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PubMedDate not supplied

[The economic impact of epilepsy].

AIMS: In this study we review the economic impact involved in suffering from this disease in an attempt to determine how it affects both the individual and society, and the potential benefits deriving from its prevention and treatment. DEVELOPMENT: The World Health Organisation and the World Bank have pointed out that 90% of the costs generated by epilepsy are produced in developing countries. Yet in most developed countries the economic impact of the disease remains partially hidden for patients by the existence of publicly funded health service. As regards spending on pharmaceutical products in Spain, the subgroup made up of the antiepileptic drugs accounted for 1.36% of the total spending throughout the year 2001. Nevertheless, the main economic consequence for most patients is the limitation they suffer in their occupational activities, which is inversely proportional to the degree of control over their seizures and considerably higher than in the general population. Moreover, in epilepsy we must not forget the costs linked to its numerous psychological and social consequences. CONCLUSIONS: As happens in other areas of health care, the way epilepsy is attended depends to a large extent on economic factors. Further studies are therefore needed to provide us with a better understanding of the role played by economics in the field of health care.

Cost of Illness↗
PubMed2004

Socio-economic status and surgery in children: myringotomies and tonsillectomies in Ontario, Canada, 1996-2000.

AIM: To examine the relation between socio-economic status and (1) receipt of paediatric otolaryngological surgery, and (2) inclusion of adjuvant procedures. METHODS: Using data on myringotomies with insertion of tympanostomy tube and tonsillectomies for all children in Ontario, Canada, from 1996 to 2000, and census data on socio-economic status, we examined the association between socio-economic status and (1) the probability of surgery (myringotomy or tonsillectomy), and (2) the probability that surgery was accompanied by an adjuvant procedure. RESULTS: Lower socio-economic status was associated with increased likelihood that a child's initial surgery was a tonsillectomy rather than a myringotomy (odds ratio per unit increase in the deprivation index = 1.09, p = 0.01, confidence interval 1.06-1.11), and with increased likelihood that those children having a myringotomy would undergo a tonsillectomy during the same hospitalization (odds ratio 1.14, p < 0.0001, confidence interval 1.11-1.16). Children from neighbourhoods with larger immigrant populations were less likely to receive either procedure (odds ratios per 1% increase in the proportion of immigrants = 0.97 (p < 0.0001, confidence interval 0.96-0.97) for myringotomies and 0.97 (p < 0.0001, confidence interval 0.97-0.98) for tonsillectomies). CONCLUSIONS: Socio-economic status was associated with treatment selection for the two most common paediatric surgical procedures. Further research should examine whether differences in treatment arise at the level of the primary care physician, the specialist, and/or are due to parental preference.

Adenoidectomy↗
PubMed2006

Effects of socio-economic and behavioural characteristics in explaining central obesity--a study on adult Asian Indians in Calcutta, India.

The present cross-sectional study on adult Asian Indians in Calcutta, India was undertaken to look into the effects of socio-economic and behavioural characteristics in explaining waist-hip ratio (WHR). A total of 500 apparently healthy individuals (300 men and 200 women) were subjects in the study. A random sampling procedure using local voter's registration list was followed to select the subjects. Only one adult (> or = 30 years) from each household was considered as participant. A total of 24 items, 14 socio-economic and 10 behavioural characters were considered. For socio-economic characters, a number of items namely employment status, types of occupation, education status, nature of housing and marital status were taken into consideration. Smoking status, physical exercise by means of outdoor activity, drinking habits and diets on the other hand were considered as behavioural characters. Information on socio-economic and behavioural characteristics was collected using an open-ended schedule specifically designed in this regard. Anthropometric measures namely height, weight and circumference of waist and hip were obtained from participants using standard techniques. The median WHR for men and women was 0.94 and 0.90 respectively. Analysis of variance revealed significant sex difference for all anthropometric measures. It was observed that more women were leading sedentary (outdoor activity not housework was considered) life than men (85.4% vs. 75.4%). Furthermore, women were predominantly nonsmokers (98.8%) whereas 40.2% men were smokers as against 51.4% ex-smokers (those who have quitted smoking during past two years). Multiple regression analysis (adjusted for age and sex) of WHR by socio-economic and behavioural characters revealed that occupation, housing, marital status, smoking condition, physical exercise, drinking habits and diets pattern cumulatively explains 75% (R2=0.75) of total variation of WHR in the study population.

Adult↗
PubMed2006

[A future image of clinical inspection from health economics].

Do you let medical costs increase in proportion to the growth rate of GDP? A way of thinking of the Council on Economic and Fiscal Policy. Should we exclude public medical insurance? It is not a problem, it is an absolute sum if you are effective. If there is no insurance, and individuals pay the total amount, there is no problem, but it is impossible. Economic development will cease if there is no insurance. As medical personnel, to offer good medical care with an appropriate cost. An appeal to the nation is necessary. Economic technical evaluation to identify a cheap method for each clinical inspection. Does medical insurance have a deficit? I. Japanese Health insurance system. (1) Health insurance union. When you look at the contribution money, it is originally 2,479,800,000,000 yen, with premium income and a profit of 45%. (2) Government management health insurance. When you look at the contribution money, it is originally 2,163,300,000,000 yen, with premium income and a profit of 36%. (1) + (2) Employed insurance meter. (3) Mutual aid. (4) National Health Insurance. II. A clinical economic method. III. Expense of medical care and its effect. A. Expense. B. A medical economic technical evaluation method. 1. Cost-effectiveness analysis CEA. 2. Cost utility analysis CUA. 3. Cost-benefit analysis CBA. 4. Expense minimization analysis.

Clinical Laboratory Techniques↗
PubMed1991

Economic losses resulting from food-borne parasitic zoonoses.

Economic losses resulting from food-borne parasitic zoonoses are difficult to assess. Estimating the global economic impact of these diseases is handicapped by inadequate information on the prevalence and public health importance of parasitic zoonoses for most countries. However, the economic losses caused by certain zoonoses has been estimated for some regions and in these instances the costs are significant. In Mexico, for example, porcine cysticercosis is responsible for a loss of more than one-half of the national investment in swine production and for more than US$17 million annually in hospitalization and treatment costs for humans with neurocysticercosis. For all of Latin America, porcine cysticercosis accounts for an economic loss of US$164 million. In Africa, losses of one to two billion dollars per year due to bovine cysticercosis have been reported. Human toxoplasmosis in the United States is estimated to be an annual economic/public health burden of more than US$400 million. The implication from these examples and other are discussed. A set of recommendations is presented for obtaining the necessary information needed to permit assigning to food-borne parasitic zoonoses their appropriate priority within each country's complex economic and public health problems.

Animals↗
PubMed1991

[Hypertension: economic aspects].

The data are provided on the economic losses caused by hypertonic disease (HD) to the national economy of Lithuania in 1980 which are estimated as the sum of money spent by the state on curative and preventive measures and economic losses due to temporary disability, invalidity and premature deaths. Economic losses including damage caused by temporary disability, invalidity and premature deaths accounted for 11.1 million roubles. The major losses were caused by temporary disability. They topped the economic damage due to premature deaths by more than two times. State expenditures on curative and preventive care for hypertonic patients in the structure of economic losses accounted for only 10.6%.

Adult↗
PubMed1978

Economic impact of rotavirus and other neonatal disease agents of animals.

Methods for estimating the economic impact of disease agents were developed and utilized to assess the relative economic importance of rotavirus and other disease agents in calves. Based on incidence data from 2 sources, Escherichia coli was responsible for the most devastating economic losses (50.9% and 74.6%). Coronaviral (17.5% and 29.7% loss) and rotaviral (3.2% and 9.1% loss) infections ranked 2nd and 3rd, respectively. In one study, cryptosporidial infections (6.5% loss) were estimated to be similar in economic impact to rotaviral infection. Salmonellosis, mycotic gastroenteritis, infectious bovine rhinotracheitis, and bovine viral diarrhea infections accounted for minor losses. The estimated average annual loss of calves for the 7-year period, 1970 through 1976, was $95,500,000/year. Based on data from 2 studies, the estimated average annual loss from E coli was $48.6 and 71.2 million; from coronaviral infection, $16.7 and 28.4 million; from rotaviral infection, $3.1 and $8.7 million; and from cryptosporidial infection, from 1 study, $6.2 million. Estimates of economic impact of disease agents on calves, and likely in other species, indicate that rotaviral infections have a relatively minor role with respect to E coli and coronaviral infections.

Animals↗
PubMed1987

The economics of clinical genetics services. I. Preview.

To an ever increasing extent, a variety of economic factors are affecting the delivery of clinical genetics services. These economic factors, which we enumerate with an historical perspective, influence how genetics professionals, patients, and third-party payers relate to genetics services. From the perspectives of each of these interested parties, the deficiency of objective information about the current economic situation is striking. The recent history of charges and reimbursement for our genetics clinic illustrates both one kind of data that is readily available and how modification of administrative procedures can improve the economic balance sheet. However, several characteristics of clinical genetics limit the possibility of economic self-sufficiency.

Cost-Benefit Analysis↗
PubMed1987

The economic benefit of treating subclinical Streptococcus agalactiae mastitis in lactating cows.

The economic benefits of treating lactating cows for Streptococcus agalactiae mastitis were studied at a large (689 milking cows) central California dairy. Postcure milk production of case cows (infected, treated, and cured) was compared with production of paired control cows (uninfected) and was matched for yield, days in milk, days in gestation, and parity. A simulation was used to plot expected lactation curves for mastitic cows (infected, not treated) with characteristics similar to those of each control cow, and these curves were compared with actual case-cow lactation curves. The difference in actual and expected production was used to calculate net economic benefits of treatment. Comparison of expected with actual production indicated a net benefit from treatment of $396/cow for cows treated in early lactation and $237 for cows treated in midlactation, but a net loss of $55 for cows treated in late lactation. Lactation number did not have a significant impact on economic benefits of treatment. In contrast to other studies indicating no economic benefit from treating mastitis during lactation, this study's positive results may have been attributable to the high cure rate (98%) and the subclinical form of mastitis being treated. Streptococcus agalactiae mastitis treatment during early and midlactation would appear to be an economically justifiable option for dairy managers.

Animals↗
PubMed1979

Economic stress and mental health.

This paper correlates economic stress with minority status, resource allocations for mental health programs, and vulnerability to mental disability. Several hypotheses are advanced:1. A major and recurring psychological pattern of the American national character is prowhite, antiblack paranoia.2. Mental health fiscal allocations and programmatic determinations in ghetto, lower socioeconomic, minority-populated urban areas are predicated on political and racist considerations, the underlying motivation being to keep minorities at greater risk of mental disability.3. Economic privation and stress increase vulnerability to mental illness, especially in a minority population for whom health, mental health, educational, and social services are grossly inadequate.4. Poverty and economic stress combine with health systems that are unresponsive to the needs of blacks and other minorities, resulting in the perpetuation of disabilities and other conditions in blacks that are potentially preventable.5. Health and mental health resources should be increased rather than diminished during periods of economic stress, especially in the public sector.6. In order to provide each citizen with access to quality health and mental health care regardless of race and/or economic status, there must be enacted a national health insurance program based on tax-levy monies that will cover all aspects of health and mental health care.7. Racism and social status will continue to be powerful determinants of the quality of service that white professionals render to black patients and to poor white patients, unless our training institutions mount a massive campaign to train appropriately and to include significant numbers of minority candidates and trainees in the effort. To date this effort is virtually nonexistent.

Humans↗
PubMed1995

National Wilms' Tumor Study: economic perspective.

The National Wilms' Tumor Study poses a question of an essentially economic nature: Can the socioeconomic impact of therapy for Wilms' tumor on the patient's family and society be lessened without compromising the efficacy of therapy? But the only proposed measure of socioeconomic impact appears to be the extent of hospitalization. From an economic perspective, more information is ideally needed from the trial to establish the magnitude of any difference in effectiveness and the magnitude of the difference in costs, so that any trade-off between the two can be assessed. In practice, the extent of the economic data needed at the end of the study will depend on the clinical outcome results and, hence, the nature of the trade-off that will have to be made. If the less extensive treatment is found to be ineffective, economic issues will not come into play. Similarly, if the less extensive treatment is clearly superior in every clinical aspect, the argument for it will probably be persuasive. The interesting situation of a trade-off arises if the less extensive treatment offers clear socioeconomic advantages but has some small clinical disadvantage. In that case, the extent and nature of an array of socioeconomic factors will need to have been measured, not just presumed. There are, of course, many problems associated with collecting and analyzing more comprehensive socioeconomic data in a long trial. This article considers a number of these problems and focuses on six important issues in designing the necessary economic components of future trials.

Child↗
PubMedDate not supplied

[Economic assessment on medications: effects on pharmaceutical industry and health administration].

The present article discuss briefly the different methods of economic assessment of drugs, how and where the methods can be included alongside clinical trials, and discuss their influence in the pharmaceutical industry and health care administration. There are several methodological limitations when adding the economic assessment into a clinical trial principally because they differs in the aims. Economic assessment is interested in efficiency and clinical trials in security and efficacy. Pharmaceutical industry have been developing pharmacoeconomic departments in order to increase the internal efficiency of the viability of new products and to generate studies for regulatory authorities. At the moment, for regulatory purposes in Spain, an economic assessment is nor required but is recommended. The standardization of the methodology of the economic assessment is a key issue that may produce the spread and adoption in health care decision making process.

Decision Making↗
PubMed1994

How economic development and family planning programs combined to reduce Indonesian fertility.

This paper examines the contributions of family planning programs, economic development, and women's status to Indonesian fertility decline from 1982 to 1987. Methodologically we unify seemingly conflicting demographic and economic frameworks into a single "structural" proximate-cause model as well as controlling statistically for the targeted (nonrandom) placement of family planning program inputs. The results are consistent with both frameworks: 75% of the fertility decline resulted from increased contraceptive use, but was induced primarily through economic development and improved education and economic opportunities for females. Even so, the dramatic impact of the changes in demand-side factors (education and economic development) on contraceptive use was possible only because there already existed a highly responsive contraceptive supply delivery system.

Adolescent↗
PubMed1994

[Costs of the treatment of enuresis nocturna. Health economic consequences of alternative methods in the treatment of enuresis nocturna].

The health economic consequences of treating nocturnal enuresis with a buzzer alarm is compared to treatment with Desmopressin. Based on age specific prevalence estimates and reported effects of the two treatments a cost-effectiveness analysis (CEA) was performed. The analysis showed a considerable difference between the costs of the two alternative treatments. A treatment based upon the buzzer alarm could result in a net saving to society of 19.2 million DKK, while a treatment based upon Desmopressin could result in expenses for society of 44.8 million DKK. A treatment based on a combination of the two will be economically neutral to the society. Treatment with a buzzer alarm or a combined treatment is therefore from a health economic point of view preferable. The health economic consequences of the introduction of new treatments are discussed, and it is recommended that health economic analyses are performed before the introduction of new treatments.

Adolescent↗
PubMed1995

Socio-economic aspects of obesity: causes or effects?

Numerous studies in the Western world show an inverse relationship between degree of obesity and socio-economic status. The relationship is most consistent among women, but it becomes obvious when focusing on obesity in men and children. To count the low socio-economic status as a cost of obesity requires that the low status is a consequence of obesity that would not occur if obesity were prevented. A few prospective cohort studies do suggest that this may be the case. However, there is also evidence suggesting that low socio-economic status promotes development of obesity. For various methodological reasons these cohort studies should be cautiously interpreted with regard to cause-and-effect relationships. Furthermore, if obesity and low socio-economic status share some causes, this would generate similar findings, and there are no studies that clearly distinguish between these possibilities. Therefore, the cause-and-effect relationship is not yet sufficiently elucidated to count the low socio-economic status of the obese as an unambiguous cost of obesity.

Causality↗
PubMed1996

Economic implications of IGT intervention: the case of a "phantom alternative'?

Diabetes is a major chronic disease (or group of diseases). It is associated with a variety of risk factors which promote its occurrence. It is also associated as a risk factor for structural and function damage (complications) in various body systems, especially the cardiovascular, renal, eye and neurological systems. Undoubtedly, diabetes is a disease of major public health importance, both in terms of its impact on the well-being of the population and its economic burden. It is thus natural to look into interventions aimed at reducing the long-term sequelae of the disease or more specifically looking into primary prevention strategies (i.e., interventions prior to the onset of the disease) and their economic implications. The purpose of this paper is to asses whether it is possible to perform economic evaluation of primary prevention strategy(ies) in subject with IGT or whether such a strategy represents, at present, a 'Phantom Alternative'. Unfortunately, the evidence about the effectiveness of primary prevention type interventions are weak at best. It is not surprising that no one has suggested a comprehensive strategy (i.e., who is doing what, to whom, where and how often) for an intervention for subjects with impaired glucose tolerance (IGT). The absence of good evidence about the effectiveness of different IGT interventions preclude a valid economic analysis. 'What-it' or 'modelling' type studies are likely to result in the typical answer-'it depends'. It is recommended, therefore, that an economic evaluation should be performed in conjunction with a clinical trial to determine the effectiveness of different IGT interventions.

Canada↗
PubMed1996

How to assess the economics of hypertension control programmes.

In this paper we summarise the discussion in the session about how to assess the economics of hypertension control programmes. The paper is structured around the four main themes discussed in the session: the methods of economic evaluation, the estimation of costs in an economic evaluation, the estimation of effects in an economic evaluation, and the relationship between economic evaluation and policy-making.

Cost of Illness↗
PubMed1997

An economic profile of American older women.

This literature review examines the economic status of American women age 65 and older in view of their longevity, employment patterns, sources of income, income levels, potential for poverty, and their economic stake in current public policy debates and actions regarding Social Security, Medicare, Medicaid, and SSI. Although women live longer and therefore must stretch their financial resources further than men, longevity is not the sole cause of their economic vulnerability. Rather, it is associated with historical patterns of economic dependence on men; with sporadic, often low-wage or nonexistent employment histories; and with public policies and programs that place undue financial pressures on older women. Living alone is a major risk factor for poverty, and women of color are doubly at risk, with the highest poverty rates of all the elderly. Middle-class women face the possibility of "cycling into poverty" after widowhood, especially if their husbands suffered long, costly illnesses or spousal pensions shrink or disappear. While women's improving educational and work opportunities are likely to result in improved financial circumstances for future generations of older women, it will be necessary to move beyond their personal efforts to the public policy arena for solutions to the often devastating effects of uninsured health care costs, pension inequities, and other pressing economic concerns for older women.

Aged↗