-01

Despite the increased focus on health care consumers' active choice, not enough is known about how to best facilitate the choice process. We sought to assess methods of improving this process for vulnerable consumers in the United States by testing alternatives that emphasize insights from behavioral economics, or 'nudges'. We performed a hypothetical choice experiment where subjects were randomized to one of five experimental conditions and asked to choose a health center (location where they would receive all their care). The conditions presented the same information about health centers in different ways, including graphically as a chart, via written summary and using behavioral economics, 'nudging' consumers toward particular choices. We hypothesized that these 'nudges' might help simplify the choice process. Our primary outcomes focused on the health center chosen and whether consumers were willing to accept 'nudges'. We found that consumer choice was influenced by the method of presentation and the majority of consumers accepted the health center they were 'nudged' towards. Consumers were accepting of choices grounded in insights from behavioral economics and further consideration should be given to their role in patient choice. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Health economic choices in old age: interdisciplinary perspectives on economic decisions and the aging mind.

Science.gov (United States)

Nielsen, Lisbeth; Phillips, John W R

2008-01-01

This chapter offers an integrative review of psychological and neurobiological differences between younger and older adults that might impact economic behavior. Focusing on key health economic challenges facing the elderly, it offers perspectives on how these psychological and neurobiological factors may influence decision-making over the life course and considers future interdisciplinary research directions. We review relevant literature from three domains that are essential for developing a comprehensive science of decision-making and economic behavior in aging (psychology, neuroscience, and economics), consider implications for prescription drug coverage and long-term care (LTC) insurance, and highlight future research directions. Older adults face many complex economic decisions that directly affect their health and well-being, including LTC insurance, prescription drug plans, and end of life care. Economic research suggests that many older Americans are not making cost-effective and economically rational decisions. While economic models provide insight into some of the financial incentives associated with these decisions, they typically do not consider the roles of cognition and affect in decision-making. Research has established that older age is associated with predictable declines in many cognitive functions and evidence is accumulating that distinct social motives and affect-processing profiles emerge in older age. It is unknown how these age differences impact the economic behaviors of older people and implies opportunities for path-breaking interdisciplinary research. Our chapter looks to develop interdisciplinary research to better understand the causes and consequences of age-related changes in economic decision-making and guide interventions to improve public programs and overall social welfare.

Behavioral Economics: A Maverick Guide

OpenAIRE

Hugh Schwartz

2014-01-01

These are the notes from the first half of a course in behavioral economics offered in Uruguay in November 2014. This part of the course, entirely verbal, was aimed at outlining the essentials of behavioral economics. The principal assignments were from the second edition of Edward Cartwright’s Behavioral Economics. The second part of the course, taught by Dr. Martin Egozcue, is not included. It emphasized prospect theory, mental accounts and inter-temporal decision making, and featured subst...

Behavioral Economics

OpenAIRE

Sendhil Mullainathan; Richard H. Thaler

2000-01-01

Behavioral Economics is the combination of psychology and economics that investigates what happens in markets in which some of the agents display human limitations and complications. We begin with a preliminary question about relevance. Does some combination of market forces, learning and evolution render these human qualities irrelevant? No. Because of limits of arbitrage less than perfect agents survive and influence market outcomes. We then discuss three important ways in which humans devi...

ENTREPRENEURSIPH IN ROMANIA. A BEHAVIORAL ECONOMICS PERSPECTIVE

Directory of Open Access Journals (Sweden)

Neațu Alina-Maria

2015-07-01

Full Text Available Economics provides insight into how entrepreneurship influences growth and development and, on the other hand, how the macro structure of a region or country impacts the type and abundance of entrepreneurship. Economic analysis provides insights for scholars, guides practitioners and policymakers. From a broader perspective, economic theories guide the understanding of human behaviors and the constant quest toward realization, comprehension and improvement of human condition. Moreover, behavioral economics combines insights of psychology, sociology and economics in trying to better understand and predict human decision-making. At the intersection of economic studies with social sciences, behavioral economics succeeds to demonstrate, using laboratory tests and experiments, that on a shorter term people are quite capable to perform profitable economic computations and adopt rational behaviors, but on a long term run they easily become fallible in performing rational mental accounting and are vulnerable to several factors such as emotions, certain mass-manipulation techniques, lack of self control or procrastination, etc. Extended research in the field of behavioral economics reports many other various behavioral anomalies that may have the ability to explain seemingly irrational and unpredictable responses of individuals, in general, and entrepreneurs, in particular – especially when finding themselves in conditions of risk, uncertainty or incomplete information. Furthermore, the elevated consistency of these abnormalities suggests that they are divergent only to our traditional models, but that they could otherwise be the norm. The present article seeks to explain how such insights from behavioral economics may help us better understand and enhance our perspective on entrepreneurship, what are some of the most frequent biases characteristic to entrepreneurial behavior and decision-making, accounting as most notable for the field of

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

Science.gov (United States)

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

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

Science.gov (United States)

Oppong, Raymond; Mistry, Hema; Frew, Emma

2013-09-13

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.

Behavioral Economics of Education

DEFF Research Database (Denmark)

Koch, Alexander Karl; Nafziger, Julia; Nielsen, Helena Skyt

2015-01-01

-dimensional rather than one-dimensional. Explicitly accounting for soft skills often implies departing from the standard economic model by integrating concepts studied in behavioral and experimental economics, such as self-control, willingness to compete, intrinsic motivation, and self-confidence. We review how...

Family Economic Security Policies and Child and Family Health.

Science.gov (United States)

Spencer, Rachael A; Komro, Kelli A

2017-03-01

In this review, we examine the effects of family economic security policies (i.e., minimum wage, earned income tax credit, unemployment insurance, Temporary Assistance to Needy Families) on child and family health outcomes, summarize policy generosity across states in the USA, and discuss directions and possibilities for future research. This manuscript is an update to a review article that was published in 2014. Millions of Americans are affected by family economic security policies each year, many of whom are the most vulnerable in society. There is increasing evidence that these policies impact health outcomes and behaviors of adults and children. Further, research indicates that, overall, policies which are more restrictive are associated with poorer health behaviors and outcomes; however, the strength of the evidence differs across each of the four policies. There is significant diversity in state-level policies, and it is plausible that these policy variations are contributing to health disparities across and within states. Despite increasing evidence of the relationship between economic policies and health, there continues to be limited attention to this issue. State policy variations offer a valuable opportunity for scientists to conduct natural experiments and contribute to evidence linking social policy effects to family and child well-being. The mounting evidence will help to guide future research and policy making for evolving toward a more nurturing society for family and child health and well-being.

Evaluating Behavioral Economic Models of Heavy Drinking Among College Students.

Science.gov (United States)

Acuff, Samuel F; Soltis, Kathryn E; Dennhardt, Ashley A; Berlin, Kristoffer S; Murphy, James G

2018-05-14

Heavy drinking among college students is a significant public health concern that can lead to profound social and health consequences, including alcohol use disorder. Behavioral economics posits that low future orientation and high valuation of alcohol (alcohol demand) combined with deficits in alternative reinforcement increase the likelihood of alcohol misuse (Bickel et al., 2011). Despite this, no study has examined the incremental utility of all three variables simultaneously in a comprehensive model METHOD: The current study uses structural equation modeling to test the associations between behavioral economic variables - alcohol demand (latent), future orientation (measured with a delay discounting task and the Consideration of Future Consequences (CFC) scale), and proportionate substance-related reinforcement - and alcohol consumption and problems among 393 heavy drinking college students. Two models are tested: 1) an iteration of the reinforcer pathology model that includes an interaction between future orientation and alcohol demand; and 2) an alternative model evaluating the interconnectedness of behavioral economic variables in predicting problematic alcohol use RESULTS: The interaction effects in model 1 were nonsignificant. Model 2 suggests that greater alcohol demand and proportionate substance-related reinforcement is associated with greater alcohol consumption and problems. Further, CFC was associated with alcohol-related problems and lower proportionate substance-related reinforcement but was not significantly associated with alcohol consumption or alcohol demand. Finally, greater proportionate substance-related reinforcement was associated with greater alcohol demand CONCLUSIONS: Our results support the validity of the behavioral economic reinforcer pathology model as applied to young adult heavy drinking. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

BEHAVIORAL ECONOMICS AND THE NEED OF PSYCHOLOGY IN ECONOMIC RESEARCH

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Andreea GRADINARU

2014-06-01

Full Text Available The turning point in economic science has now come, marked especially by triggering the biggest crisis since the Great Depression of '29-'33, has called into question the need to reconsider the status of economic science and finding ways in which it can increase its practical foundations. In the elaboration of this study I’ve took into account the fact that beyond any abstract, formal and mathematical model, economics is a science, having the man in its center. Furthermore, every economic process is based on the human being. But the way individuals behave does not follow precisely the pattern predicted by classical and neoclassical models, but most of the time they are making decisions under the influence of psychological factors. Starting from these assumptions I considered important to highlight a real need for psychology in economic research. Therefore, the aim of this work is exclusively theoretical meant to show that the study of psychological factors is necessary in economic research, because it allows a better explanation of the economic problems and lead to obtaining results closer to reality than those who only take into consideration economic factors. In this way I appealed to behavioral economics. This represents a new trend of economic thinking that reunites psychology with economy. The thing that I observed after finishing the study is that behavioral economics can increase the explanatory power of economics by providing more realistic psychological bases, because human behavior is not only the subject matter of economics but psychology too.

Work stress and health risk behavior.

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Siegrist, Johannes; Rödel, Andreas

2006-12-01

This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.

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Emanuel, Ezekiel J; Ubel, Peter A; Kessler, Judd B; Meyer, Gregg; Muller, Ralph W; Navathe, Amol S; Patel, Pankaj; Pearl, Robert; Rosenthal, Meredith B; Sacks, Lee; Sen, Aditi P; Sherman, Paul; Volpp, Kevin G

2016-01-19

Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.

Health-related behaviors among pregnant women with hypertension

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Agnieszka Maria Bień

2017-01-01

Full Text Available Introduction. The healthy and unhealthy behaviors of a pregnant woman influence both her own health and that of her unborn child, affecting its future development. The purpose of the study was to evaluate the health-related behaviors of pregnant women with hypertension.   Material i method. The study was performed between November 2011 and February 2012 and included 80 hypertensive pregnant women hospitalized in a high risk pregnancy ward. The study used a diagnostic survey with questionnaires. Results. Statistical analyses showed a correlation between the respondents’ health-related behaviors and their socio-demographic characteristics: exercise was correlated with age (p=0.01, and rest during the day was correlated with support in everyday responsibilities (p<0.00001, and with the respondents’ socio-economic standing (p=0.03. Correlations were also found between healthy eating habits and residence (0.006, education (p=0.05, and sodium intake (p=0.0003, as well as between education and substance use (p=0.0003. Conclusion. Health-related behaviors of pregnant women with hypertension are influenced by their education, support they receive in daily responsibilities, and their socio-economic standing. The diagnosis of hypertension in pregnant women does not necessarily prompt them to discontinue all unhealthy behaviors.

APPLICATIONS OF BEHAVIORAL ECONOMICS IN UNIVERSITY LIFE

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GEORGE NICULESCU

2017-11-01

Full Text Available In the first part of the article I have dealt with the role and place of behavioral economics in the economic sciences. Classical economic theories are criticized by the behavioral economy. We think we are rational beings and that we make logical decisions based on the information we have at our disposal. In fact, we have our own cognitive limitations that can lead to hasty decisions or confusing judgments; the real individual is a complex person, with actions that result in failures and incomprehensible behaviors for the economics Behavioral economics is trying to explain why individuals often make irrational choices, and why decisions they take do not follow exactly the patterns predicted by classical and neoclassical economic models. This paper is trying to assess the individual behavior involved in the decision making process in the university space. This article describes aloso a series of experiments on behavioral economics. The experiments are from university life and contest the hypothesis of the perfectly rational person's existence in making decisions and the neoclassical economic theories and models that are based only on the premise of the existence of homo oeconomicus rationalis. Observations and experiments conducted with students at Constantin Brancusi University in Târgu-Jiu are relevant in challenging the hypothesis of perfect rationality, preference stability, perfect information and market efficiency. The research method used in this article is the experiment. Study results are useful for academic management.

Aging Men’s Health-Related Behaviors

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Terry Peak

2014-11-01

Full Text Available This conceptual review summarizes the current research on older men and their health-related behaviors with special attention given to the influence of the hegemonic masculinity framework over the life span. The authors consider whether masculinity precepts can be modified to enable men to alter their gendered morbidity/mortality factors and achieve healthier and longer lives. Also included is an overview of the gender-based research and health education efforts to persuade men to adopt more effective health-related behaviors or health practices earlier in the life span. Given the current attention being paid to men’s health, for example, their higher risk of morbidity and mortality both generally and at younger ages, and the associated health care costs tied to those risks, the ethical and economic implications of this review may prove useful.

Economic Holobiont: Influence of Parasites, Microbiota and Chemosignals on Economic Behavior

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Petr Houdek

2018-05-01

Full Text Available The article is a perspective on utilization of microorganisms and chemosignals in studying human economic behavior. Research in biological roots of economic development has already confirmed that parasitic pressure influenced the creation and development of cultural norms and institutions. However, other effects of microorganisms on human groups and individual decision-making and behavior are heavily understudied. The perspective discusses how parasitic infections, sexually transmitted organisms and microbiota (i.e., “human holobiont” could causally influence risk-seeking behavior, impulsivity, social dominance, empathy, political views and gender differences. As a case study, the parasite Toxoplasma gondii and its influence on economic preferences, personal characteristics and human appearance are examined. I also briefly review how chemosignals influence decision-making, particularly in the social preferences domain. I mention some predictions that arise from the paradigm of economic holobiont for the economic science. The conclusion summarizes limitations of the discussed findings and the stated speculations.

[Fostering of health economics in Germany].

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Ulrich, V

2012-05-01

Health economics is now well established in Germany with the aim to apply economic tools to answer problems in health and health care. After a short review of the international development of health economics and the development in Germany in particular, the article looks at selected recent topics of health economic analysis in Germany (economic evaluation, industrial economics, health and education).

Modeling the Economic Behavior of Households within the Context of Development of Economic Thought

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Ivanov Roman V.

2017-04-01

Full Text Available The main purpose of the publication is to study formation of the household economic behavior modeling in the context of development of economic thought and methods of the economic-mathematical modeling. The study was carried out under the assumption that, when studying the development of theoretical and methodological foundations of the economic behavior of households one must take into account not only the history of development of economic theory, but also the transformation of attitudes in other areas of human knowledge, in particular the paradigm shift in scientific thinking. It has been specified that the massive use of mathematical methods in economics is associated with formation of the marginal theory and at the same time – with the proliferation of the marginal analysis. At the present stage, the economic behavior of households is being analyzed in the terms of concepts such as neoclassicism, institutionalism and behaviorism. But by dividing the concepts of «individual» and «household», it can be argued that precisely the institutionalism in conjunction with synergistic approach provide the basis for elaboration of strategies for the economic behavior of households, ensuring their economic security.

Are Financial Incentives for Lifestyle Behavior Change Informed or Inspired by Behavioral Economics? A Mapping Review.

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McGill, Bronwyn; O'Hara, Blythe J; Bauman, Adrian; Grunseit, Anne C; Phongsavan, Philayrath

2018-01-01

To identify the behavioral economics (BE) conceptual underpinnings of lifestyle financial incentive (FI) interventions. A mapping review of peer-reviewed literature was conducted by searching electronic databases. Inclusion criteria were real-world FI interventions explicitly mentioning BE, targeting individuals, or populations with lifestyle-related behavioral outcomes. Exclusion criteria were hypothetical studies, health professional focus, clinically oriented interventions. Study characteristics were tabulated according to purpose, categorization of BE concepts and FI types, design, outcome measures, study quality, and findings. Data Synthesis and Analysis: Financial incentives were categorized according to type and payment structure. Behavioral economics concepts explicitly used in the intervention design were grouped based on common patterns of thinking. The interplay between FI types, BE concepts, and outcome was assessed. Seventeen studies were identified from 1452 unique records. Analysis showed 76.5% (n = 13) of studies explicitly incorporated BE concepts. Six studies provided clear theoretical justification for the inclusion of BE. No pattern in the type of FI and BE concepts used was apparent. Not all FI interventions claiming BE inclusion did so. For interventions that explicitly included BE, the degree to which this was portrayed and woven into the design varied. This review identified BE concepts common to FI interventions, a first step in providing emergent and pragmatic information to public health and health promotion program planners.

Health economics and health policy: experiences from New Zealand.

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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.

Behavioral economics: Past, present, and future

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Richard H. Thaler

2018-04-01

Full Text Available “Behavioral economics” attempts to incorporate insights from other social sciences, especially psychology, in order to enrich the standard economic model. The interest in the psychology of human behavior returns economics to its earliest roots. Adam Smith talked about such key concepts as loss aversion, overconfidence, and self-control. Nevertheless, the modern version of behavioral economics introduced in the 1980s met with resistance by some economists, who preferred to retain the standard neo-classical model. They introduced several arguments for why psychology could safely be ignored. In this essay I show that these arguments have been rejected, both theoretically and empirically, so it is time to move on. The new approach should include two different kinds of theories: normative models that characterize the optimal solution to specific problems and descriptive models that capture how humans actually behave. The latter theories will incorporate some variables I call supposedly irrelevant factors, which can improve the explanatory power of economic models.

A HUMANISING ECONOMIC APPROACH ON COMPETITION POLICY OR HOW THE BEHAVIORAL ECONOMICS BLENDS WITH “TRADITIONAL ECONOMICS”

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Liviana Andreea Niminet

2015-07-01

Full Text Available Behavioral are crucial for understanding both the consumer’s attitude and firms’ attitude as well as for understanding the market outcomes. The past ten years brought a lot of attention from researchers and policy-makers on the behavioral economics issue. Classical, traditional economic models rely on the assumptions of rationality and ordered preferences. Behavioral economics explores interactions between demand and supply including information framing, the use of heuristics in decision-making and time-inconsistent preferences. The research on behavioral economics has led to an extensive debate about the relative merits of both traditional and behavioral economics. First of all we propose to highlight the advantages and disadvantages of behavioral economics versus traditional economics on a very sensitive issue: the competition policy. Then we address market issues that can be solved by means of behavioral economics afterwards turning out attention to the remedies of behavioral economics and ,last but not least, the United Kingdom successful model on the matter of competition policy.

The role of behavioral economics and behavioral decision making in Americans' retirement savings decisions.

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Knoll, Melissa A Z

2010-01-01

Traditional economic theory posits that people make decisions by maximizing a utility function in which all of the relevant constraints and preferences are included and weighed appropriately. Behavioral economists and decision-making researchers, however, are interested in how people make decisions in the face of incomplete information, limited cognitive resources, and decision biases. Empirical findings in the areas of behavioral economics and judgment and decision making (JDM) demonstrate departures from the notion that man is economically rational, illustrating instead that people often act in ways that are economically suboptimal. This article outlines findings from the JDM and behavioral-economics literatures that highlight the many behavioral impediments to saving that individuals may encounter on their way to financial security. I discuss how behavioral and psychological issues, such as self-control, emotions, and choice architecture can help policymakers understand what factors, aside from purely economic ones, may affect individuals' savings behavior.

Nutrition economics - characterising the economic and health impact of nutrition.

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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.

The behavioral economics of violence.

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Rachlin, Howard

2004-12-01

From the viewpoint of teleological behaviorism the first question to ask in attempting to understand any behavior, including violent behavior, is: What are its contingencies of reward and punishment? Or, to put the question in economic terms: What are the short-term and long-term costs and benefits that such behavior entails? Let us therefore consider the costs and benefits of youth violence. Among the short-term costs of violent behavior are the physical effort of the act, the possibility of immediate physical retaliation, immediate social disapproval, and the opportunity cost of other social acts that the violent behavior takes the place of (you can't be affectionate and violent at the same time, for instance). Among the immediate benefits of violent behavior are the intrinsic satisfaction of the violent act itself and any extrinsic benefit; if A violently appropriates B's new sneakers then obtaining the sneakers reinforces A's violence. These immediate benefits may well outweigh the costs in many contexts. Among the long-term costs of violent behavior are delayed retaliation, possible social disapproval and loss of social support, rejection from a social group, job loss, and health risks associated with a violent lifestyle. Among the long-term benefits are long-term intimidation of others (your neighbor is less likely to build a fence on your property if you have a reputation for violence), and a possibly exciting lifestyle. These long-term benefits may well be outweighed by the long-term costs. Opposition of long-term net costs to short-term net benefits, where it exists, creates a personal self-control trap: Overall satisfaction may decrease monotonically with rate of the target behavior but, regardless of its rate, the immediate satisfaction of doing it is always higher than that of not doing it. In the case of violent behavior, this trap is exacerbated by the fact that as a person's violence increases, net immediate reinforcement also increases (due to

[Socioeconomic differentials in health and health related behaviors: findings from the Korea Youth Panel Survey].

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Khang, Young-Ho; Cho, Sung-Il; Yang, Seungmi; Lee, Moo-Song

2005-11-01

This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. The perceived economic hardships predicted the health

Behavioral economics and the ‘new’ paternalism1

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Rostislav Kapeliushnikov

2015-03-01

Full Text Available The paper provides a critical appraisal of the normative program of behavioral economics known as ‘new paternalism’. First, it explores the theoretical foundations of behavioral economics, describes major behavioral anomalies associated with bounded rationality of economic agents and discusses its normative principles and political implications. It then discusses the main empirical and conceptual drawbacks of new paternalism and provides arguments for the alternative non-welfarist normative tradition based on the idea of freedom.

Analysis of Health Behavior Theories for Clustering of Health Behaviors.

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Choi, Seung Hee; Duffy, Sonia A

The objective of this article was to review the utility of established behavior theories, including the Health Belief Model, Theory of Reasoned Action, Theory of Planned Behavior, Transtheoretical Model, and Health Promotion Model, for addressing multiple health behaviors among people who smoke. It is critical to design future interventions for multiple health behavior changes tailored to individuals who currently smoke, yet it has not been addressed. Five health behavior theories/models were analyzed and critically evaluated. A review of the literature included a search of PubMed and Google Scholar from 2010 to 2016. Two hundred sixty-seven articles (252 studies from the initial search and 15 studies from the references of initially identified studies) were included in the analysis. Most of the health behavior theories/models emphasize psychological and cognitive constructs that can be applied only to one specific behavior at a time, thus making them not suitable to address multiple health behaviors. However, the Health Promotion Model incorporates "related behavior factors" that can explain multiple health behaviors among persons who smoke. Future multiple behavior interventions guided by the Health Promotion Model are necessary to show the utility and applicability of the model to address multiple health behaviors.

Essays in behavioral economics : Applied game theory and experiments

NARCIS (Netherlands)

Mermer, A.G.

2014-01-01

Behavioral Economics aims at understanding the decision of economic agents who are not necessarily monetary utility maximizers and accounts for the fact that agents may have other concerns next to economic gain. This thesis contributes to the literature by studying the behavior of economic agents

Economic Recession and Obesity-Related Internet Search Behavior in Taiwan: Analysis of Google Trends Data.

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Wang, Ho-Wei; Chen, Duan-Rung

2018-04-06

Obesity is highly correlated with the development of chronic diseases and has become a critical public health issue that must be countered by aggressive action. This study determined whether data from Google Trends could provide insight into trends in obesity-related search behaviors in Taiwan. Using Google Trends, we examined how changes in economic conditions-using business cycle indicators as a proxy-were associated with people's internet search behaviors related to obesity awareness, health behaviors, and fast food restaurants. Monthly business cycle indicators were obtained from the Taiwan National Development Council. Weekly Taiwan Stock Exchange (TWSE) weighted index data were accessed and downloaded from Yahoo Finance. The weekly relative search volumes (RSV) of obesity-related terms were downloaded from Google Trends. RSVs of obesity-related terms and the TWSE from January 2007 to December 2011 (60 months) were analyzed using correlation analysis. During an economic recession, the RSV of obesity awareness and health behaviors declined (r=.441, P<.001; r=.593, P<.001, respectively); however, the RSV for fast food restaurants increased (r=-.437, P<.001). Findings indicated that when the economy was faltering, people tended to be less likely to search for information related to health behaviors and obesity awareness; moreover, they were more likely to search for fast food restaurants. Macroeconomic conditions can have an impact on people's health-related internet searches. ©Ho-Wei Wang, Duan-Rung Chen. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 06.04.2018.

Behavioral Effects in Forming the Preferences of the Economic Selection of the Economic Subject

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Svetlana, V. Belikova

2017-03-01

Full Text Available An attempt has been made to substantiate the behavioral features of the economic choice of an economic entity in the context of the decision-making environment transformation, and also to study their influence on the forming subjective preferences. At the same time, the behavioral paradigm is identified as a basic theoretical construct, which makes it possible to identify the main irrationalizing factors. Based on the study of the conceptual provisions of the behavioral paradigm, it was concluded that the preferences of the economic entity in the process of implementing the economic choice are formed under the influence of motivational and cognitive predictors, which limit the rationality of the economic entity. Deviating from rational criteria towards irrational, the economic entity shapes its preferences on the basis of economic and non-economic criteria, systematically making mistakes in the context of the influence of cognitive distortions manifested in decision-making under modern conditions. Based on the findings, the author constructs a model of economic choice, taking into account behavioral predictors. Among the most important cognitive distortions are herd instinct, professional deformation, "curse of knowledge", bias toward information retrieval, error of substantiation of assessment, bias of confirmation, neglect of formalized methods of cognition, conservatism, preferences of personified trust and heuristics of asymmetric perception.

Editorial: 3rd Special Issue on behavior change, health, and health disparities.

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Higgins, Stephen T

2016-11-01

This Special Issue of Preventive Medicine (PM) is the 3rd that we have organized on behavior change, health, and health disparities. This is a topic of critical importance to improving U.S. population health. There is broad scientific consensus that personal behaviors such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. Hence, effectively promoting health-related behavior change needs to be a key component of health care research and policy. There is also broad recognition that while these problems extend throughout the population, they disproportionately impact economically disadvantaged populations and other vulnerable populations and represent a major contributor to health disparities. Thus, behavior change represents an essential step in curtailing health disparities, which receives special attention in this 3rd Special Issue. We also devote considerable space to the longstanding challenges of reducing cigarette smoking and use of other tobacco and nicotine delivery products in vulnerable populations, obesity, and for the first time food insecurity. Across each of these topics we include contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of the Exclusion of Behavioral Health from Health Information Technology (HIT) Legislation on the Future of Integrated Health Care.

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Cohen, Deborah

2015-10-01

Past research has shown abundant comorbidity between physical chronic health conditions and mental illness. The focal point of the conversation to reduce cost is better care coordination through the implementation of health information technology (HIT). At the policy level, the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act) was implemented as a way to increase the implementation of HIT. However, behavioral health providers have been largely excluded from obtaining access to the funds provided by the HITECH Act. Without further intervention, disjointed care coordination between physical and behavioral health providers will continue.

Health Promotion Behaviors of Women and Affecting Factors

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Naile Bilgili

2009-12-01

Full Text Available AIM: Women should be healthy and have health promotion behaviors, so they can accomplish both their maternal and social tasks. This descriptive study was conducted to determine the healthy life-style behaviors of married women and the factors which could affect those behaviors. METHOD: The population comprised all married women older than 15 years and who live in Ankara Kale region. Three hundred-sixty five married women were included in the study. The questionnaire form and the healthy life-style behaviors scale was used for data collection. RESULTS: The mean score taken from scale was 112.2±19.4. The scores of the women who graduated from middle school / high school, who have sufficient income and good socio-economic status, who have a perception of physical health fairly good and who have any chronic disease in their families, have significantly higher mean scores from healthy life-style behaviors scale and subgroups (p<0.05 CONCLUSION: Health promotion behaviors of the women was low and some factors like education level, income, socioeconomic status, perception of health, having any chronic illness and using regular medicine affected healthy life-style behaviors. It is recommended that nurses, who have education and consultation roles, should inform the women about health promotion behaviors and encourage them to use that information in their lives. [TAF Prev Med Bull 2009; 8(6.000: 497-502

Behavioral economics: "nudging" underserved populations to be screened for cancer.

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Purnell, Jason Q; Thompson, Tess; Kreuter, Matthew W; McBride, Timothy D

2015-01-15

Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture). In the area of judgment, we describe ways practitioners can use the availability and representativeness of heuristics and the tendency toward unrealistic optimism to increase perceptions of risk and highlight benefits of screening. We describe how several behavioral economic principles involved in decision-making can influence screening attitudes, including how framing and context effects can be manipulated to highlight personally salient features of cancer screening tests. Finally, we offer suggestions about ways practitioners can apply principles related to choice architecture to health care systems in which cancer screening takes place. These recommendations include the use of incentives to increase screening, introduction of default options, appropriate feedback throughout the decision-making and behavior completion process, and clear presentation of complex choices, particularly in the context of colorectal cancer screening. We conclude by noting gaps in knowledge and propose future research questions to guide this promising area of research and practice.

Systematic overview of economic evaluations of health-related rehabilitation.

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Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

2016-01-01

Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Nutrition economics – characterising the economic and health impact of nutrition

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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

Health economic assessment: a methodological primer.

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Simoens, Steven

2009-12-01

This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

Health Economic Assessment: A Methodological Primer

Directory of Open Access Journals (Sweden)

Steven Simoens

2009-11-01

Full Text Available This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs, an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis, and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

Behavioral economics holds potential to deliver better results for patients, insurers, and employers.

Science.gov (United States)

Loewenstein, George; Asch, David A; Volpp, Kevin G

2013-07-01

Many programs being implemented by US employers, insurers, and health care providers use incentives to encourage patients to take better care of themselves. We critically review a range of these efforts and show that many programs, although well-meaning, are unlikely to have much impact because they require information, expertise, and self-control that few patients possess. As a result, benefits are likely to accrue disproportionately to patients who already are taking adequate care of their health. We show how these programs could be made more effective through the use of insights from behavioral economics. For example, incentive programs that offer patients small and frequent payments for behavior that would benefit the patients, such as medication adherence, can be more effective than programs with incentives that are far less visible because they are folded into a paycheck or used to reduce a monthly premium. Deploying more-nuanced insights from behavioral economics can lead to policies with the potential to increase patient engagement and deliver dividends for patients and favorable cost-effectiveness ratios for insurers, employers, and other relevant commercial entities.

Health economic evaluation in Greece.

Science.gov (United States)

Rovithis, Dimitrios

2006-01-01

There is a growing volume of literature on health economic evaluation, with this form of analysis becoming increasingly influential at the decision-making level worldwide. The purpose of this study was to review the current state of health economic evaluation in Greece, with a view to uncovering reasons why its use in this country is limited. A search of the NHS Economic Evaluation Database was undertaken. The search included cost, cost-of-illness, cost-minimization, cost-effectiveness, cost-consequences, cost-utility, and cost-benefit analyses and was narrowed only to Greek authors undertaking solo or joint health economic evaluation in Greece. The search revealed that, in Greece, very little health economic evaluation has been undertaken. The main reason for the lack of interest is that the current chaotic healthcare system structure and financing does not provide the appropriate incentives to stimulate a powerful interest in this type of research. This condition is a result of the lack of a long-term national health policy and the hesitation of the present and past Greek governments to date to proceed to large-scale reforms because of political considerations. The Greek governments have also been content with the good health indicators being achieved. Even if it is accepted that good health prevails in Greece, slower economic growth rates, an ageing population, and the continuous immigration will place increasing pressure on healthcare resources and will necessitate a more rational use of these resources. Health economic evaluation, by weighing benefits against costs, therefore, has an important role to play.

Women's television watching and reproductive health behavior in Bangladesh

Directory of Open Access Journals (Sweden)

Mizanur Rahman

2017-12-01

Full Text Available Bangladesh has made significant social, economic, and health progress in recent decades, yet many reproductive health indicators remain weak. Access to television (TV is increasing rapidly and provides a potential mechanism for influencing health behavior. We present a conceptual framework for the influence of different types of TV exposure on individual’s aspirations and health behavior through the mechanisms of observational learning and ideational change. We analyze data from two large national surveys conducted in 2010 and 2011 to examine the association between women’s TV watching and five reproductive health behaviors controlling for the effects of observed confounders. We find that TV watchers are significantly more likely to desire fewer children, are more likely to use contraceptives, and are less likely to have a birth in the two years before the survey. They are more likely to seek at least four antenatal care visits and to utilize a skilled birth attendant. Consequently, continued increase in the reach of TV and associated growth in TV viewing is potentially an important driver of health behaviors in the country.

When Do Financial Incentives Reduce Intrinsic Motivation? Comparing Behaviors Studied in Psychological and Economic Literatures

Science.gov (United States)

2013-01-01

Objective: To review existing evidence on the potential of incentives to undermine or “crowd out” intrinsic motivation, in order to establish whether and when it predicts financial incentives to crowd out motivation for health-related behaviors. Method: We conducted a conceptual analysis to compare definitions and operationalizations of the effect, and reviewed existing evidence to identify potential moderators of the effect. Results: In the psychological literature, we find strong evidence for an undermining effect of tangible rewards on intrinsic motivation for simple tasks when motivation manifest in behavior is initially high. In the economic literature, evidence for undermining effects exists for a broader variety of behaviors, in settings that involve a conflict of interest between parties. By contrast, for health related behaviors, baseline levels of incentivized behaviors are usually low, and only a subset involve an interpersonal conflict of interest. Correspondingly, we find no evidence for crowding out of incentivized health behaviors. Conclusion: The existing evidence does not warrant a priori predictions that an undermining effect would be found for health-related behaviors. Health-related behaviors and incentives schemes differ greatly in moderating characteristics, which should be the focus of future research. PMID:24001245

When do financial incentives reduce intrinsic motivation? comparing behaviors studied in psychological and economic literatures.

Science.gov (United States)

Promberger, Marianne; Marteau, Theresa M

2013-09-01

To review existing evidence on the potential of incentives to undermine or "crowd out" intrinsic motivation, in order to establish whether and when it predicts financial incentives to crowd out motivation for health-related behaviors. We conducted a conceptual analysis to compare definitions and operationalizations of the effect, and reviewed existing evidence to identify potential moderators of the effect. In the psychological literature, we find strong evidence for an undermining effect of tangible rewards on intrinsic motivation for simple tasks when motivation manifest in behavior is initially high. In the economic literature, evidence for undermining effects exists for a broader variety of behaviors, in settings that involve a conflict of interest between parties. By contrast, for health related behaviors, baseline levels of incentivized behaviors are usually low, and only a subset involve an interpersonal conflict of interest. Correspondingly, we find no evidence for crowding out of incentivized health behaviors. The existing evidence does not warrant a priori predictions that an undermining effect would be found for health-related behaviors. Health-related behaviors and incentives schemes differ greatly in moderating characteristics, which should be the focus of future research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The economics of health

OpenAIRE

Beck, V; Quinn, M; Dunn, A; Edmunds Otter, M; Hammer, N; Pitchforth, E

2008-01-01

Health economics has, in recent years, become a major area of research in economics. This important collection presents a careful selection of the best articles and is classified according to eight fields within health economics. It thus provides a comprehensive cross-section of the large and disparate literature on the subject. It forms, in a real sense, a book which will be invaluable for teachers and researchers who wish to have these frequently cited articles easily to hand. It will be es...

Behavioral Economics and the Public Acceptance of Synthetic Biology.

Science.gov (United States)

Oliver, Adam

2018-01-01

Different applications of synthetic biology are alike in that their possible negative consequences are highly uncertain, potentially catastrophic, and perhaps irreversible; therefore, they are also alike in that public attitudes about them are fertile ground for behavioral economic phenomena. Findings from behavioral economics suggest that people may not respond to such applications according to the normal rules of economic evaluation, by which the value of an outcome is multiplied by the mathematical probability that the outcome will occur. Possibly, then, synthetic biology applications challenge the normative postulates of the standard approach, too. I want to first consider how some of the phenomena described by behavioral economists-and behavioral scientists more broadly-might affect people's perceptions of the uncertainties associated with synthetic biology. My analysis will be far from complete, however, because behavioral economics is essentially the study of human behavior, and thus its reach is potentially vast and its development longstanding and ongoing. Nonetheless, I hope to give an indicative perspective on how some aspects of behavioral economics might affect the assessment and perceived acceptability of synthetic biology. I will then consider the issue of agency. Should policy-makers respect people's reactions to synthetic biology when those reactions are known to be driven by behavioral economic phenomena rather than following the normative postulates of rational choice theory? Or should policy-makers dismiss these reactions as inherently biased? I will argue that the normative force of these human reactions (probably) depends on phenomenon and context. © 2018 The Hastings Center.

Is economics coursework, or majoring in economics, associated with different civic behaviors?

OpenAIRE

Sam Allgood; William Bosshardt; Wilbert Van der Klaauw; Michael Watts

2010-01-01

Studies regularly link levels of educational attainment to civic behavior and attitudes, but only a few investigate the role played by specific coursework. Using data collected from students who attended one of four public universities in our study, we investigate the relationship between economics coursework and civic behavior after graduation. Drawing from large samples of students in economics, business, or general majors, we compare responses across the three groups and by the number of u...

Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

Science.gov (United States)

Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer

2017-03-01

The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.

Investor decisions through the lens of behavioral economics

Directory of Open Access Journals (Sweden)

David S. Murphy

2013-07-01

Full Text Available Traditional economic theory postulates that people are rational. This implies that people make decisions to maximize their utility functions and to do this, that they have fully and correctly evaluated their preferences and limitations. Behavioral economics recognizes that this is not always true, that sometimes information is incomplete. This article is examines some of the effects of behavioral economics (which come largely from cognitive psychology in decision-making by investors in the stock exchanges.

Editorial: 2nd Special Issue on behavior change, health, and health disparities.

Science.gov (United States)

Higgins, Stephen T

2015-11-01

This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policy makers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems. Copyright © 2015 Elsevier Inc. All rights reserved.

When does "economic man" dominate social behavior?

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Camerer, Colin F; Fehr, Ernst

2006-01-06

The canonical model in economics considers people to be rational and self-regarding. However, much evidence challenges this view, raising the question of when "Economic Man" dominates the outcome of social interactions, and when bounded rationality or other-regarding preferences dominate. Here we show that strategic incentives are the key to answering this question. A minority of self-regarding individuals can trigger a "noncooperative" aggregate outcome if their behavior generates incentives for the majority of other-regarding individuals to mimic the minority's behavior. Likewise, a minority of other-regarding individuals can generate a "cooperative" aggregate outcome if their behavior generates incentives for a majority of self-regarding people to behave cooperatively. Similarly, in strategic games, aggregate outcomes can be either far from or close to Nash equilibrium if players with high degrees of strategic thinking mimic or erase the effects of others who do very little strategic thinking. Recently developed theories of other-regarding preferences and bounded rationality explain these findings and provide better predictions of actual aggregate behavior than does traditional economic theory.

Behavioral Economics and Climate Change Policy

OpenAIRE

John M. Gowdy

2007-01-01

The policy recommendations of most economists are based on the rational actor model of human behavior. Behavior is assumed to be self-regarding, preferences are assumed to be stable, and decisions are assumed to be unaffected by social context or frame of reference. The related fields of behavioral economics, game theory, and neuroscience have confirmed that human behavior is other regarding, and that people exhibit systematic patterns of decision-making that are "irrational" according to the...

Behavioral Economics: A New Lens for Understanding Genomic Decision Making.

Science.gov (United States)

Moore, Scott Emory; Ulbrich, Holley H; Hepburn, Kenneth; Holaday, Bonnie; Mayo, Rachel; Sharp, Julia; Pruitt, Rosanne H

2018-05-01

This article seeks to take the next step in examining the insights that nurses and other healthcare providers can derive from applying behavioral economic concepts to support genomic decision making. As genomic science continues to permeate clinical practice, nurses must continue to adapt practice to meet new challenges. Decisions associated with genomics are often not simple and dichotomous in nature. They can be complex and challenging for all involved. This article offers an introduction to behavioral economics as a possible tool to help support patients', families', and caregivers' decision making related to genomics. Using current writings from nursing, ethics, behavioral economic, and other healthcare scholars, we review key concepts of behavioral economics and discuss their relevance to supporting genomic decision making. Behavioral economic concepts-particularly relativity, deliberation, and choice architecture-are specifically examined as new ways to view the complexities of genomic decision making. Each concept is explored through patient decision making and clinical practice examples. This article also discusses next steps and practice implications for further development of the behavioral economic lens in nursing. Behavioral economics provides valuable insight into the unique nature of genetic decision-making practices. Nurses are often a source of information and support for patients during clinical decision making. This article seeks to offer behavioral economic concepts as a framework for understanding and examining the unique nature of genomic decision making. As genetic and genomic testing become more common in practice, it will continue to grow in importance for nurses to be able to support the autonomous decision making of patients, their families, and caregivers. © 2018 Sigma Theta Tau International.

Economic theory and evidence on smoking behavior of adults.

Science.gov (United States)

Sloan, Frank A; Wang, Yang

2008-11-01

To describe: (i) three alternative conceptual frameworks used by economists to study addictive behaviors: rational, imperfectly rational and irrational addiction; (ii) empirical economic evidence on each framework and specific channels to explain adult smoking matched to the frameworks; and (iii) policy implications for each framework. A systematic review and appraisal of important theoretical and empirical economic studies on smoking. There is some empirical support for each framework. For rational and imperfectly rational addiction there is some evidence that anticipated future cigarette prices influence current cigarette consumption, and quitting costs are high for smokers. Smokers are more risk-tolerant in the financial domain than are others and tend to attach a lower value to being in good health. Findings on differences in rates of time preference by smoking status are mixed; however, short-term rates are higher than long-term rates for both smokers and non-smokers, a stylized fact consistent with hyperbolic discounting. The economic literature lends no empirical support to the view that mature adults smoke because they underestimate the probability of harm to health from smoking. In support of the irrationality framework, smokers tend to be more impulsive than others in domains not related directly to smoking, implying that they may be sensitive to cues that trigger smoking. Much promising economic research uses the imperfectly rational addiction framework, but empirical research based on this framework is still in its infancy.

Health Economic Evaluation of Telehealthcare

DEFF Research Database (Denmark)

Udsen, Flemming Witt

for decision making meant to inform adaptation of the health economic evaluation approach. Based on developments in realist evaluation and experiences with conducting the evaluation of TeleCare North, four principles for health economic evaluation of complex telehealthcare interventions is outlined in order....... The results from the TeleCare North trial were used directly in a national decision to implement the telehealthcare solution to patients with severe COPD in Denmark and lead to considerable debate nationally. This debate could be viewed as an actual account of the usefulness of health economic evaluation...

Health-related economic costs of the Three-Mile Island accident.

Science.gov (United States)

Hu, T W; Slaysman, K S

1984-01-01

On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.

[Health and health-related behaviors according to sexual attraction and behavior].

Science.gov (United States)

Pérez, Glòria; Martí-Pastor, Marc; Gotsens, Mercè; Bartoll, Xavier; Diez, Elia; Borrell, Carme

2015-01-01

to Describe perceived health, mental health and certain health-related behaviors according to sexual attraction and behavior in the population residing in Barcelona in 2011. Perceived health, mental health, chronic conditions and health-related behaviors were analyzed in 2675 people aged 15 to 64 years. The Barcelona Health Survey for 2011 was used, which included questions on sexual attraction and behavior. Multivariate robust Poisson regression models were fitted to obtain adjusted prevalence ratios. People feeling same-sex attraction reported a higher prevalence of worse perceived and mental health. These people and those who had had sex with persons of the same sex more frequently reported harmful health-related behaviors. Lesbian, gay, transgender and bisexual people may have health problems that should be explored in depth, prevented, and attended. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

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

Science.gov (United States)

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. Copyright © 2013 Elsevier Ltd. All rights reserved.

Social memory, social stress, and economic behaviors

OpenAIRE

Taiki Takahashi

2005-01-01

Social memory plays a pivotal role in social behaviors, from mating behaviors to cooperative behaviors based on reciprocal altruism. More specifically, social/person recognition memory is supposed, by behavioral-economic and game-theoretic analysis, to be required for tit- for-tat like cooperative behaviors to evolve under the N-person iterated prisoner fs dilemma game condition. Meanwhile, humans are known to show a social stress response during face-to-face social interactions, which might ...

The contention within health economics: a micro-economic foundation using a macro-economic analysis.

Science.gov (United States)

Yaxley, I L

1998-03-01

Health economists claim to use market economics combined with the micro-economic concepts of opportunity cost and the margin to advise on priority setting. However, they are advising on setting priorities through a macro-economic analysis using the costs of the supplier, thus prioritising the producer and not the consumer as the dynamic of economic activity. For health economists any contention within priority setting is due to lack of data not their confusion over fundamental concepts.

Economic Rationality in Choosing between Short-Term Bad-Health Choices and Longer-Term Good-Health Choices

Directory of Open Access Journals (Sweden)

David Campbell

2013-11-01

Full Text Available Non-contagious, chronic disease has been identified as a global health risk. Poor lifestyle choices, such as smoking, alcohol, drug and solvent abuse, physical inactivity, and unhealthy diet have been identified as important factors affecting the increasing incidence of chronic disease. The following focuses on the circumstance affecting the lifestyle or behavioral choices of Aboriginal and Torres Strait Islander peoples in remote-/very remote Australia. Poor behavioral choices are the result of endogenous characteristics that are influenced by a range of stressful exogenous variables making up the psychosocial determinants including social disenfranchisement, cultural loss, insurmountable tasks, the loss of volitional control and resource constraints. It is shown that poor behavioral choices can be economically rational; especially under highly stressful conditions. Stressful circumstances erode individual capacity to commit to long-term positive health alternatives such as self-investment in education. Policies directed at removing the impediments and providing incentives to behaviors involving better health choices can lead to reductions in smoking and alcohol consumption and improved health outcomes. Multijurisdictional culturally acceptable policies directed at distal variables relating to the psychosocial determinants of health and personal mastery and control can be cost effective. While the content of this paper is focused on the conditions of colonized peoples, it has broader relevance.

The Making of Behavioral Development Economics

OpenAIRE

Demeritt, Allison; Hoff, Karla

2018-01-01

A core insight from early behavioral economics is that much of human judgment and behavior is influenced by "fast thinking" that is intuitive, associative, and automatic; very little human thinking resembles the rational thinking that characterizes homo economicus. What is less well-recognized is that innate reliance on cognitive shortcuts means that cultural mental models --categories, co...

Obesity: can behavioral economics help?

Science.gov (United States)

Just, David R; Payne, Collin R

2009-12-01

Consumers regularly and predictably behave in ways that contradict standard assumptions of economic analysis such that they make decisions that prevent them from reaching rationally intended goals. These contradictions play a significant role with respect to consumers' food decisions and the effect these decisions have on their health. Food decisions that are rationally derived include those that trade short-term gains of sensory pleasure (hedonic) for longer term gains of health and wellness (utilitarian). However, extra-rational food decisions are much more common. They can occur because of the contexts in which they are made--such as being distracted or pressed for time. In these contexts, heuristics (or rules of thumb) are used. Because food decisions are made with little cognitive involvement, food policies designed to appeal to highly cognitive thought (e.g., fat taxes, detailed information labels) are likely to have little impact. Furthermore, food marketing environments influence not only what foods consumers buy but also how much. As a general principle, when individuals do not behave in their own interest, markets will feed perverse and sub-optimal behaviors. Given the limited ability of individuals to retain and use accurate health information coupled with varying levels of self control, profit motivations of marketers can become predatory--though not necessarily malicious. Alternative policy options that do not restrict choice are outlined, which enable consumers to make better decisions. These options allow for profit motivations of marketers to align with the long-term well being of the consumer.

Psychology, behavioral economics, and public policy

OpenAIRE

Amir, O; Ariely, D; Cooke, A; Dunning, D; Epley, N; Gneezy, U; Koszegi, B; Lichtenstein, D; Mazar, N; Mullainathan, S; Prelec, D; Shafir, E; Silva, J

2005-01-01

Economics has typically been the social science of choice to inform public policy and policymakers. In the current paper we contemplate the role behavioral science can play in enlightening policymakers. In particular, we provide some examples of research that has and can be used to inform policy, reflect on the kind of behavioral science that is important for policy, and approaches for convincing policy-makers to listen to behavioral scientists. We suggest that policymakers are unlikely to in...

Behavioral economic measures of alcohol reward value as problem severity indicators in college students.

Science.gov (United States)

Skidmore, Jessica R; Murphy, James G; Martens, Matthew P

2014-06-01

The aims of the current study were to examine the associations among behavioral economic measures of alcohol value derived from 3 distinct measurement approaches, and to evaluate their respective relations with traditional indicators of alcohol problem severity in college drinkers. Five behavioral economic metrics were derived from hypothetical demand curves that quantify reward value by plotting consumption and expenditures as a function of price, another metric measured proportional behavioral allocation and enjoyment related to alcohol versus other activities, and a final metric measured relative discretionary expenditures on alcohol (RDEA). The sample included 207 heavy-drinking college students (53% female) who were recruited through an on-campus health center or university courses. Factor analysis revealed that the alcohol valuation construct comprises 2 factors: 1 factor that reflects participants' levels of alcohol price sensitivity (demand persistence), and a second factor that reflects participants' maximum consumption and monetary and behavioral allocation toward alcohol (amplitude of demand). The demand persistence and behavioral allocation metrics demonstrated the strongest and most consistent multivariate relations with alcohol-related problems, even when controlling for other well-established predictors. The results suggest that behavioral economic indices of reward value show meaningful relations with alcohol problem severity in young adults. Despite the presence of some gender differences, these measures appear to be useful problem indicators for men and women. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Health economic evaluation: important principles and methodology.

Science.gov (United States)

Rudmik, Luke; Drummond, Michael

2013-06-01

To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

Behavioral Economics: “Nudging” Underserved Populations to Be Screened for Cancer

Science.gov (United States)

Thompson, Tess; Kreuter, Matthew W.; McBride, Timothy D.

2015-01-01

Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture). In the area of judgment, we describe ways practitioners can use the availability and representativeness of heuristics and the tendency toward unrealistic optimism to increase perceptions of risk and highlight benefits of screening. We describe how several behavioral economic principles involved in decision-making can influence screening attitudes, including how framing and context effects can be manipulated to highlight personally salient features of cancer screening tests. Finally, we offer suggestions about ways practitioners can apply principles related to choice architecture to health care systems in which cancer screening takes place. These recommendations include the use of incentives to increase screening, introduction of default options, appropriate feedback throughout the decision-making and behavior completion process, and clear presentation of complex choices, particularly in the context of colorectal cancer screening. We conclude by noting gaps in knowledge and propose future research questions to guide this promising area of research and practice. PMID:25590600

Neural systems supporting and affecting economically relevant behavior

Directory of Open Access Journals (Sweden)

Braeutigam S

2012-05-01

Full Text Available Sven BraeutigamOxford Centre for Human Brain Activity, University of Oxford, Oxford, United KingdomAbstract: For about a hundred years, theorists and traders alike have tried to unravel and understand the mechanisms and hidden rules underlying and perhaps determining economically relevant behavior. This review focuses on recent developments in neuroeconomics, where the emphasis is placed on two directions of research: first, research exploiting common experiences of urban inhabitants in industrialized societies to provide experimental paradigms with a broader real-life content; second, research based on behavioral genetics, which provides an additional dimension for experimental control and manipulation. In addition, possible limitations of state-of-the-art neuroeconomics research are addressed. It is argued that observations of neuronal systems involved in economic behavior converge to some extent across the technologies and paradigms used. Conceptually, the data available as of today raise the possibility that neuroeconomic research might provide evidence at the neuronal level for the existence of multiple systems of thought and for the importance of conflict. Methodologically, Bayesian approaches in particular may play an important role in identifying mechanisms and establishing causality between patterns of neural activity and economic behavior.Keywords: neuroeconomics, behavioral genetics, decision-making, consumer behavior, neural system

Social Capital And Economic Behavior Of Farmers

Directory of Open Access Journals (Sweden)

Heliawaty

2015-01-01

Full Text Available Abstrac The purpose of this study to analyze the relationship between social capital affects economic behavior in producing coffee plants in improving coffee farmers income. This study was conducted in the district of Bantaeng South Sulawesi. Subdistrict Tampobulu selected purposively. The study lasted for four months of April to July 2014. The data used in this study consist of primary data and secondary data. It can be concluded that social capital is trust networking and institutions affect economic behavior namely the production of coffee plants. Trust improving technology adoption Robusta and Arabica coffee cuttings while distrust led to rampant theft of coffee is still green. Networking affect the price of coffee and institutions influence the behavior of farmers in obtaining venture capital through middlemen. It is expected that future studies should be focused on the factors that influence the innovative behavior in increasing the production of coffee plants.

The impact of economic globalisation on health.

Science.gov (United States)

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.

Factors associated with health risk behaviors among Brazilian adolescents: an integrative review.

Science.gov (United States)

Moura, Luciana Ramos de; Torres, Lilian Machado; Cadete, Matilde Meire Miranda; Cunha, Cristiane de Freitas

2018-01-01

Identifying knowledge about factors associated with health risk behaviors among Brazilian adolescents. An integrative review of the literature conducted in the Cochrane, IBECS, LILACS, MEDLINE and SciELO databases in relation to risk behaviors recommended by the Centers for Disease Control and Prevention. Thirty-seven (37) studies were analyzed, with a predominance of risky sexual behavior, tobacco use and violent behavior. Advancing age favored unprotected sex, alcohol and tobacco use. Family and friends influence was related to smoking and alcoholism. Males were more involved in situations of violence and the female gender was associated with physical inactivity. Belonging to a lower economic class was related to unprotected sex, physical inactivity, unhealthy dietary behaviors and violence. Studying in private school was related to unhealthy dietary behavior. Risk behaviors were related to social, economic and family factors and they tend to agglomerate.

Global health funding and economic development.

Science.gov (United States)

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

2012-04-10

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.

Global health funding and economic development

Directory of Open Access Journals (Sweden)

Martin Greg

2012-04-01

Full Text Available Abstract 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.

Economic Decisions in Farm Animal Health

DEFF Research Database (Denmark)

Ettema, Jehan Frans; Kudahl, Anne Braad; Sørensen, Jan Tind

Animal health economics deals with quantifying the economic effects of animal disease, decision support tools in animal health management and further analysis of the management's impact at animal, herd or national level. Scientists from The Netherlands, France and Sweden have since 1988 organised...... informal workshops to exchange their knowledge and expertise in this field of science. This report contains the summary of the presentations given by 12 PhD students and 2 senior scientists of the Animal Health Economics workshops which was held on the 9th and 10th of November, 2006 at the Research Centre...... Foulum in Denmark. Different disciplines and approaches within Animal Health Economics are dealt with by the different scientists and the report contains a variety of novel results and projects. The resulting discussion is summarized in the report....

HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION.

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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.

Health economic evaluation in England.

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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. Copyright © 2014. Published by Elsevier GmbH.

Behavioral Economics and Public Opinion

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Sunstein, Cass R.; Reisch, Lucia A.

2018-01-01

In recent years, there has been a great deal of discussion of uses of behavioral economics in policy circles, with a focus on empirical, conceptual and ethical questions. On the basis of data from many nations, our forthcoming book asks and answers a question pressing in democratic......-approve of behaviorally informed polices? (Short answer: Yes.) Do citizens of different nations agree with each other? (Short answer: Mostly yes, but with intriguing qualifications, involving diverging levels of trust and different evaluations of liberty.) This article previews our book, providing new insights...

Health, "illth," and economic growth: medicine, environment, and economics at the crossroads.

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Egger, Garry

2009-07-01

Economic growth has been the single biggest contributor to population health since the Industrial Revolution. The growth paradigm, by definition, is dynamic, implying similar diminishing returns on investment at both the macro- and the micro-economic levels. Changes in patterns of health in developing countries, from predominantly microbial-related infectious diseases to lifestyle-related chronic diseases (e.g., obesity, type 2 diabetes) beyond a point of economic growth described as the epidemiologic transition, suggest the start of certain declining benefits from further investment in the growth model. These changes are reflected in slowing improvements in some health indices (e.g., mortality, infant mortality) and deterioration in others (e.g., disability-associated life years, obesity, chronic diseases). Adverse environmental consequences, such as climate change from economic development, are also related to disease outcomes through the development of inflammatory processes due to an immune reaction to new environmental and lifestyle-related inducers. Both increases in chronic disease and climate change can be seen as growth problems with a similar economic cause and potential economic and public health-rather than personal health-solutions. Some common approaches for dealing with both are discussed, with a plea for greater involvement by health scientists in the economic and environmental debates in order to deal effectively with issues like obesity and chronic disease.

Health and economic development: introduction to the symposium.

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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.

Unpaid work in health economic evaluations.

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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. Copyright © 2015 Elsevier Ltd. All rights reserved.

Emotions, perceptions and economic behavior. A critical-philosophical approach to the place of Psychology in Economics

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Vicente Caballero de la Torre

2012-10-01

Full Text Available This paper presents the origin of the issue of empathy in the History of Ideas and its importance in economics, as well as its revitalization. It concludes that it is not the study of empathy, so fashionable today, but the study of decision making the place where Economics can find the nature of emotions in relation to human behavior. This nature is its power to inhibit behavior. The study of repentance is itself more interesting and helpful for the economy than the study of empathy. Finally, the institutional approach is presented as the best in order to understand the issues related to economic human behavior

Guidelines for reporting health economic research.

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Haddad, F S; McLawhorn, A S

2016-02-01

Health economic evaluations potentially provide valuable information to clinicians, health care administrators, and policy makers regarding the financial implications of decisions about the care of patients. The highest quality research should be used to inform decisions that have direct impact on the access to care and the outcome of treatment. However, economic analyses are often complex and use research methods which are relatively unfamiliar to clinicians. Furthermore, health economic data have substantial national, regional, and institutional variability, which can limit the external validity of the results of a study. Therefore, minimum guidelines that aim to standardise the quality and transparency of reporting health economic research have been developed, and instruments are available to assist in the assessment of its quality and the interpretation of results. The purpose of this editorial is to discuss the principal types of health economic studies, to review the most common instruments for judging the quality of these studies and to describe current reporting guidelines. Recommendations for the submission of these types of studies to The Bone & Joint Journal are provided. Cite this article: Bone Joint J 2016;98-B:147-51. ©2016 The British Editorial Society of Bone & Joint Surgery.

Improving utilization of and retention in PMTCT services: can behavioral economics help?

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Taylor, Nicholas Kenji; Buttenheim, Alison M

2013-10-10

The most recent strategic call to action of the World Health Organization sets the elimination of pediatric HIV as a goal. While recent efforts have focused on building infrastructure and ensuring access to high-quality treatment, we must now turn our focus to the behavior change needed to eliminate vertical transmission. We make the case for the application of concepts from the field of behavioral economics to prevention of mother-to-child transmission (PMTCT) programs to more effectively address demand-side issues of uptake and retention. We introduce five concepts from the field of behavioral economics and discuss their application to PMTCT programs: 1) Mentor mothers who come from similar circumstances as PMTCT patients can serve as social references who provide temporally salient modeling of utilization of services and adherence to treatment. 2) Economic incentives, like cell phone minutes or food vouchers, that reward adherence to PMTCT protocols leverage present bias, the observation that people are generally biased toward immediate versus future awards. 3) Default bias, our preference for the default option, is already being used in many countries in the form of opt-out testing, and could be expanded to all PMTCT programs. 4) We are hardwired to avoid loss more than to pursue an equivalent gain. PMTCT programs can take advantage of loss aversion through the use of commitment contracts that incentivize mothers to return to the clinic in order to avoid both reputational and financial loss. Eliminating vertical transmission of HIV is an ambitious goal. To close the remaining gap, innovations are needed to address demand for PMTCT services. Behavioral economics offers a set of tools that can be engineered into PMTCT programs to increase uptake and improve retention with minimal investment.

The Dow is Killing Me: Risky Health Behaviors and the Stock Market.

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Cotti, Chad; Dunn, Richard A; Tefft, Nathan

2015-07-01

We investigate how risky health behaviors and self-reported health vary with the Dow Jones Industrial Average (DJIA) and during stock market crashes. Because stock market indices are leading indicators of economic performance, this research contributes to our understanding of the macroeconomic determinants of health. Existing studies typically rely on the unemployment rate to proxy for economic performance, but this measure captures only one of many channels through which the economic environment may influence individual health decisions. We find that large, negative monthly DJIA returns, decreases in the level of the DJIA, and stock market crashes are widely associated with worsening self-reported mental health and more cigarette smoking, binge drinking, and fatal car accidents involving alcohol. These results are consistent with predictions from rational addiction models and have implications for research on the association between consumption and stock prices. Copyright © 2014 John Wiley & Sons, Ltd.

Socioeconomic Status, Health Behaviors, Obesity and Self-Rated Health among Older Arabs in Israel.

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Khalaila, R N Rabia

2017-03-01

Socioeconomic inequalities in health are well documented. Recently, researchers have shown interest in exploring the mechanisms by which measures of SES operate through it to impact SRH, such as material, psychosocial and behavioral factors. To examine the relationships between SES indicators and self-rated health (SRH); and to determine whether health behaviors and obesity mediate the association between SES indicators and SRH. A secondary analysis of data previously collected through the third survey of socioeconomic and health status of the Arab population in Israel, in which the SRH of 878 Arab-Israelis age 50 or older were analyzed using logistic regression. The results showed that higher education level and current employment in old age are associated with better SRH. However, neither subjective economic status nor family income was associated with SRH. Greater physical activity was found to be related to good\\very good SRH, while obesity was associated with less than good SRH. Finally, health behaviors (physical activity) and obesity were revealed as mediators between SES indicators (education and employment status) and SRH. The results highlight the importance of high education level and employment status in old age to reduce health inequalities. The findings also show that the relationship between SES and SRH can operate through behavioral mechanisms (i.e., physical activity) and their consequences (i.e., obesity), that can, however, be changed in old age.

View from Behavioral Economics Theory: Case of Latvian Rural Entrepreneurs

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Igo Cals

2013-11-01

Full Text Available The theory of classical economics treats entrepreneurs as subjects who make rational economic decisions. Empirical surveys prove the fact that daily economic decisions made by a separate economic entity can be explained by concepts of behavioral economics rather than classical economics. The economic behavior of entrepreneurs happens to be based on bounded rationality instead of financial justification. The objective of an economic activity presented as economically efficient can turn out to be socially important to a specific entrepreneur and not to national economy as a whole. In the EU countries, agriculture is a subsidised industry of national economy. In this light, status consumption and purchase of positional goods should create a special interest among economists. The objective of this article is to present true reasons of economic decisions made by rural entrepreneurs and to analyse the value hierarchy of Latvian rural entrepreneurs through carrying out a field work and with the help of set of instruments developed by modern economics theory.

[Health economics and antibiotic therapy].

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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.

THE CAUSES OF ECONOMIC CRISIS. A BEHAVIORAL FOUNDATION.

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Soim Horatiu Florin

2012-07-01

Full Text Available The cyclical path of economy is a common place in the economic theory. The economic crisis that started in 2007 was not only one of the most severe since the WWII but it came unexpectedly. The cause of the crises and of the surprise consists in the economic models and theories that were founded on the rationality and maximization behavior of the economic actor. People lack the rationality the mainstream economics assume. This is why both economists and simple people do not act as theory predicts and finally economy does not tend toward equilibrium but suffers recurrent crises. This crisis started as a financial one, because of the subprime loans made in USA, but have spread in production sector because of credit frozen, is now in transforming into a social crisis because of austerity measures taken by governments. The paper analyzes the theoretical foundation of economic theory and how the facts that characterize the recent economic evolution fit with the non mainstream theories. It presents the figures of the economic evolution in the last 3 years and explains them based of the agent’s behavior described by Herbert Simon and Daniel Kahneman. Their challenge of mainstream economics is based on an analyze of human behavior. Herbert Simon introduced the concept of bounded rationality as opposed to perfect rationality postulated by neoclassic economics and Daniel Kahneman realized experiments that proved that people cannot stick with the performances assumed by mainstream economics. Their conclusion permit to understand the approach of George Soros who says that people actions are bounded by reflexivity and as a consequences sometimes economy move not toward but far from equilibrium, creating bubbles that end in financial and economic crises. As Akerlof mention the cause of the crisis is the reliance of a false theory which said that we are safe. The conclusion is that we need new theories more close to the real life and an agent description

[Ethics versus economics in public health? On the integration of economic rationality in a discourse of public health ethics].

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Rothgang, H; Staber, J

2009-05-01

In the course of establishing the discourse of public health ethics in Germany, we discuss whether economic efficiency should be part of public health ethics and, if necessary, how efficiency should be conceptualized. Based on the welfare economics theory, we build a theoretical framework that demands an integration of economic rationality in public health ethics. Furthermore, we consider the possible implementation of welfare efficiency against the background of current practice in an economic evaluation of health care in Germany. The indifference of the welfare efficiency criterion with respect to distribution leads to the conclusion that efficiency must not be the only criteria of public health ethics. Therefore, an ethical approach of principles should be chosen for public health ethics. Possible conflicts between principles of such an approach are outlined.

Metro nature, environmental health, and economic value.

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Wolf, Kathleen L; Robbins, Alicia S T

2015-05-01

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. We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values. 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. 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. 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.

A Framework for Developing the Structure of Public Health Economic Models.

Science.gov (United States)

Squires, Hazel; Chilcott, James; Akehurst, Ronald; Burr, Jennifer; Kelly, Michael P

2016-01-01

A conceptual modeling framework is a methodology that assists modelers through the process of developing a model structure. Public health interventions tend to operate in dynamically complex systems. Modeling public health interventions requires broader considerations than clinical ones. Inappropriately simple models may lead to poor validity and credibility, resulting in suboptimal allocation of resources. This article presents the first conceptual modeling framework for public health economic evaluation. The framework presented here was informed by literature reviews of the key challenges in public health economic modeling and existing conceptual modeling frameworks; qualitative research to understand the experiences of modelers when developing public health economic models; and piloting a draft version of the framework. The conceptual modeling framework comprises four key principles of good practice and a proposed methodology. The key principles are that 1) a systems approach to modeling should be taken; 2) a documented understanding of the problem is imperative before and alongside developing and justifying the model structure; 3) strong communication with stakeholders and members of the team throughout model development is essential; and 4) a systematic consideration of the determinants of health is central to identifying the key impacts of public health interventions. The methodology consists of four phases: phase A, aligning the framework with the decision-making process; phase B, identifying relevant stakeholders; phase C, understanding the problem; and phase D, developing and justifying the model structure. Key areas for further research involve evaluation of the framework in diverse case studies and the development of methods for modeling individual and social behavior. This approach could improve the quality of Public Health economic models, supporting efficient allocation of scarce resources. Copyright © 2016 International Society for Pharmacoeconomics

75 FR 50783 - Committee for Social, Behavioral, and Economic Sciences Notice of Meeting

Science.gov (United States)

2010-08-17

... NATIONAL SCIENCE FOUNDATION ADVISORY Committee for Social, Behavioral, and Economic Sciences..., Behavioral, and Economic Sciences ( 1171). Date/Time: September 7, 2010; 8:30 a.m. to 6 p.m. September 8... Assistant Director, Directorate for Social, Behavioral, and Economic Sciences, National Science Foundation...

Tax Compliance Models: From Economic to Behavioral Approaches

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Larissa Margareta BĂTRÂNCEA

2012-06-01

Full Text Available The paper reviews the models of tax compliance with an emphasis on economic and behavioral perspectives. Although the standard tax evasion model of Allingham and Sandmo and other similar economic models capture some important aspects of tax compliance (i.e., taxpayers’ response to increases in tax rate, audit probability, penalty rate they do not suffice the need for an accurate prediction of taxpayers’ behavior. The reason is that they do not offer a comprehensive perspective on the sociological and psychological factors which shape compliance (i.e., attitudes, beliefs, norms, perceptions, motivations. Therefore, the researchers have considered examining taxpayers’ inner motivations, beliefs, perceptions, attitudes in order to accurately predict taxpayers’ behavior. As a response to their quest, behavioral models of tax compliance have emerged. Among the sociological and psychological factors which shape tax compliance, the ‘slippery slope’ framework singles out trust in authorities and the perception of the power of authorities. The aim of the paper is to contribute to the understanding of the reasons for which there is a need for a tax compliance model which incorporates both economic and behavioral features and why governments and tax authorities should consider these models when designing fiscal policies.

Helping patients make better decisions: how to apply behavioral economics in clinical practice

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Courtney MR

2014-10-01

Full Text Available Maureen Reni Courtney,1 Christy Spivey,2 Kathy M Daniel1 1College of Nursing, 2College of Business, University of Texas at Arlington, Arlington, TX, USA  Abstract: Clinicians are committed to effectively educating patients and helping them to make sound decisions concerning their own health care. However, how do clinicians determine what is effective education? How do they present information clearly and in a manner that patients understand and can use to make informed decisions? Behavioral economics (BE is a subfield of economics that can assist clinicians to better understand how individuals actually make decisions. BE research can help guide interactions with patients so that information is presented and discussed in a more deliberate and impactful way. We can be more effective providers of care when we understand the factors that influence how our patients make decisions, factors of which we may have been largely unaware. BE research that focuses on health care and medical decision making is becoming more widely known, and what has been reported suggests that BE interventions can be effective in the medical realm. The purpose of this article is to provide clinicians with an overview of BE decision science and derived practice strategies to promote more effective behavior change in patients.Keywords: nursing, message framing, defaults, incentives, social norms, commitment devices, health care

A hermeneutic science: health economics and Habermas.

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Small, Neil; Mannion, Russell

2005-01-01

Mainstream health economics labours under a misleading understanding of the nature of the topic area and suffers from a concomitant poverty of thinking about theory and method. The purpose here is to explore this critical position and argue that health economics should aspire to being more than a technical discipline. It can, and should, engage with transformative discourse. It is argued that the hermeneutic sciences, emphasising interpretation not instrumentality or domination, offer a route into the change to which one seeks to contribute. The article specifically focuses on the way Habermas provides insights in his approach to knowledge, reason and political economy. How he emphasises complexity and interaction within cultural milieu is explored and primacy is given to preserving the life-world against the encroachments of a narrow rationalization. The argument for a critical re-imagining of health economics is presented in three stages. First, the antecedents, current assumptions and critical voices from contemporary economics and health economics are reviewed. Second, the way in which health is best understood via engaging with the complexity of both the subject itself and the society and culture within which it is embedded is explored. Third, the contribution that hermeneutics, and Habermas' critical theory, could make to a new health economics is examined. The paper offers a radical alternative to health economics. It explores the shortcomings of current thinking and argues an optimistic position. Progress via reason is possible if one reframes both in the direction of communication and in the appreciation of reflexivity and communality. This is a position that resonates with many who challenge prevailing paradigms, in economics and elsewhere.

Crowdfunding our health: Economic risks and benefits.

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Renwick, Matthew J; Mossialos, Elias

2017-10-01

Crowdfunding is an expanding form of alternative financing that is gaining traction in the health sector. This article presents a typology for crowdfunded health projects and a review of the main economic benefits and risks of crowdfunding in the health market. We use evidence from a literature review, complimented by expert interviews, to extend the fundamental principles and established theories of crowdfunding to a health market context. Crowdfunded health projects can be classified into four types according to the venture's purpose and funding method. These are projects covering health expenses, fundraising health initiatives, supporting health research, or financing commercial health innovation. Crowdfunding could economically benefit the health sector by expanding market participation, drawing money and awareness to neglected health issues, improving access to funding, and fostering project accountability and social engagement. However, the economic risks of health-related crowdfunding include inefficient priority setting, heightened financial risk, inconsistent regulatory policies, intellectual property rights concerns, and fraud. Theorized crowdfunding behaviours such as signalling and herding can be observed in the market for health-related crowdfunding. Broader threats of market failure stemming from adverse selection and moral hazard also apply. Many of the discussed economic benefits and risks of crowdfunding health campaigns are shared more broadly with those of crowdfunding projects in other sectors. Where crowdfunding health care appears to diverge from theory is the negative externality inefficient priority setting may have towards achieving broader public health goals. Therefore, the market for crowdfunding health care must be economically stable, as well as designed to optimally and equitably improve public health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

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Edwards, Rhiannon Tudor; Charles, Joanna Mary; Lloyd-Williams, Huw

2013-10-24

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. 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. 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. In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may find it useful to think in this broader

The Economic Crisis and Public Health

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Victor Sidel

2009-06-01

Full Text Available The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.

Behavioral economic analysis of cue-elicited craving for alcohol.

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MacKillop, James; O'Hagen, Sean; Lisman, Stephen A; Murphy, James G; Ray, Lara A; Tidey, Jennifer W; McGeary, John E; Monti, Peter M

2010-09-01

Craving as a motivational determinant of drug use remains controversial because of ambiguous empirical findings. A behavioral economic approach may clarify the nature of craving, theorizing that subjective craving functionally reflects an acute increase in a drug's value. The current study tested this hypothesis via a multidimensional assessment of alcohol demand over the course of an alcohol cue reactivity procedure. One-way within-subjects design. Human laboratory environment. Heavy drinkers (n = 92) underwent exposures to neutral (water) cues followed by personalized alcohol cues. Participants were assessed for craving, alcohol demand, affect, and salivation following each exposure. Alcohol versus neutral cues significantly increased craving and multiple behavioral economic measures of the relative value of alcohol, including alcohol consumption under conditions of zero cost (intensity), maximum expenditure on alcohol (O(max)), persistence in drinking to higher prices (breakpoint) and proportionate price insensitivity (normalized P(max)). Craving was significantly correlated with demand measures at levels ranging from 0.21-0.43. These findings support the potential utility of a behavioral economic approach to understanding the role of environmental stimuli in alcohol-related decision making. Specifically, they suggest that the behavioral economic indices of demand may provide complementary motivational information that is related to though not entirely redundant with measures of subjective craving.

Proposers’ Economic Status Affects Behavioral and Neural Responses to Unfairness

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Yijie Zheng

2017-05-01

Full Text Available Economic status played an important role in the modulation of economic decision making. The present fMRI study aimed at investigating how economic status modulated behavioral and neural responses to unfairness in a modified Ultimatum Game (UG. During scanning, participants played as responders in the UG, and they were informed of the economic status of proposers before receiving offers. At the behavioral level, higher rejection rates and lower fairness ratings were revealed when proposers were in high economic status than in low economic status. Besides, the most time-consuming decisions tended to occur at lower unfairness level when the proposers were in high (relative to low economic status. At the neural level, stronger activation of left thalamus was revealed when fair offers were proposed by proposers in high rather than in low economic status. Greater activation of right medial prefrontal cortex was revealed during acceptance to unfair offers in high economic status condition rather than in low economic status condition. Taken together, these findings shed light on the significance of proposers’ economic status in responders’ social decision making in UG.

INTERRELATIONSHIP S BETWEEN HEALTH, ENVIRONMENT QUALITY AND ECONOMIC ACTIVITY: WHAT CONSEQUENCES FOR ECONOMIC CONVERGENCE?

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Alassane Drabo

2010-03-01

Full Text Available This paper examines the link between health indicators, environmental variables and economic development, and th e consequences of this relationship on economic convergence for a large sample of rich and poor countries. While in economic literature income and environment are seen to have an inverted-U shaped relationship (Environment Kuznets Curve hypothesis, it is also well established that an improvement in environmental quality is positively related to health. Our study focuses on the implications of this relationship for economic convergence. In the early stage of economic development, the gain from income growth could be cancelled or mitigated by environmental degradation through populations' health (and other channels and create a vicious circle in economic activity unlike in developed countries. This in turn could slow down economic convergence. To empirically assess these issues, we proceeded to an econometric analysis through three equations: a growth equation, a health equation and an environment equation. We found that health is a channel through which environment impacts economic growth. When we take into account the effect of environment quality on economic growth, the speed of convergence tends to increase slightly. This shows that environmental quality could be considered as a constraint for economic convergence.

Relationship of socioeconomic status with health behaviors and self-perceived health in the elderly: A community-based study, Turkey.

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Simsek, Hatice; Doganay, Sinem; Budak, Refik; Ucku, Reyhan

2014-10-01

The purpose of the present study was to determine the effects of socioeconomic status on health behaviors and perceived health. The present cross-sectional study included 2947 community-dwelling older adults aged 65 years and older. Dependent variables were health behaviors and self-perceived health. The independent variable was socioeconomic status. In men, the risk of unhealthy diet was higher among the uneducated group (OR 4.48) and among those with poor/very poor economic status (OR 3.31). Additionally, in men, having poor/very poor self-perceived health was found to be 3.50-fold significantly higher among the uneducated group than the secondary school and higher-educated group. Lower education level and lower social class were found to be protective factors for smoking in women. In women, the risk of unhealthy diet was found to be 1.54- and 2.18-fold significantly higher, respectively, among those who graduated from primary school and uneducated. There was also a relationship between poor/very poor economic status and unhealthy diet among elderly women (OR 2.80). In women, the risk of physical inactivity was found to be 1.98-fold significantly higher in the uneducated group and 1.79-fold significantly higher in those with poor/very poor economic status, 0.33-fold significantly lower in skilled employees/white collar workers. With regard to self-perceived health status, education level and perceived economic status were significantly related to poor/very poor health status in women (OR 2.09 and OR 4.08, respectively). In older men and women, lower socioeconomic status increases the risk of unhealthy diet and poor health perception. In older women, lower socioeconomic status is a protective factor for smoking, but it also increases physical inactivity. © 2013 Japan Geriatrics Society.

[HEALTH ECONOMIC ANALYSIS AND FAIR DECISION MAKING].

Science.gov (United States)

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.

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

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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. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Kahneman and Tversky and the Origin of Behavioral Economics

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Heukelom, F.

2007-01-01

Kahneman and Tversky and their behavioral economics stand in a long tradition of applying mathematics to human behavior. In the seventeenth century, attempts to describe rational behavior in mathematical terms run into problems with the formulation of the St. Petersburg paradox. Bernoulli’s

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

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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.

Behavioural, Financial, and Health & Medical Economics: A Connection

NARCIS (Netherlands)

C-L. Chang (Chia-Lin); M.J. McAleer (Michael); W.-K. Wong (Wing-Keung)

2015-01-01

textabstractThis Opinion article briefly reviews some of the literature in behavioural and financial economics that are related to health & medical economics. We then discuss some of the research on behavioural and financial economics that could be extended to health & medical economics beyond the

Associations between media use and health information-seeking behavior on vaccinations in South Korea

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Jiyeon Kim

2017-09-01

Full Text Available Abstract Background Although vaccinations are critical for preventing emerging infectious diseases, scant research has been conducted on risk communication. With socio-economic characteristics, health behavior, and underlying diseases under control, we investigated associations between media use, health information-seeking behavior, health information type, and vaccination in the population. Methods This study relied on a national survey of Korean adults (n = 1367. Participants were adult males and females age 20 and older. Web and face-to-face surveys were conducted throughout July 2014. The main outcome was vaccination (categorized as yes or no. Independent variables were time spent on media, frequency of health information-seeking behavior, and types of health information sought. Results Controlling for co-variates, logistic regression analysis was conducted to identify factors that influence Korean adults being vaccinated. Results revealed that accessible information about emerging infectious diseases, listening to the radio, and reading the newspaper were associated with increased odds of being vaccinated. Active seeking health information as well as being female and of higher socio-economic status were positively correlated with Korean adults being vaccinated. Conclusion It is critical to promote health information-seeking behavior and use diverse media channels to increase acceptance and awareness of emerging infectious diseases and vaccinations. Because there are differences in vaccination awareness depending on social class, it is critical to reduce communication inequality, strengthen accessibility to vaccinations, and devise appropriate risk communication strategies that ensure Korean adults receive vaccinations.

Associations between media use and health information-seeking behavior on vaccinations in South Korea.

Science.gov (United States)

Kim, Jiyeon; Jung, Minsoo

2017-09-11

Although vaccinations are critical for preventing emerging infectious diseases, scant research has been conducted on risk communication. With socio-economic characteristics, health behavior, and underlying diseases under control, we investigated associations between media use, health information-seeking behavior, health information type, and vaccination in the population. This study relied on a national survey of Korean adults (n = 1367). Participants were adult males and females age 20 and older. Web and face-to-face surveys were conducted throughout July 2014. The main outcome was vaccination (categorized as yes or no). Independent variables were time spent on media, frequency of health information-seeking behavior, and types of health information sought. Controlling for co-variates, logistic regression analysis was conducted to identify factors that influence Korean adults being vaccinated. Results revealed that accessible information about emerging infectious diseases, listening to the radio, and reading the newspaper were associated with increased odds of being vaccinated. Active seeking health information as well as being female and of higher socio-economic status were positively correlated with Korean adults being vaccinated. It is critical to promote health information-seeking behavior and use diverse media channels to increase acceptance and awareness of emerging infectious diseases and vaccinations. Because there are differences in vaccination awareness depending on social class, it is critical to reduce communication inequality, strengthen accessibility to vaccinations, and devise appropriate risk communication strategies that ensure Korean adults receive vaccinations.

Lighting a Fire Under Public Health and Safety Education: Influence Through Rational Choice, Reasoned Behavior, and Behavioral Economics

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2016-09-01

Gigerenzer, Gerd, and Daniel G. Goldstein . “Reasoning the Fast and Frugal Way: Models of Bounded Rationality.” Psychological Review 103, no. 4 (1996): 650–69...27 Ward Edwards, “The Theory of Decision Making,” Psychological Bulletin 51, no. 4 (1954): 381. 28...human behavior. Prominent models in health research include the Health Belief Model, Social Cognitive Theory, and the Theory of Reasoned Action.43 An

Economic values, ethics, and ecosystem health

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Thomas P. Holmes; Randall A. Kramer

1995-01-01

Economic valuations of changes in ecosystem health can provide quantitative information for social decisions. However, willingness to pay for ecosystem health may be motivated by an environmental ethic regarding the right thing to do. Counterpreferential choices based on an environmental ethic are inconsistent with the normative basis of welfare economics. In this...

BEHAVIORAL INPUTS TO THE THEORETICAL APPROACH OF THE ECONOMIC CRISIS

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Sinziana BALTATESCU

2015-09-01

Full Text Available The current economic and financial crisis gave room for the theoretical debates to reemerge. The economic reality challenged the mainstream neoclassical approach leaving the opportunity for the Austrian School, Post Keynesianism or Institutionalists to bring in front theories that seem to better explain the economic crisis and thus, leaving space for more efficient economic policies to result. In this context, the main assumptions of the mainstream theoretical approach are challenged and reevaluated, behavioral economics is one of the main challengers. Without developing in an integrated school of thought yet, behavioral economics brings new elements within the framework of economic thinking. How are the main theoretical approaches integrating these new elements and whether this process is going to narrow the theory or enrich it to be more comprehensive are questions to which this paper tries to answer, or, at least, to leave room for an answer.

Beliefs, Preferences and Health Insurance Behavior : Verwachtingen, voorkeuren en gedrag in relatie tot een zorgverzekering

NARCIS (Netherlands)

K.J. van Wilgenburg (Kim)

2018-01-01

markdownabstractThis thesis contributes to an accumulation of research that uses behavioral economics to provide insights into social issues of substantial policy interest. The main body of the thesis uses data on beliefs, preferences and health insurance behavior collected purposefully for this

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

Science.gov (United States)

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

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.

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S M Thumbi

Full Text Available 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.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.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 for household

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.

Science.gov (United States)

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

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. 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. 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 for household size, the

[Occupational health protection in business economics--business plan for health intervention].

Science.gov (United States)

Rydlewska-Liszkowska, Izabela

2011-01-01

One of the company's actions for strengthening human capital is the protection of health and safety of its employees. Its implementation needs financial resources, therefore, employers expect tangible effectiveness in terms of health and economics. Business plan as an element of company planning can be a helpful tool for new health interventions management. The aim of this work was to elaborate a business plan framework for occupational health interventions at the company level, combining occupational health practices with company management and economics. The business plan of occupational health interventions was based on the literature review, the author's own research projects and meta-analysis of research reports on economic relations between occupational health status and company productivity. The study resulted in the development of the business plan for occupational health interventions at the company level. It consists of summary and several sections that address such issues as the key elements of the intervention discussed against a background of the company economics and management, occupational health and safety status of the staff, employees' health care organization, organizational plan of providing the employees with health protection, marketing plan, including specificity of health interventions in the company marketing plan and financial plan, reflecting the economic effects of health care interventions on the overall financial management of the company. Business plan defines occupational health and safety interventions as a part of the company activities as a whole. Planning health care interventions without relating them to the statutory goals of the company may have the adverse impact on the financial balance and profitability of the company. Therefore, business plan by providing the opportunity of comparing different options of occupational health interventions to be implemented by employers is a key element of the management of employees

Behavioural, Financial, and Health & Medical Economics: A Connection

OpenAIRE

Chang, Chia-Lin; McAleer, Michael; Wong, Wing-Keung

2015-01-01

textabstractThis Opinion article briefly reviews some of the literature in behavioural and financial economics that are related to health & medical economics. We then discuss some of the research on behavioural and financial economics that could be extended to health & medical economics beyond the existing areas in theory, statistics and econometrics.

Towards a Theory of Revealed Economic Behavior: The Economic-Neurosciences Interface

NARCIS (Netherlands)

Pennings, J.M.E.; Garcia, P.; Hendrix, E.M.T.

2005-01-01

Based on recent findings from economics and the neurosciences, we present a conceptual decision-making model that provides insight into human decision-making and illustrates how behavioral outcomes are transformed into phenomena. The model may be viewed as a bridge between the seemingly disparate

Behavioral Economics and Empirical Public Policy

Science.gov (United States)

Hursh, Steven R.; Roma, Peter G.

2013-01-01

The application of economics principles to the analysis of behavior has yielded novel insights on value and choice across contexts ranging from laboratory animal research to clinical populations to national trends of global impact. Recent innovations in demand curve methods provide a credible means of quantitatively comparing qualitatively…

Health capabilities and diabetes self-management: the impact of economic, social, and cultural resources.

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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

[Aspects of economic responsibility in health care].

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Hauke, Eugen

2007-01-01

According to the final consensus of a panel of intense discussions, the health care system should/can not be excluded from the economic laws of efficiency. Appropriate adaptation of various methods and instruments of economics make these tools applicable for use in the health care system. Due to errors in the implementation of economic methods, though, the question arises who is economically responsible in the health care system. The answer is found at three different levels of the health care system. The physician plays a leading role, both personally and professionally, in being primarily responsible for the direct medical treatment of the patient. The physician's dependence, however, on the health care system reduces his independence, which markedly affects his decision-making and treatment. Management of and in health care institutions is largely independent of the profession learned. Managers and physicians acting as managers must be appropriately and duly educated in the necessary specific talents and knowledge. The organisation of a health care system should also be reserved for trained specialists where the physicians as well as other professionals are obliged to acquire the skills necessary.

[Basic principles and methodological considerations of health economic evaluations].

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Loza, Cesar; Castillo-Portilla, Manuel; Rojas, José Luis; Huayanay, Leandro

2011-01-01

Health Economics is an essential instrument for health management, and economic evaluations can be considered as tools assisting the decision-making process for the allocation of resources in health. Currently, economic evaluations are increasingly being used worldwide, thus encouraging evidence-based decision-making and seeking efficient and rational alternatives within the framework of health services activities. In this review, we present an overview and define the basic types of economic evaluations, with emphasis on complete Economic Evaluations (EE). In addition, we review key concepts regarding the perspectives from which EE can be conducted, the types of costs that can be considered, the time horizon, discounting, assessment of uncertainty and decision rules. Finally, we describe concepts about the extrapolation and spread of economic evaluations in health.

77 FR 62538 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

Science.gov (United States)

2012-10-15

... NATIONAL SCIENCE FOUNDATION Advisory Committee for Social, Behavioral and Economic Sciences..., Behavioral and Economic Sciences ( 1171). Date/Time: November 15, 2012; 8:00 a.m. to 5:00 p.m. Place..., Behavioral and Economic Sciences, National Science Foundation, 4201 Wilson Boulevard, Room 905, Arlington...

The economic effect of Planet Health on preventing bulimia nervosa.

Science.gov (United States)

Wang, Li Yan; Nichols, Lauren P; Austin, S Bryn

2011-08-01

To assess the economic effect of the school-based obesity prevention program Planet Health on preventing disordered weight control behaviors and to determine the cost-effectiveness of the intervention in terms of its combined effect on prevention of obesity and disordered weight control behaviors. On the basis of the intervention's short-term effect on disordered weight control behaviors prevention, we projected the number of girls who were prevented from developing bulimia nervosa by age 17 years. We further estimated medical costs saved and quality-adjusted life years gained by the intervention over 10 years. As a final step, we compared the intervention costs with the combined intervention benefits from both obesity prevention (reported previously) and prevention of disordered weight control behaviors to determine the overall cost-effectiveness of the intervention. Middle schools. A sample of 254 intervention girls aged 10 to 14 years. The Planet Health program was implemented during the school years from 1995 to 1997 and was designed to promote healthful nutrition and physical activity among youth. Intervention costs, medical costs saved, quality-adjusted life years gained, and cost-effectiveness ratio. An estimated 1 case of bulimia nervosa would have been prevented. As a result, an estimated $33 999 in medical costs and 0.7 quality-adjusted life years would be saved. At an intervention cost of $46 803, the combined prevention of obesity and disordered weight control behaviors would yield a net savings of $14 238 and a gain of 4.8 quality-adjusted life years. Primary prevention programs, such as Planet Health, warrant careful consideration by policy makers and program planners. The findings of this study provide additional argument for integrated prevention of obesity and eating disorders.

76 FR 65219 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

Science.gov (United States)

2011-10-20

... NATIONAL SCIENCE FOUNDATION Advisory Committee for Social, Behavioral and Economic Sciences..., Behavioral and Economic Sciences ( 1171) Date/Time: November 3, 2011; 1 p.m. to 5:30 p.m. November 4, 2011; 8..., Directorate for Social, Behavioral and Economic Sciences, National Science Foundation, 4201 Wilson Boulevard...

Economic disadvantage and young children's emotional and behavioral problems: mechanisms of risk.

Science.gov (United States)

Rijlaarsdam, Jolien; Stevens, Gonneke W J M; van der Ende, Jan; Hofman, Albert; Jaddoe, Vincent W V; Mackenbach, Johan P; Verhulst, Frank C; Tiemeier, Henning

2013-01-01

This study aimed to establish potential mechanisms through which economic disadvantage contributes to the development of young children's internalizing and externalizing problems. Prospective data from fetal life to age 3 years were collected in a total of 2,169 families participating in the Generation R Study. The observed physical home environment, the provision of learning materials in the home, maternal depressive symptoms, parenting stress, and harsh disciplining practices were all analyzed as potential mediators of the association between economic disadvantage and children's internalizing and externalizing problem scores. Findings from structural equation modeling showed that for both internalizing and externalizing problems, the mechanisms underlying the effect of economic disadvantage included maternal depressive symptoms, along with parenting stress and harsh disciplining. For internalizing but not for externalizing problem scores, the lack of provision of learning materials in the home was an additional mechanism explaining the effect of economic disadvantage. The current results suggest that interventions that focus solely on raising income levels may not adequately address problems in the family processes that emerge as a result of economic disadvantage. Policies to improve the mental health of mothers with young children but also their home environments are needed to change the economic gradient in child behavior.

Economy Over Security: Why Crises Fail to Impact Economic Behavior in East Asia

Science.gov (United States)

2017-12-01

SECURITY: WHY CRISES FAIL TO IMPACT ECONOMIC BEHAVIOR IN EAST ASIA by Aaron R. Sipos December 2017 Thesis Advisor: Michael Glosny Second...REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE ECONOMY OVER SECURITY: WHY CRISES FAIL TO IMPACT ECONOMIC BEHAVIOR IN EAST...release. Distribution is unlimited. 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) This study examines changes in economic behavior in

Early Adolescent Health Risk Behaviors, Conflict Resolution Strategies, and School Climate

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LaRusso, Maria; Selman, Robert

2011-01-01

Drawing upon an ethnically and socio-economically diverse sample of 323 7th grade students from twelve urban schools within one school district, this mixed method study examined early adolescents' self-reported health risk behaviors as related to their conflict resolution strategies and their school's conflict resolution climate. Survey data…

77 FR 25207 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

Science.gov (United States)

2012-04-27

... NATIONAL SCIENCE FOUNDATION Advisory Committee for Social, Behavioral and Economic Sciences..., Behavioral and Economic Sciences ( 1171). Date/Time: May 17, 2012; 8:30 a.m. to 5:30 p.m.; May 18, 2012; 8:30..., Directorate for Social, Behavioral and Economic Sciences, National Science Foundation, 4201 Wilson Boulevard...

75 FR 25886 - Advisory Committee for Social, Behavioral, and Economic Sciences; Notice of Meeting

Science.gov (United States)

2010-05-10

... NATIONAL SCIENCE FOUNDATION Advisory Committee for Social, Behavioral, and Economic Sciences..., Behavioral, and Economic Sciences ( 1171). Date/Time: May 20, 2010; 8:30 a.m. to 5:30 p.m. May 21, 2010; 8:30..., Directorate for Social, Behavioral, and Economic Sciences, National Science Foundation, 4201 Wilson Boulevard...

78 FR 25309 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

Science.gov (United States)

2013-04-30

... NATIONAL SCIENCE FOUNDATION ADVISORY Advisory Committee for Social, Behavioral and Economic..., Behavioral and Economic Sciences ( 1171) Date/Time: May 20, 2013; 9:00 a.m. to 5:15 p.m. May 21, 2013; 9:00 a..., Directorate for Social, Behavioral and Economic Sciences, National Science Foundation, 4201 Wilson Boulevard...

76 FR 24062 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

Science.gov (United States)

2011-04-29

... NATIONAL SCIENCE FOUNDATION Advisory Committee for Social, Behavioral and Economic Sciences..., Behavioral and Economic Sciences ( 1171) Date/Time: May 19, 2011; 9 a.m. to 5:30 p.m. May 20, 2011; 9 a.m. to..., Directorate for Social, Behavioral and Economic Sciences, National Science Foundation, 4201 Wilson Boulevard...

Field Experiments in Behavioral and Public Economics

OpenAIRE

Bhanot, Syon Pandya

2015-01-01

The three essays in this dissertation present field experiments exploring phenomena in behavioral and public economics in real-world settings. The first essay outlines a field experiment that uses mailers with peer rank information to motivate water conservation. The essay contributes some of the first pieces of evidence on how comparisons with specific peers might influence behavior. The main finding is that while competitive framing of peer information has positive impacts on efficient h...

Economic Stress, Emotional Quality of Life, and Problem Behavior in Chinese Adolescents with and without Economic Disadvantage

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Shek, Daniel T. L.

2005-01-01

The relationships between perceived economic stress (current economic hardship and future economic worry) and emotional quality of life (existential well-being, life satisfaction, self-esteem, sense of mastery, psychological morbidity) as well as problem behavior (substance abuse and delinquency) were examined in 1519 Chinese adolescents with and…

Poverty dynamics in Germany: Evidence on the relationship between persistent poverty and health behavior.

Science.gov (United States)

Aue, Katja; Roosen, Jutta; Jensen, Helen H

2016-03-01

Previous studies have found poverty to be related to lower levels of health due to poor health behavior such as unhealthy eating, smoking or less physical activity. Longer periods of poverty seem to be especially harmful for individual health behavior. Studies have shown that poverty has a dynamic character. Moreover, poverty is increasingly regarded as being a multidimensional construct and one that considers more aspects than income alone. Against this background this paper analyzes the relationship between health behavior and persistent spells of income poverty as well as a combined poverty indicator using data of the German Socio-Economic Panel (2000-2010). Next to cross-sectional logistic regression models we estimate fixed-effects models to analyze the effect of persistent poverty on dietary behavior, tobacco consumption, and physical activity. Cross-sectional results suggest that persistent poverty is related to poor health behavior, particularly regarding tobacco consumption and physical activity. Results also show that multidimensional and dynamic aspects of poverty matter. Complementary panel analyses reveal negative effects for the combined poverty indicator only for dietary behavior in the total sample. However, by analyzing the sample by gender we identify further effects of persistent poverty on health behavior. The analyses show that not only do individuals in poverty but also those in precarious situations show health-damaging behavior more often. Copyright © 2016 Elsevier Ltd. All rights reserved.

Benford's law and the FSD distribution of economic behavioral micro data

Science.gov (United States)

Villas-Boas, Sofia B.; Fu, Qiuzi; Judge, George

2017-11-01

In this paper, we focus on the first significant digit (FSD) distribution of European micro income data and use information theoretic-entropy based methods to investigate the degree to which Benford's FSD law is consistent with the nature of these economic behavioral systems. We demonstrate that Benford's law is not an empirical phenomenon that occurs only in important distributions in physical statistics, but that it also arises in self-organizing dynamic economic behavioral systems. The empirical likelihood member of the minimum divergence-entropy family, is used to recover country based income FSD probability density functions and to demonstrate the implications of using a Benford prior reference distribution in economic behavioral system information recovery.

On the costs of self-interested economic behavior: how does stinginess get under the skin?

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Dunn, Elizabeth W; Ashton-James, Claire E; Hanson, Margaret D; Aknin, Lara B

2010-05-01

The present study examined how financial decisions 'get under the skin'. Participants played an economic game in which they could donate some of their payment to another student. Affect was measured afterward and salivary cortisol was measured before and afterward. Participants who kept more money for themselves reported less positive affect, more negative affect, and more shame. Shame predicted higher levels of post-game cortisol, controlling for pre-game cortisol; stingy economic behavior therefore produced a significant indirect effect on cortisol via shame. Thus, shame and cortisol represent plausible emotional and biological pathways linking everyday decisions with downstream consequences for health.

Health behaviors of postmenopausal women

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Maria Jasińska

2014-03-01

Full Text Available Introduction: Health status and health-related quality of life of postmenopausal women are issues, which nowadays pose a serious challenge to many domains of science. Climacteric symptoms which occur at this stage of life, lower its quality and make a negative contribution to self-reported health status, are mostly observed in a particular group of women. Evaluation of health behaviors performed using a standardized questionnaire, the Health Behavior Inventory (HBI, may help establish a comprehensive diagnosis of women’s health, and thus select effective interventions. A systemic approach to menopause assumes that full fitness of women and good quality of their lives can be maintained not only by means of pharmacotherapy but also other forms of action, especially health education oriented towards changes in the lifestyle and promotion of healthy behaviors. The aim of this study is to perform a HBI-based assessment of women’s health behaviors in such categories as healthy eating habits (HEH, preventive behaviors (PB, positive mental attitudes (PMA, and health practices (HP. Material and methods: The study involved 151 healthy postmenopausal women. A research tool was a standardized questionnaire, the Health Behavior Inventory (HBI. Results: The surveyed women obtained 70% of the maximum score on average, which suggests a medium level of health behaviors in this group. The levels of health behaviors in the categories of positive mental attitudes and health practices significantly differed between older women and their younger counterparts (higher levels were observed among older respondents. There were also significant differences in the levels of healthy behaviors between women with secondary and higher education (those better educated declared healthy behaviors more often. There was no correlation between the level of health behaviors and the BMI of the surveyed women. Conclusions : Older women attached greater

La economía del la salud: ¿debe ser de interés para el campo sanitario? Health economics: should it concern the health sector?

Directory of Open Access Journals (Sweden)

Manuel Collazo Herrera

2002-11-01

Full Text Available This paper addresses the most important features of health economics, especially its scope and applications within the sphere of health. Health economics is a field of study which allows countries to gear their health policies toward making more rational use of their resources and expanding and improving their health care services. Such policies should, on the other hand, aim to generate strategies for adequately managing human, technical, economic, and financial resources so as to reap the finest health benefits possible. A knowledge of how economics can be applied to health will enable health professionals to introduce an economics culture into their daily work. In other words, it will allow them to keep in mind the scope of their various working tools¾health planning, national health accounts and accounting, and economic assessment methods, which include health and pharmaceutical technology assessment and pharmacoeconomics¾as well as the place that economics has in health research. Hopefully, a knowledge of these aspects of economic analysis will provide decision-makers with one more tool they can apply in selecting more efficient options and attaining the highest health benefits at the lowest possible cost for the national health system.

A behavioral economics perspective on tobacco taxation.

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Cherukupalli, Rajeev

2010-04-01

Economic studies of taxation typically estimate external costs of tobacco use to be low and refrain from recommending large tobacco taxes. Behavioral economics suggests that a rational decision-making process by individuals fully aware of tobacco's hazards might still lead to overconsumption through the psychological tendency to favor immediate gratification over future harm. Taxes can serve as a self-control device to help reduce tobacco use and enable successful quit attempts. Whether taxes are appropriately high depends on how excessively people underrate the harm from tobacco use and varies with a country's circumstances. Such taxes are likely to be more equitable for poorer subgroups than traditional economic analysis suggests, which would strengthen the case for increased tobacco taxation globally.

Autoshaped choice in artificial neural networks: implications for behavioral economics and neuroeconomics.

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Burgos, José E; García-Leal, Óscar

2015-05-01

An existing neural network model of conditioning was used to simulate autoshaped choice. In this phenomenon, pigeons first receive an autoshaping procedure with two keylight stimuli X and Y separately paired with food in a forward-delay manner, intermittently for X and continuously for Y. Then pigeons receive unreinforced choice test trials of X and Y concurrently present. Most pigeons choose Y. This preference for a more valuable response alternative is a form of economic behavior that makes the phenomenon relevant to behavioral economics. The phenomenon also suggests a role for Pavlovian contingencies in economic behavior. The model used, in contrast to others, predicts autoshaping and automaintenance, so it is uniquely positioned to predict autoshaped choice. The model also contemplates neural substrates of economic behavior in neuroeconomics, such as dopaminergic and hippocampal systems. A feedforward neural network architecture was designed to simulate a neuroanatomical differentiation between two environment-behavior relations X-R1 and Y-R2, [corrected] where R1 and R2 denote two different emitted responses (not unconditionally elicited by the reward). Networks with this architecture received a training protocol that simulated an autoshaped-choice procedure. Most networks simulated the phenomenon. Implications for behavioral economics and neuroeconomics, limitations, and the issue of model appraisal are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Managing Air Quality - Human Health, Environmental and Economic Assessments

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Human health and environmental assessments characterize health and environmental risks associated with exposure to pollution. Economic assessments evaluate the cost and economic impact of a policy or regulation & can estimate economic benefits.

Health Economics as Rhetoric: The Limited Impact of Health Economics on Funding Decisions in Four European Countries.

Science.gov (United States)

Franken, Margreet; Heintz, Emelie; Gerber-Grote, Andreas; Raftery, James

2016-12-01

A response to the challenge of high-cost treatments in health care has been economic evaluation. Cost-effectiveness analysis presented as cost per quality-adjusted life-years gained has been controversial, raising heated support and opposition. To assess the impact of economic evaluation in decisions on what to fund in four European countries and discuss the implications of our findings. We used a protocol to review the key features of the application of economic evaluation in reimbursement decision making in England, Germany, the Netherlands, and Sweden, reporting country-specific highlights. Although the institutions and processes vary by country, health economic evaluation has had limited impact on restricting access of controversial high-cost drugs. Even in those countries that have gone the furthest, ways have been found to avoid refusing to fund high-cost drugs for particular diseases including cancer, multiple sclerosis, and orphan diseases. Economic evaluation may, however, have helped some countries to negotiate price reductions for some drugs. It has also extended to the discussion of clinical effectiveness to include cost. The differences in approaches but similarities in outcomes suggest that health economic evaluation be viewed largely as rhetoric (in D.N. McCloskey's terms in The Rhetoric of Economics, 1985). This is not to imply that economics had no impact: rather that it usually contributed to the discourse in ways that differed by country. The reasons for this no doubt vary by perspective, from political science to ethics. Economic evaluation may have less to do with rationing or denial of medical treatments than to do with expanding the discourse used to discuss such issues. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Organizational economics and health care markets.

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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.

Health-economic evaluation in implant trials: design considerations.

Science.gov (United States)

Alt, Volker; Pavlidis, Theodoros; Szalay, Gabor; Heiss, Christian; Schnettler, Reinhard

2009-01-01

In today's world, demonstration of the safety, efficacy, and quality of a new treatment strategy is no longer sufficient in many countries for market entry and reimbursement in the public healthcare system. This implies that new implants in orthopedic and orthopedic trauma surgery not only must be shown to lead to better medical outcome compared with the standard of care implant, but also must be shown to exhibit "good value" for the money for the public health-care system based on sound economic data from health-economic studies. The purpose of this article is to elucidate a framework for health-economic aspects alongside implant trials, with the assumption that the new implant is more costly but potentially better than the control implant. Cost-effectiveness, cost-utility, and cost-benefit studies are suitable for the assessment of the health-economic value of a new implant. The following criteria should be considered for a health-economic study design in the context with an implant: i) it should state medical benefits of the new implant compared with the control implant; ii) it should precise the type of health economic study; iii) it should define the methodological approach, perspective of the study, and types of costs; iv) if necessary, it should state discount costs and/benefits; and v) a sound sensitivity analysis should be included. Furthermore, close cooperation between researchers, clinicians, and health economists is essential.

THE IMPACT OF SOCIO-RELIGIOUS BELIEFS AND RURAL POVERTY ON HEALTH CARE BEHAVIOR: CASE STUDIES IN THE POOR HOUSING COMMUNITY IN KEDAH, MALAYSIA.

OpenAIRE

Saodah Abd. Rahman; Md Sayed Uddin.

2018-01-01

Numerous studies have found that health-seeking behavior depends on the individual\\\\\\'s socio-cultural differences, demographic profiles, level of economic conditions, religiousness and religious affiliations, and the availability of health care providers. Existing literature indicates that health status and health behavior among poor and low-income groups was found to be very low and vulnerable under conditions. This study examines health status and health care seeking behaviors in household...

A qualitative investigation of the health economic impacts of bariatric surgery for obesity and implications for improved practice in health economics.

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Campbell, Julie A; Ezzy, Douglas; Neil, Amanda; Hensher, Martin; Venn, Alison; Sharman, Melanie J; Palmer, Andrew J

2018-06-01

Obesity is an economic problem. Bariatric surgery is cost-effective for severe and resistant obesity. Most economic evaluations of bariatric surgery use administrative data and narrowly defined direct medical costs in their quantitative analyses. Demand far outstrips supply for bariatric surgery. Further allocation of health care resources to bariatric surgery (particularly public) could be stimulated by new health economic evidence that supports the provision of bariatric surgery. We postulated that qualitative research methods would elicit important health economic dimensions of bariatric surgery that would typically be omitted from the current economic evaluation framework, nor be reported and therefore not considered by policymakers with sufficient priority. We listened to patients: Focus group data were analysed thematically with software assistance. Key themes were identified inductively through a dialogue between the qualitative data and pre-existing economic theory (perspective, externalities, and emotional capital). We identified the concept of emotional capital where participants described life-changing desires to be productive and participate in their communities postoperatively. After self-funding bariatric surgery, some participants experienced financial distress. We recommend a mixed-methods approach to the economic evaluation of bariatric surgery. This could be operationalised in health economic model conceptualisation and construction, through to the separate reporting of qualitative results to supplement quantitative results. Copyright © 2018 John Wiley & Sons, Ltd.

Risky music-listening behaviors and associated health-risk behaviors.

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Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

2012-06-01

To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes, alcohol, cannabis, and hard drugs) and unsafe sexual intercourse. A total of 944 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their music-listening and traditional health-risk behaviors. Multiple logistic regression analyses were used to examine associations between music-listening and traditional health-risk behaviors. Risky MP3-player listeners used cannabis more often during the past 4 weeks. Students exposed to risky sound levels during discotheque and pop concert attendance used cannabis less often during the past 4 weeks, were more often binge drinkers, and reported inconsistent condom use during sexual intercourse. The coexistence of risky music-listening behaviors with other health-risk behaviors provides evidence in support of the integration of risky music-listening behaviors within research on and programs aimed at reducing more traditional health-risk behaviors, such as substance abuse and unsafe sexual intercourse.

Dopamine, behavioral economics, and effort

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John D Salamone

2009-09-01

Full Text Available Abstract. There are numerous problems with the hypothesis that brain dopamine (DA systems, particularly in the nucleus accumbens, directly mediate the rewarding or primary motivational characteristics of natural stimuli such as food. Research and theory related to the functions of mesolimbic DA are undergoing a substantial conceptual restructuring, with the traditional emphasis on hedonia and primary reward yielding to other concepts and lines of inquiry. The present review is focused upon the involvement of nucleus accumbens DA in behavioral activation and effort-related processes. Viewed from the framework of behavioral economics, the effects of accumbens DA depletions and antagonism on food-reinforced behavior are highly dependent upon the work requirements of the instrumental task, and DA depleted rats are more sensitive to increases in response costs (i.e., ratio requirements. Moreover, interference with accumbens DA transmission exerts a powerful influence over effort-related choice behavior. Rats with accumbens DA depletions or antagonism reallocate their instrumental behavior away from food-reinforced tasks that have high response requirements, and instead these rats select a less-effortful type of food-seeking behavior. Nucleus accumbens DA and adenosine interact in the regulation of effort-related functions, and other brain structures (anterior cingulate cortex, amygdala, ventral pallidum also are involved. Studies of the brain systems regulating effort-based processes may have implications for understanding drug abuse, as well as energy-related disorders such as psychomotor slowing, fatigue or anergia in depression and other neurological disorders.

Economic demand predicts addiction-like behavior and therapeutic efficacy of oxytocin in the rat

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Bentzley, Brandon S.; Jhou, Thomas C.; Aston-Jones, Gary

2014-01-01

Development of new treatments for drug addiction will depend on high-throughput screening in animal models. However, an addiction biomarker fit for rapid testing, and useful in both humans and animals, is not currently available. Economic models are promising candidates. They offer a structured quantitative approach to modeling behavior that is mathematically identical across species, and accruing evidence indicates economic-based descriptors of human behavior may be particularly useful biomarkers of addiction severity. However, economic demand has not yet been established as a biomarker of addiction-like behavior in animals, an essential final step in linking animal and human studies of addiction through economic models. We recently developed a mathematical approach for rapidly modeling economic demand in rats trained to self-administer cocaine. We show here that economic demand, as both a spontaneous trait and induced state, predicts addiction-like behavior, including relapse propensity, drug seeking in abstinence, and compulsive (punished) drug taking. These findings confirm economic demand as a biomarker of addiction-like behavior in rats. They also support the view that excessive motivation plays an important role in addiction while extending the idea that drug dependence represents a shift from initially recreational to compulsive drug use. Finally, we found that economic demand for cocaine predicted the efficacy of a promising pharmacotherapy (oxytocin) in attenuating cocaine-seeking behaviors across individuals, demonstrating that economic measures may be used to rapidly identify the clinical utility of prospective addiction treatments. PMID:25071176

Behavioral economics.

Science.gov (United States)

Chambers, David W

2009-01-01

It is human nature to overestimate how rational we are, both in general and even when we are trying to be. Such irrationality is not random, and the search for and explanation of patterns of fuzzy thinking is the basis for a new academic discipline known as behavioral economics. Examples are given of some of the best understood of our foibles, including prospect theory, framing, anchoring, salience, confirmation bias, superstition, and ownership. Humans have two cognitive systems: one conscious, deliberate, slow, and rational; the other fast, pattern-based, emotionally tinged, and intuitive. Each is subject to its own kind of error. In the case of rational thought, we tend to exaggerate our capacity; for intuition, we fail to train it or recognize contexts where it is inappropriate. Humans are especially poor at estimating probabilities, or even understanding what they are. It is a common human failing to reason backwards from random outcomes that are favorable to beliefs about our power to predict the future. Five suggestions are offered for thinking within our means.

Economic Cycles in a Behavioral Disequilibrium Perspective

DEFF Research Database (Denmark)

Mosekilde, Erik; Sterman, J.D.

1997-01-01

The paper reviews the characteristic features of the main economic cycles and discusses the behavioral foundation for each mode at the microlevel. The analysis continues to illustrate some of the nonlinear dynamic phenomena that can arise through interaction between the various modes and through...

The feasibility study: a health economics perspective

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Brenda Gannon

2017-02-01

Full Text Available The remit of research funding bodies is to prioritise funding for research that is of relevance and of high quality. This in turn will aim to raise the quality of healthcare and benefit to patients. Researchers are faced with increasing demands and expectations from the public purse and patients. The emphasis is to improve the quality of their research, with the ultimate aim of improving population health. While guidelines on feasibility study methods concentrate heavily on trials, there appears less guidance on application of health economics within feasibility studies, yet these are a less costly way to determine first of all if a full randomised controlled trial (RCT is feasible. A feasibility study assesses if the study can be done in a small RCT type study. Since by definition, a feasibility study does not evaluate the outcome, researchers often omit the health economics aspects but do however include statistical analysis. This leaves a gap in interpretation for policy makers and potential funders. It also means that any resulting publication does not include relevant information and therefore comparison across studies in terms of difficulty in collecting cost data is not possible. The main aim of this commentary therefore, is to demonstrate a suggested health economics analysis within a feasibility study and to recommend to researchers to include these aspects from the conception of their intervention. This paper proposes a number of points, with rationale for each point, to indicate the health economics data and the potential benefits required for coherent interpretation of the feasibility of future economic evaluations in a full trial. Economic evaluation is necessary if implementation into standard care is anticipated. Therefore, collection and summary analysis of relevant data is good practice at each point of the intervention development. Current guidelines for economic evaluation, for example, The Medical Research Guidelines in the

A Behavioral Economics Perspective on Tobacco Taxation

Science.gov (United States)

2010-01-01

Economic studies of taxation typically estimate external costs of tobacco use to be low and refrain from recommending large tobacco taxes. Behavioral economics suggests that a rational decision-making process by individuals fully aware of tobacco's hazards might still lead to overconsumption through the psychological tendency to favor immediate gratification over future harm. Taxes can serve as a self-control device to help reduce tobacco use and enable successful quit attempts. Whether taxes are appropriately high depends on how excessively people underrate the harm from tobacco use and varies with a country's circumstances. Such taxes are likely to be more equitable for poorer subgroups than traditional economic analysis suggests, which would strengthen the case for increased tobacco taxation globally. PMID:20220113

Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior.

Science.gov (United States)

Akulume, Martha; Kiwanuka, Suzanne N

2016-01-01

Objective . The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology . One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation). Results . For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers' segregation behavior, but intention emerged as the strongest and most significant ( r = 0.524, P theory of planned behavior model explained 52.5% of the variance in health workers' segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion . Generally, health workers' health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers' health care waste segregation behaviors.

Psychosocial and Health Behavior Outcomes of Young Adults with Asthma or Diabetes.

Science.gov (United States)

Berge, Jerica M; Bauer, Katherine W; Eisenberg, Marla E; Denny, Kara; Neumark-Sztainer, Dianne

2012-04-30

Previous research has shown a relationship between childhood/adolescent chronic conditions and negative health behaviors, psychological outcomes, and social outcomes. Less is known about whether these negative outcomes are experienced by young adults with chronic health conditions. The purpose of this paper is to investigate how young adults' BMI, health behaviors, and psychological and social outcomes differ depending on whether they have diabetes, asthma, or neither of these chronic conditions. Data were drawn from the third wave of Project EAT-III: Eating and Activity in Young Adults, a population-based study of 2287 young adults (mean age = 25.3; range 19.8 - 31.2). General linear models were used to test differences in BMI, health behaviors (e.g., fast food intake) and psychosocial outcomes (e.g. depressive symptoms) by young adults' chronic disease status. Young adults with diabetes had higher BMIs, engaged in less physical activity and more unhealthy weight control behaviors and binge eating, had lower self-esteem and lower body satisfaction, and experienced more depressive symptoms and appearance-based teasing compared to young adults with asthma or no chronic conditions, after adjusting for age, race/ethnicity, socio-economic status (SES) and, when relevant, for BMI. There were no significant differences between young adults with asthma and young adults with no chronic condition on all of the psychosocial and health behavior outcomes. Young adults with diabetes reported higher prevalence of negative health behaviors and psychosocial outcomes. Providers may find it useful to assess for negative health behaviors and psychosocial variables with young adults with diabetes in order to improve treatment and quality of life for these individuals.

Health lifestyle behaviors among U.S. adults

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Jarron M. Saint Onge

2017-12-01

Full Text Available Existing research that studies individual health behaviors and conceive of behaviors as simplistically reflecting narrow intentions toward health may obscure the social organization of health behaviors. Instead, we examine how eight health behaviors group together to form distinct health behavior niches. Using nationally-representative data from U.S. adults aged 18 and over from the 2004–2009 National Health Interview Survey (NHIS, we use Latent Class Analysis to identify classes of behavior based on smoking status, alcohol use, physical activity, physician visits, and flu vaccination. We identify 7 distinct health behavior classes including concordant health promoting (44%, concordant health compromising (26%, and discordant classes (30%. We find significant race/ethnic, sex, regional, and age differences in class membership. We show that health behavior classes are associated with prospective mortality, suggesting that they are valid representations of health lifestyles. We discuss the implications of our results for sociological theories of health behaviors, as well as for multiple behavior interventions seeking to improve population health.

BEHAVIOR RISK FACTORS IN INDONESIA: NATIONAL HOUSEHOLD HEALTH SURVEY 2001

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Ch. M. Kristanti

2012-09-01

Full Text Available A series of National Household Health Surveys (NHHS reported the occurrence of epidemiological transition caused by demographic transition and prolonged economical diversity, Communicable diseases are still prevalent, followed by the emergence of Non Communicable Diseases (NCDs, which are due to an increasing level of behavior risk factors in the population. In the NHHS 2001, a morbidity survey collected information about behavioral risk indicators, whereas the WHO'S STEPwise approach was one of the study instruments. The 'WHO Step 1 questionnaire' was adapted with some modifications. Samples of NHHS, morbidity survey was sub-sample of module sample of National Social Economic Survey (NSES 2001. A sample of 15,148 people aged 10 years+ were analyzed to identify their behavior regarding smoking, alcohol consumption and physical activity. These findings are a representation of the national figures, which were presented by characteristics of the population such as: sex, age, residence, region and economic status. Economic status was divided into 5 strata, which were calculated from a quintile of household expenditure. The results showed that 29.7% of the population aged 10 years+ are daily smokers. This is more prevalent in males than females (58.9% vs. 3.7%. This behavior increases by age group, except for the oldest; there are slightly more smokers in rural areas than urban areas (31% vs. 28%, and no difference among regions (30-31%. Those with better economic status are less likely to smoke than poorer ones. Alcohol consumption is reportedly very low (2.7%, more prevalent in males than females (4.9% vs. 0.8%, and higher in rural areas than urban areas (3.1% vs. 2.1%. Eastern Indonesia, was higher than Sumatra, Java and Bali (6.3%, 4.7%, and 1.2% respectively. There were no differences in alcohol consumption according to economic status'.' Physical inactivity is very high (68%, more prevalent in females than males (73% vs. 63%, and higher in

The Economic Viability of Ethnicity: Economic Behavior as an Expression of Ethnic Identity among Serbian Immigrants in the USA

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Saša Nedeljković

2016-03-01

Full Text Available The economic aspect of ethnicity represents a wide topic of research which still hasn’t been extensively studied in Serbian ethnology and anthropology. It encompasses numerous kinds of relationships between people who belong to the same ethnic group, as well as all kinds of economic discrimination or economic favorizing based on ethnic identity. In this paper I shall attempt to highlight some of the basic characteristics of this issue, and to point out the interconnectedness of economic behavior and ethnic identity, based on one case study. I shall also demonstrate some of the specifics of the socio-economic system within which the studied topic was considered (USA, as well as the complex and ambiguous influence that this system has had on ethnic identity through certain economic actions. The paper focuses on the economic aspect of ethnicity of the Serbian Diaspora in the US, and certain specific issues are considered through the example of the economic behavior of one Serbian immigrant from Romania.

Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

Directory of Open Access Journals (Sweden)

Martha Akulume

2016-01-01

Full Text Available Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation. Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers’ segregation behavior, but intention emerged as the strongest and most significant (r=0.524, P<0.001. The theory of planned behavior model explained 52.5% of the variance in health workers’ segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers’ health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers’ health care waste segregation behaviors.

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

Science.gov (United States)

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

Adolescents' expectations for the future predict health behaviors in early adulthood.

Science.gov (United States)

McDade, Thomas W; Chyu, Laura; Duncan, Greg J; Hoyt, Lindsay T; Doane, Leah D; Adam, Emma K

2011-08-01

Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual's investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.-perceived chances of living to middle age and perceived chances of attending college-are associated with an individual's engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Public health in major socio-economic crisis].

Science.gov (United States)

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.

Fiscal incentives, behavior change and health promotion: what place in the health-in-all-policies toolkit?

Science.gov (United States)

Sassi, Franco; Belloni, Annalisa

2014-06-01

Taxes, subsidies and welfare benefits may provide financial incentives to encourage healthy behaviors or discourage less healthy ones. Historically, taxes have been used in many countries to deter behaviors like tobacco smoking or harmful alcohol use. More recently, an increasing number of governments have sought to expand the scope for the use of fiscal measures in health promotion to foods and beverages high in fat, salt or sugar. A strong public health rationale, supported by a growing body of evidence of the health impacts of taxes and other fiscal measures, adds to the more traditional rationale for the use of commodity taxes, which hinges on their revenue-generating potential and their ability to address the costs imposed by consumers of health-related commodities on other individuals. Despite limitations in the existing evidence base, reviewed in this paper, taxes have been shown to generate significant health gains when applied to tobacco products and alcoholic beverages. In the case of foods and non-alcoholic beverages, the effects tend to build up over time and are stronger in people with lower socio-economic status. However, a number of potentially undesirable effects suggest that governments should exercise caution in planning and implementing taxes on health-related commodities. In particular, commodity taxes are generally regressive, and this is especially the case for taxes on tobacco, foods and non-alcoholic beverages, although the actual size of the tax burden involved is relatively modest. In addition, taxes may negatively impact on economic efficiency and social welfare, and may incentivize illicit activities. © OECD (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Behavioral Economics and Public Policy 102: Beyond Nudging

OpenAIRE

Saurabh Bhargava; George Loewenstein

2015-01-01

Policymakers have recently embraced Behavioral Economics as an alternative approach which recognizes the limits and consequences of human decision-making. Early applications of BE ("nudges") produced notable successes and helped to set the stage for more aggressive applications aimed at the deeper causes of policy problems. We contend that policies that aspire to simplify products and incentives, rather than choice environments, aggressively protect consumers from behavioral exploitation, and...

[Valuation of health-related quality of life and utilities in health economics].

Science.gov (United States)

Greiner, Wolfgang; Klose, Kristina

2014-01-01

Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group). Copyright © 2014. Published by Elsevier GmbH.

Importance of Economic Evaluation in Health Care: An Indian Perspective.

Science.gov (United States)

Dang, Amit; Likhar, Nishkarsh; Alok, Utkarsh

2016-05-01

Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Return to work, economic hardship, and women's postpartum health.

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Tucker, Jenna N; Grzywacz, Joseph G; Leng, Iris; Clinch, C Randall; Arcury, Thomas A

2010-10-01

This study followed a sample of 217 new mothers in a North Carolina county as they returned to work full-time, measuring their mental and physical health-related quality of life through 16 months postpartum. In general, working mothers of infants had mental health scores that were comparable to the general population of U.S. women, and physical health that was slightly better than women in general. Using ANCOVA and controlling for important demographic characteristics, health-related quality of life was compared between mothers experiencing low and high levels of economic hardship. Across the study period, women with high economic hardship, who constituted 30.7% of the sample, had levels of mental and physical health below those of women with low economic hardship. Mothers with high economic hardship also had less stable health trajectories than mothers with low economic hardship. The findings highlight the importance of reconsidering the traditionally accepted postpartum recovery period of six weeks and extending benefits, such as paid maternity and sick leave, as well as stable yet flexible work schedules.

Behavioral Economics and Marketing in Aid of Decision Making Among the Poor

OpenAIRE

Bertrand, Marianne; Shafir, Eldar; Mullainathan, Sendhil

2006-01-01

This article considers several aspects of the economic decision making of the poor from the perspective of behavioral economics, and it focuses on potential contributions from marketing. Among other things, the authors consider some relevant facets of the social and institutional environments in which the poor interact, and they review some behavioral patterns that are likely to arise in these contexts. A behaviorally more informed perspective can help make sense of what might otherwise be co...

Economics and Health Reform: Academic Research and Public Policy.

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Glied, Sherry A; Miller, Erin A

2015-08-01

Two prior studies, conducted in 1966 and in 1979, examined the role of economic research in health policy development. Both concluded that health economics had not been an important contributor to policy. Passage of the Affordable Care Act offers an opportunity to reassess this question. We find that the evolution of health economics research has given it an increasingly important role in policy. Research in the field has followed three related paths over the past century-institutionalist research that described problems; theoretical research, which proposed relationships that might extend beyond existing institutions; and empirical assessments of structural parameters identified in the theoretical research. These three strands operating in concert allowed economic research to be used to predict the fiscal and coverage consequences of alternative policy paths. This ability made economic research a powerful policy force. Key conclusions of health economics research are clearly evident in the Affordable Care Act. © The Author(s) 2015.

Diets and Health: How Food Decisions Are Shaped by Biology, Economics, Geography, and Social Interactions.

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Drewnowski, Adam; Kawachi, Ichiro

2015-09-01

Health is shaped by both personal choices and features of the food environment. Food-choice decisions depend on complex interactions between biology and behavior, and are further modulated by the built environment and community structure. That lower-income families have lower-quality diets is well established. Yet, diet quality also varies across small geographic neighborhoods and can be influenced by transportation, retail, and ease of access to healthy foods, as well as by attitudes, beliefs, and social interactions. The learnings from the Seattle Obesity Study (SOS II) can be usefully applied to the much larger, more complex, and far more socially and ethnically diverse urban environment of New York City. The Kavli HUMAN Project (KHP) is ideally positioned to advance the understanding of health disparities by exploring the multiple underpinnings of food decision making. By combining geo-localized food shopping and consumption data with health behaviors, diet quality measures, and biomarkers, also coded by geographic location, the KHP will create the first-of-its-kind bio-behavioral, economic, and cultural atlas of diet quality and health for New York City.

How behavioral science can advance digital health.

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Pagoto, Sherry; Bennett, Gary G

2013-09-01

The field of behavioral science has produced myriad data on health behavior change strategies and leveraged such data into effective human-delivered interventions to improve health. Unfortunately, the impact of traditional health behavior change interventions has been heavily constrained by patient and provider burden, limited ability to measure and intervene upon behavior in real time, variable adherence, low rates of implementation, and poor third-party coverage. Digital health technologies, including mobile phones, sensors, and online social networks, by being available in real time, are being explored as tools to increase our understanding of health behavior and to enhance the impact of behavioral interventions. The recent explosion of industry attention to the development of novel health technologies is exciting but has far outpaced research. This Special Section of Translational Behavioral Medicine, Smartphones, Sensors, and Social Networks: A New Age of Health Behavior Change features a collection of studies that leverage health technologies to measure, change, and/or understand health behavior. We propose five key areas in which behavioral science can improve the impact of digital health technologies on public health. First, research is needed to identify which health technologies actually impact behavior and health outcomes. Second, we need to understand how online social networks can be leveraged to impact health behavior on a large scale. Third, a team science approach is needed in the developmental process of health technologies. Fourth, behavioral scientists should identify how a balance can be struck between the fast pace of innovation and the much slower pace of research. Fifth, behavioral scientists have an integral role in informing the development of health technologies and facilitating the movement of health technologies into the healthcare system.

[Intelligence and the explanation for socio-economic inequalities in health].

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Huisman, M; Mackenbach, J P

2007-05-12

Attention is increasingly being paid to the role of cognitive ability to explain socio-economic inequalities in health. The universal socio-economic gradient in health, where each rung lower on the socio-economic ladder implies worse health, has still not been satisfactorily explained scientifically. Because cognitive ability is related to a multitude of social outcomes in a similarly graded manner, hypothesising that cognitive ability plays a major role in health inequalities by socio-economic status is appealing. Recent empirical studies have shown that at least part of socio-economic health inequalities can indeed be explained by differences in cognitive ability. However, this does not imply that we should be pessimistic about future attempts to break the chain that links socio-economic status and cognitive ability with health. During some life stages, environmental factors may be able to influence cognitive ability. Interventions may therefore be targeted in order to optimize these effects. In addition, there is evidence that cognitive ability is correlated with health-related behaviours such as smoking, excessive alcohol consumption and obesity. Therefore, another opportunity for reducing health inequalities related to cognitive ability and socio-economic status would be to develop tailored interventions to improve health-related behaviours in disadvantaged groups. However, the first priority is to further investigate the role of cognitive ability in health inequalities by examining various health outcomes, different age groups and variations across the life course.

Economics as a factor in models of behavioral motivation and change.

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Montoya, I D; Atkinson, J S; Trevino, R A

2000-02-01

This note first presents a summary of four main behavioral models that are used to explain behavioral motivation and change. Three models are based on psychosocial theory. They are: 1) the Theory of Reasoned Action, 2) the Theory of Planned Behavior, and 3) the Theory of Stages-of-Change. The fourth model is based on economic theory and is known as the Rational Addiction Model. Each model is analyzed for its strengths and weaknesses. The note concludes by arguing for the usefulness of integrating the economic and the psychosocial models to study drug use. Specific examples and suggestions are presented.

Social Determinants of Economic Behavior of Older Adults in Europe

OpenAIRE

Youssim, Iaroslav

2015-01-01

This PhD thesis contributes to the growing economic literature which studies effects of social and cultural variables on economic behavior of older adults in Europe. Landes, cited in Guiso et al. (2006), states that "if we learn anything from the history of economic development, it is that culture makes all the difference” (p. 29). Indeed, in the recent years economists put an effort to apply their analytical frameworks and empirical tools to study the role of culture on economic outcomes (Gu...

Bringing the patient back in: behavioral decision-making and choice in medical economics.

Science.gov (United States)

Mendoza, Roger Lee

2018-04-01

We explore the behavioral methodology and "revolution" in economics through the lens of medical economics. We address two questions: (1) Are mainstream economic assumptions of utility-maximization realistic approximations of people's actual behavior? (2) Do people maximize subjective expected utility, particularly in choosing from among the available options? In doing so, we illustrate-in terms of a hypothetical experimental sample of patients with dry eye diagnosis-why and how utility in pharmacoeconomic assessments might be valued differently by patients when subjective psychological, social, cognitive, and emotional factors are considered. While experimentally-observed or surveyed behavior yields stated (rather than revealed) preferences, behaviorism offers a robust toolset in understanding drug, medical device, and treatment-related decisions compared to the optimizing calculus assumed by mainstream economists. It might also do so more perilously than economists have previously understood, in light of the intractable uncertainties, information asymmetries, insulated third-party agents, entry barriers, and externalities that characterize healthcare. Behavioral work has been carried out in many sub-fields of economics. Only recently has it been extended to healthcare. This offers medical economists both the challenge and opportunity of balancing efficiency presumptions with relatively autonomous patient choices, notwithstanding their predictable, yet seemingly consistent, irrationality. Despite its comparative youth and limitations, the scientific contributions of behaviorism are secure and its future in medical economics appears to be promising.

The SIGMA plants economic behavior

International Nuclear Information System (INIS)

Rivarola, Martin E.; Bergallo, Juan E.

1999-01-01

In this work, the economical behavior of the Uranium Enrichment Plants, built using the Gaseous Isotopic Separation using Advanced Methods (SIGMA) (Separacion Isotopica Gaseosa por Metodos Avanzados) technology is analyzed. The calculations were made using an integrated computer code, where the cost of each main component of the plant is estimated. The program computes the production cost for several configurations of enrichment cascades, each one corresponding to a production rate. The program also includes a numerical optimizer and it seeks the SIGMA optimal configuration for a given set of design parameters. The present work does not contemplate the model and calculation of the auxiliary system costs. The total amortization cost is obtained by using the cascade capital cost and assuming that the auxiliary system represents a fixed part of the total cost.The results obtained show that the SIGMA technology for Enrichment Uranium Plants could achieve economical competition in a much lower production scale than the conventional Gaseous Diffusion Enrichment Plants. (author)

Behavioral Health Services in the Changing Landscape of Private Health Plans.

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Horgan, Constance M; Stewart, Maureen T; Reif, Sharon; Garnick, Deborah W; Hodgkin, Dominic; Merrick, Elizabeth L; Quinn, Amity E

2016-06-01

Health plans play a key role in facilitating improvements in population health and may engage in activities that have an impact on access, cost, and quality of behavioral health care. Although behavioral health care is becoming more integrated with general medical care, its delivery system has unique aspects. The study examined how health plans deliver and manage behavioral health care in the context of the Affordable Care Act (ACA) and the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). This is a critical time to examine how health plans manage behavioral health care. A nationally representative survey of private health plans (weighted N=8,431 products; 89% response rate) was conducted in 2010 during the first year of MHPAEA, when plans were subject to the law but before final regulations, and just before the ACA went into effect. The survey addressed behavioral health coverage, cost-sharing, contracting arrangements, medical home innovations, support for technology, and financial incentives to improve behavioral health care. Coverage for inpatient and outpatient behavioral health services was stable between 2003 and 2010. In 2010, health plans were more likely than in 2003 to manage behavioral health care through internal arrangements and to contract for other services. Medical home initiatives were common and almost always included behavioral health, but financial incentives did not. Some plans facilitated providers' use of technology to improve care delivery, but this was not the norm. Health plans are key to mainstreaming and supporting delivery of high-quality behavioral health services. Since 2003, plans have made changes to support delivery of behavioral health services in the context of a rapidly changing environment.

Recessions and seniors' health, health behaviors, and healthcare use: analysis of the Medicare Current Beneficiary Survey.

Science.gov (United States)

McInerney, Melissa; Mellor, Jennifer M

2012-09-01

A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994-2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed. Copyright © 2012 Elsevier B.V. All rights reserved.

[Knowledge of medical doctors about health economics].

Science.gov (United States)

Rodríguez-Ledesma, María de Los Angeles; Constantino-Casas, Patricia; García-Contreras, Fernando; Garduño-Espinosa, Juan

2007-01-01

To identify the level of knowledge about health economics of physicians with different academic degree, working place and medical activities. A questionnaire with 24 items about commonly used health economics concepts was applied. Face validity, content, construct, and consistency of the questionnaire were assessed. 523 Mexican physicians from public and private health institutions in Sinaloa and Distrito Federal were interviewed. The average general score was 4.1 +/- 2.1 (0 to 10 scale), for physicians at the IMSS was 4.1 +/- 2.1, SSA 4.3 +/- 2.5, ISSSTE 3.3 +/- 2; SEDENA 3.9 +/- 2.3 and in private medical services 4.4 +/- 2.2 (p = 0.001). Interns scored 3.7 +/- 2.1; physicians with specialties different from family medicine 4.3 +/- 2.2 and family physicians 4 +/- 2 (p = 0.05). The question that got the most correct answers was the definition of direct costs (82%) and the one with fewest was the percentage of the gross national product recommended by the World Health Organization for the health sector (11%). Interviewed physicians had poor knowledge about health economics. Academic degree and institutional work were factors related to that knowledge.

Designing and Undertaking a Health Economics Study of Digital Health Interventions.

Science.gov (United States)

McNamee, Paul; Murray, Elizabeth; Kelly, Michael P; Bojke, Laura; Chilcott, Jim; Fischer, Alastair; West, Robert; Yardley, Lucy

2016-11-01

This paper introduces and discusses key issues in the economic evaluation of digital health interventions. The purpose is to stimulate debate so that existing economic techniques may be refined or new methods developed. The paper does not seek to provide definitive guidance on appropriate methods of economic analysis for digital health interventions. This paper describes existing guides and analytic frameworks that have been suggested for the economic evaluation of healthcare interventions. Using selected examples of digital health interventions, it assesses how well existing guides and frameworks align to digital health interventions. It shows that digital health interventions may be best characterized as complex interventions in complex systems. Key features of complexity relate to intervention complexity, outcome complexity, and causal pathway complexity, with much of this driven by iterative intervention development over time and uncertainty regarding likely reach of the interventions among the relevant population. These characteristics imply that more-complex methods of economic evaluation are likely to be better able to capture fully the impact of the intervention on costs and benefits over the appropriate time horizon. This complexity includes wider measurement of costs and benefits, and a modeling framework that is able to capture dynamic interactions among the intervention, the population of interest, and the environment. The authors recommend that future research should develop and apply more-flexible modeling techniques to allow better prediction of the interdependency between interventions and important environmental influences. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Social, economic, and behavioral variables associated with oral health-related quality of life among Brazilian adults

Directory of Open Access Journals (Sweden)

Marilisa Carneiro Leão Gabardo

2015-05-01

Full Text Available The aim of this study was to investigate the association between sociodemographic, socioeconomic, psychosocial, and behavioral variables and oral health as assessed using the 14-question short version of the Oral Health Impact Profile (OHIP-14. A cross-sectional study was performed with 1095 adult residents from 38 census tracts in the municipality of São Leopoldo, State of Rio Grande do Sul, Brazil. Responses to the OHIP-14 were dichotomized, and bivariate (Chi-square and multivariate analysis (logistic regression and Wald's test were performed. In the bivariate analysis, the worse effects were reported by female individuals, the elderly, those with low family income, less schooling, those reporting a lower quality of life and social support, and smokers. In the multivariate analysis the following variables maintained their statistical significance: gender (female, age (50-59 years, family income (low, quality of life (low, social support (low, moderate, and smoking (smokers. Individuals' self-perception of their oral health was related to sociodemographic, socioeconomic, psychosocial, and behavioral variables, thus confirming that emphasis should be placed on social factors when addressing oral health problems.

Socio-economic disparities in health system responsiveness in India.

Science.gov (United States)

Malhotra, Chetna; Do, Young Kyung

2013-03-01

To assess the magnitude of socio-economic disparities in health system responsiveness in India after correcting for potential reporting heterogeneity by socio-economic characteristics (education and wealth). Data from Wave 1 of the Study on Global Ageing and Adult Health (2007-2008) involving six Indian states were used. Seven health system responsiveness domains were considered for a respondent's last visit to an outpatient service in 12 months: prompt attention, dignity, clarity of information, autonomy, confidentiality, choice and quality of basic amenities. Hierarchical ordered probit models (correcting for reporting heterogeneity through anchoring vignettes) were used to assess the association of socio-economic characteristics with the seven responsiveness domains, controlling for age, gender and area of residence. Stratified analysis was also conducted among users of public and private health facilities. Our statistical models accounting for reporting heterogeneity revealed socio-economic disparities in all health system responsiveness domains. Estimates suggested that individuals from the lowest wealth group, for example, were less likely than individuals from the highest wealth group to report 'very good' on the dignity domain by 8% points (10% vs 18%). Stratified analysis showed that such disparities existed among users of both public and private health facilities. Socio-economic disparities exist in health system responsiveness in India, irrespective of the type of health facility used. Policy efforts to monitor and improve these disparities are required at the health system level.

Working toward financial sustainability of integrated behavioral health services in a public health care system.

Science.gov (United States)

Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

2012-06-01

The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

ACADEMIC YOUTH’S HEALTH BEHAVIOR

Directory of Open Access Journals (Sweden)

Agnieszka Radzimińska

2016-12-01

Full Text Available Introduction: A very important role in the protection of human health is their life style, their habits and patterns of conduct. Early adulthood is the best period to achieve long-term benefits from a selection of healthy living. However, the results of studies on health-related behavior of youth in Poland and in the world are not satisfactory. The purpose of the study: The purpose of the research was to assess the health behaviors of students of higher education in Bydgoszcz. Material: The study involved 272 students (124 women and 148 men Bydgoszcz higher education students in the following fields of study: physiotherapy, nutrition, logistics and national security. The Inventory of Health-Related Behavior by Zygfryd Juczyński has been used in the research. The statistical analysis was performed using the package PQ Stat 1.6.2. Results: Throughout the treatment group an average level of health-related behavior has been shown. The results of the different categories of health-related behavior were lower than the results of the standardization groups. A higher level of health behavior has been shown in a group of medical students compared to non-medical students. The results for women were higher than men's results. Conclusions: The results of personal research and the research findings of other authors demonstrate that there is a need for implementation of programs of health promotion and health education in all fields of study.

Behavioral economic insights into physician tobacco treatment decision-making.

Science.gov (United States)

Leone, Frank T; Evers-Casey, Sarah; Graden, Sarah; Schnoll, Robert

2015-03-01

Physicians self-report high adherence rates for Ask and Advise behaviors of tobacco dependence treatment but are much less likely to engage in "next steps" consistent with sophisticated management of chronic illness. A variety of potential explanations have been offered, yet each lacks face validity in light of experience with other challenging medical conditions. Conduct a preliminary exploration of the behavioral economics of tobacco treatment decision-making in the face of uncertain outcomes, seeking evidence that behaviors may be explained within the framework of Prospect Theory. Four physician cohorts were polled regarding their impressions of the utility of tobacco use treatment and their estimations of "success" probabilities. Contingent valuation was estimated by asking respondents to make monetary tradeoffs relative to three common chronic conditions. Responses from all four cohorts showed a similar pattern of high utility of tobacco use treatment but low success probability when compared with the other chronic medical conditions. Following instructional methods aimed at controverting cognitive biases related to tobacco, this pattern was reversed, with success probabilities attaining higher valuation than for diabetes. Important presuppositions regarding the potential "success" of tobacco-related patient interactions are likely limiting physician engagement by favoring the most secure visit outcome despite the limited potential for health gains. Under these conditions, low engagement rates would be consistent with Prospect Theory predictions. Interventions aimed at counteracting the cognitive biases limiting estimations of success probabilities seem to effectively reverse this pattern and provide clues to improving the adoption of target clinical behaviors.

Behavioral Economic Insights into Physician Tobacco Treatment Decision-Making

Science.gov (United States)

Evers-Casey, Sarah; Graden, Sarah; Schnoll, Robert

2015-01-01

Rationale: Physicians self-report high adherence rates for Ask and Advise behaviors of tobacco dependence treatment but are much less likely to engage in “next steps” consistent with sophisticated management of chronic illness. A variety of potential explanations have been offered, yet each lacks face validity in light of experience with other challenging medical conditions. Objective: Conduct a preliminary exploration of the behavioral economics of tobacco treatment decision-making in the face of uncertain outcomes, seeking evidence that behaviors may be explained within the framework of Prospect Theory. Methods: Four physician cohorts were polled regarding their impressions of the utility of tobacco use treatment and their estimations of “success” probabilities. Contingent valuation was estimated by asking respondents to make monetary tradeoffs relative to three common chronic conditions. Measurements and Main Results: Responses from all four cohorts showed a similar pattern of high utility of tobacco use treatment but low success probability when compared with the other chronic medical conditions. Following instructional methods aimed at controverting cognitive biases related to tobacco, this pattern was reversed, with success probabilities attaining higher valuation than for diabetes. Conclusions: Important presuppositions regarding the potential “success” of tobacco-related patient interactions are likely limiting physician engagement by favoring the most secure visit outcome despite the limited potential for health gains. Under these conditions, low engagement rates would be consistent with Prospect Theory predictions. Interventions aimed at counteracting the cognitive biases limiting estimations of success probabilities seem to effectively reverse this pattern and provide clues to improving the adoption of target clinical behaviors. PMID:25664676

Four decades of health economics through a bibliometric lens.

Science.gov (United States)

Wagstaff, Adam; Culyer, Anthony J

2012-03-01

In this paper, we take a bibliometric tour of the last forty years of health economics using bibliographic "metadata" from EconLit supplemented by citation data from Google Scholar and our own topical classifications. We report the growth of health economics (we find 33,000 publications since 1969-12,000 more than in the economics of education) and list the 300 most-cited publications broken down by topic. We report the changing topical and geographic focus of health economics (the topics 'Determinants of health and ill-health' and 'Health statistics and econometrics' both show an upward trend, and the field has expanded appreciably into the developing world). We also compare authors, countries, institutions and journals in terms of the volume of publications and their influence as measured through various citation-based indices (Grossman, the US, Harvard and the JHE emerge close to or at the top on a variety of measures). Copyright © 2012 World Bank. Published by Elsevier B.V. All rights reserved.

Does inequality in health impede economic growth?

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Grimm, Michael

2011-01-01

This paper investigates the effects of inequality in health on economic growth in low and middle income countries. The empirical part of the paper uses an original cross-national panel data set covering 62 low and middle income countries over the period 1985 to 2007. I find a substantial and relatively robust negative effect of health inequality on income levels and income growth controlling for life expectancy, country and time fixed-effects and a large number of other effects that have been shown to matter for growth. The effect also holds if health inequality is instrumented to circumvent a potential problem of reverse causality. Hence, reducing inequality in the access to health care and to health-related information can make a substantial contribution to economic growth.

Health economic analyses in medical nutrition: a systematic literature review

Directory of Open Access Journals (Sweden)

Walzer S

2014-03-01

Full Text Available Stefan Walzer,1,2 Daniel Droeschel,1,3 Mark Nuijten,4 Hélène Chevrou-Séverac5 1MArS Market Access and Pricing Strategy GmbH, Weil am Rhein, Germany; 2State University Baden-Wuerttemberg, Loerrach, Germany; 3Riedlingen University, SRH FernHochschule, Riedlingen, Germany; 4Ars Accessus Medica BV, Amsterdam, the Netherlands, 5Nestlé Health Science, Vevey, Switzerland Background: Medical nutrition is a specific nutrition category either covering specific dietary needs and/or nutrient deficiency in patients or feeding patients unable to eat normally. Medical nutrition is regulated by a specific bill in Europe and in the US, with specific legislation and guidelines, and is provided to patients with special nutritional needs and indications for nutrition support. Therefore, medical nutrition products are delivered by medical prescription and supervised by health care professionals. Although these products have existed for more than 2 decades, health economic evidence of medical nutrition interventions is scarce. This research assesses the current published health economic evidence for medical nutrition by performing a systematic literature review related to health economic analysis of medical nutrition. Methods: A systematic literature search was done using standard literature databases, including PubMed, the Health Technology Assessment Database, and the National Health Service Economic Evaluation Database. Additionally, a free web-based search was conducted using the same search terms utilized in the systematic database search. The clinical background and basis of the analysis, health economic design, and results were extracted from the papers finally selected. The Drummond checklist was used to validate the quality of health economic modeling studies and the AMSTAR (A Measurement Tool to Assess Systematic Reviews checklist was used for published systematic reviews. Results: Fifty-three papers were identified and obtained via PubMed, or directly

Applying the AHP in Health Economic Evaluations of New Technology.

NARCIS (Netherlands)

Hummel, J. Marjan; Steuten, Lotte Maria Gertruda; Groothuis-Oudshoorn, Catharina Gerarda Maria; IJzerman, Maarten Joost

2011-01-01

Much research in health care is devoted to health economical modelling. Even though the Analytic Hierarchy Process (AHP) is increasingly being applied in health care, its value to health economical modelling is still unrecognized. We explored the value of using AHP-derived results in a health

Probabilistic sensitivity analysis in health economics.

Science.gov (United States)

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. © The Author(s) 2011.

HEALTH, EDUCATION AND ECONOMIC GROWTH IN MALAYSIA

OpenAIRE

Rahmah Ismaila and Doris Padmini Selvaratnamb

1999-01-01

Human capital is vital for the development of a country. Investment in human capital ranges from basic needs expenditure to education and health provision. Economic growth is often used to measure the progress and development of a country. Today other indicators are used to emphasize physical quality of life, for example, education, health and basic needs provision. Using a simultaneous equation model, this paper estimates the relationship between economic growth and human capital variables i...

HUMAN RESOURCE MANAGEMENT IN TERMS OF BEHAVIORAL ECONOMICS

Directory of Open Access Journals (Sweden)

Ewa Mazanowska

2015-01-01

Full Text Available Behaviourists believe human capital is seen as the potential in people. They believe that the human resource in the organization are intangible assets embodied in the employees, not the people themselves. Behavioral economics emphasizes that people aren’t owned by the company, only their abilities and skills made available to the employer on the basis of certain legal relations which holds it to manage these assets in a rational way. Recognition of behavioral economics also highlights the aspects of development and human capital perspective, which appear in the may resource Staff in the future. These may be limited to: raise, awareness of capacity, internal aspirations, motives. Human capital management is nothing but a recognition of the relevant characteristics of the potential held within the company Staff and correct its use. As a consequence, it can bring tangible benefits to the organization.

Health economic analyses in medical nutrition: a systematic literature review.

Science.gov (United States)

Walzer, Stefan; Droeschel, Daniel; Nuijten, Mark; Chevrou-Séverac, Hélène

2014-01-01

Medical nutrition is a specific nutrition category either covering specific dietary needs and/or nutrient deficiency in patients or feeding patients unable to eat normally. Medical nutrition is regulated by a specific bill in Europe and in the US, with specific legislation and guidelines, and is provided to patients with special nutritional needs and indications for nutrition support. Therefore, medical nutrition products are delivered by medical prescription and supervised by health care professionals. Although these products have existed for more than 2 decades, health economic evidence of medical nutrition interventions is scarce. This research assesses the current published health economic evidence for medical nutrition by performing a systematic literature review related to health economic analysis of medical nutrition. A systematic literature search was done using standard literature databases, including PubMed, the Health Technology Assessment Database, and the National Health Service Economic Evaluation Database. Additionally, a free web-based search was conducted using the same search terms utilized in the systematic database search. The clinical background and basis of the analysis, health economic design, and results were extracted from the papers finally selected. The Drummond checklist was used to validate the quality of health economic modeling studies and the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist was used for published systematic reviews. Fifty-three papers were identified and obtained via PubMed, or directly via journal webpages for further assessment. Thirty-two papers were finally included in a thorough data extraction procedure, including those identified by a "gray literature search" utilizing the Google search engine and cross-reference searches. Results regarding content of the studies showed that malnutrition was the underlying clinical condition in most cases (32%). In addition, gastrointestinal disorders (eg

Responsible leader behavior in health sectors.

Science.gov (United States)

Longest, Beaufort

2017-02-06

Purpose The purpose of this paper is to expand attention to responsible leader behavior in the world's health sectors by explaining how this concept applies to health sectors, considering why health sector leaders should behave responsibly, reviewing how they can do so, and asserting potential impact through an applied example. Design/methodology/approach This paper is a viewpoint, reflecting conceptualizations rooted in leadership literature which are then specifically applied to health sectors. A definition of responsible leader behavior is affirmed and applied specifically in health sectors. Conceptualizations and viewpoints about practice of responsible leader behavior in health sectors and potential consequences are then discussed and asserted. Findings Leadership failures and debacles found in health, but more so in other sectors, have led leadership researchers to offer insights, many of them empirical, into the challenges of leadership especially by more clearly delineating responsible leader behavior. Practical implications Much of what has been learned in the research about responsible leader behavior offers pathways for health sector leaders to more fully practice responsible leadership. Social implications This paper asserts and provides a supporting example that greater levels of responsible leader behavior in health sectors hold potentially important societal benefits. Originality/value This paper is the first to apply emerging conceptualizations and early empirical findings about responsible leader behavior specifically to leaders in health sectors.

Health behavior disparities: a universal trend or a peculiarity for the developed countries?

Directory of Open Access Journals (Sweden)

Andreeva, Tatiana

2011-05-01

Full Text Available BACKGROUND. It is generally recognized that those poorer and less educated are more likely to have unhealthy behaviors. These disparities by socio-economic status (SES are observed with regards to different behaviors known to influence health outcomes in terms of diseases and deaths. However, this consistent pattern was found in population-wide studies in developed countries, while in certain demographic groups it was not seen. So the objective was to check if the SES-behavior association pattern was present in available data collected in Ukraine.METHODS. For current study, all available datasets were considered if they included data on SES, education, and gender. Outcomes were measurements of health behaviors including use of psychoactive substances, food consumption, and physical activity.RESULTS. Prevalence of many health behaviors differs in men and women in Ukraine. More men than women use legal and illegal drugs. With regard to education and SES, Ukrainian data reveals either absence of association found in developed countries or its inverted pattern: till recently, women with university education were more likely to smoke than those less educated; teenagers from more affluent families use alcohol more likely than those from poorer ones.CONCLUSION. Inconsistency of SES-behavior association patterns in Ukraine with those seen in the West may be due to a different perception of health behaviors in people who grew up in the former Soviet Union. Behaviors pertinent to men were considered rather masculine and risky than those health-related. We theorize that the revealed absence of SES-behavior association may be because the behaviors are not perceived as those related to health which is an important resource for life. If a behavior is not known as a ‘health behavior’, the society is less likely to stratify with regard to its practicing. So, if the hypothesis is correct, there may be more disparities in younger cohorts than in older ones

A systematic review of economic evaluations of health and health-related interventions in Bangladesh

Science.gov (United States)

2011-01-01

Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The

A systematic review of economic evaluations of health and health-related interventions in Bangladesh

Directory of Open Access Journals (Sweden)

Koehlmoos Tracey P

2011-07-01

Full Text Available Abstract Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER. Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis

Economic hardships in adulthood and mental health in Sweden. The Swedish National Public Health Survey 2009.

Science.gov (United States)

Ahnquist, Johanna; Wamala, Sarah P

2011-10-11

Possible accumulative effects of a combined economic hardship's measure, including both income and non-income related economic hardships measures, on mental health has not been well investigated. The aim of this paper was to investigate; (i) independent associations between multiple measures of economic hardships and mental health problems, and (ii) associations between a combined economic hardships measure and mental health problems. We analysed data from the 2009 Swedish National Survey of Public Health comprising a randomly selected representative national sample combined with a randomly selected supplementary sample from four county councils and three municipalities consisting of 23,153 men and 28,261 women aged 16-84 years. Mental health problems included; psychological distress (GHQ-12), severe anxiety and use of antidepressant medication. Economic hardship was measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. The results from multivariate adjusted (age, country of birth, educational level, occupational status, employment status, family status and long term illness) logistic regression analysis indicate that self-reported current economic difficulties (inability to pay for ordinary bills and lack of cash reserves), were significantly associated with both women's and men's mental health problems (all indicators), while low income was not. In addition, we found a statistically significant graded association between mental health problems and levels of economic hardships. The findings indicate that indicators of self-reported current economic difficulties seem to be more strongly associated with poor mental health outcomes than the more conventional measure low income. Furthermore, the likelihood of mental health problems differed significantly in a graded fashion in relation to levels of economic hardships.

Economic hardships in adulthood and mental health in Sweden. the Swedish National Public Health Survey 2009

Directory of Open Access Journals (Sweden)

Ahnquist Johanna

2011-10-01

Full Text Available Abstract Background Possible accumulative effects of a combined economic hardship's measure, including both income and non-income related economic hardships measures, on mental health has not been well investigated. The aim of this paper was to investigate; (i independent associations between multiple measures of economic hardships and mental health problems, and (ii associations between a combined economic hardships measure and mental health problems. Methods We analysed data from the 2009 Swedish National Survey of Public Health comprising a randomly selected representative national sample combined with a randomly selected supplementary sample from four county councils and three municipalities consisting of 23,153 men and 28,261 women aged 16-84 years. Mental health problems included; psychological distress (GHQ-12, severe anxiety and use of antidepressant medication. Economic hardship was measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Results The results from multivariate adjusted (age, country of birth, educational level, occupational status, employment status, family status and long term illness logistic regression analysis indicate that self-reported current economic difficulties (inability to pay for ordinary bills and lack of cash reserves, were significantly associated with both women's and men's mental health problems (all indicators, while low income was not. In addition, we found a statistically significant graded association between mental health problems and levels of economic hardships. Conclusions The findings indicate that indicators of self-reported current economic difficulties seem to be more strongly associated with poor mental health outcomes than the more conventional measure low income. Furthermore, the likelihood of mental health problems differed significantly in a graded fashion in relation to levels of economic hardships.

Economic modeling of surgical disease: a measure of public health interventions.

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Corlew, D Scott

2013-07-01

The measurement of the burden of disease and the interventions that address that burden can be done in various units. Reducing these measures to the common denominator of economic units (i.e., currency) enables comparison with other health entities, interventions, and even other fields. Economic assessment is complex, however, because of the multifactorial components of what constitutes health and what constitutes health interventions, as well as the coupling of those data to economic means. To perform economic modeling in a meaningful manner, it is necessary to: (1) define the health problem to be addressed; (2) define the intervention to be assessed; (3) define a measure of the effect of the health entity with and without the intervention (which includes defining the counterfactual); and (4) determine the appropriate method of converting the health effect to economics. This paper discusses technical aspects of how economic modeling can be done both of disease entities and of interventions. Two examples of economic modeling applied to surgical problems are then given.

Intensive Care Nurses’ Belief Systems Regarding the Health Economics: A Focused Ethnography

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Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

2016-01-01

Background: Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses’ beliefs and their effect on nurse’s: practices and behavior patterns regarding the health economics. Methods: In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Findings: Eight beliefs were found that gave meaning to ICU nurse’s practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2. Monitoring and auditing improve consumption; 3. There is a fear of possible shortage in the future; 4. Supply and replacement of equipment is difficult; 5. Higher prices lead to more accurate consumption; 6. The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8. Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. Conclusions: ICU nurses’ belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the

Intensive Care Nurses' Belief Systems Regarding the Health Economics: A Focused Ethnography.

Science.gov (United States)

Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

2016-09-01

Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses' beliefs and their effect on nurse's practices and behavior patterns regarding the health economics. In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Eight beliefs were found that gave meaning to ICU nurse's practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2.Monitoring and auditing improve consumption; 3.There is a fear of possible shortage in the future; 4.Supply and replacement of equipment is difficult; 5.Higher prices lead to more accurate consumption; 6.The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8.Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. ICU nurses' belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the reforms in various aspects, such as the hospital

The Effects of Prenatal Care Utilization on Maternal Health and Health Behaviors.

Science.gov (United States)

Yan, Ji

2017-08-01

While many economic studies have explored the role of prenatal care in infant health production, the literature is sporadic on the effects of prenatal care on the mother. This research contributes to this understudied but important area using a unique large dataset of sibling newborns delivered by 0.17 million mothers. We apply within-mother estimators to find robust evidence that poor prenatal care utilization due to late onset of care, low frequency of care visits, or combinations of the two significantly increases the risks of maternal insufficient gestational weight gain, prenatal smoking, premature rupture of membranes, precipitous labor, no breastfeeding, postnatal underweight, and postpartum smoking. The magnitude of the estimates relative to the respective sample means of the outcome variables ranges from 3% to 33%. The results highlight the importance of receiving timely and sufficient prenatal care in improving maternal health and health behaviors during pregnancy as well as after childbirth. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Four decades of health economics through a bibliometric lens

OpenAIRE

Wagstaff, Adam; Culyer, Anthony J.

2011-01-01

This paper takes a bibliometric tour of the past 40 years of health economics using bibliographic "metadata" from EconLit supplemented by citation data from Google Scholar and the authors' topical classifications. The authors report the growth of health economics (33,000 publications since 1969 -- 12,000 more than in the economics of education) and list the 300 most-cited publications brok...

Teaching Health Care in Introductory Economics

Science.gov (United States)

Cutler, David M.

2017-01-01

Health care is one of the economy's biggest industries, so it is natural that the health care industry should play some role in the teaching of introductory economics. There are many ways that health care can appear in such a context: in the teaching of microeconomics, as a macroeconomic issue, to learn about social welfare, and even to learn how…

Economic evaluation of occupational health and safety programmes in health care.

Science.gov (United States)

Guzman, J; Tompa, E; Koehoorn, M; de Boer, H; Macdonald, S; Alamgir, H

2015-10-01

Evidence-based resource allocation in the public health care sector requires reliable economic evaluations that are different from those needed in the commercial sector. To describe a framework for conducting economic evaluations of occupational health and safety (OHS) programmes in health care developed with sector stakeholders. To define key resources and outcomes to be considered in economic evaluations of OHS programmes and to integrate these into a comprehensive framework. Participatory action research supported by mixed qualitative and quantitative methods, including a multi-stakeholder working group, 25 key informant interviews, a 41-member Delphi panel and structured nominal group discussions. We found three resources had top priority: OHS staff time, training the workers and programme planning, promotion and evaluation. Similarly, five outcomes had top priority: number of injuries, safety climate, job satisfaction, quality of care and work days lost. The resulting framework was built around seven principles of good practice that stakeholders can use to assist them in conducting economic evaluations of OHS programmes. Use of a framework resulting from this participatory action research approach may increase the quality of economic evaluations of OHS programmes and facilitate programme comparisons for evidence-based resource allocation decisions. The principles may be applicable to other service sectors funded from general taxes and more broadly to economic evaluations of OHS programmes in general. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Decision modeling for economic evaluation of health technologies].

Science.gov (United States)

de Soárez, Patrícia Coelho; Soares, Marta Oliveira; Novaes, Hillegonda Maria Dutilh

2014-10-01

Most economic evaluations that participate in decision-making processes for incorporation and financing of technologies of health systems use decision models to assess the costs and benefits of the compared strategies. Despite the large number of economic evaluations conducted in Brazil, there is a pressing need to conduct an in-depth methodological study of the types of decision models and their applicability in our setting. The objective of this literature review is to contribute to the knowledge and use of decision models in the national context of economic evaluations of health technologies. This article presents general definitions about models and concerns with their use; it describes the main models: decision trees, Markov chains, micro-simulation, simulation of discrete and dynamic events; it discusses the elements involved in the choice of model; and exemplifies the models addressed in national economic evaluation studies of diagnostic and therapeutic preventive technologies and health programs.

Introduction to health economics for the medical practitioner

OpenAIRE

Kernick, D

2003-01-01

Against a background of increasing demands on limited resources, health economics is exerting an influence on decision making at all levels of health care. Health economics seeks to facilitate decision making by offering an explicit decision making framework based on the principle of efficiency. It is not the only consideration but it is an important one and practitioners will need to have an understanding of its basic principles and how it can impact on clinical decision making. This article...

ECONOMIC IMPLICATIONS OF INSUFFICIENT HEALTH LITERACY

OpenAIRE

Dukić, Nikolina; Arbula Blecich, Andrea; Cerović, Ljerka

2013-01-01

The main goal of this paper is to elaborate the importance of health literacy in cost-effective utilization of health care services which influence the efficiency of the entire health care sector. In order to complement the theoretical framework of the economic implications and the circular influence of health literacy on the economy, an empirical analysis was carried out using S–TOFHLA. The results suggest that the patients’ personal characteristics and the accessibil...

Behavioral health leadership: new directions in occupational mental health.

Science.gov (United States)

Adler, Amy B; Saboe, Kristin N; Anderson, James; Sipos, Maurice L; Thomas, Jeffrey L

2014-10-01

The impact of stress on mental health in high-risk occupations may be mitigated by organizational factors such as leadership. Studies have documented the impact of general leadership skills on employee performance and mental health. Other researchers have begun examining specific leadership domains that address relevant organizational outcomes, such as safety climate leadership. One emerging approach focuses on domain-specific leadership behaviors that may moderate the impact of combat deployment on mental health. In a recent study, US soldiers deployed to Afghanistan rated leaders on behaviors promoting management of combat operational stress. When soldiers rated their leaders high on these behaviors, soldiers also reported better mental health and feeling more comfortable with the idea of seeking mental health treatment. These associations held even after controlling for overall leadership ratings. Operational stress leader behaviors also moderated the relationship between combat exposure and soldier health. Domain-specific leadership offers an important step in identifying measures to moderate the impact of high-risk occupations on employee health.

The Effect of Health Beliefs, Media Perceptions, and Communicative Behaviors on Health Behavioral Intention: An Integrated Health Campaign Model on Social Media.

Science.gov (United States)

Yoo, Sun-Wook; Kim, Jarim; Lee, Yeunjae

2018-01-01

Social media have recently gained attention as a potential health campaign tool. This study examines this line of expectation concerning the role social media may play in health campaigns by testing an integrated health campaign model that combines insights from research on social media-specific perceptions and communicative behaviors in order to predict health behaviors. Specifically, this study aims to (a) develop a more holistic social media campaign model for predicting health behaviors in the social media context, (b) investigate how social media channel-related perceptions affect preventive health behaviors, and (c) investigate how communicative behaviors mediate perceptions and behavioral intention. The study conducted an online survey of 498 females who followed the Purple Ribbon Twitter campaign (@pprb), a cervical cancer prevention campaign. The results indicated that information acquisition mediated perceived risk's effect on intention. Information acquisition also mediated the relationships between intention and information selection and information transmission. On the other hand, social media-related perceptions indirectly impacted behavioral intention through communicative behaviors. The findings' theoretical and practical implications are discussed.

Comprehensive Health Care Economics Curriculum and Training in Radiology Residency.

Science.gov (United States)

Keiper, Mark; Donovan, Timothy; DeVries, Matthew

2018-06-01

To investigate the ability to successfully develop and institute a comprehensive health care economics skills curriculum in radiology residency training utilizing didactic lectures, case scenario exercises, and residency miniretreats. A comprehensive health care economics skills curriculum was developed to significantly expand upon the basic ACGME radiology residency milestone System-Based Practice, SBP2: Health Care Economics requirements and include additional education in business and contract negotiation, radiology sales and marketing, and governmental and private payers' influence in the practice of radiology. A health care economics curriculum for radiology residents incorporating three phases of education was developed and implemented. Phase 1 of the curriculum constituted basic education through didactic lectures covering System-Based Practice, SBP2: Health Care Economics requirements. Phase 2 constituted further, more advanced didactic lectures on radiology sales and marketing techniques as well as government and private insurers' role in the business of radiology. Phase 3 applied knowledge attained from the initial two phases to real-life case scenario exercises and radiology department business miniretreats with the remainder of the radiology department. A health care economics skills curriculum in radiology residency is attainable and essential in the education of future radiology residents in the ever-changing climate of health care economics. Institution of more comprehensive programs will likely maximize the long-term success of radiology as a specialty by identifying and educating future leaders in the field of radiology. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Analysis of Behavioral Economics in Crowdsensing: A Loss Aversion Cooperation Model

Directory of Open Access Journals (Sweden)

Deng Li

2018-01-01

Full Text Available The existing incentive mechanisms of crowdsourcing construct the expected utility function based on the assumption of rational people in traditional economics. A large number of studies in behavioral economics have demonstrated the defects of the traditional utility function and introduced a new parameter called loss aversion coefficient to calculate individual utility when it suffers a loss. In this paper, combination of behavioral economics and a payment algorithm based on the loss aversion is proposed. Compared with usual incentive mechanisms, the node utility function is redefined by the loss aversion characteristic of the node. Experimental results show that the proposed algorithm can get a higher rate of cooperation with a lower payment price and has good scalability compared with the traditional incentive mechanism.

Veterans Health Administration Behavioral Health Data

Data.gov (United States)

U.S. Department of Health & Human Services — A list of VHA hospitals with behavioral health measure data. VHA reports data on a set of core performance measures for Hospital-Based Inpatient Psychiatric Services...

Benefits Innovations in Employee Behavioral Health.

Science.gov (United States)

Sherman, Bruce; Block, Lori

2017-01-01

More and more employers recognize the business impact of behavioral health concerns in the workplace. This article provides insights into some of the current innovations in behavioral health benefits, along with their rationale for development. Areas of innovation include conceptual and delivery models, technological advance- ments, tools for engaging employees and ways of quantifying the business value of behavioral health benefits. The rapid growth of innovative behavioral health services should provide employers with confidence that they can tailor a program best suited to their priorities, organizational culture and cost limitations.

Health Risk Behavior in Foster Youth

Science.gov (United States)

Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie; Monasterio, Erica; Robbins, Nancy

2010-01-01

Problem Adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore identification of risk behavior is critical. Method A secondary analysis of data from a larger study investigated the health risk behavior of 56 foster youth using the CHIP-AE. Findings Foster youth had some increased risk behavior. Younger adolescents and those in kinship care had less risky behavior. Youth had more risk behavior when: in group homes, parental death, histories of physical or emotional abuse, or history of attempted suicide. Conclusions These results point to areas of strength and vulnerability in foster youth. PMID:19490278

ADOLESCENTS WITH BEHAVIORAL PROBLEMS: PERSONALITY, QUALITY OF LIFE AND SOCIAL HEALTH CARE

Directory of Open Access Journals (Sweden)

S. Ya. Volgina

2013-01-01

Full Text Available Deviant behavior of adolescents is a serious social problem in today's society because of the significant prevalence of this phenomenon. Authors present the results of the study of adolescents with behavioral problems. Aim: optimization of medical and social care for adolescents with behavioral problems. Patients and methods: the authors studied the incidence of this condition among children aged from 15 to 17 years using the software package «SOC/PEDIATRIA-2». The features of the personality structure of adolescents with deviant behavior were revealed using the adopted Russian short version of MMPI-MINI-MULT. Demographic and social characteristics of the families of adolescents were assessed. SF-36 questionnaire was applied for the quality of life assessment of the studied category. Results: increasing morbidity among adolescents was revealed due to various reasons: economic, medical and social. The study allowed to develop personal characteristics of the criteria in order to timely identify adolescents with accentuated and psychopathological features. The characteristics of quality of life were used as criteria of health care for adolescents with behavioral problems. The measures for the prevention and correction of deviant behavior among adolescents were proposed, including intersectoral integration and active participation of family in the process of rehabilitation. Conclusions: it is necessary to identify adolescents with deviant behavior timely, followed by a set of measures to provide them with health and social care to protect their health.

Self-rated health in rural Appalachia: health perceptions are incongruent with health status and health behaviors

Directory of Open Access Journals (Sweden)

Pyle Donald N

2011-04-01

Full Text Available Abstract Background Appalachia is characterized by poor health behaviors, poor health status, and health disparities. Recent interventions have not demonstrated much success in improving health status or reducing health disparities in the Appalachian region. Since one's perception of personal health precedes his or her health behaviors, the purpose of this project was to evaluate the self-rated health of Appalachian adults in relation to objective health status and current health behaviors. Methods Appalachian adults (n = 1,576 were surveyed regarding health behaviors - soda consumer (drink ≥ 355 ml/d, or non-consumer (drink 30 min > 1 d/wk and sedentary (exercise Results Respondents reported being healthy, while being sedentary (65%, hypertensive (76%, overweight (73%, or hyperlipidemic (79%. Between 57% and 66% of the respondents who considered themselves healthy had at least two disease conditions or poor health behaviors. Jaccard Binary Similarity coefficients and odds ratios showed the probability of reporting being healthy when having a disease condition or poor health behavior was high. Conclusions The association between self-rated health and poor health indicators in Appalachian adults is distorted. The public health challenge is to formulate messages and programs about health and health needs which take into account the current distortion about health in Appalachia and the cultural context in which this distortion was shaped.

Relationships Between eHealth Literacy and Health Behaviors in Korean Adults.

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Kim, Sun-Hee; Son, Youn-Jung

2017-02-01

The Internet is a useful and accessible source for health-related information for modern healthcare consumers. Individuals with adequate eHealth literacy have an incentive to use the Internet to access health-related information, and they consider themselves capable of using Web-based knowledge for health. This cross-sectional study aimed to describe the relationship between eHealth literacy and health behaviors. A total of 230 adults aged 18 to 39 years and residing in South Korea participated in the study. The mean (SD) score for eHealth literacy was 25.52 (4.35) of a total possible score of 40. The main source of health information was the Internet. Using hierarchical linear regression, the results showed that eHealth literacy was the strongest predictor of health behaviors after adjusting for general characteristics. These findings indicate that eHealth literacy can be an important factor in promoting individual health behaviors. Further research on eHealth literacy and actual health behaviors including intention and self-reported health behaviors are required to explain the impact of eHealth literacy on overall health status.

[Principles of health economic evaluation for use by caregivers].

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Derumeaux-Burel, Hélène; Derancourt, Christian; Rambhojan, Christine; Branchard, Olivier; Hayes, Nathalie; Bénard, Antoine

2017-01-01

The aim of health economic evaluation is to maximize health gains from limited resources. By definition, health economic evaluation is comparative, based on average costs and outcomes of compared interventions. Incremental costs and outcomes are used to calculate the cost-effectiveness ratio, which represents the average incremental cost per gained unit of effectiveness (i.e.: a year of life) with the evaluated intervention compared to the reference. The health economic rationale applies to all health domains. We cannot spend collective resources (health insurance) without asking ourselves about their potential alternative uses. This reasoning is useful to caregivers for understanding resources allocation decisions and healthcare recommandations. Caregivers should grab this field of expertise because they are central in this strategic reflection for defining the future French healthcare landscape. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The behavioral economics of substance use disorders: reinforcement pathologies and their repair.

Science.gov (United States)

Bickel, Warren K; Johnson, Matthew W; Koffarnus, Mikhail N; MacKillop, James; Murphy, James G

2014-01-01

The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics.

Quixotic medicine: physical and economic laws perilously disregarded in health care and medical education.

Science.gov (United States)

Haburchak, David R; Mitchell, Bradford C; Boomer, Craig J

2008-12-01

Wise medical practice requires balancing the idealistic goals of medicine with the physical and economic realities of their application. Clinicians should know and employ the rules, maxims, and heuristics that summarize these goals and constraints. There has been little formal study of rules or laws pertaining to therapeutics and prognosis, so the authors postulate four physical and four economic laws that apply to health care: the laws of (1) finitude, (2) inertia, (3) entropy, and (4) the uncertainty principle; and the laws of (5) diminishing returns, (6) unintended consequences, (7) distribution, and (8) economizing. These laws manifest themselves in the absence of health, the pathogenesis of disease, prognosis, and the behaviors of participants in the health care enterprise. Physicians and the public perilously disregard these laws, frequently producing misdiagnoses, distraction, false expectations, unanticipated and undesirable outcomes, inequitable distribution of scarce resources, distrust, and cynicism: in short, quixotic medicine. The origins and public reinforcement of quixotic medicine make it deaf to calls for pragmatism. To achieve the Accreditation Council of Graduate Medical Education competency of systems-based practice, the authors recommend that premedical education return to a broader liberal arts curriculum and that medical education and training foster didactic and experiential knowledge of these eight laws.

A behavioral economic analysis of the nonmedical use of prescription drugs among young adults.

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Pickover, Alison M; Messina, Bryan G; Correia, Christopher J; Garza, Kimberly B; Murphy, James G

2016-02-01

The nonmedical use of prescription drugs is a widely recognized public health issue, and young adults are particularly vulnerable to their use. Behavioral economic drug purchase tasks capture an individual's strength of desire and motivation for a particular drug. We examined young adult prescription drug purchase and consumption patterns using hypothetical behavioral economic purchase tasks for prescription sedatives/tranquilizers, stimulants, and opiate pain relievers. We also examined relations between demand, use frequency, and Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) substance use disorder (SUD) symptoms, and sex differences in these relations. Undergraduate students who endorsed past-year prescription drug use (N = 393) completed an online questionnaire for course credit. Measures assessed substance use frequency and DSM-5 SUD symptoms. Hypothetical purchase tasks for sedatives, stimulants, and pain relievers assessed participants' consumption and expenditure patterns for these substances across 25 prices. Past-year prescription sedative, stimulant, and pain reliever use was endorsed by 138, 258, and 189 participants, respectively. Among these users, consumption for their respective substance decreased as a function of ascending price, as expected. Demand indices for a prescription drug were associated with each other and with use frequency and SUD symptoms, with variability across substances but largely not by sex. In addition, demand for prescription pain relievers differentially predicted symptoms independent of use, with differences for females and males. In conclusion, hypothetical consumption and expenditure patterns for prescription drugs were generally well described by behavioral economic demand curves, and the observed associations with use and SUD symptoms provide support for the utility of prescription drug purchase tasks. PsycINFO Database Record (c) 2016 APA, all rights reserved.

Behavioral Economic Predictors of Overweight Children's Weight Loss

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Best, John R.; Theim, Kelly R.; Gredysa, Dana M.; Stein, Richard I.; Welch, R. Robinson; Saelens, Brian E.; Perri, Michael G.; Schechtman, Kenneth B.; Epstein, Leonard H.; Wilfley, Denise E.

2012-01-01

Objective: Our goal was to determine whether behavioral economic constructs--including impulsivity (i.e., steep discounting of delayed food and monetary rewards), the relative reinforcing value of food (RRV[subscript food]), and environmental enrichment (i.e., the presence of alternatives to unhealthy foods in the home and neighborhood…

Protecting Pakistan's health during the global economic crisis.

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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.

Management system of organizational and economic changes in health services

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Natalya Vasilyevna Krivenko

2013-03-01

Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market

Evaluation of socio-economic factors affecting the demand for health

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Abdosaleh Jafari

2014-04-01

Full Text Available Introduction: Individual health has been proved to be under the influence of various factors such as the use of health care services, diet, smoking and alcohol, physical environment, and health-related behaviors. Therefore, the main determinants of health are factors such as income, education, and access to health services, and systematic changes in these factors lead to socio-economic injustice in health. The present study was carried out through library and internet search. Medline and Google Scholar databases were also utilized. Combining Contents and Results: According to the present study, an increase in health input expenses would inevitably lead to aggravation of the health situation and decrease in income would result in the worst health status of the poor. Moreover, people with higher education use less health inputs; however, they enjoy higher status than those with lower educational levels. Conclusion: Health demand approach provides only a part of the information needed for policy-makers and decision-makers in health system. Theoretical and empirical analyses of the health claim could indicate that policy actions are likely to be more effective in overcoming barriers to health but are not capable of determining which one is likely to be more cost-effective . The demand for information about the health only provides the necessary tools about the benefits of special policy making decisions. So the tool should be combined with other techniques including cost-effectiveness and cost-benefit analyses.

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

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

2006-11-15

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. 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. 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. 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 Cochrane reviewers and economists to

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

Directory of Open Access Journals (Sweden)

McDaid David

2006-11-01

Full Text Available Abstract 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

The Contribution of J.M. Keynes to the Analysis of the Psychological Motives of Economic Behavior

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Maria A. Kozlova

2016-01-01

Full Text Available The article examines the contribution of John Maynard Keynes to the study of the psychological motives of economic behavior. The origins of the analysis of the psychological motives in economics before Keynes are reviewed. The relative importance of rational and irrational motives of economic behavior in the Keynesian theory is analyzed. It is shown that Keynes's analysis of the behavior of the economic agents under uncertainty and the lack of information contributed to the elaboration of the bounded rationality theory by Simon. The article also describes the input of Keynes to the formation of a new «Keynesian» model of human behavior, which implies the importance of expectations, taking into account the psychological and social factors of economic behavior. The main psychological tendencies in the actions of the consumers and investors described by Keynes (the basic psychological law, liquidity preference, the influence of the «market psychology» on the investor's decisions and their relevance nowadays are examined. The article shows further development of the ideas of Keynes in the Akerlof and Shiller's theory of animal spirits and in the financial instability hypothesis of Minsky. It also gives a description of a confidence multiplier, introduced by Akerlof and Shiller, and shows how the cosumers' confidence can be measured nowadays. Besides, the article stresses that the study of the psychological motives of economic behavior, undertaken by Keynes, contributed to the development of such new disciplines at the interface between the economy and psychology as the economic psychology and behavioral economics.

Evidence for the credibility of health economic models for health policy decision-making

DEFF Research Database (Denmark)

Søgaard, Rikke; Lindholt, Jes S.

2012-01-01

OBJECTIVE: To investigate whether the credibility of health economic models of screening for abdominal aortic aneurysms for health policy decision-making has improved since 2005 when a systematic review by Campbell et al. concluded that reporting standards were poor and there was divergence between...... benefited from general advances in health economic modelling and some improvements in reporting were noted. However, the low level of agreement between studies in model structures and assumptions, and difficulty in justifying these (convergent validity), remain a threat to the credibility of health economic...... models. Decision-makers should not accept the results of a modelling study if the methods are not fully transparent and justified. Modellers should, whenever relevant, supplement a primary report of results with a technical report detailing and discussing the methodological choices made....

Economic Benefits of Investing in Women's Health: A Systematic Review.

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Kristine Husøy Onarheim

Full Text Available 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.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.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.This review highlights the untapped potential of initiatives that aim to address women's health. Societies that prioritize women's health will likely have better

Economic Benefits of Investing in Women's Health: A Systematic Review.

Science.gov (United States)

Onarheim, Kristine Husøy; Iversen, Johanne Helene; Bloom, David E

2016-01-01

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. 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. 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. This review highlights the untapped potential of initiatives that aim to address women's health. Societies that prioritize women's health will likely have better population health

The economic value of improving the health of disadvantaged Americans.

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Schoeni, Robert F; Dow, William H; Miller, Wilhelmine D; Pamuk, Elsie R

2011-01-01

Higher educational attainment is associated with better health status and longer life. This analysis estimates the annual dollar value of the benefits that would accrue to less-educated American adults if they experienced the lower mortality rates and better health of those with a college education. Using estimates of differences in mortality among adults aged ≥ 25 years by educational attainment from the National Longitudinal Mortality Survey and of education-based differentials in health status from published studies based on the Medical Expenditure Panel Survey, combined with existing estimates of the economic value of a healthy life year, the economic value of raising the health of individuals with less than a college education to the health of the college educated is estimated. The annual economic value that would accrue to disadvantaged (less-educated) Americans if their health and longevity improved to that of college-educated Americans is $1.02 trillion. This modeling exercise does not fully account for the social costs and benefits of particular policies and programs to reduce health disparities; rather, it provides a sense of the magnitude of the economic value lost in health disparities to compare with other social issues vying for attention. The aggregate economic gains from interventions that improve the health of disadvantaged Americans are potentially large. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.

A Framework for Including Family Health Spillovers in Economic Evaluation.

Science.gov (United States)

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

2016-02-01

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. © The Author(s) 2015.

The Behavioral Economics of Substance Use Disorders: reinforcement pathologies and their repair

Science.gov (United States)

Bickel, Warren K.; Johnson, Matthew W.; Koffarnus, Mikhail N.; MacKillop, James; Murphy, James G.

2015-01-01

The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics. PMID:24679180

The role of health economics in the evaluation of surgery and operative technologies.

Science.gov (United States)

Taylor, Matthew

2017-02-01

Dr Matthew Taylor is the director of York Health Economics Consortium and leads the Consortium's health technology assessment program. The work of York Health Economics Consortium involves empirical research in health economics for both the private and public sectors. Dr Taylor is the scientific lead for the National Institute for Health and Care Excellence (NICE) Economic and Methodological Unit and a former member of NICE's Public Health Advisory Committee. He is also managing director (Europe) of Minerva, an international network of health economics consultancies. Copyright © 2016 Elsevier Inc. All rights reserved.

Lifecycle effects of a recession on health behaviors: Boom, bust, and recovery in Iceland.

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Ásgeirsdóttir, Tinna Laufey; Corman, Hope; Noonan, Kelly; Reichman, Nancy E

2016-03-01

This study uses individual-level longitudinal data from Iceland, a country that experienced a severe economic crisis in 2008 and substantial recovery by 2012, to investigate the extent to which the effects of a recession on health behaviors are lingering or short-lived and to explore trajectories in health behaviors from pre-crisis boom, to crisis, to recovery. Health-compromising behaviors (smoking, heavy drinking, sugared soft drinks, sweets, fast food, and tanning) declined during the crisis, and all but sweets continued to decline during the recovery. Health-promoting behaviors (consumption of fruit, fish oil, and vitamins/minerals and getting recommended sleep) followed more idiosyncratic paths. Overall, most behaviors reverted back to their pre-crisis levels or trends during the recovery, and these short-term deviations in trajectories were probably too short-lived in this recession to have major impacts on health or mortality. A notable exception is for binge drinking, which declined by 10% during the 2 crisis years, continued to fall (at a slower rate of 8%) during the 3 recovery years, and did not revert back to the upward pre-crisis trend during our observation period. These lingering effects, which directionally run counter to the pre-crisis upward trend in consumption and do not reflect price increases during the recovery period, suggest that alcohol is a potential pathway by which recessions improve health and/or reduce mortality. Copyright © 2015 Elsevier B.V. All rights reserved.

A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

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Candida Graham

2014-01-01

Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

Building new computational models to support health behavior change and maintenance: new opportunities in behavioral research.

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Spruijt-Metz, Donna; Hekler, Eric; Saranummi, Niilo; Intille, Stephen; Korhonen, Ilkka; Nilsen, Wendy; Rivera, Daniel E; Spring, Bonnie; Michie, Susan; Asch, David A; Sanna, Alberto; Salcedo, Vicente Traver; Kukakfa, Rita; Pavel, Misha

2015-09-01

Adverse and suboptimal health behaviors and habits are responsible for approximately 40 % of preventable deaths, in addition to their unfavorable effects on quality of life and economics. Our current understanding of human behavior is largely based on static "snapshots" of human behavior, rather than ongoing, dynamic feedback loops of behavior in response to ever-changing biological, social, personal, and environmental states. This paper first discusses how new technologies (i.e., mobile sensors, smartphones, ubiquitous computing, and cloud-enabled processing/computing) and emerging systems modeling techniques enable the development of new, dynamic, and empirical models of human behavior that could facilitate just-in-time adaptive, scalable interventions. The paper then describes concrete steps to the creation of robust dynamic mathematical models of behavior including: (1) establishing "gold standard" measures, (2) the creation of a behavioral ontology for shared language and understanding tools that both enable dynamic theorizing across disciplines, (3) the development of data sharing resources, and (4) facilitating improved sharing of mathematical models and tools to support rapid aggregation of the models. We conclude with the discussion of what might be incorporated into a "knowledge commons," which could help to bring together these disparate activities into a unified system and structure for organizing knowledge about behavior.

Behavioral economics: from advising organizations to nudging individuals

NARCIS (Netherlands)

Sent, E.-M.; Heukelom, F.

2017-01-01

This paper starts from a distinction between “old” and “new” behavioral economics. The former is associated with, amongst others, a Carnegie group around Herbert Simon and a Michigan cluster led by George Katona. The roots of the latter may be traced to the work of especially Amos Tversky and Daniel

Public health interventions: evaluating the economic evaluations

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Martin Forster

2013-10-01

Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...

CURRENT ECONOMIC AND MEDICAL REFORMS IN THE ROMANIAN HEALTH CARE SYSTEM

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Dragoi Mihaela Cristina

2011-12-01

Full Text Available The issue of health has always been, both in social reality and in academia and research, a sensitive topic considering the relationship each individual has with his own health and the health care system as a public policy. At public opinion levels and not only, health care is the most important sector demanding the outmost attention, considering that individual health is the fundamental prerequisite for well-being, happiness and a satisfying life. The ever present research and practical question is on the optimal financing of the health care system. Any answer to this question is also a political decision, reflecting the social-economic value of health for a particular country. The size of the resource pool and the criteria and methods for resource allocation are the central economic problems for any health system. This paper takes into consideration the limited resources of the national health care system (the rationalization of health services, the common methods of health financing, the specificity of health services market (the health market being highly asymmetric, with health professionals knowing most if not all of the relevant information, such as diagnosis, treatment options and costs and consumers fully dependent on the information provided in each case and the performance of all hospitals in Romania, in order to assess the latest strategic decisions (introduction of co-payment and merging and reconversion of hospitals taken within the Romanian health care system and their social and economic implications. The main finding show that, even though the intention of reforming and transforming the Romanian health care system into a more efficient one is obvious, the lack of economic and demographic analysis may results into greater discrepancies nationwide. This paper is aimed to renew the necessity of joint collaboration between the economic and medical field, since the relationship between health and economic development runs both ways

Ethical and Economic Perspectives on Global Health Interventions

OpenAIRE

Sonia Bhalotra; Thomas Pogge

2012-01-01

Interventions that improve childhood health directly improve the quality of life and, in addition, have multiplier effects, producing sustained population and economic gains in poor countries. We suggest how contemporary global institutions shaping the development, pricing and distribution of vaccines and drugs may be modified to deliver large improvements in health. To support a justice argument for such modification, we show how the current global economic order may contribute to perpetuati...

Health care in the developing world: the role of economists and economics.

Science.gov (United States)

Lee, K

1983-01-01

This paper does not address itself to high theory or to complex methodologies; nor does it offer any detailed illumination of key economic concepts. Rather, it focuses on the role of economists and economics (not the same thing) in the formulation of health policies, and in influencing an evaluation of health strategies appropriate to the requirements of the developing world. The paper argues that the 'climate' has changed sufficiently in the developing world to promote a close interest in the economics of health and health care. Evidence exists of a growing willingness to employ economists and economic analysis to resource allocation issues within the health sector. Accordingly, a glossary of economic concepts in presented to demonstrate that economics does possess certain ideas, distinct from other disciplines, which can be of considerable value to health planners and health managers alike. The text also sets out, in tabular form, many of the key questions that should be of close interest to policy-makers, and indicates the economic concepts and techniques that can be applied. At the same time, it is noted that there are very real conceptual and methodological problems likely to be faced by those wishing to apply economic reasoning to the health sector. The paper then moves on from analysis to consider implementation, and investigates the political constraints and institutional barriers to the acceptance of economic analysis in the health sector. In the past, the nature of the economics of health has sometimes been considered improper, i.e. views have been expressed that services should be made available to those for whom they may be beneficial, as a matter of right without regard to economics.(ABSTRACT TRUNCATED AT 250 WORDS)

Prioritizing health services research: an economic perspective.

Science.gov (United States)

Gandjour, Afschin

2016-05-01

Given limited resources policymakers need to decide about how much and in what areas of health services research (HSR) to invest. The purpose of this study is to provide guidance for priority setting of HSR projects based on economic theory. The conceptual analysis starts from the premise that competition in health care is valuable-a position that seems to predominate among Western policymakers. The principle of competition rests on economic theory and, in particular, its branch of welfare economics. Based on economic theory, the role of HSR is to detect and alleviate information asymmetry, negative externalities, and harm caused by competition and inappropriate incentives for competition. A hierarchy of HSR projects is provided; following the ethical principle of harm ('do not harm'), the detection and prevention of harm would receive highest priority among HSR projects. Agreeing that competition is valuable in achieving efficiency and quality of care (and therefore agreeing to the assumptions of economic theory) implies accepting the role of HSR in detecting market failure and the HSR hierarchy as suggested. Disagreement would require an alternative coherent concept of improving efficiency and quality of care.

Priorities of low-income urban residents for interventions to address the socio-economic determinants of health.

Science.gov (United States)

Danis, Marion; Kotwani, Namrata; Garrett, Joanne; Rivera, Ivonne; Davies-Cole, John; Carter-Nolan, Pamela

2010-11-01

To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health. We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions. Given a budget valued at approximately twice an estimated cost of medical and dental care ($885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions. Poor and low-income residents' priorities may usefully inform allocation of social services that affect health.

[Economic analysis of health promotion conducted in an enterprise].

Science.gov (United States)

Wang, Zhi-chun; Yang, Xue-ying; Kang, Wen-long; Wang, Wen-jing

2013-12-01

To take intervention measures for health promotion after investigation of occupational health needs among employees, to analyze the economic input and output of the intervention measures, and to analyze the feasibility of health promotion through cost-effectiveness analysis and cost-benefit analysis. A survey was conducted in an enterprise using a self-designed questionnaire to investigate the general information on enterprise, occupational history of each employee, awareness of occupational health knowledge, awareness of general health knowledge, awareness of hypertension, acquired immune deficiency syndrome, etc., lifestyle, and needs for health knowledge. Intervention measures were taken in the enterprise according to the investigation results, and then investigation and economic analysis of investment in health promotion, economic benefit, and absence of employees were performed using the questionnaire. After intervention, the awareness rate of the Code of Occupational Disease Prevention increased from 4.5% to 15.3%, the awareness rate of the definition of occupational diseases increased from 4.5% to 73.5%, and the awareness rate of the prevention and control measures for occupational diseases increased from 38.4% to 85.8%. Before intervention, 25.4%of all employees thought salt intake needed to be reduced, and this proportion increased to 92.5% after intervention. After the control strategy for health promotion, the benefit of health promotion that results from avoiding absence of employees and preventing occupational diseases was more than ten times the investment in health promotion, suggesting a significant benefit of health promotion conducted in the enterprise. The return on health promotion's investment for enterprise is worth. Health promotion really not just contribute to improve hygienic knowledge but increase the economic benefit.

The influence of social capital and socio-economic conditions on self-rated health among residents of an economically and health-deprived South African township

Directory of Open Access Journals (Sweden)

Cramm Jane M

2011-11-01

Full Text Available Abstract Background Surprisingly few studies have investigated the interplay of multiple factors affecting self-rated health outcomes and the role of social capital on health in developing countries, a prerequisite to strengthening our understanding of the influence of social and economic conditions on health and the most effective aid. Our study aimed to identify social and economic conditions for health among residents of an economically and health-deprived community. Methods Data were gathered through a survey administered to respondents from 1,020 households in Grahamstown a suburb in the Eastern Cape, South Africa (response rate 97.9%. We investigated the influence of social and economic conditions (education, employment, income, social capital, housing quality and neighborhood quality on self-rated health. We used ordinal logistic regression analyses to identify the relationship of these conditions and self-rated health. Results Our study found that education and social capital positively correlated with health; unemployment, poor educational level and advanced age negatively correlated. We found no significant correlations between self-rated health and housing quality, neighbourhood quality, income, gender, or marital status. Conclusion We highlight the possible impacts of social capital, employment, and education on health, and suggest that health outcomes may be improved through interventions beyond the health system: creating job opportunities, strengthening social capital, bettering educational systems, and promoting educational access. Policymakers should consider the benefits of such programmes when addressing health outcomes in financially distressed districts.

Considerations regarding the Effects of Economic Crisis on Employee Communicational Behavior

OpenAIRE

Popescu Manoela; Crenicean Cecilia Luminita

2011-01-01

The economic crisis has caused significant changes in socio-economic entities strategies. In conclusion, firms were obliged to develop strategies for crisis as a result of their focus on customer, without understanding the customer as an employee. Moreover, strategic changes are not the result of company development, but as a direct effect of economic context. Otherwise, firms do not reflect the strategic communication behavior of their employees. Therefore, such a strategy may not be viable ...

THE IMPACT OF CREDIT AND CAPITAL SUPPORTS ON ECONOMIC BEHAVIOR OF FARM HOUSEHOLDS: A HOUSEHOLD ECONOMIC APPROACH

Directory of Open Access Journals (Sweden)

Bernardus Bala de Rosari

2014-07-01

Full Text Available This research aimed at analysing the demand and allocation of credit and capital supports by farm household and impact on production, consumption, and investment. The research was conducted in East Nusa Tenggara Timur (ENT Province, one of targeted region of credit and capital supports policy of the government. Data collection was conducted from April to June 2013 by sampling for 178 households of farmers in Kupang District and Timor Tengah Selatan (TTS District. The result of this research showed that the allocation of credit and capital supports caused increaseof cattle production, consumption expenditure, and investment. The usage of credit and capital supports was depend on economical situation of the household itself. The decision of farm household on using credit and capital supports had impact on overall economical behavior of household, i.e. production, consumption and investment behavior. The transmission use was reciprocally interacted. Finally, the policy of credit and capital supports scheme for farmers should be adjusted with the context of farm household economics.

Health Behavior and Behavioral Economics: Economic Preferences and Physical Activity Stages of Change in a Low-Income African American Community

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Leonard, Tammy; Shuval, Kerem; de Oliveira, Angela; Skinner, Celette Sugg; Eckel, Catherine; Murdoch, James C.

2014-01-01

Purpose To examine the relationship between physical activity stages of change and preferences for financial risk and time. Design A cross-sectional, community-based study. Setting A low-income, urban, African American neighborhood. Subjects 169 adults Measures Self-reported physical activity stages of change—precontemplation to maintenance, objectively measured BMI and waist circumference, and economic preferences for time and risk measured via incentivized economic experiments. Analysis Multivariable ordered logistic regression models were used to examine the association between physical activity stages of change and economic preferences while controlling for demographic characteristics of the individuals. Results Individuals who are more tolerant of financial risks (OR=1.31, pfinancial risk tolerance or 1 unit increase in the time preference measure, respectively. Conclusions Greater tolerance of financial risk and more patient time preferences among this low-income ethnic minority population are associated with a more advanced physical activity stage. Further exploration is clearly warranted in larger and more representative samples. PMID:23448410

Nutrition economics: an innovative approach to informed public health management.

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Nuijten, Mark; Lenoir-Wijnkoop, Irene

2011-09-01

The role of nutrition to optimize the use of scarce resources through its linkage with health and welfare should be considered of interest by healthcare decision makers. A favorable impact of food on non-communicable disorders and general health status will improve healthcare expenditure and quality of life.In health economics, an analysis of the costs and effects of a healthcare technology by means of a cost-effectiveness analysis has become an established tool. Projections about the effectiveness and expected costs of an intervention can be modeled using realistic and explicit assumptions based on outcomes from randomized clinical studies. However, the use of health economic techniques to assess costs and effects is not solely restricted to classic healthcare products such as medicines. To illustrate this we used two published cost-effectiveness studies, which consider respectively a preventive treatment against severe respiratory syncytial virus infection in children at high risk of hospitalization and the use of prebiotics for the primary prevention of atopic dermatitis.These examples illustrate that there is a parallel between the methodologies for extrapolation of intermediate outcomes to long-term outcomes between a cost-effectiveness analysis for pharmaceutical or nutrition, as long as the clinical evidence for nutrition fulfils the requirements for pharmaceuticals. Another requirement is that there is clinical widely accepted evidence that matches a comparable level of epidemiological observations about the link between short-term and long-term outcomes.Better understanding of how nutritional status and behavior may interplay with the socioeconomic environment will ultimately contribute to preserving the sustainability of healthcare provisions. Copyright © 2011 Elsevier B.V. All rights reserved.

Economic transition and health transition: comparing China and Russia.

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Liu, Y; Rao, K; Fei, J

1998-05-01

Drawing on experiences from China and Russia (the world's two largest transitional economies), this paper empirically examines the impact of economic reforms on health status. While China's overall health status continued to improve after the economic reform, Russia experienced a serious deterioration in its population health. The observed differences in health performance between China and Russia can be explained by the different impacts of economic reforms on three major socioeconomic determinants of health. Depending on whether or not the reform improves physical environment (as reflected in income level and nutritional status), social environment (including social stability and security system), and health care, we would observe either a positive or a negative net effect on health. Despite remarkable differences in overall health development, China and Russia share some common problems. Mental and social health problems such as suicides and alcohol poisoning have been on the rise in both countries. These problems were much more serious in Russia, where political and social instability was more pronounced, associated with Russia's relatively radical reform process. With their economies moving toward a free market system, health sectors in China and Russia are undergoing marketization, which has had serious detrimental effect on the public health services.

Economic value of U.S. fossil fuel electricity health impacts.

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Machol, Ben; Rizk, Sarah

2013-02-01

Fossil fuel energy has several externalities not accounted for in the retail price, including associated adverse human health impacts, future costs from climate change, and other environmental damages. Here, we quantify the economic value of health impacts associated with PM(2.5) and PM(2.5) precursors (NO(x) and SO(2)) on a per kilowatt hour basis. We provide figures based on state electricity profiles, national averages and fossil fuel type. We find that the economic value of improved human health associated with avoiding emissions from fossil fuel electricity in the United States ranges from a low of $0.005-$0.013/kWh in California to a high of $0.41-$1.01/kWh in Maryland. When accounting for the adverse health impacts of imported electricity, the California figure increases to $0.03-$0.07/kWh. Nationally, the average economic value of health impacts associated with fossil fuel usage is $0.14-$0.35/kWh. For coal, oil, and natural gas, respectively, associated economic values of health impacts are $0.19-$0.45/kWh, $0.08-$0.19/kWh, and $0.01-$0.02/kWh. For coal and oil, these costs are larger than the typical retail price of electricity, demonstrating the magnitude of the externality. When the economic value of health impacts resulting from air emissions is considered, our analysis suggests that on average, U.S. consumers of electricity should be willing to pay $0.24-$0.45/kWh for alternatives such as energy efficiency investments or emission-free renewable sources that avoid fossil fuel combustion. The economic value of health impacts is approximately an order of magnitude larger than estimates of the social cost of carbon for fossil fuel electricity. In total, we estimate that the economic value of health impacts from fossil fuel electricity in the United States is $361.7-886.5 billion annually, representing 2.5-6.0% of the national GDP. Published by Elsevier Ltd.

Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?

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Huter, Kai; Dubas-Jakóbczyk, Katarzyna; Kocot, Ewa; Kissimova-Skarbek, Katarzyna; Rothgang, Heinz

2018-01-01

In the light of demographic developments health promotion interventions for older people are gaining importance. In addition to methodological challenges arising from the economic evaluation of health promotion interventions in general, there are specific methodological problems for the particular target group of older people. There are especially four main methodological challenges that are discussed in the literature. They concern measurement and valuation of informal caregiving, accounting for productivity costs, effects of unrelated cost in added life years and the inclusion of 'beyond-health' benefits. This paper focuses on the question whether and to what extent specific methodological requirements are actually met in applied health economic evaluations. Following a systematic review of pertinent health economic evaluations, the included studies are analysed on the basis of four assessment criteria that are derived from methodological debates on the economic evaluation of health promotion interventions in general and economic evaluations targeting older people in particular. Of the 37 studies included in the systematic review, only very few include cost and outcome categories discussed as being of specific relevance to the assessment of health promotion interventions for older people. The few studies that consider these aspects use very heterogeneous methods, thus there is no common methodological standard. There is a strong need for the development of guidelines to achieve better comparability and to include cost categories and outcomes that are relevant for older people. Disregarding these methodological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and, hence, an age-based rationing of public health care.

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

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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.

The macro-economic determinants of health and health inequalities-umbrella review protocol.

Science.gov (United States)

Naik, Yannish; Baker, Peter; Walker, Ian; Tillmann, Taavi; Bash, Kristin; Quantz, Darryl; Hillier-Brown, Frances; Bambra, Clare

2017-11-03

The economic determinants of health have been widely recognised as crucial factors affecting health; however, to date, no comprehensive review has been undertaken to summarise these factors and the ways in which they can influence health. We conceptualise the economy as a complex system made up of underlying approaches, regulation from institutions, markets, finance, labour, the public-private balance as well as production and distributional effects, which collectively impact on health through the effect of moderators. This protocol details the methods for an umbrella review to explore the macro-economic factors, strategies, policies and interventions that affect health outcomes and health inequalities. We will identify relevant systematic reviews using search terms derived from the Journal of Economic Literature classification. Reviews will be included if they meet the Database of Abstracts and Reviews of Effects criteria for systematic reviews. Reviews of studies with and without controls will be included; both association and intervention studies will be included. Primary outcomes will include but are not limited to morbidity, mortality, prevalence and incidence of conditions and life expectancy. Secondary outcomes will include health inequalities by gender, ethnicity or socio-economic status. Six databases will be searched using tailored versions of our piloted search strategy to locate relevant reviews. Data will be extracted using a standardized pro forma, and the findings will be synthesized into a conceptual framework to address our review aim. Our umbrella review protocol provides a robust method to systematically appraise the evidence in this field, using new conceptual models derived specifically to address the study question. This will yield important information for policymakers, practitioners and researchers at the local, national and international level. It will also help set the future research agenda in this field and guide the development of

Conceptual model and economic experiments to explain nonpersistence and enable mechanism designs fostering behavioral change.

Science.gov (United States)

Djawadi, Behnud Mir; Fahr, René; Turk, Florian

2014-12-01

Medical nonpersistence is a worldwide problem of striking magnitude. Although many fields of studies including epidemiology, sociology, and psychology try to identify determinants for medical nonpersistence, comprehensive research to explain medical nonpersistence from an economics perspective is rather scarce. The aim of the study was to develop a conceptual framework that augments standard economic choice theory with psychological concepts of behavioral economics to understand how patients' preferences for discontinuing with therapy arise over the course of the medical treatment. The availability of such a framework allows the targeted design of mechanisms for intervention strategies. Our conceptual framework models the patient as an active economic agent who evaluates the benefits and costs for continuing with therapy. We argue that a combination of loss aversion and mental accounting operations explains why patients discontinue with therapy at a specific point in time. We designed a randomized laboratory economic experiment with a student subject pool to investigate the behavioral predictions. Subjects continue with therapy as long as experienced utility losses have to be compensated. As soon as previous losses are evened out, subjects perceive the marginal benefit of persistence lower than in the beginning of the treatment. Consequently, subjects start to discontinue with therapy. Our results highlight that concepts of behavioral economics capture the dynamic structure of medical nonpersistence better than does standard economic choice theory. We recommend that behavioral economics should be a mandatory part of the development of possible intervention strategies aimed at improving patients' compliance and persistence behavior. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Parental influence on children's oral health-related behavior.

Science.gov (United States)

Poutanen, Raija; Lahti, Satu; Tolvanen, Mimmi; Hausen, Hannu

2006-10-01

The aim of this study was to determine whether there are differences between oral health-related knowledge, attitudes, beliefs and behaviors of children and their parents, and to identify the family-related factors associated with children's poor or good oral health-related behavior. The data were gathered by means of questionnaires from 11-12-year-old schoolchildren and their parents who replied without having knowledge of the answers of the others. Differences between subgroups of children were analyzed by cross-tabulation, and the factors related to children's good or poor oral health-related behavior by logistic regression analyses. Parents of children who reported good oral health-related behavior had better knowledge and more favorable behaviors than those of other parents. Predictors for a child's poor oral health-related behavior were the child's poor knowledge, male gender, the parent's frequent consumption of sweets, and the parent's infrequent use of xylitol gum. When a less strict threshold for the child's poor oral health-related behavior was used, more predictors entered the model: the parent's unfavorable use of fluoride toothpaste; among girls, the parent's lack of knowledge; and among children whose mother's occupation level was high, the parent's infrequent use of xylitol gum. The parents of children whose oral health behavior was favorable were more likely to have a high level occupation and favorable oral health-related behaviors. Oral health-related knowledge of children and their parents seems to be associated with children's oral health-related behavior. Parents' behaviors, but not attitudes, were associated with children's oral health behavior.

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

Science.gov (United States)

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.

Health economics of insomnia therapy: implications for policy.

Science.gov (United States)

Botteman, Marc

2009-09-01

Chronic primary insomnia is a major public health problem causing significant burden for those affected. Rising health care costs may cause increased financial pressures on governments and private payers, forcing stricter cost-control measures and, as a result, insomnia, often considered a lifestyle condition, may not receive the proper attention it deserves. In order to highlight the benefits that can be achieved through successful treatment of insomnia, there is a need for further comparative studies of existing and emerging treatments, cost burden of illness and cost-effectiveness analyses. Health economic assessment of insomnia and its treatments is an emerging area. The development of comprehensive assessment of insomnia treatments, however, has been hindered by complexities and gaps in the available data. Health economic models of insomnia, such as the one detailed here, should enable researchers to better address the effects of different treatments on clinical and economic measures for insomnia and related comorbidities. It is apparent that research into the cost-effectiveness of therapies for insomnia is in its infancy and further work is needed.

The Icelandic economic collapse, smoking, and the role of labor-market changes.

Science.gov (United States)

Ólafsdóttir, Thorhildur; Hrafnkelsson, Birgir; Ásgeirsdóttir, Tinna Laufey

2015-05-01

Smoking is related to health deterioration through increased risk of various diseases. Changes in this health behavior could contribute to the documented health improvements during economic downturns. Furthermore, the reasons for changes in behavior are not well understood. We explore smoking behavior in Iceland before and after the sudden and unexpected economic crisis in 2008. Furthermore, to explore the mechanisms through which smoking could be affected we focus on the role of labor-market changes. Both real income and working hours fell significantly and economic theory suggests that such changes can affect health behaviors which in turn affect health. We use individual longitudinal data from 2007 to 2009, incidentally before and after the crisis hit. The data originates from a postal survey, collected by The Public Health Institute in Iceland. Two outcomes are explored: smoking participation and smoking intensity, using pooled ordinary least squares (OLS) and linear probability models. The detected reduction in both outcomes is not explained by the changes in labor-market variables. Other factors in the demand function for tobacco play a more important role. The most notable are real prices which increased in particular for imported goods because of the devaluation of the Icelandic currency as a result of the economic collapse.

Investing in health for economic development: The case of Mexico

OpenAIRE

Lustig, Nora

2006-01-01

Health is an asset with an intrinsic value as well as an instrumental value. Good health is a source of wellbeing and highly valued throughout the world. Health is not only the absence of illness, but capacity to develop a person’s potential. Health is also an important determinant of economic growth. Given the importance of health, both as a source of human welfare and a determinant of overall economic growth, the Popular Health Insurance (Seguro Popular) was first introduced in Mexico as a ...

FDA actions against health economic promotions, 2002-2011.

Science.gov (United States)

Neumann, Peter J; Bliss, Sarah K

2012-01-01

To investigate Food and Drug Administration (FDA) regulatory actions against drug companies' health economic promotions from 2002 through 2011 to understand how frequently and in what circumstances the agency has considered such promotions false or misleading. We reviewed all warning letters and notices of violation ("untitled letters") issued by the FDA's Division of Drug Marketing, Advertising and Communications (DDMAC) to pharmaceutical companies from January 2002 through December 2011. We analyzed letters containing a violation related to "health economic promotion," defined according to one of several categories (e.g., implied claims of cost savings due to work productivity or economic claims containing unsupported statements about effectiveness or safety). We also collected information on factors such as the indication and type of media involved and whether the letter referenced Section 114 of the Food and Drug Administration Modernization Act. Of 291 DDMAC letters sent to pharmaceutical companies during the study period, 35 (12%) cited a health economic violation. The most common type of violation cited was an implied claim of cost savings due to work productivity or functioning (found in 20 letters) and economic claims containing unsubstantiated comparative claims of effectiveness, safety, or interchangeability (7 letters). The violations covered various indications, mostly commonly psychiatric disorders (6 letters) and pain (6 letters). No DDMAC letter pertained to Food and Drug Administration Modernization Act Section 114. The FDA has cited inappropriate health economic promotions in roughly 12% of the letters issued by the DDMAC. The letters highlight drug companies' interest in promoting the value of their products and the FDA's concerns in certain cases about the lack of supporting evidence. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Economic Sanctions as Determinants of Health [Abstract

NARCIS (Netherlands)

F. Kokabisaghi (Fatemeh)

2017-01-01

markdownabstract__Background:__ In the recent years economic sanctions have been very often applied in order to force states to change their behavior at international level and conform to the international law. Many studies show that sanctions are associated with deterioration of people’s enjoyment

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

Science.gov (United States)

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.

Who needs the assumption of opportunistic behavior? Transaction cost economics does not!

DEFF Research Database (Denmark)

Koch, Carsten Allan

2000-01-01

The assumption of opportunistic behavior, familiar from transaction cost economics, has been and remains highly controversial. But opportunistic behavior, albeit undoubtedly an extremely important form of motivation, is not a necessary condition for the contractual problems studied by transaction...

The role of narcissism in health-risk and health-protective behaviors.

Science.gov (United States)

Hill, Erin M

2016-09-01

This study examined the role of narcissism in health-risk and health-protective behaviors in a sample of 365 undergraduate students. Regression analyses were used to test the influence of narcissism on health behaviors. Narcissism was positively predictive of alcohol use, marijuana use, and risky driving behaviors, and it was associated with an increased likelihood of consistently having a healthy eating pattern. Narcissism was also positively predictive of physical activity. Results are discussed with reference to the potential short-term and long-term health implications and the need for future research on the factors involved in the relationship between narcissism and health behaviors. © The Author(s) 2015.

Barriers and Facilitators for Health Behavior Change among Adults from Multi-Problem Households: A Qualitative Study

NARCIS (Netherlands)

Nagelhout, Gera; Hogeling, Lette; Spruijt, Renate; Postma, Nathalie; Vries, de Hein

2017-01-01

Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults from

Behavioral Economics Interventions to Improve Outpatient Antibiotic Prescribing for Acute Respiratory Infections: a Cost-Effectiveness Analysis.

Science.gov (United States)

Gong, Cynthia L; Zangwill, Kenneth M; Hay, Joel W; Meeker, Daniella; Doctor, Jason N

2018-05-08

Behavioral economics interventions have been shown to effectively reduce the rates of inappropriate antibiotic prescriptions for acute respiratory infections (ARIs). To determine the cost-effectiveness of three behavioral economic interventions designed to reduce inappropriate antibiotic prescriptions for ARIs. Thirty-year Markov model from the US societal perspective with inputs derived from the literature and CDC surveillance data. Forty-five-year-old adults with signs and symptoms of ARI presenting to a healthcare provider. (1) Provider education on guidelines for the appropriate treatment of ARIs; (2) Suggested Alternatives, which utilizes computerized clinical decision support to suggest non-antibiotic treatment choices in lieu of antibiotics; (3) Accountable Justification, which mandates free-text justification into the patient's electronic health record when antibiotics are prescribed; and (4) Peer Comparison, which sends a periodic email to prescribers about his/her rate of inappropriate antibiotic prescribing relative to clinician colleagues. Discounted costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios. Each intervention has lower costs but higher QALYs compared to provider education. Total costs for each intervention were $178.21, $173.22, $172.82, and $172.52, and total QALYs were 14.68, 14.73, 14.74, and 14.74 for the control, Suggested Alternatives, Accountable Justification, and Peer Comparison groups, respectively. Results were most sensitive to the quality-of-life of the uninfected state, and the likelihood and costs for antibiotic-associated adverse events. Behavioral economics interventions can be cost-effective strategies for reducing inappropriate antibiotic prescriptions by reducing healthcare resource utilization.

Health economics of blood transfusion safety - focus on sub-Saharan Africa

NARCIS (Netherlands)

van Hulst, Marinus; Smit Sibinga, Cees Th. Smit; Postma, Maarten J.

Background and objectives. Health economics provides a standardised methodology for valid comparisons of interventions in different fields of health care. This review discusses the health economic evaluations of strategies to enhance blood product safety in sub-Saharan Africa Methods. We reviewed

Wealth and Health Behavior: Testing the Concept of a Health Cost.

Science.gov (United States)

van Kippersluis, Hans; Galama, Titus J

2014-11-01

Wealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of unhealthy consumption. The health cost increases with wealth and the degree of unhealthiness, leading wealthier individuals to consume more healthy and moderately unhealthy, but fewer severely unhealthy goods. The empirical evidence presented suggests that differences in health costs may indeed partially explain behavioral differences, and ultimately health outcomes, between wealth groups.

The hidden cost of wildfires: Economic valuation of health effects of wildfire smoke exposure in Southern California

Science.gov (United States)

Richardson, L.A.; Champ, P.A.; Loomis, J.B.

2012-01-01

There is a growing concern that human health impacts from exposure to wildfire smoke are ignored in estimates of monetized damages from wildfires. Current research highlights the need for better data collection and analysis of these impacts. Using unique primary data, this paper quantifies the economic cost of health effects from the largest wildfire in Los Angeles County's modern history. A cost of illness estimate is $9.50 per exposed person per day. However, theory and empirical research consistently find that this measure largely underestimates the true economic cost of health effects from exposure to a pollutant in that it ignores the cost of defensive actions taken as well as disutility. For the first time, the defensive behavior method is applied to calculate the willingness to pay for a reduction in one wildfire smoke induced symptom day, which is estimated to be $84.42 per exposed person per day. ?? 2011.

Social and economic value of Portuguese community pharmacies in health care.

Science.gov (United States)

Félix, Jorge; Ferreira, Diana; Afonso-Silva, Marta; Gomes, Marta Vargas; Ferreira, César; Vandewalle, Björn; Marques, Sara; Mota, Melina; Costa, Suzete; Cary, Maria; Teixeira, Inês; Paulino, Ema; Macedo, Bruno; Barbosa, Carlos Maurício

2017-08-29

Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal. The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: "with service" versus "without service". It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption. Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.

Leisure-time physical activity in university students from 23 countries: associations with health beliefs, risk awareness, and national economic development.

Science.gov (United States)

Haase, Anne; Steptoe, Andrew; Sallis, James F; Wardle, Jane

2004-07-01

Physical inactivity has been linked with chronic disease and obesity in most western populations. However, prevalence of inactivity, health beliefs, and knowledge of the risks of inactivity have rarely been assessed across a wide range of developed and developing countries. A cross-sectional survey was carried out with 19,298 university students from 23 countries varying in culture and level of economic development. Data concerning leisure-time physical activity, health beliefs, and health knowledge were collected. The prevalence of inactivity in leisure time varied with cultural and economic developmental factors, averaging 23% (North-Western Europe and the United States), 30% (Central and Eastern Europe), 39% (Mediterranean), 42% (Pacific Asian), and 44% (developing countries). The likelihood of leisure-time physical activity was positively associated with the strength of beliefs in the health benefits of activity and with national economic development (per capita gross domestic product). Knowledge about activity and health was disappointing, with only 40-60% being aware that physical activity was relevant to risk of heart disease. Leisure-time physical activity is below recommended levels in a substantial proportion of students, and is related to cultural factors and stage of national economic development. The relationship between health beliefs and behavior is robust across cultures, but health knowledge remains deficient. Copyright 2004 The Institute for Cancer Prevention and Elsevier Inc.

What Factors Affect Health Seeking Behavior?

African Journals Online (AJOL)

reducing cost, disability and death from diseases. (2). However, good health ... The Health Belief Model where the concept is the 'perceived susceptibility', which refers ... behavioral intentions and actions (6). ... integrated behavioral model.

Consolidated Health Economic Evaluation Reporting Standards (CHEERS)--explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force.

Science.gov (United States)

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 because substantial information must be conveyed to allow scrutiny of study findings. Despite a growth in published reports, existing reporting guidelines are not widely adopted. There is also a need to consolidate and update existing guidelines and promote their use in a user-friendly manner. A checklist is one way to help authors, editors, and peer reviewers use guidelines to improve reporting. The task force's overall goal was to provide recommendations to optimize the reporting of health economic evaluations. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines into one current, useful reporting guidance. The CHEERS Elaboration and Explanation Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force facilitates the use of the CHEERS statement by providing examples and explanations for each recommendation. 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. Previously published checklists or guidance documents related to reporting economic evaluations were identified from a systematic review and subsequent survey of task force members. A list of possible items from these efforts was created. A two-round, modified Delphi Panel with representatives from academia, clinical practice, industry, and government, as well as the editorial community, was used to identify a minimum set of items important for reporting from the larger list. Out of 44 candidate items, 24 items and accompanying recommendations were developed, with some specific recommendations for single study-based and model-based economic evaluations. The final

Modeling human behavior in economics and social science.

Science.gov (United States)

Dolfin, M; Leonida, L; Outada, N

2017-12-01

The complex interactions between human behaviors and social economic sciences is critically analyzed in this paper in view of possible applications of mathematical modeling as an attainable interdisciplinary approach to understand and simulate the aforementioned dynamics. The quest is developed along three steps: Firstly an overall analysis of social and economic sciences indicates the main requirements that a contribution of mathematical modeling should bring to these sciences; subsequently the focus moves to an overview of mathematical tools and to the selection of those which appear, according to the authors bias, appropriate to the modeling; finally, a survey of applications is presented looking ahead to research perspectives. Copyright © 2017 Elsevier B.V. All rights reserved.

Electronic health records: eliciting behavioral health providers' beliefs.

Science.gov (United States)

Shank, Nancy; Willborn, Elizabeth; Pytlikzillig, Lisa; Noel, Harmonijoie

2012-04-01

Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

How economic empowerment reduces women's reproductive health vulnerability in Tanzania

NARCIS (Netherlands)

Westeneng, J.; D'Exelle, B.S.H.

2015-01-01

This article uses data from Northern Tanzania to analyse how economic empowerment helps women reduce their reproductive health (RH) vulnerability. It analyses the effect of women's employment and economic contribution to their household on health care use at three phases in the reproductive cycle:

Association of health professional leadership behaviors on health promotion practice beliefs.

Science.gov (United States)

Stone, Jacqueline D; Belcher, Harolyn M E; Attoh, Prince; D'Abundo, Michelle; Gong, Tao

2017-04-01

Leadership is a process by which an individual influences a group or individual to achieve a common goal, in this case health promotion for individuals with disabilities. (1) To examine the association between the transformational leadership behaviors of the Association of University Centers on Disabilities (AUCD) network professionals and their practice beliefs about health promotion activities, specifically cardiovascular fitness and healthy weight, for people with disabilities. (2) To determine if discipline and/or years of practice moderate the association between transformational leadership behaviors and practice beliefs regarding health promotion. There is a positive association between transformational leadership behaviors and health professionals practice beliefs regarding health promotion activities for persons with disabilities. A quantitative cross-sectional web-based survey design was used to determine the association between leadership behaviors and practices beliefs regarding health promotion for people with disabilities. The Multifactor Leadership Questionnaire and an adapted version of the Role of Health Promotion in Physical Therapy Survey were used to measure leadership and practice beliefs, respectively. Multiple regression analysis was applied to determine the association of leadership behaviors with health promotion practice beliefs variables. Transformational leadership behaviors of the AUCD network professionals were positively associated with health promotion practice beliefs about cardiovascular fitness for people with disabilities. Years post licensure and discipline did not moderate the association between transformational leadership and practice beliefs regarding health promotion. Transformational leadership may facilitate health professionals' health promotion practices for people with disabilities. Further research and training in leadership is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Individual health and the visibility of village economic inequality: Longitudinal evidence from native Amazonians in Bolivia.

Science.gov (United States)

Undurraga, Eduardo A; Nica, Veronica; Zhang, Rebecca; Mensah, Irene C; Godoy, Ricardo A

2016-12-01

Mounting evidence suggests that income inequality is associated with worse individual health. But does the visibility of inequality matter? Using data from a horticultural-foraging society of native Amazonians in Bolivia (Tsimane'), we examined whether village inequality in resources and behaviors with greater cultural visibility is more likely to bear a negative association with health than village inequality in less conspicuous resources. We draw on a nine-year annual panel (2002-2010) from 13 Tsimane' villages for our main analysis, and an additional survey to gauge the cultural visibility of resources. We measured inequality using the Gini coefficient. We tested the robustness of our results using a shorter two-year annual panel (2008-2009) in another 40 Tsimane' villages and an additional measure of inequality (coefficient of variation, CV). Behaviors with low cultural visibility (e.g., household farm area planted with staples) were less likely to be associated with individual health, compared to more conspicuous behaviors (e.g., expenditures in durable goods, consumption of domesticated animals). We find some evidence that property rights and access to resources matter, with inequality of privately-owned resources showing a larger effect on health. More inequality was associated with improved perceived health - maybe due to improved health prospects from increasing wealth - and worse anthropometric indicators. For example, a unit increase in the Gini coefficient of expenditures in durable goods was associated with 0.24 fewer episodes of stress and a six percentage-point lower probability of reporting illness. A one-point increase in the CV of village inequality in meat consumption was associated with a 4 and 3 percentage-point lower probability of reporting illness and being in bed due to illness, and a 0.05 SD decrease in age-sex standardized arm-muscle area. In small-scale, rural societies at the periphery of market economies, nominal economic inequality in

The Family Economic Environment as a Context for Children's Development.

Science.gov (United States)

Farran, Dale Clark; Margolis, Lewis H.

1987-01-01

Longitudinally examines how the complexities of the family economic environment may affect children's health, behavior, and ideas about the world of work. Family economic factors considered include father's/mother's work status (especially parental unemployment); per-capita income; health insurance; father's job security; and satisfaction with…

Towards integration of health economics into medical education and clinical practice in Saudi Arabia.

Science.gov (United States)

Da'ar, Omar B; Al Shehri, Ali M

2015-04-01

In an era of expanding health sectors and rising costs, doctors are expected to have a working knowledge of health economics to better use resources and improve outcomes and quality of health care. This article recognizes the dearth of knowledge and application of economic analyses in medical education and clinical practice in Saudi Arabia. In particular, it highlights the desirability of knowledge of health economics in ensuring certain competencies in medical education and the rationale for inviting doctors to apply knowledge of economics in Saudi Arabia. In addition, the article discusses challenges that hinder integrating health economics into clinical practice. Furthermore, the article typifies some of the important economic phenomena that physicians need to discern. Besides, the article provides implications for incorporating economic analysis into medical education and clinical practice in Saudi Arabia. Finally, the article concludes by demonstrating how health economics can enhance doctors' knowledge and recommends the country to move towards integrating health economics into medical education and clinical practice for best practice.

Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

OpenAIRE

Akulume, Martha; Kiwanuka, Suzanne N.

2016-01-01

Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and externa...

African Health Economics and Policy Research Capacity Building ...