Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ECONOMICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed2006

Economic modeling in chronic obstructive pulmonary disease.

Calculating the cost-effectiveness of interventions is an important step in accurately assessing the health and financial burdens of a disease. Although clinical trials that include cost data can be used to compare the cost-effectiveness of specific interventions, they only deal with outcomes within the time frame of the trial. Health economic models can synthesize epidemiologic, clinical, economic, and quality-of-life data from many different sources and extrapolate results to a point many years in the future. The models generally compare interventions with respect to the costs per life-year gained or per quality-adjusted life-year gained. The use of health economic models to assess the economic burden of chronic obstructive pulmonary disease (COPD) and the value of interventions is growing, and will continue to do so as the burden of the disease is better appreciated. Several COPD disease-state models have been described; each uses a consistent definition of COPD severity that is based on FEV(1)% predicted, but the models differ in the allowed transitions, disease progression estimates, utility weights, and costs. This article reviews COPD health economic models and discusses the importance of survival benefits and utilities (health state valuations) for COPD in economic models.

Cost of Illness↗
PubMed1991

The health effects of economic insecurity.

BACKGROUND: Interest in the health and behavioral effects of economic insecurity appears to vary with the performance of the economy. The current recession in the United States and Western Europe and growing unemployment in Eastern Europe make it timely to analytically review the recent research concerned with the health effects of economic contraction. METHODS: The research concerned with the health and behavioral effects of economic insecurity is organized by dependent variable and method. Rules for determining which effects are supported by strong and which by weak evidence are developed and applied to the literature. RESULTS: Evidence for effects on symptoms of psychological distress, seeking help for psychological distress, and nonspecific physiological illness is strong. Evidence for effects on suicide, child abuse, adverse birth outcomes, and heart disease is characterized as weak or sufficiently controversial to warrant skepticism. CONCLUSIONS: The health effects of economic security are undoubtedly mediated by economic policies. Estimating the effect of policy alternatives on the incidence of various outcomes is, however, very difficult given the current state of the research. The effect of rising unemployment on health in Eastern Europe cannot, moreover, be estimated from existing research. Effects estimated from Western economies probably do not generalize to situations in which the meaning of economic insecurity is conditioned by profound social and political reforms.

Adult↗
PubMed2000

The effect of economic sanctions on the mortality of Iraqi children prior to the 1991 Persian Gulf War.

OBJECTIVES: This study examined the effect of sanctions on mortality among Iraqi children. METHODS: The effects of economic sanctions on health are not well known. Past studies on the effect of economic sanctions on mortality have suffered from unreliable data sources and the collinearity of sanctions with other negative economic events. We overcame these weaknesses by using individual child records from a retrospective survey of mothers conducted after the 1991 Persian Gulf War to examine the effect of sanctions on mortality among Iraqi children. Multivariate proportional hazards analysis was used to assess the effect of economic sanctions prior to war (from August through December 1990). RESULTS: We found that after controlling for child and maternal characteristics, when economic sanctions were entered into the proportional hazards equation, the risk of dying increased dramatically. This increase was highly significant statistically. CONCLUSIONS: Innovative application of robust epidemiologic research tools can contribute to assessments of health and well-being even under the methodological and practical constraints of comprehensive economic sanctions, but more research is needed.

Child↗
PubMed1994

The emerging government requirement for economic evaluation of pharmaceuticals.

With the advent of government guidelines for the provision of cost-effectiveness data, economic evidence has been elevated to a status similar to that of evidence of efficacy and safety, which is required before licensing of pharmaceutical products. Whilst the precise nature of government requirements is likely to vary from place to place, they pose a number of practical problems for pharmaceutical companies, in the funding of studies and in the need to modify the clinical trials programme to facilitate economic data collection. Economic evaluation requirements have been viewed by various parties as a basis for pricing and reimbursement, as a form of cost containment and as a way of securing more value for money in the healthcare system. It is unlikely that economic evidence could ever form the sole basis for setting price, since both industry and government often seek to introduce other factors into the price negotiations. Requirements for economic evidence may also be an inefficient form of cost containment, compared with other methods such as budgetary caps. These offer some potential as a way of securing more value for money, but they should be applied equally across all health technologies. In the future there needs to be much more clarity of purpose in government guidelines, and methodological standards for economic analysis need to be refined.

Clinical Trials as Topic↗
PubMed1994

Economic incentives and disincentives for efficient prescribing.

Efficient prescribing is a controversial concept when defined in economic terms. Such terms imply that neither the best nor the cheapest drug may be efficient. Efficiency depends on patient evaluations of outcomes--an essential, yet still underdeveloped, field of inquiry. Encouraging prescribing efficiency (once it is clear what efficient treatments are) may require the use of incentives, (economic and otherwise). Although physicians do react to economic incentives, encouraging them to also act as good economists rather than only as good healthcare providers may be difficult since economic efficiency goals may conflict with pure medical goals. While it is conceptually reasonable to assume that economic incentives will accomplish behavioural change, other (noneconomic) incentive mechanisms may appear less controversial. Since it is the result, not the process, that is important, a mix of incentives to achieve efficient solutions is suggested. However, further investigation into both health and economic outcomes research and debate on proper efficiency goals should precede the discussion of optimal incentives.

Cost-Benefit Analysis↗
PubMed1997

The Danish approach to standards for economic evaluation methodologies.

Standards for economic evaluation have now been proposed in several countries. The background for this article is a report commissioned in 1994 by the Danish health authorities (the National Board of Health and the Danish Ministry of Health) on the state of the art of economic evaluation: are the methods ready to be used for systematic decision-making in the Danish healthcare sector? The themes of this article are the attitude towards economic evaluation of medical technologies and healthcare services in Denmark, the areas for application and the desirability and feasibility of a standard set of methods for conducting economic evaluations. In addition, the current state of methodologies in economic evaluation is briefly outlined. On the background of a roundtable discussion of interested parties, the Danish health authorities have decided to introduce economic evaluation of new pharmaceutical products, on a voluntary basis for 2 to 3 years, when application has been made for public reimbursement.

Denmark↗
PubMed2004

A bioeconomic approach to derive economic values for pasture-based sheep genetic improvement programs.

Economic values for a range of different maternal and carcass sheep performance traits were derived for hill sheep in the United Kingdom. A bioeconomic model that includes estimates of available energy supply and herbage intake for sheep from hill and mountain pastures, together with that from improved grassland, has provided a base from which to define the economic limitations to genetic improvement in harsh environments. The degree to which different farm systems can accommodate changes in animal performance as a result of genetic improvement was explored. Results showed that genetic improvement in harsh environments is likely to be of greater benefit to farms with fewer constraints to improvements in production, such as better quality pasture or a higher ratio of improved grassland to hill pasture. For farm types in the harshest locations, the economic value of improving litter size was only positive within defined production limits. Increasing litter size beyond these limits resulted in diminishing marginal returns because the costs of additional inputs outweighed the benefits of extra returns. Results also showed that relative improvements in maternal characteristics are at least as economically important as improvements in lamb carcass quality. The effects of variation in market prices on economic values for the major costs and returns of the sheep enterprises showed that, in general, economic values are robust. The methodology described could be adapted and applied to other extensive sheep systems worldwide.

Animal Feed↗
PubMed1999

Medical causes of female sickness absence during economic transition in Poland.

The current transformation of property relations and economic restructuring, along with many other factors, influence the health condition of workers. The present study was undertaken to investigate the trends in the rate and causes of female sickness absence during the period of economic transition in Poland, based on the absence analysis in one of the largest (before the process of restructuring) plants of the motor car industry. Vital for the current trends in the workers' absenteeism is the reduction in the rate of employment. The group investigated was composed of 3215 women and 5373 men employed during the years 1989-94. The main variable examined was the reason for the worker's discharge: (1) quitting the job because of health problems, (2) retirement, (3) termination of work contract due to economic problems of the plant, (4) change of affiliation agreed between the former and present employers. The structural transformations in the plant under study brought about the discharge of about 77% of workers during the period between 1989 and 1994, mostly owing to the termination of work contracts for economic reasons, and earlier retirement. The increase in the rate of sickness absence involved to a higher extent female workers; it amounted to 30% compared to 12% for male workers. Among the workers quitting employment, the rate of sickness absence was twice as high as that for the workers still under employment. The largest differences were noted for the female population; they concerned cardiovascular diseases, neoplasms and complications of pregnancy, delivery and the puerperium. The economic transformation processes make a considerable impact on the occurrence of sick absenteeism in workplaces. Workers leaving their jobs because of health problems, as well as those discharged for economic reasons belong to the highest risk group.

Absenteeism↗
PubMed2000

An economic approach to animal models of alcoholism.

Researchers have long sought an animal model for human alcohol consumption. This article describes an economic-based approach to a model of alcohol preference in rats. The procedures are based on an analogy between clinical accounts of human drinking and the economic analysis of consumption. Both clinical and economic investigators typically define consumption patterns in terms of the influence of negative consequences. For example, the clinical account emphasizes the persistence of heavy drinking despite mounting alcohol-related aversive consequences, and in economic analyses, the term "inelastic demand" is used to refer to the persistence of consumption despite large increases in prices. In the experimental procedure described here, rats worked for alcohol and food. Presses on one lever earned a drink of 10 percent alcohol plus saccharin, and presses on a second lever earned isocaloric drinks of a starch solution. After behavior stabilized, the response requirements (which are analogous to prices) for one or both drinks were increased. The rats maintained baseline alcohol consumption levels despite large increases in the "price" of alcohol. In contrast, the same price increases markedly reduced starch intake. That is, food consumption was sensitive to price hikes, but alcohol consumption was not. The results demonstrate that a common economic framework can be used to describe human and animal behavior and, hence, the possibility of an animal model of human alcohol consumption. The article also points out that economic concepts provide a framework for understanding a wide range of human drinking patterns, including controlled social drinking and excessive alcoholic drinking.

Alcoholic Beverages↗
PubMed2001

Towards ethical inquiry in the economic evaluation of nursing practice.

Economic evaluation is a critical tool for nursing and health care. The authors claim that economic inquiry needs to be supported by expertise in ethical inquiry, that the nursing profession needs to examine values concurrently with economics. Drawing on 2 ethnographic studies of nursing practice, the authors illustrate nurses' invisible work, their invisible triaging of clients, and the invisible costs to nurses and clients. They argue that invisible work, triage, and costs are embedded in a number of values, and that if nursing is to respond to the consequences of health reform, it must examine the values inherent in economic measurement and subsequent health-policy decisions; what is invisible may go "uncounted" unless economic evaluation is informed by ethical inquiry. The authors conclude by suggesting that economic and ethical inquiry be integrated in order to foster a system that is more humane as well as more effective and efficient for all those involved in health-care delivery.

Anthropology, Cultural↗
PubMed2005

[Models of economic evaluation of health and safety interventions at workplace].

Economic analyses and evaluation of the effect of workers' health on the national economy have begun to play a significant role in decision-making processes in terms of relations between health and safety in the work environment and the financial policy of enterprises. The economic dimension of consequences of occupational diseases and accidents at work is more frequently associated with the financial policy of enterprises understood as an element of costs involved. This gains particular significance when enterprises must maintain and improve economic effectiveness especially in the case of limited resources and permanent competition on the market. Therefore, the evaluation of economic interventions in the area of health and safety at workplace and its results are so important in the enterprise decision-making process. Several models of economic evaluation are used in assessing effectiveness of actions aimed at improving health and safety at workplace against a background of the overall economic situation of enterprises. The author presents the principles of six models, which have been used in the evaluation process. These models are based on information about costs of interventions/programs designed to reduce harmful effects of working conditions on workers' health and information concerning the results of individual ventures. They also take account of the influence of changes in working conditions on reduced sick absence, increased effectiveness of enterprises, production costs, and changes in productivity. The relationship between costs of intervention and its effects in financial terms based on cost-benefit analysis is the measure of effectiveness of health investments. The models presented show in practice a number of limitations, resulting mostly from the way the data are recorded in individual enterprises. Therefore, it is recommended that evaluation should be preceded by a precise definition of its aims, the range of the intervention and effects to be attained, which should provide the basis for defining the means and resources necessary for its implementation. This mainly applies to availability of data on costs and effects as well as to calculation methods, which can be used in view of collected numerical data.

Health Promotion↗
PubMed2006

Economic evaluations in pain management: principles and methods.

This paper describes how investigators may design, conduct, and report economic evaluations of pharmacotherapy for pain and symptom management. Because economic evaluation of therapeutic interventions is becoming increasingly important, there is a need for guidance on how economic evaluations can be optimally conducted. The steps required to conduct an economic evaluation are described to provide this guidance. Economic evaluations require two or more therapeutic interventions to be compared in relation to costs and effects. There are five types of economic evaluations, based on analysis of: (1) cost-effectiveness, (2) cost-utility, (3) cost-minimization, (4) cost-consequence, and (5) cost-benefit analyses. The six required steps are: identify the perspective of the study; identify the alternatives that will be compared; identify the relevant costs and effects; determine how to collect the cost and effect data; determine how to perform calculation for cost and effects data; and determine the manner in which to depict the results and draw comparisons.

Costs and Cost Analysis↗
PubMedDate not supplied

Perspectives in health economics.

This paper, originally presented at the Institute d'Etudes Politiques de Paris, October 12, 1993, provides a perspective on envisioned changes in the practice of health economics. Foreseen changes include: (1) Study of more homogeneous units of analysis; (2) More original data gathering; (3) Increased attention to uncertainty and the supply of and demand for information; (4) Increased attention to institutional structures and their effects on economic behaviour; (5) Expansion of relevant tools for studying economic issues in health care; and (6) Continuing breakdown of disciplinary barriers between health economics and other disciplines. Of these, the two overriding features will be increased emphasis on understanding the many roles of uncertainty in economic behaviour, institutions, and outcomes in health care, and in the use of more and more 'micro' data to study these issues.

Data Collection↗
PubMed1996

The economic determinants of Greek return migration to the islands of the East Aegean.

"The purpose of this article is to investigate the economic determinants of Greek return migration to the islands of the East Aegean, a region comprising hundreds of islands of different size in four administrative departments....[It] examines the sensitivity of return migration flows to changes in economic variables which influence decisions to return....The purpose...is to investigate the effect on return migration not only of economic development in the host country (push factors) but also of economic development in the islands of the East Aegean (pull factors), given their isolation from the mainland and their different economic structures." (SUMMARY IN SPA AND FRE)

Behavior↗
PubMed2002

Quality of systematic reviews of economic evaluations in health care.

CONTEXT: Reviews performed almost a decade ago showed considerable gaps in the quality of reporting and methods applied to economic evaluations of health care interventions. Measures taken by the research community to address the issue included the promulgation of guidelines and the publicizing of good practice in economic evaluation. METHODS: To assess the quality of methods of systematic reviews, economic evaluations in health care, and reporting methods, we conducted full-text searches of private and public databases for the period 1990 through March 2001 and corresponded with researchers active in the field. A total of 102 reports were identified, but only 39 were included. Quality of systematic reviews was assessed by a 6-item checklist. RESULTS: Quality of review methods was reasonable, but more attention needs to be paid to search methods and standardization of evaluation instruments. The reviews found consistent evidence of serious methodological flaws in a significant number of economic evaluations. Lack of clear descriptions of methods, lack of explanation and justification for the framework and approach used, and low-quality estimates of effectiveness for the interventions evaluated were the most frequent flaws. Modest improvements in quality of conducting and reporting economic evaluations appear to have taken place in the last decade. CONCLUSIONS: Proper allocation of resources on the basis of economic evaluations remains uncertain. Editorial teams and regulatory bodies should perform quality assurance based on a single widely accepted and validated standard instrument.

Cost-Benefit Analysis↗
PubMed1999

The appropriate uses of qualitative methods in health economics.

Ontology, epistemology and methodology are not subjects frequently discussed in health economics, yet they are of great relevance to the question of how, or whether, to use qualitative methods as a means of examining certain issues. The paper discusses the nature of enquiry in health economics and then details the nature of qualitative methods and the constructivist philosophy with which they are most commonly associated. The paper continues by examining different areas in the study of economics: neo-classical positive economics, alternative approaches to explanatory economics and normative welfare economics. For each area the philosophical approach is outlined as are the areas of research interest. Appropriate roles for qualitative methods within these philosophical approaches are then suggested. The paper concludes by warning that health economists should not use qualitative methods naively. They must be aware of the potential difficulties: both of inadvertently ending up outside the intended research philosophy and of conducting research which is accepted by neither economists nor qualitative researchers. If, however, health economists are aware of ontological, epistemological and methodological issues, they can make an informed decision about the appropriateness of qualitative methods in their research and thereby potentially enhance their ability to answer the questions in which they are interested.

Health Services Research↗
PubMed1975

The association of economic status with the occurrence of lung cancer.

Lung cancer in men was shown to be inversely associated with economic class by analysis of 1959-61 mortality rates from Buffalo, New York. Using five economis strata, white men below and above age 55 in the poorest group had rates 2.6 and 3.8 times higher than those in the richest. For women, the trend was not significant. The question that was investigated was whether, for males, an economic-class trend for smoking existed which paralleled that for lung cancer. Individuals from a Buffalo sample survey were classified according to cigarette smoking habits. Age was found highly associated with both smoking and economic class. In data from white males stratified for age, no significant association was observed between smoking and econimic class. In women, the upper economic groups smoked more, particularly those above age 55. Thus, a strong inverse economic class gradient for lung cancer in men, observed by other investigators among women, cannot be explained by class-related cigarette smoking patterns alone. The possible interaction of cigarette-smoking with other potential etiologic factors that may be associated with economic class is discussed.

Adult↗
PubMed1985

Survival of cancer patients by economic status in a free care setting.

Patients with lung, breast, and colorectal cancer were classified as to their economic status for comparison of survival. Patients at the City of Hope Medical Center are admitted and treated without regard to their economic status, providing an excellent place to test the effect of low economic status on survival. In none of these disease sites was an effect of low economic status observed, even when adjusting for age, sex, stage, smoking status, and alcohol usage. The only variable that consistently predicted survival was stage of disease; when accounting for stage, there was no independent effect of low economic status. In the presence of uniform care, low economic status as defined in this study is not a factor in patient survival.

Age Factors↗