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Sari TP, Sirohi R, Tyagi P, Tiwari G, Pal J, Kunadia NN, Verma K, Badgujar PC, Pareek S. Protein hydrolysates prepared by Alcalase using ultrasound and microwave pretreated almond meal and their characterization. J Food Sci Technol 2024; 61:1157-1164. [PMID: 38562599 PMCID: PMC10981644 DOI: 10.1007/s13197-024-05945-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 01/31/2024] [Accepted: 02/11/2024] [Indexed: 04/04/2024]
Abstract
The study aimed to optimize ultrasonic (US: 40 kHz/200 W for 10, 20, 30, 40, and 50 min), and microwave (MW: 160 W for 45, 90, 125, 180, and 225 s) pretreatment conditions on protein extraction yield and degree of protein hydrolysis (DH) from almond de-oiled meal, an industrial by-product. First order model was used to describe the kinetics of almond protein hydrolysates obtained with Alcalase. The highest DH, 10.95% was recorded for the US-50 min and 8.87% for MW-45 s; while it was 5.76% for the untreated/control sample. At these optimized pretreatment conditions, a 1.16- and 1.18-fold increment in protein recovery was observed for the US and MW pretreatments, respectively in comparison to the conventional alkaline extraction. The molecular weight distribution recorded for pretreated samples disclosed a significant reduction in the band thickness in comparison with control. Both the pretreatments resulted in a significant increase (P < 0.05) in the antioxidant activity, and TCA solubility index when compared with the control. Results evinced that US and/or MW pretreatments before enzymatic hydrolysis can be a promising approach for the valorization of almond meal for its subsequent use as an ingredient for functional foods/nutraceuticals which otherwise fetches low value as an animal feed.
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Affiliation(s)
- T. P. Sari
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management (NIFTEM-K), Kundli, Sonipat, Haryana 131028 India
| | - Ranjna Sirohi
- Rajasthan Agricultural Research Institute, Durgapura, Jaipur, Rajasthan 302018 India
- SKN Agriculture University, Jobner, Rajasthan 303329 India
| | - Prajwal Tyagi
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management (NIFTEM-K), Kundli, Sonipat, Haryana 131028 India
| | - Gyanendra Tiwari
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management (NIFTEM-K), Kundli, Sonipat, Haryana 131028 India
| | - Jyotiraditya Pal
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management (NIFTEM-K), Kundli, Sonipat, Haryana 131028 India
| | - Nihar N. Kunadia
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management (NIFTEM-K), Kundli, Sonipat, Haryana 131028 India
| | - Kiran Verma
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management (NIFTEM-K), Kundli, Sonipat, Haryana 131028 India
| | - Prarabdh C. Badgujar
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management (NIFTEM-K), Kundli, Sonipat, Haryana 131028 India
| | - Sunil Pareek
- Department of Agriculture and Environmental Sciences, National Institute of Food Technology Entrepreneurship and Management (NIFTEM-K), Kundli, Sonipat, Haryana 131028 India
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Telleria IB, Uriguen AF. [Translated article] Should the funding of laxatives be reconsidered? Farm Hosp 2024:S1130-6343(24)00059-X. [PMID: 38705828 DOI: 10.1016/j.farma.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/28/2024] [Indexed: 05/07/2024] Open
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Small R, Nugent R, Webb D, Hutchinson B, Spencer G, Ngongo C, Chestnov R, Tarlton D. Advancing progress on tobacco control in low-income and middle-income countries through economic analysis. Tob Control 2024; 33:s3-s9. [PMID: 38697661 DOI: 10.1136/tc-2023-058335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND More than 80% of the world's 1.3 billion tobacco users live in low-income and middle-income countries (LMICs), where progress to address tobacco and its harms has been slow. The perception that tobacco control detracts from economic priorities has impeded progress. The Secretariat of the WHO Framework Convention on Tobacco Control (FCTC) is leading the FCTC 2030 project, which includes technical assistance to LMICs to analyse the economic costs of tobacco use and the benefits of tobacco control. METHODS The Secretariat of the WHO FCTC, United Nations Development Programme and WHO supported 21 LMICs between 2017 and 2022 to complete national investment cases to guide country implementation of the WHO FCTC, with analytical support provided by RTI International. These country-level cases combine customised estimates of tobacco's economic impact with qualitative analysis of socio-political factors influencing tobacco control. This paper overviews the approach, observed tobacco control advancements and learnings from 21 countries: Armenia, Cabo Verde, Cambodia, Chad, Colombia, Costa Rica, El Salvador, Eswatini, Georgia, Ghana, Jordan, Laos, Madagascar, Myanmar, Nepal, Samoa, Sierra Leone, Sri Lanka, Suriname, Tunisia and Zambia. RESULTS Tobacco control advancements in line with investment case findings and recommendations have been observed in 17 of the 21 countries, and many have improved collaboration and policy coherence between health and economic stakeholders. CONCLUSIONS Tobacco control must be seen as more than a health concern. Tobacco control leads to economic benefits and contributes to sustainable development. National investment cases can support country ownership and leadership to advance tobacco control.
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Affiliation(s)
- Roy Small
- HIV, Health and Development Group, United Nations Development Programme, New York, New York, USA
| | - Rachel Nugent
- Department of Global Health, University of Washington, Seattle, Washington, USA
- RTI International, Research Triangle Park, North Carolina, USA
| | - Douglas Webb
- United Nations Development Programme, Tbilsi, Georgia
| | | | | | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
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Tauras JA. Tobacco control in low-income and middle-income countries: findings from WHO FCTC investment cases. Tob Control 2024; 33:s1-s2. [PMID: 38697657 DOI: 10.1136/tc-2024-058717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Affiliation(s)
- John A Tauras
- Department of Economics, University of Illinois Chicago, Chicago, Illinois, USA
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Nugent R, Hutchinson B, Mann N, Ngongo C, Spencer G, Grafton D, Small R. Evolving methodology of national tobacco control investment cases. Tob Control 2024; 33:s10-s16. [PMID: 38697658 DOI: 10.1136/tc-2023-058336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/19/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND This article describes an investment case methodology for tobacco control that was applied in 36 countries between 2017 and 2022. METHODS The WHO Framework Convention on Tobacco Control (FCTC) investment cases compared two scenarios: a base case that calculated the tobacco-attributable mortality, morbidity and economic costs with status quo tobacco control, and an intervention scenario that described changes in those same outcomes from fully implementing and enforcing a variety of proven, evidence-based tobacco control policies and interventions. Health consequences included the tobacco-attributable share of mortality and morbidity from 38 diseases. The healthcare expenditures and the socioeconomic costs from the prevalence of those conditions were combined to calculate the total losses due to tobacco. The monetised benefits of improvements in health resulting from tobacco control implementation were compared with costs of expanding tobacco control to assess returns on investment in each country. An institutional and context analysis assessed the political and economic dimensions of tobacco control in each context. RESULTS We applied a rigorous yet flexible methodology in 36 countries over 5 years. The replicable model and framework may be used to inform development of tobacco control cases in countries worldwide. CONCLUSION Investment cases constitute a tool that development partners and advocates have demanded in even greater numbers. The economic argument for tobacco control provided by this set of country-contextualised analyses can be a strong tool for policy change.
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Affiliation(s)
- Rachel Nugent
- Department of Global Health, University of Washington, Seattle, Washington, USA
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Nathan Mann
- RTI International, Research Triangle Park, North Carolina, USA
| | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
| | | | | | - Roy Small
- HIV, Health and Development Group, United Nations Development Programme, New York, New York, USA
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Spencer G, Nugent R, Mann N, Hutchinson B, Ngongo C, Tarlton D, Small R, Webb D. Equity implications of tobacco taxation: results from WHO FCTC investment cases. Tob Control 2024; 33:s27-s33. [PMID: 38697660 DOI: 10.1136/tc-2023-058338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/19/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Across time, geographies and country income levels, smoking prevalence is highest among people with lower incomes. Smoking causes further impoverishment of those on the lower end of the income spectrum through expenditure on tobacco and greater risk of ill health. METHODS This paper summarises the results of investment case equity analyses for 19 countries, presenting the effects of increased taxation on smoking prevalence, health and expenditures. We disaggregate the number of people who smoke, smoking-attributable mortality and cigarette expenditures using smoking prevalence data by income quintile. A uniform 30% increase in price was applied across countries. We estimated the effects of the price increase on smoking prevalence, mortality and cigarette expenditures. RESULTS In all but one country (Bhutan), a one-time 30% increase in price would reduce smoking prevalence by the largest percent among the poorest 20% of the population. All income groups in all countries would spend more on cigarettes with a 30% increase in price. However, the poorest 20% would pay an average of 12% of the additional money spent. CONCLUSIONS Our results confirm that health benefits from increases in price through taxation are pro-poor. Even in countries where smoking prevalence is higher among wealthier groups, increasing prices can still be pro-poor due to variable responsiveness to higher prices. The costs associated with higher smoking prevalence among the poor, together with often limited access to healthcare services and displaced spending on basic needs, result in health inequality and perpetuate the cycle of poverty.
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Affiliation(s)
| | - Rachel Nugent
- RTI International, Research Triangle Park, North Carolina, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Nathan Mann
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Carrie Ngongo
- RTI International, Research Triangle Park, North Carolina, USA
| | | | - Roy Small
- HIV, Health and Development Group, United Nations Development Programme, New York, New York, USA
| | - Douglas Webb
- United Nations Development Programme, Amman, Jordan
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López MÁ, Fuster M, Fleckman J, George A, Chaparro MP. Time-Trends in Food Insecurity Among US-Born and Foreign-Born Hispanic Adults by Language Use: An Analysis of National Health and Nutrition Examination Survey Data, 1999-2018. J Acad Nutr Diet 2024; 124:583-593.e1. [PMID: 38042524 PMCID: PMC11032228 DOI: 10.1016/j.jand.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 11/18/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Historically, food insecurity prevalence has been higher in Hispanic households than in non-Hispanic White households. Food insecurity prevalence among Hispanic adults, US-born and foreign-born, may vary by language use. OBJECTIVE To explore whether or not the relationship between language use and food insecurity varied over time (1999-2018) among US-born and foreign-born Hispanic adults. DESIGN Trends analysis and multivariable logistic regression modeling using pooled cross-sectional data. PARTICIPANTS AND SETTING Fifteen thousand sixty-two Hispanic adults participating in the United States National Health and Nutrition Examination Survey (1999-2018). MAIN OUTCOME MEASURES Food insecurity prevalence, assessed with the US Household Food Security Survey Module. STATISTICAL ANALYSIS Unadjusted food insecurity trends from 1999 to 2018 by language use (mostly English, both languages equally, or mostly Spanish) among US-born and foreign-born Hispanic adults were analyzed using piecewise-linear regression of log prevalence rates. Multivariable logistic regression models adjusted for sociodemographic characteristics and with an interaction term between language use and time were used to determine if odds of food insecurity among US-born and foreign-born Hispanic adults varied by language use between 1999 and 2018. RESULTS Hispanic adults' food insecurity prevalence followed an upward linear trend from 1999 to 2018; this was significant for US-born mostly English-speakers (P < 0.001), US-born mostly Spanish-speakers (P = 0.013), and foreign-born mostly Spanish-speakers (P < 0.001). In fully adjusted logistic regression models, foreign-born Hispanic adults who spoke both languages equally (odds ratio 1.8, 95% CI 1.2 to 2.6) and those who spoke mostly Spanish (odds ratio 1.9, 95% CI 1.4 to 2.8) had significantly higher food insecurity odds, compared with mostly English-speakers. No variations in associations across time were observed between language use and food insecurity (interaction P value > 0.1). CONCLUSIONS Hispanic adults' unadjusted food insecurity trends from 1999 to 2018 varied by language use. When adjusted for sociodemographic characteristics and compared with mostly English-speakers, food insecurity odds were significantly higher only among foreign-born Hispanic adults who spoke either both languages equally or mostly Spanish. Food assistance programs should linguistically adapt their services for Hispanic adults.
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Affiliation(s)
- Miguel Ángel López
- Department of Social, Behavioral and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Gretchen Swanson Center for Nutrition, Omaha, Nebraska.
| | - Melissa Fuster
- Department of Social, Behavioral and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Julia Fleckman
- Department of Social, Behavioral and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Amy George
- Department of Spanish and Portuguese, School of Liberal Arts, Tulane University, New Orleans, Louisiana
| | - M Pia Chaparro
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
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Shafir E. Daniel Kahneman obituary: psychologist who revolutionized the way we think about thinking. Nature 2024; 629:526. [PMID: 38702535 DOI: 10.1038/d41586-024-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
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Sharif FV, Yousefi N, Sharif Z. Economic Evaluations of Anti-obesity Interventions in Obese Adults: An Umbrella Review. Obes Surg 2024; 34:1834-1845. [PMID: 38438668 DOI: 10.1007/s11695-024-07104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024]
Abstract
This umbrella review amalgamates the outcomes of economic evaluations pertaining to bariatric surgeries, pharmacotherapy, and gastric balloon for adult obesity treatment. Six databases were systematically searched. The inclusion criteria were established following the Patient/population Intervention Comparison and Outcomes (PICO) statement. Fifteen reviews met all the inclusion criteria. Eight studies focused on surgical interventions, four on pharmacotherapy, and three on both interventions. No systematic review of the economic evaluation of gastric balloons was identified. The majority of reviews advocated bariatric surgery as a cost-effective approach; however, there was discordance in the interpretation of pharmacological cost-effectiveness. Most of the economic evaluations were conducted from the payer and the healthcare system perspectives. We propose that future economic evaluations assessing weight loss interventions in adults adopt a societal perspective and longer-term time horizons.
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Affiliation(s)
| | - Nazila Yousefi
- Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Sharif
- School of Pharmacy, Alborz University of Medical Sciences, Karaj, Iran.
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Luangsinsiri C, Thavorncharoensap M, Chaikledkaew U, Pattanaprateep O, Sornpaisarn B, Rehm J. Lifetime costs of alcohol consumption in Thailand: protocol for an incidence-based cost-of-illness study using Markov model. BMJ Open 2024; 14:e079829. [PMID: 38684264 DOI: 10.1136/bmjopen-2023-079829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Several prevalence-based cost-of-illness (COI) studies have been conducted to estimate the economic burden of alcohol consumption borne by a particular society in a given year. Yet there are few studies examining the economic costs incurred by an individual drinker over his/her lifetime. Thus, this study aims to estimate the costs incurred by an individual drinker's alcohol consumption over his or her lifetime in Thailand. METHODS AND ANALYSIS An incidence-based COI approach will be employed. To project individuals' associated costs over a lifetime, a Markov modelling technique will be used. The following six alcohol-related diseases/conditions will be considered in the model: hypertension, haemorrhagic stroke, liver cirrhosis, liver cancer, alcohol use disorders and road injury. The analysis will cover both direct (ie, direct healthcare cost, costs of property damage due to road traffic accidents) and indirect costs (ie, productivity loss due to premature mortality and hospital-related absenteeism). The human capital approach will be adopted to estimate the cost of productivity loss. All costs will be presented in Thai baht, 2022. ETHICS AND DISSEMINATION The Institutional Review Board of Mahidol University, Faculty of Dentistry/Faculty of Pharmacy has confirmed that no ethical approval is required (COE.No.MU-DT/PY-IRB 2021/010.0605). Dissemination of the study findings will be carried out through peer-reviewed publications, conferences and engagement with policy-makers and public health stakeholders.
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Affiliation(s)
- Chaisiri Luangsinsiri
- Doctor of Philosophy Program in Social, Economic, and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Montarat Thavorncharoensap
- Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Mahidol University Health Technology Assessment (MUHTA) International Graduate Program, Mahidol University, Bangkok, Thailand
| | - Usa Chaikledkaew
- Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Mahidol University Health Technology Assessment (MUHTA) International Graduate Program, Mahidol University, Bangkok, Thailand
| | - Oraluck Pattanaprateep
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Bundit Sornpaisarn
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Bundell S, Chase-Lubitz J. Should the Maldives be creating new land? Nature 2024:10.1038/d41586-024-01228-9. [PMID: 38658723 DOI: 10.1038/d41586-024-01228-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
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Thiboonboon K, Lourenco RDA, Cronin P, Khoo T, Goodall S. Economic Evaluations of Obesity-Targeted Sugar-Sweetened Beverage (SSB) Taxes-A Review to Identify Methodological Issues. Health Policy 2024; 144:105076. [PMID: 38692186 DOI: 10.1016/j.healthpol.2024.105076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 04/06/2024] [Accepted: 04/20/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Economic evaluations of public health interventions like sugar-sweetened beverage (SSB) taxes face difficulties similar to those previously identified in other public health areas. This stems from challenges in accurately attributing effects, capturing outcomes and costs beyond health, and integrating equity effects. This review examines how these challenges were addressed in economic evaluations of SSB taxes. METHODS A systematic review was conducted to identify economic evaluations of SSB taxes focused on addressing obesity in adults, published up to February 2021. The methodological challenges examined include measuring effects, valuing outcomes, assessing costs, and incorporating equity. RESULTS Fourteen economic evaluations of SSB taxes were identified. Across these evaluations, estimating SSB tax effects was uncertain due to a reliance on indirect evidence that was less robust than evidence from randomised controlled trials. Health outcomes, like quality-adjusted life years, along with a healthcare system perspective for costs, dominated the evaluations of SSB taxes, with a limited focus on broader non-health consequences. Equity analyses were common but employed significantly different approaches and exhibited varying degrees of quality. CONCLUSION Addressing the methodological challenges remains an issue for economic evaluations of public health interventions like SSB taxes, suggesting the need for increased attention on those issues in future studies. Dedicated methodological guidelines, in particular addressing the measurement of effect and incorporation of equity impacts, are warranted.
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Affiliation(s)
- Kittiphong Thiboonboon
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia, Level 5, Building 20 100 Broadway, Chippendale, NSW 2008, Australia.
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia, Level 5, Building 20 100 Broadway, Chippendale, NSW 2008, Australia
| | - Paula Cronin
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia, Level 5, Building 20 100 Broadway, Chippendale, NSW 2008, Australia
| | - Terence Khoo
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia, Level 5, Building 20 100 Broadway, Chippendale, NSW 2008, Australia
| | - Stephen Goodall
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia, Level 5, Building 20 100 Broadway, Chippendale, NSW 2008, Australia
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Gombault-Datzenko E, Costa N, Mounié M, Tavassoli N, Mathieu C, Roussel H, Lagarrigue JM, Berard E, Rolland Y, Molinier L. Cost of care pathways before and after appropriate and inappropriate transfers to the emergency department among nursing home residents: results from the FINE study. BMC Geriatr 2024; 24:353. [PMID: 38641801 PMCID: PMC11027376 DOI: 10.1186/s12877-024-04946-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 04/03/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Transfers of nursing home (NH) residents to the emergency department (ED) is frequent. Our main objective was to assess the cost of care pathways 6 months before and after the transfer to the emergency department among NH residents, according to the type of transfer (i.e. appropriate or inappropriate). METHODS This was a part of an observational, multicenter, case-control study: the Factors associated with INappropriate transfer to the Emergency department among nursing home residents (FINE) study. Sixteen public hospitals of the former Midi-Pyrénées region participated in recruitment, in 2016. During the inclusion period, all NH residents arriving at the ED were included. A pluri-disciplinary team categorized each transfer to the ED into 2 groups: appropriate or inappropriate. Direct medical and nonmedical costs were assessed from the French Health Insurance (FHI) perspective. Healthcare resources were retrospectively gathered from the FHI database and valued using the tariffs reimbursed by the FHI. Costs were recorded over a 6-month period before and after transfer to the ED. Other variables were used for analysis: sex, age, Charlson score, season, death and presence inside the NH of a coordinating physician or a geriatric nursing assistant. RESULTS Among the 1037 patients initially included in the FINE study, 616 who were listed in the FHI database were included in this economic study. Among them, 132 (21.4%) had an inappropriate transfer to the ED. In the 6 months before ED transfer, total direct costs on average amounted to 8,145€ vs. 6,493€ in the inappropriate and appropriate transfer groups, respectively. In the 6 months after ED transfer, they amounted on average to 9,050€ vs. 12,094€. CONCLUSIONS Total costs on average are higher after transfer to the ED, but there is no significant increase in healthcare expenditure with inappropriate ED transfer. Support for NH staff and better pathways of care could be necessary to reduce healthcare expenditures in NH residents. TRIAL REGISTRATION clinicaltrials.gov, NCT02677272.
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Affiliation(s)
- E Gombault-Datzenko
- Present address: Department of Medical Information (DIM), Toulouse University Hospital, 2 rue Viguerie, Toulouse Cedex 9, 31059, France.
| | - N Costa
- Present address: Department of Medical Information (DIM), Toulouse University Hospital, 2 rue Viguerie, Toulouse Cedex 9, 31059, France
- INSERM, UMR 1295, Toulouse, France
| | - M Mounié
- Present address: Department of Medical Information (DIM), Toulouse University Hospital, 2 rue Viguerie, Toulouse Cedex 9, 31059, France
- INSERM, UMR 1295, Toulouse, France
| | - N Tavassoli
- Gérontopôle, Toulouse University Hospital, Toulouse, France
| | - C Mathieu
- Gérontopôle, Toulouse University Hospital, Toulouse, France
- CREAI-ORS Occitanie, Toulouse, France
| | - H Roussel
- CNAM, DRSM Occitanie, 2 rue Georges Vivent, Toulouse, 31082, France
| | - J M Lagarrigue
- MSA Midi-Pyrénées Nord, 180 Avenue Marcel Unal, Montauban, 82000, France
| | - E Berard
- INSERM, UMR 1295, Toulouse, France
- Department of Epidemiology, University Hospital of Toulouse, 37 Allées Jules Guesde, Toulouse, 31000, France
| | - Y Rolland
- INSERM, UMR 1295, Toulouse, France
- Gérontopôle, Toulouse University Hospital, Toulouse, France
| | - L Molinier
- Present address: Department of Medical Information (DIM), Toulouse University Hospital, 2 rue Viguerie, Toulouse Cedex 9, 31059, France
- INSERM, UMR 1295, Toulouse, France
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Kumar A, Singh AR, Raghav LP, Deng Y, He X, Bansal R, Kumar P, Naidoo R. State-of-the-art review on energy sharing and trading of resilient multi microgrids. iScience 2024; 27:109549. [PMID: 38623328 PMCID: PMC11016907 DOI: 10.1016/j.isci.2024.109549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Independently run single microgrids (MGs) encounter difficulties with inadequate self-consumption of local renewable energy and frequent power exchange with the grid. Combining numerous MGs to form a multi-microgrid (MMG) is a viable approach to enhance smart distribution networks' operational and financial performance. However, the correlation and coordination of intermittent power generation within each MG network pose many techno-economic challenges for energy sharing and trading. This review offers a comprehensive analysis of these challenges within the framework of MMG operations. It examines state-of-the-art methodologies for optimizing multi-energy dispatch and scrutinizes contemporary strategies within energy markets that contribute to the resilience of power systems. The discourse extends to the burgeoning role of blockchain technology in revolutionizing decentralized market frameworks and the intricacies of MMG coordination for reliable and cost-effective energy distribution. Overall, this study provides ample inspiration for theoretical and practical research to the new entrants and experts alike to develop new concepts for energy markets, scheduling and novel operating models for future resilient multi-energy networked systems/MMGs.
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Affiliation(s)
- Abhishek Kumar
- Research Group for Energy Network Transition (ReGENT), College of Electrical Engineering, Zhejiang University, Hangzhou, P.R. China
| | - Arvind R. Singh
- School of Physics and Electronics Engineering, Hanjiang Normal University, Shiyan, P.R. China
- Department of Electrical, Electronic and Computer Engineering, University of Pretoria, Pretoria, South Africa
| | - L. Phani Raghav
- Department of Electrical Engineering, Anil Neerukonda Institute of Technology and Sciences, India
| | - Yan Deng
- Research Group for Energy Network Transition (ReGENT), College of Electrical Engineering, Zhejiang University, Hangzhou, P.R. China
| | - Xiangning He
- Research Group for Energy Network Transition (ReGENT), College of Electrical Engineering, Zhejiang University, Hangzhou, P.R. China
| | - R.C. Bansal
- Department of Electrical, Electronic and Computer Engineering, University of Pretoria, Pretoria, South Africa
- Department of Electrical Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | - Praveen Kumar
- Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Guwahati, India
| | - R.M. Naidoo
- Department of Electrical, Electronic and Computer Engineering, University of Pretoria, Pretoria, South Africa
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Stone AB, Zorrilla Vaca A, Lirk P, Gerner P, Vlassakov K. Anesthesia start time documentation accuracy where peripheral nerve block is the primary anesthetic. Reg Anesth Pain Med 2024:rapm-2024-105292. [PMID: 38642928 DOI: 10.1136/rapm-2024-105292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/30/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION When used as the primary anesthetic, nerve blocks are not billed as separate procedures. In this scenario, the anesthesia start (AStart) time should include the block procedural time. We measured how often AStart time was documented before the nerve block was placed in the preoperative area, and compared cases where a block team performed the nerve block and cases where the intraoperative anesthesia attending supervised the nerve block. We hypothesized that the involvement of a regional anesthesia team would lead to more accurate documentation of AStart. We also estimated the lost revenue due to inaccurate start time documentation. METHODS The study population were patients undergoing surgery with a peripheral nerve block as the primary anesthetic. For this analysis, AStart occurring less than 10 min before the in-operating room time was defined as potentially inaccurate. Lost potential revenue was estimated by taking the difference between the documented time of local anesthetic administration and the documented AStart time. RESULTS A total of 745 cases were analyzed. Overall, 439 cases (58%) cases were identified as having potentially inaccurate start times. There were higher rates of inaccurate AStart documentation by the block team (316/482, 65.5%) compared with blocks supervised by the in-room anesthesia attendings (123/263, 46.7%, p<0.001). Overall, the estimated loss in billable revenue during the study period was a total of $70 265. CONCLUSIONS The performance of primary regional anesthesia procedure by a block team increased the incidence of inaccurate documentation and uncaptured potential revenue. There is need for education about accurate nerve block documentation for anesthesiologists, especially when separate teams are used.
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Affiliation(s)
- Alexander B Stone
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Andrés Zorrilla Vaca
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Philipp Lirk
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Philipp Gerner
- Harvard Medical School, Boston, Massachusetts, USA
- Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kamen Vlassakov
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Chilaka C, Rinehart AJ, Wang H, Ward FA. Sustaining aquifers hydrologically, economically, and institutionally: Policy analysis of the Ogallala in New Mexico. Sci Total Environ 2024; 921:170727. [PMID: 38350566 DOI: 10.1016/j.scitotenv.2024.170727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/15/2024]
Abstract
Groundwater discharge exceeding recharge threatens sustainable aquifer water use internationally. Interest remains high in discovering more hydrologically sustainable and economically affordable measures to protect these aquifers. Previous research has conducted various aquifer assessments. Some work has investigated costs and benefits of various plans that would limit aquifer pumping. Despite notable advances in this kind of analysis, little published work to date has unified these elements into a science-based integrated framework to inform more sustainable aquifer policy design. This work's novel contribution is to integrate analysis of hydrology, economics, institutions, and policy into a unified scientific framework to inform choices on more sustainable pumping strategies while protecting economic activity for agricultural and urban water-using sectors. It does so by conceptualizing, formulating, designing, and applying a mathematical programming framework to replicate historically observed pumping patterns in parts of the Southern and Central High Plains Ogallala Aquifer region in New Mexico, USA. We first calibrated the optimization framework to replicate the historically observed data. We then go on to identify least cost pumping caps that would have partly restored the aquifer to its 2014 level by 2020, while comparing the performance of four other partial aquifer protection policy measures. Findings indicate a surprisingly low cost that could have been incurred to partially protect the aquifer over that period. However, these low costs are complicated by (1) decreasing water quality outside of the irrigated regions and (2) focusing of lateral inputs to a narrower zone of depression around the irrigated regions. These findings carry important implications for identifying more sustainable aquifer management plans internationally. The work's importance comes from its capacity to inform policy debates over a range of water shortage sharing plans, while respecting institutional constraints governing equitable burden sharing.
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Affiliation(s)
- Chibuzo Chilaka
- Water Science and Management Program, New Mexico State University, United States of America.
| | - Alex J Rinehart
- Department of Earth and Environmental Science, New Mexico Institute of Mining and Technology, United States of America.
| | - Haoying Wang
- Department of Business and Technology Management, New Mexico Institute of Mining and Technology, United States of America.
| | - Frank A Ward
- Department of Agricultural Economics and Agricultural Business, Water Science and Management Program, New Mexico State University, United States of America.
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Singh Chawla D. Revealed: the ten research papers that policy documents cite most. Nature 2024:10.1038/d41586-024-00660-1. [PMID: 38627485 DOI: 10.1038/d41586-024-00660-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
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Ascher S, Gordon J, Bongiovanni I, Watson I, Hermannsson K, Gillespie S, Sarangi S, Biakhmetov B, Bhargava PC, Bhaskar T, Krishna BB, Pandey A, You S. Trigeneration based on the pyrolysis of rural waste in India: Environmental impact, economic feasibility and business model innovation. Sci Total Environ 2024; 921:170718. [PMID: 38331270 DOI: 10.1016/j.scitotenv.2024.170718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/10/2024] [Accepted: 02/03/2024] [Indexed: 02/10/2024]
Abstract
Pyrolysis-based waste-to-bioenergy development has the potential to resolve some of the major challenges facing rural communities in India such as poor electrification, household air pollution, and farmland degradation and contamination. Existing understanding and analysis of the economic feasibility and environmental impact of bioenergy deployment in rural areas is limited by parameter uncertainties, and relevant business model innovation following economic evaluation is even scarcer. This paper uses findings from a new field survey of 1200 rural households to estimate the economic feasibility and environmental impact of a pyrolysis-based bioenergy trigeneration development that was designed to tackle these challenges. Based on the survey results, probability distributions were constructed and used to supply input parameters for cost-benefit analysis and life cycle assessment. Monte Carlo simulation was applied to characterise the uncertainties of economic feasibility and environmental impact accounting. It was shown that the global warming potential of the development was 350 kg of CO2-eq per capita per annum. Also, the survey identified a significant mismatch between feedstock prices considered in the literature and prices asked for by the surveyed villagers. The results of the cost-benefit analysis and life cycle assessment were then applied to propose two novel business models inspired by the Business Model Canvas, which had the potential to achieve up to 90 % economic profitability and result in a benefit-cost ratio of 1.35-1.75. This is the first study achieving combined environmental and economic analysis and business model innovation for rural bioenergy production in developing countries.
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Affiliation(s)
- Simon Ascher
- James Watt School of Engineering, University of Glasgow, G12 8QQ, UK
| | - Jillian Gordon
- Adam Smith Business School, University of Glasgow, G12 8QQ, UK.
| | - Ivano Bongiovanni
- Business School, University of Queensland, Brisbane, QLD, Australia.
| | - Ian Watson
- James Watt School of Engineering, University of Glasgow, G12 8QQ, UK
| | - Kristinn Hermannsson
- Robert Owen Centre for Educational Change, School of Education, University of Glasgow, Glasgow, UK
| | - Steven Gillespie
- School of Social and Environmental Sustainability, University of Glasgow, Dumfries DG1 4ZL, UK
| | | | | | - Preeti Chaturvedi Bhargava
- Aquatic Toxicology Lab, Environmental Toxicology Division, CSIR-Indian Institute of Toxicology Research, Vishvigyan Bhawan, 31, M.G. Marg, Lucknow 226001, India
| | - Thallada Bhaskar
- Material Resource Efficiency Division (MRED), CSIR-Indian Institute of Petroleum, Dehradun 248005, Uttarakhand, India; Academy of Scientific and Innovative Research (AcSIR), CSIR-HRDC Campus, Sector 19, Kamla Nagar, Ghaziabad 210002, India
| | - Bhavya B Krishna
- Material Resource Efficiency Division (MRED), CSIR-Indian Institute of Petroleum, Dehradun 248005, Uttarakhand, India
| | - Ashok Pandey
- Sustainability Cluster, School of Engineering, University of Petroleum and Energy Studies, Dehradun 248 007, India; Centre for Innovation and Translational Research, CSIR-Indian Institute of Toxicology Research, Lucknow 226001, India; Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, South Korea
| | - Siming You
- James Watt School of Engineering, University of Glasgow, G12 8QQ, UK.
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Surís X, Pueyo-Sánchez MJ, Ricart A, Naranjo A, Casanova T, Gómez-Vaquero C, Duaso E, Cancio-Trujillo JM, Sánchez-Martín J, Pérez-Mitru A. [Cost-effectiveness analysis of fracture liaison services in Catalonia]. J Healthc Qual Res 2024:S2603-6479(24)00023-X. [PMID: 38614935 DOI: 10.1016/j.jhqr.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/13/2023] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE To assess the cost-effectiveness of Fracture Liaison Service (FLS) compared to the standard of care for secondary prevention of fragility fractures form the perspective of the Catalan Health Service. METHODS Cost-utility assessment through a Markov model that simulated disease progression of a patients' cohort candidates to initiate antiosteoporotic treatment after a fragility fracture. A time horizon of 10 years and a 6-month duration per cycle was established. Clinical, economics and quality of life parameters were obtained from the literature and derived from four Catalan FLS. The Catalan Health Service perspective was adopted, considering direct health costs expressed in 2022 euros. A 3% discount rate was applied on costs and outcomes. Uncertainty was assessed through multiple sensitivity analyses. RESULTS Compared to the standard of care, FLS would promote antiosteoporotic initiation and persistence, reducing the incidence and mortality associated with subsequent fragility fractures. This incremental clinical benefit was estimated at 0.055 years and 0.112 quality-adjusted life years (QALYs) per patient. A higher cost (€1,073.79 per patient) was estimated, resulting into an incremental cost-utility ratio of €9,602.72 per QALYs gained. The sensitivity analyses performed were consistent, corroborating the robustness and conservative approach of the base-case. CONCLUSIONS The introduction of FLS for the secondary prevention of FF would represent a cost-effective strategy from the Catalan Health Service perspective.
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Affiliation(s)
- X Surís
- Departament de Salut, Pla director de les malalties reumàtiques i de l'aparell locomotor, Barcelona, España; Servicio de Reumatología, Hospital General de Granollers, Barcelona, España; Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España; Gerència de Processos Integrats en Salut, Àrea Assistencial, Servei Català de la Salut, Barcelona, España.
| | - M J Pueyo-Sánchez
- Àrea Integral de Salut Barcelona Esquerra, Consorci Sanitari de Barcelona, Regió Sanitària Barcelona, Servei Català de la Salut, Barcelona, España
| | - A Ricart
- Gerència de Processos Integrats en Salut, Àrea Assistencial, Servei Català de la Salut, Barcelona, España
| | - A Naranjo
- Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrin, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - T Casanova
- Servicio de Medicina Interna, Complex Hospitalari Moisès Broggi, Sant Joan Despí, Barcelona, España
| | - C Gómez-Vaquero
- Servicio de Reumatología, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL)-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - E Duaso
- Servicio de Geriatría, Atención Paliativa, Dependencia y Discapacidad, Hospital Universitari d'Igualada (Consorci Sanitari de l'Anoia), Barcelona, España
| | - J M Cancio-Trujillo
- Servicio de Geriatría y Cuidados Paliativos de Badalona Serveis Assistencials (BSA), Barcelona, España; Escuela Superior de Salud de Tecnocampus, Universidad Pompeu Fabra, Barcelona, España
| | | | - A Pérez-Mitru
- Market Access Area, Pharmalex Spain, Barcelona, España
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21
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Pouliopoulos J, Anthony C, Imran M, Graham RM, McCrohon J, Holloway C, Kotlyar E, Muthiah K, Keogh AM, Hayward CS, Macdonald PS, Jabbour A. Cost-Effectiveness of Cardiovascular Magnetic Resonance for Rejection Surveillance After Cardiac Transplantation in the Australian Health Care System. Heart Lung Circ 2024:S1443-9506(24)00164-1. [PMID: 38604884 DOI: 10.1016/j.hlc.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/07/2024] [Accepted: 03/02/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Heart transplantation is an effective treatment for end-stage congestive heart failure, however, achieving the right balance of immunosuppression to maintain graft function while minimising adverse effects is challenging. Serial endomyocardial biopsies (EMBs) are currently the standard for rejection surveillance, despite being invasive. Replacing EMB-based surveillance with cardiac magnetic resonance (CMR)-based surveillance for acute cardiac allograft rejection has shown feasibility. This study aimed to assess the cost-effectiveness of CMR-based surveillance in the first year after heart transplantation. METHOD A prospective clinical trial was conducted with 40 orthotopic heart transplant (OHT) recipients. Participants were randomly allocated into two surveillance groups: EMB-based, and CMR-based. The trial included economic evaluations, comparing the frequency and cost of surveillance modalities in relation to quality-adjusted life years (QALYs) within the first year post-transplantation. Sensitivity analysis encompassed modelled data from observed EMB and CMR arms, integrating two hypothetical models of expedited CMR-based surveillance. RESULTS In the CMR cohort, 238 CMR scans and 15 EMBs were conducted, versus (vs) 235 EMBs in the EMB group. CMR surveillance yielded comparable rejection rates (CMR 74 vs EMB 94 events, p=0.10) and did not increase hospitalisation risk (CMR 32 vs EMB 46 events, p=0.031). It significantly reduced the necessity for invasive EMBs by 94%, lowered costs by an average of AUD$32,878.61, and enhanced cumulative QALY by 0.588 compared with EMB. Sensitivity analysis showed that increased surveillance with expedited CMR Models 1 and 2 were more cost-effective than EMB (all p<0.01), with CMR Model 1 achieving the greatest cost savings (AUD$34,091.12±AUD$23,271.86 less) and utility increase (+0.62±1.49 QALYs, p=0.011), signifying an optimal cost-utility ratio. Model 2 showed comparable utility to the base CMR model (p=0.900) while offering the benefit of heightened surveillance frequency during periods of elevated rejection risk. CONCLUSIONS CMR-based rejection surveillance in orthotopic heart transplant recipients provides a cost-effective alternative to EMB-based surveillance. Furthermore, it reduces the need for invasive procedures, without increased risk of rejection or hospitalisation for patients, and can be incorporated economically for expedited surveillance. These findings have important implications for improving patient care and optimising resource allocation in post-transplant management.
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Affiliation(s)
- Jim Pouliopoulos
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia; School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Chris Anthony
- Alfred Health and Monash University, Melbourne, Vic, Australia
| | - Muhammad Imran
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia
| | - Robert M Graham
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia; School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia; Alfred Health and Monash University, Melbourne, Vic, Australia
| | - Jane McCrohon
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia
| | - Cameron Holloway
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia
| | - Eugene Kotlyar
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia
| | - Kavitha Muthiah
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia
| | - Anne M Keogh
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia; School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Christopher S Hayward
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
| | - Peter S Macdonald
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia; School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Andrew Jabbour
- Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia; School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
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Marta A, Marques JP, Santos C, Coutinho-Santos L, Vaz-Pereira S, Costa J, Arede P, Félix R, Geada S, Gouveia N, Silva R, Baptista M, Lume M, Parreira R, Azevedo Soares C, Menéres MJ, Lemos C, Melo Beirão J. The socioeconomic epidemiology of inherited retinal diseases in Portugal. Orphanet J Rare Dis 2024; 19:151. [PMID: 38594754 PMCID: PMC11003026 DOI: 10.1186/s13023-024-03161-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 03/30/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Inherited retinal diseases (IRDs) are a group of rare degenerative disorders of the retina that can lead to blindness from birth to late middle age. Knowing the target population and its resources is essential to better plan support measures. The aim of this study was to evaluate the socioeconomic characteristics of regions in Portugal where IRD patients reside to inform the planning of vision aid and rehabilitation intervention measures. RESULTS This study included 1082 patients from 973 families, aged 3 to 92 years, with a mean age of 44.8 ± 18.1 years. Patients living with an IRD were identified in 190 of the 308 municipalities. According to this study, the estimated IRD prevalence in Portugal was 10.4 per 100,000 inhabitants, and by municipalities, it ranged from 0 to 131.2 per 100,000 inhabitants. Overall, regions with a higher prevalence of IRD have a lower population density (r=-0.371, p < 0.001), a higher illiteracy rate (r = 0.404, p < 0.001) and an overall older population (r = 0.475, p < 0.001). Additionally, there is a lower proportion of doctor per capita (r = 0.350, p < 0.001), higher social security pensions beneficiaries (r = 0.439, p < 0.001), worse water quality for human consumption (r=-0.194, p = 0.008), fewer audiences at the cinema (r=-0.315, p < 0.001) and lower proportion of foreign guests in tourist accommodations (r=-0.287, p < 0.001). CONCLUSION The number of identified patients with IRD varied between regions. Using data from national statistics (PORDATA), we observed differences in socioeconomic characteristics between regions. Multiple targeted aid strategies can be developed to ensure that all IRD patients are granted full clinical and socioeconomic support.
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Affiliation(s)
- Ana Marta
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, EPE (CHUdSA), Porto, Portugal.
- Instituto Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal.
| | - João Pedro Marques
- Centro de Responsabilidade Integrado de Oftalmologia do Centro Hospitalar e Universitário de Coimbra, EPE (CRIO-CHUC), Coimbra, Portugal
- Clinical Academic Center of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University Clinic of Ophthalmology, University of Coimbra (FMUC), Coimbra, Portugal
| | - Cristina Santos
- Instituto de Oftalmologia Dr. Gama Pinto (IOGP), Lisboa, Portugal
- Faculdade de Ciências Médicas, NMS, FCM, NOVA Medical School, Universidade NOVA de Lisboa, 7 iNOVA4Health, Lisboa, Portugal
| | | | - Sara Vaz-Pereira
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Norte (CHULN), Lisboa, Portugal
- Department of Ophthalmology, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - José Costa
- Department of Ophthalmology, Hospital de Braga (HB), Braga, Portugal
| | - Pedro Arede
- Department of Ophthalmology, Centro Hospitalar Lisboa Ocidental, EPE (CHLO), Lisboa, Portugal
| | - Raquel Félix
- Centro de Responsabilidade Integrado de Oftalmologia do Centro Hospitalar e Universitário de Coimbra, EPE (CRIO-CHUC), Coimbra, Portugal
| | - Sara Geada
- Centro de Responsabilidade Integrado de Oftalmologia do Centro Hospitalar e Universitário de Coimbra, EPE (CRIO-CHUC), Coimbra, Portugal
| | - Nuno Gouveia
- Centro de Responsabilidade Integrado de Oftalmologia do Centro Hospitalar e Universitário de Coimbra, EPE (CRIO-CHUC), Coimbra, Portugal
| | - Rui Silva
- Department of Ophthalmology, Hospital de Braga (HB), Braga, Portugal
| | - Margarida Baptista
- Department of Ophthalmology, Centro Hospitalar Lisboa Ocidental, EPE (CHLO), Lisboa, Portugal
| | - Miguel Lume
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, EPE (CHUdSA), Porto, Portugal
| | - Ricardo Parreira
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, EPE (CHUdSA), Porto, Portugal
| | - Célia Azevedo Soares
- Medical Genetics Department, Centro de Genética Médica Jacinto Magalhães, Centro Hospitalar Universitário de Santo António, EPE (CHUdSA), Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Medical Science Department, Universidade de Aveiro, Aveiro, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Maria João Menéres
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, EPE (CHUdSA), Porto, Portugal
- Instituto Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Carolina Lemos
- Instituto Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
- Centro Hospitalar Universitário de Santo António, EPE (CHUdSA), Largo do Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - João Melo Beirão
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, EPE (CHUdSA), Porto, Portugal
- Instituto Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
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Forrester N. CERN's impact goes way beyond tiny particles. Nature 2024; 628:S1-S3. [PMID: 38632484 DOI: 10.1038/d41586-024-01100-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
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Lu TT, Parent SC, Chaytor N, Amiri S, Palmer K, McPherson S, Jett J, Ries R, McDonell MG, Murphy SM. Budget Impact Tool for Implementing Contingency Management for Co-occurring Alcohol Use Disorders and Serious Mental Illness. Psychiatr Serv 2024; 75:326-332. [PMID: 37855102 PMCID: PMC10984796 DOI: 10.1176/appi.ps.20220547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
OBJECTIVE Contingency management (CM) is a behavioral intervention in which tangible incentives are provided to patients when they achieve a desired behavior (e.g., reducing or abstaining from alcohol use). The authors sought to describe the resource requirements and associated costs of various CM versions (usual, high magnitude, and shaping) tailored to a high-risk population with co-occurring serious mental illness and severe alcohol use disorder. METHODS A microcosting analysis was conducted to identify the resource requirements of the different CM versions. This approach included semistructured interviews with site investigators, who also staffed the intervention. The resource costing method-multiplying the number of units of each resource utilized by its respective unit cost-was used to value the resources from a provider's perspective. All cost estimates were calculated in 2021 U.S. dollars. RESULTS The cost of setting up a CM program was $6,038 per site. Assuming full capacity and 56% of urine samples meeting the requirement for receipt of the CM incentive, the average cost of 16 weeks of usual and shaping CM treatments was $1,119-$1,136 and of high-magnitude CM was $1,848-$1,865 per participant. CONCLUSIONS A customizable tool was created to estimate the costs associated with various levels of treatment success and CM design features. After the trial, the tool will be updated and used to finalize per-participant cost for incorporation into a comprehensive economic evaluation. This costing tool will help a growing number of treatment providers who are interested in implementing CM with budgeting for and sustaining CM in their practices.
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Affiliation(s)
- Thanh T Lu
- Center for Public Health Methods, RTI International, Research Triangle Park, North Carolina
| | - Sara C Parent
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Naomi Chaytor
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Solmaz Amiri
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle
| | - Katharine Palmer
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Sterling McPherson
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Julianne Jett
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Richard Ries
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Michael G McDonell
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane
| | - Sean M Murphy
- Department of Population Health Sciences, Weill Cornell Medical College, New York City
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Merkaj E, Zhllima E, Imami D, Gjika I, Guerrero-López CM, Drope J. Impact of cigarette price and tobacco control policies on youth smoking experimentation in Albania. Tob Control 2024:tc-2023-058196. [PMID: 38443163 DOI: 10.1136/tc-2023-058196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 02/17/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Albania has one of the highest smoking prevalence in Europe especially among the youth. There is a lack of evidence in Albania, as well as in most of Eastern Europe and middle-income countries, regarding the effect of price on smoking experimentation. OBJECTIVE The study aims to assess the effect of price and tobacco control policies on youth smoking experimentation in Albania. METHODS We used microdata from the Global Youth Tobacco Survey in Albania for 2004, 2009, 2015 and 2020. We constructed a pseudo-longitudinal dataset and estimated a split-population model to assess the hazard of smoking experimentation. RESULTS Price is a significant predictor of smoking experimentation among teenagers in Albania for both males and females (p<0.001). Being male increases the odds for smoking experimentation by more than 50% as compared with females (p<0.001), whereas females appear to be more price sensitive. Peer and parent smoking are also important determinants for smoking experimentation. Introducing penalties for smokers and legal entities violating smoke-free policies implemented in 2014 is also associated with a lower hazard of smoking experimentation. CONCLUSION Price is a significant predictor of smoking experimentation among teenagers in Albania for both males and females. A combination of increasing taxes and strengthening the rule of law to control tobacco use in public spaces, in addition to public awareness campaigns targeting both youth and smoking parents, could help to significantly reduce the probability of smoking experimentation.
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Affiliation(s)
| | - Edvin Zhllima
- Agricultural University of Tirana, Tirana, Albania
- Development Solutions Associates (DSA), Tirana, Albania
| | - Drini Imami
- Agricultural University of Tirana, Tirana, Albania
- Development Solutions Associates (DSA), Tirana, Albania
| | | | | | - Jeffrey Drope
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Morris D, Gillespie D, Dockrell MJ, Cook M, Horton M, Brown J, Langley TE. Potential smoke-free dividend across local areas in England: a cross-sectional analysis. Tob Control 2024:tc-2023-058264. [PMID: 38508755 DOI: 10.1136/tc-2023-058264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/09/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The value that might be added to local economies each year through the money that people who smoke tobacco would save if everyone quit smoking is called the 'smoke-free dividend'. This study aimed to estimate the value of the smoke-free dividend across local areas in England, and how it relates to the average income in those areas. METHODS The study was a cross-sectional descriptive analysis of tobacco expenditure from the Smoking Toolkit Study (STS) matched to income and smoking prevalence data for English local authorities. The STS sample was from 2014 to 2020 and comprised 18 721 adults who smoke cigarettes. Self-reported expenditure estimates from the STS were adjusted for under-reporting. This adjustment aimed to align the total expenditure estimate with figures derived from government tax receipts and national estimates of illicit tobacco use. The smoke-free dividend is calculated as 93% of spending on legal tobacco, which is the percentage estimated to leave the local economy, plus 100% of spending on illicit tobacco. RESULTS The total dividend in England is estimated to be £10.9 billion each year, which equates to £1776 per person who smokes or £246 per adult regardless of smoking status. The estimated dividend is greater in areas with lower average income, with a correlation coefficient of -0.521 (95% CI -0.629, -0.392) between the average income of local areas and the dividend per adult. CONCLUSIONS This study has estimated that local economies could gain a substantial dividend if everybody stopped smoking, which is larger in lower income areas, meaning that geographical economic inequalities could be reduced.
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Affiliation(s)
- Damon Morris
- Sheffield Addictions Research Group, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
- SPECTRUM Consortium, UK
| | - Duncan Gillespie
- Sheffield Addictions Research Group, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
- SPECTRUM Consortium, UK
| | - Martin J Dockrell
- SPECTRUM Consortium, UK
- Office for Health Improvement and Disparities, London, UK
| | - Mark Cook
- Office for Health Improvement and Disparities, London, UK
| | - Marie Horton
- SPECTRUM Consortium, UK
- Office for Health Improvement and Disparities, London, UK
| | - Jamie Brown
- SPECTRUM Consortium, UK
- Behavioural Science and Health, University College London, London, UK
| | - Tessa Elisabeth Langley
- SPECTRUM Consortium, UK
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
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Machado EAT, Batista S, Braga FDO, Alves Filho CAF, Almeida Filho JA, Lopes PG, Cartobei CL, Oliveira LDB, Pereira PJDM, Niemeyer Filho P. Optimizing resources: financial evaluation of flow diverters versus stent assisted coiling in large and giant cerebral aneurysm management in Brazil public health system. J Neurointerv Surg 2024:jnis-2024-021583. [PMID: 38503509 DOI: 10.1136/jnis-2024-021583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Cerebral aneurysms, especially large and giant aneurysms, pose challenges in neurointerventional surgery. Treatment choices involve clinical presentation, aneurysm details, and global resource variations. Neurointerventional methods, while innovative, may be cost restrictive in certain regions. In public healthcare, cost is crucial, notably in countries like Brazil. This study examines the device specific cost estimation of flow diverters (FD) and traditional stent assisted coiling (SAC) for large and giant cerebral aneurysms, providing insights into optimizing neurosurgical interventions within the Brazilian public health system's unique challenges. METHODS A comprehensive retrospective analysis was conducted at our medical center of cases of large and giant aneurysms treated between 2013 and 2023. Determination of the estimated number of coils for aneurysms previously treated with FDs at our center was made, with the cost of each case, and the difference between both treatments was calculated. RESULTS We investigated the profiles of 77 patients: 40 had large aneurysms (51.9%) and 37 had giant aneurysms (48.1%). Large aneurysms had a mean cost difference of US$274 (standard deviation (SD) $2071), underscoring the device specific cost estimation of FDs over SAC in their treatment. For giant aneurysms, the mean cost difference increased to $6396 (SD $2694), indicating FDs as the more economically sound choice. CONCLUSION Our study indicated that, for the treatment of giant aneurysms and some large aneurysms, the FD intervention was more economical than SAC.
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Affiliation(s)
| | - Savio Batista
- Department of Endovascular Neurosurgery, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fausto de Oliveira Braga
- Department of Endovascular Neurosurgery, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
| | | | | | - Plínio Gabriel Lopes
- Department of Endovascular Neurosurgery, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
| | - Carlos Leandro Cartobei
- Department of Endovascular Neurosurgery, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
| | | | | | - Paulo Niemeyer Filho
- Department of Neurosurgery, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
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Jawad M, Awawda S, Abla R, Chalak A, Khader YS, Nakkash RT, Mostafa A, Salloum RG, Abu-Rmeileh NME. Impact of waterpipe tobacco taxation on consumption, government revenue and premature deaths averted in Jordan, Lebanon and Palestine: a simulation study. Tob Control 2024; 33:e85-e90. [PMID: 36601792 PMCID: PMC10958304 DOI: 10.1136/tc-2022-057284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Despite the high prevalence of waterpipe tobacco smoking in the Eastern Mediterranean region, evidence supporting its fiscal measures is limited. We modelled the impact of waterpipe tobacco-specific excise taxes on consumption, government revenue and premature deaths averted in Jordan, Lebanon and Palestine. METHODS We developed a simulation model using country-specific and market share-specific price, consumption and price elasticity data from WHO, UN Comtrade and nationally representative surveys. We modelled increases to specific excise taxes to meet a 35.9% tax burden on 20 g of waterpipe tobacco in Lebanon and Jordan, in line with the global average, and to double government revenues from excise duties in Palestine, which has surpassed this average. RESULTS Specific excise tax was raised by $1.14 ($0.18-$1.32) in Jordan, $2.41 ($0.03-$2.44) in Lebanon (alongside removal of ad valorem taxes) and $2.39 ($1.72-$4.11) in Palestine per 20 g of waterpipe tobacco. Government revenue increased by $126.3 million in Jordan, $53.8 million in Lebanon and $162.4 million in Palestine while waterpipes smoked decreased by 32.4% in Jordan, 71.0% in Lebanon and 16.3% in Palestine. The corresponding numbers of premature deaths averted annually were approximately 162 000; 1 000 000; and 52 000. DISCUSSION Increases in waterpipe tobacco-specific excise taxes substantially reduce smoking and increase government revenue and averted premature deaths in Jordan, Lebanon and Palestine. This has positive implications for both public health and financing and should be considered a policy priority.
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Affiliation(s)
- Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, UK
| | - Sameera Awawda
- Department of Economics and Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Ruba Abla
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Ali Chalak
- Department of Agriculture, American University of Beirut, Beirut, Lebanon
| | - Yousef S Khader
- Epidemiology and Biostatistics, Jordan University of Science and Technology, Irbid, Jordan
| | - Rima T Nakkash
- Health Behaviour and Education Department, American University of Beirut, Beirut, Lebanon
| | - Aya Mostafa
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ramzi G Salloum
- Health Outcomes and Policy, University of Florida, Gainesville, Florida, USA
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Xie Y, Zhou Z, Sun Q, Zhao M, Pu J, Li Q, Sun Y, Dai H, Li T. Social-economic transitions and vulnerability to extreme temperature events from 1960 to 2020 in Chinese cities. iScience 2024; 27:109066. [PMID: 38361620 PMCID: PMC10867637 DOI: 10.1016/j.isci.2024.109066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/13/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
Climate change leads to more frequent and intense extreme temperature events, causing a significant number of excess deaths. Using an epidemiological approach, we analyze all-cause deaths related to heatwaves and cold spells in 2,852 Chinese counties from 1960 to 2020. Economic losses associated with these events are determined through the value of statistical life. Findings reveal that cold-related cumulative excess deaths (1,133 thousand) are approximately 2.5 times higher than heat-related deaths, despite an increase in heat-related fatalities in recent decades. Monetized mortality due to heat-related events is estimated at 1,284 billion CNY, while cold-related economic loss is 1,510 billion CNY. Notably, cities located in colder regions experience more heat-related excess deaths, and vice versa. Economic development does not significantly reduce mortality risks to heatwaves across China. This study provides insights into the spatial-temporal heterogeneity of heatwaves and cold spells mortality, essential for policymakers ensuring long-term climate adaptation and sustainability.
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Affiliation(s)
- Yang Xie
- School of Economics and Management, Beihang University, Beijing, China
| | - Ziqiao Zhou
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Qinghua Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengdan Zhao
- School of Economics and Management, Beihang University, Beijing, China
| | - Jinlu Pu
- School of Economics and Management, Beihang University, Beijing, China
| | - Qiutong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hancheng Dai
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Gheorghe A, Mehndiratta A, Baker P, Gulliver S, Singh M, Tyagi K, Guzman J. Measuring progress in institutionalising evidence-informed priority-setting in the Indian healthcare system: an application using the iProSE scale. BMJ Evid Based Med 2024:bmjebm-2023-112485. [PMID: 38458655 DOI: 10.1136/bmjebm-2023-112485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Adrian Gheorghe
- Center for Global Development, Washington, DC, USA
- School of Public Health, Imperial College London, London, UK
| | | | - Peter Baker
- Center for Global Development, Washington, DC, USA
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Turnbull MR, Gallo TF, Carter HE, Drew M, Toohey LA, Waddington G. Estimating the cost of sports injuries: A scoping review. J Sci Med Sport 2024:S1440-2440(24)00078-1. [PMID: 38514294 DOI: 10.1016/j.jsams.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/19/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES Provide an overview of the methods used to estimate the cost of sports-related injury published to date, and to highlight considerations and opportunities for future research. DESIGN Scoping review. METHODS Scopus, MEDLINE and CINHAL were searched from 1st January 2000 to 1st January 2023. Studies were screened by two independent reviewers and were eligible if they reported on a cost analysis or cost estimation of sports related injury. RESULTS Thirty-one studies fulfilled the inclusion criteria. Twenty-seven studies (87 %) were published since 2014. The type of costs included direct healthcare costs (12 studies), indirect costs (10 studies) and a combination of both (9 studies). Twenty-one studies (68 %) used a bottom-up costing approach to measure costs of sports injury and estimated direct costs from the service rates or fee schedules of health systems, hospital, insurance companies or national insurance boards. A top-down approach was used in seven studies (23 %) to estimate the indirect salary cost of time-loss injuries using data from publicly available resources. Ten studies were from the cost perspective of a sporting organisation (32 %). There was a lack of explicit reporting of the costing method used and the perspective of those bearing the costs. CONCLUSIONS Estimating the cost of sports injuries is an emerging area of research, with publications increasing in recent years. However, there remains a lack of methodological guidance to inform or appraise these studies. The expansion of established cost of illness checklists with sport injury explanations to guide future cost of sports injury studies is recommended.
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Affiliation(s)
- Matthew R Turnbull
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Australia.
| | - Tania F Gallo
- Cricket Australia, Australia. https://twitter.com/TG2389
| | - Hannah E Carter
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Australia. https://twitter.com/Hannah_E_Carter
| | - Michael Drew
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Australia. https://twitter.com/_mickdrew
| | - Liam A Toohey
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Australia; Australian Institute of Sport, Australia. https://twitter.com/LiamAToohey
| | - Gordon Waddington
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Australia; Australian Institute of Sport, Australia. https://twitter.com/DrGWaddington
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De Guzman KR, Gavanescu D, Smith AC, Snoswell CL. Economic evaluations of telepharmacy services in non-cancer settings: A systematic review. Res Social Adm Pharm 2024; 20:246-254. [PMID: 38195343 DOI: 10.1016/j.sapharm.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/19/2023] [Accepted: 01/04/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Telepharmacy is the provision of pharmacy services from a distance to a patient using telecommunications and other technologies. There has been limited research investigating the cost-effectiveness of telepharmacy services. OBJECTIVE To provide a comprehensive review and narrative synthesis of the available economic evidence on telepharmacy services in non-cancer settings. METHOD A systematic literature search of four databases including PubMed, Embase, CINAHL, and EconLit was undertaken to identify economic evaluations comparing telepharmacy services to standard pharmacy care. Abstracts and full texts were screened by two independent reviewers for inclusion against the eligibility criteria. Key economic findings were extracted from included articles to determine the cost-effectiveness of the reported telepharmacy services. RESULTS The review included six studies; two were cost-minimisation analyses, three were cost effectiveness analyses (CEA) and one study conducted both a CEA and cost-utility analysis. Telepharmacy services predominantly relied upon telephone modes of communication, with three that used remote patient monitoring. These services managed a variety of clinical situations which included newly initiated antibiotics, antiretroviral therapy management, and medications for chronic conditions, as well as hypertension management. Articles were of relatively high reporting quality, scoring an average of 83% on the Consolidated Health Economics Reporting Standards checklist. Four of the six studies reported that telepharmacy was less costly than usual care, with two that reported telepharmacy as cost-effective to the healthcare system according to a specified cost-effectiveness threshold. CONCLUSIONS Overall, this review demonstrates that there is emerging evidence that telepharmacy services can be cost-effective compared with standard care in non-cancer settings. Further research is needed to complement these findings, particularly reflecting the increased uptake of telehealth and telepharmacy services since the onset of the Coronavirus disease pandemic.
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Affiliation(s)
- Keshia R De Guzman
- Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia; School of Pharmacy, The University of Queensland, Brisbane, Australia; Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia.
| | - Danielle Gavanescu
- Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia; Centre for Innovative Medical Technology, University of Southern Denmark, Denmark
| | - Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia
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Nawaz S, Moon KJ, Hasenstab KA, Bryant I, Singh P, Montesano VL, Knudsen K, Wastler HM, Blouin A, Breitborde NJK, Seiber EE. Costs of Coordinated Specialty Care for First-Episode Psychosis: A Microcosting Analysis. Psychiatr Serv 2024; 75:295-298. [PMID: 37731346 DOI: 10.1176/appi.ps.20230241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
In this study, the authors measured and described the costs of coordinated specialty care (CSC) for first-episode psychosis in Ohio. A microcosting tool was used to estimate personnel and nonpersonnel costs of service delivery at seven CSC programs. Average annual cost per participant (N=511 participants) was estimated as $17,810 (95% CI=$9,141-$26,479). On average, 61% (95% CI=53%-69%) of annual program costs were nonbillable. Key cost drivers included facility costs, administrative tasks, and social services. Novel financing models may redress reimbursement gaps incurred by CSC programs.
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Affiliation(s)
- Saira Nawaz
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Kyle J Moon
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Kathryn A Hasenstab
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Ian Bryant
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Parvati Singh
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Vicki L Montesano
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Kraig Knudsen
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Heather M Wastler
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Alexandra Blouin
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Nicholas J K Breitborde
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
| | - Eric E Seiber
- Center for Health Outcomes and Policy Evaluation Studies (Nawaz, Moon, Hasenstab, Bryant, Seiber) and Division of Epidemiology (Singh), College of Public Health, Ohio State University, Columbus; Ohio Department of Mental Health and Addiction Services, Columbus (Montesano, Knudsen); Department of Psychiatry and Behavioral Health (Wastler, Blouin, Breitborde), College of Medicine, Ohio State University, Columbus
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Aganaba T. Act now to prevent a 'gold rush' in outer space. Nature 2024; 627:261-263. [PMID: 38467880 DOI: 10.1038/d41586-024-00722-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
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Affiliation(s)
- Wesley Sowers
- Department of Psychiatry, University of Pittsburgh Medical Center, and Center for Public Service Psychiatry, Western Psychiatric Hospital, Pittsburgh
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Gomes CM, Marchini G, de Bessa J, Carvalhal G, Caldeira MPR, Saldiva PH, Krieger JE, Agena F, Reis S, Paschoal C, Froes M, Srougi M, Nahas WC, Favorito LA. The landscape of biomedical research funding in Brazil: a current overview. Int Braz J Urol 2024; 50:209-222. [PMID: 38386791 PMCID: PMC10953608 DOI: 10.1590/s1677-5538.ibju.2024.9905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/02/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE The objective of this narrative review is to discuss the current state of research funding in Brazil. MATERIALS AND METHODS This study is based on the most recent edition of the course Funding for Research and Innovation in the University of Sao Paulo School of Medicine which was a three-day course with 12 hours of instruction. The course brought together leading experts in the field to comprehensively discuss the current state of research funding in Brazil. Each speaker provided a presentation on a specific topic related to research funding. After the workshop, speakers assembled relevant topics in this manuscript. RESULTS collaborative research is critical for securing research funding. It optimizes proposal competitiveness, amplifies societal impact, and manages risks effectively. As such, fostering and supporting these collaborations is paramount for both researchers and funding agencies. To maintain the highest integrity in research, investigators involved in these collaborations must disclose any relationships that could potentially influence the outcomes or interpretation of their projects. CONCLUSIONS In Brazil, the mainstay of research funding stems from public entities, with agencies such as CNPq, CAPES, and state bodies like FAPESP, FAPERJ, FAPEMIG and others at the forefront. Concurrently, industry funding offers viable pathways, especially through industry-sponsored studies, investigator-led projects, and collaborative initiatives. The Brazilian funding landscape is further enriched by innovative platforms, including crowdfunding and the contributions of institutions like the Serrapilheira Institute. Internationally, esteemed organizations such as the National Institutes of Health (NIH) and the Bill & Melinda Gates Foundation stand out as potential funders.
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Affiliation(s)
- Cristiano M. Gomes
- Universidade de São PauloHospital das Clinicas da Faculdade de MedicinaDepartamento de UrologiaSão PauloSPBrasilDepartamento de Urologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil;
| | - Giovanni Marchini
- Universidade de São PauloHospital das Clinicas da Faculdade de MedicinaDepartamento de UrologiaSão PauloSPBrasilDepartamento de Urologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil;
| | - Jose de Bessa
- Universidade Estadual de Feira de SantanaDepartamento de CirurgiaFeira de SantanaBABrasilDepartamento de Cirurgia, Universidade Estadual de Feira de Santana - UEFS, Feira de Santana, BA, Brasil;
| | - Gustavo Carvalhal
- Pontificia Universidade Catolica do Rio Grande do SulPorto AlegreRSBrasilPontificia Universidade Catolica do Rio Grande do Sul – PUC RS, Porto Alegre, RS, Brasil;
| | - Marina P. R. Caldeira
- Universidade de São PauloFaculdade de MedicinaUnidade de Apoio à Pesquisa e InovaçãoSão PauloSPBrasilUnidade de Apoio à Pesquisa e Inovação, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil;
| | - Paulo Hilario Saldiva
- Universidade de São PauloFaculdade de MedicinaDepartamento de PatologiaSão PauloSPBrasilDepartamento de Patologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil;
| | - Jose Eduardo Krieger
- Faculdade de Medicina da Universidade de São PauloHospital das ClínicasInstituto do CoraçãoSão PauloSPBrasilInstituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil.
| | - Fabiana Agena
- Universidade de São PauloHospital das Clinicas da Faculdade de MedicinaDepartamento de UrologiaSão PauloSPBrasilDepartamento de Urologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil;
| | - Sabrina Reis
- Universidade de São PauloHospital das Clinicas da Faculdade de MedicinaDepartamento de UrologiaSão PauloSPBrasilDepartamento de Urologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil;
| | - Candice Paschoal
- Universidade de São PauloHospital das Clinicas da Faculdade de MedicinaDepartamento de UrologiaSão PauloSPBrasilDepartamento de Urologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil;
| | - Milena Froes
- Universidade de São PauloEscola de EnfermagemSão PauloSPBrasilEscola de Enfermagem da Universidade de São Paulo, São Paulo, SP, Brasil;
| | - Miguel Srougi
- Instituto D'Or de Pesquisa e EnsinoSão PauloSPBrasilInstituto D'Or de Pesquisa e Ensino, São Paulo, SP, Brasil;
| | - William C. Nahas
- Universidade de São PauloHospital das Clinicas da Faculdade de MedicinaDepartamento de UrologiaSão PauloSPBrasilDepartamento de Urologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil;
| | - Luciano A. Favorito
- Universidade Estadual do Rio de JaneiroUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital – Universidade Estadual do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brasil
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Davis S, Goodacre S, Horner D, Pandor A, Holland M, de Wit K, Hunt BJ, Griffin XL. Effectiveness and cost effectiveness of pharmacological thromboprophylaxis for medical inpatients: decision analysis modelling study. BMJ Med 2024; 3:e000408. [PMID: 38389721 PMCID: PMC10882286 DOI: 10.1136/bmjmed-2022-000408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/03/2024] [Indexed: 02/24/2024]
Abstract
Objective To determine the balance of costs, risks, and benefits for different thromboprophylaxis strategies for medical patients during hospital admission. Design Decision analysis modelling study. Setting NHS hospitals in England. Population Eligible adult medical inpatients, excluding patients in critical care and pregnant women. Interventions Pharmacological thromboprophylaxis (low molecular weight heparin) for all medical inpatients, thromboprophylaxis for none, and thromboprophylaxis given to higher risk inpatients according to risk assessment models (Padua, Caprini, IMPROVE, Intermountain, Kucher, Geneva, and Rothberg) previously validated in medical cohorts. Main outcome measures Lifetime costs and quality adjusted life years (QALYs). Costs were assessed from the perspective of the NHS and Personal Social Services in England. Other outcomes assessed were incidence and treatment of venous thromboembolism, major bleeds including intracranial haemorrhage, chronic thromboembolic complications, and overall survival. Results Offering thromboprophylaxis to all medical inpatients had a high probability (>99%) of being the most cost effective strategy (at a threshold of £20 000 (€23 440; $25 270) per QALY) in the probabilistic sensitivity analysis, when applying performance data from the Padua risk assessment model, which was typical of that observed across several risk assessment models in a medical inpatient cohort. Thromboprophylaxis for all medical inpatients was estimated to result in 0.0552 additional QALYs (95% credible interval 0.0209 to 0.1111) while generating cost savings of £28.44 (-£47 to £105) compared with thromboprophylaxis for none. No other risk assessment model was more cost effective than thromboprophylaxis for all medical inpatients when assessed in deterministic analysis. Risk based thromboprophylaxis was found to have a high (76.6%) probability of being the most cost effective strategy only when assuming a risk assessment model with very high sensitivity is available (sensitivity 99.9% and specificity 23.7% v base case sensitivity 49.3% and specificity 73.0%). Conclusions Offering pharmacological thromboprophylaxis to all eligible medical inpatients appears to be the most cost effective strategy. To be cost effective, any risk assessment model would need to have a very high sensitivity resulting in widespread thromboprophylaxis in all patients except those at the very lowest risk, who could potentially avoid prophylactic anticoagulation during their hospital stay.
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Affiliation(s)
- Sarah Davis
- Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Steve Goodacre
- Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Daniel Horner
- Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
- Department of Emergency and Intensive Care Medicine, Northern Care Alliance Foundation Trust, Salford, UK
- Division of Immunology, Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Abdullah Pandor
- Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Mark Holland
- School of Clinical and Biomedical Sciences, Faculty of Health and Wellbeing, University of Bolton, Bolton, UK
| | - Kerstin de Wit
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Beverley J Hunt
- Department of Thrombosis & Haemostasis, Kings Healthcare Partners, London, UK
| | - Xavier Luke Griffin
- Barts Bone and Joint Health, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Filby S, Van Walbeek C, Pan L. Cigarette excise tax structure and cigarette prices in nine sub-Saharan African countries: evidence from the Global Adult Tobacco Survey. Tob Control 2024; 33:208-214. [PMID: 38378207 PMCID: PMC10882183 DOI: 10.1136/tc-2022-057414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/22/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Economic theory predicts that the excise tax structure influences the distribution of cigarette prices. Evidence shows that uniform specific excise tax structures exhibit the least price variability relative to other tax structures. The distribution of cigarette prices under different excise tax structures has never been examined for a group of African countries. OBJECTIVES To examine the distribution of cigarette prices under different tax structures in nine African countries and to critically evaluate the effectiveness of African regional tax directives in promoting public health. METHODS Data from the Global Adult Tobacco Survey, conducted in eight African countries during 2012-2018, and data from the 2017 Gambia Tobacco Survey were used to construct survey-derived cigarette prices. The coefficients of variation and skewness of the price distribution were compared in the context of each country's cigarette excise tax structure. RESULTS The least price variability is found in countries with a uniform specific tax, or a mixed system with a minimum specific floor. Cigarette price variability is largest in countries with uniform ad valorem tax structures. Three of the four countries with ad valorem tax structures are in regional blocs, where the tax directives specify that they should implement an ad valorem structure. CONCLUSIONS Regional tax directives that require the adoption of uniform specific excise taxes, or high minimum specific floors, could be an efficient way to get multiple African countries to adopt a tax structure that reduces substitution possibilities in response to excise tax increases.
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Affiliation(s)
- Samantha Filby
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Corné Van Walbeek
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Liping Pan
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Ali FRM, Seaman EL, Diaz MC, Ajose J, King BA. Trends in unit sales of cooling flavoured e-cigarettes, USA, 2017-2021. Tob Control 2024; 33:147-153. [PMID: 35840317 DOI: 10.1136/tc-2022-057395] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/24/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Flavours that produce a cooling sensation, such as menthol, enhance the appeal of e-cigarettes among youth; but not all e-cigarettes that produce cooling sensations are labelled as menthol. This study assessed trends in unit sales of cooling flavoured e-cigarettes in the USA. DESIGN E-cigarette retail sales during 26 January 2017 to 28 November 2021 were licensed from Information Resources, Inc, which records brick-and-mortar retail scanner sales but not online or vape shop sales. Cooling flavours were identified using six descriptors: menthol, ice, cool, chill, freeze or frost; ambiguous flavours were verified using online searches. Cooling flavours were categorised by characterising flavour (menthol, mint, other) and product type (prefilled cartridges, disposables, e-liquids). Joinpoint regression was used to assess sales and price trends. RESULTS During January 2017 to November 2021, unit sales of cooling flavoured e-cigarettes increased by 693.0% (1.5 to 12.0 million units); the percentage of these sales from total sales increased from 26.4% to 54.9%. Among cooling flavours, percentage of menthol sales decreased from 94.5% to 73.0% (p<0.001). Among menthol cooling flavours, percentage of prefilled cartridges increased from 67.2% to 96.6% (p<0.001); among non-menthol cooling flavours, percentage of disposable e-cigarettes increased from 5.2% to 99.2% (p<0.001). There were no significant price differences between cooling and non-cooling flavoured disposable e-cigarettes. CONCLUSION The percentage of cooling flavoured e-cigarette sales from total sales doubled during 2017-2021, and sales of non-menthol cooling disposable e-cigarettes experienced the highest percentage increase. Cooling flavoured e-cigarettes are important to consider when developing strategies to address flavoured e-cigarette use among youth.
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Affiliation(s)
- Fatma Romeh M Ali
- Non-Infectious Disease Programs, CDC Foundation, Atlanta, Georgia, USA
| | | | - Megan C Diaz
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Julianah Ajose
- Non-Infectious Disease Programs, CDC Foundation, Atlanta, Georgia, USA
| | - Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Tecce E, Sarikonda A, Leibold A, Mansoor Ali D, Thalheimer S, Sami A, Heller J, Prasad S, Sharan A, Harrop J, Vaccaro A, Sivaganesan A. Does Body Mass Index Influence Intraoperative Costs and Operative Times for Anterior Cervical Discectomy and Fusion? A Time-Driven Activity-Based Costing Analysis. World Neurosurg 2024:S1878-8750(24)00271-7. [PMID: 38382758 DOI: 10.1016/j.wneu.2024.02.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Spine surgeons are often unaware of drivers of cost variation for anterior cervical discectomy and fusion (ACDF). We used time-driven activity-based costing to assess the relationship between body mass index (BMI), total cost, and operating room (OR) times for ACDFs. METHODS Total cost was divided into direct and indirect costs. Individual costs were obtained by direct observation, electronic medical records, and through querying multiple departments. Timestamps for all involved personnel and material resources were documented. Total intraoperative costs were estimated for all ACDFs from 2017 to 2022. All patients were categorized into distinct BMI-based cohorts. Linear regression models were performed to assess the relationship between BMI, total cost, and OR times. RESULTS A total of 959 patients underwent ACDFs between 2017 and 2022. The average age and BMI were 58.1 ± 11.2 years and 30.2 ± 6.4 kg/m2, respectively. The average total intraoperative cost per case was $7120 ± $2963. Multivariable regression analysis revealed that BMI was not significantly associated with total cost (P = 0.36), supply cost (P = 0.39), or personnel cost (P = 0.20). Higher BMI was significantly associated with increased time spent in the OR (P = 0.018); however, it was not a significant factor for the duration of surgery itself (P = 0.755). Rather, higher BMI was significantly associated with nonoperative OR time (P < 0.001). CONCLUSIONS Time-driven activity-based costing is a feasible and scalable methodology for understanding the true intraoperative costs of ACDF. Although higher BMI was not associated with increased total cost, it was associated with increased preparatory time in the OR.
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Affiliation(s)
- Eric Tecce
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Advith Sarikonda
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA.
| | - Adam Leibold
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Daniyal Mansoor Ali
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Sara Thalheimer
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Ashmal Sami
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Joshua Heller
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Srinivas Prasad
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Ashwini Sharan
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - James Harrop
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
| | - Alexander Vaccaro
- Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ahilan Sivaganesan
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
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Reinert M. How science is helping farmers to find a balance between agriculture and solar farms. Nature 2024:10.1038/d41586-024-00518-6. [PMID: 38374387 DOI: 10.1038/d41586-024-00518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
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Faraji M, Sharifi T, Mohammad-Pour S, Javan-Noughabi J, Aboutorabi A, Yousefi S, Jakovljevic M. Out-of-pocket pharmaceutical expenditure and its determinants among Iranian households with elderly members: a double-hurdle model. Cost Eff Resour Alloc 2024; 22:15. [PMID: 38373969 PMCID: PMC10877920 DOI: 10.1186/s12962-024-00521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES The population of older adults continues to grow in Iran, with pharmaceutical costs as a leading driver of household health-related costs. The present study was conducted to estimate the out-of-pocket pharmaceutical expenditure and its socioeconomic predictors among households with the elderly in Iran. METHOD This study is a secondary analysis using 2019 national household expenditure and income survey data in Iran. The sample size was 9381 households with at least one member older than 65. The double-hurdle model in STATA 16 was used to examine the association between independent variables and households' out-of-pocket pharmaceutical expenditures. RESULTS The mean out-of-pocket pharmaceutical expenditures for each household with elderly member was $8065 per year. There was a positive association between the (female) gender of the household head, urban residence, employment status, insurance expenditure and a higher level of education of the head of the household with the out-of-pocket pharmaceutical expenditures (P < 0.05). The income of elderly households did not affect these expenditures (P > 0.05). CONCLUSIONS This study showed that the socioeconomic characteristics of elderly families not only influenced their decision to enter the medicine market, but also the rate of medicine purchase. It is helpful to manage and control the pharmaceutical costs among the elderly.
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Affiliation(s)
- Mehran Faraji
- Department of Health Economics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Sharifi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Saeed Mohammad-Pour
- Department of Health Economics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
| | - Javad Javan-Noughabi
- Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Aboutorabi
- Department of Health Economics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Yousefi
- Kenneth Levene Graduate School of Business, Faculty of Graduate Studies and Research, University of Regina, Regina, SK, Canada
| | - Mihajlo Jakovljevic
- UNESCO-TWAS, Trieste, 34100, Italy
- Shaanxi University of Technology, Hanzhong, 723099, China
- Department of Global Health Economics and Policy, University of Kragujevac, 34000, Kragujevac, Serbia
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Kahrl F, Lin J. Changing economics of China's power system suggest that batteries and renewables may be a lower cost way to meet peak demand growth than coal. iScience 2024; 27:108975. [PMID: 38327799 PMCID: PMC10847674 DOI: 10.1016/j.isci.2024.108975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/08/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
Concerns around reliability in China's electricity sector have rekindled interest in a traditional solution: building more coal-fired generation. However, over the past decade China's electricity sector has seen significant changes in supply costs, demand patterns, and regulation and markets, with falling costs for renewable and storage generation, "peakier" demand, and the creation of wholesale markets. These changes suggest that traditional approaches to evaluating the economics of different supply options may be outdated. This paper illustrates how a net capacity cost metric - fixed costs minus net market revenues - might be a useful metric for evaluating supply options to meet peak demand growth in China. Using a simplified example with recent resource cost data, the paper illustrates how, with a net capacity cost metric, electricity storage and solar PV may be a more cost-effective option for meeting peak demand growth than coal-fired generation.
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Affiliation(s)
- Fritz Kahrl
- Energy Markets and Policy Group, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jiang Lin
- Energy Markets and Policy Group, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
- Department of Agricultural and Resource Economics, University of California, Berkeley, Berkeley, CA, USA
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Faramarzi A, Norouzi S, Dehdarirad H, Aghlmand S, Yusefzadeh H, Javan-Noughabi J. The global economic burden of COVID-19 disease: a comprehensive systematic review and meta-analysis. Syst Rev 2024; 13:68. [PMID: 38365735 PMCID: PMC10870589 DOI: 10.1186/s13643-024-02476-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused a considerable threat to the economics of patients, health systems, and society. OBJECTIVES This meta-analysis aims to quantitatively assess the global economic burden of COVID-19. METHODS A comprehensive search was performed in the PubMed, Scopus, and Web of Science databases to identify studies examining the economic impact of COVID-19. The selected studies were classified into two categories based on the cost-of-illness (COI) study approach: top-down and bottom-up studies. The results of top-down COI studies were presented by calculating the average costs as a percentage of gross domestic product (GDP) and health expenditures. Conversely, the findings of bottom-up studies were analyzed through meta-analysis using the standardized mean difference. RESULTS The implemented search strategy yielded 3271 records, of which 27 studies met the inclusion criteria, consisting of 7 top-down and 20 bottom-up studies. The included studies were conducted in various countries, including the USA (5), China (5), Spain (2), Brazil (2), South Korea (2), India (2), and one study each in Italy, South Africa, the Philippines, Greece, Iran, Kenya, Nigeria, and the Kingdom of Saudi Arabia. The results of the top-down studies indicated that indirect costs represent 10.53% of GDP, while the total estimated cost accounts for 85.91% of healthcare expenditures and 9.13% of GDP. In contrast, the bottom-up studies revealed that the average direct medical costs ranged from US $1264 to US $79,315. The meta-analysis demonstrated that the medical costs for COVID-19 patients in the intensive care unit (ICU) were approximately twice as high as those for patients in general wards, with a range from 0.05 to 3.48 times higher. CONCLUSIONS Our study indicates that the COVID-19 pandemic has imposed a significant economic burden worldwide, with varying degrees of impact across countries. The findings of our study, along with those of other research, underscore the vital role of economic consequences in the post-COVID-19 era for communities and families. Therefore, policymakers and health administrators should prioritize economic programs and accord them heightened attention.
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Affiliation(s)
- Ahmad Faramarzi
- Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
| | - Soheila Norouzi
- Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Hossein Dehdarirad
- Department of Medical Library and Information Science, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Aghlmand
- Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Hasan Yusefzadeh
- Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Javad Javan-Noughabi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Ndosi M, Livermore P. Beyond aches and pain: the hidden economic burden of musculoskeletal conditions in children and adolescents. Evid Based Nurs 2024:ebnurs-2023-103891. [PMID: 38360064 DOI: 10.1136/ebnurs-2023-103891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Polly Livermore
- Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK
- NIHR GOSH BRC, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Ospel JM, Kunz WG, Rinkel LA, Sanelli PC, Hirsch JA. What should neurointerventionalists know about cost-effectiveness research, and why should they care? J Neurointerv Surg 2024; 16:221-224. [PMID: 37468268 DOI: 10.1136/jnis-2023-020753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Johanna M Ospel
- Department of Diagnostic Imaging, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Wolfgang G Kunz
- Department of Radiology, Ludwig Maximilians University Munich, Munich, Germany
| | - Leon A Rinkel
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Neurology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Pina C Sanelli
- Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA
- Institute for Health System Science, Northwell Health Feinstein Institutes for Medical Research, Manhasset, New York, USA
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Valiente R, Tunstall H, Kong AY, Wilson LB, Gillespie D, Angus C, Brennan A, Shortt NK, Pearce J. Geographical differences in the financial impacts of different forms of tobacco licence fees on small retailers in Scotland. Tob Control 2024:tc-2023-058342. [PMID: 38326025 DOI: 10.1136/tc-2023-058342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Retailer licencing fees are a promising avenue to regulate tobacco availability. However, they face strong opposition from retailers and the tobacco industry, who argue significant financial impacts. This study compares the impacts of different forms of tobacco licence schemes on retailers' profits in Scotland. METHODS We calculated gross profits from tobacco sales in 179 convenience stores across Scotland using 1 099 697 electronic point-of-sale records from 16 weeks between 2019 and 2022. We estimated different fees using universal, volumetric and separate urban/rural schemes. We identified the point at which 50% of retailers would no longer make a gross profit on tobacco sales for each scheme and modelled the financial impact of 10 incremental fee levels. The financial impact was assessed based on changes in retailers' tobacco gross profits. Differences by neighbourhood deprivation and urban/rural status were examined. RESULTS The gross profit from tobacco per convenience store averaged £15 859/year. Profits were 2.29 times higher in urban (vs rural) areas and 1.59 times higher in high-deprivation (vs low-deprivation) areas, attributable to higher sales volumes. Tobacco gross profit decreased proportionally with increasing fee levels. Universal and urban/rural fees had greater gross profit reductions in rural and/or less deprived areas, where profits were lower, compared with volumetric fees. CONCLUSION The introduction of tobacco licence fees offers a potential opportunity for reducing the availability of tobacco retailers. The likely impact of a tobacco licence fee is sensitive to the type of licence scheme implemented, the level at which fees are set and the retailers' location in relation to neighbourhood deprivation and rurality.
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Affiliation(s)
- Roberto Valiente
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Helena Tunstall
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Amanda Y Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- TSET Health Promotion Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Luke B Wilson
- SPECTRUM Consortium, UK
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- SPECTRUM Consortium, UK
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Colin Angus
- SPECTRUM Consortium, UK
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- SPECTRUM Consortium, UK
- Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health (CRESH), School of GeoSciences, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
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Stundner O, Hoerner E, Zhong H, Poeran J, Liu J, Illescas A, Memtsoudis SG. Trends of liposomal bupivacaine utilization in major lower extremity total joint arthroplasty in the USA: a population-based study. Reg Anesth Pain Med 2024; 49:139-143. [PMID: 37567594 DOI: 10.1136/rapm-2023-104784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION Liposomal bupivacaine has been marketed for the achievement of long-acting local or regional anesthesia after major lower extremity total joint arthroplasty. However, it is comparatively expensive and controversy remains regarding its ability to decrease healthcare costs. With mounting evidence suggesting non-superiority in efficacy, compared with plain bupivacaine, we sought to investigate trends in liposomal bupivacaine use and identify changes in practice. METHODS We identified adult patients from the Premier Healthcare Database who underwent elective total joint arthroplasty between 2012 and 2021. Prevalence and trends of liposomal bupivacaine utilization were compared on the individual patient and hospital levels. Log-rank tests were performed to assess the influence of location, teaching status, or hospital size on time to hospital-level liposomal bupivacaine termination. RESULTS Among 103,165 total joint arthroplasty cases, liposomal bupivacaine use increased between 2012 and 2015 (from 0.4% to 22.8%) and decreased by approximately 1%-3% annually thereafter (15.7% in 2021). Liposomal bupivacaine was ever used in approximately 60% of hospitals. Hospital-level initiation of liposomal bupivacaine use peaked in 2014 and decreased thereafter (from 32.8% in 2013 to 4.3% in 2021), while termination rates increased (from 1.4% in 2014 to 9.9% in 2019). Non-teaching hospitals and those located in the South and West regions were more likely to retain liposomal bupivacaine longer than teaching or Midwest/Northeast hospitals, respectively (p=0.023 and p=0.014). DISCUSSION Liposomal bupivacaine use peaked around 2015 and has been declining thereafter on individual patient and hospital levels. How these trends correlate with health outcomes and expenditures would be a strategic target for future research.
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Affiliation(s)
- Ottokar Stundner
- Department of Anesthesiology and Intensive Care, Medizinische Universität Innsbruck, Innsbruck, Austria
- Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medizinische Privatuniversität, Salzburg, Austria
| | - Elisabeth Hoerner
- Department of Anesthesiology and Intensive Care, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Haoyan Zhong
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
| | - Jashvant Poeran
- Department of Orthopaedics/Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jiabin Liu
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
| | - Alex Illescas
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
| | - Stavros G Memtsoudis
- Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medizinische Privatuniversität, Salzburg, Austria
- Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, New York, USA
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Havlik JL, Wahid S, Ososanya L, Tang D, Lee MS, Tsai J. Distribution of CARES Act Provider Relief Funding to Psychiatric Care Organizations. Psychiatr Serv 2024; 75:194-197. [PMID: 37674396 DOI: 10.1176/appi.ps.20230040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
More than $100 billion in Coronavirus Aid, Relief, and Economic Security (CARES) Act funding was intended to support financially stressed health care providers during the COVID-19 pandemic. The distribution of the CARES Act's Provider Relief Fund among psychiatrists is poorly understood. Analyzing funding received by 2,593 psychiatric care organizations (PCOs), the authors found that funding was more equally distributed across care organizations of different sizes in psychiatry versus other specialties. Substantially less relief funding was received by PCOs per provider relative to other specialties. This disparity in relief funding is surprising given that specific earmarks of the CARES Act were intended to improve U.S. mental health care capacity, meriting further attention.
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Affiliation(s)
- John L Havlik
- Department of Psychiatry, Yale University School of Medicine, New Haven (Havlik, Tsai); Biological Sciences Division, University of Chicago, Chicago (Wahid, Ososanya, Tang, Lee); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai)
| | - Syed Wahid
- Department of Psychiatry, Yale University School of Medicine, New Haven (Havlik, Tsai); Biological Sciences Division, University of Chicago, Chicago (Wahid, Ososanya, Tang, Lee); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai)
| | - Lydia Ososanya
- Department of Psychiatry, Yale University School of Medicine, New Haven (Havlik, Tsai); Biological Sciences Division, University of Chicago, Chicago (Wahid, Ososanya, Tang, Lee); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai)
| | - Deanna Tang
- Department of Psychiatry, Yale University School of Medicine, New Haven (Havlik, Tsai); Biological Sciences Division, University of Chicago, Chicago (Wahid, Ososanya, Tang, Lee); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai)
| | - Megan S Lee
- Department of Psychiatry, Yale University School of Medicine, New Haven (Havlik, Tsai); Biological Sciences Division, University of Chicago, Chicago (Wahid, Ososanya, Tang, Lee); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai)
| | - Jack Tsai
- Department of Psychiatry, Yale University School of Medicine, New Haven (Havlik, Tsai); Biological Sciences Division, University of Chicago, Chicago (Wahid, Ososanya, Tang, Lee); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai)
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50
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Ali SH. Deep-sea mining opponents: there's no free lunch when it comes to clean energy. Nature 2024; 626:480. [PMID: 38351335 DOI: 10.1038/d41586-024-00404-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
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