Money for methadone: preliminary findings from a study of Alameda County's new maintenance policy.
Explore the source record for details and available documents.
Adult↗
SEARCH · Search PubMed
Results for “Financing, Personal”
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.
Age differences in performance awareness on a complex financial decision-making task.
Individuals tend to be overconfident when making retrospective judgments about the quality of their decisions. However, few studies have focused on age differences in estimates of decision quality. In the present experiment performance estimates were provided by task-trained and untrained young and old individuals following completion of a series of complex financial decisions. Confidence levels were assessed by examining discrepancies between perceived and actual solution quality. Performance estimates of all 4 groups contained appreciable estimation error; however, no group showed a substantial directional bias toward underconfidence or overconfidence. Young trainees were significantly less confident in the quality of their decisions than young novices, but a comparable training effect was not found among older individuals. One's knowledge of the task, prior decision-making experience, and level of self-esteem may combine to determine the accuracy of one's retrospective performance estimates.
Adult↗
The U.S. health care system is dysfunctional.
Explore the source record for details and available documents.
Attitude to Health↗
Costs attributable to AIDS at household level in Chad.
This paper assesses the economic costs of AIDS at the household level in Chad, one of the poorest countries in the world. One hundred and ninety-three AIDS patients living in four different regions were found by case identification at hospital level and through community based organizations providing psycho-social relief. They were matched by age, sex, professional category and zone of residence with controls. Costs were evaluated through a standard questionnaire. Costs at household level attributable to AIDS up to death were US$836 per case. Costs related to productivity losses made up 28% of total costs. More than half of total costs (56%) were health care related expenditures and funeral costs contributed 16%. AIDS cases relied more often on borrowing and the selling of household assets than controls for treatment. Household expenditures of AIDS cases were much higher than control households mainly due to health related expenditure. The response of concerned families to HIV/AIDS implies high costs and for most households, especially in low-income settings, the consequences of AIDS are devastating. Innovative strategies on how best to assist households are thus requested and may include the strengthening of care and treatment services being offered to AIDS cases.
Acquired Immunodeficiency Syndrome↗
Safety and efficacy of L-tryptophan and behavioral incentives for treatment of cocaine dependence: a randomized clinical trial.
L-tryptophan(ie, tryptophan)has shown promise as a pharmacotherapy in cocaine addiction treatment. Abstinent contingent voucher incentives have shown efficacy in abstinence initiation and maintenance for treatment of cocaine dependence. The present study evaluated these two approaches singly and in combination in a relapse prevention+treatment design. A double-blind, parallel-group, placebo-controlled design was used. Cocaine-dependent patients(N=199) were stratified and randomized to one of four groups: tryptophan+contingent vouchers, tryptophan+non-contingent vouchers, placebo+contingent vouchers, and placebo+non-contingent vouchers. The study included residential stabilization (4-9 days), where patients achieved initial cocaine abstinence; outpatient treatment evaluation(16 weeks), where patients received medication, vouchers, and urine testing thrice weekly; and disposition. Main outcomes were retention in treatment, urinalysis, self-reported drug use, and self-reported side effects. Tryptophan did not significantly prevent relapse to cocaine use or attenuate cocaine use after relapse. Contingent vouchers significantly increased the time to cocaine relapse and produced less cocaine use relative to non-contingent vouchers. Results demonstrate the sensitivity of this methodology for detecting decreases in cocaine use, as evidenced by significant changes of the contingent voucher conditions; this suggests that tryptophan's lack of efficacy was not due to model insensitivity for detecting significant differences in cocaine use. This study also showed that contingent vouchers were effective in the novel experimental model of relapse prevention.
Adolescent↗
Residential and nursing home care of elderly people with cognitive impairment: prevalence, mortality and costs.
Cognitive impairment among residents has considerable resource implications for both individuals and those responsible for publicly funded care. Two linked surveys were carried out in England: (1) a longitudinal study followed 2500 admissions to publicly funded care up to 42 months after admission; and (2) a cross-sectional survey of 618 homes collected information about 11,900 residents. Information was collected about cognitive impairment using the Minimum Data Set Cognitive Performance Scale. Cognitive impairment was associated with source of funding and type of home. Although level of cognitive impairment has some effect, fees and costs were most influenced by type of home. At the same level of impairment, self-funded residents were more likely to be located in relatively low-cost settings than publicly funded residents. In independent homes fees were lower for publicly funded than for self-funded residents. Overall median length of stay of publicly funded admissions was 18 months. For the most part length of stay was not associated with level of cognitive impairment on admission. It is concluded that more information is needed about the effect of quality of care on people with cognitive impairment in different settings. If the same quality of care can be achieved in residential and nursing homes, the evidence would suggest that changes in placement policies could result in potential savings to the public purse.
Activities of Daily Living↗
Financial strain and life satisfaction in Hong Kong elderly Chinese: moderating effect of life management strategies including selection, optimization, and compensation.
For many Hong Kong Chinese elderly, financial strain is quite a common occurrence. This study examines the moderating effect of life management strategies including selection, optimization, and compensation in the relationship between financial strain on life satisfaction. The data came from a survey of a representative community sample of 421 elderly respondents in Hong Kong. Using multiple regression models, the authors found that selection and optimization of life management strategies moderated the linkage between financial strain and life satisfaction even after controlling socio-demographic variables, but sense of control over finances did not. Findings suggest that life management strategies should be enhanced to protect older people under chronic financial strain from low level of life satisfaction
Aged↗
Measuring awareness of financial skills: reliability and validity of a new measure.
This paper examines the psychometric properties of a three-part (participant, informant, and performance) Measure for assessing Awareness of Financial Skills (MAFS). The MAFS was administered to 10 seniors with dementia and 25 well-functioning seniors, and their informants. Measures of cognitive functioning, social desirability, neuroticism, and perceived control were administered to each participant to allow for an assessment of validity. Internal consistency estimates for the participant and informant questionnaires were found to be 0.92 and 0.97, respectively. Convergent validity analysis indicated that performance on this measure was related to level of cognitive functioning, with higher level of unawareness associated with decreased cognitive ability. Discriminant validity analysis showed that performance on this measure was not related to social desirability or neuroticism. This study provides evidence that the MAFS is a reliable and valid tool for assessing awareness of financial skills in older adults.
Aged↗
Sources of income and depression in elderly Hong Kong Chinese: mediating and moderating effects of social support and financial strain.
This study examines the relationship between major source of income (i.e., adult children, financial independence and government welfare) and depression among elderly Hong Kong people. We also assessed the mediating and moderating effects of family social support and financial strain in the linkage between source of income and depression. The data came from a cross-sectional survey of a representative community sample of 1106 elderly respondents in Hong Kong. Using multiple regression models, data revealed that there was a differential impact of major sources of income on depression. Welfare participation and financial independence contributed to a higher level of depressive symptoms whereas people whose source of income was their adult children were more likely to report a lower level of depression than the others who were not. We also found that family social support was either a complete mediator or partial mediator in the relationship between different major sources of income and depression but it was not a significant moderator in the linkage between different major sources of income and depression. In contrast, financial strain was a significant moderator in the link between different major sources of income and depression. Specific and effective interventions must be developed for those who are financially independent or on welfare.
Aged↗
Living alone and depression in Chinese older adults.
Western literature has repeatedly indicated a strong relationship between living alone and depression among the aged population, however, studies among the Chinese population are scarce. In this paper, we examine whether the association between living alone and depression is independent of health status, social support and financial strain among Chinese older adults, and subsequently assess whether such association persists after adjusting these variables. Cross-sectional data drawn from the Hong Kong Population Census consisting of 2,003 Chinese elderly people aged 60 or over were analyzed. Chi-square tests and logistic regression analyses revealed that living alone results in higher levels of depressive symptoms for older women but not for older men. This relationship remained significant even when socio-demographic variables, health indicators, social support, and financial strains were adjusted; yet, the impact of living alone with depression disappeared when all variables were controlled. In summary, this paper is the first to report that living alone is an independent risk factor contributing to depression among Chinese older women, as well as identifying certain significant factors including social support and health indicators that can affect and explain the link between living alone and depression. Preventive measures and related issues were discussed.
Activities of Daily Living↗
Willingness to pay for hypothetical malaria vaccines in rural Burkina Faso.
AIMS: This study aims to set priorities for anti-disease malaria vaccines by determining community preference in a hyperendemic area. METHODS: A bidding game technique was used to elucidate willingness to pay in rural Burkina Faso and 2,326 adults were interviewed. RESULTS: It is shown that there are significant differences between community preference for an anti-disease vaccine aimed at reducing pathology in pregnant women, and for a vaccine directed against childhood malaria. While the target population was willing to pay CFAfr 2101 for a vaccine against maternal malaria, its members were prepared to pay only CFAfr 1433 for a vaccine against childhood malaria. CONCLUSIONS: Whilst it is increasingly likely that anti-disease malaria vaccines will become available in the foreseeable future, lessons from the past suggest that a lack of acceptance and support from the intended recipients may lead to less than optimal compliance, and hence efficacy. For the planning of vaccine development and application strategies, it is therefore highly important to take community views into account. Here it is argued that such information could help researchers and funding agencies to set priorities for future vaccine research.
Adult↗
The economic burden of unintentional injuries: a community-based cost analysis in Bavi, Vietnam.
AIMS: Relatively little is known about patterns of injury at the community level in Vietnam and their economic consequences. This study sought to estimate the costs of various unintentional injuries in Bavi District during one year; to describe how costs depended on gender, age, circumstances, and severity of injury; and to describe how the economic burden of unintentional injuries was distributed between households, government, and health insurance agency. METHODS: A cohort study was undertaken, which involved four cross-sectional household surveys among sampled communities in the Bavi District during the year 2000, each asking about injuries in the preceding three months. The costing system in public healthcare in Vietnam was applied as well as information from the victims. RESULTS: The total cost of injuries over one year in Bavi District was estimated to be D3,412,539,000 (Vietnamese dong) (US$235,347), equivalent to the annual income of 1,800 people. In total, 90% of this economic burden fell on households, only 8% on government, and 2% on the health insurance agency. The cost of a severe injury to the corresponded to approximately seven months of earned income. Home and traffic injuries together accounted for more than 80% of the total cost, 45% and 38% respectively. The highest unit cost was related to traffic injuries, followed by home, "other", work-related, and school injuries in descending order. DISCUSSION: The results can be considered as an economic baseline that can be used in evaluations of future interventions aimed at preventing injuries.
Accidents↗
Differential effects of cigarette price on youth smoking intensity.
OBJECTIVES: Data from the 1992, 1993, and 1994 Monitoring the Future Surveys were used to investigate the differential effects of cigarette price on the intensity of youth cigarette smoking. METHODS: Respondents were classified into non-smokers; individuals who smoked less than one cigarette per day; individuals who smoked one to five cigarettes per day; individuals who smoked one-half pack a day; and individuals who smoked one pack or more a day. A Threshold of Change Model was estimated with information on cigarette prices as the main explanatory variables. RESULTS: Dummy variables indicating medium and high prices were found to have varying effects on different levels of smoking intensity, even though higher prices were associated with lower smoking in all cases. The differences are more striking in the high-price case. The effects of higher prices are largest at the heaviest smoking levels. CONCLUSION: Cigarette prices are an effective tool to discourage youth smoking. The differential effects of cigarette price on smoking intensity warrant further investigation.
Adolescent↗
Assessment of the relative reinforcement value of smoking and drinking using a multiple-choice measurement strategy.
To examine the relative reinforcement value of smoking and drinking, separately and in combination, a multiple-choice questionnaire was administered to 78 individuals seeking outpatient treatment for concurrent tobacco and alcohol dependence. Participants made choices between pairs of substances and then between each substance and a series of monetary values. Results demonstrated that the combination (one cigarette and one drink) was preferred over each individual substance. The mean crossover monetary points for a cigarette (8.1 US dollars) and a drink (10.8 US dollars) were significantly lower than for the combination (13.75 US dollars). Correlational analyses revealed positive associations between drug reinforcement values and dependence-related measures. The utility of this measurement strategy in understanding and treating polydrug use is discussed.
Adult↗
Incentives in smoking cessation: status of the field and implications for research and practice with pregnant smokers.
We review the rationale and empirical evidence for the use of incentive and contingency management strategies for smoking cessation. Plausible theoretical rationales exist for the application of these strategies to smoking cessation, and a great deal of research with illicit drug users in laboratory or controlled treatment settings suggests such strategies can be effective. Contingency management methods have been effective in modifying smoking behavior in volunteers not seeking cessation assistance in highly controlled settings. Incentives have been used primarily as a component of worksite interventions, in community-wide quit-and-win programs, in quasiexperimental and experimental trials, and more recently with low-income pregnant women. Worksite studies have rarely been designed to isolate the impact of incentives. Nevertheless, they appear to be useful in these settings especially in increasing participation and increasing awareness about the deleterious effects of smoking. Quit-and-win programs are used widely in the United States and internationally and appear to attract many participants and produce modest quit rates. The quality of the evaluations of quit-and-win programs varies considerably, and none has employed rigorous control or comparison groups to sufficiently identify the effect of incentives. Recent controlled studies have yielded promising results with pregnant smokers, and larger trials are in progress. We discuss key methodological issues in mounting and evaluating incentive interventions, particularly during pregnancy, and discuss the practical and ethical issues arising from the use of incentives.
Adult↗
Value to smokers of improved cessation products: evidence from a willingness-to-pay survey.
The present study demonstrated the use of willingness to pay to value hypothetical new smoking cessation products. Data came from a baseline survey of participants in a clinical trial of medications for smoking cessation (N=356) conducted in New Haven, Connecticut. We analyzed individual willingness to pay for a hypothetical tobacco cessation treatment that is (a) more effective than those currently available and then (b) more effective and attenuates the weight gain often associated with smoking cessation. A majority of the respondents (n=280; 84%) were willing to pay for the more effective treatment, and, of those, 175 (63%) were willing to pay more if the increased effectiveness was accompanied by attenuation of the weight gain associated with smoking cessation. The present study suggests the validity of using willingness-to-pay surveys in assessing the value of new smoking cessation products and products with multifaceted improvements. From these data, we calculated estimates of the value of a quit. For the population studied, this survey suggests a substantial market for more effective smoking cessation treatments.
Adult↗
Do patients with benign paroxysmal positional vertigo receive prompt treatment? Analysis of waiting times and human and financial costs associated with current practice.
This study retrospectively analysed how 20 patients with posterior canal benign paroxysmal positional vertigo (BPPV) were managed from primary care, to treatment in tertiary care. The average time from first referral to treatment was 93 weeks, with an average of 58 weeks within primary care and 40 weeks within hospital care. At least 85% of cases had classical symptoms of BPPV and could have been easily identified by Primary Care Physicians at first referral, had they been trained to recognise and diagnose the condition. It was concluded that patients could be treated more efficiently and at less cost if the condition was identified at first referral in primary care, and treated in either primary care or dedicated BPPV clinics receiving referrals from primary care. A dedicated clinic for BPPV is recommended, which will substantially reduce waiting time for treatment and save primary care and hospitals time and money by avoiding unnecessary appointments and medication.
Adult↗
The value of good quality drinking water to Canadians and the role of risk perceptions: a preliminary analysis.
Canadian municipal water utilities have had to face many difficulties in the past few years, not the least of which has been an erosion of consumer confidence in the safety of publicly supplied drinking water. This paper discusses how economic theory is used to develop a methodology for determining consumers' or society's preferences for better quality drinking water and how these preferences are expressed in the trade-offs made between money and two different types of risk reductions: mortality and morbidity. These trade-offs are observed by examining actual consumer behavior and/or in structured (hypothetical) market choices. The information gained can be used to structure more efficient water pricing schemes for municipal water utilities and to aid these utilities in their infrastructure investment decisions.
Adult↗