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Aims and background Whole-genome sequencing (WGS) is increasingly applied in clinical practice and expected to replace standard-of-care (SoC) genetic diagnostics in hematological malignancies. This study aims to assess and compare the fully burdened cost (‘micro-costing’) per patient for Swedish laboratories using WGS and SoC, respectively, in pediatric and adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Methods The resource use and cost details associated with SoC, e.g. chromosome banding analysis, fluorescent in situ hybridization, and targeted sequencing analysis, were collected via activity-based costing methods from four diagnostic laboratories. For WGS, corresponding data was collected from two of the centers. A simulation-based scenario model was developed for analyzing the WGS cost based on different annual sample throughput to evaluate economy of scale. Results The average SoC total cost per patient was €2,465 for pediatric AML and €2,201 for pediatric ALL, while in adults, the corresponding cost was €2,458 for AML and €1,207 for ALL. The average WGS cost (90x tumor/30x normal; sequenced on the Illumina NovaSeq 6000 platform) was estimated to €3,472 based on an annual throughput of 2,500 analyses, however, with an annual volume of 7,500 analyses the average cost would decrease by 23% to €2,671. Conclusion In summary, WGS is currently more costly than SoC, however the cost can be reduced by utilizing laboratories with higher throughput and by the expected decline in cost of reagents. Our data provides guidance to decision-makers for the resource allocation needed when implementing WGS in diagnostics of hematological malignancies.

Aims and backgroundWhole-genome sequencing (WGS) is increasingly applied in clinical practice and expected to replace standard-of-care (SoC) genetic diagnostics in hematological malignancies. This study aims to assess and compare the fully burdened cost ('micro-costing') per patient for Swedish laboratories using WGS and SoC, respectively, in pediatric and adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).MethodsThe resource use and cost details associated with SoC, e.g. chromosome banding analysis, fluorescent in situ hybridization, and targeted sequencing analysis, were collected via activity-based costing methods from four diagnostic laboratories. For WGS, corresponding data was collected from two of the centers. A simulation-based scenario model was developed for analyzing the WGS cost based on different annual sample throughput to evaluate economy of scale.ResultsThe average SoC total cost per patient was 2,465 for pediatric AML and 2,201 for pediatric ALL, while in adults, the corresponding cost was 2,458 for AML and 1,207 for ALL. The average WGS cost (90x tumor/30x normal; sequenced on the Illumina NovaSeq 6000 platform) was estimated to 3,472 based on an annual throughput of 2,500 analyses, however, with an annual volume of 7,500 analyses the average cost would decrease by 23% to 2,671.ConclusionIn summary, WGS is currently more costly than SoC, however the cost can be reduced by utilizing laboratories with higher throughput and by the expected decline in cost of reagents. Our data provides guidance to decision-makers for the resource allocation needed when implementing WGS in diagnostics of hematological malignancies., QC 20240828

Aims and background Whole-genome sequencing (WGS) is increasingly applied in clinical practice and expected to replace standard-of-care (SoC) genetic diagnostics in hematological malignancies. This study aims to assess and compare the fully burdened cost (‘micro-costing’) per patient for Swedish laboratories using WGS and SoC, respectively, in pediatric and adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Methods The resource use and cost details associated with SoC, e.g. chromosome banding analysis, fluorescent in situ hybridization, and targeted sequencing analysis, were collected via activity-based costing methods from four diagnostic laboratories. For WGS, corresponding data was collected from two of the centers. A simulation-based scenario model was developed for analyzing the WGS cost based on different annual sample throughput to evaluate economy of scale. Results The average SoC total cost per patient was €2,465 for pediatric AML and €2,201 for pediatric ALL, while in adults, the corresponding cost was €2,458 for AML and €1,207 for ALL. The average WGS cost (90x tumor/30x normal; sequenced on the Illumina NovaSeq 6000 platform) was estimated to €3,472 based on an annual throughput of 2,500 analyses, however, with an annual volume of 7,500 analyses the average cost would decrease by 23% to €2,671. Conclusion In summary, WGS is currently more costly than SoC, however the cost can be reduced by utilizing laboratories with higher throughput and by the expected decline in cost of reagents. Our data provides guidance to decision-makers for the resource allocation needed when implementing WGS in diagnostics of hematological malignancies.

Aims and background Whole-genome sequencing (WGS) is increasingly applied in clinical practice and expected to replace standard-of-care (SoC) genetic diagnostics in hematological malignancies. This study aims to assess and compare the fully burdened cost (‘micro-costing’) per patient for Swedish laboratories using WGS and SoC, respectively, in pediatric and adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Methods The resource use and cost details associated with SoC, e.g. chromosome banding analysis, fluorescent in situ hybridization, and targeted sequencing analysis, were collected via activity-based costing methods from four diagnostic laboratories. For WGS, corresponding data was collected from two of the centers. A simulation-based scenario model was developed for analyzing the WGS cost based on different annual sample throughput to evaluate economy of scale. Results The average SoC total cost per patient was €2,465 for pediatric AML and €2,201 for pediatric ALL, while in adults, the corresponding cost was €2,458 for AML and €1,207 for ALL. The average WGS cost (90x tumor/30x normal; sequenced on the Illumina NovaSeq 6000 platform) was estimated to €3,472 based on an annual throughput of 2,500 analyses, however, with an annual volume of 7,500 analyses the average cost would decrease by 23% to €2,671. Conclusion In summary, WGS is currently more costly than SoC, however the cost can be reduced by utilizing laboratories with higher throughput and by the expected decline in cost of reagents. Our data provides guidance to decision-makers for the resource allocation needed when implementing WGS in diagnostics of hematological malignancies.

Case Mix Index (CMI) represents a standard indicator of hospital disease seriousness at both the national and international level. CMI is structured to compute hospital payments and not to follow up disease seriousness. It is considerably related to the data accuracy as well as patients’ medical records. The main aim of the study was to quantify the factors influencing the differences in CMI depending on the types of healthcare facilities, their geographical location, as well as the procedural aspects within the Slovak healthcare system. We use data published by the Institute for Economic and Social Reforms, which continuously surveys the quality and outputs of healthcare provided in the Slovak Republic. The data comes from multiple datasets that are issued by healthcare authorities and stakeholders is the Slovak Republic such as insurance companies, the Ministry of Health of the Slovak Republic, the Ministry of Finance of the Slovak Republic, healthcare facilities, the National Health Information Centre etc. Regression analysis indicates that the positive impact on the Case Mix Index is possessed by the Operating experience of doctors and Overall inpatients satisfaction; whilst the negative impact on Case Mix Index values is documented for variables Total rehospitalisation within 30 d, Intensive care unit mortality, Economy, and Transparency.

Aims and background Whole-genome sequencing (WGS) is increasingly applied in clinical practice and expected to replace standard-of-care (SoC) genetic diagnostics in hematological malignancies. This study aims to assess and compare the fully burdened cost (‘micro-costing’) per patient for Swedish laboratories using WGS and SoC, respectively, in pediatric and adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Methods The resource use and cost details associated with SoC, e.g. chromosome banding analysis, fluorescent in situ hybridization, and targeted sequencing analysis, were collected via activity-based costing methods from four diagnostic laboratories. For WGS, corresponding data was collected from two of the centers. A simulation-based scenario model was developed for analyzing the WGS cost based on different annual sample throughput to evaluate economy of scale. Results The average SoC total cost per patient was €2,465 for pediatric AML and €2,201 for pediatric ALL, while in adults, the corresponding cost was €2,458 for AML and €1,207 for ALL. The average WGS cost (90x tumor/30x normal; sequenced on the Illumina NovaSeq 6000 platform) was estimated to €3,472 based on an annual throughput of 2,500 analyses, however, with an annual volume of 7,500 analyses the average cost would decrease by 23% to €2,671. Conclusion In summary, WGS is currently more costly than SoC, however the cost can be reduced by utilizing laboratories with higher throughput and by the expected decline in cost of reagents. Our data provides guidance to decision-makers for the resource allocation needed when implementing WGS in diagnostics of hematological malignancies.

AimTo assess, from a United States (US) payer's perspective, the cost-effectiveness of gels designed to separate the endometrial surfaces (intrauterine spacers) placed following intrauterine surgery.Materials and methodsA decision tree model was developed to estimate the cost-effectiveness of intrauterine spacers used to facilitate endometrial repair and prevent the formation (primary prevention) and reformation (secondary prevention) of intrauterine adhesions (IUAs) and associated pregnancy- and birth-related adverse outcomes. Event rates and costs were extrapolated from data available in the existing literature. Sensitivity analyses were conducted to corroborate the base case results.ResultsIn this model, using intrauterine spacers for adhesion prevention led to net cost savings for US payers of $2,905 per patient over a 3.5-year time horizon. These savings were driven by the direct benefit of preventing procedures associated with IUA formation ($2,162 net savings) and the indirect benefit of preventing pregnancy-related complications often associated with IUA formation ($3,002). These factors offset the incremental cost of intrauterine spacer use of $1,539 based on an assumed price of $1,800 and the related increase in normal deliveries of $931. Model outcomes were sensitive to the probability of preterm and normal deliveries. Budget impact analyses show overall cost savings of $19.96 per initial member within a US healthcare plan, translating to $20 million over a 5-year time horizon for a one-million-member plan.LimitationsThere are no available data on the effects of intrauterine spacers or IUAs on patients' quality of life. Resultingly, the model could not evaluate patients' utility related to treatment with or without intrauterine spacers and instead focused on costs and events avoided.ConclusionThis analysis robustly demonstrated that intrauterine spacers would be cost-saving to healthcare payers, including both per-patient and per-plan member, through a re

Aims: To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective. Materials and methods: A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naive or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was obtained from the BE OPTIMAL (bDMARD-naive) and BE COMPLETE (TNFi-experienced) trials while a network meta-analysis (NMA) informed the efficacy of the comparators. Resource use and drug costs were obtained from published studies and databases of drug retail prices in Sweden. A willingness-to-pay threshold of euro50,000 per quality-adjusted life year (QALY) was applied. Results: In bDMARD-naive patients, bimekizumab achieved greater QALYs (14.08) than with all comparators except infliximab (14.22), dominated guselkumab every 4 and 8 weeks, ixekizumab, secukinumab 300 mg, ustekinumab 45 mg and 90 mg, and was cost-effective against risankizumab, tofacitinib, upadacitinib and TNFis, except adalimumab biosimilar. In TNFi-experienced patients, bimekizumab led to greater QALYs (13.56) than all comparators except certolizumab pegol (13.84), and dominated ixekizumab and secukinumab 300 mg while being cost-effective against all other IL-17A-, IL-23- and JAK inhibitors. Limitations: An NMA informed the comparative effectiveness estimates. Given gaps in evidence of disease management and indirect costs specific to HAQ-DI scores, and sequential clinical trial evidence in PsA, non-PsA cost data from similar joint conditions were used, and one line o

Aims: To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective. Materials and methods: A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naive or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was obtained from the BE OPTIMAL (bDMARD-naive) and BE COMPLETE (TNFi-experienced) trials while a network meta-analysis (NMA) informed the efficacy of the comparators. Resource use and drug costs were obtained from published studies and databases of drug retail prices in Sweden. A willingness-to-pay threshold of euro50,000 per quality-adjusted life year (QALY) was applied. Results: In bDMARD-naive patients, bimekizumab achieved greater QALYs (14.08) than with all comparators except infliximab (14.22), dominated guselkumab every 4 and 8 weeks, ixekizumab, secukinumab 300 mg, ustekinumab 45 mg and 90 mg, and was cost-effective against risankizumab, tofacitinib, upadacitinib and TNFis, except adalimumab biosimilar. In TNFi-experienced patients, bimekizumab led to greater QALYs (13.56) than all comparators except certolizumab pegol (13.84), and dominated ixekizumab and secukinumab 300 mg while being cost-effective against all other IL-17A-, IL-23- and JAK inhibitors. Limitations: An NMA informed the comparative effectiveness estimates. Given gaps in evidence of disease management and indirect costs specific to HAQ-DI scores, and sequential clinical trial evidence in PsA, non-PsA cost data from similar joint conditions were used, and one line o

Aims: To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective. Materials and methods: A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naive or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was obtained from the BE OPTIMAL (bDMARD-naive) and BE COMPLETE (TNFi-experienced) trials while a network meta-analysis (NMA) informed the efficacy of the comparators. Resource use and drug costs were obtained from published studies and databases of drug retail prices in Sweden. A willingness-to-pay threshold of euro50,000 per quality-adjusted life year (QALY) was applied. Results: In bDMARD-naive patients, bimekizumab achieved greater QALYs (14.08) than with all comparators except infliximab (14.22), dominated guselkumab every 4 and 8 weeks, ixekizumab, secukinumab 300 mg, ustekinumab 45 mg and 90 mg, and was cost-effective against risankizumab, tofacitinib, upadacitinib and TNFis, except adalimumab biosimilar. In TNFi-experienced patients, bimekizumab led to greater QALYs (13.56) than all comparators except certolizumab pegol (13.84), and dominated ixekizumab and secukinumab 300 mg while being cost-effective against all other IL-17A-, IL-23- and JAK inhibitors. Limitations: An NMA informed the comparative effectiveness estimates. Given gaps in evidence of disease management and indirect costs specific to HAQ-DI scores, and sequential clinical trial evidence in PsA, non-PsA cost data from similar joint conditions were used, and one line o

Aims: To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective. Materials and methods: A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naive or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was obtained from the BE OPTIMAL (bDMARD-naive) and BE COMPLETE (TNFi-experienced) trials while a network meta-analysis (NMA) informed the efficacy of the comparators. Resource use and drug costs were obtained from published studies and databases of drug retail prices in Sweden. A willingness-to-pay threshold of euro50,000 per quality-adjusted life year (QALY) was applied. Results: In bDMARD-naive patients, bimekizumab achieved greater QALYs (14.08) than with all comparators except infliximab (14.22), dominated guselkumab every 4 and 8 weeks, ixekizumab, secukinumab 300 mg, ustekinumab 45 mg and 90 mg, and was cost-effective against risankizumab, tofacitinib, upadacitinib and TNFis, except adalimumab biosimilar. In TNFi-experienced patients, bimekizumab led to greater QALYs (13.56) than all comparators except certolizumab pegol (13.84), and dominated ixekizumab and secukinumab 300 mg while being cost-effective against all other IL-17A-, IL-23- and JAK inhibitors. Limitations: An NMA informed the comparative effectiveness estimates. Given gaps in evidence of disease management and indirect costs specific to HAQ-DI scores, and sequential clinical trial evidence in PsA, non-PsA cost data from similar joint conditions were used, and one line o

Rationale The health of the population aged 55 to 69 influences their labour supply and retirement decisions. This article aims to document their health status, in Spain and in other European countries, drawing on data from the Survey on Health, Ageing and Retirement in Europe (SHARE). Takeaways •There are marked differences by gender in the health status of the Spanish population aged 65 to 69. Among women, 62.9% report chronic health problems, 30.1% mobility limitations and 32.1% depression-related symptoms, compared with 53.3%, 15.8% and 16.3%, respectively, among men. These prevalences are significantly higher in the 65 to 69 age group than in the 55 to 64 age group. •However, there were some improvements in the incidence of health problems between cohorts in these age groups. For instance, the prevalence of chronic diseases and of mobility limitations among women aged 55 to 64 was lower in 2015 than in 2004. •In comparison with other European countries, in Spain the prevalence of the three health indicators considered is high among women between 65 and 69. Moreover, Spain is one of the countries with the highest increases in health problems in the 65 to 69 age group compared with the 55 to 64 age group.

Aims: To evaluate the cost-effectiveness of bimekizumab, an inhibitor of IL-17F and IL-17A, against biologic and targeted synthetic disease-modifying antirheumatic drugs (DMARD) for psoriatic arthritis (PsA) from the Swedish healthcare system perspective. Materials and methods: A Markov model was developed to simulate the clinical pathway of biologic [b] DMARD-naive or tumor necrosis factor inhibitor experienced [TNFi-exp] PsA patients over a lifetime horizon. Treatment response was incorporated as achievement of the American College of Rheumatology 50% (ACR50) and Psoriasis Area and Severity Index 75% (PASI75) response, and changes in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score. The efficacy of bimekizumab was obtained from the BE OPTIMAL (bDMARD-naive) and BE COMPLETE (TNFi-experienced) trials while a network meta-analysis (NMA) informed the efficacy of the comparators. Resource use and drug costs were obtained from published studies and databases of drug retail prices in Sweden. A willingness-to-pay threshold of euro50,000 per quality-adjusted life year (QALY) was applied. Results: In bDMARD-naive patients, bimekizumab achieved greater QALYs (14.08) than with all comparators except infliximab (14.22), dominated guselkumab every 4 and 8 weeks, ixekizumab, secukinumab 300 mg, ustekinumab 45 mg and 90 mg, and was cost-effective against risankizumab, tofacitinib, upadacitinib and TNFis, except adalimumab biosimilar. In TNFi-experienced patients, bimekizumab led to greater QALYs (13.56) than all comparators except certolizumab pegol (13.84), and dominated ixekizumab and secukinumab 300 mg while being cost-effective against all other IL-17A-, IL-23- and JAK inhibitors. Limitations: An NMA informed the comparative effectiveness estimates. Given gaps in evidence of disease management and indirect costs specific to HAQ-DI scores, and sequential clinical trial evidence in PsA, non-PsA cost data from similar joint conditions were used, and one line o

Rationale The last year has seen growing demand for healthcare services, but the causes of this increase, and how persistent it will be, are as yet uncertain. Should these dynamics prove to be long-lasting and associated with a prolonged deterioration in the general health of the Spanish population, they could have a significant economic impact. Takeaways •The latest waves of the Centro de Investigaciones Sociológicas healthcare barometer show an increase in demand for healthcare services in Spain. The number of workers losing work days as a result of illness, temporary disability or injury has also risen. •There is considerable uncertainty as to the causes and potential persistence of these developments, although some dynamics appear to be in line with the predictions made in the literature studying COVID-19 sequelae among a widely vaccinated population. •If these developments prove to be long-lasting and associated with a prolonged deterioration in the general health of the Spanish population, they may require a structural increase in healthcare expenditure that is as yet difficult to estimate, as well as having an adverse, but highly uncertain, impact on potential output.

Motivación La salud de la población de 55-69 años condiciona su oferta de trabajo y decisión de jubilación. El objetivo de este artículo es documentar el estado de salud de estos colectivos, en España y en otros países europeos, a partir de la Survey on Health, Ageing and Retirement in Europe. Ideas principales •Las diferencias por género en la salud de los españoles de 65-69 años son sustanciales: entre las mujeres, el 62,9 % reportan problemas crónicos, el 30,1 % problemas de movilidad y el 32,1 % síntomas asociados a la depresión; entre los hombres, estos valores son del 53,3 %, el 15,8 % y el 16,3 %, respectivamente. Estas prevalencias son significativamente mayores entre las personas de 65-69 años que entre las de 55-64 años. •No obstante, se han producido algunas mejoras en la incidencia de problemas de salud entre cohortes a estas edades. Por ejemplo, al comparar 2015 con 2004, las mujeres de entre 55 y 64 años presentaban menores prevalencias de problemas crónicos de salud y de movilidad. •En el contexto europeo, se observan prevalencias elevadas de estos problemas de salud para las mujeres españolas de 65-69 años. España es uno de los países con mayores aumentos en las prevalencias en el grupo de 65-69 años respecto al grupo de 55-64 años.

Motivación En el último año se ha observado un aumento de la demanda de servicios sanitarios, cuyas causas y grado de persistencia son todavía inciertos. Si dichas dinámicas se prologaran en el tiempo y estuvieran relacionadas con un deterioro persistente en la salud general de la población española, su impacto económico podría ser significativo. Ideas principales •Las últimas olas del barómetro sanitario del Centro de Investigaciones Sociológicas muestran un incremento de la demanda de servicios sanitarios en nuestro país. También se ha observado un aumento en los ocupados que pierden días de trabajo por enfermedad, incapacidad temporal o accidente. •Existe una considerable incertidumbre en cuanto a las causas y al posible grado de persistencia de estos desarrollos, algunos de los cuales parecen estar en línea con las predicciones de la literatura que estudia las secuelas del COVID-19 sobre una población ampliamente vacunada que resulta infectada. •En la medida en que estos desarrollos puedan resultar duraderos y estar asociados a un deterioro persistente en la salud general de la población española, podrían requerir un aumento estructural del gasto sanitario —aún difícil de cuantificar— y afectar negativamente —aunque con elevada incertidumbre— al producto potencial.

The coronavirus pandemic triggered strong political action across Europe. Mandatory restrictions to increase social distancing were imposed, commonly known as lockdowns. In some cases, entire countries were virtually locked down for several weeks at a time, contributing to a very severe downturn in economic activity. To mitigate the policy induced economic crisis, governments responded by introducing expansionary fiscal and monetary measures to support businesses and households.One country, Sweden, served as an outlier. It restricted the spread of the virus primarily through voluntary measures rather than strict lockdowns. In this study, we compare the health and economic outcomes in Sweden with those of comparable Western European countries. We answer the question of whether the Swedish policy of using voluntary social-distancing measures led to a better or worse outcome compared to those countries relying on extensive lockdowns.Our results clearly show that the benefits of the lockdown policy on the excess death rate was at best limited, while the economic costs were significant. The Swedish policy of advice and trust in the population to act responsibly was relatively successful. Unlike most other Western European countries, Sweden managed to combine one of the lowest excess death rates with relatively small economic costs. Furthermore, Sweden’s fiscal position remained remarkably strong during and after the pandemic, in sharp contrast to the fiscal deterioration in those countries that pursued more stringent lockdown policies.While we make no claims of presenting a comprehensive study that covers all possible dimensions of a complex question, the macroeconomic outcome suggests an overreaction, if not panic, among policymakers in many Western European countries. Future policymakers should rely on empirical evidence instead of panicking and adopting extreme measures. The panicked implementation of strict measures during the pandemic did far more harm than good—eve

The prevalence of mental ill-health is increasing among young people in many developed countries, raising concerns about their well-being. Experts have pointed to several potential contributing factors, including a heightened emphasis on educational achievement and performance evaluation, as well as shifting demands in the high-skilled job market. In this paper, we study the effect of introducing earlier grades in compulsory school on child mental health in Sweden. To do so, we exploit a grading reform in Swedish compulsory schools in which grades were introduced at an earlier age, in 6th grade instead of 8th grade as was previously the case. The reform provides a situation where the age at which children receive their first grade is arbitrary depending on if the child is born before or after the year-end. We show that girls who are exposed to one year earlier grades are more likely to be diagnosed with depression or anxiety by the end of compulsory school, controlling for potential age effects in a difference-in-discontinuities setup. We do not find similar effects among boys. Overall, these results imply that girls’ mental well-being may be particularly responsive to educational assessment through grades at earlier ages.

ObjectivesPreterm birth occurs in more than 10% of U.S. births and is the leading cause of U.S. neonatal deaths, with estimated annual costs exceeding $25 billion USD. Using real-world data, we modeled the potential clinical and economic utility of a prematurity-reduction program comprising screening in a racially and ethnically diverse population with a validated proteomic biomarker risk predictor, followed by case management with or without pharmacological treatment.MethodsThe ACCORDANT microsimulation model used individual patient data from a prespecified, randomly selected sub-cohort (N = 847) of a multicenter, observational study of U.S. subjects receiving standard obstetric care with masked risk predictor assessment (TREETOP; NCT02787213). All subjects were included in three arms across 500 simulated trials: standard of care (SoC, control); risk predictor/case management comprising increased outreach, education and specialist care (RP-CM, active); and multimodal management (risk predictor/case management with pharmacological treatment) (RP-MM, active). In the active arms, only subjects stratified as higher risk by the predictor were modeled as receiving the intervention, whereas lower-risk subjects received standard care. Higher-risk subjects' gestational ages at birth were shifted based on published efficacies, and dependent outcomes, calibrated using national datasets, were changed accordingly. Subjects otherwise retained their original TREETOP outcomes. Arms were compared using survival analysis for neonatal and maternal hospital length of stay, bootstrap intervals for neonatal cost, and Fisher's exact test for neonatal morbidity/mortality (significance, p < .05).ResultsThe model predicted improvements for all outcomes. RP-CM decreased neonatal and maternal hospital stay by 19% (p = .029) and 8.5% (p = .001), respectively; neonatal costs' point estimate by 16% (p = .098); and moderate-to-severe neonatal morbidity/mortality by 29% (p = .025). RP-MM streng

We explore the effects of health and healthcare utilization on household saving and financial portfolios using data from the Japanese Household Panel Survey and the Keio Household Panel Survey. Poor psychological well-being is found to be associated with lower levels of savings and smaller financial portfolios, whereas associations with poor physical health are largely absent. Significantly, our findings do not support the hypothesis that poorer physical health is associated with savings accumulation. In contrast, healthcare utilization in the form of hospital visits, hospitalization, and health screening is associated with greater savings and larger financial portfolios. This suggests that healthcare-based incentives to accumulate savings and financial wealth are related to channels associated with investment in health.

Various grading reforms and trends of more lenient grading have contributed to grade inflation in Sweden and other countries. Previous research shows that over-grading increases higher education enrolment, achievements and earnings, but no study has yet addressed the potential impact of grading bias on health. In this paper, we hypothesize that over-grading has a protective impact on mental health, either through a direct effect of performance feedback, or through mechanisms such as self-efficacy and university admission distortions. We test this hypothesis using Swedish individual-level register data for individuals graduating from upper secondary school in the years 2001-2004. Grading bias, which we interpret as over-grading, is constructed as the residual of final upper secondary school grades having controlled for results in a standardised test, itself not subject to grading leniency. Over-grading is further isolated by considering only within-school variation in over-grading and controlling for prior grades and school production. We show that over-grading has substantial significant protective impacts on the mental health of young adults, but only among female students. That grades themselves, independent of knowledge, substantially impact the production of health highlights an important health production mechanism, and also implies that any changes to the design of grading systems must consider these wider health implications.

In the last couple of decades, there has been a lot of interest on the impact of macroeconomic fluctuations on health and mortality rates. Many studies, for different countries, find that mortality is procyclical. However, studies examining the effects of more recent recessions are less conclusive, finding mortality to be less procyclical, or even countercyclical. In this paper, using data of Spanish provinces from 1999 to 2016, we investigate how this relationship works in the context of a country that is subject to extreme business cycle fluctuations. Furthermore, we analyze the impact of unemployment for different mortality causes and we explore differences by sex, age group and level of education. In general terms, we find mortality to be procyclical so that when the economy is in a recession, mortality falls. When exploring mortality causes, we show that deaths from cardiovascular disease, cancer, senility, transport accidents and homicides are procyclical. By sex, we find procyclicality for both men and women. By age, mortality is procyclical for all age groups; however, the causes of death that result in this procyclical behavior are specific to each age group. By educational level, suicide appears as a countercyclical cause for individuals with intermediate levels of education.

We explore how involuntary and voluntary exits from self-employment affect life and health satisfaction. To that end, we use rich longitudinal data from the German Socio-Economic Panel from 1985 to 2017 and a difference-in-differences estimator. We find that while transitioning from self-employment to salaried employment brings small improvements in health and life satisfaction, the negative psychological costs of business failure (i.e., switching from self-employment to unemployment) are substantial and exceed the costs of involuntarily losing a salaried job. Meanwhile, leaving self-employment has no consequences for self-reported physical health and behaviors such as smoking and drinking, implying that the costs of losing self-employment are mainly psychological. Moreover, former business owners fail to adapt to an involuntary self-employment exit even 2 or more years after this traumatic event. Our findings imply that policies encouraging entrepreneurship should also carefully consider the nonmonetary implications of business failure. © 2020, The Author(s).

Medical device companies may play a role in the type of treatments provided to patients, namely by influencing physicians to use their products. Physicians interact frequently with medical device representatives, which raises concerns that these relationships might bias healthcare providers. Using data on payments from medical device companies to physicians combined with hospital discharge datasets, I assess the impact of payments on medical treatments. The specific setting of this study is treatment provided to heart attack patients arriving at the Emergency Room (ER) in Florida hospitals. Using an instrumental variables approach, I find that patients treated by doctors who interact with the industry are more likely to receive an invasive procedure. I find no significant impact on healthcare outcomes. However, interactions result in higher medical device costs (up to 16% increase) and total hospital costs (up to 3% increase). The results can have implications for the design of regulations on physician-industry interactions., info:eu-repo/semantics/published

The recent outbreak of Covid-19 has infected the world at an incredible speed. While there are many similarities across countries in terms of the characteristics of the epidemic spread, there are also large differences across regions. In this paper, we examine regional variation in the outbreak across continental France. We use information on the number of deaths and discharged patients from Covid-19 and socio-economic variables at the department level. Controlling for other factors, we corroborate existing evidence that, unfortunately, inequality kills: departments with more inequality face a higher incidence rate of the disease, expressed as the number of deaths and discharged (gravely ill) patients. Using covariance analysis combining both deaths and releases, we find no statistically differential relationship across factors that contribute to deaths or recoveries., info:eu-repo/semantics/published

The exchange rate pass-through into the consumer price index on healthcare goods and services was measured by estimating a FAVAR model for Colombia. Results provide evidence of an incomplete and heterogeneous effect. There is no indication of transmission to the services or insurance indexes, but there is a significant effect on the medicines and devices indexes that have implications for out-of-pocket expenditure. Therefore, this indicates that the Colombian healthcare system effectively protects consumers from exchange rate volatility, but may need to design policies to protect consumers from price rises in medicines and goods that are not covered by the national benefits package., Se mide el efecto transmisión de la tasa de cambio al índice de precios al consumidor de los bienes y servicios de salud haciendo uso de un modelo FAVAR. Los resultados obtenidos proveen evidencia de un efecto incompleto y heterogéneo. No se encuentra un efecto transmisión a los sectores de servicios y seguros, sin embargo, se encuentra dicho efecto en medicinas y bienes, que tienen implicaciones para el gasto de bolsillo. Lo anterior indica que el sistema de salud colombiano protege a los consumidores de la volatilidad de la tasa de cambio, pero necesita políticas orientadas a sectores no cubiertos., O efeito da transmissão da taxa de câmbio sobre o índice de preços ao consumidor de bens e serviços de saúde é medido usando um modelo FAVAR. Os resultados obtidos fornecem evidências de um efeito incompleto e heterogêneo. Não se encontra nenhum efeito de transmissão para os setores de serviços e de seguros; no entanto, esse efeito é encontrado em medicamentos e bens, que têm implicações para as despesas extras. Isso indica que o sistema de saúde colombiano protege os consumidores da volatilidade da taxa de câmbio, mas precisa de políticas orientadas para os setores não cobertos.

The purpose of the study is to evaluate the degree of information and the population opinion regarding the vaccination process. The paper aims to evaluate both the reasons of decreasing the vaccination degree and the sources of wrong information on this topic to better identify between mistakes and correct knowledge.Vaccines are biological products prepared following specifical tehcniques to improve the body's immunity against particula, given conditions. The lives of millions of children from 188 countries who received different vaccines (diptero-tetanus-pertussis, measles, polio) were saved in the world along the time (WHO, 2017). In Romania, the antidifteric vaccination introduced in 1960 made disappear the disease in 1990. No case of diphtheria has been confirmed so far.Unfortunately, in 2016, the vaccine coverage has fallen below 90% (CNSCBT, 2017) because of either parents' refusal and the failure in attending a family doctor.Therefore, today, the society is facing a serious situation caused by: a) insufficient and erroneous information of parents expressing their opposition to vaccination and b) manipulation of organizations against vaccination.

The purpose of the study is to evaluate the degree of information and the population opinion regarding the vaccination process. The paper aims to evaluate both the reasons of decreasing the vaccination degree and the sources of wrong information on this topic to better identify between mistakes and correct knowledge.Vaccines are biological products prepared following specifical tehcniques to improve the body's immunity against particula, given conditions. The lives of millions of children from 188 countries who received different vaccines (diptero-tetanus-pertussis, measles, polio) were saved in the world along the time (WHO, 2017). In Romania, the antidifteric vaccination introduced in 1960 made disappear the disease in 1990. No case of diphtheria has been confirmed so far.Unfortunately, in 2016, the vaccine coverage has fallen below 90% (CNSCBT, 2017) because of either parents' refusal and the failure in attending a family doctor.Therefore, today, the society is facing a serious situation caused by: a) insufficient and erroneous information of parents expressing their opposition to vaccination and b) manipulation of organizations against vaccination.

Health has always been the most valuable and beautiful gift that Nature offered to humans. Unfortunately, nowadays, people value and desire more wealth than health; often they remain indifferent to the degradation of their own health. Only in front of serious diagnoses people start appreciating their true wealth – the health. The allopathic medicine has no giants’ power, as it sometimes treats symptoms and diseases instead of illnesses’ fundamental causes.Education, the other field revealing the horizon of knowledge, provides creative alternatives for spending revenues in favour of healthy individuals and societal robust development. The purpose almost remains the same: use both complex potentials and opportunities to increase motivation, accomplish joy of life and fulfil desires to build wellbeing. The link between Health and Education has complex links and hidden mechanisms waiting for to be explored and used in favour of all.

Human-made GHGs work against us when they trap too much sunlight and block outward radiation. Scientists worry that the accumulation of these gases in the atmosphere has changed and will continue to change the climate. Potential climate risks include more severe weather patterns; hobbled ecosystems, with less biodiversity; changes in patterns of drought and flood, with less potable water; inundation of coastal areas from rising sea levels; and a greater spread of infectious diseases such as malaria, yellow fever, and cholera. On the plus side, climate change might benefit agriculture and forestry in certain locations by increasing productivity as a result of longer growing seasons and increased fertilization. Although climate change is not the same as day-to-day or even year-to-year fluctuations in the weather, the nature of these fluctuations could be altered by climate change.

PurposeNegative surgical margins status is of extreme importance for better prognosis and lower recurrence rate in patients undergoing surgical treatment for oral squamous cell carcinoma (OSCC). Standard histopathology is time consuming and current optical procedures come with various limitations. We examined the potential of a new imaging technique-opto-magnetic imaging spectroscopy (OMIS) in discriminating tumor (OSCC) from adjacent non-tumor oral cavity tissue.MethodsA total of 46 samples from 21 patients were included in this study. Samples were taken from a fresh surgical specimen of primary OSCC. Digital imaging of samples was performed within 60 min of resection using OMIS device. Images were processed through a specifically designed convolution algorithm based on light-matter interaction. As a result a convolution spectrum was generated. Predictive value of spectral data was assessed using correlation tests and Naive Bayes classification model.ResultsThere was no significant correlation in distribution of characteristic peaks between tumor and non-tumor tissue (P>0.05). Tumor tissue showed more magnetic activity compared to non-tumor tissue. Naive Bayes classifier with kernel density estimation discriminated tumor from non-tumor tissue with the accuracy of 82.61%, 86.96% sensitivity, 78.26% specificity and the AUC value of 0.917.ConclusionOMIS seems to be a promising optical method for ex vivo characterization of OSCC and non-tumor tissue. Further investigation is necessary to determine how tissue type and level of pathological transformation impact OMIS results. Ultimately, this could aid surgeons in using this method as an in vivo indicator for surgical resection with safe margins.

The Health Gap documents the large and persistent health gaps that exist across and within relatively rich countries today. Marmot argues that in developed countries, poor health does not cause low incomes; rather, low socioeconomic status leads to poor health, but not because of proximate factors like differential health care access, which can explain only a small portion of these gaps. Therefore, to eliminate health gaps, policy should focus on the deep causes of disease: poverty, education, and occupational mobility, among others. While Marmot’s ethical arguments are quite compelling, his recommendations are too strong given the current evidence. Policies need to be based on a clearer understanding of why things work, when, and for whom. (JEL H51, I10, I13, I15, I18, I28)

The Health Gap documents the large and persistent health gaps that exist across and within relatively rich countries today. Marmot argues that in developed countries, poor health does not cause low incomes; rather, low socioeconomic status leads to poor health, but not because of proximate factors like differential health care access, which can explain only a small portion of these gaps. Therefore, to eliminate health gaps, policy should focus on the deep causes of disease: poverty, education, and occupational mobility, among others. While Marmot’s ethical arguments are quite compelling, his recommendations are too strong given the current evidence. Policies need to be based on a clearer understanding of why things work, when, and for whom. (JEL H51, I10, I13, I15, I18, I28)

We use an event study approach to examine the economic consequences of hospital admissions for adults in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance, hospital admissions increase out-of-pocket medical spending, unpaid medical bills and bankruptcy, and reduce earnings, income, access to credit and consumer borrowing. The earnings decline is substantial compared to the out-of-pocket spending increase, and is minimally insured prior to age-eligibility for Social Security Retirement Income. Relative to the insured non-elderly, the uninsured non-elderly experience much larger increases in unpaid medical bills and bankruptcy rates following a hospital admission. Hospital admissions trigger less than 5 percent of all bankruptcies.

OBJECTIVE: The objective is to systematically review the literature on economic evaluations of screening interventions for early diagnosis of dementia disorders. METHODS: A systematic search of published economic evaluation studies in English was conducted using specified key words in relevant databased and websites. Data extracted included methods and empirical evidence (costs, effects, incremental cost-effectiveness ratio) and we assessed if the conclusions made in terms of cost-effectiveness were supported by the reported evidence. The included studies were also assessed for reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. RESULTS: Fourteen studies were identified and broadly fell into two groups: screening without biomarkers and screening using biomarkers. There was a considerable heterogeneity in methodological approaches, target populations, study time frames, and perspectives as well as types of biomarkers used. The sensitivity and specificity of screening instruments are one of the important aspects in estimating the cost-effectiveness of the interventions. Cost-effectiveness of non-biomarker based interventions cannot be judged due to lack of information. The biomarkers based screening have the potential to be cost-effective but their effectiveness has to be established first. CONCLUSION: More economic evaluations studies as well as good quality effectiveness studies are required in screening strategies before these can be implemented in the clinical practice.

We consider a Paired Kidney Exchange (PKE) model in which patients’ preferences are restricted so that patients prefer kidneys from compatible younger donors to kidneys from older ones. We propose a family of rules, sequential priority rules, that only allow for pairwise exchanges and satisfy individual rationality, efficiency, strategy-proofness, and non-bossiness. These rules allocate kidneys according to a priority algorithm that gives priority to patients with younger donors and assign kidneys from younger donors first. We extend the analysis to rules that allow multiple ways exchanges and to the case of patients who have more than one potential donor., Ministerio de Educación y Ciencia (MEC), Junta de Andalucía, Depto. de Análisis Económico y Economía Cuantitativa, Fac. de Ciencias Económicas y Empresariales, TRUE, pub

In this paper we assess properties of commonly used estimates of total effects of obesity on mortality and identify consequences of these properties for inferences. We argue that standard estimates have important shortcomings that at best limit the reach of inferences and at worst lead to misleading conclusions. Although some of these limitations are routinely acknowledged, rarely is their use accompanied by careful scrutiny of their weaknesses, let alone by a quantitative assessment of their sensitivity to violations of some stringent assumptions on which they are based. In this paper we develop an integrated framework based on a multistate hazard model to describe properties of the simpler standard estimates, identify conditions under which their performance is best, and define the nature of biases and interpretational ambiguities that emerge when empirical conditions depart more than modestly from optimal ones. In particular, we show formally that estimates from limited panel data and two-state hazard models with obesity as a covariate, the workhorse in this area, produce estimates that are difficult to interpret and compare across studies and, in some cases, biased. Finally, we propose a simple procedure that can be employed when the use of conventional two-state models is risky and illustrate its application to an a empirical case.

If two partners smoke, their quit behavior may be related through correlation in unobserved individual characteristics and through common shocks. However, there may also be a causal effect whereby the quit behavior of one partner is affected by the quit decision of the other partner. If so, there is a spousal peer effect on the decision to quit smoking. We use data containing retrospective information of Dutch partnered individuals about their age of onset of smoking and their age of quitting smoking. We estimate mixed proportional hazard models of starting rates and quit rates of smoking in which we allow unobserved heterogeneity to be correlated across partners. Using a timing of events approach, we determine whether the quitting-to-smoke decision of one partner has a causal effect on the quitting-to-smoke decision of the other partner. We find no evidence of substantial spousal peer effects in the decision to quit smoking. Apparently, love conquers all but nicotine addiction.

In this paper we assess properties of commonly used estimates of total effects of obesity on mortality and identify consequences of these properties for inferences. We argue that standard estimates have important shortcomings that at best limit the reach of inferences and at worst lead to misleading conclusions. Although some of these limitations are routinely acknowledged, rarely is their use accompanied by careful scrutiny of their weaknesses, let alone by a quantitative assessment of their sensitivity to violations of some stringent assumptions on which they are based. In this paper we develop an integrated framework based on a multistate hazard model to describe properties of the simpler standard estimates, identify conditions under which their performance is best, and define the nature of biases and interpretational ambiguities that emerge when empirical conditions depart more than modestly from optimal ones. In particular, we show formally that estimates from limited panel data and two-state hazard models with obesity as a covariate, the workhorse in this area, produce estimates that are difficult to interpret and compare across studies and, in some cases, biased. Finally, we propose a simple procedure that can be employed when the use of conventional two-state models is risky and illustrate its application to an a empirical case.

Este estudio utiliza datos de dos encuestas de individuos en Estados Unidos, el Panel Study of Income Dynamics (PSID) y el Medical Expenses Panel Survey (MEPS), para analizar posibles diferencias en el estado de salud entre las personas casadas y las solteras, ambas en edad de trabajar. Cuando se comparan individuos con la misma edad, renta, educación, sexo y raza, se encuentra que las personas casadas declaran un estado de salud superior al de las solteras. Esta diferencia es aproximadamente de 5 puntos porcentuales en edades de 35-40 años y aumenta hasta 10 puntos porcentuales en edades de 55-59 años. El mejor estado de salud entre los casados es similar para hombres y mujeres. Por otra parte, una vez se mantienen constantes las diferencias no observadas en la salud innata (modelizadas como una variable latente que varía con la edad, y que está potencialmente correlacionada entre periodos y con la probabilidad de estar casado) encontramos que el efecto positivo del matrimonio sobre la salud desaparece entre los jóvenes (hasta 40 años), mientras que se sitúa alrededor de 5 puntos porcentuales en edades más avanzadas (entre los 55 y 59 años). Estos resultados indican que los diferenciales observados se deben principalmente a un sesgo de selección a edades tempranas, pero que puede haber un efecto protector del matrimonio a edades avanzadas. Explorando los mecanismos existentes detrás de este resultado, encontramos que una mejor salud innata se asocia con una mayor probabilidad de estar casado y una menor probabilidad de divorciarse, y que existe un fuerte emparejamiento selectivo de las parejas según su salud innata. También encontramos que las personas casadas tienen una mayor probabilidad de seguir comportamientos saludables que las solteras. Finalmente, encontramos que la tenencia de un seguro médico es una variable muy importante a la hora de explicar el efecto beneficioso del matrimonio sobre la salud, Using data from the Panel Study of Income Dynamics (PSID) and the Medical Expenditure Panel Survey (MEPS), we analyze the health gap between married and unmarried individuals of working-age. Controlling for observables, we find a gap that peaks at 10 percentage points at ages 55-59 years. The marriage health gap is similar for men and women. If we allow for unobserved heterogeneity in innate health (permanent and age-dependent), potentially correlated with timing and likelihood of marriage, we find that the effect of marriage on health disappears below age 40 years, while about 5 percentage points difference between married and unmarried individuals remains at older ages (55-59 years). This indicates that the observed gap is mainly driven by selection into marriage at younger ages, but there might be a protective effect of marriage at older ages. Exploring the mechanisms behind this result, we find that better innate health is associated with a higher probability of marriage and a lower probability of divorce, and there is strong assortative mating among couples by innate health. We also find that married individuals are more likely to have a healthier behavior compared to unmarried ones. Finally, we find that health insurance is critical for the benefi cial effect of marriage

Nowadays, physical exercise and sports activities are regarded as the best means for people to keep fit and boost their health. In Vietnam, exercising on a daily basis is still underappreciated as twothirds of the population only exercise at trivial or low levels. Based on applying the baseline category logit model, we conduct an analysis to figure out the factors affecting people’s level of exercise. The findings show that males tend to engage in physical activities more than females, with the difference potentially being as high as 18.9%. In addition, females with a high educational background (university or higher) usually exercise less than those with lower education, perhaps due to their job’s attributes and their different routines. The opposite is the case in males, yet the differences for both genders are relatively small (only about 1%). The study also shows that those with higher BMI have higher activity levels. In particular, those with the highest BMI (BMI = 37.2) have a likelihood of regularly exercising as high as 74%. Furthermore, improved health communication systems and regular health check-ups at home are also associated with more frequent exercise and engagement in sport., info:eu-repo/semantics/published

This paper uses a propensity score matching approach to assess the impact of Ghana’s National Health Insurance Scheme (NHIS) on health utilization and health outcomes for children under five years old using a nationally representative Multiple Indicator Cluster Survey from 2011. The results show that even though health insurance is free for children, around half of them are not insured, with the probability of enrollment being significantly affected by many characteristics. Nationally, the insurance increases both health care utilization and the overall health status of children. Nevertheless, there are important discrepancies across regional results suggesting that the largest gains are found in the poorest regions, which correspond to those with the worse average health outcomes. However, some other regions present none or only very limited gains attributable to the insurance., info:eu-repo/semantics/published

Financial incentives are a common tool to encourage overcoming self-control problems and developing beneficial habits. There are different means by which such incentives can be provided, yet, up to date there is little empirical evidence on the relative effectiveness of different incentive designs. In this paper, we conduct a field experiment to explore whether and how incentives that are economically equivalent but framed differently affect the likelihood of exercising at a gym. We find that framing incentives in terms of losses, meaning individuals lose cash incentives by not exercising, encourages more frequent visits to the gym than framing incentives in terms of financial gains. After removing these incentives, we observe habit formation in gym exercise only if incentives were framed as losses rather than gains. The findings are consistent with the concept of loss aversion and suggest that cost reductions and performance improvements can be achieved if opting to frame incentives in terms of losses., info:eu-repo/semantics/published

This paper investigates whether self-rated health (SRH) covaries with individual hospital records. By linking the Danish Longitudinal Survey on Ageing with individual hospital records covering all hospital admissions from 1995 to 2006, I show that SRH is correlated to historical, current, and future hospital records. I use both measures separately to control for health in a regression of mortality on wealth. Using only historical and current hospitalization controls for health yields the common result that SRH is a stronger predictor of mortality than objective health measures. The addition of future hospitalizations as controls shows that the estimated gradient on wealth is similar to one in which SRH is the control. The results suggest that with a sufficiently long time series of individual records, objective health measures can predict mortality to the same extent as global self-rated measures.

At present, the global aging process of inhabitants represents a serious social challenge that is related to those countries whose size or economic power is not that significant aspect. Rapid increase of older population results in an increasing inquiry of long-term health care services (long-term care – LTC). As a result of a progress in research as well as investments in health care services, health care constantly improves, but there are increasing inequalities in health of vulnerable groups of inhabitants, such as elderly. The given article focuses on the above mentioned facts and its primary aim is to emphasize the importance of multi-dimensional analyses of available social services in the process of population global aging. In the presented partial results, the research focused on the analysis of social services providers in Slovakia from the point of view of their form, structure, capacity and regional differences. The secondary aim of the article is concentrated on an urgent need to resolve the issue of the Slovak population aging by means of chosen demographic indicators, as well as it focuses on a significance of legal framework formation that would provide long-term health care in Slovakia via social and health care services development.

Background: General health examinations (GHE) have become an increasingly common measure for preventive medicine in Vietnam. However there has still been a lack of understanding about what make Vietnamese (not)attend GHE. The effects of budget or time constraints remain to evaluated. Better-informed policy making needs these inputs. Aim & Objectives: This study aims to investigate factors that may affect Vietnamese behaviors with respect to periodic GHE. Main objectives are to: i) explore empirical relationships between influencing factors and periodic GHE frequencies; and, ii) predict the probabilities of attending GHE and associated conditions.Materials and Methods: The study uses a 2,068-observation categorical dataset obtained from a Vietnamese survey in 2016Q4. The analysis is then performed using the methods of baseline-category logits for establishing relationships between predictor and response variables. Results: There exist relationships among: (i) GHE expenditure and time consumption; (ii) health priority and sensitivity to health data; (iii) insurance status, and (iv) the frequency of GHE, with most p’s< 0.01. The general trend shows that psychological factors tend to increase the probability of attending GHE, while costs and time consumption diminish it. Conclusion: (a) People tend to attend GHE if they have resources and a priority for health, with a 72.7% probability; (b) Expenditure and time consumption obstacles reduce the probability of periodic GHE; (c) Setting a health priority and having habit of consuming health data tend to increase the probability of attending periodic GHE; (d) Health insurance should play a positive role in promoting GHE., info:eu-repo/semantics/published

There is an increasing body of evidence that the intensity in which alcohol is drunk is of greater concern than the frequency or overall quantity consumed. This paper provides an extensive analysis of the demand for alcohol as measured by total quantity, frequency, and intensity. A unique large sample of cross-sectional data from Sweden 2004–2011 allows reduced-form alcohol demand equations to be estimated for beer, wine, and spirits, split by alcohol drinking pattern (average vs. binge drinkers) and gender. Results find a negative beer excise rate effect for participation and frequency, and positive effect for intensity. The effect was stronger for binge drinkers. Generally, the results also show a positive socioeconomic (income and education) gradient in frequency demand and a negative gradient in the intensity demand. Female wine drinkers show a positive socioeconomic gradient in both frequency and intensity. The findings highlight the complexity of this policy space. Tax increases appear to reduce frequency but raise intensity consumed. The more educated and higher earners drink more in total, but less intensely when they do and this is likely to explain in part why poor health is concentrated amongst lower socioeconomic status individuals.

In this research, we use a survey dataset from 900 Vietnamese patients, of which 605 have health insurance, to establish empirical relations between medical expenditures, actual insurance coverage rate, residency status, socioeconomic status of patients and their perceived dis/satisfaction toward the health insurance services/values. The results show that actual insurance coverage and medical expenditures contribute to higher probabilities of satisfaction, but with coverage rate having much higher influence. In addition, threshold insurance coverage and expenditures are estimated, showing that perceptions are immensely heterogeneous regarding values of benefits, following which the poor and non-resident patients being those most efficient for the healthcare system to target and demonstrate positive policy changes. This group's threshold coverage is only 63.4%, a little above the current mean 58%. Finally, as the universal insurance and full coverage is impossible, Vietnamese health insurance policy should switch to support the most vulnerable, with more flexible health insurance and financing options as the current system has proved too rigid to be of value to the poor., info:eu-repo/semantics/published

Waiting time for elective surgery is a key problem in the current medical world. This paper aims to reproduce, by a Monte Carlo simulation model, the relationship between hospital capacity, inpatient activity, and surgery waiting list size in teaching hospitals. Inpatient activity is simulated by fitting a Normal distribution to real inpatient activity data, and the effect of the number of beds on inpatient activity is modelled with a linear regression model. Analysis is performed with data of the University Multi-Hospital Complex of Santiago de Compostela (Santiago de Compostela, Spain), by considering two scenarios regarding the elastiticity of demand with bed increase. If demand does not grow with an increase on bed capacity, small changes lead to drastic reductions in the waiting lists. However, if demand grows as bed capacity does, adding additional capacity merely makes waiting lists worse.