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 739 records · Page 41Linked to original sources
PubMed2005

[Changes in mortality inequality in relation to the South Korean economic crisis: use of area-based socioeconomic position].

OBJECTIVES: An abrupt economic decline may widen the socioeconomic differences in health between the advantaged and disadvantaged in a society. The aim of this study was to examine whether the South Korean economic crisis of 1997-98 affected the socioeconomic inequality from all-causes and from cause-specific mortality between 1995 and 2001. METHODS: Population denominators were obtained from the registration population data, with the number of death (numerators) calculated from raw death certificate data. The indicator used to assess the geographic socioeconomic position was the per capita regional tax revenue. Administrative districts (Si-Gun-Gu) were ranked according to this socioeconomic measure, and divided into equal population size quintiles on the basis of this ranking. The sex- and 5-year age-specific numbers of the population and deaths were used to compute the sex- and age-adjusted mortality rates (via direct standardization method), standardized mortality ratios (via indirect standardization methods) and relative indices of inequality (RII) (via Poisson regression). RESULTS: Geographic inequalities from all-causes of mortality, as measured by RII, did not increase as a result of the economic crisis (from 1998-2001). This was true for both sexes and all age groups. However, the cause-specific analyses showed that socioeconomic inequalities in mortalities from external causes were affected by South Korean economic crisis. For males, the RIIs for mortalities from transport accidents and intentional self-harm increased between, 1995 and 2001. For females, the RII for mortality from intentional self-harm increased during the same period. CONCLUSIONS: The South Korean economic crisis widened the geographic inequality in mortalities from major external causes. This increased inequality requires social discourse and counter policies with respect to the rising health inequalities in the South Korean society.

Adolescent↗
PubMed2005

Enhancing economic models for the analysis of animal disease.

This paper discusses how economic tools can be targeted and combined to enhance their usefulness in analyses of animal disease problems. It briefly reviews the most commonly used economic modelling techniques to clarify the applicability of specific economic methods to different problems in animal health analysis. The paper then reviews applications of these methods in the literature and suggests how further research could integrate and improve different economic approaches and link epidemiological and economic methods to address a wider range of issues at different scales of analysis.

Animal Diseases↗
PubMed1997

Health economics: a clinician's perspective.

Health care economics is primarily concerned with the study of scarcity and choice. This has become increasingly important as health care spending is reduced. Reductions in spending are driven by federal and provincial government deficit reduction. Health economics analysis can be applied from a number of perspectives. Many physicians perceive health economics as a cost cutting exercise not primarily concerned with the quality of patient care. Health economics analysis may lead to ethical dilemmas in the physician/patient relationship. The physician's obligation to maintain an ethical relationship with patients may conflict with his or her role as rationer of health resources. It is difficult to balance conflicting roles, but physicians are obliged to participate in the economic debate to ensure optimal patient care.

Attitude of Health Personnel↗
PubMed1998

Ecology, economics and political will: the vicissitudes of malaria strategies in Asia.

The documented history of malaria in parts of Asia goes back more than 2,000 years, during which the disease has been a major player on the socioeconomic stage in many nation states as they waxed and waned in power and prosperity. On a much shorter time scale, the last half century has seen in microcosm a history of large fluctuations in endemicity and impact of malaria across the spectrum of rice fields and rain forests, mountains and plains that reflect the vast ecological diversity inhabited by this majority aggregation of mankind. That period has seen some of the most dramatic changes in social and economic structure, in population size, density and mobility, and in political structure in history: all have played a part in the changing face of malaria in this extensive region of the world. While the majority of global malaria cases currently reside in Africa, greater numbers inhabited Asia earlier this century before malaria programs savored significant success, and now Asia harbors a global threat in the form of the epicenter of multidrug resistant Plasmodium falciparum which is gradually encompassing the tropical world. The latter reflects directly the vicissitudes of economic change over recent decades, particularly the mobility of populations in search of commerce, trade and personal fortunes, or caught in the misfortunes of physical conflicts. The period from the 1950s to the 1990s has witnessed near "eradication" followed by resurgence of malaria in Sri Lanka, control and resurgence in India, the influence of war and postwar instability on drug resistance in Cambodia, increase in severe and cerebral malaria in Myanmar during prolonged political turmoil, the essential disappearance of the disease from all but forested border areas of Thailand where it remains for the moment intractable, the basic elimination of vivax malaria from many provinces of central China. Both positive and negative experiences have lessons to teach in the debate between eradication and control as alternative strategies. China has for years held high the goal of "basic elimination", eradication by another name, in sensible semi-defiance of WHO dictates. The Chinese experience makes it clear that, given community organization, exhaustive attention to case detection, management and focus elimination, plus the political will at all levels of society, it is possible both to eliminate malaria from large areas of an expansive nation and to implement surveillance necessary to maintain something approaching eradication status in those areas. But China has not succeeded in the international border regions of the tropical south where unfettered population movement confounds the program. Thailand, Malaysia and to an extent Vietnam have also reached essential elimination in their rice field plains by vigorous vertical programs but fall short at their forested borders. Economics is central to the history of the rise and fall of nations, and to the history of disease in the people who constitute nations. The current love affair with free market economics as the main driving force for advance of national wealth puts severe limitations on the essential involvement of communities in malaria management. The task of malaria control or elimination needs to be clearly related to the basic macroeconomic process that preoccupies governments, not cloistered away in the health sector Historically malaria has had a severe, measurable, negative impact on the productivity of nations. Economic models need rehoning with political aplomb and integrating with technical and demographic strategies. Recent decades in Chinese malaria history carry some lessons that may be relevant in this context.

Asia, Southeastern↗
PubMed1998

Economic impact of resistance in the community.

Antimicrobial resistance is assumed to be an important health problem and an economic burden to society. However, the relationship between the emergence of in vitro microbiological resistance and its clinical and socioeconomic consequences has not yet been satisfactorily determined for either nosocomial or community-acquired infection. In the case of both nosocomial and community-acquired infection, previous exhaustive reviews of published and unpublished reports concluded that mortality, likelihood of hospitalization, and length of hospital stay were usually at least twice as great for patients infected with drug-resistant strains as for those infected with drug-susceptible strains of the same bacteria. However, evaluation of the economic impact of resistance is still problematic and the adverse economic and health effects of drug-resistant bacterial infections can only be roughly quantified. Decision analysis models, such as decision trees, can aid evaluation of the impact of resistance on health and economic outcomes from the perspective of a given decision maker. A model of cost analysis should be based on a knowledge of the incremental consumption of resources specifically dependent on the dynamics of antimicrobial resistance in a given clinical setting (e.g. home care or hospital care). In general, we can assume that the increased rate of isolation of resistant strains from community-acquired infections correlates positively with an increase in morbidity, mortality, risk of hospitalization and the need for additional days in hospital and for more expensive and powerful antibiotics. We implemented and simulated a general decision-tree model to analyse the influence of antibiotic resistance on the economic outcomes of community-acquired lower respiratory tract infections, from the perspective of both society and the health-care local organization (HCLO). This model allows simulation of the impact of different degrees of resistance on the direct costs of an antibiotic therapy as well as on the cost-effectiveness of antibiotics with different degrees of resistance.

Community-Acquired Infections↗
PubMed1995

Nutritional change and economic crisis in an urban Congolese community.

BACKGROUND: In 1986, the government of Congo undertook a structural adjustment programme to cope with the economic crisis. We present the results of a study whose objectives were to assess the evolution of nutritional status of an urban community between 1986 and 1991 and to identify specific groups for which the nutritional status may have worsened. METHODS: Two cross-sectional surveys were carried out on representative samples of Brazzaville children < 6 years old: 2295 children were surveyed in 1986 and 2373 in 1991. Anthropometric assessment of nutritional status was performed. For children, weight-for-height and height-for-age indices were used according to WHO recommendations. Wasting and stunting were respectively defined as indices under -2 z-scores. Body mass index of mothers was calculated and risk of chronic energy deficiency (CED) was defined as < 18.5 kg/m2. Socioeconomic data relative to the households were also collected. Multivariate statistical methods were used to obtain adjusted estimates of nutritional changes in the community. RESULTS: Data analysis led to several converging results: increase in the percentage of low birthweight (10.2% in 1985 versus 18.7% in 1990), increase in the percentage of CED (from 7.9% to 10.5%), and increase in the prevalence of wasting (from 2.9% to 4.2%). By contrast, the overall prevalence of stunting decreased from 13.9% to 11.0%. After statistical adjustment, the factors found to influence the evolution of anthropometric status were: age of child, age of mother, schooling of mother and household characteristics such as number of preschool children, economic level and head of household's occupation. CONCLUSIONS: The study enables the negative effects of the economic crisis to be quantified. Body mass index is shown to be sensitive to economic changes. It could be recommended as a possible indicator for monitoring the nutritional status at population level. The results also call for a new impetus in preventive health programmes and the implementation of nutritional surveillance activities.

Adolescent↗
PubMed1992

Zimbabwe's success story in education and health: will it weather economic structural adjustment?

The beginning of the 1980s saw the birth of Zimbabwe as a result of a protracted liberation war. It coincided with global interest in primary health care, the concept of universal primary school education and, unfortunately, moves towards economic stabilization and structural adjustment programmes. Economic structural adjustment was adopted by several sub Saharan African countries with dire consequences for the poor and vulnerable. Zimbabwe's commitment to social justice and to equitable distribution of resources demonstrated a practical move away from the culture of rhetoric so characteristic of many governments and non-governmental organisations and agencies. This commitment has been translated into impressive improvements in health and education. Current evidence shows that education has had a positive impact on health and related areas like contraceptive use, child mortality and the nutrition status of children. Conversely nutrition and health conditions among school children are important determinants of educational outcomes. Hitherto Zimbabwe's economy has been sufficiently strong to avoid excessive dependence on the International Monetary Fund, the World Bank and other foreign financial institutions. Unfortunately, however, the current economic recession together with economic structural adjustment programmes are beginning to have a negative impact on health and education. Will true synergism between health and education weather these structural problems? It seems that the people and government of Zimbabwe have the capacity and resolve to weather such a storm.

Economics↗
PubMed1989

The economic law of population distribution and migration.

"The economic law of population distribution and migration has been studied chiefly based on the Chinese situation. The distribution and development of productive forces decide the distribution and migration of population, and in turn, the latter influences the former. The population distributions in three different stages of social development, namely agricultural, industrial and information society, are described. A new concept in population economics is introduced, i.e. population economic density, which is different from the concept of population density. The formula of population economic density is P(population)/R(resources). Many kinds of migration are analysed, and it is believed that the main efficient cause of migration is economy."

Asia↗
PubMed1991

[Trends and fluctuations in morbidity and mortality by selected causes, and economic activity: Costa Rica, Chile, and Guatemala, 1960-1986].

"The paper examines the relationship between medium and short-term changes in aggregate economic activity, and national morbidity and mortality rates by certain causes. Although overall mortality conditions have continued to improve during the economic crisis of the nineteen-eighties in the three countries studied, mortality by some causes...[has] discontinued [its] decline and [has] even increased [its] rates in some recent years.... The short-term changes in mortality in Costa Rica and Chile are generally lower than in Guatemala, but tend to be more systematic in their inverse relationship with economic fluctuations in the former. Many of the causes studied affect young and older adults, which are groups that have so far received little attention in evaluations of the health effects of economic crises in the region." (SUMMARY IN ENG)

Age Factors↗
PubMed2002

Economic analyses of respiratory syncytial virus immunoprophylaxis in high-risk infants: a systematic review.

OBJECTIVE: To systematically review all published economic analyses of the only 2 available agents for respiratory syncytial virus immunoprophylaxis in high-risk infants: respiratory syncytial virus immunoglobulin intravenous and palivizumab. DATA SOURCES: Economic evaluations of respiratory syncytial virus immunoprophylactic agents were identified from the MEDLINE and HealthSTAR databases using various combinations of the following search terms: respiratory syncytial virus immunoglobulin intravenous, palivizumab, cost, and cost-effectiveness. The search was limited to articles published in English between January 1, 1990, and August 31, 2001. Additional studies were obtained by searching bibliographies of all relevant identified articles. STUDY SELECTION: Only studies that performed an economic analysis of either or both of these agents in an infant population were included. Letters to the editor and commentaries that included informal economic analyses were excluded. Twelve of the 21 identified studies met the selection criteria. DATA EXTRACTION: Two of us (S.K.-B. and J.D.) independently reviewed the articles and extracted summary information using a standardized abstraction form, with differences resolved by consensus. DATA SYNTHESIS: Estimates ranging from cost savings to considerable incremental costs per hospitalization avoided with use of either agent were observed across studies. Studies comparing the 2 agents reported mixed results about their relative cost-effectiveness in different infant subgroups. The divergent results may be explained by differences in the study methods and assumptions, but they also reflect the poor quality of some of the economic analyses. CONCLUSION: In light of the issues identified in this review, providers, payers, and health policymakers need to critically appraise and judiciously interpret cost-effectiveness research on these agents.

Antibodies, Monoclonal↗
PubMed1998

Economics and ethics in mental health care: traditions and trade-offs.

BACKGROUND: Both economic and ethical perspectives are exerting increasing influence at all levels of mental health policy and practice; yet there is little consensus on how these two different perspectives are to be reconciled or explicitly incorporated into decision-making. AIM: This review article is directed towards a fuller understanding of the complex trade-offs and compromises that are or may be made by clinicians, managers and policy-makers alike in the context of mental health care planning and delivery. METHOD: We briefly outline a number of key principles of health care economics and ethics, and then focus on the particular incentives and trade-offs that are raised by these principles at three levels of the mental health system: government and society; purchasers and providers; and users and carers. RESULTS: At the level of government and society, we find (economically influenced) attempts to reform mental health care offset by concerns revolving around access to care: whether society is prepared to forgo economic benefits in exchange for improved equity depends to a considerable extent on the prevailing ethical paradigm. The implementation of these reforms at the level of purchasers and providers has helped to focus attention on evaluation and prioritization, but has also introduced "perverse incentives" such as cost-shifting and cream-skimming, which can impede access to or continuity of appropriate care for mentally ill people. Finally, we detect opportunities for moral hazard and other forms of strategic behaviour that are thrown up by the nature of the carer:user relationship in mental health care. CONCLUSION: We conclude by highlighting the need to move towards a more open, accountable and evidence-based mental health care system. Acknowledgement of and progress towards these three requirements will not deliver ideal levels of efficiency or equity, but will foster a greater understanding of the relevance of ethical considerations to mental health policies and strategies that are often influenced strongly or solely by economic arguments, whilst also demonstrating that equity must come at a price.

Journal Article↗
PubMed2006

Whither trial-based economic evaluation for health care decision making?

The randomised controlled trial (RCT) has developed a central role in applied cost-effectiveness studies in health care as the vehicle for analysis. This paper considers the role of trial-based economic evaluation in this era of explicit decision making. It is argued that any framework for economic analysis can only be judged insofar as it can inform two key decisions and be consistent with the objectives of a health care system subject to its resource constraints. The two decisions are, firstly, whether to adopt a health technology given existing evidence and, secondly, an assessment of whether more evidence is required to support this decision in the future. It is argued that a framework of economic analysis is needed which can estimate costs and effects, based on all the available evidence, relating to the full range of possible alternative interventions and clinical strategies, over an appropriate time horizon and for specific patient groups. It must also enable the accumulated evidence to be synthesised in an explicit and transparent way in order to fully represent the decision uncertainty. These requirements suggest that, in most circumstances, the use of a single RCT as a vehicle for economic analysis will be an inadequate and partial basis for decision making. It is argued that RCT evidence, with or without economic content, should be viewed as simply one of the sources of evidence, which must be placed in a broader framework of evidence synthesis and decision analysis.

Cost-Benefit Analysis↗
PubMed2001

Methodological limitations of economic evaluations of antenatal screening.

A review of recent economic studies of antenatal screening reveals widespread violation of accepted economic evaluation methodology. In particular, the costs and benefits of antenatal screening are often misclassified and conflated, and the non-resource effects of averted costs are often excluded from the evaluation process. The result is a widespread violation of the explicit and systematic approaches taken by economic analysts more generally, and conclusions that may be described as misleading. This letter calls for economic analysts to be consistent in their application of economic evaluation methodology to antenatal screening programmes.

Abortion, Legal↗
PubMed2002

Vertical and horizontal aspects of socio-economic inequity in general practitioner contacts in Scotland.

Health status varies across socio-economic groups and health status is generally assumed to predict health care needs. Therefore the need for health care varies across socio-economic groups, and studies of equity in the distribution of health care between socio-economic groups must compare levels of utilisation with levels of need. Economic studies of equity in health care generally assume that health care needs can be derived from the current health-health care relationship. They therefore do not consider whether the current health-health care relationship is (vertically) equitable and the focus is restricted to horizontal inequity. This paper proposes a framework for incorporating the implications of vertical inequity for the socio-economic distribution of health care. An alternative to the current health-health care relationship is proposed using a restriction on the health-elasticity of health care. The health-elasticity of general practitioner contacts in Scotland is found to be generally negative, but positive at low levels of health status. Pro-rich estimates of horizontal inequity and vertical inequity are obtained but neither is statistically significant. Further analysis demonstrates that the magnitude of vertical inequity in health care may be larger than horizontal inequity.

Adolescent↗
PubMedDate not supplied

Planning and management for health in periods of economic stringency and instability: a contingency approach.

The mid-1970s marked the end of the longest period of uninterrupted economic growth in history, and initiated in Europe--and other parts of the world--a period of economic stagnation and instability. Along with the prosperity explosion of the past, the pattern of health problems has changed and is still changing. Moreover, the demand for health care has kept on rising, without much improvement of health status in general. Thus, there is a critical need to rethink policies, and to ensure that future changes occur within the limits of shrinking resources and the allotted time-span. In particular, the change in priorities envisaged by the Health for All 2000 (HFA 2000) strategies will need to take place against the background of an ageing population, social instability, and continuing development of new lifestyles and persistent economic scarcity. It is by analysing that background that this article seeks to make recommendations as to how health planning and management might successfully cope with the policy reorientation of the HFA 2000 strategy. The structure of this article is as follows. Firstly, the changes taking place in planning conditions will be reviewed, and form the basis of a framework for subsequent analysis of the planning environment. Following this framework, some of the conflicts likely to be faced in planning and management will be discussed, many of which are the consequence of economic stringency and instability. Also the requirements for an improvement of the effectiveness and efficiency of planning will be identified. Finally, a limited number of approaches to planning will be considered, for their appropriateness to the present-day economic circumstances. The point of view elucidated throughout is that there is no single solution which is 'best' under all circumstances. The conclusion, rather, is that the selection of particular theory or method of planning and management should depend both on the objectives of the decision maker and on the determinants of the planning environment. General prescriptions should not be made. At the same time, some elements have to be stressed in all types of planning, namely: the orientation towards outcomes or outputs of problems; the attention to long-term strategic thinking; and, the application of more efficient, flexible and less bureaucratic approaches.

Decision Making, Organizational↗
PubMed1982

Socio-economic class differences in cancer incidence in Cali, Colombia.

Based on census tract information, cancer incidence rates for three socio-economic strata of the city of Cali, Colombia, were calculated. Strong negative associations with socio-economic status were found for cancers of the cervix and stomach. Colon cancer and endocrine-related cancers were positively associated with socio-economic status, while no such association was found for rectal cancer. Contrary to data from developed countries, all smoking-related cancers were positively associated with socio-economic class. The role of socio-economic gradients in developing countries is stressed as a basis for etiological research.

Adolescent↗
PubMed1993

Assessing the economic benefits of antiherpes therapy.

Increasing pressures on health-care budgets mean that health-care treatments and programmes need not only to demonstrate that they are efficacious, but also that they deliver good value for money. In the context of pharmaceuticals it is likely that both in Australia and Ontario (Canada) evidence of cost effectiveness will become a mandatory requirement prior to reimbursement (government subsidy) of drugs. However, in most jurisdictions economic data will be one of a number of factors taken into account by decision makers, be they policy makers, members of formulary committees, or individual prescribers. Methods of economic evaluation have been developed for the assessment of healthcare treatments, but these have not been extensively applied to antiherpes therapy. However, this paper, based on a literature review of the clinical trials of acyclovir, shows that there are many indicators of potential economic benefit, depending on the clinical indication, in length or quality of life, savings in other health-care resources, or wider benefits (e.g., reductions in lost work time). If appropriate economic data are to be gathered in future for new antiherpes therapy, a more systematic approach is required, conducting economic evaluation alongside, or as an integral part of, clinical trials. This raises important logistical and methodological challenges. It is important that researchers acknowledge these challenges early so that they can be adequately addressed.

Acyclovir↗
PubMed2002

Regional economic impacts of water management alternatives: the case of Devils Lake, North Dakota, USA.

Devils Lake, located in a closed basin in northeastern North Dakota has over a century-long history of highly fluctuating water levels. The lake has risen nearly 25 feet (7.7 m) since 1993, more than doubling its surface area. Rising water levels have affected rural lands, transportation routes, and communities near the lake. In response to rising lake levels, Federal, state and local agencies have adopted a three-part approach to flood damage reduction, consisting of (1) upper basin water management to reduce the amount of water reaching the lake, (2) protection for structures and infrastructure if the lake continues to rise, and (3) developing an emergency outlet to release some lake water. The purpose of this study was to provide information about the net regional economic effects of a proposed emergency outlet for Devils Lake. An input-output model was used to estimate the regional economic effects of the outlet, under two scenarios: (1) the most likely future situation (MLS) and (2) a best case situation (BCS) (i.e., where the benefits from the outlet would be greatest), albeit an unlikely one. Regional economic effects of the outlet include effects on transportation (road and railroad construction), agriculture (land kept in production, returned to production sooner, or kept in production longer), residential relocations, and outlet construction expenditures. Effects are measured as changes in gross business volume (gross receipts) for various sectors, secondary employment, and local tax collections. The net regional economic effects of the proposed outlet would be relatively small, and consideration of these economic impacts would not strengthen the case for an outlet.

Commerce↗