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Jaya IGNM, Folmer H. Spatiotemporal high-resolution prediction and mapping: methodology and application to dengue disease. JOURNAL OF GEOGRAPHICAL SYSTEMS 2022; 24:527-581. [PMID: 35221792 PMCID: PMC8857957 DOI: 10.1007/s10109-021-00368-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/08/2021] [Indexed: 05/16/2023]
Abstract
UNLABELLED Dengue disease has become a major public health problem. Accurate and precise identification, prediction and mapping of high-risk areas are crucial elements of an effective and efficient early warning system in countering the spread of dengue disease. In this paper, we present the fusion area-cell spatiotemporal generalized geoadditive-Gaussian Markov random field (FGG-GMRF) framework for joint estimation of an area-cell model, involving temporally varying coefficients, spatially and temporally structured and unstructured random effects, and spatiotemporal interaction of the random effects. The spatiotemporal Gaussian field is applied to determine the unobserved relative risk at cell level. It is transformed to a Gaussian Markov random field using the finite element method and the linear stochastic partial differential equation approach to solve the "big n" problem. Sub-area relative risk estimates are obtained as block averages of the cell outcomes within each sub-area boundary. The FGG-GMRF model is estimated by applying Bayesian Integrated Nested Laplace Approximation. In the application to Bandung city, Indonesia, we combine low-resolution area level (district) spatiotemporal data on population at risk and incidence and high-resolution cell level data on weather variables to obtain predictions of relative risk at subdistrict level. The predicted dengue relative risk at subdistrict level suggests significant fine-scale heterogeneities which are not apparent when examining the area level. The relative risk varies considerably across subdistricts and time, with the latter showing an increase in the period January-July and a decrease in the period August-December. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10109-021-00368-0.
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Affiliation(s)
- I. Gede Nyoman Mindra Jaya
- Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Statistics Department, Padjadjaran University, Bandung, Indonesia
| | - Henk Folmer
- Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Statistics Department, Padjadjaran University, Bandung, Indonesia
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2
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Abstract
Background Health care systems around the world struggle with high prices for new cancer drugs. The purpose of this study was to conduct a gedankenexperiment and calculate how much health expenditures would change if a cure for cancer through pharmaceutical treatment were made available. The cancer cure was conceived to eliminate both cancer deaths and the underlying morbidity burden of cancer. Furthermore, the cure was hypothesized to arrive in incremental steps but at infinitesimally small time intervals (resulting, effectively, in an immediate cure). Methods The analysis used secondary data and was conducted from the viewpoint of the German social health insurance. As its underlying method, it used a cause-elimination life-table approach. To account for the age distribution of the population, the study weighted age-specific increases in remaining life expectancy by age-specific population sizes. It considered drug acquisition costs as well as savings and life extension costs from eliminating cancer. All cancer drugs that underwent a mandatory early benefit assessment in Germany between 2011 and 2015/16 and were granted an added benefit were included. Data on age- and gender-specific probabilities of survival, population sizes, causes of death, and health expenditures, as well as data on cancer costs were taken from the German Federal Office of Statistics and the German Federal Social Insurance Office. Results Based on the cause-elimination life-table approach and accounting for the age structure of the German population, curing cancer in Germany yields an increase in average remaining life expectancy by 2.66 life years. Based on the current incremental cost-effectiveness ratio of new cancer drugs, which is on average €101,493 per life year gained (€39,751/0.39 life years), the German social health insurance would need to pay €280,497 per insuree to eliminate cancer. Dividing this figure by current average remaining lifetime health expenditures yields a ratio of 2.07, which represents a multiplier of current health expenditures. Conclusions Eliminating cancer at current price levels would more than triple total health expenditures in Germany. As the current price of a cure requires a drastic reduction of non-health consumption, it appears that current prices for cancer drugs already on the market (i.e., small steps towards a cure) need careful reconsideration. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07327-x.
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Affiliation(s)
- Afschin Gandjour
- Frankfurt School of Finance & Management, Adickesallee 32-34, 60322, Frankfurt am Main, Germany.
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3
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de Vries H, Vahl J, Muris J, Evers S, van der Horst H, Cheung KL. Effects of the reform of the Dutch healthcare into managed competition: Results of a Delphi study among experts. Health Policy 2020; 125:27-33. [PMID: 33189409 DOI: 10.1016/j.healthpol.2020.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/17/2020] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND In 2006 a major healthcare reform was introduced in the Netherlands, implying managed competition. This study explored the level of consensus on the outcomes and desired changes of this new system, and differences between stakeholder groups. METHODS A three-round Delphi-study was conducted among Dutch healthcare insurers, health economists, and professionals in general practice (GP) care and mental health (MH) care. In the first round, 20 experts indicated the most important advantages and disadvantages of the Dutch managed competition, and desired changes. Experts in the second (n = 106) and third round (N = 88) rated the importance of the 88 factors identified in the first round. RESULTS Only healthcare insurers reached consensus on important advantages (i.e. improved efficiency; room for choice). Health economists reached almost no consensus on any factors. GP and MH-care professionals reached most consensus on disadvantages (i.e. focus on price over quality, increased bureaucracy) and desired changes (i.e. reduce bargaining power of healthcare insurers; increase attention for care of complex patients); half of them suggested abolishment of managed competition. CONCLUSION GP and MH-care professionals were most dissatisfied and suggested several changes or even abolishment of the 2006 reform; healthcare insurers mentioned some benefits. This level of dissatisfaction among health care professionals indicates that there is room for improvement, preferably developed in conjunction with stakeholders.
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Affiliation(s)
- Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, the Netherlands.
| | - Jos Vahl
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, the Netherlands
| | - Jean Muris
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, the Netherlands
| | - Silvia Evers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Henriëtte van der Horst
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health, Amsterdam UMC, Free University Amsterdam, the Netherlands
| | - Kei Long Cheung
- Health Behaviour Change Research Group, Department of Health Sciences, College of Health and Life Sciences, Brunel University London, United Kingdom
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Petrelli A, Di Napoli A, Demuru E, Ventura M, Gnavi R, Di Minco L, Tamburini C, Mirisola C, Sebastiani G. Socioeconomic and citizenship inequalities in hospitalisation of the adult population in Italy. PLoS One 2020; 15:e0231564. [PMID: 32324771 PMCID: PMC7179888 DOI: 10.1371/journal.pone.0231564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/26/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Higher levels of hospital admissions among people with lower socioeconomic level, including immigrants, have been observed in developed countries. In Europe, immigrants present a more frequent use of emergency services compared to the native population. The aim of our study was to evaluate the socioeconomic and citizenship differences in the hospitalisation of the adult population in Italy. METHODS The study was conducted using the database created by the record linkage between the National Health Interview Survey (2005) with the National Hospital Discharge Database (2005-2014). 79,341 individuals aged 18-64 years were included. The outcomes were acute hospital admissions, urgent admissions and length of stay (1-7 days, > = 8 days). Education level, occupational status, self-perceived economic resources and migratory status were considered as socioeconomic determinants. A multivariate proportional hazards model for recurrent events was used to estimate the risk of total hospital admissions. Logistic models were used to estimate the risk of urgent hospitalisation as well as of length of stay. RESULTS Low education level, the lack of employment and negative self-perceived economic resources were conditions associated with the risk of hospitalisation, a longer hospital stay and greater recourse to urgent hospitalisation. Foreigners had a lower risk of hospitalisation (HR = 0.75; 95% CI:0.68-0.83) but a higher risk of urgent hospitalisation (OR = 1.36; 95% CI:1.18-1.55) and more frequent hospitalisations with a length of stay of at least eight days (OR = 1.19; 95% CI:1.02-1.40). CONCLUSIONS To improve equity in access, effective primary, secondary and tertiary prevention strategies must be strengthened, as should access to appropriate levels of care.
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Affiliation(s)
- Alessio Petrelli
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
- * E-mail:
| | - Anteo Di Napoli
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Elena Demuru
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Martina Ventura
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Roberto Gnavi
- Epidemiology Unit, ASL TO3, Grugliasco, Turin, Italy
| | | | | | - Concetta Mirisola
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
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Ratushnyak S, Hoogendoorn M, van Baal PHM. Cost-Effectiveness of Cancer Screening: Health and Costs in Life Years Gained. Am J Prev Med 2019; 57:792-799. [PMID: 31753260 DOI: 10.1016/j.amepre.2019.07.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Studies reporting on the cost-effectiveness of cancer screening usually account for quality of life losses and healthcare costs owing to cancer but do not account for future costs and quality of life losses related to competing risks. This study aims to demonstrate the impact of medical costs and quality of life losses of other diseases in the life years gained on the cost-effectiveness of U.S. cancer screening. METHODS Cost-effectiveness studies of breast, cervical, and colorectal cancer screening in the U.S. were identified using a systematic literature review. Incremental cost-effectiveness ratios of the eligible articles were updated by adding lifetime expenditures and health losses per quality-adjusted life year gained because of competing risks. This was accomplished using data on medical spending and quality of life by age and disease from the Medical Expenditure Panel Survey (2011-2015) combined with cause-deleted life tables. The study was conducted in 2018. RESULTS The impact of quality of life losses and healthcare expenditures of competing risks in life years gained incurred owing to screening were the highest for breast cancer and the lowest for cervical cancer. The updates suggest that incremental cost-effectiveness ratios are underestimated by $10,300-$13,700 per quality-adjusted life year gained if quality of life losses and healthcare expenditures of competing risks are omitted in economic evaluations. Furthermore, cancer screening programs that were considered cost saving, were found not to be so following the inclusion of medical expenditures of competing risks. CONCLUSIONS Practical difficulties in quantifying quality of life losses and healthcare expenditures owing to competing risks in life years gained can be overcome. Their inclusion can have a substantial impact on the cost-effectiveness of cancer screening programs.
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Affiliation(s)
- Svetlana Ratushnyak
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Center of Healthcare Quality Assessment and Control, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Martine Hoogendoorn
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Pieter H M van Baal
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
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A methodology to design a performance management system in preventive care. BMC Health Serv Res 2018; 18:1002. [PMID: 30594191 PMCID: PMC6311075 DOI: 10.1186/s12913-018-3837-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 12/18/2018] [Indexed: 11/14/2022] Open
Abstract
Background Preventive care has gained increasing attention in health reforms around the world due to its ability to reduce the burden of disease and to save health costs. Nevertheless, there is a gap in terms of the development of reliable systems to measure and evaluate performance of preventive care in order to support decision-making and increase service outcomes. The aim of this study is to define a methodology for designing a performance management system (PMS) in order to effectively support the planning, control and evaluation of preventive care and to identify the factors that influence such a process. Methods The methodology is based on the participatory action research approach, which implies collaboration between researchers and practitioners. The study was articulated in four phases and carried out in an Italian regional healthcare system that was undergoing a major reorganization process. Results The findings provide insights into the peculiarities that affect preventive care and highlight two categories of critical factors: general issues regarding the process and specific issues regarding preventive care. The first category includes the importance of interactions between academics, physicians and policy-makers, the impact of workloads and red tape on employee involvement and the increased conservation mechanisms during periods of institutional change. The second category concerns the strong heterogeneity of preventive activities within health organizations, the huge amount of regulations and the incompleteness of information systems. Conclusion The development of a PMS for preventive care can best be served by collaborative methods that involve academics, professionals and policy-makers, whose roles and responsibilities must be clearly defined, and by an improvement in transparency and communication within organizations in order to enhance the involvement of different professionals at appropriate times and in appropriate ways. Key recommendations that may improve the maintenance and use of information systems are proposed to policy-makers. Electronic supplementary material The online version of this article (10.1186/s12913-018-3837-8) contains supplementary material, which is available to authorized users.
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Shah M, Patil S, Patel B, Agarwal M, Davila CD, Garg L, Agrawal S, Kapur NK, Jorde UP. Causes and Predictors of 30-Day Readmission in Patients With Acute Myocardial Infarction and Cardiogenic Shock. Circ Heart Fail 2018; 11:e004310. [DOI: 10.1161/circheartfailure.117.004310] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background:
Acute myocardial infarction (AMI) occurs as a result of irreversible damage to cardiac myocytes secondary to lack of blood supply. Cardiogenic shock complicating AMI has significant associated morbidity and mortality, and data on postdischarge outcomes are limited.
Methods and Results:
We derived the study cohort of patients with AMI and cardiogenic shock from the 2013 to 2014 Healthcare Cost and Utilization Project National Readmission Database. Incidence, predictors, and causes of 30-day readmissions were analyzed. From 43 212 index admissions for AMI with cardiogenic shock, 26 016 (60.2%) survived to discharge and 5277 (20.2% of survivors) patients were readmitted within 30 days. More than 50% of these readmissions occurred within first 10 days. Cardiac causes accounted for 42% of 30-day readmissions (heart failure 20.6%; acute coronary syndrome 11.6%). Among noncardiac causes, respiratory (11.4%), infectious (9.4%), medical or surgical care complications (6.3%), gastrointestinal/hepatobiliary (6.5%), and renal causes (4.8%) were most common. Length of stay ≥8 days (odds ratio [OR], 2.04; 95% confidence interval [CI], 1.70–2.44;
P
<0.01), acute deep venous thrombosis (OR, 1.26; 95% CI, 1.08–1.48;
P
<0.01), liver disease (OR, 1.25; 95% CI, 1.03–1.50;
P
=0.02), systemic thromboembolism (OR, 1.21; 95% CI, 1.02–1.44;
P
=0.02), peripheral vascular disease (OR, 1.16; 95% CI, 1.07–1.27;
P
<0.01), diabetes mellitus (OR, 1.16; 95% CI, 1.08–1.24;
P
<0.01), long-term ventricular assist device implantation (OR, 1.77; 95% CI, 1.23–2.55;
P
<0.01), intraaortic balloon pump use (OR, 1.10; 95% CI, 1.02–1.18;
P
<0.01), performance of coronary artery bypass grafting (OR, 0.85; 95% CI, 0.77–0.93;
P
<0.01), private insurance (OR, 0.72; 95% CI, 0.64–0.80;
P
<0.01), and discharge to home (OR, 0.85; 95% CI, 0.73–0.98;
P
=0.03) were among the independent predictors of 30-day readmission.
Conclusions:
In-hospital mortality and 30-day readmission in cardiogenic shock complicating AMI are significantly elevated. Patients are readmitted mainly for noncardiac causes. Identification of high-risk factors may guide interventions to improve outcomes within this population.
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Affiliation(s)
- Mahek Shah
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
| | - Shantanu Patil
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
| | - Brijesh Patel
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
| | - Manyoo Agarwal
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
| | - Carlos D. Davila
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
| | - Lohit Garg
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
| | - Sahil Agrawal
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
| | - Navin K. Kapur
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
| | - Ulrich P. Jorde
- Department of Cardiology, Lehigh Valley Hospital, Allentown, PA (M.S., B.P., L.G.). Department of Medicine, University of Pittsburgh Medical Center, PA (S.P.). Department of Medicine, University of Tennessee Health Science Center, Memphis (M.A.). The Cardiovascular Center, Tufts Medical Center, Boston, MA (C.D.D., N.K.K.). Department of Cardiology, St Luke’s University Health Network, Bethlehem, PA (S.A.). Department of Cardiology, Montefiore-Einstein Heart Center, Bronx, NY (U.P.J.)
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Botes R, Vermeulen KM, Correia J, Buskens E, Janssen F. Relative contribution of various chronic diseases and multi-morbidity to potential disability among Dutch elderly. BMC Health Serv Res 2018; 18:24. [PMID: 29334922 PMCID: PMC5769323 DOI: 10.1186/s12913-017-2820-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 12/28/2017] [Indexed: 11/16/2022] Open
Abstract
Background The amount of time spent living with disease greatly influences elderly people’s wellbeing, disability and healthcare costs, but differs by disease, age and sex. Methods We assessed how various single and combined diseases differentially affect life years spent living with disease in Dutch elderly men and women (65+) over their remaining life course. Multistate life table calculations were applied to age and sex-specific disease prevalence, incidence and death rates for the Netherlands in 2007. We distinguished congestive heart failure, coronary heart disease (CHD), breast and prostate cancer, colon cancer, lung cancer, diabetes, COPD, stroke, dementia and osteoarthritis. Results Across ages 65, 70, 75, 80 and 85, CHD caused the most time spent living with disease for Dutch men (from 7.6 years at age 65 to 3.7 years at age 85) and osteoarthritis for Dutch women (from 11.7 years at age 65 to 4.8 years at age 85). Of the various co-occurrences of disease, the combination of diabetes and osteoarthritis led to the most time spent living with disease, for both men (from 11.2 years at age 65 to 4.9 -years at age 85) and women (from 14.2 years at age 65 to 6.0 years at age 85). Conclusions Specific single and multi-morbid diseases affect men and women differently at different phases in the life course in terms of the time spent living with disease, and consequently, their potential disability. Timely sex and age-specific interventions targeting prevention of the single and combined diseases identified could reduce healthcare costs and increase wellbeing in elderly people.
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Affiliation(s)
- Riaan Botes
- Clinical Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
| | - Karin M Vermeulen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Janine Correia
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
| | - Erik Buskens
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Fanny Janssen
- Population Research Centre, University of Groningen, Groningen, the Netherlands.,The Netherlands Interdisciplinary Demographic Institute, The Hague, the Netherlands
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9
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Williams JE, Helsel B, Nelson B, Eke R. EXERCISE CONSIDERATIONS FOR TYPE 1 AND TYPE 2 DIABETES. ACSM'S HEALTH & FITNESS JOURNAL 2018. [DOI: 10.1249/fit.0000000000000359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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Afonso RF, Balardin JB, Lazar S, Sato JR, Igarashi N, Santaella DF, Lacerda SS, Amaro E, Kozasa EH. Greater Cortical Thickness in Elderly Female Yoga Practitioners-A Cross-Sectional Study. Front Aging Neurosci 2017; 9:201. [PMID: 28676757 PMCID: PMC5476728 DOI: 10.3389/fnagi.2017.00201] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 06/06/2017] [Indexed: 12/17/2022] Open
Abstract
Yoga, a mind-body activity that requires attentional engagement, has been associated with positive changes in brain structure and function, especially in areas related to awareness, attention, executive functions and memory. Normal aging, on the other hand, has also been associated with structural and functional brain changes, but these generally involve decreased cognitive functions. The aim of this cross-sectional study was to compare brain cortical thickness (CT) in elderly yoga practitioners and a group of age-matched healthy non-practitioners. We tested 21 older women who had practiced hatha yoga for at least 8 years and 21 women naive to yoga, meditation or any mind-body interventions who were matched to the first group in age, years of formal education and physical activity level. A T1-weighted MPRAGE sequence was acquired for each participant. Yoga practitioners showed significantly greater CT in a left prefrontal lobe cluster, which included portions of the lateral middle frontal gyrus, anterior superior frontal gyrus and dorsal superior frontal gyrus. We found greater CT in the left prefrontal cortex of healthy elderly women who trained yoga for a minimum of 8 years compared with women in the control group.
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Affiliation(s)
- Rui F Afonso
- Hospital Israelita Albert EinsteinSão Paulo, Brazil
| | | | - Sara Lazar
- Massachusetts General Hospital-Harvard Medical SchoolBoston, MA, United States
| | - João R Sato
- Universidade Federal do ABCSão Bernardo, Brazil
| | | | - Danilo F Santaella
- Hospital Israelita Albert EinsteinSão Paulo, Brazil.,Centro de Práticas Esportivas da Universidade de São Paulo (CEPEUSP)São Paulo, Brazil
| | | | - Edson Amaro
- Hospital Israelita Albert EinsteinSão Paulo, Brazil
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11
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Wouterse B, Huisman M, Meijboom BR, Deeg DJH, Polder JJ. The effect of trends in health and longevity on health services use by older adults. BMC Health Serv Res 2015; 15:574. [PMID: 26704342 PMCID: PMC4690430 DOI: 10.1186/s12913-015-1239-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Indexed: 11/23/2022] Open
Abstract
Background The effect of population aging on future health services use depends on the relationship between longevity gains and health. Whether further gains in life expectancy will be paired by improvements in health is uncertain. We therefore analyze the effect of population ageing on health services use under different health scenarios. We focus on the possibly diverging trends between different dimensions of health and their effect on health services use. Methods Using longitudinal data on health and health services use, a latent Markov model has been estimated that includes different dimensions of health. We use this model to perform a simulation study and analyze the health dynamics that drive the effect of population aging. We simulate three health scenarios on the relationship between longevity and health (expansion of morbidity, compression of morbidity, and the dynamic equilibrium scenario). We use the scenarios to predict costs of health services use in the Netherlands between 2010 and 2050. Results Hospital use is predicted to decline after 2040, whereas long-term care will continue to rise up to 2050. Considerable differences in expenditure growth rates between scenarios with the same life expectancy but different trends in health are found. Compression of morbidity generally leads to the lowest growth. The effect of additional life expectancy gains within the same health scenario is relatively small for hospital care, but considerable for long-term care. Conclusions By comparing different health scenarios resulting in the same life expectancy, we show that health improvements do contain costs when they decrease morbidity but not mortality. This suggests that investing in healthy aging can contribute to containing health expenditure growth.
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Affiliation(s)
- Bram Wouterse
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands. .,Center for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, >The Netherlands. .,CPB Netherlands Bureau for Economic Policy Analysis, P.O. Box 80510, The Hague, 2508 GM, >The Netherlands.
| | - Martijn Huisman
- EMGO + Institute on Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, >The Netherlands. .,Department of Sociology, VU University, Amsterdam, >The Netherlands.
| | - Bert R Meijboom
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | - Dorly J H Deeg
- EMGO + Institute on Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, >The Netherlands. .,Department of Psychiatry, VU University Medical Center, Amsterdam, >The Netherlands.
| | - Johan J Polder
- Tranzo Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands. .,Center for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, >The Netherlands.
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Caldwell GW. In silico tools used for compound selection during target-based drug discovery and development. Expert Opin Drug Discov 2015; 10:901-23. [DOI: 10.1517/17460441.2015.1043885] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Gary W Caldwell
- Janssen Research & Development LLC, Discovery Sciences, Spring House, PA, USA
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