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Hungarian A poszttraumás stressz szindróma (PTSD) az egyik olyan pszichiátriai betegség, ami az egészségügyi ellátó rendszer szélesebb körű használatához vezethet, azonban kevés ismerettel rendelkezünk arról, hogy milyen betegségteher vizsgálatok állnak rendelkezésre ehhez kapcsolódóan. Magyarországi költségelemzést eddig nem publikáltak a PTSD betegségterhével kapcsolatosan és nemzetközi szinten is kevés, módszertanilag rendkívül heterogén szakirodalom áll csak rendelkezésre. A tanulmány célja, hogy betöltse ezt az űrt és szisztematikusan áttekintse a PTSD betegségterhével foglalkozó szakirodalmat. Kutatásom során Medline-keresést végeztem 2022. augusztusig bezárólag, mely során a beválogatási kritériumok a következők voltak: (1) eredeti közlemények, (2) angol nyelvű absztrakttal, melyek (3) költségelemzést jelentettek PTSD-ben. Az így kiválasztott 15 tanulmány közül mindegyikben részletesen tárgyalták a direkt egészségügyi költségeket, két tanulmányban elemezték a direkt nem egészségügyi költségeket is, ideértve az informális ellátás költségeit, két további cikk az indirekt költségeket is vizsgálta. A tanulmányok széles skálán mutattak ki költségkülönbségeket: az egy betegre jutó éves direkt egészségügyi kiadások Ausztráliában 4 461 és 43 362 EUR között mozogtak, az Egyesült Államokban 2 442 és 35 967 EUR között, míg Európában 217 és 36 204 EUR között változtak. Szintén jelentős eltéréseket tapasztaltak a direkt nem egészségügyi költségek terén, ahol az összegek 98 és 9 372 EUR között mozogtak. Az indirekt költségek tekintetében a legalacsonyabb összeg 2 918 EUR, míg a legmagasabb 11 061 EUR volt. A tanulmányokból továbbá kiderült, hogy a gépjármű balesetet és a bántalmazást követő PTSD-ben figyelték meg a legmagasabb költségeket, de a betegség súlyossága is szignifikánsan növeli a keletkező költségeket volumenét. English Post-traumatic stress disorder (PTSD) is a psychiatric condition associated with increased utilization of healthcare services. Despite its significance, there is a paucity of comprehensive studies addressing the burden of illness related to PTSD, and the existing literature displays considerable methodological heterogeneity. Notably, there has been no published cost analysis of the disease burden of PTSD in Hungary, and international literature on the topic remains limited. This study aims to address this gap by systematically reviewing the literature on the burden of PTSD. A systematic search of the Medline database was conducted up to August 2022, employing the following inclusion criteria: (1) original publications, (2) English-language abstracts, and (3) studies reporting cost analyses of PTSD. Fifteen studies meeting these criteria were selected for review. All of these studies provided detailed discussions of direct healthcare costs, while two studies additionally analyzed direct non-healthcare costs, including informal care costs. Moreover, two articles examined indirect costs. The analysis revealed a broad range of cost estimates. In Australia, annual direct healthcare expenditure per patient ranged from €4,461 to €43,362. In the United States, costs varied from €2,442 to €35,967, and in Europe, from €217 to €36,204. Direct non-healthcare costs exhibited significant variability, ranging from €98 to €9,372. Indirect costs were reported to range from €2,918 to €11,061. The studies indicated that the highest costs were associated with PTSD resulting from motor vehicle accidents and abuse. Additionally, the severity of the illness was found to significantly elevate the total costs incurred.

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

This article examines the relationship between parental provision of alcohol and teenage risky behavior. The study analyzes data from the Youth Risk Behavior Surveillance System and state laws regarding parental provision of alcohol. The results suggest that parental exemption laws, which allow parents to provide alcohol to their underage children, are associated with a slight increase in teenage alcohol use and binge drinking. However, these laws are also associated with later sexual initiation and fewer sexual partners. The findings suggest that while parental provision exemptions may delay teenage drinking, they may not reduce risky behavior once teenagers begin drinking. [Extracted from the article]

This paper examines the labour market and health effects of a non-contributory long-term unemployment (LTU) benefit targeted at middle-aged disadvantaged workers. To do so, we exploit a Spanish reform introduced in July 2012 that increased the age eligibility threshold to receive the benefit from 52 to 55. Our results show that men who were eligible for the benefit experience a reduction in injury hospitalisations by 12.9% as well as a 2 percentage points drop in the probability of a mental health diagnosis. None of the results are significant for women. We document two factors that explain the gender differences: the labour market impact of the reform is stronger for men, and eligible men are concentrated in more physically demanding sectors, like construction. Importantly, we also find evidence of a program substitution effect between LTU and partial disability benefits. Our results highlight the role of long-term unemployment benefits as a protecting device for the (physical and mental) health of middle-aged, low-educated workers who are in a disadvantaged position in the labour market. [ABSTRACT FROM AUTHOR]

India has not only maintained its top position among countries with the largest number of underweight adults but has also jumped to a higher position among countries with largest increase in the proportion of overweight people in the last three decades. More studies focus on double burden of malnutrition among women than on men. This study uses the quantile regression model to analyse the covariates associated with low and high body mass index (BMI) primarily among men aged 20–54 years during 2015–2016 in India. Occupations that involve more manual work help in maintaining a normal BMI along with better education, dietary diversity, and less sedentary lifestyle. A gendered comparison of men and their spouses highlights the differences in the association of covariates with BMI for men and women. The results from this study will provide insights for behavioural change at an individual level and inputs for public health intervention for addressing ill health concerns arising from underweight, overweight, or obesity. [ABSTRACT FROM AUTHOR]

School-based mental health services (SBMH) may increase students' access to care, which could yield benefits for mental health status and human capital-related outcomes. We use a difference-in-differences design with 19 years of survey and administrative data to estimate the impacts of SBMH on a range of K–12 student outcomes. SBMH increases average outpatient mental health service use and reduces self-reported suicide attempts. There is weaker evidence that SBMH reduces suspensions and juvenile justice involvement and no evidence that SBMH affects average attendance, standardized test scores, or self-reported substance use. [ABSTRACT FROM AUTHOR]

We study how the societal disruptions of the COVID-19 pandemic impacted diagnosis of a prevalent childhood mental health condition, attention deficit hyperactivity disorder (ADHD). Using both nationwide private health insurance claims and a single state's comprehensive electronic health records, we compare children exposed to the pandemic to same-aged children prior to the pandemic. We find the pandemic reduced new ADHD diagnoses by 8.6 percent among boys and 11.0 percent among girls nationwide through February 2021. We further show that higher levels of in-person schooling in fall 2020 dampened the decline for girls but had no moderating effect for boys. [ABSTRACT FROM AUTHOR]

Objective: To assess the psychometric properties of the EuroQol-5-Dimension five-level instrument (EQ-5D-5L) proxy in caregivers of children and adolescents with Duchenne muscular dystrophy (DMD) or spinal muscular atrophy (SMA). Method: Data were collected using the EQ-5D-5L proxy for individuals with DMD or SMA, as reported by their caregivers. Ceiling and floor effects, reliability (Cronbach's alpha), convergent and divergent validity (Spearman's correlation coefficient and Bland–Altman plot) and known-group validity (analysis of variance) was used to assess the instrument's psychometric properties. Results: Totally, 855 caregivers completed the questionnaire. Significant floor effects were observed for most dimensions of the EQ-5D-5L in both SMA and DMD samples. The EQ-5D-5L was strongly correlated with the hypothesized subscales of the SF-12, which confirmed satisfactory convergent and divergent validity. The EQ-5D-5L can significantly differentiate between impaired functional groups for individuals, demonstrating satisfactory discriminative ability. The agreement between the EQ-5D-5L utility and EQ-VAS scores was poor. Conclusions: Based on the measurement properties assessed in this study, the EQ-5D-5L proxy is a valid and reliable tool for measuring the health-related quality of life of individuals with DMD or SMA rated by caregivers. Further studies should examine the content validity of the EQ-5D as well as the performance of its young version in these two patient groups. [ABSTRACT FROM AUTHOR]

Despite the increasing attention on energy poverty due to its health implications, the South African story is yet to be told, while pathways of influence have received little empirical investigation in the extant literature. This study examines how energy poverty affects mental distress in post-apartheid South Africa and explores gender and locational heterogeneities in outcomes as well as potential pathways. We use five years of longitudinal data extracted from the National Income Dynamics Survey (NIDS). We employ the Lewbel instrumental variable method to resolve endogeneity and apply causal mediation analysis to identify potential channels of effect. The findings suggest that energy poverty is associated with an increase in mental distress. This outcome is consistent across different estimation methods and conceptualisations of energy poverty. The deteriorating effect of energy poverty on mental distress is more pronounced among females and rural residents. We further establish that experiences of persistent cough and chest pains/tightness serve as potential pathways in the link between energy poverty and mental distress. We encourage the South African government to increase budgetary allocations to the free basic electricity policy and provide connection subsidies to poor households, which have the potential to alleviate energy poverty and reduce mental distress as a result.

One of the most recent global aims is to increase life expectancy since healthy people are seen as human capital that may boost the economy. The study investigates the role of governance in the globalisation-life expectancy nexus using 39 African countries between 1996 and 2019.

Digital technologies have significantly changed the way adolescents perceive the world around them. The perception of the social environment is crucial for their well-being and health.

Aims: To describe healthcare costs of patients with metastatic castration-resistant prostate cancer (mCRPC) initiating first-line (1 L) therapies from a US payer perspective. Methods: Patients initiating a Flatiron oncologist-defined 1 L mCRPC therapy (index date) on or after mCRPC diagnosis were identified from linked electronic medical records/claims data from the Flatiron Metastatic Prostate Cancer (PC) Core Registry and Komodo's Healthcare Map. Patients were excluded if they initiated a clinical trial drug in 1 L, had <12 months of insurance eligibility prior to index, or no claims in Komodo's Healthcare Map for the Flatiron oncologist-defined index therapy. All-cause and PC-related total costs per-patient-per-month (PPPM), including costs for services and procedures from medical claims (i.e. medical costs) and costs from pharmacy claims (i.e. pharmacy costs), were described in the 12-month baseline period before 1 L therapy initiation (including the baseline pre- and post- mCRPC progression periods) and during 1 L therapy (follow-up). Results: Among 459 patients with mCRPC (mean age 70 years, 57% White, 16% Black, 45% commercially-insured, 43% Medicare Advantage-insured, and 12% Medicaid-insured), average baseline all-cause total costs (PPPM) were $4,576 ($4,166 pre-mCRPC progression, $8,278 post-mCRPC progression). Average baseline PC-related total costs were $2,935 ($2,537 pre-mCRPC progression, $6,661 post-mCRPC progression). During an average 1 L duration of 8.5 months, mean total costs were $13,746 (all-cause) and $12,061 (PC-related) PPPM. The cost increase following 1 L therapy initiation was driven by higher PC-related outpatient and pharmacy costs. PC-related medical costs PPPM increased from $1,504 during baseline to $5,585 following 1 L mCRPC therapy initiation. Limitations: All analyses were descriptive; statistical testing was not performed. Conclusion: Incremental costs of progression to mCRPC are significant, with the majority of costs driven by higher PC-related costs. Using contemporary data, this study highlights the importance of utilizing effective therapies that slow progression and reduce healthcare resource demands despite the initial investment in treatment costs. PLAIN LANGUAGE SUMMARY: Prostate cancer is one of the most common causes of cancer death in men. While outcomes are good if treated early, some patients may develop advanced disease that is more difficult and costly to treat. The most advanced form is late-stage hormone-resistant prostate cancer. Previous studies found that healthcare costs and use of medical services increase when prostate cancer advances to this stage. New medications are available, but their costs are not well known. Our study reviewed clinical information and health insurance data to estimate the healthcare costs and medical services used by 459 men who received drug treatment for late-stage hormone-resistant prostate cancer between 2017 and 2021 in the United States. In the year before a diagnosis and the start of drug treatment for late-stage hormone-resistant prostate cancer, total healthcare costs per month were approximately $4,000. After diagnosis of but before drug treatment for late-stage hormone-resistant prostate cancer, monthly healthcare costs nearly doubled, to approximately $8,000. Most of the additional $4,000 were specifically related to prostate cancer. After the start of the first drug treatment, total healthcare costs increased to approximately $13,500 every month. Most of the costs were related to medical office/clinic visits and medications. As their disease progressed, men received additional therapies, and office/clinic visits and use of chemotherapy also increased. These results emphasize the high healthcare costs and large number of medical services used by men with late-stage hormone-resistant prostate cancer. Therapies that slow progression to advanced prostate cancer may help to reduce high healthcare costs. [ABSTRACT FROM AUTHOR]

This study ai ms to verify and analyze the existence of cognitive dissonance in the self-assessment of health by individuals in Brazil, that is, the difference between self-rated health and the health status of individuals. To accomplish this, we use data from the 2013 National Health Survey, which collected the self-assessments that individuals made of their health and information about their health status. This information was used to build indices that seek to represent a person's health status in relation to chronic illnesses, physical and mental well-being, eating habits and lifestyle. To identify the presence of cognitive dissonance, the CUB (Combination of a discrete Uniform and shifted Binomial distributions) model was used, which relates self-assessed health with the developed indices. Cognitive dissonance was identified in self-assessed health in relation to eating habits and lifestyle, and this dissonance may be associated with a present bias in the self-assessment of health in Brazil. [ABSTRACT FROM AUTHOR]

Purpose: The present study investigates the nexus between health performance dynamics and economic growth in 43 countries in sub-Saharan Africa for the period 2004–2018. Design/methodology/approach: Four health performance dynamics are used, notably: total life expectancy, male life expectancy, female life expectancy and risk of maternal death. The empirical evidence is based on quantile regressions (QRs) in order to put into perspective the conditional distribution of economic growth. Findings: The following findings are established: (1) total life expectancy and male life expectancy increase economic growth exclusively in the 10th and 90th quantiles of economic growth; (2) female life expectancy boosts economic growth in the 90th quantile of economic growth and (3) the risk of maternal death reduces economic growth in the 75th and 90th quantiles of economic growth. Policy implications are discussed. Originality/value: The study complements the literature on the nexus between health performance and economic growth by assessing the nexuses throughout the conditional distribution of economic growth. [ABSTRACT FROM AUTHOR]

The areas most affected by the opioid crisis have witnessed deteriorating economic conditions, although it is unclear if this represents a causal relationship. I provide new evidence on this question by leveraging a natural experiment that sharply decreased the supply of hydrocodone, the most commonly prescribed opioid in the United States, relative to other opioids. Areas with larger reductions in hydrocodone prescribing experienced relative improvements in labor force participation and employment. However, these areas also witnessed higher growth in drug-related arrests. I find some evidence of reductions in illicit opioid deaths, which are offset by increases in other drug-related deaths. [ABSTRACT FROM AUTHOR]

Background and objective: Population-based estimates of the socioeconomic burden of multiple sclerosis (MS) are limited, especially regarding primary healthcare. This study aimed to estimate the excess costs of people with MS that could be attributed to their MS, including primary healthcare. Methods: An observational study was conducted of the 2806 working-aged people with MS in Stockholm, Sweden and 28,060 propensity score matched references without MS. Register-based resource use was quantified for 2018. Annual healthcare costs (primary, specialised outpatient, and inpatient healthcare visits along with prescribed drugs) and productivity losses (operationalised by sickness absence and disability pension days) were quantified using bottom-up costing. The costs of people with MS were compared with those of the references using independent t-tests with bootstrapped 95% confidence intervals (CIs) to isolate the excess costs of MS from the mean difference. Results: The mean annual excess costs of MS for healthcare were €7381 (95% CI 6991–7816) per person with MS with disease-modifying therapies as the largest component (€4262, 95% CI 4026–4497). There was a mean annual excess cost for primary healthcare of €695 (95% CI 585–832) per person with MS, comprising 9.4% of the excess healthcare costs of MS. The mean annual excess costs of MS for productivity losses were €13,173 (95% CI 12,325–14,019) per person with MS, predominately from disability pension (79.3%). Conclusions: The socioeconomic burden of MS in Sweden from healthcare consumption and productivity losses was quantified, updating knowledge on the cost structure of the substantial excess costs of MS. [ABSTRACT FROM AUTHOR]