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Health economics and outcomes research

Leyla Ismayilova, Eleni Gaveras, Austin Blum, Alexice Tô-Camier, Rachel Nanema
OBJECTIVES: Research about the mental health of children in Francophone West Africa is scarce. This paper examines the relationships between adverse childhood experiences, including exposure to violence and exploitation, and mental health outcomes among children living in ultra-poverty in rural Burkina Faso. METHODS: This paper utilizes baseline data collected from 360 children ages 10-15 and 360 of their mothers recruited from twelve impoverished villages in the Nord Region of Burkina, located near the Sahel Desert and affected by extreme food insecurity...
2016: PloS One
Gustavo Bergonzoli, Luis G Castellanos, Rodolfo Rodríguez, Lina María Garcia
Objectives To explore the relationships among social, economic, environmental, and health services determinants of tuberculosis (TB) morbidity and mortality, and to identify the mechanisms that mediate such associations in countries of Latin America and the Caribbean (LAC). Methods This was an ecological study of 26 LAC countries that had accurate data available on 38 selected variables for the year 2010. The countries represented 99% of the TB burden in LAC. Multivariate linear regression was used to identify associations among determinants of health and TB morbidity and mortality...
February 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Sairam Parthasarathy, Mary A Carskadon, Girardin Jean-Louis, Judith Owens, Adam Bramoweth, Daniel Combs, Lauren Hale, Elizabeth Harrison, Chantelle N Hart, Brant P Hasler, Sarah M Honaker, Elisabeth Hertenstein, Samuel Kuna, Clete Kushida, Jessica C Levenson, Caitlin Murray, Allan I Pack, Vivek Pillai, Kristi Pruiksma, Azizi Seixas, Patrick Strollo, Saurabh S Thosar, Natasha Williams, Daniel Buysse
A wealth of scientific knowledge is being generated in sleep and circadian science. In order for us to realize the return on investment for such scientific knowledge and to improve the health of the nation, we need to disseminate and implement research findings into practice. An implementation gap - termed a "quality chasm" by the Institutes of Medicine - separates the scientific knowledge we possess and the implementation of such knowledge into preventative interventions or healthcare treatments. It is frequently reported that a time lag of 17 years transpires before medical research reaches clinical practice...
October 10, 2016: Sleep
Jason Madan, Tony Ades, Pelham Barton, Laura Bojke, Ernest Choy, Philip Helliwell, Paresh Jobanputra, Ken Stein, Andrew Stevens, Jonathan Tosh, Suzanne Verstappen, Allan Wailoo
INTRODUCTION: Biologic therapies are efficacious but costly. A number of health economic models have been developed to determine the most cost-effective way of using them in the treatment pathway. These models have produced conflicting results, driven by differences in assumptions, model structure, and data, which undermine the credibility of funding decisions based on modeling studies. A Consensus Working Party met to discuss recommendations and approaches for future models of biologic therapies...
December 2015: Rheumatol Ther
Paul McNamee, Elizabeth Murray, Michael P Kelly, Laura Bojke, Jim Chilcott, Alastair Fischer, Robert West, Lucy Yardley
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...
November 2016: American Journal of Preventive Medicine
Natalie K Bradford, Liam J Caffery, Anthony C Smith
INTRODUCTION: With the escalating costs of health care, issues with recruitment and retention of health practitioners in rural areas, and poor economies of scale, the question of delivering people to services or services to people is a dilemma for health authorities around the world. People living in rural areas have poorer health outcomes compared to their urban counterparts, and the problem of how to provide health care and deliver services in rural locations is an ongoing challenge...
October 2016: Rural and Remote Health
Huifen Ma, Weiyan Jian, Tingting Xu, Yasheng He, John A Rizzo, Hai Fang
BACKGROUND: The number of pharmacoeconomic publications in the literature from China has risen rapidly, but the quality of pharmacoeconomic publications from China has not been analyzed. OBJECTIVES: This study aims to identify all recent pharmacoeconomic publications from China, to critically appraise the reporting quality, and to summarize the results. METHODS: Four databases (PubMed, Web of Science, Medline, and EmBase) were searched for original articles published up to December 31, 2014...
October 2016: Medicine (Baltimore)
David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Bridget Gray, Andrew Briggs, Ranjit Lall, Tim Js Chesser, Ian Pallister, Sarah E Lamb, Keith Willett
BACKGROUND: Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES: We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN: A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study...
October 2016: Health Technology Assessment: HTA
Amy O'Donnell, Catherine McParlin, Stephen C Robson, Fiona Beyer, Eoin Moloney, Andrew Bryant, Jennifer Bradley, Colin Muirhead, Catherine Nelson-Piercy, Dorothy Newbury-Birch, Justine Norman, Emma Simpson, Brian Swallow, Laura Yates, Luke Vale
BACKGROUND: Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG...
October 2016: Health Technology Assessment: HTA
Ahmad Elnahas, Timothy D Jackson, Allan Okrainec, Peter C Austin, Chaim M Bell, David R Urbach
BACKGROUND: In 2009, the Ontario Bariatric Network was established to address the exploding demand by Ontario residents for bariatric surgery services outside Canada. We compared the use of postoperative hospital services between out-of-country surgery recipients and patients within the Ontario Bariatric Network. METHODS: We conducted a population-based, comparative study using administrative data held at the Institute for Clinical Evaluative Sciences. We included Ontario residents who underwent bariatric surgery between 2007 and 2012 either outside the country or at one of the Ontario Bariatric Network's designated centres of excellence...
July 2016: CMAJ Open
Yin Zhou, Gary A Abel, Willie Hamilton, Kathy Pritchard-Jones, Cary P Gross, Fiona M Walter, Cristina Renzi, Sam Johnson, Sean McPhail, Lucy Elliss-Brookes, Georgios Lyratzopoulos
Many patients with cancer are diagnosed through an emergency presentation, which is associated with inferior clinical and patient-reported outcomes compared with those of patients who are diagnosed electively or through screening. Reducing the proportion of patients with cancer who are diagnosed as emergencies is, therefore, desirable; however, the optimal means of achieving this aim are uncertain owing to the involvement of different tumour, patient and health-care factors, often in combination. Most relevant evidence relates to patients with colorectal or lung cancer in a few economically developed countries, and defines emergency presentations contextually (that is, whether patients presented to emergency health-care services and/or received emergency treatment shortly before their diagnosis) as opposed to clinically (whether patients presented with life-threatening manifestations of their cancer)...
October 11, 2016: Nature Reviews. Clinical Oncology
Minna Kumpu, Salla Atkins, Merrick Zwarenstein, Lungiswa Nkonki
BACKGROUND: Novel research training approaches are needed in global health, particularly in sub-Saharan African universities, to support strengthening of health systems and services. Blended learning (BL), combining face-to-face teaching with computer-based technologies, is also an accessible and flexible education method for teaching global health and related topics. When organised as inter-institutional collaboration, BL also has potential for sharing teaching resources. However, there is insufficient data on the costs of BL in higher education...
2016: Global Health Action
Vladimir Khanassov, Pierre Pluye, Sarah Descoteaux, Jeannie L Haggerty, Grant Russell, Jane Gunn, Jean-Frederic Levesque
: Access to community-based primary health care (hereafter, 'primary care') is a priority in many countries. Health care systems have emphasized policies that help the community 'get the right service in the right place at the right time'. However, little is known about organizational interventions in primary care that are aimed to improve access for populations in situations of vulnerability (e.g., socioeconomically disadvantaged) and how successful they are. The purpose of this scoping review was to map the existing evidence on organizational interventions that improve access to primary care services for vulnerable populations...
October 10, 2016: International Journal for Equity in Health
Éva Belicza, Péter Mihalicza, Judit Lám, Cecília Surján
The European Health Care Outcomes, Performance and Efficiency research was financed by the European Union between 2010 and 2013. In this program a new methodology was developed which made the analysis of regularly collected data and international benchmarking of the healthcare results of 5 socially and economically critical diagnosis group between the 7 participant countries possible. This paper presents the most important areas of the development, such as (1) the principles of the methodology, (2) the definition of available databases, code systems, (3) the events to be analysed, (4) the general rules of analyses and indicator development, (5) the exact methodology of data collection, processing, and analysis, (6) the methods of risk adjustment, (7) and the development of the standardised database...
October 2016: Orvosi Hetilap
Pierre Pratley
Research on the association between women's empowerment and maternal and child health has rapidly expanded. However, questions concerning the measurement and aggregation of quantitative indicators of women's empowerment and their associations with measures of maternal and child health status and healthcare utilization remain unanswered. Major challenges include complexity in measuring progress in several dimensions and the situational, context dependent nature of the empowerment process as it relates to improvements in maternal and child health status and maternal care seeking behaviors...
August 22, 2016: Social Science & Medicine
Nandita Bhan, Krishna Dipankar Rao, Shivani Kachwaha
BACKGROUND: Research on health inequalities can be instrumental in drawing attention to the health of socioeconomically vulnerable groups in India in the context of rapid economic growth. It can shape the dialogue for public health action, emphasizing the need for greater investments in health, and monitor effectiveness of health programs. Our objective was to examine trends in studies on health inequalities in the last 25 years. METHODS: We conducted a systematic literature review of studies on health inequalities published from 1990...
October 6, 2016: International Journal for Equity in Health
Suzanne L de Kunder, Kim Rijkers, Sander M J van Kuijk, Silvia M A A Evers, Rob A de Bie, Henk van Santbrink
BACKGROUND: With a steep increase in the number of instrumented spinal fusion procedures, there is a need for comparative data to develop evidence based treatment recommendations. Currently, the available data on cost and clinical effectiveness of the two most frequently performed surgeries for lumbar spondylolisthesis, transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF), are not sufficient. Therefore, current guidelines do not advise which is the most appropriate surgical treatment strategy for these patients...
October 6, 2016: BMC Musculoskeletal Disorders
Bik-Wai Bilvick Tai, Yuna H Bae, Quang A Le
BACKGROUND: Patient-centered care has become increasingly important and relevant for informed health care decision making. OBJECTIVE: Our study aimed to perform a systematic review of health economic evaluation studies from the patient's perspective. METHODS: PubMed, EMBASE, and Cochrane Central databases were searched through May 2014 for cost-effectiveness, cost-utility, and cost-benefit studies using the patient's perspective in their analysis...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Nicola Totton, Joanna M Charles, Claire A Hawkes, Val Morrison, Zoe Hoare, Michelle Williams, Aaron W Pritchard, Swapna Alexander, Andrew Lemmey, Robert T Woods, Catherine Sackley, Pip Logan, Rhiannon T Edwards, Clare Wilkinson
OBJECTIVE: To conduct a rigorous feasibility study for a future definitive parallel-group randomised controlled trial (RCT) and economic evaluation of an enhanced rehabilitation package for hip fracture. SETTING: Recruitment from 3 acute hospitals in North Wales. Intervention delivery in the community. PARTICIPANTS: Older adults (aged ≥65) who received surgical treatment for hip fracture, lived independently prior to fracture, had mental capacity (assessed by clinical team) and received rehabilitation in the North Wales area...
October 5, 2016: BMJ Open
Nadia Steiber
Handgrip strength is an important biomarker of healthy ageing and a powerful predictor of future morbidity and mortality both in younger and older populations. Therefore, the measurement of handgrip strength is increasingly used as a simple but efficient screening tool for health vulnerability. This study presents normative reference values for handgrip strength in Germany for use in research and clinical practice. It is the first study to provide normative data across the life course that is stratified by sex, age, and body height...
2016: PloS One
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