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 73 records · Page 4Linked to original sources
PubMed1993

Economics, health and health economics: HYEs (healthy-years equivalent) versus QALYs (quality-adjusted live-year)

This paper responds to Culyer and Wagstaff's (CW) and Buckingham's (B) arguments. We refute their claim about the equivalence of HYEs and QALYs; they fail to distinguish between choice under uncertainty and under certainty. CW assume that all individuals have a specific form of utility function, which yields their conclusion of equivalence. B's arguments confuse the measurement technique and the utility theory from which it stems; his argument about the normative superiority of the QALY construct is inconsistent with economic thinking. The HYE, by being compatible with the principles of economics, is superior to the QALY for economic evaluations of health care interventions.

Canada↗
PubMed1989

Economic stress and suicide: multilevel analyses. Part 2: Cross-level analyses of economic stress and suicidal ideation.

This paper reports the second of two studies of the hypothesis that the economy affects suicide; both studies were based in the same community during approximately the same time period. Although many aggregate-level tests have been conducted using archival measures of unemployment and suicide (the approach used in Part 1), the impact of economic climate on suicidal ideation has not been measured at the individual level. In the study reported here, aggregate economic indicators were combined with individual-level measures of stressful events, symptoms, and suicidal ideation obtained in a survey of Los Angeles from 1978 to 1982. Each of the two studies revealed small associations between economic stress and suicide or suicidal ideation, but they were inconsistent with respect to specific subgroups.

Adult↗
PubMed1979

Dentists' incomes, fees, practice costs, and the Economic Stabilization Act: 1952 to 1976. Bureau of Economic and Behavioral Research.

Throughout the 20-year period from 1952 to 1972, dentists' net incomes, adjusted for inflation, increased and provided greater monetary rewards to the practice of dentistry. Evidence discloses a close association between the purchasing power of dentists' net incomes and the general level of economic activity (measured by the GNP inconstant dollars). Dentists are not immune to temporary recessions. The period from 1972 to 1974, with the imposed fee guidelines of Nixon's Economic Stabilization Act, was unusual. With effective fee guidelines during the latter two phases coupled with freely fluctuating input prices, dentists were caught in an income squeeze. During 1972 to 1974, the purchasing power of dentists' net incomes fell at a rate of 10.1% per year as the price index of practice costs outpaced dentists' fees. After the Economic Stabilization Act expired in 1974, trends returned to normal. Dentists' net incomes increased at rates consistent with changes in the GNP and dentists' fees increased slightly faster than the "Price Index of Cost of Conducting a Dental Practice."

Costs and Cost Analysis↗
PubMed1977

[Productive life-span of dairy cows and its economic significance. III. Economic evaluation: results obtained by model calculations (authors transl)].

A reduction of the forced replacement rate is found to be of major economic importance on the farm level. In the model, the income earned from a fifth lactation of a cow showing an average production is approximately Dfl 440 higher than the earned income per annum over the average herd life of 4.3 lactations. A farm with a herd of fifty cows showing average production and an average herd life of 5.3 years will have approximately Dfl 9600 more earned income each year than a similar farm with an average herd life of 3.3 years. The yield resulting from a longer herd life is subject to the law of diminishing returns. For the annual income from a dairy herd, a sixth lactation is of less importance than a fifth lactation, etc. The economic importance of a long herd life appears to be remarkably stable, i.e. hardly affected by: (a) The average productive capacity of the herd as regards milk and/or meat. (Note: Differences in milk-producing capacity within a herd have a marked effect on the economic value of an additional lactation by an individual cow). (b) The presence or absence of a moderate genetic improvement (1 per cent per annum) in milk-yield.

Animals↗
PubMed2004

Economic analysis of a transesophageal echocardiography-guided approach to cardioversion of patients with atrial fibrillation: the ACUTE economic data at eight weeks.

OBJECTIVES: The aim of this study was to compare the relative cost of a transesophageal echocardiography (TEE)-guided strategy versus conventional strategy for patients with atrial fibrillation (AF) >2 days duration undergoing electrical cardioversion over an eight-week period. BACKGROUND: The Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) trial found no difference in embolic rates between the two approaches. However, the TEE-guided strategy had a shorter time to cardioversion and a lower rate of composite bleeding. While similar clinical efficacy was concluded, the relative cost of these two strategies has not been explored. METHODS: Two economic approaches were employed in the ACUTE trial. The first approach was based on hospital charge data from complete hospital Universal Billing Code of 1992 forms, a detailed hospital charge questionnaire, or imputation. Regression analysis was used to investigate the added cost of adverse events. The second economic approach involved the development of an independent analytic model simulating treatment and actual ACUTE outcome costs as a validation of clinically derived data. Sensitivity analysis was performed on the analytic model to investigate the potential range in cost differences between the strategies. RESULTS: A total of 833 of the 1,222 patients were enrolled from 53 U.S. sites; TEE-guided (n = 420) and conventional (n = 413). At eight-week follow-up, total mean costs did not significantly differ between the two groups, respectively (6,508 dollars vs. 6,239 dollars; difference of 269 dollars; p = 0.50). Cumulative costs were 24% higher in the conventional group, primarily due to increased incidence of bleeding and hospital costs associated with bleeding. A separate analytic model showed that treatment costs were higher for the TEE-guided strategy, but outcome costs were higher for the conventional strategy. Sensitivity analysis of the analytic model illustrated that varying the incidence and cost of major bleeding and the cost of TEE had the greatest impact on cost differences between the two groups. CONCLUSIONS: In patients with AF >2 days duration undergoing electrical cardioversion, the TEE-guided group showed little difference in patient costs compared with the conventional group. The TEE strategy had higher initial treatment costs but lower outcome-associated costs. Cumulative costs were 24% higher in the conventional group, primarily due to bleeding. The TEE-guided strategy is an economically feasible approach compared with the conventional strategy.

Aged↗
PubMed2006

Socio-economic driving forces of land-use change in Kunshan, the Yangtze River Delta economic area of China.

This paper analyzes characteristics, major driving forces and alternative management measures of land-use change in Kunshan, Jiangsu province, China. The study used remote sensing (RS) maps and socio-economic data. Based on RS-derived maps, two change matrices were constructed for detecting land-use change between 1987 and 1994, and between 1994 and 2000 through pixel-to-pixel comparisons. The outcomes indicated that paddy fields, dryland, and forested land moderately decreased by 8.2%, 29% and 2.6% from 1987 to 1994, and by 4.1%, 7.6% and 8% from 1994 to 2000, respectively. In contrast, the following increased greatly from 1987 to 1994: artificial ponds by 48%, urban settlements by 87.6%, rural settlements by 41.1%, and construction land by 511.8%. From 1994 to 2000, these land covers increased by 3.6%, 28.1%, 23.4% and 47.1%, respectively. For the whole area, fragmentation of land cover was very significant. In addition, socio-economic data were used to analyze major driving forces triggering land-use change through bivariate analysis. The results indicated that industrialization, urbanization, population growth, and China's economic reform measures are four major driving forces contributing to land-use change in Kunshan. Finally, we introduced some possible management measures such as urban growth boundary (UGB) and incentive-based policies. We pointed out that, given the rapidity of the observed changes, it is critical that additional studies be undertaken to evaluate these suggested policies, focusing on what their effects might be in this region, and how these might be implemented.

Agriculture↗
PubMed2004

Economic consequences of the adverse reactions related with antipsychotics: an economic model comparing tolerability of ziprasidone, olanzapine, risperidone, and haloperidol in Spain.

Frequency of adverse reactions (ARs) related with antipsychotics usage is high. Along with clinical implications, economic impact might be important. The purpose of this study was to model the economic consequences of ARs related with ziprasidone, olanzapine, risperidone, and haloperidol in Spain, by means of a cost-effectiveness model developed using a Markov modeling approach. The model simulated treatment of a cohort of 1000 schizophrenics for 12 months, initiating treatment with one of four antipsychotic drugs; haloperidol, risperidone, olanzapine and ziprasidone. Conditional probabilities of developing any of four adverse events were calculated. Treatment was modified (decrease dose, switch medication) according to incidence of ARs and physician judgments, obtained from a local cross-sectional study and clinical trials previously published. The analysis was conducted in year 2002 from a third party payer perspective. Results are shown as annual cost per month with psychotic symptoms controlled and included univariate sensitivity analysis. The therapeutic strategy starting with ziprasidone showed the lower costs and the greater number of months with symptoms controlled in most scenarios evaluated versus the other options considered, although the differences were weak: 9.6, 9.3, 9.5 and 9.5 controlled months per patient in base scenario, with annual cost per patient per month with symptoms controlled of 1035 Euros, 1084 Euros, 1087 Euros and 1090 Euros for ziprasidone, haloperidol, risperidone and olanzapine, respectively. Results were robust to one-way sensitivity analysis. Despite the unlike drug prices of antipsychotics, a considerable economic impact due to adverse reactions was seen in our setting. These results should be taken into account by health decision makers and clinicians in the management of patients with schizophrenia.

Antipsychotic Agents↗
PubMedDate not supplied

[Economic aspects of outpatient rehabilitation--methods and results of a study about economic efficiency of outpatient rehabilitation in Mecklenburg-Vorpommern].

Since the recent changes in the German social code the outpatient rehabilitation system gains importance. While more and more studies investigate the medical outcomes of outpatient rehabilitation, the economic effects have hardly been examined so far. This article first presents fundamental methods to use for economic evaluation of outpatient rehabilitation and subsequently outlines the findings of a project comparing the economic effects of outpatient and inpatient rehabilitation in Mecklenburg-Vorpommern. The study statistically covers the total population of applicants for orthopaedic-traumatologic rehabilitation who are suitable for outpatient rehabilitation. A randomized and controlled study, it investigates outcome parameters of the two variants of rehabilitation compared. If the results are approximately equal, the differences between amounts and periods of payments and costs for the pension insurance agency are analyzed. And in fact, the results obtained so far from the investigation confirm that, in suitable patients, outpatient rehabilitation can achieve approximately the same outcomes as inpatient rehabilitation - but at distinctly lower costs. Although in the short term (i. e., at the end of treatment) outcome levels are somewhat lower, better results found even one year later however indicate a more sustained effect.

Ambulatory Care↗
PubMed2005

[Empirical standard costs for health economic evaluation in Germany -- a proposal by the working group methods in health economic evaluation].

Measurement of health care costs is a crucial task in health economic evaluation. Various guidelines with different amount of details have been set up for costing methods in economic evaluation which, however, do not precisely stipulate how to value resource consumption. In this article we present a proposal for the standardisation of the monetary valuation of health care utilisation occurring in the follow up period after the actual intervention to be evaluated. From a societal perspective the primary direct and indirect cost components are considered, such as outpatient medical care, pharmaceuticals, non-physician health services, inpatient care, days of sick leave and early retirement due to sickness. The standard costs are based on administrative charges and rates or on official statistics. They are based on the most current data sources which are mainly from 2002 and 2003. This system of standard costs aims at an average valuation of resource consumption. This makes for the comparability of different health economic studies. Most standard costs are not based on market prices but on administratively specified charges and rates. This implies that institutional changes which are quite common in the health care system, may also affect the valuation rates, for example the introduction of DRGs. This should be taken into account when updating the system of standard costs.

Ambulatory Care↗
PubMed2006

Economics on trial: the use and abuse of economic methods in third party tobacco litigation.

OBJECTIVE: To analyse how the tobacco industry responded to economic models and methods used in third party payer tobacco litigation that has occurred since 1994. METHODS: Identified 12 third party payer cases and reviewed the transcripts using WinMax qualitative software. Focused on defendant's opening and closing statements, followed by trial testimony, depositions, and plaintiff's transcripts. RESULTS: Tobacco industry defendants tried to create doubt and confusion about whether or not smoking caused disease and by extension led to health care costs; argued that the economic models used were not legitimate and were not appropriate for estimating the costs incurred by plaintiffs; and criticised the data sources used because they did not consist of the individuals whose health care costs were being sought. CONCLUSIONS: Faced with a new and unprecedented wave of anti-tobacco litigation from third party payers, the tobacco industry tried to adapt strategies that had been used successfully in the past-creation of unfounded doubt and confusion, and manipulation of the discovery process to force plaintiffs to withdraw or concede defeat. The strategies failed because credible economic models of the health care costs of smoking had been developed that were able to quantify the damages to a large group of health care recipients, because plaintiff's attorneys were able to commit significant resources and willing to undertake substantial financial risk to defend their new legal approaches, and because previous arguments related to individual responsibility were deemed irrelevant in third party litigation.

Cost of Illness↗
PubMed2000

Are the WOSCOPS clinical and economic findings generalizable to other populations? A case study for Belgium. The WOSCOPS Economic Analysis Group. West of Scotland Coronary Prevention Study.

AIMS: As the West of Scotland Coronary Prevention Study (WOSCOPS) was conducted in Scotland, a country well-known for its high cardiovascular risk, the generalizability of its findings on pravastatin's clinical and economic effects has been questioned. This study examines the legitimacy of this concern, using Belgium as a case study. METHODS AND RESULTS: Local information on the prevalence and clustering of risk factors in individual patients was used in a risk equation to estimate the reference risk in Belgium. In contrast to prevailing beliefs, this risk was shown to coincide with the trial population's risk. As the relative risk reduction documented in a trial should apply across populations, the health benefits observed in WOSCOPS can clearly be extrapolated. This information in combination with local costs was then used to assess the economic efficiency of primary prevention with pravastatin in Belgium by means of a previously developed model. In parallel with the original estimates for the United Kingdom, the cost-effectiveness ratios remain well within the range of what is considered strong to moderate evidence for adoption and appropriate utilization, over a wide range of input values. CONCLUSION: This study demonstrates that the clinical and economic findings from WOSCOPS can indeed be generalized to other populations.

Anticholesteremic Agents↗
PubMed1990

What every doctor should know about economics. Part 2. The benefits of economic appraisal.

In this article we have discussed a number of aspects of economic appraisal. Economic evaluation considers both costs and benefits. Cost-benefit analysis requires the evaluation of health in dollar terms but allows the comparison of health programmes with other programmes or the evaluation of one project alone. Because of the problems that are associated with placing a monetary value on life and health, cost-benefit analysis has not been used in the health field as extensively as has cost-effectiveness analysis. Cost-effectiveness analysis is used to compare alternative programmes with the same health goal. The importance of quality as well as length of life as health outcomes has led to the development of cost-utility analysis. Finally, a good economic evaluation of health care requires the collaboration of clinicians and health economists.

Cost-Benefit Analysis↗
PubMed2005

[Comprehensive management patterns of economic fruit forest in Dashan Village and their ecological and economic benefits].

With the theories of economy and ecology, this paper analyzed the main management patterns of economic fruit forest in the Dashan Village, Huoqiu County, Anhui Province. The results showed that 9-year-old mandarin-tea, 5-year-old persimmon-potato-watermelon, 7-year-old pear-potato-soybean, and 7-year-old pear-balloonflower had obvious social, economic and ecological benefits. Their net economic benefits were 8 700.00, 12 351.00, 12 337.50 and 22 500.00 yuan x hm(-2), respectively, higher than that of single crop planting. In these patterns, the crown density between rows could reach 0.3 - 0.4, and the light utilization rate increased by 20% - 30%.

China↗
PubMed1990

[Economic attitudes in the activities of therapeutic-prophylactic facilities under the conditions of new economic mechanisms].

For two years an experiment on restructuring of health services system is being conducted in Leningrad. The economic mechanisms are being introduced into the health services system which allow health authorities, using internal resources, to considerably improve the delivery of medical care for the population. The introduction of economic incentives into the system of payment for labour, the use of some economic mechanisms into the co-operation between medical institutions led to considerable intensification of labour, improved the discipline and performance indices of medical institutions. The most expedient form of work proved to be collective contract which allowed to considerably broaden the rights of doctors and staff. Institutions working on the basis of collective contract achieved much better results. Unnecessary hospitalization of patients has decreased and planned hospitalization increased, intensification of labour is going on which permits to significantly increase wages. Intra-sectorial cost accounting relationships is a progressive form of public health organization and management.

Delivery of Health Care↗
PubMed1989

Economic stress and suicide: multilevel analyses. Part 1: Aggregate time-series analyses of economic stress and suicide.

Of the research on health and economic stress, the approach that has produced the strongest findings has been the aggregate time-series analysis of unemployment and suicide rates. A review of the literature indicates that this aggregate work has been disputed on both methodological and interpretive grounds. To address these issues, two studies of the relationship between economic stress and suicide were conducted on the same population. The first, reported in this paper (Part 1), replicated the aggregate time-series work with improvements in method, using monthly data for 1975-1982 for Los Angeles. A second study (reported in Part 2) combined aggregate economic indicators with individual-level measures of stressful events, symptoms, and suicidal ideation.

Adult↗
PubMed1988

Some demographic and economic aspects of Third World and First World urbanization and the economic implications thereof for South Africa.

"This paper analyses various demographic and economic features of the urbanization process that is taking place in Third World (developing) and First World (developed) countries. A comparison of some demographic and economic differences between contemporary Third World urbanization and First World urbanization at a comparable stage of development is made. The aim is to see what South African urbanization can learn from the comparison between Third and First World urbanization."

Africa↗
PubMed2000

[Economic significance of heart failure. An overview of costs and economics of therapy].

The economic burden of congestive heart failure is significant. Approximately 1 to 2% of total health care expenditure is attributed to the diagnosis, treatment and prevention of congestive heart failure. A great share of this expenditure is related to the costs of long-term complications and productivity losses. In order to manage these costs, providers and policymakers increasingly have to focus on economically attractive interventions. Pharmacoeconomic analyses aid the systematic selection of cost-effective drug therapy in congestive heart failure in an era of increasing cost-containment.

Adrenergic beta-Antagonists↗
PubMed1989

Clinical economics education in the International Clinical Epidemiology Network. INCLEN Economics Faculty.

The application of rigorous epidemiologic methods to clinical questions has broadened the scope of research in epidemiology and enhanced the quality of clinical research. The International Clinical Epidemiology Network (INCLEN) has enabled physicians from developing countries to obtain training in epidemiologic methods and to provide leadership in clinical epidemiology in their home schools of medicine. The INCLEN program has recently incorporated another major theme of research training, clinical economics, which introduces research related to the effective use of limited resources. This article describes the rationale for the development of the INCLEN Clinical Economics program, outlines its organization and curriculum, and explores the challenges to its successful implementation.

Cost-Benefit Analysis↗