WorldWideScience

Sample records for health economic assessment

  1. Health economic assessment: a methodological primer.

    Science.gov (United States)

    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.

  2. 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.

  3. Managing Air Quality - Human Health, Environmental and Economic Assessments

    Science.gov (United States)

    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.

  4. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  5. Quality assessment of published health economic analyses from South America.

    Science.gov (United States)

    Machado, Márcio; Iskedjian, Michael; Einarson, Thomas R

    2006-05-01

    Health economic analyses have become important to healthcare systems worldwide. No studies have previously examined South America's contribution in this area. To survey the literature with the purpose of reviewing, quantifying, and assessing the quality of published South American health economic analyses. A search of MEDLINE (1990-December 2004), EMBASE (1990-December 2004), International Pharmaceutical Abstracts (1990-December 2004), Literatura Latino-Americana e do Caribe em Ciências da Saúde (1982-December 2004), and Sistema de Informacion Esencial en Terapéutica y Salud (1980-December 2004) was completed using the key words cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-minimization analysis (CMA), and cost-benefit analysis (CBA); abbreviations CEA, CUA, CMA, and CBA; and all South American country names. Papers were categorized by type and country by 2 independent reviewers. Quality was assessed using a 12 item checklist, characterizing scores as 4 (good), 3 (acceptable), 2 (poor), 1 (unable to judge), and 0 (unacceptable). To be included in our investigation, studies needed to have simultaneously examined costs and outcomes. We retrieved 25 articles; one duplicate article was rejected, leaving 24 (CEA = 15, CBA = 6, CMA = 3; Brazil = 9, Argentina = 5, Colombia = 3, Chile = 2, Ecuador = 2, 1 each from Peru, Uruguay, Venezuela). Variability between raters was less than 0.5 point on overall scores (OS) and less than 1 point on all individual items. Mean OS was 2.6 (SD 1.0, range 1.4-3.8). CBAs scored highest (OS 2.8, SD 0.8), CEAs next (OS 2.7, SD 0.7), and CMAs lowest (OS 2.0, SD 0.5). When scored by type of question, definition of study aim scored highest (OS 3.0, SD 0.8), while ethical issues scored lowest (OS 1.5, SD 0.9). By country, Peru scored highest (mean OS 3.8) and Uruguay had the lowest scores (mean OS 2.2). A nonsignificant time trend was noted for OS (R2 = 0.12; p = 0.104). Quality scores of health economic analyses

  6. The impact of inclusion criteria in health economic assessments.

    Science.gov (United States)

    Richter, Anke; Thieda, Patricia; Thaler, Kylie; Gartlehner, Gerald

    2011-05-01

    The debate surrounding whether the findings of efficacy studies are applicable to real-world treatment situations is ongoing. The issue of lack of applicability due to a lack of clinical heterogeneity could be addressed by employing less restrictive inclusion criteria. Given that health economic assessments based on cost-effectiveness measures are required by many governments and insurance providers, the impact of this choice may be far reaching. The objective of this article was to explore the use of a pilot study to examine the impact of inclusion criteria on cost-effectiveness results and clinical heterogeneity. A health economic assessment was conducted using QRISK®2 and simulation modelling of different population groups within the pilot study in Lower Austria. Patients were referred by their family physicians to 'Active Prevention' (Vorsorge Aktiv), a community-based lifestyle intervention focused on exercise and nutritional programmes. Cardiovascular risk factors were recorded before and after the intervention and translated to cardiovascular events. As expected, enforcing restrictive inclusion criteria produced stronger and more irrefutable computations - in the expected number of events, the number of deaths, the incremental cost per life-year saved and in the 95% confidence interval. These findings provide insight into the issues surrounding clinical heterogeneity and the need for restrictive inclusion criteria. This is not a full health economic assessment of the intervention. While inclusion criteria provide stronger results by limiting populations to those who would benefit the most, they must be enforced, both within and outside the clinical trial setting. Enforcement has costs, both monetary and arising from unintended negative consequences of enforcement mechanisms. All these considerations will affect the results realized by the payer organization. A pilot study can reveal whether an intervention may be cost effective 'enough' without restrictive

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

    Science.gov (United States)

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

    2011-01-01

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

  8. Assessing Health, Economic, and Social Equity Impacts of Graphic ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The provisions include a requirement for graphic health warnings (GHWs) to take up at least 50% of the front and back of tobacco product packaging starting in November 2013. The law also prohibits misleading terms suggesting that one tobacco product is less harmful than another. While the law marks a significant step to ...

  9. An Economical Custom-Built Drone for Assessing Whale Health

    Directory of Open Access Journals (Sweden)

    Vanessa Pirotta

    2017-12-01

    Full Text Available Drones or Unmanned Aerial Vehicles (UAVs have huge potential to improve the safety and efficiency of sample collection from wild animals under logistically challenging circumstances. Here we present a method for surveying population health that uses UAVs to sample respiratory vapor, ‘whale blow,' exhaled by free-swimming humpback whales (Megaptera novaeangliae, and coupled this with amplification and sequencing of respiratory tract microbiota. We developed a low-cost multirotor UAV incorporating a sterile petri dish with a remotely operated ‘blow' to sample whale blow with minimal disturbance to the whales. This design addressed several sampling challenges: accessibility; safety; cost, and critically, minimized the collection of atmospheric and seawater microbiota and other potential sources of sample contamination. We collected 59 samples of blow from northward migrating humpback whales off Sydney, Australia and used high throughput sequencing of bacterial ribosomal gene markers to identify putative respiratory tract microbiota. Model-based comparisons with seawater and drone-captured air demonstrated that our system minimized external sources of contamination and successfully captured sufficient material to identify whale blow-specific microbial taxa. Whale-specific taxa included species and genera previously associated with the respiratory tracts or oral cavities of mammals (e.g., Pseudomonas, Clostridia, Cardiobacterium, as well as species previously isolated from dolphin or killer whale blowholes (Corynebacteria, others. Many examples of exogenous marine species were identified, including Tenacibaculum and Psychrobacter spp. that have been associated with the skin microbiota of marine mammals and fish and may include pathogens. This information provides a baseline of respiratory tract microbiota profiles of contemporary whale health. Customized UAVs are a promising new tool for marine megafauna research and may have broad application in

  10. The role of decision analytic modeling in the health economic assessment of spinal intervention.

    Science.gov (United States)

    Edwards, Natalie C; Skelly, Andrea C; Ziewacz, John E; Cahill, Kevin; McGirt, Matthew J

    2014-10-15

    Narrative review. To review the common tenets, strengths, and weaknesses of decision modeling for health economic assessment and to review the use of decision modeling in the spine literature to date. For the majority of spinal interventions, well-designed prospective, randomized, pragmatic cost-effectiveness studies that address the specific decision-in-need are lacking. Decision analytic modeling allows for the estimation of cost-effectiveness based on data available to date. Given the rising demands for proven value in spine care, the use of decision analytic modeling is rapidly increasing by clinicians and policy makers. This narrative review discusses the general components of decision analytic models, how decision analytic models are populated and the trade-offs entailed, makes recommendations for how users of spine intervention decision models might go about appraising the models, and presents an overview of published spine economic models. A proper, integrated, clinical, and economic critical appraisal is necessary in the evaluation of the strength of evidence provided by a modeling evaluation. As is the case with clinical research, all options for collecting health economic or value data are not without their limitations and flaws. There is substantial heterogeneity across the 20 spine intervention health economic modeling studies summarized with respect to study design, models used, reporting, and general quality. There is sparse evidence for populating spine intervention models. Results mostly showed that interventions were cost-effective based on $100,000/quality-adjusted life-year threshold. Spine care providers, as partners with their health economic colleagues, have unique clinical expertise and perspectives that are critical to interpret the strengths and weaknesses of health economic models. Health economic models must be critically appraised for both clinical validity and economic quality before altering health care policy, payment strategies, or

  11. Public health and economic risk assessment of waterborne contaminants and pathogens in Finland.

    Science.gov (United States)

    Juntunen, Janne; Meriläinen, Päivi; Simola, Antti

    2017-12-01

    This study shows that a variety of mathematical modeling techniques can be applied in a comprehensive assessment of the risks involved in drinking water production. In order to track the effects from water sources to the end consumers, we employed four models from different fields of study. First, two models of the physical environment, which track the movement of harmful substances from the sources to the water distribution. Second, a statistical quantitative microbial risk assessment (QMRA) to assess the public health risks of the consumption of such water. Finally, a regional computable general equilibrium (CGE) model to assess the economic effects of increased illnesses. In order to substantiate our analysis, we used an illustrative case of a recently built artificial recharge system in Southern Finland that provides water for a 300,000 inhabitant area. We examine the effects of various chemicals and microbes separately. Our economic calculations allow for direct effects on labor productivity due to absenteeism, increased health care expenditures and indirect effects for local businesses. We found that even a considerable risk has no notable threat to public health and thus barely measurable economic consequences. Any epidemic is likely to spread widely in the urban setting we examined, but is also going to be short-lived in both public health and economic terms. Our estimate for the ratio of total and direct effects is 1.4, which indicates the importance of general equilibrium effects. Furthermore, the total welfare loss is 2.4 times higher than the initial productivity loss. The major remaining uncertainty in the economic assessment is the indirect effects. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. [Contextual indicators to assess social determinants of health and the Spanish economic recession].

    Science.gov (United States)

    Cabrera-León, Andrés; Daponte Codina, Antonio; Mateo, Inmaculada; Arroyo-Borrell, Elena; Bartoll, Xavier; Bravo, María José; Domínguez-Berjón, María Felicitas; Renart, Gemma; Álvarez-Dardet, Carlos; Marí-Dell'Olmo, Marc; Bolívar Muñoz, Julia; Saez, Marc; Escribà-Agüir, Vicenta; Palència, Laia; López, María José; Saurina, Carme; Puig, Vanessa; Martín, Unai; Gotsens, Mercè; Borrell, Carme; Serra Saurina, Laura; Sordo, Luis; Bacigalupe, Amaia; Rodríguez-Sanz, Maica; Pérez, Glòria; Espelt, Albert; Ruiz, Miguel; Bernal, Mariola

    To provide indicators to assess the impact on health, its social determinants and health inequalities from a social context and the recent economic recession in Spain and its autonomous regions. Based on the Spanish conceptual framework for determinants of social inequalities in health, we identified indicators sequentially from key documents, Web of Science, and organisations with official statistics. The information collected resulted in a large directory of indicators which was reviewed by an expert panel. We then selected a set of these indicators according to geographical (availability of data according to autonomous regions) and temporal (from at least 2006 to 2012) criteria. We identified 203 contextual indicators related to social determinants of health and selected 96 (47%) based on the above criteria; 16% of the identified indicators did not satisfy the geographical criteria and 35% did not satisfy the temporal criteria. At least 80% of the indicators related to dependence and healthcare services were excluded. The final selection of indicators covered all areas for social determinants of health, and 62% of these were not available on the Internet. Around 40% of the indicators were extracted from sources related to the Spanish Statistics Institute. We have provided an extensive directory of contextual indicators on social determinants of health and a database to facilitate assessment of the impact of the economic recession on health and health inequalities in Spain and its autonomous regions. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products.

    Science.gov (United States)

    Lötters, F J B; Lenoir-Wijnkoop, I; Fardellone, P; Rizzoli, R; Rocher, E; Poley, M J

    2013-01-01

    Osteoporosis has become a major health concern, carrying a substantial burden in terms of health outcomes and costs. We constructed a model to quantify the potential effect of an additional intake of calcium from dairy foods on the risk of osteoporotic fracture, taking a health economics perspective. This study seeks, first, to estimate the impact of an increased dairy consumption on reducing the burden of osteoporosis in terms of health outcomes and costs, and, second, to contribute to a generic methodology for assessing the health-economic outcomes of food products. We constructed a model that generated the number of hip fractures that potentially can be prevented with dairy foods intakes, and then calculated costs avoided, considering the healthcare costs of hip fractures and the costs of additional dairy foods, as well as the number of disability-adjusted life years (DALYs) lost due to hip fractures associated with low nutritional calcium intake. Separate analyses were done for The Netherlands, France, and Sweden, three countries with different levels of dairy products consumption. The number of hip fractures that may potentially be prevented each year with additional dairy products was highest in France (2,023), followed by Sweden (455) and The Netherlands (132). The yearly number of DALYs lost was 6,263 for France, 1,246 for Sweden, and 374 for The Netherlands. The corresponding total costs that might potentially be avoided are about 129 million, 34 million, and 6 million Euros, in these countries, respectively. This study quantified the potential nutrition economic impact of increased dairy consumption on osteoporotic fractures, building connections between the fields of nutrition and health economics. Future research should further collect longitudinal population data for documenting the net benefits of increasing dairy consumption on bone health and on the related utilization of healthcare resources.

  14. A framework for assessing Health Economic Evaluation (HEE) quality appraisal instruments.

    Science.gov (United States)

    Langer, Astrid

    2012-08-16

    Health economic evaluations support the health care decision-making process by providing information on costs and consequences of health interventions. The quality of such studies is assessed by health economic evaluation (HEE) quality appraisal instruments. At present, there is no instrument for measuring and improving the quality of such HEE quality appraisal instruments. Therefore, the objectives of this study are to establish a framework for assessing the quality of HEE quality appraisal instruments to support and improve their quality, and to apply this framework to those HEE quality appraisal instruments which have been subject to more scrutiny than others, in order to test the framework and to demonstrate the shortcomings of existing HEE quality appraisal instruments. To develop the quality assessment framework for HEE quality appraisal instruments, the experiences of using appraisal tools for clinical guidelines are used. Based on a deductive iterative process, clinical guideline appraisal instruments identified through literature search are reviewed, consolidated, and adapted to produce the final quality assessment framework for HEE quality appraisal instruments. The final quality assessment framework for HEE quality appraisal instruments consists of 36 items organized within 7 dimensions, each of which captures a specific domain of quality. Applying the quality assessment framework to four existing HEE quality appraisal instruments, it is found that these four quality appraisal instruments are of variable quality. The framework described in this study should be regarded as a starting point for appraising the quality of HEE quality appraisal instruments. This framework can be used by HEE quality appraisal instrument producers to support and improve the quality and acceptance of existing and future HEE quality appraisal instruments. By applying this framework, users of HEE quality appraisal instruments can become aware of methodological deficiencies

  15. Methods of international health technology assessment agencies for economic evaluations--a comparative analysis.

    Science.gov (United States)

    Mathes, Tim; Jacobs, Esther; Morfeld, Jana-Carina; Pieper, Dawid

    2013-09-30

    The number of Health Technology Assessment (HTA) agencies increases. One component of HTAs are economic aspects. To incorporate economic aspects commonly economic evaluations are performed. A convergence of recommendations for methods of health economic evaluations between international HTA agencies would facilitate the adaption of results to different settings and avoid unnecessary expense. A first step in this direction is a detailed analysis of existing similarities and differences in recommendations to identify potential for harmonization. The objective is to provide an overview and comparison of the methodological recommendations of international HTA agencies for economic evaluations. The webpages of 127 international HTA agencies were searched for guidelines containing recommendations on methods for the preparation of economic evaluations. Additionally, the HTA agencies were requested information on methods for economic evaluations. Recommendations of the included guidelines were extracted in standardized tables according to 13 methodological aspects. All process steps were performed independently by two reviewers. Finally 25 publications of 14 HTA agencies were included in the analysis. Methods for economic evaluations vary widely. The greatest accordance could be found for the type of analysis and comparator. Cost-utility-analyses or cost-effectiveness-analyses are recommended. The comparator should continuously be usual care. Again the greatest differences were shown in the recommendations on the measurement/sources of effects, discounting and in the analysis of sensitivity. The main difference regarding effects is the focus either on efficacy or effectiveness. Recommended discounting rates range from 1.5%-5% for effects and 3%-5% for costs whereby it is mostly recommended to use the same rate for costs and effects. With respect to the analysis of sensitivity the main difference is that oftentimes the probabilistic or deterministic approach is recommended

  16. Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products

    OpenAIRE

    Lötters, Freek; Lenoir-Wijnkoop, Irene; Fardellone, P.; Rizzoli, R.; Rocher, E.; Poley, Marten

    2013-01-01

    markdownabstract__Abstract__ Osteoporosis has become a major health concern, carrying a substantial burden in terms of health outcomes and costs. We constructed a model to quantify the potential effect of an additional intake of calcium from dairy foods on the risk of osteoporotic fracture, taking a health economics perspective. Introduction: This study seeks, first, to estimate the impact of an increased dairy consumption on reducing the burden of osteoporosis in terms of health outcomes and...

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

    Science.gov (United States)

    Thomas, Steve; Keegan, Conor; Barry, Sarah; Layte, Richard; Jowett, Matt; Normand, Charles

    2013-10-30

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

  18. Comprehensively Measuring Health-Related Subjective Well-Being: Dimensionality Analysis for Improved Outcome Assessment in Health Economics.

    Science.gov (United States)

    de Vries, Marieke; Emons, Wilco H M; Plantinga, Arnoud; Pietersma, Suzanne; van den Hout, Wilbert B; Stiggelbout, Anne M; van den Akker-van Marle, M Elske

    2016-01-01

    Allocation of inevitably limited financial resources for health care requires assessment of an intervention's effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World Health Organization's definition of health, a recent Delphi procedure showed that assessment needs to put more emphasis on mental and social dimensions. To identify the core dimensions of health-related subjective well-being (HR-SWB) for a new, more comprehensive outcome measure. We formulated items for each domain of an initial Delphi-based set of 21 domains of HR-SWB. We tested these items in a large sample (N = 1143) and used dimensionality analyses to find a smaller number of latent factors. Exploratory factor analysis suggested a five-factor model, which explained 65% of the total variance. Factors related to physical independence, positive affect, negative affect, autonomy, and personal growth. Correlations between the factors ranged from 0.19 to 0.59. A closer inspection of the factors revealed an overlap between the newly identified core dimensions of HR-SWB and the validation scales, but the dimensions of HR-SWB also seemed to reflect additional aspects. This shows that the dimensions of HR-SWB we identified go beyond the existing health-related QOL instruments. We identified a set of five key dimensions to be included in a new, comprehensive measure of HR-SWB that reliably captures these dimensions and fills in the gaps of the existent measures used in economic evaluations. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. 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...

  20. Spatiotemporal Assessment of PM2.5-Related Economic Losses from Health Impacts during 2014–2016 in China

    Directory of Open Access Journals (Sweden)

    Yang Yang

    2018-06-01

    Full Text Available Background: Particulate air pollution, especially PM2.5, is highly correlated with various adverse health impacts and, ultimately, economic losses for society, however, few studies have undertaken a spatiotemporal assessment of PM2.5-related economic losses from health impacts covering all of the main cities in China. Methods: PM2.5 concentration data were retrieved for 190 Chinese cities for the period 2014–2016. We used a log-linear exposure–response model and monetary valuation methods, such as value of a statistical life (VSL, amended human capital (AHC, and cost of illness to evaluate PM2.5-related economic losses from health impacts at the city level. In addition, Monte Carlo simulation was used to analyze uncertainty. Results: The average economic loss was 0.3% (AHC to 1% (VSL of the total gross domestic product (GDP of 190 Chinese cities from 2014 to 2016. Overall, China experienced a downward trend in total economic losses over the three-year period, but the Beijing–Tianjin–Hebei, Shandong Peninsula, Yangtze River Delta, and Chengdu-Chongqing regions experienced greater annual economic losses. Conclusions: Exploration of spatiotemporal variations in PM2.5-related economic losses from long-term health impacts could provide new information for policymakers regarding priority areas for PM2.5 pollution prevention and control in China.

  1. Assessment of validation of health-economics decision models in intervention studies of seasonal influenza and breast cancer

    NARCIS (Netherlands)

    De Boer, P.T.; Frederix, G.W.; Al, M.J.; Feenstra, T.F.; Vemer, P.

    2015-01-01

    Objectives: We aimed to review recently published health-economic (HE) decision models to assess the reporting of validation efforts. An infectious disease (seasonal influenza, SI) and a chronic disease (breast cancer, BC) were used as examples, giving a preliminary insight in the reporting of

  2. Low-carbon energy policy and ambient air pollution in Shanghai, China: A health-based economic assessment

    International Nuclear Information System (INIS)

    Chen Changhong; Chen Bingheng; Wang Bingyan; Huang Cheng; Zhao Jing; Dai Yi; Kan Haidong

    2007-01-01

    Energy and related health issues are of growing concern worldwide today. To investigate the potential public health and economic impact of ambient air pollution under various low-carbon energy scenarios in Shanghai, we estimated the exposure level of Shanghai residents to air pollution under various planned scenarios, and assessed the public health impact using concentration-response functions derived from available epidemiologic studies. We then estimated the corresponding economic values of the health effects based on unit values for each health outcome. Our results show that ambient air pollution in relation to low-carbon energy scenarios could have a significant impact on the future health status of Shanghai residents, both in physical and monetary terms. Compared with the base case scenario, implementation of various low-carbon energy scenarios could prevent 2804-8249 and 9870-23,100 PM 10 -related avoidable deaths (mid-value) in 2010 and 2020, respectively. It could also decrease incidence of several relevant diseases. The corresponding economic benefits could reach 507.31-1492.33 and 2642.45-6192.11 million U.S. dollars (mid-value) in 2010 and 2020, respectively. These findings illustrate that a low-carbon energy policy will not only decrease the emission of greenhouse gases, but also play an active role in the reduction of air pollutant emissions, improvement of air quality, and promotion of public health. Our estimates can provide useful information to local decision-makers for further cost-benefit analysis

  3. Low-carbon energy policy and ambient air pollution in Shanghai, China: a health-based economic assessment.

    Science.gov (United States)

    Chen, Changhong; Chen, Bingheng; Wang, Bingyan; Huang, Cheng; Zhao, Jing; Dai, Yi; Kan, Haidong

    2007-02-01

    Energy and related health issues are of growing concern worldwide today. To investigate the potential public health and economic impact of ambient air pollution under various low-carbon energy scenarios in Shanghai, we estimated the exposure level of Shanghai residents to air pollution under various planned scenarios, and assessed the public health impact using concentration-response functions derived from available epidemiologic studies. We then estimated the corresponding economic values of the health effects based on unit values for each health outcome. Our results show that ambient air pollution in relation to low-carbon energy scenarios could have a significant impact on the future health status of Shanghai residents, both in physical and monetary terms. Compared with the base case scenario, implementation of various low-carbon energy scenarios could prevent 2804-8249 and 9870-23,100 PM10-related avoidable deaths (mid-value) in 2010 and 2020, respectively. It could also decrease incidence of several relevant diseases. The corresponding economic benefits could reach 507.31-1492.33 and 2642.45-6192.11 million U.S. dollars (mid-value) in 2010 and 2020, respectively. These findings illustrate that a low-carbon energy policy will not only decrease the emission of greenhouse gases, but also play an active role in the reduction of air pollutant emissions, improvement of air quality, and promotion of public health. Our estimates can provide useful information to local decision-makers for further cost-benefit analysis.

  4. Economic assessment of coal-fired and nuclear power generation in the year 2000 -Equal health hazard risk basis-

    International Nuclear Information System (INIS)

    Seong, Ki Bong; Lee, Byong Whi

    1989-01-01

    On the basis of equal health hazard risk, economic assessment of nuclear was compared with that of coal for the expansion planning of electric power generation in the year 2000. In comparing health risks, the risk of coal was roughly ten times higher than that of nuclear according to various previous risk assessments of energy system. The zero risk condition can never be achievable. Therefore, only excess relative health risk of coal over nuclear was considered as social cost. The social cost of health risk was estimated by calculation of mortality and morbidity costs. Mortality cost was $250,000 and morbidity cost was $90,000 in the year 2000.(1986US$) Through Cost/Benefit Analysis, the optimal emission standards of coal-fired power generation were predicted. These were obtained at the point of least social cost for power generation. In the year 2000, the optimal emission standard of SO x was analyzed as 165ppm for coal-fired power plants in Korea. From this assessment, economic comparison of nuclear and coal in the year 2000 showed that nuclear would be more economical than coal, whereas uncertainty of future power generation cost of nuclear would be larger than that of coal. (Author)

  5. Medical and health economic assessment of radiosurgery for the treatment of brain metastasis

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2009-03-01

    treatment groups. Methodologically less rigorous studies provide no conclusive evidence with regard to medical effectiveness and safety, comparing SRS to WBRT, neurosurgery (NS or hypofractionated radiotherapy (HCSRT. The quality of life is not investigated in any of the studies. Within the searched databases a total of 320 economic publications are identified. Five publications are eligible for this report. The five reports have a quiet variable quality. Concerning the economic efficiency of alternative equipment, while assuming equal effectiveness, the calculations show, that economic efficiency depends to a large extend on the number of patients treated. In case the two alternative equipments are used solely for SRS, the Gamma Knife might be more cost-efficient. Otherwise an adapted linear accelerator is most likely to be beneficial because of its flexibility. One Health Technology Assessment (HTA states, that the cost for a Gamma Knife and a dedicated linear accelerator are comparable, while an adapted version is cheaper. No reports concerning ethical, legal and social aspects are identified. Discussion: Overall, quantity and quality of identified studies is limited. However, the identified studies indicate that the prognosis of patients with brain metastases is despite highly developed and modern treatment regimes still limited. Conclusive evidence with regard to the effectiveness of identified interventions is only available for the combined treatment of SRS and WBRT compared to SRS or WBRT alone. Furthermore, there is insufficient evidence to compare SRS with WBRT, NS or HCSRT. The efficiency of the different equipments depends to a great extent on the number and the indications of the patients treated. If dedicated systems are used to their full capacity, there is some evidence for superior cost-effectiveness. If more treatment flexibility is required, adapted systems seem to be advantageous. However, equal treatment effectiveness is a necessary assumption for these

  6. [Exploring models for the assessment of the economic, social, political, and scientific impact of health research].

    Science.gov (United States)

    Macías-Angel, Beatriz; Agudelo-Calderón, Carlos A

    2015-05-01

    Health research produces effects on the health of populations. This document approaches the frameworks and the models used by developed countries to assess the impact of health research through documentary analysis of research with the highest impact. With this, it was possible to identify two guiding axes of analysis: one having to do with focus, and the other having to do with emphasis. With these, the published models, their uses, their reach, and their origins are related. Our study brings awareness to the features they have and the areas in which Colombia could implement them. We found that the framework for evaluating health research known as the "payback model" is a model for monitoring research that tracks the process and research results with multidimensional categorization of the impacts of research.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  9. Assessing associations between socio-economic environment and self-reported health in Amsterdam using bespoke environments.

    Directory of Open Access Journals (Sweden)

    Eleonore M Veldhuizen

    Full Text Available The study of the relationship between residential environment and health at micro area level has a long time been hampered by a lack of micro-scale data. Nowadays data is registered at a much more detailed scale. In combination with Geographic Information System (GIS-techniques this creates opportunities to look at the relationship at different scales, including very local ones. The study illustrates the use of a 'bespoke environment' approach to assess the relationship between health and socio-economic environment.We created these environments by buffer-operations and used micro-scale data on 6-digit postcode level to describe these individually tailored areas around survey respondents in an accurate way. To capture the full extent of area effects we maximized variation in socio-economic characteristics between areas. The area effect was assessed using logistic regression analysis.Although the contribution of the socio-economic environment in the explanation of health was not strong it tended to be stronger at a very local level. A positive association was observed only when these factors were measured in buffers smaller than 200 meters. Stronger associations were observed when restricting the analysis to socioeconomically homogeneous buffers. Scale effects proved to be highly important but potential boundary effects seemed not to play an important role. Administrative areas and buffers of comparable sizes came up with comparable area effects.This study shows that socio-economic area effects reveal only on a very micro-scale. It underlines the importance of the availability of micro-scale data. Through scaling, bespoke environments add a new dimension to study environment and health.

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

    Science.gov (United States)

    Erim, Daniel O; Resch, Stephen C; Goldie, Sue J

    2012-09-14

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

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

    Directory of Open Access Journals (Sweden)

    Erim Daniel O

    2012-09-01

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

  12. [Evaluation of disease management programmes--assessing methods and initial outcomes from a health economic perspective].

    Science.gov (United States)

    Birnbaum, Dana Sophie; Braun, Sebastian

    2010-01-01

    Evaluation represents a substantial component of the concept of Disease Management Programmes. This and the fact that the implementation of Disease Management Programmes constitutes a major change in the German healthcare system require that the criteria established by the German Federal Social Insurance Authority (Bundesversicherungsamt) be carefully reviewed. The present paper focuses on the evaluation method and the economic data. The pre-/-post study design used in the evaluation is known to be vulnerable to threats to internal validity. The objective of this paper is to analyze whether these threats to internal validity which have been known theoretically are confirmed by the results of the final reports. A review of the final reports of health insurance companies like the AOK, Barmer and a group of the BKK in Westfalen-Lippe shows that this question can be answered in the affirmative. The pre-/-post design without control groups is unable to recognize the failure or success of the Disease Management concept. The reasons include a high drop-out rate as well as the lack of consideration of the characteristics of chronic disease. Hence the evaluation method has failed to prove the quality of Disease Management Programmes in Germany. This is why consistent further development is needed.

  13. Assessing Cross-disciplinary Efficiency of Soil Amendments for Agro-biologically, Economically, and Ecologically Integrated Soil Health Management

    Science.gov (United States)

    2010-01-01

    Preventive and/or manipulative practices will be needed to maintain soil's biological, physiochemical, nutritional, and structural health in natural, managed, and disturbed ecosystems as a foundation for food security and global ecosystem sustainability. While there is a substantial body of interdisciplinary science on understanding function and structure of soil ecosystems, key gaps must be bridged in assessing integrated agro-biological, ecological, economical, and environmental efficiency of soil manipulation practices in time and space across ecosystems. This presentation discusses the application of a fertilizer use efficiency (FUE) model for assessing agronomic, economic, ecological, environmental, and nematode (pest) management efficiency of soil amendments. FUE is defined as increase in host productivity and/or decrease in plant-parasitic nematode population density in response to a given fertilizer treatment. Using the effects of nutrient amendment on Heterodera glycines population density and normalized difference vegetative index (indicator of physiological activities) of a soybean cultivar ‘CX 252’, how the FUE model recognizes variable responses and separates nutrient deficiency and toxicity from nematode parasitism as well as suitability of treatments designed to achieve desired biological and physiochemical soil health conditions is demonstrated. As part of bridging gaps between agricultural and ecological approaches to integrated understanding and management of soil health, modifications of the FUE model for analyzing the relationships amongst nematode community structure, soil parameters (eg. pH, nutrients, %OM), and plant response to soil amendment is discussed. PMID:22736840

  14. Health economics of rubella: a systematic review to assess the value of rubella vaccination.

    Science.gov (United States)

    Babigumira, Joseph B; Morgan, Ian; Levin, Ann

    2013-04-29

    Most cases of rubella and congenital rubella syndrome (CRS) occur in low- and middle-income countries. The World Health Organization (WHO) has recently recommended that countries accelerate the uptake of rubella vaccination and the GAVI Alliance is now supporting large scale measles-rubella vaccination campaigns. We performed a review of health economic evaluations of rubella and CRS to identify gaps in the evidence base and suggest possible areas of future research to support the planned global expansion of rubella vaccination and efforts towards potential rubella elimination and eradication. We performed a systematic search of on-line databases and identified articles published between 1970 and 2012 on costs of rubella and CRS treatment and the costs, cost-effectiveness or cost-benefit of rubella vaccination. We reviewed the studies and categorized them by the income level of the countries in which they were performed, study design, and research question answered. We analyzed their methodology, data sources, and other details. We used these data to identify gaps in the evidence and to suggest possible future areas of scientific study. We identified 27 studies: 11 cost analyses, 11 cost-benefit analyses, 4 cost-effectiveness analyses, and 1 cost-utility analysis. Of these, 20 studies were conducted in high-income countries, 5 in upper-middle income countries and two in lower-middle income countries. We did not find any studies conducted in low-income countries. CRS was estimated to cost (in 2012 US$) between $4,200 and $57,000 per case annually in middle-income countries and up to $140,000 over a lifetime in high-income countries. Rubella vaccination programs, including the vaccination of health workers, children, and women had favorable cost-effectiveness, cost-utility, or cost-benefit ratios in high- and middle-income countries. Treatment of CRS is costly and rubella vaccination programs are highly cost-effective. However, in order for research to support the

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

    Science.gov (United States)

    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.

  16. Integrated assessment of the health and economic benefits of long-term renewable energy development in China

    Science.gov (United States)

    Dai, H.; Xie, Y.; Zhang, Y.

    2017-12-01

    Context/Purpose: Power generation from renewable energy (RE) could substitute huge amount of fossil energy in the power sector and have substantial co-benefits of air quality and human health improvement. In 2016, China National Renewable Energy Center (CNREC) released China Renewable Energy Outlook, CREO2016 and CREO2017, towards 2030 and 2050, respectively, in which two scenarios are proposed, namely, a conservative "Stated Policy" scenario and a more ambitious "High RE" scenario. This study, together with CNREC, aims to quantify the health and economic benefits of developing renewable energy at the provincial level in China up to 2030 and 2050. Methods: For this purpose, we developed an integrated approach that combines a power dispatch model at CNREC, an air pollutant emission projection model using energy consumption data from the Long-range Energy Alternatives Planning System (LEAP) model, an air quality model (GEOS-Chem at Harvard), an own-developed health model, and a macro economic model (Computable General Equilibrium model). Results: All together, we attempt to quantify how developing RE could reduce the concentration of PM2.5 and ozone in 30 provinces of China, how the human health could be improved in terms of mortality, morbidity and work hour loss, and what is the economic value of the health improvement in terms of increased GDP and the value of statistical life lost. The results show that developing RE as stated in the CREO2016 could prevent chronic mortality of 286 thousand people in China in 2030 alone, the value of saved statistical life is worthy 1200 billion Yuan, equivalent to 1.2% of GDP. In addition, averagely, due to reduced mortality and improved morbidity each person could work additionally by 1.16 hours per year, this could contribute to an increase of GDP by 0.1% in 2030. The assessment up to 2050 is still underway. Interpretation: The results imply that when the external benefit of renewable energy is taken into account, RE could be

  17. Essays in health economics and labor economics

    NARCIS (Netherlands)

    Palali, Ali

    2015-01-01

    The economics literature presents a growing number of studies focusing on risky health behaviors such as tobacco use or cannabis use. One of the most important characteristics of these risky health behaviors is that they harm the users and the people around the users, causing great social and

  18. A Health Economics Approach to US Value Assessment Frameworks-Introduction: An ISPOR Special Task Force Report [1].

    Science.gov (United States)

    Neumann, Peter J; Willke, Richard J; Garrison, Louis P

    2018-02-01

    Concerns about rising spending on prescription drugs and other areas of health care have led to multiple initiatives in the United States designed to measure and communicate the value of pharmaceuticals and other technologies for decision making. In this section we introduce the work of the International Society for Pharmacoeconomics and Outcomes Research Special Task Force on US Value Assessment Frameworks formed to review relevant perspectives and appropriate approaches and methods to support the definition and use of high-quality value frameworks. The Special Task Force was part of the International Society for Pharmacoeconomics and Outcomes Research Initiative on US Value Assessment Frameworks, which enlisted the expertise of leading health economists, concentrating on what the field of health economics can provide to help inform the development and use of value assessment frameworks. We focus on five value framework initiatives: the American College of Cardiology/American Heart Association, the American Society of Clinical Oncology, the Institute for Clinical and Economic Review, the Memorial Sloan Kettering Cancer Center, and the National Comprehensive Cancer Network. These entities differ in their missions, scope of activities, and methodological approaches. Because they are gaining visibility and some traction in the United States, it is essential to scrutinize whether the frameworks use approaches that are transparent as well as conceptually and methodologically sound. Our objectives were to describe the conceptual bases for value and its use in decision making, critically examine existing value frameworks, discuss the importance of sound conceptual underpinning, identify key elements of value relevant to specific decision contexts, and recommend good practice in value definition and implementation as well as areas for further research. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc

  19. Public health interventions: evaluating the economic evaluations

    Directory of Open Access Journals (Sweden)

    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...

  20. Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products

    NARCIS (Netherlands)

    F.J.B. Lötters (Freek); I. Lenoir-Wijnkoop (Irene); P. Fardellone; R. Rizzoli; E. Rocher; M.J. Poley (Marten)

    2013-01-01

    markdownabstract__Abstract__ Osteoporosis has become a major health concern, carrying a substantial burden in terms of health outcomes and costs. We constructed a model to quantify the potential effect of an additional intake of calcium from dairy foods on the risk of osteoporotic fracture,

  1. [Fostering of health economics in Germany].

    Science.gov (United States)

    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).

  2. The assessment of chronic health conditions on work performance, absence, and total economic impact for employers.

    Science.gov (United States)

    Collins, James J; Baase, Catherine M; Sharda, Claire E; Ozminkowski, Ronald J; Nicholson, Sean; Billotti, Gary M; Turpin, Robin S; Olson, Michael; Berger, Marc L

    2005-06-01

    The objective of this study was to determine the prevalence and estimate total costs for chronic health conditions in the U.S. workforce for the Dow Chemical Company (Dow). Using the Stanford Presenteeism Scale, information was collected from workers at five locations on work impairment and absenteeism based on self-reported "primary" chronic health conditions. Survey data were merged with employee demographics, medical and pharmaceutical claims, smoking status, biometric health risk factors, payroll records, and job type. Almost 65% of respondents reported having one or more of the surveyed chronic conditions. The most common were allergies, arthritis/joint pain or stiffness, and back or neck disorders. The associated absenteeism by chronic condition ranged from 0.9 to 5.9 hours in a 4-week period, and on-the-job work impairment ranged from a 17.8% to 36.4% decrement in ability to function at work. The presence of a chronic condition was the most important determinant of the reported levels of work impairment and absence after adjusting for other factors (P < 0.000). The total cost of chronic conditions was estimated to be 10.7% of the total labor costs for Dow in the United States; 6.8% was attributable to work impairment alone. For all chronic conditions studied, the cost associated with performance based work loss or "presenteeism" greatly exceeded the combined costs of absenteeism and medical treatment combined.

  3. Dynamic models for health economic assessments of pertussis vaccines : what goes around comes around ...

    NARCIS (Netherlands)

    Rozenbaum, M.H.; De Cao, E.; Westra, T.A.; Postma, M.J.

    2012-01-01

    Despite childhood vaccination programs, pertussis remains endemic. To reduce the burden of pertussis, various extended pertussis vaccination strategies have been suggested. The aim of this article is to evaluate dynamic models used to assess the cost-effectiveness of vaccination. In total, 16

  4. Prognostic Health Management System: Component Selection Based on Risk Criteria and Economic Benefit Assessment

    International Nuclear Information System (INIS)

    Pham, B.T.; Agarwal, V.; Lybeck, N.J.; Tawfik, M.S.

    2012-01-01

    Long-term operation (LTO), i.e., beyond 60 years, of the current fleet of nuclear power plants (NPPs) is an important element in the overall energy stability of the United States in coming decades. Problem Statement and Proposed Approach: - For LTO of NPPs, early and proactive diagnosis of degradation at systems, structures, and components (SSCs) level is required; - Periodic maintenance versus Proactive maintenance; - Prognostic Health Monitoring (PHM) can be used to better manage aging and degradation mechanisms, including emerging mechanisms; - Selection of components is crucial for implementing the PHM system; - Approach is to develop a quantitative framework that aids systematic identification of plant components that are selected for cost-effective PHM.

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Assessment of the Effects of Economic Sanctions on Iranians' Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review.

    Science.gov (United States)

    Kokabisaghi, Fatemeh

    2018-01-20

    Over the years, economic sanctions have contributed to violation of right to health in target countries. Iran has been under comprehensive unilateral economic sanctions by groups of countries (not United Nations [UN]) in recent years. They have been intensified from 2012 because of international community's uncertainty about peaceful purpose of Iran's nuclear program and inadequacy of trust-building actions of this country. This review aimed to identify the humanitarian effects of the sanctions on the right of Iranians to health and the obligations of Iran and international community about it. To assess economic sanction policies and identify violated rights and the obligations of states according to international human rights laws, in this study, Human Rights Impact Assessments (HRIA) tool is used. Applying this tool requires collection of evidences regarding the situation of rights. To provide such evidence, a systematic review of literature which involved 55 papers retrieved from the web-based databases and official webpages of Iran's government and UN' health and human rights committees and organizations was done. All articles about the consequences of economic sanctions related to nuclear activities of Iran on welfare and health of Iranians published from January 2012 till February 2017 in English and Persian languages were included. Search terms were economic sanctions, embargoes, Iran, welfare, health and medicine. Additional studies were identified by cross checking the reference lists of accessed articles. All selected papers were abstracted and entered into a matrix describing study design and findings, and categorized into a framework of themes reflecting the areas covered (health and its determinants). According to HRIA framework, related obligations of Iran and other states about adverse effects of the sanctions on Iranians' right to health were extracted. The sanctions on Iran caused a fall of country's revenues, devaluation of national currency, and

  7. Assessment of the Effects of Economic Sanctions on Iranians’ Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review

    Science.gov (United States)

    Kokabisaghi, Fatemeh

    2018-01-01

    Background: Over the years, economic sanctions have contributed to violation of right to health in target countries. Iran has been under comprehensive unilateral economic sanctions by groups of countries (not United Nations [UN]) in recent years. They have been intensified from 2012 because of international community’s uncertainty about peaceful purpose of Iran’s nuclear program and inadequacy of trust-building actions of this country. This review aimed to identify the humanitarian effects of the sanctions on the right of Iranians to health and the obligations of Iran and international community about it. Methods: To assess economic sanction policies and identify violated rights and the obligations of states according to international human rights laws, in this study, Human Rights Impact Assessments (HRIA) tool is used. Applying this tool requires collection of evidences regarding the situation of rights. To provide such evidence, a systematic review of literature which involved 55 papers retrieved from the web-based databases and official webpages of Iran’s government and UN’ health and human rights committees and organizations was done. All articles about the consequences of economic sanctions related to nuclear activities of Iran on welfare and health of Iranians published from January 2012 till February 2017 in English and Persian languages were included. Search terms were economic sanctions, embargoes, Iran, welfare, health and medicine. Additional studies were identified by cross checking the reference lists of accessed articles. All selected papers were abstracted and entered into a matrix describing study design and findings, and categorized into a framework of themes reflecting the areas covered (health and its determinants). According to HRIA framework, related obligations of Iran and other states about adverse effects of the sanctions on Iranians’ right to health were extracted. Results: The sanctions on Iran caused a fall of country

  8. 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...

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

    NARCIS (Netherlands)

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

    2015-01-01

    BACKGROUND: Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes mellitus (GDM) and

  10. Are economic evaluations and health technology assessments increasingly demanded in times of rationing health services? The case of the Argentine financial crisis.

    Science.gov (United States)

    Rubinstein, Adolfo; Belizán, María; Discacciati, Vilda

    2007-01-01

    After 4 years of deepening recession, Argentina's economy plummeted after default in 2002. This crisis critically affected health expenditures and triggered acute rationing. Our objective was to explore health decision-makers' knowledge and attitudes about economic evaluations (EE) and whether health technology assessment (HTA) were increasingly used for decision making. A qualitative design based on semistructured interviews and focus groups was used to explore how decision makers belonging to different health sectors implement resource allocation decisions. Informants were mostly unaware of EE. The most important criteria mentioned to adopt a treatment were evidence of effectiveness, social/stakeholder demand, or resource availability. Despite general positive attitudes about EE, knowledge was rather limited. Although cost considerations were widely accepted by purchasers and managers, clinicians argued about these issues as interfering with the doctor-patient relationship. Other important perceived barriers to HTA use were lack of confidence in the transferability of studies conducted in developed countries and institutional fragmentation of the Argentine healthcare system. The new macroeconomic context was cited as a justification of implicit rationing measures. Although explicit priority setting was implemented by many purchasers and managers, HTA was not used to improve technical and/or allocative efficiency. The crisis seems to be a strong incentive to extend the use of HTA in Argentina, provided decision makers are aware as well as involved in the generation of local studies.

  11. Work or place? Assessing the concurrent effects of workplace exploitation and area-of-residence economic inequality on individual health.

    Science.gov (United States)

    Muntaner, Carles; Li, Yong; Ng, Edwin; Benach, Joan; Chung, Haejoo

    2011-01-01

    Building on previous multilevel studies in social epidemiology, this cross-sectional study examines, simultaneously, the contextual effects of workplace exploitation and area-of-residence economic inequality on social inequalities in health among low-income nursing assistants. A total of 868 nursing assistants recruited from 55 nursing homes in Kentucky, Ohio, and West Virginia were surveyed between 1999 and 2001. Using a cross-classified multilevel design, the authors tested the effects of area-of-residence (income inequality and racial segregation), workplace (type of nursing home ownership and managerial pressure), and individual-level (age, gender, race/ethnicity, health insurance, length of employment, social support, type of nursing unit, preexisting psychopathology, physical health, education, and income) variables on health (self-reported health and activity limitations) and behavioral outcomes (alcohol use and caffeine consumption). Findings reveal that overall health was associated with both workplace exploitation and area-of-residence income inequality; area of residence was associated with activity limitations and binge drinking; and workplace exploitation was associated with caffeine consumption. This study explicitly accounts for the multiple contextual structure and effects of economic inequality on health. More work is necessary to replicate the current findings and establish robust conclusions on workplace and area of residence that might help inform interventions.

  12. [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.

  13. An economic assessment of the health effects and crop yield losses caused by air pollution in mainland China.

    Science.gov (United States)

    Miao, Weijie; Huang, Xin; Song, Yu

    2017-06-01

    Air pollution is severe in China, and pollutants such as PM 2.5 and surface O 3 may cause major damage to human health and crops, respectively. Few studies have considered the health effects of PM 2.5 or the loss of crop yields due to surface O 3 using model-simulated air pollution data in China. We used gridded outputs from the WRF-Chem model, high resolution population data, and crop yield data to evaluate the effects on human health and crop yield in mainland China. Our results showed that outdoor PM 2.5 pollution was responsible for 1.70-1.99 million cases of all-cause mortality in 2006. The economic costs of these health effects were estimated to be 151.1-176.9 billion USD, of which 90% were attributed to mortality. The estimated crop yield losses for wheat, rice, maize, and soybean were approximately 9, 4.6, 0.44, and 0.34 million tons, respectively, resulting in economic losses of 3.4 billion USD. The total economic losses due to ambient air pollution were estimated to be 154.5-180.3 billion USD, accounting for approximately 5.7%-6.6% of the total GDP of China in 2006. Our results show that both population health and staple crop yields in China have been significantly affected by exposure to air pollution. Measures should be taken to reduce emissions, improve air quality, and mitigate the economic loss. Copyright © 2016. Published by Elsevier B.V.

  14. 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.

  15. Quality Assessment of Published Articles in Iranian Journals Related to Economic Evaluation in Health Care Programs Based on Drummond’s Checklist: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Aziz Rezapour

    2017-09-01

    Full Text Available Health economic evaluation research plays an important role in selecting cost-effective interventions. The purpose of this study was to assess the quality of published articles in Iranian journals related to economic evaluation in health care programs based on Drummond’s checklist in terms of numbers, features, and quality. In the present review study, published articles (Persian and English in Iranian journals related to economic evaluation in health care programs were searched using electronic databases. In addition, the methodological quality of articles’ structure was analyzed by Drummond’s standard checklist. Based on the inclusion criteria, the search of databases resulted in 27 articles that fully covered economic evaluation in health care programs. A review of articles in accordance with Drummond’s criteria showed that the majority of studies had flaws. The most common methodological weakness in the articles was in terms of cost calculation and valuation. Considering such methodological faults in these studies, it is anticipated that these studies would not provide an appropriate feedback to policy makers to allocate health care resources correctly and select suitable cost-effective interventions. Therefore, researchers are required to comply with the standard guidelines in order to better execute and report on economic evaluation studies.

  16. Quality Assessment of Published Articles in Iranian Journals Related to Economic Evaluation in Health Care Programs Based on Drummond's Checklist: A Narrative Review.

    Science.gov (United States)

    Rezapour, Aziz; Jafari, Abdosaleh; Mirmasoudi, Kosha; Talebianpour, Hamid

    2017-09-01

    Health economic evaluation research plays an important role in selecting cost-effective interventions. The purpose of this study was to assess the quality of published articles in Iranian journals related to economic evaluation in health care programs based on Drummond's checklist in terms of numbers, features, and quality. In the present review study, published articles (Persian and English) in Iranian journals related to economic evaluation in health care programs were searched using electronic databases. In addition, the methodological quality of articles' structure was analyzed by Drummond's standard checklist. Based on the inclusion criteria, the search of databases resulted in 27 articles that fully covered economic evaluation in health care programs. A review of articles in accordance with Drummond's criteria showed that the majority of studies had flaws. The most common methodological weakness in the articles was in terms of cost calculation and valuation. Considering such methodological faults in these studies, it is anticipated that these studies would not provide an appropriate feedback to policy makers to allocate health care resources correctly and select suitable cost-effective interventions. Therefore, researchers are required to comply with the standard guidelines in order to better execute and report on economic evaluation studies.

  17. Economic assessment of sterifeed process

    International Nuclear Information System (INIS)

    Mat Rasol Awang; Hassan Hamdani Mutaat

    2004-01-01

    The economics of a processing technology depends on its cost. Two types of costs commonly used in the estimation are a fixed cost and the other is variable cost. The cost structure that included in the fixed cost, mainly, the cost of land, building and machineries, and the variable cost covers raw materials, salary / wages, utilities, irradiation charge, other miscellaneous expenses and contingencies. The assessment were made by treating the economic data using discounted cash flow projection method to deduce the economic indicators: Net Present Value (NPV), Internal Rate of Return (IRR), Benefit to Cost (B/C) ratio, that would suggest the project feasibility, either feasible or otherwise. The NPV, IRR, B/C deduced from Sterifeed Process showed the economic of this technology was infeasible due high cost incurred in transportation, labour as well as the cost of machinery. This is accomplished by sensitivity test performed on these cost components. However, cost structure derived from Sterifeed Plant serves as a model cost structure for economic assessment in production of Sterifeed, a fermented ruminant feed, and to work further on the economic of the project. This paper discuss economic evaluation of Sterifeed process in different scenarios that carried out in the Sterifeed process operations and deduction were made to derive a model production unit for commercialisation. (Author)

  18. Using risk analysis in Health Impact Assessment: the impact of different relative risks for men and women in different socio-economic groups

    DEFF Research Database (Denmark)

    Nilunger, Louise; Diderichsen, Finn; Burström, Bo

    2004-01-01

    The aim of this study is to contribute to the emerging field of quantification of Health Impact Assessment (HIA), by analysing how different relative risks affect the burden of disease for various socio-economic groups (SES). Risk analysis, utilising attributable and impact fraction, raises several...... methodological considerations. The present study illustrates this by measuring the impact of changed distribution levels of smoking on lung cancer, ischemic heart disease (IHD), chronic obstructive lung disorder (COLD) and stroke for the highest and lowest socio-economic groups measured in disability adjusted...... the highest and lowest socio-economic groups may decrease by 75% or increase by 21% depending on the size of the relative risk. Assuming the same smoking prevalence for the lowest socio-economic group as for the highest (impact fraction), then the inequality may decrease by 7-26%. Consequently, the size...

  19. Health economic evaluation in England.

    Science.gov (United States)

    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.

  20. Assessment of health and economic effects by PM2.5 pollution in Beijing: a combined exposure-response and computable general equilibrium analysis.

    Science.gov (United States)

    Wang, Guizhi; Gu, SaiJu; Chen, Jibo; Wu, Xianhua; Yu, Jun

    2016-12-01

    Assessment of the health and economic impacts of PM2.5 pollution is of great importance for urban air pollution prevention and control. In this study, we evaluate the damage of PM2.5 pollution using Beijing as an example. First, we use exposure-response functions to estimate the adverse health effects due to PM2.5 pollution. Then, the corresponding labour loss and excess medical expenditure are computed as two conducting variables. Finally, different from the conventional valuation methods, this paper introduces the two conducting variables into the computable general equilibrium (CGE) model to assess the impacts on sectors and the whole economic system caused by PM2.5 pollution. The results show that, substantial health effects of the residents in Beijing from PM2.5 pollution occurred in 2013, including 20,043 premature deaths and about one million other related medical cases. Correspondingly, using the 2010 social accounting data, Beijing gross domestic product loss due to the health impact of PM2.5 pollution is estimated as 1286.97 (95% CI: 488.58-1936.33) million RMB. This demonstrates that PM2.5 pollution not only has adverse health effects, but also brings huge economic loss.

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

    Directory of Open Access Journals (Sweden)

    Irene eLenoir-Wijnkoop

    2015-05-01

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

  2. Economic assessment of energetic scenarios

    International Nuclear Information System (INIS)

    Grandjean, Alain; Bureau, Dominique; Schubert, Katheline; Henriet, Fanny; Maggiar, Nicolas; Criqui, Patrick; Le Teno, Helene; Baumstark, Luc; Crassous, Renaud; Roques, Fabien

    2013-09-01

    This publication gathers contributions proposed by different members of the Economic Council for a Sustainable Development (CEDD) on the issue of energy transition, and more precisely on scenarios elaborated with respect to energy transition. A first set of contributions addresses models of energy transition (assessment of scenario costs to reach a factor 4; the issue of de-carbonation of energy consumption; study of ELECsim, a tool to highlight costs of scenarios of evolution of the electric power system). The second part addresses arbitrations and choice assessment (the importance of social and economic impacts of scenarios; challenges related to the joint definition of the discount rate and of the evolution of carbon value in time; the issue of assessment of the integration of renewable energies into the power system)

  3. 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.

  4. [Health economics and antibiotic therapy].

    Science.gov (United States)

    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.

  5. Guidelines for reporting health economic research.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Boehler, Christian E H; de Graaf, Gimon; Steuten, Lotte; Yang, Yaling; Abadie, Fabienne

    2015-01-01

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

  7. Assessing the economic benefits of vaccines based on the health investment life course framework: a review of a broader approach to evaluate malaria vaccination.

    Science.gov (United States)

    Constenla, Dagna

    2015-03-24

    Economic evaluations have routinely understated the net benefits of vaccination by not including the full range of economic benefits that accrue over the lifetime of a vaccinated person. Broader approaches for evaluating benefits of vaccination can be used to more accurately calculate the value of vaccination. This paper reflects on the methodology of one such approach - the health investment life course approach - that looks at the impact of vaccine investment on lifetime returns. The role of this approach on vaccine decision-making will be assessed using the malaria health investment life course model example. We describe a framework that measures the impact of a health policy decision on government accounts over many generations. The methodological issues emerging from this approach are illustrated with an example from a recently completed health investment life course analysis of malaria vaccination in Ghana. Beyond the results, various conceptual and practical challenges of applying this framework to Ghana are discussed in this paper. The current framework seeks to understand how disease and available technologies can impact a range of economic parameters such as labour force participation, education, healthcare consumption, productivity, wages or economic growth, and taxation following their introduction. The framework is unique amongst previous economic models in malaria because it considers future tax revenue for governments. The framework is complementary to cost-effectiveness and budget impact analysis. The intent of this paper is to stimulate discussion on how existing and new methodology can add to knowledge regarding the benefits from investing in new and underutilized vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Literacy, health and economic factors

    OpenAIRE

    Kukubajska, Marija Emilija; Koceva, Sonja

    2015-01-01

    Economic disadvantage in less developed regions of the world is expected to result into higher illiteracy rate, among children in particular. Some developed countries do not follow this pattern. A paradox indicates: they pay special attention to nutrition and dietetics, yet record surprising illiteracy. Poor regions welcome new concepts of healthy nutrition and healthy education, while they also integrate existing traditional nutrition, just as developed societies promote health agricultural ...

  9. The economics of health insurance.

    Science.gov (United States)

    Jha, Saurabh; Baker, Tom

    2012-12-01

    Insurance plays an important role in the United States, most importantly in but not limited to medical care. The authors introduce basic economic concepts that make medical care and health insurance different from other goods and services traded in the market. They emphasize that competitive pricing in the marketplace for insurance leads, quite rationally, to risk classification, market segmentation, and market failure. The article serves as a springboard for understanding the basis of the reforms that regulate the health insurance market in the Patient Protection and Affordable Care Act. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  10. Neuroeconomics and behavioral health economics

    DEFF Research Database (Denmark)

    Larsen, Torben

    2009-01-01

      Objective: Neuroeconomics integrates behavioral economics, psychology and neuroscience. Recently, this line of research is summarized in a neuroeconomic model (NeM) which addresses behavioral health from a new angle as surveyed in this study. Data and Method Firstly, NeM is used as framework...... for explanation of the neural dynamics of normal decision making. Secondly, the literature is reviewed for evidence on hypothesized applications of NeM in behavioral health. Results I. The present bias as documented by neuroeconomic game-trials is explained by NeM as rooted in the basal activation of Amygdala...... mechanism. In this case neuroeconomics may serve as an evidence-based public monitoring across specific historical meditation settings. Conclusion Neuroeconomics reveal the action-mechanism of dominant behavioral health interventions as integrated home care for patients suffering from stroke, heart failure...

  11. Referral Systems to Integrate Health and Economic Strengthening Services for People with HIV: A Qualitative Assessment in Malawi.

    Science.gov (United States)

    Sears, Clinton; Andersson, Zach; Cann, Meredith

    2016-12-23

    Supporting the diverse needs of people living with HIV (PLHIV) can help reduce the individual and structural barriers they face in adhering to antiretroviral treatment (ART). The Livelihoods and Food Security Technical Assistance II (LIFT) project sought to improve adherence in Malawi by establishing 2 referral systems linking community-based economic strengthening and livelihoods services to clinical health facilities. One referral system in Balaka district, started in October 2013, connected clients to more than 20 types of services while the other simplified approach in Kasungu and Lilongwe districts, started in July 2014, connected PLHIV attending HIV and nutrition support facilities directly to community savings groups. From June to July 2015, LIFT visited referral sites in Balaka, Kasungu, and Lilongwe districts to collect qualitative data on referral utility, the perceived association of referrals with client and household health and vulnerability, and the added value of the referral system as perceived by network member providers. We interviewed a random sample of 152 adult clients (60 from Balaka, 57 from Kasungu, and 35 from Lilongwe) who had completed their referral. We also conducted 2 focus group discussions per district with network providers. Clients in all 3 districts indicated their ability to save money had improved after receiving a referral, although the percentage was higher among clients in the simplified Kasungu and Lilongwe model than the more complex Balaka model (85.6% vs. 56.0%, respectively). Nearly 70% of all clients interviewed had HIV infection; 72.7% of PLHIV in Balaka and 95.7% of PLHIV in Kasungu and Lilongwe credited referrals for helping them stay on their ART. After the referral, 76.0% of clients in Balaka and 92.3% of clients in Kasungu and Lilongwe indicated they would be willing to spend their savings on health costs. The more diverse referral network and use of an mHealth app to manage data in Balaka hindered provider uptake

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

    Science.gov (United States)

    Fanourgiakis, John; Kanoupakis, Emmanuel

    2015-08-01

    In a time of economic recession health technology assessment is an established aid in decision making in many countries in order to identify cost-containment policy options. Moreover, as the volume, complexity, and cost of new medical technology increases, the need for evaluating benefits, risks and costs becomes increasingly important. In recent years there has been a proliferation of health technology assessment initiatives internationally, aimed in introducing rationality in the decision-making process, informing reimbursement, providing clinical guidance on the use of medical technologies across the world in an evidence-based decision-making environment and in pricing decisions. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  13. [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.

  14. The feasibility study: a health economics perspective

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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.

  16. 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.

  17. A Health Economics Approach to US Value Assessment Frameworks-Summary and Recommendations of the ISPOR Special Task Force Report [7].

    Science.gov (United States)

    Garrison, Louis P; Neumann, Peter J; Willke, Richard J; Basu, Anirban; Danzon, Patricia M; Doshi, Jalpa A; Drummond, Michael F; Lakdawalla, Darius N; Pauly, Mark V; Phelps, Charles E; Ramsey, Scott D; Towse, Adrian; Weinstein, Milton C

    2018-02-01

    This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e.g., insurance value and equity) as part of either an "augmented" cost-effectiveness analysis or a multicriteria decision analysis. Given an aggregation of elements to a measure of value, consistent use of a cost-effectiveness threshold can help ensure the maximization of health gain and well-being for a given budget. These decisions can benefit from the use of deliberative processes. The six recommendations are to: 1) be explicit about decision context and perspective in value assessment frameworks; 2) base health plan coverage and reimbursement decisions on an evaluation of the incremental costs and benefits of health care technologies as is provided by cost-effectiveness analysis; 3) develop value thresholds to serve as one important input to help guide coverage and reimbursement decisions; 4) manage budget constraints and affordability on the basis of cost-effectiveness principles; 5) test and consider using structured deliberative processes for health plan coverage and reimbursement decisions; and 6) explore and test novel elements of benefit to improve value measures that reflect the perspectives of both plan members and patients. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. A health economic model to assess the cost-effectiveness of OPTIFAST® for the treatment of obesity in USA.

    Science.gov (United States)

    Nuijten, Mark; Marczewska, Agnieszka; Araujo Torress, Krysmaru; Rasouli, Bahareh; Perugini, Moreno

    2018-04-20

    Obesity is associated with high direct medical costs and indirect costs resulting from productivity loss. High prevalence of obesity generates a justified need to identify cost-effective weight loss approaches from a payer's perspective. Within the variety of weight management techniques, OPTIFAST ® is a clinically recognized and scientifically proven total meal replacement Low Calorie Diet that provides meaningful results in terms of weight loss and reduction in comorbidities. The objective of this study is assess potential cost-savings of OPTIFAST ® program in the USA, as compared to "no intervention" and pharmacotherapy. An event-driven decision analytic model was used to estimate payer's cost-savings from reimbursement of the 1-year OPTIFAST ® program over 3 years in the USA. The analysis was performed for the broad population of obese persons (BMI >30 kg/m 2 ) undergoing the OPTIFAST ® program versus liraglutide 3 mg, naltrexone/bupropion and versus "no intervention". The model included risk of complications related to increased BMI. Data sources included published literature, clinical trials, official USA price/tariff lists and national population statistics. The primary perspective was that of a USA payer; costs provided in 2016 US dollars. OPTIFAST ® leads over a period of 3 years to cost-savings of USD 9,285 per class I and II obese patient (BMI 30-39.9 kg/m 2 ) as compared to liraglutide and USD 685 as compared to naltrexone/bupropion. In the same time perspective, the OPTIFAST ® program leads to a reduction of cost of obesity complications of USD 1,951 as compared to "no intervention" with the incremental cost-effectiveness ratio of USD 6,475 per QALY. Scenario analyses show also substantial cost-savings in patients with class III obesity (BMI ≥40.0 kg/m 2 ) and patients with obesity (BMI 30-39.9 kg/m2) and type 2 diabetes versus all three previous comparators and bariatric surgery. Reimbursing OPTIFAST ® leads to meaningful cost

  19. Basic Principles of Health Economics Applied - How to Assess if Transcatheter Aortic Valve Implantation is Worth the Investment.

    Science.gov (United States)

    Brunn, Matthias; Durand-Zaleski, Isabelle

    2013-08-01

    This article attempts to present some highlights from the rich economic literature pertaining to interventional cardiology and transcatheter aortic valve implantation (TAVI). There are currently more questions than answers, not surprisingly given the pace of technological change in interventional cardiology. For clinicians who work in a strictly regulated environment and have limited control over their use of medical technologies, this article will hopefully shed some light on the motives for policy decisions. For clinicians who make decisions on the resources used to treat their patients, it aims to provide the means of looking for evidence that will allow for informed decisions from both clinical and economic perspectives.

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

    Science.gov (United States)

    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.

  1. Assessment of the public health in the course of the Eurasian Economic Community programme 'Reclamation of areas of the Eurasian Economic Community member-states affected by the uranium mines'

    International Nuclear Information System (INIS)

    Kiselev, M.F.; Tukov, A.R.; Metlyaev, E.G.; Seregin, V.A.

    2012-01-01

    Full text: The inter-state target programme of the Eurasian Economic Community 'Reclamation of areas of the Eurasian Economic Community member-states affected by the uranium mines' includes assessment of impact of these facilities on the public health at the adjacent areas and estimation of potential risk of radiation induced diseases. This work will be carried out as follows: collection of indicators of the State medical statistic reporting by areas of natural uranium mining and milling waste storage to be reclaimed; data input to the database, data verification, calculation of relative indexes and estimation of potential risk of radiation induced diseases; comparative analysis of the public health at inspected and reference areas, estimation of potential risk of radiation induced diseases; development of recommendations on enhancing medical service of the population. Burnasyan Federal Medical Biophysical Centre developed the method of data collection in order to assess and to perform the comparative analysis of the public health. At the early stage of the programme, for the purpose of the comparative analysis of the public health at the contaminated areas, we are going to identify areas affected by uranium plants and some reference areas with approximately same quality of health-care service. When collecting medical data of the public, the special attention will be paid to malignant neoplasm incidence, including trachea, bronchus, lung cancer and psycho-somatic diseases (hypertension, coronary heart disease, peptic ulcer and duodenal ulcers, and others). This kind of data will be collected as the number of registered patients by sex and age groups in the report of the state medical statistics 'Information on malignant neoplasm incidence over 1990 - 2014' (according to the reporting form 'Information on the number of diseases registered at the area under the clinic service'). The statistical bodies of the Eurasian Economic Community member-states will organize the

  2. 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.

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

    Science.gov (United States)

    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

  4. Assessing economic tradeoffs in forest management.

    Science.gov (United States)

    Ernie Niemi; Ed. Whitelaw

    1999-01-01

    Method is described for assessing the competing demands for forest resources in a forest management plan by addressing economics values, economic impacts, and perceptions of fairness around each demand. Economics trends and forces that shape the dynamic ecosystem-economy relation are developed. The method is demonstrated through an illustrative analysis of a forest-...

  5. Economics and Health Reform: Academic Research and Public Policy.

    Science.gov (United States)

    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.

  6. 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.

  7. Assessing associations between socio-economic environment and self-reported health in Amsterdam using bespoke environments

    NARCIS (Netherlands)

    Veldhuizen, Eleonore M.; Stronks, Karien; Kunst, Anton E.

    2013-01-01

    The study of the relationship between residential environment and health at micro area level has a long time been hampered by a lack of micro-scale data. Nowadays data is registered at a much more detailed scale. In combination with Geographic Information System (GIS)-techniques this creates

  8. Assessing sufficient capability: A new approach to economic evaluation.

    Science.gov (United States)

    Mitchell, Paul Mark; Roberts, Tracy E; Barton, Pelham M; Coast, Joanna

    2015-08-01

    Amartya Sen's capability approach has been discussed widely in the health economics discipline. Although measures have been developed to assess capability in economic evaluation, there has been much less attention paid to the decision rules that might be applied alongside. Here, new methods, drawing on the multidimensional poverty and health economics literature, are developed for conducting economic evaluation within the capability approach and focusing on an objective of achieving "sufficient capability". This objective more closely reflects the concern with equity that pervades the capability approach and the method has the advantage of retaining the longitudinal aspect of estimating outcome that is associated with quality-adjusted life years (QALYs), whilst also drawing on notions of shortfall associated with assessments of poverty. Economic evaluation from this perspective is illustrated in an osteoarthritis patient group undergoing joint replacement, with capability wellbeing assessed using ICECAP-O. Recommendations for taking the sufficient capability approach forward are provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Economic values, ethics, and ecosystem health

    Science.gov (United States)

    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...

  10. The Economic Crisis and Public Health

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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.

  13. 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

  14. 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.

  15. Metro nature, environmental health, and economic value.

    Science.gov (United States)

    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.

  16. Assessing the economic burden of illness for tuberculosis patients in Benin: determinants and consequences of catastrophic health expenditures and inequities.

    Science.gov (United States)

    Laokri, Samia; Dramaix-Wilmet, Michèle; Kassa, Ferdinand; Anagonou, Séverin; Dujardin, Bruno

    2014-10-01

    To inform policy-making, we measured the risk, causes and consequences of catastrophic expenditures for tuberculosis and investigated potential inequities. Between August 2008 and February 2009, a cross-sectional study was conducted among all (245) smear-positive pulmonary tuberculosis patients of six health districts from southern Benin. A standardised survey questionnaire covered the period of time elapsing from onset of tuberculosis symptoms to completion of treatment. Total direct cost exceeding the conventional 10% threshold of annual income was defined as catastrophic and used as principal outcome in a multivariable logistic regression. A sensitivity analysis was performed while varying the thresholds. A pure gradient of direct costs of tuberculosis in relation to income was observed. Incidence (78.1%) and intensity (14.8%) of catastrophic expenditure were high; varying thresholds was insensitive to the intensity. Incurring catastrophic expenditure was independently associated with lower- and middle-income quintiles (adjusted odd ratio (aOR) = 36.2, 95% CI [12.3-106.3] and aOR = 6.4 [2.8-14.6]), adverse pre-diagnosis stage (aOR = 5.4 [2.2-13.3]) and less education (aOR = 4.1[1.9-8.7]). Households incurred important days lost due to TB, indebtedness (37.1%), dissaving (51.0%) and other coping strategies (52.7%). Catastrophic direct costs and substantial indirect and coping costs may persist under the 'free' tuberculosis diagnosis and treatment strategy, as well as inequities in financial hardship. © 2014 John Wiley & Sons Ltd.

  17. Crowdfunding our health: Economic risks and benefits.

    Science.gov (United States)

    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.

  18. Applying Behavioral Economics to Public Health Policy

    Science.gov (United States)

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

    2016-01-01

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

  19. Hypertension, a health economics perspective.

    Science.gov (United States)

    Alcocer, Luis; Cueto, Liliana

    2008-06-01

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

  20. 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…

  1. 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.

  2. The behavioral economics of health and health care.

    Science.gov (United States)

    Rice, Thomas

    2013-01-01

    People often make decisions in health care that are not in their best interest, ranging from failing to enroll in health insurance to which they are entitled, to engaging in extremely harmful behaviors. Traditional economic theory provides a limited tool kit for improving behavior because it assumes that people make decisions in a rational way, have the mental capacity to deal with huge amounts of information and choice, and have tastes endemic to them and not open to manipulation. Melding economics with psychology, behavioral economics acknowledges that people often do not act rationally in the economic sense. It therefore offers a potentially richer set of tools than provided by traditional economic theory to understand and influence behaviors. Only recently, however, has it been applied to health care. This article provides an overview of behavioral economics, reviews some of its contributions, and shows how it can be used in health care to improve people's decisions and health.

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

    Energy Technology Data Exchange (ETDEWEB)

    Dutta, A.; Davis, R.

    2011-12-01

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

  4. 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....

  5. 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.

  6. 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...

  7. Assessing economic consequences of radiation accidents

    International Nuclear Information System (INIS)

    Rowe, M.D.; Lee, J.C.; Grimshaw, C.A.; Kalb, P.D.

    1987-01-01

    A recent review of existing models and methods for assessing potential consequences of accidents in the high-level radioactive waste (HLW) disposal system identifies economic consequence assessment methods as a weak point. Existing methods have mostly been designed to assess economic consequences of reactor accidents, the possible scale of which can be several orders of magnitude greater than anything possible in the HLW disposal system. There is therefore some question about the applicability of these methods, their assumptions, and their level of detail to assessments of smaller accidents. The US Dept. of Energy funded this study to determine needs for code modifications or model development for assessing economic costs of accidents in the HLW disposal system. The objectives of the study were as follows: (1) review the literature on economic consequences of accidents to determine the availability of assessment methods and data and their applicability to the HLW disposal system before closure. (2) Determine needs for expansion, revision, or adaptation of methods and data for modeling economic consequences of accidents of the scale projected for the disposal system. (3) Gather data that might be useful for the needed revisions for modeling economic impacts on this scale

  8. Unpaid work in health economic evaluations.

    Science.gov (United States)

    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.

  9. 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.

  10. 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.

  11. 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...

  12. A hermeneutic science: health economics and Habermas.

    Science.gov (United States)

    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.

  13. 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

  14. Delayed and differential effects of the economic crisis in Sweden in the 1990s on health-related exclusion from the labour market: A health equity assessment

    OpenAIRE

    Burstrom, Bo; Nylen, Lotta; Barr, Ben; Clayton, Stephen; Holland, Paula; Whitehead, Margaret

    2012-01-01

    Abstract\\ud \\ud Many OECD countries are currently experiencing economic crisis and introducing counter-measures with unknown effects. To learn from previous experience, we explored whether there were delayed or differential effects of the Swedish recession in the 1990s and the government's response to it for people with limiting longstanding illness or disability (LLSI) from different socioeconomic groups (SEGs), by policy analysis and secondary data analysis of the Swedish Survey of Living C...

  15. 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.

  16. DUPIC fuel cycle economics assessment (1)

    International Nuclear Information System (INIS)

    Choi, H. B.; Roh, G. H.; Kim, D. H.

    1999-04-01

    This is a state-of-art report that describes the current status of the DUPIC fuel cycle economics analysis conducted by the DUPIC fuel compatibility assessment group of the DUPIC fuel development project. For the DUPIC fuel cycle economics analysis, the DUPIC fuel compatibility assessment group has organized the 1st technical meeting composed of 8 domestic specialists from government, academy, industry, etc. and a foreign specialist of hot-cell design from TRI on July 16, 1998. This report contains the presentation material of the 1st technical meeting, published date used for the economics analysis and opinions of participants, which could be utilized for further DUPIC fuel cycle and back-end fuel cycle economics analyses. (author). 11 refs., 7 charts

  17. Assessing economic consequences of radiation accidents

    International Nuclear Information System (INIS)

    Rowe, M.D.; Lee, J.C.; Grimshaw, C.A.; Kalb, P.D.

    1987-01-01

    This project reviewed the literature on the economic consequences of accidents to determine the availability of assessment methods and data and their applicability to the high-level radioactive waste (HLW) disposal system before closure; determined needs for expansion, revision, or adaptation of methods and data for modeling economic consequences of accidents of the scale projected for the disposal system; and gathered data that might be useful for the needed revisions. 8 refs., 1 tab

  18. [Aspects of economic responsibility in health care].

    Science.gov (United States)

    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.

  19. [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.

  20. 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

  1. 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.

  2. Shamba Maisha: A pilot study assessing impacts of a micro-irrigation intervention on the health and economic wellbeing of HIV patients

    Directory of Open Access Journals (Sweden)

    Onjolo Elijah

    2010-05-01

    Full Text Available Abstract Background HIV/AIDS negatively impacts poverty alleviation and food security, which reciprocally hinder the rapid scale up and effectiveness of HIV care programs. Nyanza province has the highest HIV prevalence (15.3%, and is the third highest contributor (2.4 million people to rural poverty in Kenya. Thus, we tested the feasibility of providing a micro-irrigation pump to HIV-positive farmers in order to evaluate its impact on health and economic advancement among HIV-positive patients and their families. Methods Thirty HIV-positive patients enrolled in the Family AIDS Care and Education Services (FACES program in Kisumu, Kenya were provided a micro-financed loan to receive an irrigation pump and farming guidance from KickStart, the developer of the pump. Economic data, CD4 counts, household health and loan repayment history were collected 12 months after the pumps were distributed. Results Mean annual family income increased by $1,332 over baseline. CD4 counts did not change significantly. Though income increased, only three (10% participants had paid off more than a quarter of the loan. Conclusions We demonstrated the feasibility of an income-generating micro-irrigation intervention among HIV-positive patients and the collection of health and economic data. While family income improved significantly, loan repayment rates were low- likely complicated by the drought that occurred in Kenya during the intervention period.

  3. Shamba Maisha: a pilot study assessing impacts of a micro-irrigation intervention on the health and economic wellbeing of HIV patients.

    Science.gov (United States)

    Pandit, Jay A; Sirotin, Nicole; Tittle, Robin; Onjolo, Elijah; Bukusi, Elizabeth A; Cohen, Craig R

    2010-05-11

    HIV/AIDS negatively impacts poverty alleviation and food security, which reciprocally hinder the rapid scale up and effectiveness of HIV care programs. Nyanza province has the highest HIV prevalence (15.3%), and is the third highest contributor (2.4 million people) to rural poverty in Kenya. Thus, we tested the feasibility of providing a micro-irrigation pump to HIV-positive farmers in order to evaluate its impact on health and economic advancement among HIV-positive patients and their families. Thirty HIV-positive patients enrolled in the Family AIDS Care and Education Services (FACES) program in Kisumu, Kenya were provided a micro-financed loan to receive an irrigation pump and farming guidance from KickStart, the developer of the pump. Economic data, CD4 counts, household health and loan repayment history were collected 12 months after the pumps were distributed. Mean annual family income increased by $1,332 over baseline. CD4 counts did not change significantly. Though income increased, only three (10%) participants had paid off more than a quarter of the loan. We demonstrated the feasibility of an income-generating micro-irrigation intervention among HIV-positive patients and the collection of health and economic data. While family income improved significantly, loan repayment rates were low- likely complicated by the drought that occurred in Kenya during the intervention period.

  4. 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

  5. Geologic coal assessment: The interface with economics

    Science.gov (United States)

    Attanasi, E.D.

    2001-01-01

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

  6. Does inequality in health impede economic growth?

    Science.gov (United States)

    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.

  7. Economic assessment of Q fever in the Netherlands

    NARCIS (Netherlands)

    Asseldonk, van M.A.P.M.; Prins, J.; Bergevoet, R.H.M.

    2013-01-01

    In this paper the economic impact of controlling the Q fever epidemic in 2007-2011 in the Netherlands is assessed. Whereas most of the long-term benefits of the implemented control programme stem from reduced disease burden and human health costs, the majority of short-term intervention costs were

  8. Presenting of a material exposure health risk assessment model in Oil and Gas Industries (case study: Pars Economic and Energy Region

    Directory of Open Access Journals (Sweden)

    M. Heydari

    2014-02-01

    Result and Conclusion: The results revealed that the quantitative amount of consequence, probability and exposure was 83.2, 8.45, and 2.2, respectively. Generally, the chemical exposure risk number was 1546 which shows that reforming plans are in highly priorities from an economical point of view. William-fine method has the benefit of an accurate chemical exposure by combination of effect severity, exposure probability and detriment rate, and also minimization of personal judgments during the assessment.

  9. Concept of economic readiness levels assessment

    Science.gov (United States)

    Yuniaristanto, Sutopo, W.; Widiyanto, A.; Putri, A. S.

    2017-11-01

    This research aims to build a concept of Economic Readiness Level (ERL) assessment for incubation center. ERL concept is arranged by considering both market and business aspects. Every aspect is divided into four phases and each of them consists of some indicators. Analytic Hierarchy Process (AHP) is used to develop the ERL in calculating the weight of every single aspect and indicator. Interval scale between 0 and 4 is also applied in indicator assessment. In order to calculate ERL, score in every indicator and the weight of both the aspect and indicator are considered. ERL value is able to show in detail the innovative product readiness level from economic sight, market and business aspect. There are four levels in Economic Readiness Level scheme which are investigation, feasibility, planning and introduction.

  10. Organizational economics and health care markets.

    Science.gov (United States)

    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.

  11. Economic impact assessment in pest risk analysis

    NARCIS (Netherlands)

    Soliman, T.A.A.; Mourits, M.C.M.; Oude Lansink, A.G.J.M.; Werf, van der W.

    2010-01-01

    According to international treaties, phytosanitary measures against introduction and spread of invasive plant pests must be justified by a science-based pest risk analysis (PRA). Part of the PRA consists of an assessment of potential economic consequences. This paper evaluates the main available

  12. Economic aspects of risk assessment in chemical safety

    Energy Technology Data Exchange (ETDEWEB)

    Drummond, M F; Shannon, H S

    1986-05-01

    This paper considers how the economic aspects of risk assessment in chemical safety can be strengthened. Its main focus is on how economic appraisal techniques, such as cost-benefit and cost-effectiveness analysis, can be adapted to the requirements of the risk-assessment process. Following a discussion of the main methodological issues raised by the use of economic appraisal, illustrated by examples from the health and safety field, a number of practical issues are discussed. These include the consideration of the distribution of costs, effects and benefits, taking account of uncertainty, risk probabilities and public perception, making the appraisal techniques useful to the early stages of the risk-assessment process and structuring the appraisal to permit continuous feedback to the participants in the risk-assessment process. It is concluded that while the way of thinking embodied in economic appraisal is highly relevant to the consideration of choices in chemical safety, the application of these principles in formal analysis of risk reduction procedures presents a more mixed picture. The main suggestions for improvement in the analyses performed are the undertaking of sensitivity analyses of study results to changes in the key assumptions, the presentation of the distribution of costs and benefits by viewpoint, the comparison of health and safety measures in terms of their incremental cost per life-year (or quality-adjusted life-year) gained and the more frequent retrospective review and revision of the economic analyses that are undertaken.

  13. Mycotoxins: significance to global economics and health

    Science.gov (United States)

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

  14. Essays on health and labor economics

    NARCIS (Netherlands)

    Hullegie, P.G.J.

    2012-01-01

    This thesis deals with a range of topics in health and labor economics. The first part examines the validity of a method that aims at improving the interpersonal comparability of self-reports in surveys. The second part is concerned with the question how the demand for medical care is related to

  15. Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European Economic Association: a protocol for a suite of systematic reviews for public health and health systems.

    Science.gov (United States)

    Pottie, Kevin; Mayhew, Alain D; Morton, Rachael L; Greenaway, Christina; Akl, Elie A; Rahman, Prinon; Zenner, Dominik; Pareek, Manish; Tugwell, Peter; Welch, Vivian; Meerpohl, Joerg; Alonso-Coello, Pablo; Hui, Charles; Biggs, Beverley-Ann; Requena-Méndez, Ana; Agbata, Eric; Noori, Teymur; Schünemann, Holger J

    2017-09-11

    The European Centre for Disease Prevention and Control is developing evidence-based guidance for voluntary screening, treatment and vaccine prevention of infectious diseases for newly arriving migrants to the European Union/European Economic Area. The objective of this systematic review protocol is to guide the identification, appraisal and synthesis of the best available evidence on prevention and assessment of the following priority infectious diseases: tuberculosis, HIV, hepatitis B, hepatitis C, measles, mumps, rubella, diphtheria, tetanus, pertussis, poliomyelitis (polio), Haemophilus influenza disease, strongyloidiasis and schistosomiasis. The search strategy will identify evidence from existing systematic reviews and then update the effectiveness and cost-effectiveness evidence using prospective trials, economic evaluations and/or recently published systematic reviews. Interdisciplinary teams have designed logic models to help define study inclusion and exclusion criteria, guiding the search strategy and identifying relevant outcomes. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. There are no ethical or safety issues. We anticipate disseminating the findings through open-access publications, conference abstracts and presentations. We plan to publish technical syntheses as GRADEpro evidence summaries and the systematic reviews as part of a special edition open-access publication on refugee health. We are following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols reporting guideline. This protocol is registered in PROSPERO: CRD42016045798. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Health economic evaluations in orthodontics: a systematic review.

    Science.gov (United States)

    Sollenius, Ola; Petrén, Sofia; Björnsson, Liselotte; Norlund, Anders; Bondemark, Lars

    2016-06-01

    Economic evaluation is assuming increasing importance as an integral component of health services research. To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently

  17. 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.

  18. Introduction to economic assessment - part 2.

    Science.gov (United States)

    McMahon, Ann; Sin, Chih Hoong

    2014-07-01

    This is the second in a series of four continuing professional development articles that explain some of the principles of economic assessment (EA) and describe how they may be applied in practice by front line practitioners leading service innovations. It introduces a methodology, with associated tools and templates, that has been used by practising nurses to conduct EAs. Our purpose is to equip readers with the knowledge to develop a technically competent, pragmatic EA that will contribute towards evidence-informed decision making and assure the best use of limited resources. If you have not already read the first article in this series ( McMahon and Sin 2013), we strongly advise you to do so as each article purposefully draws and builds on those that have gone before. The time out exercises in the first article required you to access source material located on the RCN website and identify a service innovation in your workplace. The time out exercises in this article draw in these same sources. We begin this article by recapping on the points covered in the first article before exploring the implications of the principles of EA and how to apply them in practice. In this article, we refer to and draw on a companion article published in this edition of Nursing Management ( pages 38-41) that sets out the most commonly cited approaches to EA in health and social care. We aim to enable readers, along with those they seek to influence, to make an informed decision as to what may be an appropriate EA approach in any specific context.

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

    Science.gov (United States)

    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

  20. Preliminary Economic Assessment of KALIMER-600

    International Nuclear Information System (INIS)

    Moon, Kee-Hwan; Kim, Seung-Su; Hahn, Do-Hee

    2008-01-01

    The GIF(GEN IV International Forum) established an Economic Modelling Working Group(EMWG) in 2003 to create economic models and guidelines to facilitate in a future evaluation of the Generation IV nuclear energy systems and assess progress toward the GIF economic goals. These goals are to have a life cycle cost advantage over other energy sources, and to have a level of financial risk comparable to other energy projects. To do this, EMWG has been developed the G4-ECONS model, which is a generic EXCEL-based model for computation of the projected levelized unit electricity cost and/or levelized non-electricity unit product cost from GEN IV energy systems. KALIMER-600 has been developed as a new design concept based on the KALIMER-150 design. KALIMER-600 is a unique design concept which has a potential to achieve GEN IV technology goals even though there is a room for a design improvement in order to make the KALIMER-600 more competitive with future generation reactors. The objective of this study is to the assess economics of KALIMER-600 by using the G4-ECONS model

  1. Assessment of Health Care and Economic Costs Due to Episodes of Acute Pesticide Intoxication in Workers of Rural Areas of the Coquimbo Region, Chile.

    Science.gov (United States)

    Ramírez-Santana, Muriel; Iglesias-Guerrero, Juan; Castillo-Riquelme, Marianela; Scheepers, Paul T J

    2014-12-01

    The increase in agricultural activity that Chile experienced in the past 20 years resulted in a boost in the use of pesticides. Despite pesticides' productivity benefits, they caused health problems such as the increased frequency of episodes of acute poisoning, which constitutes a relevant problem in terms of occupational health. The Chilean authorities require several preventive measures at workplaces, which are not always implemented, increasing the risk of intoxications in farmers. So far in Chile, there are no studies concerning the public health care expenses associated with acute work-related pesticide intoxications. From the societal perspective, there are costs involved if the worker needs to take sick leave and families incur costs to take care of their sick members. This study aimed to determine the costs associated with health care services used by people who suffered from work-related acute pesticide poisoning, as well as the economic costs for the families of the workers involved, and finally the costs of these episodes for the employer/industrial sector. This study considered a 3-year period (January 2009 to December 2011). Three sources of data were reviewed: reported cases at the Regional Health Authority, for the profile of the intoxications; registers of patients attended in public hospitals, for data on costs of health care services; and public information of living conditions nationwide. The overall costs of a single case depend on the severity of intoxication, days of sick leave, and type of health care needed. Most cases (77%) would be ambulatory and would be assisted at an emergency room, with an average cost of US $330 per case. Those cases that might need hospitalization (23%) and, therefore, more days off work have an average cost of US $1158 per case. Taking into account the number of patients reported each year in the country, the cost per annum would be about US $185,000, but considering the underreporting of intoxications and

  2. Agroecosystem health assessment in Mashhad

    Directory of Open Access Journals (Sweden)

    kazem vafabakhsh

    2009-06-01

    Full Text Available Agroecosystem Health investigating requires a holistic approach based on its biophysical, socio-economic and human community dimensions. In order to assess Agroecosystem Health in Mahhad, this research was conducted for the period of 1982 to 2002. The assessment necessitates the selection of indicators which represent various aspects of the agroecosystem. The purpose of this study was to establish a conceptual framework that facilitates the assessment of Agroecosyetem Health. The first step was to develop a set of indicators. Data on structural, functional, and organizational indicators were collected from official documents and statistics and also questionnaires. Results showed that from 1982 to 1997 Health Index (HI decreased and the lowest HI was in 1997 and after that trend of HI was improved. Sensitivity analysis showed that functional criteria had the highest correlation with HI. To improve the HI in short term, the most effective parameters would be functional indices such as chemicals, water use efficiency, soil degradation, machinery costs, and education indices. The index of people’s concern on environmental issues showed that 69% are concerned about the environment. This could be a good reason for the governmental and non-governmental organizations to focus on environmental health and try to improve the level of HI. The index of government’s financial support to agricultural section has decreased from 1982 to 1997.

  3. 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.

  4. Global health and economic impacts of future ozone pollution

    International Nuclear Information System (INIS)

    Selin, N E; Nam, K M; Reilly, J M; Paltsev, S; Prinn, R G; Webster, M D; Wu, S

    2009-01-01

    We assess the human health and economic impacts of projected 2000-2050 changes in ozone pollution using the MIT Emissions Prediction and Policy Analysis - Health Effects (EPPA-HE) model, in combination with results from the GEOS-Chem global tropospheric chemistry model of climate and chemistry effects of projected future emissions. We use EPPA-HE to assess the human health damages (including mortality and morbidity) caused by ozone pollution, and quantify their economic impacts in sixteen world regions. We compare the costs of ozone pollution under scenarios with 2000 and 2050 ozone precursor and greenhouse gas emissions (using the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A1B scenario). We estimate that health costs due to global ozone pollution above pre-industrial levels by 2050 will be $580 billion (year 2000$) and that mortalities from acute exposure will exceed 2 million. We find that previous methodologies underestimate costs of air pollution by more than a third because they do not take into account the long-term, compounding effects of health costs. The economic effects of emissions changes far exceed the influence of climate alone.

  5. Health needs assessment

    Directory of Open Access Journals (Sweden)

    Ibrahim A Bani

    2008-01-01

    The findings of the assessment of the health needs of Jazan presented in this review could be utilized as a baseline and reference information for policy formulation, subsequent planning and cost effective intervention programs. It could also be utilized for the curriculum development or review for a community oriented medical schools.

  6. 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

  7. 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.

  8. Economic assessment of mushroom project commercialisation

    International Nuclear Information System (INIS)

    Mat Rasol Awang; Rosnani Abdul Rashid; Hassan Hamdani Hassan Mutaat; Meswan Maskom

    2010-01-01

    The market value of mushroom is worth US $45 billion comprising: US $28-30 billion from food, US $9-10 billion from medicinal products and US $3.5-4 billion from wild mushroom. Malaysian import deficit of mushroom over the year 2001-2007 was 40,933 metric ton that worth of RM 187.7 million. The existing local market is lucrative and the potential world market is very large. Having cultivation technology in placed, understanding key value chains of cultivation technology processes, this paper assesses the case study of project economic of mushroom commercialization. (author)

  9. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Timothy K.; Goodman, Chris D. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Boldt, R. Gabriel [London Health Sciences Centre, London, Ontario (Canada); Warner, Andrew; Palma, David A. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Rodrigues, George B. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Lock, Michael I. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Zaric, Gregory S. [Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Ivey Business School, Western University, London, Ontario (Canada); Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada)

    2016-04-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  10. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    International Nuclear Information System (INIS)

    Nguyen, Timothy K.; Goodman, Chris D.; Boldt, R. Gabriel; Warner, Andrew; Palma, David A.; Rodrigues, George B.; Lock, Michael I.; Mishra, Mark V.; Zaric, Gregory S.; Louie, Alexander V.

    2016-01-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  11. Economic Journal in Russia: Quality Assessment Issues

    Directory of Open Access Journals (Sweden)

    Ol’ga Valentinovna Tret’yakova

    2016-05-01

    Full Text Available The paper attempts to assess economic journals included in the List of peer-reviewed scientific journals and editions that are authorized to publish the principal research findings of doctoral (candidate’s dissertations (the VAK List, it was established by the Decision of the Ministry of Education and Science of the Russian Federation and entered into force on December 01, 2016. The general assessment of the journals that include more than 380 titles is carried out by analyzing their bibliometric indicators in the system of the Russian Science Citation Index, in particular, by examining the values of their impact factors. The analysis conducted at the Institute of Socio-economic Development of Territories of RAS shows that a relatively small number of economic journals publish a significant proportion of articles that obtain a large share of citations. The author reveals that the new VAK List includes over 50% of journals specializing in economic sciences, which have a lower level of citation or which are virtually not cited at all. This indirectly indicates that such journals are “left behind” the “main stream of science”, that their significance is local, availability low, attractiveness for the audience and scientific authority insufficient. The analysis proves that when forming the list of peer-reviewed scientific publications recommended for publication of dissertation research findings, along with other criteria, it is advisable to use tools that help assess the level of the journal. It is very important that the evaluation had quantitative expression and served as a specific measure for ranking the journals. One of these tools may be a criterion value for the two-year impact factor, which helps identify journals with a sufficient citation level. The paper presents the results of analysis of the RSCI list, which was proposed by the Council for Science under the Ministry of Education and Science of the Russian Federation as an

  12. 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

  13. 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.

  14. An economic assessment of low carbon vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Summerton, P. [Cambridge Econometrics CE, Cambridge (United Kingdom); Harrison, P. [European Climate Foundation ECF, Brussels (Belgium)] (eds.)

    2013-03-15

    The study aimed to analyse the economic impacts of decarbonizing light duty vehicles. As part of the study, the impacts of the European Commissions proposed 2020 CO2 regulation for cars and vans have been assessed. The analysis showed that a shift to low-carbon vehicles would increase spending on vehicle technology, therefore generating positive direct employment impacts, but potentially adding 1,000-1,100 euro to the capital cost of the average new car in 2020. However, these additional technology costs would be offset by fuel savings of around 400 euro per year, indicating an effective break-even point for drivers of approximately three years. At the EU level, the cost of running and maintaining the European car fleet would become 33-35 billion euro lower each year than in a 'do nothing scenario' by 2030, leading to positive economic impacts including indirect employment gains. Data on the cost of low carbon vehicle technologies has largely been sourced from the auto industry itself, with the study supported by a core working group including Nissan, GE, the European Association of Automotive Suppliers (CLEPA), and the European Storage Battery Manufacturers Association (Eurobat). Fuel price projections for the study were based on the IEA's World Energy Outlook, while technical modelling was carried out using the transport policy scoping tool SULTAN (developed by Ricardo-AEA for the European Commission) and the Road Vehicle Cost and Efficiency Calculation Framework, also developed by Ricardo-AEA. Macro-economic modelling was done using the E3ME model, which has previously been used for several European Commission and EU government impact assessments. This report focuses on efficient use of fossil fuels in internal combustion- and hybrid electric vehicles. It will be followed by a second report, which will focus on further reducing the use of fossil fuels by also substituting them with domestically produced energy carriers, such as electricity and

  15. Systematic overview of economic evaluations of health-related rehabilitation.

    Science.gov (United States)

    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.

  16. Assessment of Public Health and Economic Impact of Intranasal Live-Attenuated Influenza Vaccination of Children in France Using a Dynamic Transmission Model.

    Science.gov (United States)

    Gerlier, L; Lamotte, M; Grenèche, S; Lenne, X; Carrat, F; Weil-Olivier, C; Damm, O; Schwehm, M; Eichner, M

    2017-04-01

    QLAIV on public health and economic outcomes in France.

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

    Science.gov (United States)

    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.

  18. The future of health economics: The potential of behavioral and experimental economics

    Directory of Open Access Journals (Sweden)

    Fredrik Hansen

    2015-05-01

    Full Text Available Health care systems around the globe are facing great challenges. The demand for health care is increasing due to the continuous development of new medical technologies, changing demographics, increasing income levels, and greater expectations from patients. The possibilities and willingness to expand health care resources, however, are limited. Consequently, health care organizations are increasingly required to take economic restrictions into account, and there is an urgent need for improved efficiency. It is reasonable to ask whether the health economics field of today is prepared and equipped to help us meet these challenges. Our aim with this article is twofold: to introduce the fields of behavioral and experimental economics and to then identify and characterize health economics areas where these two fields have a promising potential. We also discuss the advantages of a pluralistic view in health economics research, and we anticipate a dynamic future for health economics.

  19. Establishment of Health Technology Assessment in Iran

    Directory of Open Access Journals (Sweden)

    Shila Doaee

    2012-06-01

    Full Text Available Objective: Health Technology Assessment (HTA aims at informing healthcare policymakers, managers and practitioners of the "clinical consequences, but also the economic, ethical, and other social implications of the diffusion and use of a specific procedure or technique on medical practice". So considering the policy-oriented nature of HTA that calls for a close integration into the functioning and governance of health systems the present study focuses on executive processes and function of the HTA office of Iran.Materials and methods: Data of this review study were collected through documented sources and observations from 2007 to 2010.Results: Health Technology Assessment began its activities as a secretariat in the Deputy of Health in 2007 and it continues as a Health Technology Assessment Office at the Management of Health Technology Assessment, Standardization, and Tariff at the Deputy of curative affairs of MOHME in the beginning of 2010.14 Technology of modern medical equipment and 8 pharmaceutical medicine are assessed, Now many of measures for HTA establishment  such as cooperation National Institute of Health Research (NIHR, Holding scientific committee meetings, Establishing  the  Master's degree of  health technology assessment ,Building capacities for health technology assessment through education in major universities of the country.Conclusion: pay attention to health technology assessment, selection and application of proper technologies in the frameworks of policy-making and managerial strategies and make efforts to develop it with the support of the governmental in Iran is necessary.

  20. Health economics and outcomes methods in risk-based decision-making for blood safety

    NARCIS (Netherlands)

    Custer, Brian; Janssen, Mart P.

    2015-01-01

    Analytical methods appropriate for health economic assessments of transfusion safety interventions have not previously been described in ways that facilitate their use. Within the context of risk-based decision-making (RBDM), health economics can be important for optimizing decisions among competing

  1. Health Economics and the Management of Degenerative Cervical Myelopathy.

    Science.gov (United States)

    Witiw, Christopher D; Smieliauskas, Fabrice; Fehlings, Michael G

    2018-01-01

    Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord impairment worldwide. Surgical intervention has been demonstrated to be effective and is becoming standard of care. Spine surgery, however, is costly and value needs to be demonstrated. This review serves to summarize the key health economic concepts as they relate to the assessment of the value of surgery for DCM. This is followed by a discussion of current health economic research on DCM, which suggests that surgery is likely to be cost effective. The review concludes with a summary of future questions that remain unanswered, such as which patient subgroups derive the most value from surgery and which surgical approaches are the most cost effective. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Pronk, Nicolaas P.

    2014-01-01

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

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

    Science.gov (United States)

    Blum, R

    1999-01-01

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

  4. (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...

  5. 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

  6. 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.

  7. Economic impacts assessment of pleuropneumonia burden and ...

    African Journals Online (AJOL)

    Contagious bovine pleuropneumonia (CBPP) is a trans-boundary infectious and contagious respiratory disease of cattle caused by Mycoplasma mycoides subsp. mycoides. It is a disease of high economic importance because of its ability to compromise food security. Information on its economic burden in pastoral cattle ...

  8. Socio-economic status of Ghanians of Subsaharan Africa assessed ...

    African Journals Online (AJOL)

    Socio-economic status of Ghanians of Subsaharan Africa assessed by subjective perception as against objective criteria: methodological considerations. The Mamprobi (Ghana) Cardiovascular Helath Programme 1975-1980.

  9. [Measurement and health economic evaluation of informal care].

    Science.gov (United States)

    Zrubka, Zsombor

    2017-09-01

    Informal care is non-financed care outside the realm of formal healthcare, which represents an increasing challenge for aging societies. Informal care has frequently been neglected in health economic analyses, while in recent years its coverage has increased considerably in the international scientific literature. This review summarizes the methodology of the health-economic assessment of informal care, including the objective and subjective metrics of caregiver burden, its financial and non-financial valuation and practical applications, with special emphasis on the introduction of care-related quality of life instruments (e.g. Care Related Quality of Life - CarerQoL instrument). Care-related quality of life is a different entity from health-related quality of life, the two cannot be combined, so their joint evaluation requires multi-criteria decision analysis methods. Therefore, it is important to determine the societal preferences of care-related quality of life versus health-related quality of life, and map the relationship of care-related quality of life with time. The local validation of tools measuring care-related quality of life, its more widespread practical application and the analysis of its effect on decision making are also important part of the future research agenda. Orv Hetil. 2017; 158(35): 1363-1372.

  10. Health economics in haemophilia: a review from the clinician's perspective.

    Science.gov (United States)

    Escobar, M A

    2010-05-01

    Health economic evaluations provide valuable information for healthcare providers, facilitating the treatment decision-making process in a climate where demand for healthcare exceeds the supply. Although an uncommon disease, haemophilia is a life-long condition that places a considerable burden on patients, healthcare systems and society. This burden is particularly large for patients with haemophilia with inhibitors, who can develop serious bleeding complications unresponsive to standard factor replacement therapies. Hence, bleeding episodes in these patients are treated with bypassing agents such as recombinant activated FVII (rFVIIa) and plasma-derived activated prothrombin complex concentrates (pd-APCC). With the efficacy of these agents now well established, a number of health economic studies have been conducted to compare their cost-effectiveness for the on-demand treatment of bleeding episodes in haemophiliacs with inhibitors. In a cost-utility analysis, which assesses the effects of treatment on quality of life (QoL) and quantity of life, the incremental cost per quality-adjusted life-year (QALY) gained (US $44,834) indicated that rFVIIa was cost-effective. Similarly, eight of 11 other economic modelling evaluations found that rFVIIa was more cost-effective than pd-APCC in the on-demand treatment of bleeding episodes. These findings indicate that treating patients with haemophilia promptly and with the most effective therapy available may result in cost savings.

  11. 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)

    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

  12. 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

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

    Science.gov (United States)

    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.

  14. 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:

  15. 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...

  16. Methodology of Economic Assessment of Corporate Finance Management Effectiveness

    OpenAIRE

    Juscu Nicolae Cristian

    2011-01-01

    “The methodology of economic assessment of corporate finance management effectiveness” deals with the analysis of the basic issues of economic aspects of corporate finance management effectiveness; the paper presents the essential issues of the existing methods for establishing the economic effectiveness of corporate finance management and control; it also proposes the improvement of the approach regarding the assessment of finance management effectiveness of a company.

  17. Economic assessment of plutonium recycle to LWRs

    International Nuclear Information System (INIS)

    1979-02-01

    This paper presents an economic evaluation of plutonium recycle in LWR's using published estimates of the cost of the various fuel cycle operations. Total, discounted and levelized fuel cycle costs are computed for four national nuclear power growth pattern scenarios; ''super large'' (>100GW(e) by 2000), ''large'' (60-70GW(e) by 2000) ''medium'' (20-25 GW(e) by 2000) and ''small'' (5-10GW(e) by 2000). It is concluded that in the ''super-large'' and ''large'' cases recycle of uranium and plutonium would have a slight economic advantage over the once-through cycle. In the ''medium'' and ''small'' cases there would be no economic advantage up to the year 2000. The uncertainty in unit fuel cycle costs is large compared with the differences between the two fuel cycles and different conclusions can easily be drawn based on different unit cost assumptions

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

    Science.gov (United States)

    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.

  19. A framework for including family health spillovers in economic evaluation

    NARCIS (Netherlands)

    H. Al-Janabi (Hareth); N.J.A. van Exel (Job); W.B.F. Brouwer (Werner); J. Coast (Joanna)

    2016-01-01

    textabstractHealth 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

  20. Presenting of a material exposure health risk assessment model in Oil and Gas Industries (case study: Pars Economic and Energy Region)

    OpenAIRE

    M. Heydari; M. Omidvari; I. M. Fam

    2014-01-01

    Introduction: One of the most important threats for employees working in chemical industries is exposing to the chemical materials. Lack of precaution and control regulations during working with chemicals can have irreparable consequences. So, in order to achieve an effective control program, it is necessary to have an appropriate assessment of the procedures involving exposure to the chemicals. William-fine method can provide an acceptable insight into hazard risk rate. . Material...

  1. 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 ...

  2. Public health and economic impact of dampness and mold

    Energy Technology Data Exchange (ETDEWEB)

    Mudarri, David; Fisk, William J.

    2007-06-01

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

  3. 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...

  4. Management system of organizational and economic changes in health services

    Directory of Open Access Journals (Sweden)

    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

  5. Housing improvements for health and associated socio-economic outcomes.

    Science.gov (United States)

    Thomson, Hilary; Thomas, Sian; Sellstrom, Eva; Petticrew, Mark

    2013-02-28

    The well established links between poor housing and poor health indicate that housing improvement may be an important mechanism through which public investment can lead to health improvement. Intervention studies which have assessed the health impacts of housing improvements are an important data resource to test assumptions about the potential for health improvement. Evaluations may not detect long term health impacts due to limited follow-up periods. Impacts on socio-economic determinants of health may be a valuable proxy indication of the potential for longer term health impacts. To assess the health and social impacts on residents following improvements to the physical fabric of housing. Twenty seven academic and grey literature bibliographic databases were searched for housing intervention studies from 1887 to July 2012 (ASSIA; Avery Index; CAB Abstracts; The Campbell Library; CINAHL; The Cochrane Library; COPAC; DH-DATA: Health Admin; EMBASE; Geobase; Global Health; IBSS; ICONDA; MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; NTIS; PAIS; PLANEX; PsycINFO; RIBA; SCIE; Sociological Abstracts; Social Science Citations Index; Science Citations Index expanded; SIGLE; SPECTR). Twelve Scandinavian grey literature and policy databases (Libris; SveMed+; Libris uppsök; DIVA; Artikelsök; NORART; DEFF; AKF; DSI; SBI; Statens Institut for Folkesundhed; Social.dk) and 23 relevant websites were searched. In addition, a request to topic experts was issued for details of relevant studies. Searches were not restricted by language or publication status. Studies which assessed change in any health outcome following housing improvement were included. This included experimental studies and uncontrolled studies. Cross-sectional studies were excluded as correlations are not able to shed light on changes in outcomes. Studies reporting only socio-economic outcomes or indirect measures of health, such as health service use, were excluded. All housing improvements which

  6. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  10. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  13. Status report on education in the economics of animal health: results from a European survey.

    Science.gov (United States)

    Waret-Szkuta, Agnès; Raboisson, Didier; Niemi, Jarkko; Aragrande, Maurizio; Gethmann, Jörn; Martins, Sara Babo; Hans, Lucie; Höreth-Böntgen, Detlef; Sans, Pierre; Stärk, Katharina D; Rushton, Jonathan; Häsler, Barbara

    2015-01-01

    Education on the use of economics applied to animal health (EAH) has been offered since the 1980s. However, it has never been institutionalized within veterinary curricula, and there is no systematic information on current teaching and education activities in Europe. Nevertheless, the need for economic skills in animal health has never been greater. Economics can add value to disease impact assessments; improve understanding of people's incentives to participate in animal health measures; and help refine resource allocation for public animal health budgets. The use of economics should improve animal health decision making. An online questionnaire was conducted in European countries to assess current and future needs and expectations of people using EAH. The main conclusion from the survey is that education in economics appears to be offered inconsistently in Europe, and information about the availability of training opportunities in this field is scarce. There is a lack of harmonization of EAH education and significant gaps exist in the veterinary curricula of many countries. Depending on whether respondents belonged to educational institutions, public bodies, or private organizations, they expressed concerns regarding the limited education on decision making and impact assessment for animal diseases or on the use of economics for general management. Both public and private organizations recognized the increasing importance of EAH in the future. This should motivate the development of teaching methods and materials that aim at developing the understanding of animal health problems for the benefit of students and professional veterinarians.

  14. 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

  15. African Health Economics and Policy Research Capacity Building ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    African Health Economics and Policy Research Capacity Building and Dissemination. As African countries move toward universal health coverage, it is clear there is a shortage of African experts with applied research skills in health financing such as fiscal space analysis, needs-based resource allocation methods, and ...

  16. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

    Mannheimer, L N; Gulis, G; Lehto, J

    2007-01-01

    health status of the population. There was a lack of multi-intersectoral knowledge, co-operation and function between sectors and actors. Enablers on the other hand were the membership of international organizations which called for new solutions, and the strong political commitment and belief...... used by which the actual problems, the governmental actions (or non-actions) (politics) and the understanding, implementation and evaluation of the initiative (policy) could be analysed. All actors involved, civil servants, politicians, representatives of the local public health institute...

  17. The economic value of improving the health of disadvantaged Americans.

    Science.gov (United States)

    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.

  18. Health effects assessment summary tables

    International Nuclear Information System (INIS)

    1999-01-01

    The document is an excellent pointer system to identify current literature or changes in assessment criteria for many chemicals of interest to Superfund. It was prepared for Superfund use by the Environmental Criteria and Assessment Office (ECAO-Cin) in EPA's Office of Health and Environmental Assessment. Chemicals considered are those for which Health Effects Assessment Documents, Health and Environmental Effects Profiles, Health Assessment Documents or Air Quality Criteria Documents have been prepared by ECAO. Radionuclides considered are those believed to be most common at Superfund sites. Tables summarize reference doses (RfDs) for toxicity from subchronic and chronic inhalation, oral exposure, slope factors and unit risk values for carcinogenicity based on lifetime inhalation and oral exposure, and radionuclide carcinogenicity

  19. Health and economic growth in South East, Nigeria | Umezinwa ...

    African Journals Online (AJOL)

    African Research Review ... In the South eastern states of Nigeria, health cannot be said to be making any significant impact in economic growth. ... There will be a meaningful economic improvement if ever there is a combined proactive engagement in healthcare delivery by the state governments and the citizens.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    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.

  2. An economic assessment of contemporary kidney transplant practice.

    Science.gov (United States)

    Axelrod, David A; Schnitzler, Mark A; Xiao, Huiling; Irish, William; Tuttle-Newhall, Elizabeth; Chang, Su-Hsin; Kasiske, Bertram L; Alhamad, Tarek; Lentine, Krista L

    2018-05-01

    Kidney transplantation is the optimal therapy for end-stage renal disease, prolonging survival and reducing spending. Prior economic analyses of kidney transplantation, using Markov models, have generally assumed compatible, low-risk donors. The economic implications of transplantation with high Kidney Donor Profile Index (KDPI) deceased donors, ABO incompatible living donors, and HLA incompatible living donors have not been assessed. The costs of transplantation and dialysis were compared with the use of discrete event simulation over a 10-year period, with data from the United States Renal Data System, University HealthSystem Consortium, and literature review. Graft failure rates and expenditures were adjusted for donor characteristics. All transplantation options were associated with improved survival compared with dialysis (transplantation: 5.20-6.34 quality-adjusted life-years [QALYs] vs dialysis: 4.03 QALYs). Living donor and low-KDPI deceased donor transplantations were cost-saving compared with dialysis, while transplantations using high-KDPI deceased donor, ABO-incompatible or HLA-incompatible living donors were cost-effective (<$100 000 per QALY). Predicted costs per QALY range from $39 939 for HLA-compatible living donor transplantation to $80 486 for HLA-incompatible donors compared with $72 476 for dialysis. In conclusion, kidney transplantation is cost-effective across all donor types despite higher costs for marginal organs and innovative living donor practices. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

  3. Socio-economic Factors and Residents' Health in Nigeria Urban ...

    African Journals Online (AJOL)

    The study then suggested the introduction of standard yardstick policy, which could be used to measure socio-economic status of residents in relation to their health status determinants in this country. African Research Review Vol. 2 (3) 2008: pp.

  4. Health Impact Assessment: Linking Public Health to ...

    Science.gov (United States)

    The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substances Control. Presented the Health Impact Assessment (HIA) at the State of California Cumulative Impacts and Community Vulnerability Symposium on July 27 in Diamond Bar, CA.

  5. [Systematic economic assessment and quality evaluation for traditional Chinese medicines].

    Science.gov (United States)

    Sun, Xiao; Guo, Li-ping; Shang, Hong-cai; Ren, Ming; Lei, Xiang

    2015-05-01

    To learn about the economic studies on traditional Chinese medicines in domestic literatures, in order to analyze the current economic assessment of traditional Chinese medicines and explore the existing problems. Efforts were made to search CNKI, VIP, Wanfang database and CBM by computer and include all literatures about economic assessment of traditional Chinese medicines published on professional domestic journals in the systematic assessment and quality evaluation. Finally, 50 articles were included in the study, and the systematic assessment and quality evaluation were made for them in terms of titles, year, authors' identity, expense source, disease type, study perspective, study design type, study target, study target source, time limit, cost calculation, effect indicator, analytical technique and sensitivity analysis. The finally quality score was 0.74, which is very low. The results of the study showed insufficient studies on economics of traditional Chinese medicines, short study duration and simple evaluation methods, which will be solved through unremitting efforts in the future.

  6. economic assessment of the performance of private sector ...

    African Journals Online (AJOL)

    Admin

    Economic and Extension, Delta State University, Asaba Campus, Nigeria ... This paper critically attempts to assess the performance of the private sector ... economy would depend to a large extent on the quantity ..... New York, USA: McGraw.

  7. Health impact assessment in Korea

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  8. Climate Change, Economic Growth, and Health

    NARCIS (Netherlands)

    Ikefuji, M.; Magnus, J.R.; Sakamoto, H.

    2010-01-01

    This paper studies the interplay between climate, health, and the economy in a stylized world with four heterogeneous regions, labeled ‘West’ (cold and rich), ‘China’ (cold and poor), ‘India’ (warm and poor), and ‘Africa’ (warm and very poor). We introduce health impacts into a simple integrated

  9. Metro nature, environmental health, and economic value

    Science.gov (United States)

    Kathleen L. Wolf; Alicia S.T. Robbins

    2015-01-01

    Background: Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities.Objectives: We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes,...

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

    Directory of Open Access Journals (Sweden)

    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

  11. 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

  12. 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...

  13. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

    Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency,...... findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.......Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency......, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA...

  14. Economic and Managerial Approach of Health Insurances

    Directory of Open Access Journals (Sweden)

    Marinela BOBOC

    2005-10-01

    Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizes the necessity and the opportunity ofcreating in Romania a medical service market based on the competing system. In Romania, the social insurances for health care are at their verybeginning. The development of the domain of the private insurances for health care is prevented even by its legislation, due to the lack of a normativeact that may regulate the management of the private insurances for health care. The establishment of the legislation related to the optional insurancesfor health care might lead to some activity norms for the companies which carry out optional insurances for health care. The change of the legislationis made in order to create normative and financial opportunities for the development of the optional medical insurances. This change, as part of thesocial protection of people, will positively influence the development of the medical insurance system. The extension of the segment of the optionalinsurances into the medical insurance segment increases the health protection budget with the value of the financial sources which do not belong tothe budgetary funds.

  15. ECONOMIC AND MANAGERIAL APPROACH OF HEALTH INSURANCES

    Directory of Open Access Journals (Sweden)

    Georgeta Dragomir

    2007-05-01

    Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizesthe necessity and the opportunity of creating in Romania a medical service market based on the competingsystem. In Romania, the social insurances for health care are at their very beginning. The development of thedomain of the private insurances for health care is prevented even by its legislation, due to the lack of anormative act that may regulate the management of the private insurances for health care. The establishment ofthe legislation related to the optional insurances for health care might lead to some activity norms for thecompanies which carry out optional insurances for health care. The change of the legislation is made in order tocreate normative and financial opportunities for the development of the optional medical insurances. Thischange, as part of the social protection of people, will positively influence the development of the medicalinsurance system. The extension of the segment of the optional insurances into the medical insurance segmentincreases the health protection budget with the value of the financial sources which do not belong to thebudgetary funds.

  16. 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.

  17. Health, social and economic consequences of hypersomnia

    DEFF Research Database (Denmark)

    Jennum, Poul; Ibsen, Rikke; Avlund, Kirsten

    2014-01-01

    with hypersomnia had significantly higher rates of health-related contact, medication use and socioeconomic cost. Furthermore, they had slightly lower employment rates, and those in employment had a lower income level than control subjects. The annual mean excess health-related cost including social transfers...... was 3,498 for patients with hypersomnia and 3,851 for their partners. The social and health-related consequences could be identified up to 11 years before the first diagnosis among both the patients and their partners and became more pronounced as the disease advanced. The health effects were......, including frequencies of primary and sector contacts and procedures, medication, labour supply and social transfer payments were extracted from the national databases. A total of 2,855 national patients was compared to 11,382 controls. About 70 % of patients and controls were married or cohabiting. Patients...

  18. [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.

  19. [Economic problems in military public health].

    Science.gov (United States)

    Petrov, G M; Moretskiĭ, A A

    2000-03-01

    There are discussed the problems of military treatment and prophylactic institution (TPI) functioning under conditions of market reform of Russian public health. Main marketing concepts in military health are determined and some recommendations on work improvement in TPI of the Armed Forces in the system of obligatory medical insurance are presented, granting population paid medical services. It is necessary to form a new type of director--military and medical manager.

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

    Science.gov (United States)

    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.

  1. An Assessment of Economic Stability under the New European Economic Governance

    Directory of Open Access Journals (Sweden)

    Gheorghe HURDUZEU

    2015-06-01

    Full Text Available The economic crisis, followed by the sovereign debt crisis, resulted in high unemployment, unsustainable public finances and deepening disparities between Euro Area member states, and underlined the necessity of strengthening economic coordination. In order to lessen the effects of the crises, to prevent further deepening of the economic context and the appearance of new similar situations, the European framework was improved by the provisions of the new economic governance. The aim of this paper is to assess the effects regarding macroeconomic stability within Euro Area member states, achieved under the new economic governance framework. In this respect, the first part of the paper consists in an overview of the provisions imposed through the European Semester, the reformed Stability and Growth Pact and the other elements of the new European governance. In order to assess the achievement of economic stability we analyzed data for Southern Euro Area member states, during 2009-2013, as this group of countries registered most issues during 2013. We took into consideration five important indicators, essential in any economy that form the macroeconomic stability pentagon: economic growth rate, unemployment rate, inflation rate, budgetary balance and current account balance. By comparing the area obtained through the macroeconomic stability pentagon, we conclude on meeting one of the main objectives of the new European governance: economic stability.

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

    Science.gov (United States)

    Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

    2013-01-01

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

  3. Social capital, economics, and health: new evidence.

    Science.gov (United States)

    Scheffler, Richard M; Brown, Timothy T

    2008-10-01

    In introducing this Special Issue on Social Capital and Health, this article tracks the popularization of the term and sheds light on the controversy surrounding the term and its definitions. It sets out four mechanisms that link social capital with health: making information available to community members, impacting social norms, enhancing the health care services and their accessibility in a community, and offering psychosocial support networks. Approaches to the measurement of social capital include the Social Capital Community Benchmark Survey (SCCBS) developed by Robert Putnam, and the Petris Social Capital Index (PSCI), which looks at community voluntary organizations using public data available for the entire United States. The article defines community social capital (CSC) as the extent and density of trust, cooperation, and associational links and activity within a given population. Four articles on CSC are introduced in two categories: those that address behaviors -- particularly utilization of health services and use of tobacco, alcohol, and drugs; and those that look at links between social capital and physical or mental health. Policy implications include: funding and/or tax subsidies that would support the creation of social capital; laws and regulations; and generation of enthusiasm among communities and leaders to develop social capital. The next steps in the research programme are to continue testing the mechanisms; to look for natural experiments; and to find better public policies to foster social capital.

  4. An Attempt to Assess the Quantitative Impact of Institutions on Economic Growth and Economic Development

    Directory of Open Access Journals (Sweden)

    Próchniak Mariusz

    2014-10-01

    Full Text Available This study aims at assessing to what extent institutional environment is responsible for worldwide differences in economic growth and economic development. To answer this question, we use an innovative approach based on a new concept of the institutions-augmented Solow model which is then estimated empirically using regression equations. The analysis covers 180 countries during the 1993-2012 period. The empirical analysis confirms a large positive impact of the quality of institutional environment on the level of economic development. The positive link has been evidenced for all five institutional indicators: two indices of economic freedom (Heritage Foundation and Fraser Institute, the governance indicator (World Bank, the democracy index (Freedom House, and the EBRD transition indicator for post-socialist countries. Differences in physical capital, human capital, and institutional environment explain about 70-75% of the worldwide differences in economic development. The institutions-augmented Solow model, however, performs slightly poorer in explaining differences in the rates of economic growth: only one institutional variable (index of economic freedom has a statistically significant impact on economic growth. In terms of originality, this paper extends the theoretical analysis of the Solow model by including institutions, on the one hand, and shows a comprehensive empirical analysis of the impact of various institutional indicators on both the level of development and the pace of economic growth, on the other. The results bring important policy implications.

  5. Economic transition and health transition: comparing China and Russia.

    Science.gov (United States)

    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.

  6. Health economic aspects of vertebral augmentation procedures.

    Science.gov (United States)

    Borgström, F; Beall, D P; Berven, S; Boonen, S; Christie, S; Kallmes, D F; Kanis, J A; Olafsson, G; Singer, A J; Åkesson, K

    2015-04-01

    We reviewed all peer-reviewed papers analysing the cost-effectiveness of vertebroplasty and balloon kyphoplasty for osteoporotic vertebral compression fractures. In general, the procedures appear to be cost effective but are very dependent upon model input details. Better data, rather than new models, are needed to answer outstanding questions. Vertebral augmentation procedures (VAPs), including vertebroplasty (VP) and balloon kyphoplasty (BKP), seek to stabilise fractured vertebral bodies and reduce pain. The aim of this paper is to review current literature on the cost-effectiveness of VAPs as well as to discuss the challenges for economic evaluation in this research area. A systematic literature search was conducted to identify existing published studies on the cost-effectiveness of VAPs in patients with osteoporosis. Only peer-reviewed published articles that fulfilled the criteria of being regarded as full economic evaluations including both morbidity and mortality in the outcome measure in the form of quality-adjusted life years (QALYs) were included. The search identified 949 studies, of which four (0.4 %) were identified as relevant with one study added later. The reviewed studies differed widely in terms of study design, modelling framework and data used, yielding different results and conclusions regarding the cost-effectiveness of VAPs. Three out of five studies indicated in the base case results that VAPs were cost effective compared to non-surgical management (NSM). The five main factors that drove the variations in the cost-effectiveness between the studies were time horizon, quality of life effect of treatment, offset time of the treatment effect, reduced number of bed days associated with VAPs and mortality benefit with treatment. The cost-effectiveness of VAPs is uncertain. In answering the remaining questions, new cost-effectiveness analysis will yield limited benefit. Rather, studies that can reduce the uncertainty in the underlying data

  7. Economic reforms and health insurance in China.

    Science.gov (United States)

    Du, Juan

    2009-08-01

    During the 1990s, Chinese state-owned enterprises (SOEs) and collective enterprises continually decreased coverage of public health insurance to their employees. This paper investigates this changing pattern of health insurance coverage in China using panel data from the China Nutrition and Health Survey (1991-2000). It is the first attempt in this literature that tries to identify precisely the effects of specific policies and reforms on health insurance coverage in the transitional period of China. The fixed effects linear model clustering at the province level is used for estimation, and results are compared to alternative models, including pooled OLS, random effects GLS model and fixed effects logit model. Strong empirical evidence is found that unemployment as a side effect of the Open Door Policy, and the deregulation of SOE and collective enterprises were the main causes for the decreasing trend. For example, urban areas that were highly affected by the Open Door Policy were associated with 17 percentage points decrease in the insurance coverage. Moreover, I found evidence that the gaps between SOE and non-SOE employees, collective and non-collective employees, urban and rural employees have considerably decreased during the ten years.

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

    Science.gov (United States)

    2011-09-01

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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Staats, Susan; Robertson, Douglas

    2009-01-01

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

  11. An economic perspective on oceans and human health

    NARCIS (Netherlands)

    Legat, Audrey; French, Veronica; McDonough, Niall

    2016-01-01

    Human health and wellbeing are intrinsically connected to our seas and oceans through a complex relationship comprising both positive and negative influences. Although significant public health impacts result from this relationship, the economic implications are rarely analysed. We reviewed the

  12. Research Ideas for the Journal of Health & Medical Economics: Opinion

    NARCIS (Netherlands)

    C-L. Chang (Chia-Lin); M.J. McAleer (Michael)

    2015-01-01

    textabstractThe purpose of this Opinion article is to discuss some ideas that might lead to papers that are suitable for publication in the Journal of Health and Medical Economics. The suggestions include the affordability and sustainability of universal health care insurance, monitoring and

  13. Emotional responses to behavioral economic incentives for health behavior change

    NARCIS (Netherlands)

    van der Swaluw, Koen; Lambooij, Mattijs S.; Mathijssen, Jolanda J.P.; Zeelenberg, Marcel; Polder, Johan J.; Prast, Henriëtte M.

    2018-01-01

    Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals

  14. Emotional Responses to Behavioral Economic Incentives for Health Behavior Change

    NARCIS (Netherlands)

    van der Swaluw, Koen; Lambooij, Mattijs S; Mathijssen, Jolanda; Zeelenberg, Marcel; Polder, Johan; Prast, Henriette

    2018-01-01

    Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals

  15. Elements for a comprehensive assessment of natural resources: bridging environmental economics with ecological economics

    International Nuclear Information System (INIS)

    Rodriguez Romero, Paulo Cesar; Cubillos Gonzalez, Alexander

    2012-01-01

    The predominance of economic assessments regarding the value of natural resources has caused a sub-valuing of the real benefits which societies can obtain from nature. This is due to a lack of knowledge about the complexity of ecological functions, as well as a dismissal of the integrated relations of the sub-systems which make up the environment. It is therefore necessary to establish conceptual bridges between environmental sciences to fill in the gaps in economic valuation methods by recurring to diverse measuring scales, participation from the different actors involved, and a principle of precaution regarding the limits of nature. This paper explores the concepts of value and economic valuation methods from the perspectives of Environmental Economics and Ecological Economics. It then proposes an integration of valuing methodologies which take into account how complementary and complex natures value relations are. This proposal of valuing integrally ecosystem goods and services contributes to adjusting political decisions more accordingly to real environmental conditions.

  16. Linking Physical Climate Research and Economic Assessments of Mitigation Policies

    Science.gov (United States)

    Stainforth, David; Calel, Raphael

    2017-04-01

    Evaluating climate change policies requires economic assessments which balance the costs and benefits of climate action. A certain class of Integrated Assessment Models (IAMS) are widely used for this type of analysis; DICE, PAGE and FUND are three of the most influential. In the economics community there has been much discussion and debate about the economic assumptions implemented within these models. Two aspects in particular have gained much attention: i) the costs of damages resulting from climate change - the so-called damage function, and ii) the choice of discount rate applied to future costs and benefits. There has, however, been rather little attention given to the consequences of the choices made in the physical climate models within these IAMS. Here we discuss the practical aspects of the implementation of the physical models in these IAMS, as well as the implications of choices made in these physical science components for economic assessments[1]. We present a simple breakdown of how these IAMS differently represent the climate system as a consequence of differing underlying physical models, different parametric assumptions (for parameters representing, for instance, feedbacks and ocean heat uptake) and different numerical approaches to solving the models. We present the physical and economic consequences of these differences and reflect on how we might better incorporate the latest physical science understanding in economic models of this type. [1] Calel, R. and Stainforth D.A., "On the Physics of Three Integrated Assessment Models", Bulletin of the American Meteorological Society, in press.

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

    Science.gov (United States)

    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.

  18. NEW INSTITUTIONAL ECONOMICS FRAMEWORK FOR ASSESSING AND IMPROVING AGRARIAN ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    H. Bachev

    2013-08-01

    Full Text Available We incorporate interdisciplinary New Institutional and Transaction Costs Economics and suggest a framework for assessing efficiency of farms and agrarian organizations. Our new approach includes: study of farm and agrarian organizations as governing rather than production structure; assessment of comparative efficiency of alternative market, contract, internal, and hybrid modes of governance; analysis of level of transaction costs and their institutional, behavioral, dimensional, technological and natural factors; determination of criteria of farm efficiency and its effective boundaries; specification of economic role of government and needs for public interventions in agrarian sector; assessment of comparative efficiency of alternative forms of public involvement.

  19. Health, social and economic consequences of dementias

    DEFF Research Database (Denmark)

    Frahm-Falkenberg, S.; Ibsen, Rikke; Kjellberg, J.

    2016-01-01

    Background and purpose: Dementia causes morbidity, disability and mortality, and as the population ages the societal burden will grow. The direct health costs and indirect costs of lost productivity and social welfare of dementia were estimated compared with matched controls in a national register......, gender, geographical area and civil status. Direct health costs included primary and secondary sector contacts, medical procedures and medication. Indirect costs included the effect on labor supply. All cost data were extracted from national databases. The entire cohort was followed for the entire period...... – before and after diagnosis. Results: In all, 78 715 patients were identified and compared with 312 813 matched controls. Patients' partners were also identified and matched with a control group. Patients had lower income and higher mortality and morbidity rates and greater use of medication. Social...

  20. Child Health and Economic Crisis in Peru

    OpenAIRE

    Paxson, Christina; Schady, Norbert

    2005-01-01

    The effect of macroeconomic crises on child health is a topic of great policy importance. This article analyzes the impact of a profound crisis in Peru on infant mortality. It finds an increase of about 2.5 percentage points in the infant mortality rate for children born during the crisis of the late 1980s, which implies that about 17,000 more children died than would have in the absence o...

  1. [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.

  2. A study of the relationship between infectious diseases and health economics: some evidences from Nepal

    Directory of Open Access Journals (Sweden)

    Shiva Raj Adhikari

    2016-06-01

    Full Text Available Objective: To measure the effectiveness of short term trainings in improving knowledge of health economics and application of economic way of thinking in policy research. Methods: The training focused to strengthen the capacity of public health practitioners to design and implement health policy and programmes especially for infectious diseases from health system and economic perspectives. We focused to measure the effects of gaining knowledge to understand the relationship between infectious diseases and poverty and to adopt a logical way of thinking to come up with a solution. This approach used in this paper to measure the “reflection” of the training is different from conventional way of evaluating training programmes. The effectiveness of the training was measured in three dimensions: (i general understanding of economics from health policy perspective; (ii application of economic analysis and appraisal tools and techniques; and (iii economic way of thinking for issues related to disease control and poverty. Results: There was a significant improvement in self-assessed knowledge after the training. Among seven knowledge related questions, in the pre-test, an average participant made 86% correct answers while in post-test, this figure increased to 100%. The results showed that there is a significant improvement in these three dimensions after the training intervention. Conclusions: The paper concluded that endogenizing knowledge of economics and way of thinking have important implications for designing alternative policy and resource utilization.

  3. 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.

  4. 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.

  5. Overcoming barriers to integrating economic analysis into risk assessment.

    Science.gov (United States)

    Hoffmann, Sandra

    2011-09-01

    Regulatory risk analysis is designed to provide decisionmakers with a clearer understanding of how policies are likely to affect risk. The systems that produce risk are biological, physical, and social and economic. As a result, risk analysis is an inherently interdisciplinary task. Yet in practice, risk analysis has been interdisciplinary in only limited ways. Risk analysis could provide more accurate assessments of risk if there were better integration of economics and other social sciences into risk assessment itself. This essay examines how discussions about risk analysis policy have influenced the roles of various disciplines in risk analysis. It explores ways in which integrated bio/physical-economic modeling could contribute to more accurate assessments of risk. It reviews examples of the kind of integrated economics-bio/physical modeling that could be used to enhance risk assessment. The essay ends with a discussion of institutional barriers to greater integration of economic modeling into risk assessment and provides suggestions on how these might be overcome. © 2011 Society for Risk Analysis.

  6. Social, Economic, and Health Disparities Among LGBT Older Adults.

    Science.gov (United States)

    Emlet, Charles A

    2016-01-01

    LGBT older adults are a heterogeneous population with collective and unique strengths and challenges. Health, personal, and economic disparities exist in this group when compared to the general population of older adults, yet subgroups such as transgender and bisexual older adults and individuals living with HIV are at greater risk for disparities and poorer health outcomes. As this population grows, further research is needed on factors that contribute to promoting health equity, while decreasing discrimination and improving competent service delivery.

  7. Assessing Your Weight and Health Risk

    Science.gov (United States)

    ... Health Professional Resources Assessing Your Weight and Health Risk Assessment of weight and health risk involves using ... risk for developing obesity-associated diseases or conditions. Risk Factors for Health Topics Associated With Obesity Along ...

  8. Economic assessment model architecture for AGC/AVLIS selection

    International Nuclear Information System (INIS)

    Hoglund, R.L.

    1984-01-01

    The economic assessment model architecture described provides the flexibility and completeness in economic analysis that the selection between AGC and AVLIS demands. Process models which are technology-specific will provide the first-order responses of process performance and cost to variations in process parameters. The economics models can be used to test the impacts of alternative deployment scenarios for a technology. Enterprise models provide global figures of merit for evaluating the DOE perspective on the uranium enrichment enterprise, and business analysis models compute the financial parameters from the private investor's viewpoint

  9. Public health policy decisions on medical innovations: what role can early economic evaluation play?

    Science.gov (United States)

    Hartz, Susanne; John, Jürgen

    2009-02-01

    Our contribution aims to explore the different ways in which early economic data can inform public health policy decisions on new medical technologies. A literature research was conducted to detect methodological contributions covering the health policy perspective. Early economic data on new technologies can support public health policy decisions in several ways. Embedded in horizon scanning and HTA activities, it adds to monitoring and assessment of innovations. It can play a role in the control of technology diffusion by informing coverage and reimbursement decisions as well as the direct public promotion of healthcare technologies, leading to increased efficiency. Major problems include the uncertainty related to economic data at early stages as well as the timing of the evaluation of an innovation. Decision-makers can benefit from the information supplied by early economic data, but the actual use in practice is difficult to determine. Further empirical evidence should be gathered, while the use could be promoted by further standardization.

  10. Methods of Economic Valuation of The Health Risks Associated with Nanomaterials

    Science.gov (United States)

    Shalhevet, S.; Haruvy, N.

    The worldwide market for nanomaterials is growing rapidly, but relatively little is still known about the potential risks associated with these materials. The potential health hazards associated with exposure to nanomaterials may lead in the future to increased health costs as well as increased economic costs to the companies involved, as has happened in the past in the case of asbestos. Therefore, it is important to make an initial estimate of the potential costs associated with these health hazards, and to prepare ahead with appropriate health insurance for individuals and financial insurance for companies. While several studies have examined the environmental and health hazards of different nanomaterials by performing life cycle impact assessments, so far these studies have concentrated on the cost of production, and did not estimate the economic impact of the health hazards. This paper discusses methods of evaluating the economic impact of potential health hazards on the public. The proposed method is based on using life cycle impact assessment studies of nanomaterials to estimate the DALYs (Disability Adjusted Life Years) associated with the increased probability of these health hazards. The economic valuation of DALY's can be carried out based on the income lost and the costs of medical treatment. The total expected increase in cost depends on the increase in the statistical probability of each disease.

  11. Economic Techniques of Occupational Health and Safety Management

    Science.gov (United States)

    Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.

    2016-10-01

    The article deals with the issues on economic techniques of occupational health and safety management. Authors’ definition of safety management is given. It is represented as a task-oriented process to identify, establish and maintain such a state of work environment in which there are no possible effects of hazardous and harmful factors, or their influence does not go beyond certain limits. It was noted that management techniques that are the part of the control mechanism, are divided into administrative, organizational and administrative, social and psychological and economic. The economic management techniques are proposed to be classified depending on the management subject, management object, in relation to an enterprise environment, depending on a control action. Technoeconomic study, feasibility study, planning, financial incentives, preferential crediting of enterprises, pricing, profit sharing and equity, preferential tax treatment for enterprises, economic regulations and standards setting have been distinguished as economic techniques.

  12. Health, Social and Economic Consequences of Polyneuropathy

    DEFF Research Database (Denmark)

    Jennum, Poul; Ibsen, Rikke; Kjellberg, Jakob

    2015-01-01

    socioeconomic costs than controls. They had very marginally lower employment rates, and those who were employed generally had lower incomes. The sum of direct net healthcare costs after the injury (general practitioner services, hospital services and medication) and indirect costs (loss of labor market income...... with a diagnosis of polyneuropathy and their partners were identified and compared with randomly chosen controls matched for age, gender, geographic area and civil status. Direct costs included frequencies of primary and secondary sector contacts and procedures, and medication. Indirect costs included the effect...... Danish Patient Registry. In addition, partners of patients in the case group were matched with partners in the corresponding control group. Almost half of the patients in the patient group had a partner. Patients had significantly higher rates of health-related contacts, medication use and greater...

  13. Avances y retos de la economía de la salud Advances and perspectives in health economics

    Directory of Open Access Journals (Sweden)

    Patricia Hernández Peña

    1995-08-01

    Full Text Available La economía de la salud como especialidad, incorpora la perspectiva económica en el campo de la salud, los servicios, y el complejo médico industrial. Se presenta su evolución desde la perspectiva de sus áreas de interés y su consolidación reflejada en la generación, difusión, réplica y aplicación del conocimiento especializado.A economia da saúde incorpora a p8erspectiva econômica no campo da saúde, os serviços e o complexo médico-industrial. Foi apresentada a evolução desse campo, desde a perspectiva das áreas de interesse e os avanços para sua consolidação, partindo dos seguintes aspectos: generação, difusão, réplica e aplicação do conhecimento especializado.Health economics is a specialized field of economic science that applies the economic perspective to the fields of health, the medical-industrial complex and health services. A brief review of the evolution of this speciality by subject, as well as the level achieved assessed in terms of generation, diffusion, reproduction and application of its specialized knowledge, is presented.

  14. 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.

  15. Physiotherapy students’ mental health assessment

    OpenAIRE

    Gesouli-Voltyraki –E.; Charisi E.; Papastergiou D.; Κostopoulou S.; Borou A.; Alverti V.; Avlakiotis K.; Spanos S.

    2012-01-01

    Introduction: Educational environment has a serious impact on students’ mental health. Few data are available on mental health of Physiotherapy students. Aim: The purpose of this study was to assess the mental heath of students in a tertiary Physiotherapy Department during the 3rd years of studies. Material and methods: 80 males and females physiotherapy students of the 5th and 6th semester of a tertiary Physiotherapy Department filled in the GHQ-28 questionnaire. Comparisons between groups w...

  16. [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.

  17. CURRENT ECONOMIC AND MEDICAL REFORMS IN THE ROMANIAN HEALTH CARE SYSTEM

    Directory of Open Access Journals (Sweden)

    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

  18. Integrated environmental and economic assessment of waste management systems

    DEFF Research Database (Denmark)

    Martinez Sanchez, Veronica

    in the “Optimization approach” the scenarios are the results of an optimization process. • The cost approach describes cost principles and level of LCA integration. Conventional and Environmental LCCs are financial assessments, i.e. include marketed goods/services, but while Environmental LCCs include environmental...... assessment of SWM systems alongside environmental impacts assessment to take budget constrains into account. In light of the need for combined environmental and economic assessment of SWM, this PhD thesis developed a consistent and comprehensive method for integrated environmental and economic assessment...... of SWM technologies and systems. The method resulted from developing further the generic Life Cycle Costing (LCC) framework suggested by Hunkeler et al. (2008) and Swarr et al. (2011) to apply it on the field of SWM. The method developed includes: two modelling approaches (Accounting and Optimization...

  19. Knowledge in health technology assessment

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2011-01-01

    Health systems are placing more and more emphasis on designing and delivering services that are focused on the patient, and there is a growing interest in patient aspects of health policy research and health technology assessment (HTA). Only a few HTA agencies use and invest in scientific methods...... to generate knowledge and evidence about the patient aspects of a given technology. This raises questions about how knowledge is produced in HTA reports and what kind of knowledge is considered relevant. This article uses a Danish HTA on patient education from 2009 as empirical material for a critical...

  20. A Systematic Review and Narrative Synthesis of Health Economic Studies Conducted for Hereditary Haemochromatosis.

    Science.gov (United States)

    de Graaff, Barbara; Neil, Amanda; Sanderson, Kristy; Si, Lei; Yee, Kwang Chien; Palmer, Andrew J

    2015-10-01

    Hereditary haemochromatosis (HH) is a common genetic condition amongst people of northern European heritage. HH is associated with increased iron absorption leading to parenchymal organ damage and multiple arthropathies. Early diagnosis and treatment prevents complications. Population screening may increase early diagnosis, but no programmes have been introduced internationally: a paucity of health economic data is often cited as a barrier. To conduct a systematic review of all health economic studies in HH. Studies were identified through electronic searching of economic/biomedical databases. Any study on HH with original economic component was included. Study quality was formally assessed. Health economic data were extracted and analysed through narrative synthesis. Thirty-eight studies met the inclusion criteria. The majority of papers reported on costs or cost effectiveness of screening programmes. Whilst most concluded screening was cost effective compared with no screening, methodological flaws limit the quality of these findings. Assumptions regarding clinical penetrance, effectiveness of screening, health-state utility values (HSUVs), exclusion of early symptomatology (such as fatigue, lethargy and multiple arthropathies) and quantification of costs associated with HH were identified as key limitations. Treatment studies concluded therapeutic venepuncture was the most cost-effective intervention. There is a paucity of high-quality health economic studies relating to HH. The development of a comprehensive HH cost-effectiveness model utilising HSUVs is required to determine whether screening is worthwhile.

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

    Science.gov (United States)

    Lieberthal, Robert D.; Leon, Juan

    2015-01-01

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

  2. Defining health-related quality of life for young wheelchair users: A qualitative health economics study.

    Directory of Open Access Journals (Sweden)

    Nathan Bray

    Full Text Available Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use.The sampling frame was children with impaired mobility (≤18 years who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants' homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life.Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1 participation and positive experiences; 2 self-worth and feeling fulfilled; 3 health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age.Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this

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

    International Nuclear Information System (INIS)

    Pennock, Michael; Ura, Karma

    2011-01-01

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

  4. Health care prices, the federal budget, and economic growth.

    Science.gov (United States)

    Monaco, R M; Phelps, J H

    1995-01-01

    Rising health care spending, led by rising prices, has had an enormous impact on the economy, especially on the federal budget. Our work shows that if rapid growth in health care prices continues, under current institutional arrangements, real economic growth and employment will be lower during the next two decades than if health price inflation were somehow reduced. How big the losses are and which sectors bear the brunt of the costs vary depending on how society chooses to fund the federal budget deficit that stems from the rising cost of federal health care programs.

  5. Quality Assessment of Economic Evaluations of Suicide and Self-Harm Interventions

    DEFF Research Database (Denmark)

    Madsen, Lizell Bustamante; Eddleston, Michael; Hansen, Kristian Schultz

    2018-01-01

    Background: Death following self-harm constitutes a major global public health challenge and there is an urgent need for governments to implement cost-effective, national suicide prevention strategies. Aim: To conduct a systematic review and quality appraisal of the economic evaluations...... of interventions aimed at preventing suicidal behavior. Method: A systematic literature search was performed in several literature databases to identify relevant articles published from 2003 to 2016. Drummond's 10-item appraisal tool was used to assess the methodological quality of the included studies. Results....... The discussion of suicide and self-harm prevention should be as nuanced as possible, including health economics along with cultural, social, and political aspects....

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

    Science.gov (United States)

    Cameron, Michael P.

    2012-01-01

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

  7. Computational health economics for identification of unprofitable health care enrollees.

    Science.gov (United States)

    Rose, Sherri; Bergquist, Savannah L; Layton, Timothy J

    2017-10-01

    Health insurers may attempt to design their health plans to attract profitable enrollees while deterring unprofitable ones. Such insurers would not be delivering socially efficient levels of care by providing health plans that maximize societal benefit, but rather intentionally distorting plan benefits to avoid high-cost enrollees, potentially to the detriment of health and efficiency. In this work, we focus on a specific component of health plan design at risk for health insurer distortion in the Health Insurance Marketplaces: the prescription drug formulary. We introduce an ensembled machine learning function to determine whether drug utilization variables are predictive of a new measure of enrollee unprofitability we derive, and thus vulnerable to distortions by insurers. Our implementation also contains a unique application-specific variable selection tool. This study demonstrates that super learning is effective in extracting the relevant signal for this prediction problem, and that a small number of drug variables can be used to identify unprofitable enrollees. The results are both encouraging and concerning. While risk adjustment appears to have been reasonably successful at weakening the relationship between therapeutic-class-specific drug utilization and unprofitability, some classes remain predictive of insurer losses. The vulnerable enrollees whose prescription drug regimens include drugs in these classes may need special protection from regulators in health insurance market design. © The Author 2017. Published by Oxford University Press.

  8. State of health economic evaluation research in Saudi Arabia: a review.

    Science.gov (United States)

    Al-Aqeel, Sinaa A

    2012-01-01

    If evaluation of economic evidence is to be used increasingly in Saudi Arabia, a review of the published literature would be useful to inform policy decision-makers of the current state of research and plan future research agendas. The purpose of this paper is to provide a critical review of the state of health economic evaluation research within the Saudi context with regard to the number, characteristics, and quality of published articles. A literature search was conducted on May 8, 2011 to identify health economic articles pertaining to Saudi Arabia in the PubMed, Embase, and EconLit databases, using the following terms alone or in combination: "cost*", "economics", "health economics", "cost-effectiveness", "cost-benefit", "cost minimization", "cost utility analysis", and "Saudi". Reference lists of the articles identified were also searched for further articles. The tables of contents of the Saudi Pharmaceutical Journal and the Saudi Medical Journal were reviewed for the previous 5 years. The search identified 535 citations. Based on a reading of abstracts and titles, 477 papers were excluded. Upon reviewing the full text of the remaining 58 papers, 43 were excluded. Fifteen papers were included. Ten were categorized as full economic evaluations and five as partial economic evaluations. These articles were published between 1997 and 2010. The majority of the studies identified did not clearly state the perspective of their evaluation. There are many concerns about the methods used to collect outcome and costs data. Only one study used some sort of sensitivity analysis to assess the effects of uncertainty on the robustness of its conclusions. This review highlights major flaws in the design, analysis, and reporting of the identified economic analyses. Such deficiencies mean that the local economic evidence available to decision-makers is not very useful. Thus, building research capability in health economics is warranted.

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

    Science.gov (United States)

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

    2013-01-01

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

  10. Economic Risk Assessment Taking Into Account the Volume Oscillator Indicators

    Directory of Open Access Journals (Sweden)

    Loredana Mihaela LAPADUSI

    2016-09-01

    Full Text Available Economic risk can be assessed from many points of view, but generally speaking it means the firm's inability to match workload with cost structure. Expansion of production capacity, adaptation to new technologies, diversification of products are only a few factors influencing risk. These, along with financial risk and bankruptcy risk constitute the most important category of risk which presents a great interest for the banks, shareholders, managers, business partners, etc. The purpose of this article is to provide a brief overview of tje oscillation of your company's activity from the point of view of economic risk. The main objective of this research lies in economic risk assessment by means of the margin of safety, the safety index and critical time point.

  11. Assessment of mutual influence of economic and ecological processes

    Directory of Open Access Journals (Sweden)

    Pavel Vasil’evich Druzhinin

    2014-05-01

    Full Text Available The article considers two issues: the assessment of the influence of economic development on the environment and the assessment of the impact of climate change on the development of certain economic sectors. The authors used methods of statistical analysis and economic-mathematical modeling. The article reveals differences in the dynamics and defines the nature of the relationship between GRP per capita and emissions of harmful substances into the atmosphere (including greenhouse gases for Russia’s regions. It is shown that the dynamics in some regions in 2000–2011 corresponds to the environmental Kuznets curve. The factors that affect the reduction of anthropogenic impact were determined. Several models for estimating the impact of changes in climatic conditions on the productivity of various crops were designed and tested

  12. Economic assessment of a waste hydrogen utilization project

    International Nuclear Information System (INIS)

    Zhou, H.; Wang, L.; Zhou, W.; Wu, J.; Wang, Q.

    1993-01-01

    This article reports an economic assessment on a hydride hydrogen recovery, purification, storage, transportation and application project (HRPSTA) set for a system including a nitrogenous fertilizer plant and a float glass factory. In this project, a pretreatment unit and metal hydride containers are used to recover and purify the hydrogen from the purge gas of the ammonia fertilizer plant and to transport and use the hydrogen in the tin bath in the float glass factory. Detailed economic assessment, cost analysis and a cash flow statement are presented, and financial net present value (NPV), as well as intrinsic rate of return (IRR), is calculated. The results shows that this project, which is feasible technologically, is profitable economically. (Author)

  13. Air Pollution, Disease Burden, and Health Economic Loss in China.

    Science.gov (United States)

    Niu, Yue; Chen, Renjie; Kan, Haidong

    2017-01-01

    As the largest developing country in the world, China is now facing one of the severest air pollution problems. The objective of this section is to evaluate the disease burden and corresponding economic loss attributable to ambient air pollution in China. We reviewed a series of studies by Chinese or foreign investigators focusing on the disease burden and economic loss in China. These studies showed both the general air pollution and haze episodes have resulted in substantial disease burden in terms of excess number of premature deaths, disability-adjusted life-year loss, and years of life lost. The corresponding economic loss has accounted for an appreciable proportion of China's national economy. Overall, the disease burden and health economic loss due to ambient air pollution in China is greater than in the remaining parts of the world, for one of the highest levels of air pollution and the largest size of exposed population. Consideration of both health and economic impacts of air pollution can facilitate the Chinese government to develop environmental policies to reduce the emissions of various air pollutants and protect the public health.

  14. Impact of economic growth on vegetation health in China based on GIMMS NDVI

    NARCIS (Netherlands)

    Jin, X.; Wan, L.; Zhang, Y.K.; Schaepman, M.E.

    2008-01-01

    The negative impact of economic development on vegetation health in China was assessed using gross domestic product (GDP) and the Global Inventory Modelling and Mapping Studies (GIMMS) Normalized Difference Vegetation Index (NDVI) data. Five levels of vegetation changes were established based on the

  15. Occupational safety and health in nanotechnology and Organisation for Economic Cooperation and Development

    Science.gov (United States)

    Murashov, Vladimir; Engel, Stefan; Savolainen, Kai; Fullam, Brian; Lee, Michelle; Kearns, Peter

    2009-10-01

    The Organization for Economic Cooperation and Development (OECD), an intergovernmental organization, is playing a critical global role in ensuring that emerging technologies, such as nanotechnology, are developed responsibly. This article describes OECD activities around occupational safety and health of nanotechnology and provides state-of-the-science overview resulting from an OECD workshop on exposure assessment and mitigation for nanotechnology workplace.

  16. Economic evaluation of influenza vaccination : Assessment for The Netherlands

    NARCIS (Netherlands)

    Postma, Maarten J.; Bos, Jasper M.; Van Gennep, Mark; Jager, Johannes C.; Baltussen, Rob; Sprenger, Marc J.W.

    1999-01-01

    Objective: The objective of this study was to determine the costs associated with influenza and the cost effectiveness (net costs per life-year gained) of influenza vaccination in The Netherlands. Design and setting: The economic evaluation comprised a cost-of-illness assessment and a

  17. An assessement of global energy resource economic potentials

    International Nuclear Information System (INIS)

    Mercure, Jean-François; Salas, Pablo

    2012-01-01

    This paper presents an assessment of global economic energy potentials for all major natural energy resources. This work is based on both an extensive literature review and calculations using natural resource assessment data. Economic potentials are presented in the form of cost-supply curves, in terms of energy flows for renewable energy sources, or fixed amounts for fossil and nuclear resources, with strong emphasis on uncertainty, using a consistent methodology that allow direct comparisons to be made. In order to interpolate through available resource assessment data and associated uncertainty, a theoretical framework and a computational methodology are given based on statistical properties of different types of resources, justified empirically by the data, and used throughout. This work aims to provide a global database for natural energy resources ready to integrate into models of energy systems, enabling to introduce at the same time uncertainty over natural resource assessments. The supplementary material provides theoretical details and tables of data and parameters that enable this extensive database to be adapted to a variety of energy systems modelling frameworks. -- Highlights: ► Global energy potentials for all major energy resources are reported. ► Theory and methodology for calculating economic energy potentials is given. ► An uncertainty analysis for all energy economic potentials is carried out.

  18. Assessing the Impact of Financial Policies on Nigeria's Economic ...

    African Journals Online (AJOL)

    Assessing the Impact of Financial Policies on Nigeria's Economic Growth. ... Furthermore, it calls for effective implementation and monitoring of financial policies as well as adequate supervision of the financial sector by the relevant authorities to avoid lopsided compliance with financial and monetary guidelines. Keywords: ...

  19. Economic assessment of oil palm projects in Nigeria. | Nwawe ...

    African Journals Online (AJOL)

    However, this study was designed to economically assess oil palm projects in Nigeria. Secondary data used for this study were collected from Nigerian Institute for Oil Palm Research (NIFOR) and related journals. The data collected were analyzed using discounted cash flow techniques. The result shows that at 32% interest ...

  20. Potential economic impact assessment for cattle parasites in Mexico review

    Science.gov (United States)

    Here, economic losses caused by cattle parasites in Mexico were estimated on an annual basis. The main factors taken into consideration for this assessment included the total number of animals at risk, potential detrimental effects of parasitism on milk production or weight gain, and records of cond...

  1. Methodology for reliability, economic and environmental assessment of wave energy

    International Nuclear Information System (INIS)

    Thorpe, T.W.; Muirhead, S.

    1994-01-01

    As part of the Preliminary Actions in Wave Energy R and D for DG XII's Joule programme, methodologies were developed to facilitate assessment of the reliability, economics and environmental impact of wave energy. This paper outlines these methodologies, their limitations and areas requiring further R and D. (author)

  2. Writing, Evaluating and Assessing Data Response Items in Economics.

    Science.gov (United States)

    Trotman-Dickenson, D. I.

    1989-01-01

    Describes some of the problems in writing data response items in economics for use by A Level and General Certificate of Secondary Education (GCSE) students. Examines the experience of two series of workshops on writing items, evaluating them and assessing responses from schools. Offers suggestions for producing packages of data response items as…

  3. The DCFR and consumer protection: an economic assessment

    NARCIS (Netherlands)

    Luth, H.A.; Cseres, K.; Larouche, P.; Chirico, F.

    2010-01-01

    This paper will discuss consumer protection in the DCFR. It will screen the DCFR and its model of consumer protection through the lens of economic analysis. The assessment will examine the general role of mandatory rules, which justification grounds they are based on and how this general model is

  4. Assessment of ecological, economic and social impacts of grain for ...

    African Journals Online (AJOL)

    In order to noticeably and systematically assess ecological, economic and social effects of the grain for green project on county level, this study investigated the benefits of carbon sequestration to the soil of farmland-converted forestland (in 0 to 20 cm soil depth), the change in household income structure and social ...

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

    Science.gov (United States)

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ferraz MB

    2015-02-01

    Full Text Available Marcos Bosi Ferraz1,21Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil; 2São Paulo Center for Health Economics (GRIDES, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil Abstract: Health care is a highly complex, dynamic, and creative sector of the economy. While health economics has to continue its efforts to improve its methods and tools to better inform decisions, the application needs to be aligned with the insights and models of other social sciences disciplines. Decisions may be guided by four concept models based on ethical and distributive justice: libertarian, communitarian, egalitarian, and utilitarian. The societal agreement on one model or a defined mix of models is critical to avoid inequity and unfair decisions in a public and/or private insurance-based health care system. The excess use of methods and tools without fully defining the basic goals and philosophical principles of the health care system and without evaluating the fitness of these measures to reaching these goals may not contribute to an efficient improvement of population health. Keywords: health care, health care system, population health

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

    Directory of Open Access Journals (Sweden)

    Suhonen Aki

    2008-04-01

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

  8. 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.

  9. Health and innovation: economic dynamics and Welfare State in Brazil

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Grabois Gadelha

    Full Text Available Abstract: The effective enforcement of the access to healthcare as fundamental right requires an important theoretical and political effort at linking the often contradictory economic and social dimensions of development. This study suggests the need for a systemic view of policies related to the industrial base and innovation in health and the construction of the Brazilian Unified National Health System (SUS. The authors investigate the relations between health, innovation, and development, seeking to show and update the political, economic, and social determinants of the recent Brazilian experience with the Health Economic-Industrial Complex (HEIC. They discuss how the agenda for innovation and domestic industrial production in health gained a central place in the project for construction of the SUS. The article thus seeks to link inherent issues from the agenda for development, production, and innovation to social policy in healthcare, as observed in recent years, and based on this analysis, points to political and conceptual challenges for implementing the SUS, especially as regards strengthening its technological and industrial base. As a byproduct, the article develops an analytical and factual focus on the consolidation of the HEIC in Brazil, both as a dynamic vector of industrial development, generating investment, income, employment, and innovations, and as a decisive element for reducing vulnerability and structural dependence in health. The authors aim to show that strengthening the SUS and orienting it to social needs is an essential part of building a social Welfare State in Brazil.

  10. Current challenges in health economic modeling of cancer therapies: a research inquiry.

    Science.gov (United States)

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

    2014-05-01

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

  11. The economic burden of personality disorders in mental health care

    NARCIS (Netherlands)

    Soeteman, D.I.; Hakkaart-van Roijen, L.; Verheul, R.; Busschbach, J.J.V.

    2008-01-01

    Objective: Some evidence suggests that personality disorders are associated with a high economic burden due to, for example, a high demand on psychiatric, health, and social care services. However, state-of-the-art cost studies for the broad range of personality disorder diagnoses are lacking. The

  12. Home Economics/Health Grades 6-12. Program Evaluation.

    Science.gov (United States)

    Des Moines Public Schools, IA. Teaching and Learning Div.

    Home economics programs are offered to students in grades 6-12 in the Des Moines INdependent Community School District (Iowa). Programs at the middle school level are exploratory, leading to occupational training in family and consumer science, child care, food service, and textile and fashion arts at the high school level. Health education…

  13. Effect of economic and security challenges on the Nigerian health ...

    African Journals Online (AJOL)

    Effect of economic and security challenges on the Nigerian health sector. Folashade T Alloh1, Pramod R Regmi1,2. 1. ... oil accounts for 75% of Nigeria's economy, so the fall in oil prices, therefore, has a significant impact on ... corruption surrounding many of the country's lawmakers in different scandals over the years have ...

  14. Health and Economic Growth in South East, Nigeria

    African Journals Online (AJOL)

    info

    to be making any significant impact in economic growth. ... The south eastern geographical space of Nigeria is the country home of the. Igbo. .... However, if, for example, many workers in one sector are not regular to work .... private health care providers, is not only associated with welfare .... individuals and families apart.

  15. 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.

  16. 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.

  17. 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.

  18. A Model for Assessing the Gender Aspect in Economic Policy

    Directory of Open Access Journals (Sweden)

    Ona Rakauskienė

    2015-06-01

    Full Text Available The purpose of research is to develop a conceptual model for assessing the impact of the gender aspect on economic policy at macro– and microeconomic levels. The research methodology is based on analysing scientific approaches to the gender aspect in economics and gender–responsive budgeting as well as determining the impact of the gender aspect on GDP, foreign trade, the state budget and the labour market. First, the major findings encompass the main idea of a conceptual model proposing that a socio–economic picture of society can be accepted as completed only when, alongside public and private sectors, includes the care/reproductive sector that is dominated by women and creating added value in the form of educated human resources; second, macroeconomics is not neutral in terms of gender equality. Gender asymmetry is manifested not only at the level of microeconomics (labour market and business but also at the level of macroeconomics (GDP, the state budget and foreign trade, which has a negative impact on economic growth and state budget revenues. In this regard, economic decisions, according to the principles of gender equality and in order to achieve gender equality in economics, must be made, as the gender aspect has to be also implemented at the macroeconomic level.

  19. Disability-adjusted life years and economic cost assessment of the health effects related to PM2.5 and PM10 pollution in Mumbai and Delhi, in India from 1991 to 2015.

    Science.gov (United States)

    Maji, Kamal Jyoti; Dikshit, Anil Kumar; Deshpande, Ashok

    2017-02-01

    Particulate air pollution is becoming a serious public health concern in urban cities in India due to air pollution-related health effects associated with disability-adjusted life years (DALYs) and economic loss. To obtain the quantitative result of health impact of particulate matter (PM) in most populated Mumbai City and most polluted Delhi City in India, an epidemiology-based exposure-response function has been used to calculate the attributable number of mortality and morbidity cases from 1991 to 2015 in a 5-year interval and the subsequent DALYs, and economic cost is estimated of the health damage based on unit values of the health outcomes. Here, we report the attributable number of mortality due to PM 10 in Mumbai and Delhi increased to 32,014 and 48,651 in 2015 compared with 19,291 and 19,716 in year 1995. And annual average mortality due to PM 2.5 in Mumbai and Delhi was 10,880 and 10,900. Premature cerebrovascular disease (CEV), ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes are about 35.3, 33.3, and 22.9% of PM 2.5 -attributable mortalities. Total DALYs due to PM10 increased from 0.34 million to 0.51 million in Mumbai and 0.34 million to 0.75 million in Delhi from average year 1995 to 2015. Among all health outcomes, mortality and chronic bronchitis shared about 95% of the total DALYs. Due to PM 10 , the estimated total economic cost at constant price year 2005 US$ increased from 2680.87 million to 4269.60 million for Mumbai City and 2714.10 million to 6394.74 million for Delhi City, from 1995 to 2015, and the total amount accounting about 1.01% of India's gross domestic product (GDP). A crucial presumption is that in 2030, PM 10 levels would have to decline by 44% (Mumbai) and 67% (Delhi) absolutely to maintain the same health outcomes in year 2015 levels. The results will help policy makers from pollution control board for further cost-benefit analyses of air pollution management programs in Mumbai and Delhi.

  20. FAMILY HEALTH MANAGEMENT AND POVERTY IN AN ECONOMIC RECESSION PERIOD IN PORTUGAL

    OpenAIRE

    Carvalho, Ana Branca; Oliveira, Ivo; Nogueira, Fernanda

    2015-01-01

    Abstract: The main purpose of this article, in the management and health, was to assess the contribution of family health and its role in local development in the context of economic recession and worsening poverty in Portugal. Material and Methods. Data were collected through the questionnaire, 1021 individuals were inquired in Portugal, with statistical treatment through inferential analysis, factorial and regression. They were asked to participate voluntarily in writing through email pa...

  1. Economic risk assessment of drought impacts on irrigated agriculture

    Science.gov (United States)

    Lopez-Nicolas, A.; Pulido-Velazquez, M.; Macian-Sorribes, H.

    2017-07-01

    In this paper we present an innovative framework for an economic risk analysis of drought impacts on irrigated agriculture. It consists on the integration of three components: stochastic time series modelling for prediction of inflows and future reservoir storages at the beginning of the irrigation season; statistical regression for the evaluation of water deliveries based on projected inflows and storages; and econometric modelling for economic assessment of the production value of agriculture based on irrigation water deliveries and crop prices. Therefore, the effect of the price volatility can be isolated from the losses due to water scarcity in the assessment of the drought impacts. Monte Carlo simulations are applied to generate probability functions of inflows, which are translated into probabilities of storages, deliveries, and finally, production value of agriculture. The framework also allows the assessment of the value of mitigation measures as reduction of economic losses during droughts. The approach was applied to the Jucar river basin, a complex system affected by multiannual severe droughts, with irrigated agriculture as the main consumptive demand. Probability distributions of deliveries and production value were obtained for each irrigation season. In the majority of the irrigation districts, drought causes a significant economic impact. The increase of crop prices can partially offset the losses from the reduction of production due to water scarcity in some districts. Emergency wells contribute to mitigating the droughts' impacts on the Jucar river system.

  2. Brick industry: Technical and economic assessment of energy saving measures

    Energy Technology Data Exchange (ETDEWEB)

    Florio, G.; Romeo, G. (Calabria Univ., Arcavacata di Rende (Italy). Dipt. di Meccanica)

    Starting from a detailed energy analysis of the production cycle of bricks, the authors make a technical and economic assessment of any possible measure aimed at rationalizing energy. They take energy conservation into consideration not only through the use of exhausted oil residues, but also through the employment of a turboalternator or an internal combustion engine for cogeneration. Both applications of cogeneration prove to be highly interesting from an economic viewpoint even though the turboalternator is put at a disadvantage in competing with internal combustion engines since it increases the overall cogeneration plant costs with respect to the latter.

  3. Accelerator assisted repositories, technical issue identification and economic assessment

    Energy Technology Data Exchange (ETDEWEB)

    Myers, T.; Favale, A.; Berwald, D. [Northrop Grumman Corp., Bethpage, NY (United States)

    1995-12-31

    An investigation (technical and economic) is presented to quantify the impact of accelerator assisted repository (AAR) system on the US national nuclear repository strategy. An overview of US spent fuel policy is presented which provides a means to comparatively assess competing spent fuel disposition technologies under investigation. The advantages of an AAR system are highlighted and discussed. A companion economic analysis is presented. The results indicate that although a US geologic waste repository will continue to be required, waste partitioning and accelerator transmutation of selected actinides, and long-lived fission products, can result in substantial benefits. (author) 18 refs.

  4. Barriers to implementation of workplace health interventions: an economic perspective.

    Science.gov (United States)

    Cherniack, Martin; Lahiri, Supriya

    2010-09-01

    To identify insurance related, structural, and workplace cultural barriers to the implementation of effective preventive and upstream clinical interventions in the working age adult population. Analysis of avoided costs from perspective of health economics theory and from empiric observations from large studies; presentation of data from our own cost-plus model on integrating health promotion and ergonomics. We identify key avoided costs issues as a misalignment of interests between employers, insurers, service institutions, and government. Conceptual limitations of neoclassical economics are attributable to work culture and supply-driven nature of health care. Effective valuation of avoided costs is a necessary condition for redirecting allocations and incentives. Key content for valuation models is discussed.

  5. Health and economic costs of alternative energy sources

    International Nuclear Information System (INIS)

    Hamilton, L.D.; Manne, A.S.

    1977-01-01

    National energy policy requires realistic totaling of costs in assessing energy alternatives. The Biomedical and Environmental Assessment Division (BEAD) at Brookhaven is estimating biomedical and environmental costs of energy production and use. All forms of energy, including new technologies, are being considered. Beginning with a compilation of pollutants from the energy system, the various paths to man are traced and health effects evaluated. Excess mortality and morbidity in the U.S. attributable to a total fuel cycle to produce 6.6x10 9 kwh - about a year's production of a 1000-MWe power plant - are being estimated. Where enough information is available, estimates are quantitative. In some instances only the nature of the potential hazard can be described. This assessment aims at providing initial estimates of relative impacts to identify where the important health hazards in each fuel cycle arise, thereby identifying key areas for judging the total costs of alternative energy sources, and those areas of research likely to improve the accuracy of the estimates. It was thus estimated that the production of electric power from all sources in the U.S. in 1975 was associated with between two to nineteen thousand deaths and twenty-nine to fourty-eight thousand disabilities; this is roughly between 0.2 and 2% of total deaths in U.S. ages 1-74. The estimated health effects associated with a total fuel cycle standardized to produce 10 10 kwh electric power were: from coal estimated deaths 20-200, estimated disabilities 300-500; from oil estimated deaths 3-150, estimated disabilities 150-300; from gas estimated deaths 0.2, estimated disabilities 20; from nuclear estimated deaths 1-3, estimated disabilities 8-30. The differences in the year 2000 between health impacts of the U.S. energy system under normal growth expectations and under conditions of a nuclear moratorium were estimated. On the assumption that the nuclear moratorium would require 320 additional 1000-MWe

  6. Role of the anesthesiologist in the wider governance of healthcare and health economics.

    Science.gov (United States)

    Martin, Janet; Cheng, Davy

    2013-09-01

    Healthcare resources will always be limited, and as a result, difficult decisions must be made about how to allocate limited resources across unlimited demands in order to maximize health gains per resource expended. Governments and hospitals now in severe financial deficits recognize that reengagement of physicians is central to their ability to contain the runaway healthcare costs. Health economic analysis provides tools and techniques to assess which investments in healthcare provide good value for money vs which options should be forgone. Robust decision-making in healthcare requires objective consideration of evidence in order to balance clinical and economic benefits vs risks. Surveys of the literature reveal very few economic analyses related to anesthesia and perioperative medicine despite increasing recognition of the need. Now is an opportune time for anesthesiologists to become familiar with the tools and methodologies of health economics in order to facilitate and lead robust decision-making in quality-based procedures. For most technologies used in anesthesia and perioperative medicine, the responsibility to determine cost-effectiveness falls to those tasked with the governance and stewardship of limited resources for unlimited demands using best evidence plus economics at the local, regional, and national levels. Applicable cost-effectiveness, cost-utility, and cost-benefits in health economics are reviewed in this article with clinical examples in anesthesia. Anesthesiologists can make a difference in the wider governance of healthcare and health economics if we advance our knowledge and skills beyond the technical to address the "other" dimensions of decision-making--most notably, the economic aspects in a value-based healthcare system.

  7. Socio-economic inequalities in health services utilization: a cross-sectional study.

    Science.gov (United States)

    Ranjbar Ezzatabadi, Mohammad; Khosravi, Ameneh; Bahrami, Mohammad Amin; Rafiei, Sima

    2018-02-12

    Purpose Developing country workers mainly face important challenges when examining equality in health services utilization among the population and identifying influential factors. The purpose of this paper us to: understand health service use among households with different socio-economic status in Isfahan province; and to investigate probable inequality determinants in service utilization. Design/methodology/approach Almost 1,040 households living in Isfahan province participated in this cross-sectional study in 2013. Data were collected by a questionnaire with three sections: demographic characteristics; socio-economic status; and health services utilization. The concentration index was applied to measure inequality. Analysts used STATA 11. Findings Economic status, educational level, insurance coverage and household gender were the most influential factors on health services utilization. Those with a high socio-economic level were more likely to demand and use such services; although self-medication patterns showed an opposite trend. Practical implications Female-headed families face with more difficulties in access to basic human needs including health. Supportive policies are needed to meet their demands. Originality/value The authors used principle component analysis to assess households' economic situation, which reduced the variables into a single index.

  8. Variations between world regions in individual health: a multilevel analysis of the role of socio-economic factors

    NARCIS (Netherlands)

    Witvliet, Margot I.; Kunst, Anton E.; Stronks, Karien; Arah, Onyebuchi A.

    2012-01-01

    Background: Living in a particular region might affect health. We aimed to assess variations between regions in individual health. The role of socio-economic factors in the associations was also investigated. Methods: World Health Survey data were analysed on 220 487 individuals. Main outcomes

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

    Science.gov (United States)

    Barber, Herbert Marion, Jr.

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

  10. Romanian Health Care Reform in the Context of Economic Crisis

    Directory of Open Access Journals (Sweden)

    Victoria Gheonea

    2010-12-01

    Full Text Available The effects of financial crisis are strongly felt in Romania, which already face with asignificant slowdown in economic growth or even economic recession. The current and internationalsituation remains still difficult, and requires high budget constraints. Under these conditions, thehealth system in Romania has become one of the most inefficient in Europe, mainly characterized bylack of transparency in the allocation of funds and inefficiency in resource use. The lack of clear andcoherent criteria to evaluate the performance of health institutions results in a difficultimplementation of efficient managerial systems to reward the efficient manager.

  11. An economic assessment of potential ethanol production pathways in Ireland

    Energy Technology Data Exchange (ETDEWEB)

    Deverell, Rory; McDonnell, Kevin; Ward, Shane; Devlin, Ger [Department of Biosystems Engineering, Agriculture and Food Science Building, University College Dublin 4, Belfield (Ireland)

    2009-10-15

    An economic assessment was conducted on five biomass-to-ethanol production pathways utilising the feedstock: wheat, triticale, sugarbeet, miscanthus and straw. The analysis includes the costs and margins for all the stakeholders along the economic chain. This analysis reveals that under current market situations in Ireland, the production of ethanol under the same tax regime as petrol makes it difficult to compete against that fuel, with tax breaks, however, it can compete against petrol. On the other hand, even under favourable tax breaks it will be difficult for indigenously produced ethanol to compete against cheaper sources of imported ethanol. Therefore, the current transport fuel market has no economic reason to consume indigenously produced ethanol made from the indigenously grown feedstock analysed at a price that reflects all the stakeholders' costs. To deliver a significant penetration of indigenous ethanol into the market would require some form of compulsory inclusion or else considerable financial supports to feedstock and ethanol producers. (author)

  12. Economic assessment of the use value of geospatial information

    Science.gov (United States)

    Bernknopf, Richard L.; Shapiro, Carl D.

    2015-01-01

    Geospatial data inform decision makers. An economic model that involves application of spatial and temporal scientific, technical, and economic data in decision making is described. The value of information (VOI) contained in geospatial data is the difference between the net benefits (in present value terms) of a decision with and without the information. A range of technologies is used to collect and distribute geospatial data. These technical activities are linked to examples that show how the data can be applied in decision making, which is a cultural activity. The economic model for assessing the VOI in geospatial data for decision making is applied to three examples: (1) a retrospective model about environmental regulation of agrochemicals; (2) a prospective model about the impact and mitigation of earthquakes in urban areas; and (3) a prospective model about developing private–public geospatial information for an ecosystem services market. Each example demonstrates the potential value of geospatial information in a decision with uncertain information.

  13. An economic assessment of potential ethanol production pathways in Ireland

    International Nuclear Information System (INIS)

    Deverell, Rory; McDonnell, Kevin; Ward, Shane; Devlin, Ger

    2009-01-01

    An economic assessment was conducted on five biomass-to-ethanol production pathways utilising the feedstock: wheat, triticale, sugarbeet, miscanthus and straw. The analysis includes the costs and margins for all the stakeholders along the economic chain. This analysis reveals that under current market situations in Ireland, the production of ethanol under the same tax regime as petrol makes it difficult to compete against that fuel, with tax breaks, however, it can compete against petrol. On the other hand, even under favourable tax breaks it will be difficult for indigenously produced ethanol to compete against cheaper sources of imported ethanol. Therefore, the current transport fuel market has no economic reason to consume indigenously produced ethanol made from the indigenously grown feedstock analysed at a price that reflects all the stakeholders' costs. To deliver a significant penetration of indigenous ethanol into the market would require some form of compulsory inclusion or else considerable financial supports to feedstock and ethanol producers.

  14. [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.

  15. [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

  16. Association Between Employee Sleep With Workplace Health and Economic Outcomes.

    Science.gov (United States)

    Burton, Wayne N; Chen, Chin-Yu; Schultz, Alyssa B; Li, Xingquan

    2017-02-01

    Poor sleep can impact occupational functioning. The current study examines health risks, medical conditions, and workplace economic outcomes associated with self-reported hours of sleep among employees. Employees of a global financial services corporation were categorized on the basis of their self-reported average hours of sleep. Differences in health care costs, productivity measures, health risks, and medical conditions were analyzed by hours of sleep while controlling for confounding variables. A strong U-shaped relationship between health care costs, short-term disability, absenteeism, and presenteeism (on-the-job work loss) and the hours of sleep was found among employees. The nadir of the "U" occurs for 7 or 8 hours of sleep per night. Worksite wellness programs often address health risks and medical conditions and may benefit from incorporating sleep education.

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

    Science.gov (United States)

    Ferraz, Marcos Bosi

    2015-01-01

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

  18. Assessment of the Economic Structure of Brazilian Agribusiness.

    Science.gov (United States)

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

    2016-01-01

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

  19. Assessment of the Economic Structure of Brazilian Agribusiness

    Science.gov (United States)

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

    2016-01-01

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

  20. Assessment of the Economic Structure of Brazilian Agribusiness

    Directory of Open Access Journals (Sweden)

    Vilmar Rodrigues Moreira

    2016-01-01

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

  1. Urbanization, economic development and health: evidence from China's labor-force dynamic survey.

    Science.gov (United States)

    Chen, Hongsheng; Liu, Ye; Li, Zhigang; Xue, Desheng

    2017-11-29

    The frequent outbreak of environmental threats in China has resulted in increased criticism regarding the health effects of China's urbanization. Urbanization is a double-edged sword with regard to health in China. Although great efforts have been made to investigate the mechanisms through which urbanization influences health, the effect of both economic development and urbanization on health in China is still unclear, and how urbanization-health (or development-health) relationships vary among different income groups remain poorly understood. To bridge these gaps, the present study investigates the impact of both urbanization and economic development on individuals' self-rated health and its underlying mechanisms in China. We use data from the national scale of the 2014 China Labor-force Dynamics Survey to analyze the impact of China's urbanization and economic development on health. A total of 14,791 individuals were sampled from 401 neighborhoods within 124 prefecture-level cities. Multilevel ordered logistic models were applied. Model results showed an inverted U-shaped relationship between individuals' self-rated health and urbanization rates (with a turning point of urbanization rate at 42.0%) and a positive linear relationship between their self-rated health and economic development. Model results also suggested that the urbanization-health relationship was inverted U-shaped for high- and middle-income people (with a turning point of urbanization rate at 0.0% and 49.2%, respectively), and the development-health relationship was inverted U-shaped for high- and low-income people (with turning points of GDP per capita at 93,462 yuan and 71,333 yuan, respectively) and linear for middle-income people. The impact of urbanization and economic development on health in China is complicated. Careful assessments are needed to understand the health impact of China's rapid urbanization. Social and environmental problems arising from rapid urbanization and economic growth

  2. A comparative assessment of the economics of plutonium disposition

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  3. 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

  4. Ecosystem change and human health: implementation economics and policy.

    Science.gov (United States)

    Pattanayak, S K; Kramer, R A; Vincent, J R

    2017-06-05

    Several recent initiatives such as Planetary Health , EcoHealth and One Health claim that human health depends on flourishing natural ecosystems. However, little has been said about the operational and implementation challenges of health-oriented conservation actions on the ground. We contend that ecological-epidemiological research must be complemented by a form of implementation science that examines: (i) the links between specific conservation actions and the resulting ecological changes, and (ii) how this ecological change impacts human health and well-being, when human behaviours are considered. Drawing on the policy evaluation tradition in public economics, first, we present three examples of recent social science research on conservation interventions that affect human health. These examples are from low- and middle-income countries in the tropics and subtropics. Second, drawing on these examples, we present three propositions related to impact evaluation and non-market valuation that can help guide future multidisciplinary research on conservation and human health. Research guided by these propositions will allow stakeholders to determine how ecosystem-mediated strategies for health promotion compare with more conventional biomedical prevention and treatment strategies for safeguarding health.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.

  5. Health and economic growth among the states of Brazil from 1991 to 2000

    Directory of Open Access Journals (Sweden)

    Kenya Noronha

    2010-12-01

    Full Text Available Health status can affect economic growth through at least three mechanisms: 1 directly, through the relationship between health status and individual earnings, 2 indirectly, through the effect of health on levels of education, and 3 through physical capital investments. Poor health status causes considerable losses in individual income by decreasing labor productivity, numbers of hours worked, and participation in the labor force. These losses can affect a population's level of wealth and contribute to decreased social well-being. The main goal of this study is to assess the relationship between health and economic growth among the Brazilian states between 1991 and 2000. In order to take into account the different epidemiological and morbidity profiles observed among the states, several health measures were selected such as infant mortality rate, hospital mortality rate in the public healthcare system due to perinatal complications, and proportion of deaths from selected causes (vascular diseases, diabetes, cancer, AIDS and other communicable diseases, homicides and ill-defined causes. Our main findings show that in Brazil health correlates positively with economic growth. We also found that decreases in infant mortality rates are closely associated with higher rates of economic growth. We found a significant negative relationship for health indicators that are related to poverty, less access to health care services and deaths from avoidable causes, such as communicable diseases and hospital mortality rates due to perinatal complications. In contrast, we found a positive and significant correlation between the proportion of deaths from diabetes and cancer, on the one hand, and economic growth, on the other.

  6. Assessing the economic effects of Latin American independence

    OpenAIRE

    Prados de la Escosura, Leandro

    2003-01-01

    This paper discusses the economic consequences of independence in Latin America. Grand interpretations that assess Nineteenth Century Latin America by comparison to the U.S. performance are examined and the alternative approach of using African and Asian post-colonial experiences as the yardstick is explored. Empirical evidence on the consequences of removing the colonial burden and opening up to the international economy is, then, examined. The paper concludes with discussion of when Latin A...

  7. A systematic review and overview of health economic evaluations of emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Sohail Bampoe

    2017-11-01

    Full Text Available Abstract Background Little is known about the economic impact of emergency laparotomy (EL surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. Methods MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC checklist. Results Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. Discussion EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Conclusions Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to

  8. A systematic review and overview of health economic evaluations of emergency laparotomy.

    Science.gov (United States)

    Bampoe, Sohail; Odor, Peter M; Ramani Moonesinghe, S; Dickinson, Matthew

    2017-01-01

    Little is known about the economic impact of emergency laparotomy (EL) surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC) checklist. Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to this type of surgery is to be pursued as a global health target. PROSPERO

  9. Using institutional and behavioural economics to examine animal health systems.

    Science.gov (United States)

    Wolf, C A

    2017-04-01

    Economics provides a framework for understanding management decisions and their policy implications for the animal health system. While the neoclassical economic model is useful for framing animal health decisions on the farm, some of its assumptions and prescriptive results may be unrealistic. Institutional and behavioural economics address some of these potential shortcomings by considering the role of information, psychology and social factors in decisions. Framing such decisions under contract theory allows us to consider asymmetric information between policy-makers and farmers. Perverse incentives may exist in the area of preventing and reporting disease. Behavioural economics examines the role of internal and external psychological and social factors. Biases, heuristics, habit, social norms and other such aspects can result in farm decision-makers arriving at what might be considered irrational or otherwise sub-optimal decisions. Framing choices and providing relevant information and examples can alleviate these behavioural issues. The implications of this approach for disease policy and an applied research and outreach programme to respond to animal diseases are discussed.

  10. Neuroeconomics and Health Economics

    DEFF Research Database (Denmark)

    Larsen, Torben

    2009-01-01

      Objective: Neuroeconomics integrates economics, psychology and neuroscience. Recently, this line of research is summarized in a neuroeconomic model (NeM) which addresses the rehabilitation of important chronic conditions from a new angle as surveyed in this study. Data and Method: Firstly, Ne......://www.integratedhomecare.eu/ . III. In-depth-relaxation is evidenced as the result of regular practice of medical meditation comprising various practical meditation settings by NGOs whereof some are rooted in the religious tradition while other aim to be post-religious. Medical meditation combines savings on health care costs...... with de-stressing benefits as reduced anxiety, less use of stimulants and a reduction of blood pressure which in all increase life-expectancy. Conclusion: Neuroeconomics helps economists to identify dominant health economic interventions that may be overlooked by traditional discipålines   [i] This part...

  11. [Health system reforms, economic constraints and ethical and legal values].

    Science.gov (United States)

    Caillol, Michel; Le Coz, Pierre; Aubry, Régis; Bréchat, Pierre-Henri

    2010-01-01

    Health system and hospital reforms have led to important and on-going legislative, structural and organizational changes. Is there any logic at work within the health system and hospitals that could call into question the principle of solidarity, the secular values of ethics that govern the texts of law and ethics? In order to respond, we compared our experiences to a review of the professional and scientific literature from 1992 to 2010. Over the course of the past eighteen years, health system organization was subjected to variations and significant tensions. These variations are witnesses to a paradigm shift: although a step towards the regionalization of the health system integrating the choice of public health priorities, consultation and participatory democracy has been implemented, nevertheless the system was then re-oriented towards the trend of returning to centralization on the basis of uniting economics, technical modernization and contracting. This change of doctrine may undermine the social mission of hospitals and the principle of solidarity. Progress, the aging population and financial constraints would force policy-makers to steer the health system towards more centralized control. Hospitals, health professionals and users may feel torn within a system that tends to simplify and minimize what is becoming increasingly complex and global. Benchmarks on values, ethics and law for the hospitals, healthcare professionals and users are questioned. These are important elements to consider when the law on the reform of hospitals, patients, health care and territories and regional health agencies is implemented.

  12. The Contribution of Health Technology Assessment, Health Needs Assessment, and Health Impact Assessment to the Assessment and Translation of Technologies in the Field of Public Health Genomics

    DEFF Research Database (Denmark)

    Rosenkotter, N.; Vondeling, H.; Blancquaert, I.

    2011-01-01

    contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic...... into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [ health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could...... medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed...

  13. Socio-economic Scenarios in Climate Assessments (IC11). Synthesis

    International Nuclear Information System (INIS)

    Van Drunen, M.; Berkhout, F.

    2011-09-01

    It is widely recognised that projections of social and economic futures are circumscribed by irreducible uncertainties and ignorance. A common analytical response is to develop scenarios that map a range of alternative possible outcomes. The application of scenarios in climate assessments in the Netherlands was investigated in this report, focusing on the use of the socio-economic scenarios 'Welvaart en Leefomgeving' (WLO - The Future of the Dutch Built Environment). This research was carried out within the Climate Changes Spatial Planning (CcSP) programme. WLO scenarios have been applied in climate assessment studies. WLO generates figures and data that are useful. Nevertheless we encountered several CcSP projects that did not apply any socio-economic scenarios, whilst this seemed necessary based on their objectives. In general, climate assessments make little sense if socio-economic developments are not taken into account. Interestingly, some of the studies that did apply socio-economic scenarios, picked only one or two of the scenarios generated by WLO. From a theoretical point of view this selective 'shopping' may lead to a tunnel vision, because it is impossible to estimate which scenario is more probable than the others. At the other hand it is often impractical to explore all four scenarios. The time horizon of WLO was in several cases too short for climate assessments. As it is probable that the structure of society has changed significantly by 2040, it is difficult to quantitatively support the storylines as was done in WLO, because many model assumptions are not correct anymore. Possibly it is better to take a backcasting approach for the second half of the century for the purpose of the CcSP programme. The two case studies described in this report provide examples of good practice that are likely to be useful in future projects that deal with scenarios. In addition, this study produced an interactive website (www.climatescenarios.nl) that provides key

  14. Assessment and economic valuation of air pollution impacts on human health over Europe and the United States as calculated by a multi-model ensemble in the framework of AQMEII3

    Science.gov (United States)

    Im, Ulas; Brandt, Jørgen; Geels, Camilla; Mantzius Hansen, Kaj; Heile Christensen, Jesper; Skou Andersen, Mikael; Solazzo, Efisio; Kioutsioukis, Ioannis; Alyuz, Ummugulsum; Balzarini, Alessandra; Baro, Rocio; Bellasio, Roberto; Bianconi, Roberto; Bieser, Johannes; Colette, Augustin; Curci, Gabriele; Farrow, Aidan; Flemming, Johannes; Fraser, Andrea; Jimenez-Guerrero, Pedro; Kitwiroon, Nutthida; Liang, Ciao-Kai; Nopmongcol, Uarporn; Pirovano, Guido; Pozzoli, Luca; Prank, Marje; Rose, Rebecca; Sokhi, Ranjeet; Tuccella, Paolo; Unal, Alper; Garcia Vivanco, Marta; West, Jason; Yarwood, Greg; Hogrefe, Christian; Galmarini, Stefano

    2018-04-01

    The impact of air pollution on human health and the associated external costs in Europe and the United States (US) for the year 2010 are modeled by a multi-model ensemble of regional models in the frame of the third phase of the Air Quality Modelling Evaluation International Initiative (AQMEII3). The modeled surface concentrations of O3, CO, SO2 and PM2.5 are used as input to the Economic Valuation of Air Pollution (EVA) system to calculate the resulting health impacts and the associated external costs from each individual model. Along with a base case simulation, additional runs were performed introducing 20 % anthropogenic emission reductions both globally and regionally in Europe, North America and east Asia, as defined by the second phase of the Task Force on Hemispheric Transport of Air Pollution (TF-HTAP2). Health impacts estimated by using concentration inputs from different chemistry-transport models (CTMs) to the EVA system can vary up to a factor of 3 in Europe (12 models) and the United States (3 models). In Europe, the multi-model mean total number of premature deaths (acute and chronic) is calculated to be 414 000, while in the US, it is estimated to be 160 000, in agreement with previous global and regional studies. The economic valuation of these health impacts is calculated to be EUR 300 billion and 145 billion in Europe and the US, respectively. A subset of models that produce the smallest error compared to the surface observations at each time step against an all-model mean ensemble results in increase of health impacts by up to 30 % in Europe, while in the US, the optimal ensemble mean led to a decrease in the calculated health impacts by ˜ 11 %. A total of 54 000 and 27 500 premature deaths can be avoided by a 20 % reduction of global anthropogenic emissions in Europe and the US, respectively. A 20 % reduction of North American anthropogenic emissions avoids a total of ˜ 1000 premature deaths in Europe and 25 000 total premature deaths in the

  15. Assessment and economic valuation of air pollution impacts on human health over Europe and the United States as calculated by a multi-model ensemble in the framework of AQMEII3

    Directory of Open Access Journals (Sweden)

    U. Im

    2018-04-01

    Full Text Available The impact of air pollution on human health and the associated external costs in Europe and the United States (US for the year 2010 are modeled by a multi-model ensemble of regional models in the frame of the third phase of the Air Quality Modelling Evaluation International Initiative (AQMEII3. The modeled surface concentrations of O3, CO, SO2 and PM2.5 are used as input to the Economic Valuation of Air Pollution (EVA system to calculate the resulting health impacts and the associated external costs from each individual model. Along with a base case simulation, additional runs were performed introducing 20 % anthropogenic emission reductions both globally and regionally in Europe, North America and east Asia, as defined by the second phase of the Task Force on Hemispheric Transport of Air Pollution (TF-HTAP2. Health impacts estimated by using concentration inputs from different chemistry–transport models (CTMs to the EVA system can vary up to a factor of 3 in Europe (12 models and the United States (3 models. In Europe, the multi-model mean total number of premature deaths (acute and chronic is calculated to be 414 000, while in the US, it is estimated to be 160 000, in agreement with previous global and regional studies. The economic valuation of these health impacts is calculated to be EUR 300 billion and 145 billion in Europe and the US, respectively. A subset of models that produce the smallest error compared to the surface observations at each time step against an all-model mean ensemble results in increase of health impacts by up to 30 % in Europe, while in the US, the optimal ensemble mean led to a decrease in the calculated health impacts by  ∼  11 %. A total of 54 000 and 27 500 premature deaths can be avoided by a 20 % reduction of global anthropogenic emissions in Europe and the US, respectively. A 20 % reduction of North American anthropogenic emissions avoids a total of  ∼  1000 premature

  16. How Economic Analysis Can Contribute to Understanding the Links between Housing and Health.

    Science.gov (United States)

    Chapman, Ralph; Preval, Nicholas; Howden-Chapman, Philippa

    2017-08-31

    An economic analysis of housing's linkages to health can assist policy makers and researchers to make better decisions about which housing interventions and policies are the most cost-beneficial. The challenge is to include cobenefits. The adoption in 2015 of the UN Sustainable Development Goals underscores the importance of understanding how policies interact, and the merit of comprehensively evaluating cobenefits. We explain our approach to the empirical assessment of such cobenefits in the housing and health context, and consider lessons from empirical economic appraisals of the impact of housing on health outcomes. Critical assumptions relating to cobenefits are explicitly examined. A key finding is that when wider policy outcome measures are included, such as mental health impacts and carbon emission reductions, it is important that effects of assumptions on outcomes are considered. Another is that differing values underlie appraisal, for example, the weight given to future generations through the discount rate. Cost-benefit analyses (CBAs) can better facilitate meaningful debate when they are based on explicit assumptions about values. In short, the insights drawn from an economic framework for housing-and-health studies are valuable, but nonetheless contingent. Given that housing interventions typically have both health and other cobenefits, and incorporate social value judgements, it is important to take a broad view but be explicit about how such interventions are assessed.

  17. Assessing elders using the functional health pattern assessment model.

    Science.gov (United States)

    Beyea, S; Matzo, M

    1989-01-01

    The impact of older Americans on the health care system requires we increase our students' awareness of their unique needs. The authors discuss strategies to develop skills using Gordon's Functional Health Patterns Assessment for assessing older clients.

  18. Beyond Expected Utility in the Economics of Health and Longevity

    OpenAIRE

    Cordoba, Juan Carlos; Ripoll, Marla

    2013-01-01

    We document various limitations of the expected utility model for the study of health and longevity. The model assumes individuals are indifferent between early and late resolution of uncertainty. This assumption gives rise to predictions regarding the economic value of life that are inconsistent with relevant evidence. For example, poor individuals would price life below the present value of foregone income or even negatively. We show that a non-expected utility model disentangling intertemp...

  19. Social and economic aspects of aquatic animal health.

    Science.gov (United States)

    Adam, K E; Gunn, G J

    2017-04-01

    Aquaculture is an increasingly important source of animal protein for a growing global population. Disease is a major constraint to production, with resultant socio-economic impacts for individuals, communities and economies which rely on aquaculture. Aquatic animal health is also strongly influenced by human factors, ranging from international trade regulations to the behaviours of individuals working in aquaculture. This article summarises the human factors associated with aquaculture production using international examples for illustration.

  20. What is Health Impact Assessment?

    Directory of Open Access Journals (Sweden)

    Ahmet Soysal

    2010-12-01

    Full Text Available Health Impact Assessment (HIA was disseminated by World Health Organization (WHO European Region in Gothenburg consensus paper in 1999. In this consensus, HIA is defined as ‘a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of population and the distribution of those effects within the population’. HIA was accepted as a goal for 4th phase of healthy city projects between 2003- 2008. HIA is a new process for our country and especially municipal boroughs, local authorities interest with it. There is no legal base for HIA in our country. EIA practices conducted since 1993 showed us that, environmental and public health was postponed. Functional and decisive implementation of HAI depends on legal basis and national acceptance. If legal basis is supplied, society must take care about it, work for strict application and have to put a crimp in going back. [TAF Prev Med Bull 2010; 9(6.000: 689-694

  1. Health technology assessment in Mexico.

    Science.gov (United States)

    Gómez-Dantés, Octavio; Frenk, Julio

    2009-07-01

    The history of health technology assessment (HTA) in Mexico is examined, starting with the efforts to incorporate this topic into the policy agenda and culminating with the recent creation of a specialized public agency. Information was gathered through a bibliographic search and interviews with actors involved in HTA in Mexico. HTA efforts were developed in Mexico since the mid-1980s with the participation both of academics and of policy makers, a relationship that eventually led to the creation of the Center for Technological Excellence within the Ministry of Health. Institutionalization of HTA in resource-constrained settings requires the development of a critical mass of researchers involved in this field, the implementation of information efforts, and the establishment of strong relationships between HTA experts and policy makers.

  2. Health economics of market access for biopharmaceuticals and biosimilars.

    Science.gov (United States)

    Simoens, Steven

    2009-09-01

    This article discusses health economic challenges of research and development, registration, pricing and reimbursement of biopharmaceuticals and biosimilars. A literature search was carried out of PubMed, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews and EconLit up to March 2009. The development process of biopharmaceuticals is risky, lengthy, complex and expensive. Registration is complicated by the inherent variation between biopharmaceuticals. Also, as biopharmaceuticals are likely to be efficacious in a subgroup of the patient population, there is a need to select the most responsive target population and to identify biomarkers. To inform pricing and reimbursement decisions, the development process needs to collect comparative data to calculate the incremental cost effectiveness and budget impact of biopharmaceuticals. There is a role for innovative mechanisms such as risk-sharing arrangements to reimburse biopharmaceuticals. Given that biosimilars are similar, but not identical to the reference biopharmaceutical, the development process needs to generate clinical trial data in order to gain marketing authorisation. From a health economic perspective, the question arises whether inherent differences between biopharmaceuticals and biosimilars produce differences in safety, effectiveness and costs: to date, this question is unresolved. The early inclusion of health economics in the process of developing biopharmaceuticals and biosimilars is imperative with a view to demonstrating their relative (cost) effectiveness and informing registration, pricing and reimbursement decisions.

  3. Repealing Federal Health Reform: Economic and Employment Consequences for States.

    Science.gov (United States)

    Ku, Leighton; Steinmetz, Erika; Brantley, Erin; Bruen, Brian

    2017-01-01

    Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans. Goal: To determine the state-by-state effect of repeal on employment and economic activity. Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal spending cuts. Findings and Conclusions: Repeal results in a $140 billion loss in federal funding for health care in 2019, leading to the loss of 2.6 million jobs (mostly in the private sector) that year across all states. A third of lost jobs are in health care, with the majority in other industries. If replacement policies are not in place, there will be a cumulative $1.5 trillion loss in gross state products and a $2.6 trillion reduction in business output from 2019 to 2023. States and health care providers will be particularly hard hit by the funding cuts.

  4. Health Economics in Medical Nutrition: An Emerging Science.

    Science.gov (United States)

    Nuijten, Mark

    2015-01-01

    The objective of this paper is to describe the applications of health economic theory to medical nutrition. The published literature provides evidence that medical nutrition, e.g. oral nutritional supplements, is an effective treatment for patients with disease related malnutrition. Malnutrition is associated with mortality risk and complication rates, including infections. Malnutrition is not a new problem and with an ageing population it continues to become a major public health concern as increasing age is associated with an increased risk of malnutrition. This overview shows that in the case RCTs are providing the clinical evidence, there is no methodological difference between a cost-effectiveness analysis for pharmaceutical or nutrition. However, in nutrition the evidence may not always come from RCT data, but will be more often based on observational data. Therefore the clinical evidence of nutrition in itself is not the issue, but the handling of clinical evidence from observational studies. As the link between the consumption of a food product and a resulting health status is often more difficult to establish than the effect of a drug treatment it requires the further development of adapted methodologies in order to correctly predict the impact of food-related health effects and health economic outcomes from a broader perspective. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.

  5. A Systematic Review of the State of Economic Evaluation for Health Care in India.

    Science.gov (United States)

    Prinja, Shankar; Chauhan, Akashdeep Singh; Angell, Blake; Gupta, Indrani; Jan, Stephen

    2015-12-01

    Economic evaluations are one of the important tools in policy making for rational allocation of resources. Given the very low public investment in the health sector in India, it is critical that resources are used wisely on interventions proven to yield best results. Hence, we undertook this study to assess the extent and quality of evidence for economic evaluation of health-care interventions and programmes in India. A comprehensive search was conducted to search for published full economic evaluations pertaining to India and addressing a health-related intervention or programme. PubMed, Scopus, Embase, ScienceDirect, and York CRD database and websites of important research agencies were identified to search for economic evaluations published from January 1980 to the middle of November 2014. Two researchers independently assessed the quality of the studies based on Drummond and modelling checklist. Out of a total of 5013 articles enlisted after literature search, a total of 104 met the inclusion criteria for this systematic review. The majority of these papers were cost-effectiveness studies (64%), led by a clinician or public-health professional (77%), using decision analysis-based methods (59%), published in an international journal (80%) and addressing communicable diseases (58%). In addition, 42% were funded by an international funding agency or UN/bilateral aid agency, and 30% focussed on pharmaceuticals. The average quality score of these full economic evaluations was 65.1%. The major limitation was the inability to address uncertainties involved in modelling as only about one-third of the studies assessed modelling structural uncertainties (33%), or ran sub-group analyses to account for heterogeneity (36.5%) or analysed methodological uncertainty (32%). The existing literature on economic evaluations in India is inadequate to feed into sound policy making. There is an urgent need to generate awareness within the government of how economic evaluation can

  6. Bibliometric trends of health economic evaluation in Sub-Saharan Africa.

    Science.gov (United States)

    Hernandez-Villafuerte, Karla; Li, Ryan; Hofman, Karen J

    2016-08-24

    Collaboration between Sub-Saharan African researchers is important for the generation and transfer of health technology assessment (HTA) evidence, in order to support priority-setting in health. The objective of this analysis was to evaluate collaboration patterns between countries. We conducted a rapid evidence assessment that included a random sample of health economic evaluations carried out in 20 countries (Angola, Botswana, Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe, Ghana, Kenya, Nigeria, Ethiopia, Uganda). We conducted bibliometric network analysis based on all first authors with a Sub-Saharan African academic affiliation and their co-authored publications ("network-articles"). Then we produced a connection map of collaboration patterns among Sub-Saharan African researchers, reflecting the number of network-articles and the country of affiliation of the main co-authors. The sample of 119 economic evaluations mostly related to treatments of communicable diseases, in particular HIV/AIDS (42/119, 35.29 %) and malaria (26/119, 21.85 %). The 39 first authors from Sub-Saharan African institutions together co-authored 729 network-articles. The network analysis showed weak collaboration between health economic researchers in Sub-Saharan Africa, with researchers being more likely to collaborate with Europe and North America than with other African countries. South Africa stood out as producing the highest number of health economic evaluations and collaborations. The development and evaluation of HTA research networks in Sub-Saharan Africa should be supported, with South Africa central to any such efforts. Organizations and institutions from high income countries interested in supporting priority setting in Sub-Saharan Africa should include promoting collaboration as part of their agendas, in order to take advantage of the potential transferability of results and methods of the

  7. New local diesel power stations: an economic assessment

    International Nuclear Information System (INIS)

    Wills, R.J.; Reuben, B.G.

    1992-01-01

    A recent investigation examined the economic potential for electricity generation in the U.K. using large slow-speed two-stroke diesel engines of around 40MW unit output. Large diesels are a high efficiency technology, resilient to fuel quality, and with high reliability. Economic analysis compared diesels with other generating options for a range of fuel scenarios and discount rates. Merit order potential and total costs were also assessed. The diesels show superior economic qualities, both in terms of investment criteria and high merit position. They are economically comparable with combined cycle gas turbines, but combined cycle plant is essentially large-scale, whereas diesels in 40 MW units sizes can provide small-scale, high-efficiency local generation. Slow-speed diesels represent a sound investment for electricity supply. Diesels in local power stations in southern England would increase supply security and diversity. They are compatible with a cautious investment approach and are appropriate for the new market conditions in electricity supply. (author)

  8. Health inequalities by socioeconomic characteristics in Spain: the economic crisis effect.

    Science.gov (United States)

    Barroso, Clara; Abásolo, Ignacio; Cáceres, José J

    2016-04-11

    An economic crisis can widen health inequalities between individuals. The aim of this paper is to explore differences in the effect of socioeconomic characteristics on Spaniards' self-assessed health status, depending on the Spanish economic situation. Data from the 2006-2007 and 2011-2012 National Health Surveys were used and binary logit and probit models were estimated to approximate the effects of socioeconomic characteristics on the likelihood to report good health. The difference between high and low education levels leads to differences in the likelihood to report good health of 16.00-16.25 and 18.15-18.22 percentage points in 2006-07 and 2011-12, respectively. In these two periods, the difference between employees and unemployed is 5.24-5.40 and 4.60-4.90 percentage points, respectively. Additionally, the difference between people who live in households with better socioeconomic conditions and those who are in worse situation reaches 5.37-5.46 and 3.63-3.74 percentage points for the same periods, respectively. The magnitude of the contribution of socioeconomic characteristics to health inequalities changes with the economic cycle; but this effect is different depending on the socioeconomic characteristics indicator that is being measured. In recessive periods, health inequalities due to education level increase, but those linked to individual professional status and household living conditions are attenuated. When the joint effects of individuals' characteristics are considered, the economic crisis brings about a slight increase in the inequalities in the probability of reporting good health between the two extreme profiles of individuals. The design of public policies aimed at preventing any worsening of health inequalities during recession periods should take into account these differential effects of socioeconomic characteristics indicators on health inequalities.

  9. A one health framework for estimating the economic costs of zoonotic diseases on society.

    Science.gov (United States)

    Narrod, Clare; Zinsstag, Jakob; Tiongco, Marites

    2012-06-01

    This article presents an integrated epidemiological and economic framework for assessing zoonoses using a "one health" concept. The framework allows for an understanding of the cross-sector economic impact of zoonoses using modified risk analysis and detailing a range of analytical tools. The goal of the framework is to link the analysis outputs of animal and human disease transmission models, economic impact models and evaluation of risk management options to gain improved understanding of factors affecting the adoption of risk management strategies so that investment planning includes the most promising interventions (or sets of interventions) in an integrated fashion. A more complete understanding of the costs of the disease and the costs and benefits of control measures would promote broader implementation of the most efficient and effective control measures, contributing to improved animal and human health, better livelihood outcomes for the poor and macroeconomic growth.

  10. Health economic research on vaccinations and immunisation practices--an introductory primer.

    Science.gov (United States)

    Szucs, Thomas D

    2005-03-18

    The economic importance of vaccines lies partly in the burden of disease that can be avoided and partly in the competition for resources between vaccines and other interventions. Up to the 1980s only few economic evaluations had been carried out. Since then the confrontation of most countries with escalating health care costs and tighter budgets have awakened the interest in pharmacoeconomic analysis. Resources used to provide health care are vast but not limitless. When clinicians are asked to participate in decisions for large groups of patients (in a managed care context, in an institution, or at the level of local health authorities), the balance between consumption of resources and the benefits of an intervention is important. Clinicians may use cost-effectiveness and cost-benefit studies to inform such decisions (but not to make them). Because of differences in methods, the presentation of results, and country-specific parameters, economic evaluations of the same vaccination strategy by different groups may have divergent results. Vaccines differ from classical medicines in at least three ways: firstly, there is a longer tradition of economic evaluations for vaccines than for medicines. Some of the most earliest economic studies were carried out in the field of vaccines in the public health arena. Secondly, comparatively fewer central decision makers need to be convinced as compared to drugs. The reason for this being a more centralised process of recommending vaccines and vaccination policies. Thirdly, externalities are more relevant in the field of vaccines. Such externalities may be positive or negative. Positive externalities are present in the case where herd immunity prevents the spread of the disease in the community. We are now undoubtedly in an era of assessment and accountability for all new technologies in healthcare. However, sufficient economic data are still lacking to support the formulation of health policy and a particular challenge for the

  11. Technical and economic assessment of solar hybrid repowering. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-09-01

    Public Service Company of New Mexico (PNM) has performed a Technical and Economic Assessment of Solar Hybrid Repowering under funding by the Department of Energy (DOE), the Electric Power Research Institute (EPRI), Western Energy Supply and Transmission (WEST) Associates, and a number of southwestern utilities. Solar hybrid repowering involves placement of solar hardware adjacent to and connected to existing gas- and oil-fueled electric generation units to displace some of or all the fossil fuel normally used during daylight hours. The subject study assesses the technical economic viability of the solar hybrid repowering concept within the southwestern United States and the PNM system. This document is a final report on the study and its results. The study was divided into the six primary tasks to allow a systematic investigation of the concept: (1) market survey and cost/benefit analysis, (2) study unit selection, (3) conceptual design and cost estimates, (4) unit economic analysis, (5) program planning, future phases, and (6) program management. Reeves Station No. 2 at Albuquerque, New Mexico, was selected for repowering with a design goal of 50 percent (25 MWe). The solar system design is based on the 10 MW solar central receiver pilot plant preliminary design for Barstow, California. SAN--1608-4-2 contains the technical drawings. (WHK)

  12. Material flow-based economic assessment of landfill mining processes.

    Science.gov (United States)

    Kieckhäfer, Karsten; Breitenstein, Anna; Spengler, Thomas S

    2017-02-01

    This paper provides an economic assessment of alternative processes for landfill mining compared to landfill aftercare with the goal of assisting landfill operators with the decision to choose between the two alternatives. A material flow-based assessment approach is developed and applied to a landfill in Germany. In addition to landfill aftercare, six alternative landfill mining processes are considered. These range from simple approaches where most of the material is incinerated or landfilled again to sophisticated technology combinations that allow for recovering highly differentiated products such as metals, plastics, glass, recycling sand, and gravel. For the alternatives, the net present value of all relevant cash flows associated with plant installation and operation, supply, recycling, and disposal of material flows, recovery of land and landfill airspace, as well as landfill closure and aftercare is computed with an extensive sensitivity analyses. The economic performance of landfill mining processes is found to be significantly influenced by the prices of thermal treatment (waste incineration as well as refuse-derived fuels incineration plant) and recovered land or airspace. The results indicate that the simple process alternatives have the highest economic potential, which contradicts the aim of recovering most of the resources. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Revised assessments of the economics of fusion power

    International Nuclear Information System (INIS)

    Han, W.E.; Ward, D.J.

    2009-01-01

    Although fusion power is being developed because of its large resource base, low environmental impact and high levels of intrinsic safety, it is also important to investigate the economics of a future fusion power plant in order to assess the potential market for the electricity produced. As part of the PPCS (Power Plant Conceptual Study) in Europe, published in 2005, an assessment was made of the likely economic performance of the range of fusion power plant concepts studied. Since that time, new work has been carried out, within the fusion programme, and particularly in the EU DEMO study, that changes a number of the important assumptions made in the PPCS. These changes allow either reduced cost versions of the PPCS plant models or, alternatively, plants with less ambitious technical assumptions at constant cost. The impact of the new results, emerging from the EU DEMO studies, on the role of fusion in the future energy market is described. A new energy economics model is employed to analyse the potential market performance of fusion power in a range of future energy scenarios and this shows that there can be a significant role for fusion in a future energy market.

  14. The health economics of cholera: A systematic review.

    Science.gov (United States)

    Hsiao, Amber; Hall, Angela H; Mogasale, Vittal; Quentin, Wilm

    2018-06-12

    Vibrio cholera is a major contributor of diarrheal illness that causes significant morbidity and mortality globally. While there is literature on the health economics of diarrheal illnesses more generally, few studies have quantified the cost-of-illness and cost-effectiveness of cholera-specific prevention and control interventions. The present systematic review provides a comprehensive overview of the literature specific to cholera as it pertains to key health economic measures. A systematic review was performed with no date restrictions up through February 2017 in PubMed, Econlit, Embase, Web of Science, and Cochrane Review to identify relevant health economics of cholera literature. After removing duplicates, a total of 1993 studies were screened and coded independently by two reviewers, resulting in 22 relevant studies. Data on population, methods, and results (cost-of-illness and cost-effectiveness of vaccination) were compared by country/region. All costs were adjusted to 2017 USD for comparability. Costs per cholera case were found to be rather low: $1000/case. There is adequate evidence to support the economic value of vaccination for the prevention and control of cholera when vaccination is targeted at high-incidence populations and/or areas with high case fatality rates due to cholera. When herd immunity is considered, vaccination also becomes a cost-effective option for the general population and is comparable in cost-effectiveness to other routine immunizations. Cholera vaccination is a viable short-to-medium term option, especially as the upfront costs of building water, sanitation, and hygiene (WASH) infrastructure are considerably higher for countries that face a significant burden of cholera. While WASH may be the more cost-effective solution in the long-term when implemented properly, cholera vaccination can still be a feasible, cost-effective strategy. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Lindhjem, Henrik; Hu Tao; Ma Zhong; Skjelvik, John Magne; Song Guojun; Vennemo, Haakon; Wu Jian; Zhang Shiqiu

    2007-01-01

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

  16. Health economics and outcomes methods in risk-based decision-making for blood safety.

    Science.gov (United States)

    Custer, Brian; Janssen, Mart P

    2015-08-01

    Analytical methods appropriate for health economic assessments of transfusion safety interventions have not previously been described in ways that facilitate their use. Within the context of risk-based decision-making (RBDM), health economics can be important for optimizing decisions among competing interventions. The objective of this review is to address key considerations and limitations of current methods as they apply to blood safety. Because a voluntary blood supply is an example of a public good, analyses should be conducted from the societal perspective when possible. Two primary study designs are recommended for most blood safety intervention assessments: budget impact analysis (BIA), which measures the cost to implement an intervention both to the blood operator but also in a broader context, and cost-utility analysis (CUA), which measures the ratio between costs and health gain achieved, in terms of reduced morbidity and mortality, by use of an intervention. These analyses often have important limitations because data that reflect specific aspects, for example, blood recipient population characteristics or complication rates, are not available. Sensitivity analyses play an important role. The impact of various uncertain factors can be studied conjointly in probabilistic sensitivity analyses. The use of BIA and CUA together provides a comprehensive assessment of the costs and benefits from implementing (or not) specific interventions. RBDM is multifaceted and impacts a broad spectrum of stakeholders. Gathering and analyzing health economic evidence as part of the RBDM process enhances the quality, completeness, and transparency of decision-making. © 2015 AABB.

  17. Public health impact and economic evaluation of vitamin D-fortified dairy products for fracture prevention in France

    OpenAIRE

    Hiligsmann, M.; Burlet, N.; Fardellone, P.; Al-Daghri, N.; Reginster, J.-Y.

    2016-01-01

    Summary The recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60?years. Introduction This study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60?years. Methods We estimated the lifetime health impacts expressed in number of fractures prevented, life...

  18. Emotional responses to behavioral economic incentives for health behavior change.

    Science.gov (United States)

    van der Swaluw, Koen; Lambooij, Mattijs S; Mathijssen, Jolanda J P; Zeelenberg, Marcel; Polder, Johan J; Prast, Henriëtte M

    2018-03-05

    Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals do not get their prize but receive feedback on what their forgone earnings would have been. This counterfactual feedback should provoke anticipated regret and increase commitment to health goals. We explored which emotions were actually expected upon missing out on a prize due to unsuccessful weight loss and which incentive-characteristics influence their likelihood and intensity. Participants reported their expected emotional response after missing out on a prize in one of 12 randomly presented incentive-scenarios, which varied in incentive type, incentive size and deadline distance. Participants primarily reported feeling disappointment, followed by regret. Regret was expected most when losing a lottery prize (vs. a fixed incentive) and intensified with prize size. Multiple features of the participant and the lottery incentive increase the occurrence and intensity of regret. As such, our findings can be helpful in designing behavioral economic incentives that leverage emotions to support health behavior change.

  19. An economic assessment of U.S. MHTGR design

    International Nuclear Information System (INIS)

    Mears, L. Daniel

    1990-01-01

    GCRA's economic goal for the U.S. MHTGR design is for the equilibrium plants to have at least a 10% power cost advantage over comparably sized, state-of-the-art coal plants. In addition, the designers are challenged to limit the overall financial risk to be on par with such a coal plant. During the past year, cost estimates and economic assessments have been updated in the U.S. MHTGR Program. Further, a major study has been completed adapting the MHTGR to a water desalination/cogeneration application. These results will be presented along with a discussion of the key GCRA design requirements that limit the overall financial risk to the prospective owner/operators of future MHTGR plants. (author)

  20. Power station impacts: socio-economic impact assessment

    International Nuclear Information System (INIS)

    Glasson, John; Elson, Martin; Barrett, Brendan; Wee, D. Van der

    1987-01-01

    The aim of this study is to assess the local social and economic impacts of a proposed nuclear power station development at Hinkley Point in Somerset. The proposed development, Hinkley Point C, would be an addition to the existing Hinkley Point A Magnox station, commissioned in 1965, and the Hinkley Point B Advanced Gas Cooled Reactor (AGR) station, commissioned in 1976. It is hoped that the study will be of assistance to the CEGB, the Somerset County and District Councils and other agencies in their studies of the proposed development. In addition, the study seeks to apply and further develop the methodology and results from previous studies by the Power Station Impacts (PSI) team for predicting the social and economic effects of proposed power station developments on their localities. (author)

  1. An economic assessment of U.S. MHTGR design

    Energy Technology Data Exchange (ETDEWEB)

    Mears, L Daniel [Gas-Cooled Reactor Associates, San Diego, CA (United States)

    1990-07-01

    GCRA's economic goal for the U.S. MHTGR design is for the equilibrium plants to have at least a 10% power cost advantage over comparably sized, state-of-the-art coal plants. In addition, the designers are challenged to limit the overall financial risk to be on par with such a coal plant. During the past year, cost estimates and economic assessments have been updated in the U.S. MHTGR Program. Further, a major study has been completed adapting the MHTGR to a water desalination/cogeneration application. These results will be presented along with a discussion of the key GCRA design requirements that limit the overall financial risk to the prospective owner/operators of future MHTGR plants. (author)

  2. Socio-economic inequalities in health and health service use among older adults in India: results from the WHO Study on Global AGEing and adult health survey.

    Science.gov (United States)

    Brinda, E M; Attermann, J; Gerdtham, U G; Enemark, U

    2016-12-01

    The objectives of this study were to measure socio-economic inequalities in self-reported health (SRH) and healthcare visits and to identify factors contributing to health inequalities among older people aged 50-plus years. This study is based on a population-based, cross-sectional survey. We accessed data of 7150 older adults from the World Health Organization's Study on Global AGEing and adult health Indian survey. We used multivariate logistic regression to assess the correlates of poor SRH. We estimated the concentration index to measure socio-economic inequalities in SRH and healthcare visits. Regression-based decomposition analysis was employed to explore the correlates contributing to poor SRH inequality. About 19% (95% CI: 18%, 20%) reported poor health (n = 1368) and these individuals were significantly less wealthy. In total, 5134 (71.8%) participants made at least one health service visit. Increasing age, female gender, low social caste, rural residence, multimorbidity, absence of pension support, and health insurance were significant correlates of poor SRH. The standardized concentration index of poor SRH -0.122 (95% CI: -0.102; -0.141) and healthcare visits 0.364 (95% CI: 0.324, 0.403) indicated pro-poor and pro-rich inequality, respectively. Economic status (62.3%), pension support (11.5%), health insurance coverage (11.5%), social caste (10.7%) and place of residence (4.1%) were important contributors to inequalities in poor health. Socio-economic disparities in health and health care are major concerns in India. Achievement of health equity demand strategies beyond health policies, to include pro-poor, social welfare policies among older Indians. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Improving the use of economics in animal health - Challenges in research, policy and education.

    Science.gov (United States)

    Rushton, Jonathan

    2017-02-01

    The way that an economist and an animal health professional use economics differs and creates frustrations. The economist is in search of optimizing resource allocation in the management of animal health and disease problems with metrics associated with the productivity of key societal resources of labour and capital. The animal health professional have a strong belief that productivity can be improved with the removal of pathogens. These differences restrict how well economics is used in animal health, and the question posed is whether this matters. The paper explores the question by looking at the changing role of animals in society and the associated change of the animal health professional's activities. It then questions if the current allocation of scarce resources for animal health are adequately allocated for societies and whether currently available data are sufficient for good allocation. A rapid review of the data on disease impacts - production losses and costs of human reaction - indicate that the data are sparse collected in different times and geographical regions. This limits what can be understood on the productivity of the economic resources used for animal health and this needs to be addressed with more systematic collection of data on disease losses and costs of animal health systems. Ideally such a process should learn lessons from the way that human health has made estimates of the burden of diseases and their capture of data on the costs of human health systems. Once available data on the global burden of animal diseases and the costs of animal health systems would allow assessments of individual disease management processes and the productivity of wider productivity change. This utopia should be aimed at if animal health is to continue to attract and maintain adequate resources. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. School-Based Influenza Vaccination: Health and Economic Impact of Maine's 2009 Influenza Vaccination Program.

    Science.gov (United States)

    Basurto-Dávila, Ricardo; Meltzer, Martin I; Mills, Dora A; Beeler Asay, Garrett R; Cho, Bo-Hyun; Graitcer, Samuel B; Dube, Nancy L; Thompson, Mark G; Patel, Suchita A; Peasah, Samuel K; Ferdinands, Jill M; Gargiullo, Paul; Messonnier, Mark; Shay, David K

    2017-12-01

    To estimate the societal economic and health impacts of Maine's school-based influenza vaccination (SIV) program during the 2009 A(H1N1) influenza pandemic. Primary and secondary data covering the 2008-09 and 2009-10 influenza seasons. We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference-in-difference-in-differences analysis to assess the program's impact on immunization among six age groups. We also developed a health and economic Markov microsimulation model and conducted Monte Carlo sensitivity analysis. We used national survey data to estimate the impact of the SIV program on vaccine coverage. We used primary data and published studies to develop the microsimulation model. The program was associated with higher immunization among children and lower immunization among adults aged 18-49 years and 65 and older. The program prevented 4,600 influenza infections and generated $4.9 million in net economic benefits. Cost savings from lower adult vaccination accounted for 54 percent of the economic gain. Economic benefits were positive in 98 percent of Monte Carlo simulations. SIV may be a cost-beneficial approach to increase immunization during pandemics, but programs should be designed to prevent lower immunization among nontargeted groups. © Health Research and Educational Trust.

  5. Transboundary smoke haze pollution in Malaysia: Inpatient health impacts and economic valuation

    International Nuclear Information System (INIS)

    Othman, Jamal; Sahani, Mazrura; Mahmud, Mastura; Sheikh Ahmad, Md Khadzir

    2014-01-01

    This study assessed the economic value of health impacts of transboundary smoke haze pollution in Kuala Lumpur and adjacent areas in the state of Selangor, Malaysia. Daily inpatient data from 2005, 2006, 2008, and 2009 for 14 haze-related illnesses were collected from four hospitals. On average, there were 19 hazy days each year during which the air pollution levels were within the Lower Moderate to Hazardous categories. No seasonal variation in inpatient cases was observed. A smoke haze occurrence was associated with an increase in inpatient cases by 2.4 per 10,000 populations each year, representing an increase of 31 percent from normal days. The average annual economic loss due to the inpatient health impact of haze was valued at MYR273,000 ($91,000 USD). - Highlights: • Transboundary smoke haze is an annual phenomenon in Malaysia. • No evidence of seasonal factors in smoke haze related inpatient cases. • Inpatient rates during a haze event increased by 31% relative to normal days. • Annual economic loss due to inpatient health impact of haze valued at $91,000. • Present value of economic loss estimated at $1.1 million to $1.7 million. - Inpatient rates soared by 31% while economic loss valued at USD91,000 annually

  6. Assessing the ecological and economic sustainability of energy crops

    International Nuclear Information System (INIS)

    Hanegraaf, M.C.; Biewinga, E.E.; Bijl, G. van der

    1998-01-01

    The production and use of biomass for energy has both positive and negative impacts on the environment. The environmental impacts of energy crops should be clarified before political choices concerning energy are made. An important aid to policy-making would be a systematic methodology to assess the environmental sustainability of energy crops. So far, most studies on the environmental aspects of energy crops deal mainly with the energy production of the crops and the possible consequences for CO 2 mitigation. The Dutch Centre for Agriculture and Environment (CLM) has developed a systematic methodology to assess the ecological and socio-economic sustainability of biomass crops. The method is best described as a multicriteria analysis of process chains and is very much related to Life Cycle Assessment (LCA). Characteristics of our methodology are the use of: definition of functional units; analysis of the entire lifecycle; definition of yield levels and corresponding agricultural practices; analysis of both ecological and economic criteria; definition of reference systems; definition of procedures for normalisation and weighting. CLM has applied the method to assess the sustainability of ten potentially interesting energy crops in four European regions. The results are used to outline the perspectives for large scale production of biomass crops with regard to the medium and long term land availability in Europe. For the crops considered, net energy budget ranges from 85 GJ net avoided energy per ha for rape seed for fuel to 248 GJ net avoided fossil energy per ha for silage maize for electricity from gasification. The methodology of the tool and its results were discussed at the concerted action ''Environmental aspects of biomass production and routes for European energy supply'' (AIR3-94-2455), organised by CLM in 1996. Major conclusions of the research: multicriteria analyhsis of process lifecycles is at present the best available option to assess the ecological

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

    Science.gov (United States)

    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.

  8. Methanol as an alternative fuel: Economic and health effects

    International Nuclear Information System (INIS)

    Yuecel, M.K.

    1991-01-01

    Switching from gasoline to methanol fuels has important economic and health effects. Replacing gasoline with methanol will affect oil markets by lowering the demand for oil and thus lowering oil prices. Increased demand for the natural gas feedstock will increase natural gas prices. Because methanol is more costly than gasoline, fuel prices will also increase. On the other hand, methanol use will reduce ozone pollution and some of the health risks associated with gasoline. Considering all three markets affected by the phasing-out of gasoline, the switch to methanol results in net gains. The health benefits from lower pollution and the lives saved from the switch from gasoline to methanol are in addition to these gains. Overall, the benefits of the policy far outweigh the costs. However, the gains in the oil market, arising from the US monopsony power in the world oil market, can be captured by other, more efficient policies. 21 refs., 2 figs., 3 tabs

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

    Science.gov (United States)

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

    2011-07-01

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

  10. Influence of health risk behavior and socio-economic status on health of Slovak adolescents

    NARCIS (Netherlands)

    Geckova, AM; van Dijk, JP; Honcariv, R; Groothoff, JW; Post, D

    Aim. To investigate the role of health risk behavior, such as smoking and alcohol consumption, in the explanation of socio-economic health differences among adolescents. The hypothesis of different exposure and the hypothesis of different vulnerability were explored. Method. In the study carried out

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

    Science.gov (United States)

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

    2016-03-01

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

  12. 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....

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

    Science.gov (United States)

    Lopert, Ruth; Viney, Rosalie

    2014-01-01

    All governments face immense challenges in providing affordable healthcare for their citizens, and the diffusion of novel health technologies is a key driver of growth in expenditure for many. Although important methodological and process variations exist around the world, health economic evaluation is increasingly seen as an important tool to support decision-making around the introduction of new health technologies, interventions and programmes in countries of varying stages of economic development. In Australia, the assessment of the comparative cost-effectiveness of new medicines proposed for subsidy under the country's national drug subsidy programme, the Pharmaceutical Benefits Scheme, was introduced in the late 1980s and became mandatory in 1993, making Australia the first country to introduce such a requirement nationally. Since then the use of health economic evaluation has expanded and been applied to support decision-making across a broader range of health technologies, as well as to programmes in public health. Copyright © 2014. Published by Elsevier GmbH.

  14. Economic assessment factors relating to spent nuclear fuel reprocessing

    International Nuclear Information System (INIS)

    This paper is in two parts. Part I discusses the factors to be applied in an economic assessment of reprocessing. It sets forth three basic cost components, namely capital costs, operating costs and the cost of capital utilization. It lists the various components of each cost area. Part II proposes a relationship between these respective cost areas, tabulates a range of costs and then develops unit costs for reprocessing operations. Finally, an addendum to the paper gives a more detailed breakdown of the capital costs of a reprocessing plant

  15. Economic assessment of a waste hydrogen utilization project

    International Nuclear Information System (INIS)

    Wang, L.; Zhou, H.; Zhou, W.; Wu, J.; Wang, Q.

    1993-01-01

    This paper reports the economic assessment on an hybrid hydrogen recovery, purification, storage, transportation and application project (HRPSTA) set for a system including a nitrogenous fertilizer plant and a float glass factory. A pretreatment unit and metal hydride containers are used to recover and purify the hydrogen from the purge gas of the ammonia fertilizer plant and to transport and use the hydrogen on the tin bath in the float glass factory. Cost analysis and cash flow statements are presented, and financial value and rate of return are calculated. The project is shown to be technologically and financially feasible. 1 fig., 4 tabs., 4 refs

  16. Ex post socio-economic assessment of the Oresund Bridge

    DEFF Research Database (Denmark)

    Knudsen, M.Aa.; Rich, Jeppe

    2013-01-01

    -economic assessment, the consumer benefits including all freight and passenger modes, are compared with the cost profile of the bridge. The monetary contributions are extrapolated to a complete 50 year period. It is revealed that the bridge from 2000–2010 generated a consumer surplus of €2 billion in 2000 prices...... to the current transport flows. The importance of having the right assumptions and the ability to model the phasing-in process are underlined. Secondly, we offer a wider discussion on why some projects are more beneficial than others. This is done by comparing the Oresund Bridge, the Channel Tunnel...

  17. Clinical and economic outcomes assessment in nuclear cardiology

    International Nuclear Information System (INIS)

    Shaw, L.J.; Miller, D.D.; Berman, D.S.; Hachamovitch, R.

    2000-01-01

    The future of nuclear medicine procedures, as understood within our current economic climate, depends upon its ability to provide relevant clinical information at similar or lower comparative costs. With an ever-increasing emphasis on cost containment, outcome assessment forms the basis of preserving the quality of patient care. Today, outcomes assessment encompasses a wide array of subjects including clinical, economic, and humanistic (i.e., quality of life) outcomes. For nuclear cardiology, evidence-based medicine would require a threshold level of evidence in order to justify the added cost of any test in a patient's work-up. This evidence would include large multicenter, observational series as well as randomized trial data in sufficiently large and diverse patient populations. The new movement in evidence-based medicine is also being applied to the introduction of new technologies, in particular when comparative modalities exist. In the past 5 years, it has seen a dramatic shift in the quality of outcomes data published in nuclear cardiology. This includes the use of statistically rigorous risk-adjusted techniques as well as large populations (i.e., >500 patients) representing multiple diverse medical care settings. This has been the direct result of the development of multiple outcomes databases that have now amassed thousands of patients worth of data. One of the benefits of examining outcomes in large patient datasets is the ability to assess individual endpoints (e.g., cardiac death) as compared with smaller datasets that often assess combined endpoints (e.g., death, myocardial infarction, or unstable angina). New technologies for the diagnosis of coronary artery disease have contributed to the rising costs of care. In the United States and in Europe, costs of care have risen dramatically, consuming an ever-increasing amount of available resources. The overuse of diagnostic angiography often leads to unnecessary revascularization that does not lead to

  18. Cost-of-illness analysis. What room in health economics?

    Science.gov (United States)

    Tarricone, Rosanna

    2006-06-01

    Cost-of-illness (COI) was the first economic evaluation technique used in the health field. The principal aim was to measure the economic burden of illness to society. Its usefulness as a decision-making tool has however been questioned since its inception. The main criticism came from welfare economists who rejected COIs because they were not grounded in welfare economics theory. Other attacks related to the use of the human capital approach (HCA) to evaluate morbidity and mortality costs since it was said that the HCA had nothing to do with the value people attach to their lives. Finally, objections were made that COI could not be of any help to decision makers and that other forms of economic evaluation (e.g. cost-effectiveness, cost-benefit analysis) would be much more useful to those taking decisions and ranking priorities. Conversely, it is here suggested that COI can be a good economic tool to inform decision makers if it is considered from another perspective. COI is a descriptive study that can provide information to support the political process as well as the management functions at different levels of the healthcare organisations. To do that, the design of the study must be innovative, capable of measuring the true cost to society; to estimate the main cost components and their incidence over total costs; to envisage the different subjects who bear the costs; to identify the actual clinical management of illness; and to explain cost variability. In order to reach these goals, COI need to be designed as observational bottom-up studies.

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

    Science.gov (United States)

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

    2016-04-01

    This study identified and prioritized resources and outcomes that should be considered in more comprehensive and scientifically rigorous health and safety economic evaluations according to healthcare sector stakeholders. A literature review and stakeholder interviews identified candidate resources and outcomes and then a Delphi panel ranked them. According to the panel, the top five resources were (a) health and safety staff time; (b) training workers; (c) program planning, promotion, and evaluation costs; (d) equipment purchases and upgrades; and (e) administration costs. The top five outcomes were (a) number of injuries, illnesses, and general sickness absences; (b) safety climate; (c) days lost due to injuries, illnesses, and general sickness absences; (d) job satisfaction and engagement; and (e) quality of care and patient safety. These findings emphasize stakeholders' stated priorities and are useful as a benchmark for assessing the quality of health and safety economic evaluations and the comprehensiveness of these findings. © 2016 The Author(s).

  20. 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

  1. 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

  2. Health Economics in Radiation Oncology: Introducing the ESTRO HERO project

    International Nuclear Information System (INIS)

    Lievens, Yolande; Grau, Cai

    2012-01-01

    New evidence based regimens and novel high precision technology have reinforced the important role of radiotherapy in the management of cancer. Current data estimate that more than 50% of all cancer patients would benefit from radiotherapy during the course of their disease. Within recent years, the radiotherapy community has become more than conscious of the ever-increasing necessity to come up with objective data to endorse the crucial role and position of radiation therapy within the rapidly changing global oncology landscape. In an era of ever expanding health care costs, proven safety and effectiveness is not sufficient anymore to obtain funding, objective data about cost and cost-effectiveness are nowadays additionally requested. It is in this context that ESTRO is launching the HERO-project (Health Economics in Radiation Oncology), with the overall aim to develop a knowledge base and a model for health economic evaluation of radiation treatments at the European level. To accomplish these objectives, the HERO project will address needs, accessibility, cost and cost-effectiveness of radiotherapy. The results will raise the profile of radiotherapy in the European cancer management context and help countries prioritizing radiotherapy as a highly cost-effective treatment strategy. This article describes the different steps and aims within the HERO-project, starting from evidence on the role of radiotherapy within the global oncology landscape and highlighting weaknesses that may undermine this position.

  3. Health economics in radiation oncology: introducing the ESTRO HERO project.

    Science.gov (United States)

    Lievens, Yolande; Grau, Cai

    2012-04-01

    New evidence based regimens and novel high precision technology have reinforced the important role of radiotherapy in the management of cancer. Current data estimate that more than 50% of all cancer patients would benefit from radiotherapy during the course of their disease. Within recent years, the radiotherapy community has become more than conscious of the ever-increasing necessity to come up with objective data to endorse the crucial role and position of radiation therapy within the rapidly changing global oncology landscape. In an era of ever expanding health care costs, proven safety and effectiveness is not sufficient anymore to obtain funding, objective data about cost and cost-effectiveness are nowadays additionally requested. It is in this context that ESTRO is launching the HERO-project (Health Economics in Radiation Oncology), with the overall aim to develop a knowledge base and a model for health economic evaluation of radiation treatments at the European level. To accomplish these objectives, the HERO project will address needs, accessibility, cost and cost-effectiveness of radiotherapy. The results will raise the profile of radiotherapy in the European cancer management context and help countries prioritizing radiotherapy as a highly cost-effective treatment strategy. This article describes the different steps and aims within the HERO-project, starting from evidence on the role of radiotherapy within the global oncology landscape and highlighting weaknesses that may undermine this position. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    Chen, M S; Chan, A

    1999-01-01

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

  5. Economic Impact Assessment of Alternative Climate Policy Strategies

    International Nuclear Information System (INIS)

    Kemfert, C.

    2001-10-01

    This paper investigates the world economic implications of climate change policy strategies, especially the evaluation of impacts by an implementation of Clean Development Mechanisms, Joint Implementation and Emissions trading with a world integrated assessment model. Of special interest in this context are the welfare spill over and competitiveness effects that result from diverse climate policy strategies. In particular, this study elaborates and compares multi gas policy strategies and explores the impacts of the inclusion of sinks. Because of the recent decision of an isolated climate policy strategy by the United States of America, we examine the economic impacts of all world regions by a non cooperative and free rider position of the USA. It turns out that Clean Development Mechanisms and Joint Implementation show evidence of improvement in the economic development in the host countries and increase the share of new applied technologies. The decomposition of welfare effects demonstrates that the competitiveness effect including the spill over effects from trade have the strongest importance because of the intense trade relations between countries. Climatic effects have a significant impact within the next 50 years, cause considerable welfare losses to world regions and will intensify if some highly responsible nations like the USA do not reduce their emissions

  6. Economic Assessment of the Use Value of Geospatial Information

    Directory of Open Access Journals (Sweden)

    Richard Bernknopf

    2015-07-01

    Full Text Available Geospatial data inform decision makers. An economic model that involves application of spatial and temporal scientific, technical, and economic data in decision making is described. The value of information (VOI contained in geospatial data is the difference between the net benefits (in present value terms of a decision with and without the information. A range of technologies is used to collect and distribute geospatial data. These technical activities are linked to examples that show how the data can be applied in decision making, which is a cultural activity. The economic model for assessing the VOI in geospatial data for decision making is applied to three examples: (1 a retrospective model about environmental regulation of agrochemicals; (2 a prospective model about the impact and mitigation of earthquakes in urban areas; and (3 a prospective model about developing private–public geospatial information for an ecosystem services market. Each example demonstrates the potential value of geospatial information in a decision with uncertain information.

  7. Impact of the east Asian economic crisis on health and health care: Malaysia's response.

    Science.gov (United States)

    Suleiman, A B; Lye, M S; Yon, R; Teoh, S C; Alias, M

    1998-01-01

    In the wake of the east Asian economic crisis, the health budget for the public sector in Malaysia was cut by 12%. The Ministry of Health responded swiftly with a series of broad-based and specific strategies. There was a careful examination of the operating expenditure and where possible measures were taken to minimise the effects of the budget constraints at the service interface. The MOH reprioritised the development of health projects. Important projects such as rural health projects and training facilities, and committed projects, were continued. In public health, population-based preventive and promotive activities were expected to experience some form of curtailment. There is a need to refocus priorities, maximise the utilisation of resources, and increase productivity at all levels and in all sectors, both public and private, in order to minimise the impact of the economic downturn on health.

  8. The Development of the Guide to Economic Analysis and Research (GEAR) Online Resource for Low- and Middle-Income Countries' Health Economics Practitioners: A Commentary.

    Science.gov (United States)

    Adeagbo, Chiaki Urai; Rattanavipapong, Waranya; Guinness, Lorna; Teerawattananon, Yot

    2018-05-01

    Public health authorities around the world are increasingly using economic evaluation to set priorities and inform decision making in health policy, especially in the development of health benefit packages. Nevertheless, researchers in low- and middle-income countries (LMICs) encounter many barriers when conducting economic evaluations. In 2015, the Health Intervention and Technology Assessment Program identified key technical and context-specific challenges faced in conducting and using health economic evaluations in LMICs. On the basis of these research findings, the Guide to Economic Analysis and Research (GEAR) online resource (www.gear4health.com) was developed as a reliable aid to researchers in LMICs that would help overcome those challenges. Funded by the Thailand Research Fund and the Bill and Melinda Gates Foundation, GEAR is a free online resource that provides a visual aid tool for planning economic evaluation studies (GEAR mind maps), a repository of national and international economic evaluation guidelines (GEAR guideline comparison), and an active link to a network of volunteer international experts (GEAR: Ask an expert). GEAR will evolve over time to provide relevant, reliable, and up-to-date information through inputs from its users (e.g., periodic survey on methodological challenges) and experts (e.g., in responding to users' questions). The objective of this commentary was to give a brief description of the development and key features of this unique collective information hub aimed at facilitating high-quality research and empowering health care decision makers and stakeholders to use economic evaluation evidence. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

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

  10. Health impacts of rapid economic changes in Thailand.

    Science.gov (United States)

    Tangcharoensathien, V; Harnvoravongchai, P; Pitayarangsarit, S; Kasemsup, V

    2000-09-01

    The economic crisis in Thailand in July 1997 had major social implications for unemployment, under employment, household income contraction, changing expenditure patterns, and child abandonment. The crisis increased poverty incidence by 1 million, of whom 54% were the ultra-poor. This paper explores and explains the short-term health impact of the crisis, using existing data and some special surveys and interviews for 2 years during 1998-99. The health impacts of the crisis are mixed, some being negative and some being positive. Household health expenditure reduced by 24% in real terms; among the poorer households, institutional care was replaced by self-medication. The pre-crisis rising trend in expenditure on alcohol and tobacco consumption was reversed. Immunization spending and coverage were sustained at a very high level after the crisis, but reports of increases in diphtheria and pertussis indicate declining programme quality. An increase in malaria, despite budget increases, had many causes but was mainly due to reduced programme effectiveness. STD incidence continued the pre-crisis downward trend. Rates of HIV risky sexual behaviour were higher among conscripts than other male workers, but in both groups there was lower condom use with casual partners. HIV serosurveillance showed a continuation of the pre-crisis downward trend among commercial sex workers (CSW, both brothel and non-brothel based), pregnant women and donated blood; this trend was slightly reversed among male STD patients and more among intravenous drug users. Condom coverage among brothel based CSW continued to increase to 97.5%, despite a 72% budget cut in free condom distribution. Poverty and lack of insurance coverage are two major determinants of absence of or inadequate antenatal care, and low birthweight. The Low Income Scheme could not adequately cover the poor but the voluntary Health Card Scheme played a health safety net role for maternal and child health. Low birthweight and

  11. Health economics made easy: guiding the initiated and uninitiated.

    OpenAIRE

    NORMAND, CHARLES

    2008-01-01

    PUBLISHED For many years it was a challenge in teaching health economics to find a textbook that exactly fits the needs of a class, not least because the needs of student are so diverse. To an extent, this remains the case despite the appearance of several new and useful contributions in the last few years. At times it seemed like cable television ? lots of choices, but nothing that is quite what you want. Cullis and West (1979) worked well for many groups, but was allowed to get out of da...

  12. A GIS tool for the economic assessment of renewable technologies

    International Nuclear Information System (INIS)

    Mahmmud, F.; Woods, J.; Watson, S.; Halliday, J.; Hossain, J.

    1997-01-01

    A Geographical Information System (GIS) has the potential to analyse a large area for the optimum selection and siting of renewable energy systems. This paper reports on a GIS based scheme for the economic assessment of a selected number of wind and photovoltaic systems in the state of Karnataka, in India. This involved the implementation of an appropriate GIS methodology. The preparation of the GIS database is often the most arduous task in GIS operations. Thus, a description of the GIS methodology and the preparation of the database for the analysis of a selection of wind and photovoltaic systems is given. This approach has enabled the identification of the high potential areas in terms of the levelised electricity costs. An overall assessment of the region for present and future scenarios is also given. (author)

  13. Methodologies for assessing socio-economic impacts of climate change

    International Nuclear Information System (INIS)

    Smit, B.

    1993-01-01

    Much of the studies on climate change impacts have focused on physical and biological impacts, yet a knowledge of the social and economic impacts of climate change is likely to have a greater impact on the public and on policymakers. A conventional assessment of the impacts of climate change begins with scenarios of future climate, commonly derived from global climate models translated to a regional scale. Estimates of biophysical conditions provided by such scenarios provide a basis for analyses of human impacts, usually considered sector by sector. The scenario approach, although having considerable merit and appeal, has some noteworthy limitations. It encourages consideration of only a small set of scenarios, requires bold assumptions to be made about adjustments in human systems, provides little direct analysis of sensitivities of human social and economic systems to climate perturbations, and usually invokes the assumption that all factors other than climate are stable and have no synergistic effects on human systems. Conventional studies concentrate on average climate, yet climate is inherently variable. A common response to this situation is to propose further development of climate models, but this is not a sufficient or necessary condition for good and useful assessments of impacts on human activities. Different approaches to socioeconomic impact analysis are needed, and approaches should be considered that include identification of sensitivities in a social or ecological system, identification of critical threshold levels or critical speeds of change in variables, and exploration of alternative methodologies such as process studies, spatial and temporal analogues, and socio-economic systems modelling. 5 refs., 3 figs

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

    Science.gov (United States)

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

    2014-03-01

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

  15. Addressing global health, economic, and environmental problems through family planning.

    Science.gov (United States)

    Speidel, J Joseph; Grossman, Richard A

    2011-06-01

    Although obstetrician-gynecologists recognize the importance of managing fertility for the reproductive health of individuals, many are not aware of the vital effect they can have on some of the world's most pressing issues. Unintended pregnancy is a key contributor to the rapid population growth that in turn impairs social welfare, hinders economic progress, and exacerbates environmental degradation. An estimated 215 million women in developing countries wish to limit their fertility but do not have access to effective contraception. In the United States, half of all pregnancies are unplanned. Voluntary prevention of unplanned pregnancies is a cost-effective, humane way to limit population growth, slow environmental degradation, and yield other health and welfare benefits. Family planning should be a top priority for our specialty.

  16. Early economic evaluation of emerging health technologies: protocol of a systematic review

    Science.gov (United States)

    2014-01-01

    Background The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. Methods/design This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to

  17. The impact of slow economic growth on health sector reform: a cross-national perspective.

    Science.gov (United States)

    Saltman, Richard B

    2018-01-24

    This paper assesses recent health sector reform strategies across Europe adopted since the onset of the 2008 financial crisis. It begins with a brief overview of the continued economic pressure on public funding for health care services, particularly in tax-funded Northern European health care systems. While economic growth rates across Europe have risen a bit in the last year, they remain below the level necessary to provide the needed expansion of public health sector revenues. This continued public revenue shortage has become the central challenge that policymakers in these health systems confront, and increasingly constrains their potential range of policy options. The paper then examines the types of targeted reforms that various European governments have introduced in response to this increased fiscal stringency. Particularly in tax-funded health systems, these efforts have been focused on two types of changes on the production side of their health systems: consolidating and/or centralizing administrative authority over public hospitals, and revamping secondary and primary health services as well as social services to reduce the volume, cost and less-than-optimal outcomes of existing public elderly care programs. While revamping elderly care services also was pursued in the social health insurance (SHI) system in the Netherlands, both the Dutch and the German health systems also made important changes on the financing side of their health systems. Both types of targeted reforms are illustrated through short country case studies. Each of these country assessments flags up new mechanisms that have been introduced and which potentially could be reshaped and applied in other national health sector contexts. Reflecting the tax-funded structure of the Canadian health system, the preponderance of cases discussed focus on tax-funded countries (Norway, Denmark, Sweden, Finland, England, Ireland), with additional brief assessments of recent changes in the SHI

  18. Evaluation and Characterization of Health Economics and Outcomes Research in SAARC Nations.

    Science.gov (United States)

    Mehta, Manthan; Nerurkar, Rajan

    2018-05-01

    To identify, evaluate, and characterize the variety, quality, and intent of the health economics and outcomes research studies being conducted in SAARC (South Asian Association for Regional Cooperation) nations. Studies published in English language between 1990 and 2015 were retrieved from Medline databases using relevant search strategies. Studies were independently reviewed as per Cochrane methodology and information on the type of research and outcomes were extracted. Quality of reporting was assessed. Of the 2638 studies screened from eight SAARC nations, a total of 179 were included for review (India = 140; Bangladesh = 12; Sri Lanka = 8; Pakistan = 7; Afghanistan = 5; Nepal = 4; Bhutan = 2; Maldives = 1). The broad study categories were cost-effectiveness analyses (CEAs = 76 studies), cost analyses (35 studies), and burden of illness (BOI=26 studies). The outcomes evaluated were direct costs, indirect costs, and incremental cost-effectiveness ratio (ICER), quality-adjusted life-years (QALYs), and disability-adjusted life-years (DALYs). Cost of medicines, consultation and hospital charges, and monitoring costs were assessed as direct medical costs along with non-direct medical costs such as travel and food for patients and caregivers. The components of indirect costs were loss of income of patients and caregivers and loss of productivity. Quality of life (QoL) was assessed in 48 studies. The most commonly used instrument for assessing QoL was the WHO-Quality of Life BREF (WHOQOL-BREF) questionnaire (76%). The Quality of Health Economic Studies (QHES) score was used for quality assessment of full economic studies (44 studies). The mean QHES score was 43.76. This review identifies various patterns of health economic studies in eight SAARC nations. The quality of economic evaluation studies for health care in India, Bangladesh, Sri Lanka, Pakistan, Afghanistan, Nepal, Bhutan, and Maldives needs improvement. There is a need to generate the capacity of researchers

  19. 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.

  20. Discounting in the economic evaluation of health care interventions.

    Science.gov (United States)

    Krahn, M; Gafni, A

    1993-05-01

    Do economic theories that underlie discounting have specific implications for program evaluation in health? In this study, both the contemporary practice and the theoretical foundations of discounting are reviewed. The social discount rate controversy is considered, and the two major concepts (i.e., opportunity cost and time preference) involved in the formulation of a social discount rate are outlined. Also described are the arguments for discounting proposed by thinkers in non-economic disciplines. Finally, the implications of choosing a discount rate for evaluation of individual health care programs are considered. It is argued that the conventional practice of discounting all health care programs at a rate of 5% may not consistently reflect societal or individual preference. Specific recommendations arising from this paper are: 1) given the considerable disagreement at the theoretical level as to the appropriate social discount rate, analysts should be specific about what theoretical approach underlies their choice of rate, especially when the analytic result is sensitive to the discount rate; 2) the discount rate chosen should be appropriate for the perspective of the analysis (social vs. individual vs. institutional, etc.); 3) when appropriate, measures should be taken to avoid double discounting, because some health related outcome measures already incorporate individuals' time preference; and 4) it is suggested that the political process may serve as the appropriate means of reflecting social values in the choice of a discount rate. In addition, the authors argue that a consensus conference approach, with political participation, offers a flexible, pragmatic, and explicit way of synthesizing the empirical, normative, and ethical considerations that underlie choice of a discount rate.

  1. [Investing in health: the economic case. Report of the WISH Investing in Health Forum 2016].

    Science.gov (United States)

    Yamey, Gavin; Beyeler, Naomi; Wadge, Hester; Jamison, Dean

    2017-01-01

    Developing country governments and aid agencies face difficult decisions on how best to allocate their finite resources. Investments in many different sectors -including education, water and sanitation, transportation, and health- can all reap social and economic benefits. This report focuses specifically on the health sector. It presents compelling evidence of the value of scaling-up health investments. The economic case for increasing these investments in health has never been stronger. Having made progress in reducing maternal and child mortality, and deaths from infectious diseases, it is essential that policymakers do not become complacent. These gains will be quickly reversed without sustained health investments. Scaled-up investments will be needed to tackle the emerging non-communicable disease (NCD) burden and to achieve universal health coverage (UHC). The value of investment in health far beyond its performance is reflected in economic prosperity through gross domestic product (GDP). People put a high monetary value on the additional years of life that health investments can bring -an inherent value to being alive for longer, unrelated to productivity. Policymakers need to do more to ensure that spending on health reflects people's priorities. To make sure services are accessible to all, governments have a clear role to play in financing health. Without public financing, there will be some who cannot afford the care they need, and they will be forced to choose sickness -perhaps even death- and financial ruin; a devastating choice that already pushes 150 million people into poverty every year. In low-income countries (LICs) and middle-income countries (MICs), public financing should be used to achieve universal coverage with a package of highly cost-effective interventions ('best buys'). Governments failing to protect the health and wealth of their people in this way will be unable to reap the benefits of long-term economic prosperity and growth. Public

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

    Directory of Open Access Journals (Sweden)

    Luis Rajmil

    2014-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Schlander Michael

    2008-01-01

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

  4. Valuation of medical resource units collected in health economic studies.

    Science.gov (United States)

    Copley-Merriman, C; Lair, T J

    1994-01-01

    This paper reviews the issues that are critical for the valuation of medical resources in the context of health economic studies. There are several points to consider when undertaking the valuation of medical resources. The perspective of the analysis should be established before determining the valuation process. Future costs should be discounted to present values, and time and effort spent in assigning a monetary value to a medical resource should be proportional to its importance in the analysis. Prices vary considerably based on location of the service and the severity of the illness episode. Because of the wide variability in pricing data, sensitivity analysis is an important component of validation of study results. A variety of data sources have been applied to the valuation of medical resources. Several types of data are reviewed in this paper, including claims data, national survey data, administrative data, and marketing research data. Valuation of medical resources collected in clinical trials is complex because of the lack of standardization of the data sources. A national pricing data source for health economic valuation would greatly facilitate study analysis and make comparisons between results more meaningful.

  5. Recent topical research on global, energy, health & medical, and tourism economics, and global software: An overview

    OpenAIRE

    Chang, Chia-Lin; McAleer, Michael

    2017-01-01

    textabstractThe paper presents an overview of recent topical research on global, energy, health & medical, and tourism economics, and global software. We have interpreted "global" in the title of the Journal of Reviews on Global Economics to cover contributions that have a global impact on economics, thereby making it "global economics". In this sense, the paper is concerned with papers on global, energy, health & medical, and tourism economics, as well as global software algorithms that have...

  6. Approaches to health assessment related to housing

    NARCIS (Netherlands)

    Guerra Santin, O.

    2006-01-01

    This research had the purpose of providing more information about possible approaches and indicators to measure indoor health in relation to housing. In researches related with health and some Life Cycle Assessment (LCA) databases, the model used for health assessment is the Impact Pathway Analysis

  7. Assessing Health Professional Education: Workshop Summary

    Science.gov (United States)

    Cuff, Patricia A.

    2014-01-01

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

  8. Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations.

    Science.gov (United States)

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

    2013-01-01

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

  9. Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP for nursing consultations.

    Directory of Open Access Journals (Sweden)

    Jesús Martín-Fernández

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

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

    Science.gov (United States)

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

    2013-01-01

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

  11. Economic and health efficiency of education funding policy.

    Science.gov (United States)

    Curtin, T R; Nelson, E A

    1999-06-01

    Public spending programmes to reduce poverty, expand primary education and improve the economic status of women are recommended priorities of aid agencies and are now gradually being reflected in third world governments' policies, in response to aid conditions imposed by the World Bank and OECD countries. However outcomes fall short of aspiration. This paper shows that donors' lending policies, especially those restricting public spending on education to the primary level, (1) perpetuate poverty, (2) minimise socio-economic impact of public health programmes and (3) prevent significant improvement in the economic status of women. These effects are the result of fundamental flaws in donors' education policy model. Evidence is presented to show that health status in developing countries will be significantly enhanced by increasing the proportion of the population which has at least post-primary education. Heads of households with just primary education have much the same probability of experiencing poverty and high mortality of their children as those with no education at all. Aid donors' policies, which require governments of developing countries to limit public funding of education to the primary level, have their roots in what is contended here to be an erroneous interpretation of human capital theory. This interpretation focuses only on the declining marginal internal rates of return on public investments in successive levels of schooling and ignores the opposite message of the increasing marginal net present values of those investments. Cars do not travel fastest in their lowest gear despite its fastest acceleration, life's long journey is not most comfortable for those with only primary schooling.

  12. Promoting Health Literacy through the Health Education Assessment Project

    Science.gov (United States)

    Marx, Eva; Hudson, Nancy; Deal, Tami B.; Pateman, Beth; Middleton, Kathleen

    2007-01-01

    Background: The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is…

  13. [Political ecology, ecological economics, and public health: interfaces for the sustainability of development and health promotion].

    Science.gov (United States)

    Porto, Marcelo Firpo; Martinez-Alier, Joan

    2007-01-01

    This article proposes to focus contributions from political ecology and ecological economics to the field of collective health with a view towards integrating the discussions around health promotion, socio-environmental sustainability, and development. Ecological economics is a recent interdisciplinary field that combines economists and other professionals from the social, human, and life sciences. The field has developed new concepts and methodologies that seek to grasp the relationship between the economy and ecological and social processes such as social metabolism and metabolic profile, thereby interrelating economic, material, and energy flows and producing indicators and indexes for (un)sustainability. Meanwhile, political ecology approaches ecological issues and socio-environmental conflicts based on the economic and power dynamics characterizing modern societies. Collective health and the discussions on health promotion can expand our understanding of territory, communities, and the role of science and institutions based on the contributions of political ecology and ecological economics in analyzing development models and the distributive and socio-environmental conflicts generated by them.

  14. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    than assessing a present situation. As part of this process, however, methods applied in risk assessment are used. Risk assessment typically characterises relation of a well-defined risk factor to a well-defined health outcome. Within HIA usually several individual risk assessments are needed...... of the causal chain from the proposal through related health determinants and risk factors to health outcomes. The stepwise analysis, systematic prioritization and consideration of horizontal interactions between the causal pathways make it feasible to use widely recognized risk assessment methods in the HIA......The level and distribution of health risks in a society is substantially influenced by measures of various policies, programmes or projects. Risk assessment can evaluate the nature, likelihood and severity of an adverse effect. Health impact assessment (HIA) provides similar function when used...

  15. Economic assessment of single-walled carbon nanotube processes

    Science.gov (United States)

    Isaacs, J. A.; Tanwani, A.; Healy, M. L.; Dahlben, L. J.

    2010-02-01

    The carbon nanotube market is steadily growing and projected to reach 1.9 billion by 2010. This study examines the economics of manufacturing single-walled carbon nanotubes (SWNT) using process-based cost models developed for arc, CVD, and HiPco processes. Using assumed input parameters, manufacturing costs are calculated for 1 g SWNT for arc, CVD, and HiPco, totaling 1,906, 1,706, and 485, respectively. For each SWNT process, the synthesis and filtration steps showed the highest costs, with direct labor as a primary cost driver. Reductions in production costs are calculated for increased working hours per day and for increased synthesis reaction yield (SRY) in each process. The process-based cost models offer a means for exploring opportunities for cost reductions, and provide a structured system for comparisons among alternative SWNT manufacturing processes. Further, the models can be used to comprehensively evaluate additional scenarios on the economics of environmental, health, and safety best manufacturing practices.

  16. Economic assessment of single-walled carbon nanotube processes

    Energy Technology Data Exchange (ETDEWEB)

    Isaacs, J. A., E-mail: jaisaacs@coe.neu.ed [Northeastern University, NSF Center for High-rate Nanomanufacturing (United States); Tanwani, A. [Infojini Solutions Inc. (United States); Healy, M. L. [Babcock Power Inc. (United States); Dahlben, L. J. [Northeastern University, NSF Center for High-rate Nanomanufacturing (United States)

    2010-02-15

    The carbon nanotube market is steadily growing and projected to reach $1.9 billion by 2010. This study examines the economics of manufacturing single-walled carbon nanotubes (SWNT) using process-based cost models developed for arc, CVD, and HiPco processes. Using assumed input parameters, manufacturing costs are calculated for 1 g SWNT for arc, CVD, and HiPco, totaling $1,906, $1,706, and $485, respectively. For each SWNT process, the synthesis and filtration steps showed the highest costs, with direct labor as a primary cost driver. Reductions in production costs are calculated for increased working hours per day and for increased synthesis reaction yield (SRY) in each process. The process-based cost models offer a means for exploring opportunities for cost reductions, and provide a structured system for comparisons among alternative SWNT manufacturing processes. Further, the models can be used to comprehensively evaluate additional scenarios on the economics of environmental, health, and safety best manufacturing practices.

  17. Tobacco, politics and economics: implications for global health.

    Science.gov (United States)

    Stebbins, K R

    1991-01-01

    This paper examines the expanding presence of multinational cigarette companies into almost every country in the world, and discusses the health implications of this global penetration. Cigarettes deserve special attention because tobacco is the only legally available consumer product that is harmful to one's health when used as intended. A temptation exists to blame governments for the existence of health-threatening products within their borders. However, this paper illustrates the extent to which extra-national forces influence domestic policies and circumstances. Cigarette smokers are often blamed for their lethal habit, despite billion-dollar promotional schemes which attract people to smoking, obscuring the harmful consequences of consuming a highly addictive drug. Multinational cigarette companies are increasingly targeting Asian and Third World populations. To facilitate this market penetration, political avenues are often pursued with considerable success, disregarding the health implications associated with cigarette tobacco. The use of tobacco in development programs (e.g. the U.S. 'Food for Peace' program) has political and economic implications for donor and recipient countries, and lucrative advantages for the tobacco companies. However, this paper recommends that corporate profits and foreign policy should not be pursued at the expense of tobacco-related diseases and premature deaths among Third World peoples.

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

    Science.gov (United States)

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

    2003-12-01

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

  19. Obesity prevalence in Mexico: impact on health and economic burden.

    Science.gov (United States)

    Rtveladze, Ketevan; Marsh, Tim; Barquera, Simon; Sanchez Romero, Luz Maria; Levy, David; Melendez, Guillermo; Webber, Laura; Kilpi, Fanny; McPherson, Klim; Brown, Martin

    2014-01-01

    Along with other countries having high and low-to-middle income, Mexico has experienced a substantial change in obesity rates. This rapid growth in obesity prevalence has led to high rates of obesity-related diseases and associated health-care costs. Micro-simulation is used to project future BMI trends. Additionally thirteen BMI-related diseases and health-care costs are estimated. The results are simulated for three hypothetical scenarios: no BMI reduction and BMI reductions of 1 % and 5 % across the population. Mexican Health and Nutrition Surveys 1999 and 2000, and Mexican National Health and Nutrition Survey 2006. Mexican adults. In 2010, 32 % of men and 26 % of women were normal weight. By 2050, the proportion of normal weight will decrease to 12 % and 9 % for males and females respectively, and more people will be obese than overweight. It is projected that by 2050 there will be 12 million cumulative incidence cases of diabetes and 8 million cumulative incidence cases of heart disease alone. For the thirteen diseases considered, costs of $US 806 million are estimated for 2010, projected to increase to $US 1·2 billion and $US 1·7 billion in 2030 and 2050 respectively. A 1 % reduction in BMI prevalence could save $US 43 million in health-care costs in 2030 and $US 85 million in 2050. Obesity rates are leading to a large health and economic burden. The projected numbers are high and Mexico should implement strong action to tackle obesity. Results presented here will be very helpful in planning and implementing policy interventions.

  20. Preference-based measures to obtain health state utility values for use in economic evaluations with child-based populations: a review and UK-based focus group assessment of patient and parent choices.

    Science.gov (United States)

    Wolstenholme, Jane L; Bargo, Danielle; Wang, Kay; Harnden, Anthony; Räisänen, Ulla; Abel, Lucy

    2018-03-21

    No current guidance is available in the UK on the choice of preference-based measure (PBM) that should be used in obtaining health-related quality of life from children. The aim of this study is to review the current usage of PBMs for obtaining health state utility values in child and adolescent populations, and to obtain information on patient and parent-proxy respondent preferences in completing PBMs in the UK. A literature review was conducted to determine which instrument is most frequently used for child-based economic evaluations and whether child or proxy responses are used. Instruments were compared on dimensions, severity levels, elicitation and valuation methods, availability of value sets and validation studies, and the range of utility values generated. Additionally, a series of focus groups of parents and young people (11-20 years) were convened to determine patient and proxy preferences. Five PBMs suitable for child populations were identified, although only the Health Utilities Index 2 (HUI2) and Child Heath Utility 9D (CHU-9D) have UK value sets. 45 papers used PBMs in this population, but many used non-child-specific PBMs. Most respondents were parent proxies, even in adolescent populations. Reported missing data ranged from 0.5 to 49.3%. The focus groups reported their experiences with the EQ-5D-Y and CHU-9D. Both the young persons' group and parent/proxy groups felt that the CHU-9D was more comprehensive but may be harder for a proxy to complete. Some younger children had difficulty understanding the CHU-9D questions, but the young persons' group nonetheless preferred responding directly. The use of PBMs in child populations is increasing, but many studies use PBMs that do not have appropriate value sets. Parent proxies are the most common respondents, but the focus group responses suggest it would be preferred, and may be more informative, for older children to self-report or for child-parent dyads to respond.

  1. Health and economic costs of alternative energy sources

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, L D [Biomedical and Environmental Assessment Division, National Center for Analysis of Energy Systems, Brookhaven National Laboratory (United States); Manne, A S [Department of Operations Research, Stanford University (United States)

    1978-08-15

    Before the United States of America can arrive at a coherent national energy policy, several ongoing debates must be resolved - on environmental hazards, health impacts, and the direct economic consequences of alternative future energy options. No one strategy is obviously correct - or uniquely ethical. Each strategy has its drawbacks, each can be blocked by one or another coalition of interest groups. The public is poorly informed by the media. A single large coal-mine accident is far more extensively reported than a long series of isolated accidents at grade crossings for coal trains, and yet the latter causes more deaths each year. Similarly, the public debate on nuclear issues is focused on low-probability, high-consequence events. It is as though national policy were being framed by a gambler whose motto is 'it's only the stakes and not the odds that matter'. The two authors of this paper come from different disciplines, yet they both believe that the odds do matter. It is essential that the public be well informed about the health risks and the economic consequences of a moratorium on the civilian uses of nuclear energy in the USA. We think that such a moratorium would adversely affect health and the economy. These impacts although small in relation, say, to the overall death rate or to the overall gross national product are not small in an absolute sense The adverse consequences of a moratorium are much more certain, and surely outweigh the impacts of any plausible accident associated with the operation of power reactors.

  2. Health and economic costs of alternative energy sources

    International Nuclear Information System (INIS)

    Hamilton, L.D.; Manne, A.S.

    1978-01-01

    Before the United States of America can arrive at a coherent national energy policy, several ongoing debates must be resolved - on environmental hazards, health impacts, and the direct economic consequences of alternative future energy options. No one strategy is obviously correct - or uniquely ethical. Each strategy has its drawbacks, each can be blocked by one or another coalition of interest groups. The public is poorly informed by the media. A single large coal-mine accident is far more extensively reported than a long series of isolated accidents at grade crossings for coal trains, and yet the latter causes more deaths each year. Similarly, the public debate on nuclear issues is focused on low-probability, high-consequence events. It is as though national policy were being framed by a gambler whose motto is 'it's only the stakes and not the odds that matter'. The two authors of this paper come from different disciplines, yet they both believe that the odds do matter. It is essential that the public be well informed about the health risks and the economic consequences of a moratorium on the civilian uses of nuclear energy in the USA. We think that such a moratorium would adversely affect health and the economy. These impacts although small in relation, say, to the overall death rate or to the overall gross national product are not small in an absolute sense The adverse consequences of a moratorium are much more certain, and surely outweigh the impacts of any plausible accident associated with the operation of power reactors

  3. Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks : A Consensus Framework from a European Vaccine Economics Community

    NARCIS (Netherlands)

    Ultsch, Bernhard; Damm, Oliver; Beutels, Philippe; Bilcke, Joke; Brueggenjuergen, Bernd; Gerber-Grote, Andreas; Greiner, Wolfgang; Hanquet, Germaine; Hutubessy, Raymond; Jit, Mark; Knol, Mirjam; von Kries, Ruediger; Kuhlmann, Alexander; Levy-Bruhl, Daniel; Perleth, Matthias; Postma, Maarten; Salo, Heini; Siebert, Uwe; Wasem, Jurgen; Wichmann, Ole

    Incremental cost-effectiveness and cost-utility analyses [health economic evaluations (HEEs)] of vaccines are routinely considered in decision making on immunization in various industrialized countries. While guidelines advocating more standardization of such HEEs (mainly for curative drugs) exist,

  4. Asia-Pacific Economic Cooperation (APEC) - Center for Global Health

    Science.gov (United States)

    As the leading economic forum in the Asia-Pacific region, APEC facilitates economic growth and prosperity in the Asia-Pacific region through trade and investment liberalization, business facilitation, and economic and technical cooperation.

  5. Integrating Ecosystem Services Into Health Impact Assessment

    Science.gov (United States)

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

  6. Waste-to-methanol: Process and economics assessment.

    Science.gov (United States)

    Iaquaniello, Gaetano; Centi, Gabriele; Salladini, Annarita; Palo, Emma; Perathoner, Siglinda; Spadaccini, Luca

    2017-11-01

    The waste-to-methanol (WtM) process and related economics are assessed to evidence that WtM is a valuable solution both from economic, strategic and environmental perspectives. Bio-methanol from Refuse-derived-fuels (RdF) has an estimated cost of production of about 110€/t for a new WtM 300t/d plant. With respect to waste-to-energy (WtE) approach, this solution allows various advantages. In considering the average market cost of methanol and the premium as biofuel, the WtM approach results in a ROI (Return of Investment) of about 29%, e.g. a payback time of about 4years. In a hybrid scheme of integration with an existing methanol plant from natural gas, the cost of production becomes a profit even without considering the cap for bio-methanol production. The WtM process allows to produce methanol with about 40% and 30-35% reduction in greenhouse gas emissions with respect to methanol production from fossil fuels and bio-resources, respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    Datta, R.; Tsai, S.P.

    1996-03-01

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

  8. EU climate policy up to 2020. An economic impact assessment

    Energy Technology Data Exchange (ETDEWEB)

    Boehringer, Christoph [Department of Economics, University of Oldenburg (Germany); Centre for European Economic Research (ZEW) Mannheim (Germany); Loeschel, Andreas [Centre for European Economic Research (ZEW) Mannheim (Germany); Moslener, Ulf [KfW Development Bank, Frankfurt (Germany); Rutherford, Thomas F. [Center for Energy Policy and Economy (CEPE), ETH Zuerich (Switzerland)

    2009-07-01

    In its fight against climate change the EU is committed to reducing its overall greenhouse gas emissions to at least 20% below 1990 levels by 2020. To meet this commitment, the EU builds on segmented market regulation with an EU-wide cap-and-trade system for emissions from energy-intensive installations (ETS sectors) and additional measures by each EU Member State covering emission sources outside the cap-and-trade system (the non-ETS sector). Furthermore, the EU has launched additional policy measures such as renewable energy subsidies in order to promote compliance with the climate policy target. Basic economic reasoning suggests that emission market segmentation and overlapping regulation can create substantial excess costs if we focus only on the climate policy target. In this paper, we evaluate the economic impacts of EU climate policy based on numerical simulations with a computable general equilibrium model of international trade and energy use. Our results highlight the importance of initial market distortions and imperfections as well as alternative baseline projections for the appropriate assessment of EU compliance cost. (author)

  9. EU climate policy up to 2020: An economic impact assessment

    Energy Technology Data Exchange (ETDEWEB)

    Boehringer, Christoph, E-mail: boehringer@uni-oldenburg.d [Department of Economics, University of Oldenburg (Germany); Centre for European Economic Research (ZEW) Mannheim (Germany); Loeschel, Andreas [Centre for European Economic Research (ZEW) Mannheim (Germany); Moslener, Ulf [KfW Development Bank, Frankfurt (Germany); Rutherford, Thomas F. [Center for Energy Policy and Economy (CEPE), ETH Zuerich (Switzerland)

    2009-07-01

    In its fight against climate change the EU is committed to reducing its overall greenhouse gas emissions to at least 20% below 1990 levels by 2020. To meet this commitment, the EU builds on segmented market regulation with an EU-wide cap-and-trade system for emissions from energy-intensive installations (ETS sectors) and additional measures by each EU Member State covering emission sources outside the cap-and-trade system (the non-ETS sector). Furthermore, the EU has launched additional policy measures such as renewable energy subsidies in order to promote compliance with the climate policy target. Basic economic reasoning suggests that emission market segmentation and overlapping regulation can create substantial excess costs if we focus only on the climate policy target. In this paper, we evaluate the economic impacts of EU climate policy based on numerical simulations with a computable general equilibrium model of international trade and energy use. Our results highlight the importance of initial market distortions and imperfections as well as alternative baseline projections for the appropriate assessment of EU compliance cost.

  10. EU climate policy up to 2020. An economic impact assessment

    International Nuclear Information System (INIS)

    Boehringer, Christoph; Loeschel, Andreas; Moslener, Ulf; Rutherford, Thomas F.

    2009-01-01

    In its fight against climate change the EU is committed to reducing its overall greenhouse gas emissions to at least 20% below 1990 levels by 2020. To meet this commitment, the EU builds on segmented market regulation with an EU-wide cap-and-trade system for emissions from energy-intensive installations (ETS sectors) and additional measures by each EU Member State covering emission sources outside the cap-and-trade system (the non-ETS sector). Furthermore, the EU has launched additional policy measures such as renewable energy subsidies in order to promote compliance with the climate policy target. Basic economic reasoning suggests that emission market segmentation and overlapping regulation can create substantial excess costs if we focus only on the climate policy target. In this paper, we evaluate the economic impacts of EU climate policy based on numerical simulations with a computable general equilibrium model of international trade and energy use. Our results highlight the importance of initial market distortions and imperfections as well as alternative baseline projections for the appropriate assessment of EU compliance cost. (author)

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

    Science.gov (United States)

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

    2013-12-01

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

  12. Health economics evaluation of a gastric cancer early detection and treatment program in China.

    Science.gov (United States)

    Li, Dan; Yuan, Yuan; Sun, Li-Ping; Fang, Xue; Zhou, Bao-Sen

    2014-01-01

    To use health economics methodology to assess the screening program on gastric cancer in Zhuanghe, China, so as to provide the basis for health decision on expanding the program of early detection and treatment. The expense of an early detection and treatment program for gastric cancer in patients found by screening, and also costs of traditional treatment in a hospital of Zhuanghe were assessed. Three major techniques of medical economics, namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA), were used to assess the screening program. RESULTS from CEA showed that investing every 25, 235 Yuan on screening program in Zhuanghe area, one gastric cancer patient could be saved. Data from CUA showed that it was cost 1, 370 Yuan per QALY saved. RESULTS from CBA showed that: the total cost was 1,945,206 Yuan with a benefit as 8,669,709 Yuan and an CBR of 4.46. The early detection and treatment program of gastric cancer appears economic and society-beneficial. We suggest that it should be carry out in more high risk areas for gastric cancer.

  13. Transboundary smoke haze pollution in Malaysia: inpatient health impacts and economic valuation.

    Science.gov (United States)

    Othman, Jamal; Sahani, Mazrura; Mahmud, Mastura; Ahmad, Md Khadzir Sheikh

    2014-06-01

    This study assessed the economic value of health impacts of transboundary smoke haze pollution in Kuala Lumpur and adjacent areas in the state of Selangor, Malaysia. Daily inpatient data from 2005, 2006, 2008, and 2009 for 14 haze-related illnesses were collected from four hospitals. On average, there were 19 hazy days each year during which the air pollution levels were within the Lower Moderate to Hazardous categories. No seasonal variation in inpatient cases was observed. A smoke haze occurrence was associated with an increase in inpatient cases by 2.4 per 10,000 populations each year, representing an increase of 31 percent from normal days. The average annual economic loss due to the inpatient health impact of haze was valued at MYR273,000 ($91,000 USD). Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Economical-environmental assessment on technologies producing electric energy

    International Nuclear Information System (INIS)

    Najafzadeh, K.

    2000-01-01

    Currently, the electric power industry is undergoing substantial regulatory and organizational change with respect to economical and environmental aspects. Under these circumstances, with utilization of analytic hierarchy process (AHP) concept, we consider the assessment of Technologies producing energy from financial and pollution viewpoint. AHP techniques is one of the efficient methods in analysis of complex and multi-criteria problems, which has plenty of applications. General pattern of this assessment has been introduced, and the main goal is determining of overall priority weights for each technology. With using this pattern, overall priority weights has been determined for thermal, combined cycle and Gas turbine plants. It has been cleared that relative priority of these plants will change, if relative priority of assessment criterions changes. For application of this approach, capital budgeting process and selection of some suitable technologies among the alternatives candidate for construction have been presented. In this process the objective is to maximize the sum of overall priority weights of technologies which have been identified from AHP. Constraints are about the construction budget and annual budget for emission allowances. This process is in the integer programming IP form an has been applied to three kind of power plants with reasonable assumptions

  15. Health effects of risk-assessment categories

    International Nuclear Information System (INIS)

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

    1983-10-01

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

  16. Health effects of risk-assessment categories

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-10-01

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

  17. Low carbon national strategy. A macro-economical assessment

    International Nuclear Information System (INIS)

    Baiz, Adam; Monnoyer-Smith, Laurence; Callonnec, Gael

    2016-11-01

    This publication briefly reports the use of the Three-ME model (Multi-sector Macroeconomic Model for the Evaluation of Environmental and Energy) to assess the combined effect of the several instruments mobilised for the transition towards a low carbon economy within the French National Low Carbon Strategy (SNBC). It first presents the Three-ME model which has been developed since 2008 by the OFCE and the Ademe, is a neo-Keynesian and hybrid model, and which comprises 14.000 equations and 70.000 parameters dealing with prices, interest rates, investments, salaries, foreign trade, State policy, a production function, and a consumption function. Some characteristics of the SNBC scenario are indicated, as well as those of a reference trend-based scenario. Obtained results are then briefly commented in terms of positive ecological and economic impacts of a carbon tax and of sector-based measures defined within the SNBC

  18. Technical and economic assessment of energy conversion technologies for MSW

    Energy Technology Data Exchange (ETDEWEB)

    Livingston, W.R.

    2002-07-01

    Thermal processes for municipal solid wastes (MSW) based on pyrolysis and/or gasification that have relevance to the emerging UK market are described in this report, and the results of the technical and economical assessment of these processes are presented. The Mitsui R21 Technology, the Thermoselect Process, the Nippon Steel Waste Melting Process, the Pyropleq Process, and the Compact Power Process are selected for detailed comparison on the basis of the overall technical concept, the energy balance and the requirements for consumables, environmental performance, and the technical and commercial status of the technology. Details are also given of a comparison of the novel thermal technologies with conventional mass burn incineration for MSW.

  19. Technical and economic assessment of energy conversion technologies for MSW

    International Nuclear Information System (INIS)

    Livingston, W.R.

    2002-01-01

    Thermal processes for municipal solid wastes (MSW) based on pyrolysis and/or gasification that have relevance to the emerging UK market are described in this report, and the results of the technical and economical assessment of these processes are presented. The Mitsui R21 Technology, the Thermoselect Process, the Nippon Steel Waste Melting Process, the Pyropleq Process, and the Compact Power Process are selected for detailed comparison on the basis of the overall technical concept, the energy balance and the requirements for consumables, environmental performance, and the technical and commercial status of the technology. Details are also given of a comparison of the novel thermal technologies with conventional mass burn incineration for MSW

  20. Assessing systemwide occupational health and safety risks of energy technologies

    International Nuclear Information System (INIS)

    Rowe, M.D.

    1982-01-01

    Input-output modelling is now being used to assess systemwide occupational and public health and safety risks of energy technologies. Some of the advantages and disadvantages of this method are presented and some of its important limitations are discussed. Its primary advantage is that it provides a standard method with which to compare technologies on a consistent basis without extensive economic analysis. Among the disadvantages are limited range of applicability, limited spectrum of health impacts, and inability to identify unusual health impacts unique to a new technology. (author)

  1. Estimating the Health and Economic Impacts of Changes in Local Air Quality

    Science.gov (United States)

    Carvour, Martha L.; Hughes, Amy E.; Fann, Neal

    2018-01-01

    Objectives. To demonstrate the benefits-mapping software Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE), which integrates local air quality data with previously published concentration–response and health–economic valuation functions to estimate the health effects of changes in air pollution levels and their economic consequences. Methods. We illustrate a local health impact assessment of ozone changes in the 10-county nonattainment area of the Dallas–Fort Worth region of Texas, estimating the short-term effects on mortality predicted by 2 scenarios for 3 years (2008, 2011, and 2013): an incremental rollback of the daily 8-hour maximum ozone levels of all area monitors by 10 parts per billion and a rollback-to-a-standard ambient level of 65 parts per billion at only monitors above that level. Results. Estimates of preventable premature deaths attributable to ozone air pollution obtained by the incremental rollback method varied little by year, whereas those obtained by the rollback-to-a-standard method varied by year and were sensitive to the choice of ordinality and the use of preloaded or imported data. Conclusions. BenMAP-CE allows local and regional public health analysts to generate timely, evidence-based estimates of the health impacts and economic consequences of potential policy options in their communities. PMID:29698094

  2. A difficult balancing act: policy actors' perspectives on using economic evaluation to inform health-care coverage decisions under the Universal Health Insurance Coverage scheme in Thailand.

    Science.gov (United States)

    Teerawattananon, Yot; Russell, Steve

    2008-03-01

    In Thailand, policymakers have come under increasing pressure to use economic evaluation to inform health-care resource allocation decisions, especially after the introduction of the Universal Health Insurance Coverage (UC) scheme. This article presents qualitative findings from research that assessed a range of policymakers' perspectives on the acceptability of using economic evaluation for the development of health-care benefit packages in Thailand. The policy analysis examined their opinions about existing decision-making processes for including health interventions in the UC benefit package, their understanding of health economic evaluation, and their attitudes, acceptance, and values relating to the use of the method. Semistructured interviews were conducted with 36 policy actors who play a major role or have some input into health resource allocation decisions within the Thai health-care system. These included 14 senior policymakers at the national level, 5 hospital directors, 10 health professionals, and 7 academics. Policy actors thought that economic evaluation information was relevant for decision-making because of the increasing need for rationing and more transparent criteria for making UC coverage decisions. Nevertheless, they raised several difficulties with using economic evaluation that would pose barriers to its introduction, including distrust in the method, conflicting philosophical positions and priorities compared to that of "health maximization," organizational allegiances, existing decision-making procedures that would be hard to change, and concerns about political pressure and acceptability.

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

    Science.gov (United States)

    Asgeirsdóttir, Tinna Laufey; Ragnarsdóttir, Dagný Osk

    2014-07-25

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

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

    Science.gov (United States)

    2014-01-01

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

  5. Australia's economic transition, unemployment, suicide and mental health needs.

    Science.gov (United States)

    Myles, Nicholas; Large, Matthew; Myles, Hannah; Adams, Robert; Liu, Dennis; Galletly, Cherrie

    2017-02-01

    There have been substantial changes in workforce and employment patterns in Australia over the past 50 years as a result of economic globalisation. This has resulted in substantial reduction in employment in the manufacturing industry often with large-scale job losses in concentrated sectors and communities. Large-scale job loss events receive significant community attention. To what extent these mass unemployment events contribute to increased psychological distress, mental illness and suicide in affected individuals warrants further consideration. Here we undertake a narrative review of published job loss literature. We discuss the impact that large-scale job loss events in the manufacturing sector may have on population mental health, with particular reference to contemporary trends in the Australian economy. We also provide a commentary on the expected outcomes of future job loss events in this context and the implications for Australian public mental health care services. Job loss due to plant closure results in a doubling of psychological distress that peaks 9 months following the unemployment event. The link between job loss and increased rates of mental illness and suicide is less clear. The threat of impending job loss and the social context in which job loss occurs has a significant bearing on psychological outcomes. The implications for Australian public mental health services are discussed.

  6. Revised Human Health Risk Assessment on Chlorpyrifos

    Science.gov (United States)

    We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

  7. Continuity of supply - Economic assessment and associated risks

    International Nuclear Information System (INIS)

    Preotescu, Dan; Albert, Hermina

    2004-01-01

    of risks that might occur, then in a subsequent stage to quantify them (economic assessment). The paper describes the most significant risk categories involved in the operation of grid companies that play on the electricity market, and a methodology to assess them is proposed. The importance and outcomes of the interconnection between the power system and the conditions to be monitored in the points where contracts between partners are carried out (electric power systems, countries) will be taken into account. (authors)

  8. A preliminary economic feasibility assessment of nuclear desalination in Madura Island

    International Nuclear Information System (INIS)

    Kim, S.-H.; Hwang, Y.-D.; Konishi, T.; Hudi Hastowo

    2005-01-01

    A joint study between KAERI and BATAN, which is entitled 'A preliminary economic feasibility assessment of nuclear desalination in Madura Island', is being conducted under the framework of the Interregional Technical Cooperation Project of IAEA, signed on Oct. 10, 2001 at IAEA. The duration of the project is January 2002 to December 2004. An economic feasibility of nuclear desalination using system-integrated modular advanced reactor (SMART), which will provide Madura Island with electricity and potable water and also support industrialisation and tourism, will be assessed during the project. The scope of this joint study includes the analyses for the short- and long-term energy and water demand as well as the supply plan for Madura Island, evaluation of the site characteristics, environmental impacts and health aspects, technical and economic evaluation of SMART and its desalination system, including the feasibility of its being identified on the Madura Island. KAERI and BATAN are cooperating in conducting a joint study, and IAEA provides technical support and a review of the study products. This paper presents the interim results of the joint study by focussing on the technical and economic aspects of nuclear desalination using SMART in Madura Island. (author)

  9. Socio-economic differences in health risk behavior in adolescence : Do they exist?

    NARCIS (Netherlands)

    Tuinstra, J; Groothoff, JW; Van den Heuvel, WJA; Post, D

    Socio-economic differences in risk behaviors in adolescence can be seen as a prelude to the re-emergence of socio-economic health differences in adulthood. We studied whether or not socio-economic differences in health risk behaviors are present in male and female adolescents in The Netherlands. The

  10. Diagnostic imaging in 2001 - a health economics perspective

    International Nuclear Information System (INIS)

    Hillman, B.J.

    1997-01-01

    Factors contributing to the growth and diffusion of new imaging technologies are discussed. The benefits derived from implementing and using new technologies are carefully evaluated against the associated costs to both patients and service providers. The need to invest in early scientific assessment of a new imaging technology in order to prevent wasted aquisition and utilisation later on is highlighted. Such assessment might involve evaluating the ability of the technology to improve diagnosis, positively impact on treatment plans and, above all, improve health. (orig.)

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  12. Health and innovation: economic dynamics and Welfare State in Brazil.

    Science.gov (United States)

    Gadelha, Carlos Augusto Grabois; Braga, Patrícia Seixas da Costa

    2016-11-03

    The effective enforcement of the access to healthcare as fundamental right requires an important theoretical and political effort at linking the often contradictory economic and social dimensions of development. This study suggests the need for a systemic view of policies related to the industrial base and innovation in health and the construction of the Brazilian Unified National Health System (SUS). The authors investigate the relations between health, innovation, and development, seeking to show and update the political, economic, and social determinants of the recent Brazilian experience with the Health Economic-Industrial Complex (HEIC). They discuss how the agenda for innovation and domestic industrial production in health gained a central place in the project for construction of the SUS. The article thus seeks to link inherent issues from the agenda for development, production, and innovation to social policy in healthcare, as observed in recent years, and based on this analysis, points to political and conceptual challenges for implementing the SUS, especially as regards strengthening its technological and industrial base. As a byproduct, the article develops an analytical and factual focus on the consolidation of the HEIC in Brazil, both as a dynamic vector of industrial development, generating investment, income, employment, and innovations, and as a decisive element for reducing vulnerability and structural dependence in health. The authors aim to show that strengthening the SUS and orienting it to social needs is an essential part of building a social Welfare State in Brazil. Resumo: A efetivação da saúde como um direito fundamental exige importante esforço, teórico e político, de articulação das dimensões econômicas e sociais, por vezes contraditórias, do desenvolvimento. Este trabalho indica a necessidade de um olhar sistêmico das políticas relacionadas à base produtiva e de inovação em saúde e à construção do Sistema Único de Sa

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

    Science.gov (United States)

    Canning, David; Schultz, T Paul

    2012-07-14

    We consider the evidence for the effect of access to reproductive health services on the achievement of Millennium Development Goals 1, 2, and 3, which aim to eradicate extreme poverty and hunger, achieve universal primary education, and promote gender equality and empower women. At the household level, controlled trials in Matlab, Bangladesh, and Navrongo, Ghana, have shown that increasing access to family planning services reduces fertility and improves birth spacing. In the Matlab study, findings from long-term follow-up showed that women's earnings, assets, and body-mass indexes, and children's schooling and body-mass indexes, substantially improved in areas with improved access to family planning services compared with outcomes in control areas. At the macroeconomic level, reductions in fertility enhance economic growth as a result of reduced youth dependency and an increased number of women participating in paid labour. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. The health and economic effects of counterfeit drugs.

    Science.gov (United States)

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

    2014-06-01

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

  15. Economic evaluations of comprehensive geriatric assessment in surgical patients: a systematic review.

    Science.gov (United States)

    Eamer, Gilgamesh; Saravana-Bawan, Bianka; van der Westhuizen, Brenden; Chambers, Thane; Ohinmaa, Arto; Khadaroo, Rachel G

    2017-10-01

    Seniors presenting with surgical disease face increased risk of postoperative morbidity and mortality and have increased treatment costs. Comprehensive Geriatric Assessment (CGA) is proposed to reduce morbidity, mortality, and the cost after surgery. A systematic review of CGA in emergency surgical patients was conducted. The primary outcome was cost-effectiveness; secondary outcomes were length of stay, return of function, and mortality. Inclusion and exclusion criteria were predefined. Systematic searches of MEDLINE, Embase, Cochrane, and National Health Service Economic Evaluation Database were performed. Text screening, bias assessment, and data extraction were performed by two authors. There were 560 articles identified; abstract review excluded 499 articles and full-text review excluded 53 articles. Eight studies were included; one nonorthopedic trauma and seven orthopedic trauma studies. Bias assessment revealed moderate to high risk of bias for all studies. Economic evaluation assessment identified two high-quality studies and six moderate or low quality studies. Pooled analysis from four studies assessed loss of function; loss of function decreased in the experimental arm (odds ratio 0.92, 95% confidence interval [CI]: 0.88-0.97). Pooled results for length of stay from five studies found a significant decrease (mean difference: -1.17, 95% CI: -1.63 to -0.71) after excluding the nonorthopedic trauma study. Pooled mortality was significantly decreased in seven studies (risk ratio: 0.78, 95% CI: 0.67-0.90). All studies decreased cost and improved health outcomes in a cost-effective manner. CGA improved return of function and mortality with reduced cost or improved utility. Our review suggests that CGA is economically dominant and the most cost-effective care model for orthogeriatric patients. Further research should examine other surgical fields. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Yannish Naik

    2017-11-01

    Full Text Available Abstract Background 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. Methods 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. Discussion 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

  17. 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

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

    Science.gov (United States)

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

    2010-04-01

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

  19. Ecological-economical approach to assessment of environment state at the Semipalatinsk test site

    International Nuclear Information System (INIS)

    Chugunova, N.S.; Balykbaeva, S.Y.

    2002-01-01

    The paper presents methods used for ecological-economical assessment of the environment condition at the former Semipalatinsk Test Site. It also presents methodology of calculating ecological and economical parameters for different options. Besides, the paper provides data describing assessment of ecological and economical damage caused by defense establishment activities at the Semipalatinsk Test Site. (author)

  20. Health economic data in reimbursement of new medical technologies: importance of the socio-economic burden as a decision-making criterion

    Directory of Open Access Journals (Sweden)

    Georgi Iskrov

    2016-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Health and economic burden of obesity in Brazil.

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    Ketevan Rtveladze

    Full Text Available INTRODUCTION: Higher and lower-middle income countries are increasingly affected by obesity. Obesity-related diseases are placing a substantial health and economic burden on Brazil. Our aim is to measure the future consequences of these trends on the associated disease burden and health care costs. METHOD: A previously developed micro-simulation model is used to project the extent of obesity, obesity-related diseases and associated healthcare costs to 2050. In total, thirteen diseases were considered: coronary heart disease, stroke, hypertension, diabetes, osteoarthritis, and eight cancers. We simulated three hypothetical intervention scenarios: no intervention, 1% and 5% reduction in body mass index (BMI. RESULTS: In 2010, nearly 57% of the Brazilian male population was overweight or obese (BMI ≥25 kg/m(2, but the model projects rates as high as 95% by 2050. A slightly less pessimistic picture is predicted for females, increasing from 43% in 2010 to 52% in 2050. Coronary heart disease, stroke, hypertension, cancers, osteoarthritis and diabetes prevalence cases are projected to at least double by 2050, reaching nearly 34,000 cases of hypertension by 2050 (per 100,000. 1% and 5% reduction in mean BMI will save over 800 prevalence cases and nearly 3,000 cases of hypertension by 2050 respectively (per 100,000. The health care costs will double from 2010 ($5.8 billion in 2050 alone ($10.1 billion. Over 40 years costs will reach $330 billion. However, with effective interventions the costs can be reduced to $302 billion by 1% and to $273 billion by 5% reduction in mean BMI across the population. CONCLUSION: Obesity rates are rapidly increasing creating a high burden of disease and associated costs. However, an effective intervention to decrease obesity by just 1% will substantially reduce obesity burden and will have a significant effect on health care expenditure.

  3. Design of an electric motorway - Social-economic assessment

    International Nuclear Information System (INIS)

    Fragnol, Ludovic; Monnoyer-Smith, Laurence

    2017-07-01

    The author reports an exploratory analysis of the economic viability of a solution of electrification of goods road transport based on the use of electrical motorways, i.e. motorways along which a catenary system would be installed to feed trucks equipped with a pantograph (a German research project). The objective is here to assess whether such a project of electrification (financed of not by users through a toll) would be profitable. The author first assesses market costs and non-market costs of each transport mode while taking hypotheses on the concerned traffic into account, and by using a full costing approach. A hierarchy of likelihood of the different studied scenarios is then built up, which allows technological choices to be sorted. Scenarios are based on a reference situation (thermal propulsion), on the use of a hybrid truck on electric motorway, of an electric shuttle tractor on electric motorway, or of an electric truck on a conventional motorway. Then, the author proposes a real-life simulations based of motorway traffic data, and on the use of the Modev traffic model

  4. Socio-economic influences on gender inequalities in child health in rural Bangladesh.

    Science.gov (United States)

    Rousham, E K

    1996-08-01

    To investigate gender inequalities in child growth and nutritional status in relation to socio-economic status in Bangladesh. A 16-month longitudinal study of child growth measuring anthropometric and socio-economic status. A rural area of Jamalpur district, northern Bangladesh. 1366 children from 2 to 6 years of age. Child height and weight were measured monthly. Morbidity, food intake and health-seeking behaviours were assessed fortnightly. Multivariable analyses were performed on the growth and nutritional status of male and female children in relation to socio-economic factors including father's occupation, parental education, birth order and family size. There was no evidence of gender bias in farming and trading/employee households but landless female children had significantly poorer height-for-age (P Bangladesh varied significantly according to occupational status, such that the effect of sex was dependent upon occupation. These effects were statistically significant during the period of natural disaster but became insignificant as local conditions improved. This demonstrates both temporal and socio-economic variation in gender inequalities in health.

  5. The Impact of the 1997-1998 East Asian Economic Crisis on Health and Health Care in Indonesia

    NARCIS (Netherlands)

    Pradhan, M.P.; Waters, H.; Saadah, F.

    2003-01-01

    This article identifies the effects of the 1997-98 East Asian economic crisis on health care use and health status in Indonesia. The article places the findings in the context of a framework showing the complex cause and effect relationships underlying the effects of economic downturns on health and

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

    Science.gov (United States)

    Baker, Rachel Mairi

    2006-11-01

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

  7. 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.

  8. Evaluating quantity and quality of literature focusing on health economics and pharmacoeconomics in Gulf Cooperation Council countries.

    Science.gov (United States)

    Eljilany, Islam; El-Dahiyat, Faris; Curley, Louise Elizabeth; Babar, Zaheer-Ud-Din

    2018-05-30

    The importance of pharmacoeconomics and health economics has been augmented. It has the potential to provide evidence to aid in optimal decision-making in the funding of cost-effective medicines and services in Gulf Cooperation Council countries (G.C.C). To evaluate the quality and quantity of health economic researches published until the end of 2017 in G.C.C. and to identify the factors that affect the quality of studies. Studies were included according to predefined inclusion and exclusion criteria. The quantity was recorded, and the quality was assessed using the Quality of Health Economic Studies (QHES) instrument. Forty-nine studies were included. The mean (SD) quality score of all studies was 57.83 (25.05), and a high number of reviewed studies (47%) were evaluated as either poor or extremely poor quality. The factors that affect the quality of studies with statistical significance were, the type and method of economic evaluation, the economic outcome was the objective of the research, author`s background, the perspective of the study, health intervention and source of funding. The use of economic evaluation studies in G.C.C was limited. Different factors that affect the quality of articles such as performing a full economic evaluation and choosing societal perspective were identified. Strategies to improve the quality of future studies were recommended.

  9. Task force report on health effects assessment

    International Nuclear Information System (INIS)

    Anderson, C.; Hushon, J.

    1978-08-01

    From April to August, 1978 MITRE supported the Health Effects Assessment Task Force sponsored by the Office of the Assistant Secretary for the Environment at DOE. The findings of that Task Force are incorporated in this report and include a detailed definition of health effects assessment, a survey of the mandates for health effects assessments within DOE/EV, a review of current DOE-EV health effects assessment activities, an analysis of the constraints affecting the health effects assessment process and a discussion of the Task Force recommendations. Included as appendices are summaries of two workshops conducted by the Task Force to determine the state-of-the-art of health effects assessment and modeling and a review of risk assessment activities in other federal agencies. The primary recommendation of the panel was that an office be designated or created under the Office of the Assistant Secretary for the Environment to coordinate the Health Effects Risk Assessment effort covering up to 40 program and policy areas; a similar need was expressed for the environmental effects assessment area. 1 tab

  10. Recent Topical Research on Global, Energy, Health & Medical, and Tourism Economics, and Global Software

    OpenAIRE

    Chang, Chia-Lin; McAleer, Michael

    2017-01-01

    textabstractThe paper presents an overview of recent topical research on global, energy, health & medical, and tourism economics, and global software. We have interpreted “global” in the title of the Journal of Reviews on Global Economics to cover contributions that have a global impact on economics, thereby making it “global economics”. In this sense, the paper is concerned with papers on global, energy, health & medical, and tourism economics, as well as global software algorithms that have...

  11. Economic impact assessment of invasive plant pests in the European Union

    NARCIS (Netherlands)

    Soliman, T.A.A.

    2012-01-01

    According to the International Plant Protection Convention (IPPC) and the Agreement on the Application of Sanitary and Phytosanitary measures (SPS Agreement) of the World Trade Organization (WTO), phytosanitary measures should be economically justifiable. The economic impact assessments within a

  12. The assessing the economic stability of the agricultural organizations of the Kemerovo region

    Directory of Open Access Journals (Sweden)

    Sekacheva Vera Mikhailovna

    2014-08-01

    Full Text Available The main aspects of the essence of economic stability analyzed in this article. The authors define the concept, the problems and the basic criteria for assessing the economic sustainability of the agricultural organizations of the Kemerovo region.

  13. Economic evaluation of nurse staffing and nurse substitution in health care: a scoping review.

    Science.gov (United States)

    Goryakin, Yevgeniy; Griffiths, Peter; Maben, Jill

    2011-04-01

    Several systematic reviews have suggested that greater nurse staffing as well as a greater proportion of registered nurses in the health workforce is associated with better patient outcomes. Others have found that nurses can substitute for doctors safely and effectively in a variety of settings. However, these reviews do not generally consider the effect of nurse staff on both patient outcomes and costs of care, and therefore say little about the cost-effectiveness of nurse-provided care. Therefore, we conducted a scoping literature review of economic evaluation studies which consider the link between nurse staffing, skill mix within the nursing team and between nurses and other medical staff to determine the nature of the available economic evidence. Scoping literature review. English-language manuscripts, published between 1989 and 2009, focussing on the relationship between costs and effects of care and the level of registered nurse staffing or nurse-physician substitution/nursing skill mix in the clinical team, using cost-effectiveness, cost-utility, or cost-benefit analysis. Articles selected for the review were identified through Medline, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Google Scholar database searches. After selecting 17 articles representing 16 unique studies for review, we summarized their main findings, and assessed their methodological quality using criteria derived from recommendations from the guidelines proposed by the Panel on Cost-Effectiveness in Health Care. In general, it was found that nurses can provide cost effective care, compared to other health professionals. On the other hand, more intensive nurse staffing was associated with both better outcomes and more expensive care, and therefore cost effectiveness was not easy to assess. Although considerable progress in economic evaluation studies has been reached in recent years, a number of methodological issues remain. In the future

  14. Current trends in Canadian health care: myths and misconceptions in health economics.

    Science.gov (United States)

    Coyte, P C

    1990-01-01

    This paper is concerned with the economic aspects of the trends in Canadian health care. Various myths and misconceptions abound regarding the applicability of economics to behaviour in the health care industry as well as to the interpretation of recent trends. Both issues are examined in this paper. While most discussions regarding health care trends begin with the share of health expenditures in Gross National Product, I propose an alternative share that adjusts for cyclical variations in both unemployment and labour force participation. Using this measure, I show that the "real" growth of resources devoted to the health care industry is much larger than that obtained with conventional measures, and that the difference in growth rates between Canada and the U.S. is narrowed considerably. The paper outlines and disputes the validity of three public health policy propositions. First, it is not empirically valid to say that the introduction of universal medical insurance in Canada successfully contained the growth in the share of society's resources devoted to the health care industry. Second, it is not correct to argue that the change in the federal funding for hospital and medical care in 1977 was a "fiscal non-event". And finally, the proposed "equity" funding formula for Ontario hospitals is unlikely to contain costs and will potentially skew hospitals towards the provision of complex forms of care instead of cost-effective community-based alternatives.

  15. Assessment factors for human health risk assessment: A discussion paper

    NARCIS (Netherlands)

    Vermeire, T.; Stevenson, H.; Pieters, M.N.; Rennen, M.; Slob, W.; Hakkert, B.C.

    1999-01-01

    The general goal of this discussion paper is to contribute toward the further harmonization of human health risk assessment. It first discusses the development of a formal, harmonized set of assessment factors. The status quo with regard to assessment factors is reviewed, that is, the type of

  16. Assessment factors for human health risk assessment: a discussion paper

    NARCIS (Netherlands)

    Vermeire TG; Stevenson H; Pieters MN; Rennen M; Slob W; Hakkert BC; Nederlandse organisatie voor; CSR; LEO; TNO-ITV

    1998-01-01

    The general goal of this discussion paper is to contribute towards further harmonisation of the human health risk assessment. It discusses the development of a formal, harmonised set of default assessment factors. The status quo with regard to assessment factors is reviewed. Options are presented

  17. State of the art for assessing the off-side economic consequences of nuclear accidents

    International Nuclear Information System (INIS)

    Gallego Diaz, E.

    1996-01-01

    The paper is intended to offer a wide perspective on th methodologies for assessing the off-side economic consequences of nuclear accidents. The element which can contribute to the cost are first reviewed, namely the application of countermeasures against radioactive contamination: population movements, decontamination, food bans; together with the resulting health effects if this is the case. The basic characteristics of the existing models and codes are also presented, including the most recent developments and intercomparisons of results. Some applications of this kind of studies in different fields are outlined. (Author) 17 refs

  18. 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.

  19. The contribution of health technology assessment, health needs assessment, and health impact assessment to the assessment and translation of technologies in the field of public health genomics.

    Science.gov (United States)

    Rosenkötter, N; Vondeling, H; Blancquaert, I; Mekel, O C L; Kristensen, F B; Brand, A

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation. Copyright © 2010 S. Karger AG, Basel.

  20. The application of statistical methods to assess economic assets

    Directory of Open Access Journals (Sweden)

    D. V.