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Health care economics

Abukari I Issaka, Kingsley E Agho, Andre M N Renzaho
OBJECTIVE: The literature on the impact of internal migration on under-five mortality in sub-Saharan Africa has been limited. This study examined the impact of internal migration on under-five mortality rate in 27 sub-Saharan African countries. DESIGN: The analysis used cross-sectional data from the most recent Demographic and Health Surveys of 27 sub-Saharan African countries. Information on the number of live births and the number of under-five deaths in the five years preceding the surveys in these countries was examined...
2016: PloS One
Mércia Mascarenhas Fernandes Cerqueira, Rafanielly de Oliveira Alves, Maria Geralda Gomes Aguiar
The scope of this study is to describe the experiences of mothers of children with intellectual disabilities who have been treated in a specialized institution in Feira de Santana, State of Bahia, during their therapeutic itineraries. The study adopted a qualitative approach and was conducted by means of semi-structured interviews. The results revealed that the discovery that their child has an intellectual disability is accepted by their mothers with emotions of shock, denial, anger, negotiation, depression and subsequent acceptance...
October 2016: Ciência & Saúde Coletiva
Janet Bouttell, James Lewsey, Claudia Geue, Grace Antony, Andrew Briggs, Gerry McCartney, Sharon Hutchinson, Lesley Graham, Mathis Heydtmann
Studies assessing the costs of alcoholic liver disease are lacking. We aimed to calculate the costs of hospitalisations before and after diagnosis compared to population controls matched by age, sex and socio-economic deprivation. We aimed to use population level data to identify a cohort of individuals hospitalised for the first time with alcoholic liver disease in Scotland between 1991 and 2011.Incident cases were classified by disease severity, sex, age group, socio-economic deprivation and year of index admission...
2016: PloS One
Joanna P MacEwan, Felicia M Forma, Jason Shafrin, Ainslie Hatch, Darius N Lakdawalla, Jean-Pierre Lindenmayer
BACKGROUND: Poor medication adherence contributes to negative treatment response, symptom relapse, and hospitalizations in schizophrenia. Many health plans use claims-based measures like medication possession ratios or proportion of days covered (PDC) to measure patient adherence to antipsychotics. Classifying patients solely on the basis of a single average PDC measure, however, may mask clinically meaningful variations over time in how patients arrive at an average PDC level. OBJECTIVE: To model patterns of medication adherence evolving over time for patients with schizophrenia who initiated treatment with an oral atypical antipsychotic and, based on these patterns, to identify groups of patients with different adherence behaviors...
November 2016: Journal of Managed Care & Specialty Pharmacy
Jason Shafrin, Taylor T Schwartz, Darius N Lakdawalla, Felicia M Forma
BACKGROUND: Nonadherence to antipsychotic medication among patients with schizophrenia results in poor symptom management and increased health care and other costs. Despite its health impact, medication adherence remains difficult to accurately assess. New technologies offer the possibility of real-time patient monitoring data on adherence, which may in turn improve clinical decision making. However, the economic benefit of accurate patient drug adherence information (PDAI) has yet to be evaluated...
November 2016: Journal of Managed Care & Specialty Pharmacy
Valerio Dimonte, Alvisa Palese, Paolo Chiari, Dario Laquintana, Gianni Tognoni, Paola Di Giulio
. The debate on the development of advanced nursing competences. The dossier aims to describe and disentagle the present Italian and international debate on the development and recognition of advanced nursing competences. Following a general brief description of the legislative national background, the attention is first of all focused on the lack of clarity on the definition of advanced competence, which is further complicated by the issue of their formal, contractual and economic recognition. To explore these issues a list of contributions is presented and some proposals are formulated to favor a better oriented development of the debate: a...
July 2016: Assistenza Infermieristica e Ricerca: AIR
Edward Ivor Broughton, Lani Marquez
There is little evidence to direct health systems toward providing efficient interventions to address medical errors, defined as an unintended act of omission or commission or one not executed as intended that may or may not cause harm to the patient but does not achieve its intended outcome. We believe that lack of guidance on what is the most efficient way to reduce medical errors and improve the quality of health-care limits the scale-up of health system improvement interventions. Challenges to economic evaluation of these interventions include defining and implementing improvement interventions in different settings with high fidelity, capturing all of the positive and negative effects of the intervention, using process measures of effectiveness rather than health outcomes, and determining the full cost of the intervention and all economic consequences of its effects...
2016: Frontiers in Public Health
Eugene T Richardson, Mohamed Bailor Barrie, J Daniel Kelly, Yusupha Dibba, Songor Koedoyoma, Paul E Farmer
Despite more than 25 documented outbreaks of Ebola since 1976, our understanding of the disease is limited, in particular the social, political, ecological, and economic forces that promote (or limit) its spread. In the following study, we seek to provide new ways of understanding the 2013-2016 Ebola pandemic. We use the term, 'pandemic,' instead of 'epidemic,' so as not to elide the global forces that shape every localized outbreak of infectious disease. By situating life histories via a biosocial approach, the forces promoting or retarding Ebola transmission come into sharper focus...
June 2016: Health and Human Rights
Elizabeth H Bradley, Heather Sipsma, Lauren A Taylor
BACKGROUND: for decades, U.S. taxpayers have been lamenting the high cost of health care. Since the mid-1980s, Americans have had double-digit spending on health care. Despite this investment, Americans are less healthy than their European and Scandinavian counterparts across an array of health measures. AIM: We sought to explore how inadequate attention to the social, behavioral, and environmental determinants of health may contribute to the American health care paradox of high health care spending and poor health outcomes...
October 24, 2016: QJM: Monthly Journal of the Association of Physicians
Sherif M Badawy, Lisa M Kuhns
BACKGROUND: The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking. OBJECTIVE: The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs...
October 25, 2016: JMIR MHealth and UHealth
P Speetjens, F Thielen, M Ten Have, R de Graaf, F Smit
Child maltreatment occurs frequently. This has detrimental effects later in life on mental health and is linked to considerable costs due to health care use and sick leave. Self-mastery, however, is a factor that may well mitigated the effects of child maltreatment . <br/> AIM: To quantify the long-term costs of child abuse and to test the hypothesis that self-mastery can modify the after-effects of maltreatment .<br/> METHOD: Data were obtained from a psychiatric cohort study (n=5618). The risk factors were emotional neglect and mental, physical and sexual abuse before the age of 16...
2016: Tijdschrift Voor Psychiatrie
Saturnin Bertrand Nguenda Anya, Atanase Yene
This paper seeks to identify the determinants of the choice of treatment of pregnant women in Cameroon. Theoretically, the methodology is based on a discrete choice model with random utility. Empirically, the econometric specification is a Nested Multinomial Logit Model. The data used comes from the Demographic Health Survey (DHS) organized in 2011 by the National Institute of Statistics. The results reveal that uneducated women or those having only a primary education prefer to meet the traditional midwives than seek modern maternal health services...
December 2016: Health Economics Review
S Banerjee, P Gunda, R F Drake, K Hamed
BACKGROUND: Nucleos(t)ide analogs (NUCs) are the standard of care for chronic hepatitis B (CHB). The present analysis aimed to determine the cost effectiveness of NUCs in Chinese healthcare settings. METHODS: A Markov model was used to simulate two therapeutic strategies for a hypothetical patient cohort diagnosed with hepatitis B e antigen-positive CHB, unwilling or unable to receive interferon therapy, and about to start treatment with any NUC. The first strategy included NUC monotherapy without sequencing (telbivudine [LDT], entecavir [ETV], tenofovir [TDF], lamivudine [LAM], adefovir dipivoxil [ADV], and combination therapies of either LDT and ADV or LDT and TDF, followed by best supportive care [BSC])...
2016: SpringerPlus
Shannon Doocy, Emily Lyles, Baptiste Hanquart, Michael Woodman
BACKGROUND: Given the large burden of non-communicable diseases (NCDs) among both Syrian refugees and the host communities within which they are settled, humanitarian actors and the government of Lebanon face immense challenges in addressing health needs. This study assessed health status, unmet needs, and utilization of health services among Syrian refugees and host communities in Lebanon. METHODS: A cross-sectional survey of Syrian refugees and host communities in Lebanon was conducted using a two-stage cluster survey design with probability proportional to size sampling...
2016: Conflict and Health
Margalida Gili, Emilio López-Navarro, Adoración Castro, Clara Homar, Capilla Navarro, Mauro García-Toro, Javier García-Campayo, Miquel Roca
BACKGROUND: Economic crises have a negative effect on mental health. Little evidence has been published on the impact of economic downturns on male and female. The aim of the study was to analyze gender differences in specific mental disorders in primary care during the current economic recession in Spain. METHOD: A total of 7,914 patients in 2006 and 5,876 patients in 2010 were recruited to collect sociodemographic data and the Primary Care Evaluation of Mental Disorders...
November 2016: Psicothema
P Maxwell Courtney, David C Markel
With renewed focus on achieving value for patients in total hip and knee arthroplasty, payors, hospitals, and physicians strive to provide quality care while minimizing cost. Large registry datasets have gained popularity in the United States to track implant survivorship and outcomes after joint replacement. Partnerships among surgeons, insurers, and health systems have improved on earlier administrative datasets from Medicare to measure quality and outcomes. Participation in state and national registries can help surgeons and hospitals gain a financial advantage in several insurers' quality programs and alternative payment models...
October 24, 2016: Journal of Knee Surgery
Andrés Palacio Chaverra
OBJECTIVE(S): Colombia has the third largest black population in the Americas after Brazil and the USA. In 2005 mortality rate under 5 in Colombia was 21.5 per 1000, with a reduction of 82% between 2005 and 1955. That rate is not in line with rates for Cuba (6.8), Chile (9.1) or Costa Rica (10.4). Here we aim to provide evidence that a further reduction of child mortality relates to the unspoken racial gap in a pioneering country in family planning and praised in the 2000 WHO report as having the world's fairest health care reform in terms of coverage and financial access...
October 24, 2016: Ethnicity & Health
Alexander Konnopka, Hans-Helmut König, Claudia Kaufmann, Nina Egger, Beate Wild, Joachim Szecsenyi, Wolfgang Herzog, Dieter Schellberg, Rainer Schaefert
BACKGROUND: Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. OBJECTIVE: To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. METHODS: An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3months and 2 booster sessions 6 and 12months after baseline...
November 2016: Journal of Psychosomatic Research
Racquel E Kohler, Jared Tomlinson, Tiyamike Eletima Chilunjika, Sven Young, Mina Hosseinipour, Clara N Lee
PURPOSE: Low- and middle-income countries face a disproportionate burden of death and disability from injuries, many of which are due to road traffic accidents or falls. Lower extremity injuries in particular have implications not only for physical disabilities affecting work and school performance, but also for quality of life (QOL) of the individual. This qualitative study explores the psychosocial impact and QOL changes due to lower extremity injuries among trauma patients in central Malawi...
October 22, 2016: Quality of Life Research
C Teljeur, P S Moran, S Walshe, S M Smith, F Cianci, L Murphy, P Harrington, M Ryan
AIMS: To systematically review the evidence on the costs and cost-effectiveness of self-management support interventions for people with diabetes. BACKGROUND: Self-management support is the provision of education and supportive interventions to increase patients' skills and confidence in managing their health problems, potentially leading to improvements in HbA1c levels in people with diabetes. METHODS: Randomized controlled trials, observational studies or economic modelling studies were eligible for inclusion in the review...
October 22, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
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