Economics of Public Health: Assessment of Health Interventions

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Behavioral Sciences behavsci	2.5	2.6	2011	27 Days	CHF 2200
Children children	2.0	2.7	2014	14.4 Days	CHF 2400
Healthcare healthcare	2.4	3.5	2013	20.5 Days	CHF 2700
International Journal of Environmental Research and Public Health ijerph	-	7.3	2004	24.3 Days	CHF 2500
Nutrients nutrients	4.8	9.2	2009	17.5 Days	CHF 2900

8 pages, 320 KiB

Open AccessArticle

Does Robotic Assisted Technique Improve Patient Utility in Total Knee Arthroplasty? A Comparative Retrospective Cohort Study

by Matteo Ratti, Daniele Ceriotti, Riccardo Rescinito, Rabia Bibi and Massimiliano Panella

Healthcare 2024, 12(16), 1650; https://doi.org/10.3390/healthcare12161650 - 19 Aug 2024

Viewed by 810

Abstract

Background: Even if robotic assisted total knee arthroplasty (RATKA) is a widely used technique, there is still a gap of knowledge about whether this technology is effective in improving the patient utility. This measure is of paramount importance for conducting cost effectiveness analysis. [...] Read more.

Background: Even if robotic assisted total knee arthroplasty (RATKA) is a widely used technique, there is still a gap of knowledge about whether this technology is effective in improving the patient utility. This measure is of paramount importance for conducting cost effectiveness analysis. The aim of this study was to compare the utility measure derived from self-reported outcomes questionnaires in patients who underwent RATKA compared to patients who underwent the manual surgery. Methods: We compared 72 patients operated with a robotic technique with 70 operated with traditional technique. The utility data were collected with the WOMAC (Western Ontario and McMaster University Osteoarthritis index) self-administrated questionnaire that investigates pain, stiffness and functionality of the patients, an then mapped to a utility value through a validated transforming function. We performed three surveys: the first one before the intervention (t0), the second one 1 year after the surgery (t1) and the third one at the 2 year follow up (t2). Results: we observed higher utility values in both groups. In detail, the mean utility score in the RATKA group increased from 0.37 to 0.71 (t1) and 0.78 (t2), while in the conventional group it increased from 0.41 to 0.78 (t1) and 0.78 (t2). The fixed effect coefficients of t1 and t2 were found to be 0.37 and 0.363 (p < 0.001 for both). The coefficient of the robotic technique, along with its interaction with the t1 and t2 time effect was non-significant. Conclusions: Even if at t1 the utility of patient who underwent RATKA were lower, at longer follow up (t2) we found no significant difference compared to traditional technique, leaving the superiority of robotic assisted technique yet to be proved. Our results may be useful for calculating the gained or lost Quality Adjusted Life Years (QALYs), so that the health care system (or an insurance company) could make an appropriate decision whether to fund the robotic approach or not, after a careful assessment of the incremental costs incurred. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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18 pages, 848 KiB

Open AccessArticle

Sex Disparities in the Direct Cost and Management of Stroke: A Population-Based Retrospective Study

by Jorgina Lucas-Noll, José L. Clua-Espuny, Misericòrdia Carles-Lavila, Cristina Solà-Adell, Íngrid Roca-Burgueño, Anna Panisello-Tafalla, Ester Gavaldà-Espelta, Lluïsa Queralt-Tomas and Mar Lleixà-Fortuño

Healthcare 2024, 12(14), 1369; https://doi.org/10.3390/healthcare12141369 - 9 Jul 2024

Viewed by 1690

Abstract

(1) Background: Previous studies have identified disparities in stroke care and outcomes by sex. Therefore, the main objective of this study was to evaluate the average cost of stroke care and the existence of differences in care provision by biological sex. (2) Methods: [...] Read more.

(1) Background: Previous studies have identified disparities in stroke care and outcomes by sex. Therefore, the main objective of this study was to evaluate the average cost of stroke care and the existence of differences in care provision by biological sex. (2) Methods: This observational study adhered to the recommendations of the STROBE statement. The calculation of costs was performed based on the production cost of the service or the rate paid for a set of services, depending on the availability of the corresponding information. (3) Results: A total of 336 patients were included, of which 47.9% were women, with a mean age of 73.3 ± 11.6 years. Women were typically older, had a higher prevalence of hypertension (p = 0.005), lower pre-stroke proportion of mRS 0-2 (p = 0.014), greater stroke severity (p < 0.001), and longer hospital stays (p = 0.017), and more were referred to residential services (p = 0.001) at 90 days. Women also required higher healthcare costs related to cardiovascular risk factors, transient ischemic strokes, institutionalization, and support needs; in contrast, they necessitated lower healthcare costs when undergoing endovascular therapy and receiving rehabilitation services. The unadjusted averaged cost of stroke care was EUR 22,605.66 (CI95% 20,442.8–24,768.4), being higher in women [p = 0.027]. The primary cost concept was hospital treatment (38.8%), followed by the costs associated with dependence and support needs (36.3%). At one year post-stroke, the percentage of women not evaluated for a degree of dependency was lower (p = 0.008). (4) Conclusions: The total unadjusted costs averaged EUR 22,605.66 (CI95% EUR 20,442.8–24,768.4), being higher in women compared to men. The primary cost concept was hospital treatment (38.8%), followed by the costs associated with dependence and support needs (36.3%). Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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21 pages, 724 KiB

Open AccessArticle

Does School Health Promotion Have Additional Value for Educational Performance? A Repeated Cross-Sectional Multilevel Study

by Lisanne Vonk, Iris Eekhout, Tim Huijts, Mark Levels and Maria Jansen

Int. J. Environ. Res. Public Health 2024, 21(6), 767; https://doi.org/10.3390/ijerph21060767 - 13 Jun 2024

Cited by 1 | Viewed by 975

Abstract

Little information is available regarding the influence of the interplay between the school context and school health promotion on educational performance. Therefore, we examined whether the variation between primary and secondary schools regarding the educational performance of students could be explained by general [...] Read more.

Little information is available regarding the influence of the interplay between the school context and school health promotion on educational performance. Therefore, we examined whether the variation between primary and secondary schools regarding the educational performance of students could be explained by general school characteristics, school population characteristics, and school health promotion and to what extent these factors interact. We performed multilevel analyses using existing data on 7021 primary schools and 1315 secondary schools in the Netherlands from the school years 2010–2011 till 2018–2019. Our outcomes were the final test score from primary education and the average grade of standardized final exams from secondary education. School health promotion was operationalized as having obtained Healthy School (HS) certification. For the test score, 7.17% of the total variation was accounted for by differences at the school level and 4.02% for the average grade. For both outcomes, the percentage of disadvantaged students in a school explained most variation. HS certification did not explain variation, but moderated some associations. We found small to moderate differences between schools regarding educational performance. Compositional differences of school populations, especially socioeconomic status, seemed more important in explaining variation in educational performance than general school characteristics and HS certification. Some associations were moderated by HS certification, but differences remained small in most cases. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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16 pages, 272 KiB

Open AccessArticle

Overcoming Barriers in Hospital-Based Health Technology Assessment (HB-HTA): International Expert Panel Consensus

by Iga Lipska, Rossella Di Bidino, Maciej Niewada, Bertalan Nemeth, Tomasz Bochenek, Monika Kukla, Barbara Więckowska, Alicja Sobczak, Katarzyna Iłowiecka, Antal Zemplenyi, Nicolas Martelli, Tess Martin, Olena Filiniuk, Kostyantyn Kosyachenko, Rabia Sucu, Oresta Piniazhko, Olha Zaliska, Andrey Avdeyev, Nasrulla Shanazarov, Marina von Pinoci and Rok Hren Show full author list Hide full author list

Healthcare 2024, 12(9), 889; https://doi.org/10.3390/healthcare12090889 - 25 Apr 2024

Viewed by 1621

Abstract

The purpose of this article is to investigate the common facilitators and barriers associated with the implementation of hospital-based health technology assessment (HB-HTA) across diverse hospital settings in seven countries. Through a two-round Delphi study, insights were gathered from a panel of 15 [...] Read more.

The purpose of this article is to investigate the common facilitators and barriers associated with the implementation of hospital-based health technology assessment (HB-HTA) across diverse hospital settings in seven countries. Through a two-round Delphi study, insights were gathered from a panel of 15 HTA specialists from France, Hungary, Italy, Kazakhstan, Poland, Switzerland, and Ukraine. Experts initially conducted a comprehensive review of the HB-HTA implementation in their respective countries, identifying the barriers and facilitators through descriptive analysis. Subsequently, panel experts ranked these identified barriers and facilitators on a seven-point Likert scale. A median agreement score ≥ 6 and interquartile range (IQR) ≤ 1 was accepted as reaching a consensus. Out of the 12 statements categorized as external and internal barriers and facilitators, the expert panel reached consensus on six statements (two barriers and four facilitators). The external barrier, which achieved consensus, was the lack of the formal recognition of the role of HB-HTA in national or regional legislations. The internal barrier reaching consensus was the limited availability of human resources dedicated to HB-HTA. This qualitative study indicates that HB-HTA still has progress to make before being formally accepted and integrated across most countries, although by building on the facilitating factors we identified there may be an opportunity for the implementation of internationally developed strategies to strengthen HB-HTA practices. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

13 pages, 1075 KiB

Open AccessArticle

Economic Evaluation of the Thai Diagnostic Autism Scale for Autism Spectrum Disorder Diagnosis in Children Aged 1–5 Years Old

by Duangkamol Tangviriyapaiboon, Unchalee Permsuwan, Chosita Pavasuthipaisit, Athithan Sriminipun and Piyameth Dilokthornsakul

Healthcare 2024, 12(7), 782; https://doi.org/10.3390/healthcare12070782 - 3 Apr 2024

Viewed by 1286

Abstract

The Thai Diagnostic Autism Scale (TDAS) was developed for autism spectrum disorder (ASD) diagnosis in Thai children aged 1–5 years. Previous studies have indicated its good performance; however, additional health resources and healthcare providers are necessary for evaluation. Therefore, this study aimed to [...] Read more.

The Thai Diagnostic Autism Scale (TDAS) was developed for autism spectrum disorder (ASD) diagnosis in Thai children aged 1–5 years. Previous studies have indicated its good performance; however, additional health resources and healthcare providers are necessary for evaluation. Therefore, this study aimed to assess the cost-effectiveness of TDAS compared to clinical diagnosis (ClinDx) for ASD diagnosis in Thai children aged 1–5 years from a societal perspective. The analysis employed a hybrid model consisting of a decision tree model for a diagnostic phase with a state transition model for a follow-up phase. A literature review was conducted to determine TDAS performance and the relative risk of death in patients with ASD. Direct medical costs were assessed through a retrospective medical records review, and a cross-sectional survey was conducted to determine direct nonmedical costs, ASD severities, and utility values. The cost of TDAS was derived from a healthcare provider interview (n = 10). The incremental cost-effectiveness ratio (ICER) compared the total lifetime cost and quality-adjusted life years (QALY) between TDAS and ClinDx. We found that TDAS could improve QALY by 1.96 but increased total lifetime cost by 5577 USD, resulting in an ICER of 2852 USD/QALY. Sensitivity analysis indicated an 81.16% chance that TDAS is cost-effective. The probabilities of different ASD severities were key influencing factors of the findings. In conclusion, TDAS is the cost-effective option for ASD diagnosis in Thai children aged 1–5 years compared to ClinDx, despite some uncertainties around inputs. Further monitoring and evaluation are warranted if TDAS is to be implemented nationwide. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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14 pages, 601 KiB

Open AccessArticle

Health Economic Evaluation of a Controlled Lifestyle Intervention: The Healthy Lifestyle Community Program (Cohort 2; HLCP-2)

by Ragna-Marie Kranz, Carmen Kettler, Christian Koeder, Sarah Husain, Corinna Anand, Nora Schoch and Heike Englert

Nutrients 2023, 15(24), 5045; https://doi.org/10.3390/nu15245045 - 8 Dec 2023

Viewed by 1466

Abstract

Non-communicable diseases (NCD) are associated with high costs for healthcare systems. We evaluated changes in total costs, comprising direct and indirect costs, due to a 24-month non-randomized, controlled lifestyle intervention trial with six measurement time points aiming to improve the risk profile for [...] Read more.

Non-communicable diseases (NCD) are associated with high costs for healthcare systems. We evaluated changes in total costs, comprising direct and indirect costs, due to a 24-month non-randomized, controlled lifestyle intervention trial with six measurement time points aiming to improve the risk profile for NCDs. Overall, 187 individuals from the general population aged ≥18 years were assigned to either the intervention group (IG; n = 112), receiving a 10-week intensive lifestyle intervention focusing on a healthy, plant-based diet; physical activity; stress management; and community support, followed by a 22-month follow-up phase including monthly seminars, or a control group (CG; n = 75) without intervention. The complete data sets of 118 participants (IG: n = 79; CG: n = 39) were analyzed. At baseline, total costs per person amounted to 67.80 ± 69.17 EUR in the IG and 48.73 ± 54.41 EUR in the CG per week. The reduction in total costs was significantly greater in the IG compared to the CG after 10 weeks (p = 0.012) and 6 months (p = 0.004), whereas direct costs differed significantly after 10 weeks (p = 0.017), 6 months (p = 0.041) and 12 months (p = 0.012) between the groups. The HLCP-2 was able to reduce health-related economic costs, primarily due to the reduction in direct costs. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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10 pages, 959 KiB

Open AccessArticle

A Sense of Scarcity Enhances the Above-Average Effect in Social Comparison

by Xiaoyan Wang and Lan Jiao

Behav. Sci. 2023, 13(10), 826; https://doi.org/10.3390/bs13100826 - 8 Oct 2023

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Abstract

Scarcity refers to a state in which an individual’s resources do not satisfy his/her needs. A sense of scarcity evokes negative emotions. A fundamental strategy for coping with this negative threat is for people to emphasize the desirability of their personal traits. In [...] Read more.

Scarcity refers to a state in which an individual’s resources do not satisfy his/her needs. A sense of scarcity evokes negative emotions. A fundamental strategy for coping with this negative threat is for people to emphasize the desirability of their personal traits. In this study, a 2 (sense of scarcity: high or low) × 2 (valence: positive or negative) mixed-design experiment was conducted to examine whether and how a sense of scarcity affected one’s self-evaluation. Participants were assigned randomly to a high- or low-scarcity group. The chances of assistance rendered to an individual during a word puzzle task were manipulated to induce a high or low sense of scarcity. Then, participants were asked to make positive and negative trait judgments of themselves compared with their average peers. The results showed that people judged their personalities to be more desirable (i.e., more positive and less negative traits) than their average peers, manifesting the above-average effect. More importantly, people with a high sense of scarcity manifested a greater above-average effect than those with a low sense of scarcity. This study suggests that people could highlight their positive aspects to cope with predicaments in social life. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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14 pages, 280 KiB

Open AccessArticle

A Qualitative Study of the Benefits and Utility of Brief Motivational Interviewing to Reduce Sexually Transmitted Infections among Men Who Have Sex with Men

by Matshidiso A. Malefo, Olalekan A. Ayo-Yusuf and Mathildah Mpata Mokgatle

Behav. Sci. 2023, 13(8), 654; https://doi.org/10.3390/bs13080654 - 4 Aug 2023

Cited by 2 | Viewed by 1324

Abstract

Several studies have demonstrated the effectiveness of motivational interviewing (MI) in reducing sexual risk behaviors. However, limited information is available on the acceptability of brief MI among men who have sex with men (MSM) in poor resource settings like sub-Saharan Africa. The objective [...] Read more.

Several studies have demonstrated the effectiveness of motivational interviewing (MI) in reducing sexual risk behaviors. However, limited information is available on the acceptability of brief MI among men who have sex with men (MSM) in poor resource settings like sub-Saharan Africa. The objective of this study was to assess the views of MSM about the benefits and utility of brief MI (bMI) in changing their risky behavior. A qualitative study among men who have sex with men (MSM) who were enrolled in a longitudinal observational study between December 2021 and May 2023. The setting was in Tshwane North and participants were scheduled for baseline, 6-month, and 12-month visits. All participants received 20 min one-on-one face-to-face brief motivational interview (bMI) sessions during their follow-up visits. At month 12, an exit interview was conducted with consenting conveniently sampled participants (n = 23) who had completed all scheduled visits and received three bMI sessions. The findings indicated that the most recalled conversation was related to multiple sexual partners, having sex under the influence of alcohol, and MSM learned more about sexually transmitted diseases. Many expressed being comfortable with the sessions because the counselor was respectful and non-judgmental. Most found the bMI sessions to have a positive impact on changing and reducing risky sexual behaviors, particularly it reportedly increased their use of condoms and reduced the number of multiple partners. MSM found the bMI to be useful and acceptable in reducing sexual risk behaviors among MSM. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

13 pages, 815 KiB

Open AccessArticle

Economic Evaluation of Anesthesiology-Led Cardiac Implantable Electronic Device Service

by Ahmed Zaky, Ryan L. Melvin, David Benz, James Davies, Vardas Panayotis, William Maddox, Ruchit Shah, Tom Lynch, Adam Beck, Kristine Hearld, Tom McElderry and Miriam Treggiari

Healthcare 2023, 11(13), 1864; https://doi.org/10.3390/healthcare11131864 - 27 Jun 2023

Viewed by 1095

Abstract

Background: Implementation of an anesthesiology-led cardiac implantable electronic device (CIED) service can be viewed to have economic and efficiency challenges. This study evaluates the cost savings of an anesthesiology-led CIED service. Methods: A total of 830 patients presented in the pre-implementation period from [...] Read more.

Background: Implementation of an anesthesiology-led cardiac implantable electronic device (CIED) service can be viewed to have economic and efficiency challenges. This study evaluates the cost savings of an anesthesiology-led CIED service. Methods: A total of 830 patients presented in the pre-implementation period from 1 March 2016 to 31 December 2017, and 1981 patients presented in the post-implementation period from 1 January 2018 to 31 October 2021. Interrupted time-series analysis for single-group comparisons was used to evaluate the cost savings resulting from reduction in operating room (OR) start delays for patients with CIEDs. Results: OR start-time delay was reduced by 10.6 min (95%CI: −20.5 to −0.83), comparing pre- to post-implementation. For an OR cost of USD 45/min, we estimated the direct cost to the department to be USD 1.68/min. The intervention translated into a total cost reduction during the intervention period of USD 250,000 (USD 18,000 to USD 470,000) per year for the institution and USD 9800 (USD 730 to USD 17,000) per year for the department. The yearly cost of employing a full-time team of CIED specialists would have been USD 135,456. The service triggered electrophysiology consultation on 13 device malfunctions. Conclusions: An anesthesiology-led CIED service resulted in substantial cost savings, increased OR efficiency and patient safety. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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26 pages, 848 KiB

Open AccessArticle

Relationships between Health Education, Health Behaviors, and Health Status among Migrants in China: A Cross-Sectional Study Based on the China Migrant Dynamic Survey

by Minji Kim and Hai Gu

Healthcare 2023, 11(12), 1768; https://doi.org/10.3390/healthcare11121768 - 15 Jun 2023

Cited by 3 | Viewed by 1810

Abstract

Managing the health of migrants has become a crucial aspect of promoting social harmony and cohesion in China. This study investigates the impact of public health education on the health status of migrants in China using cross-sectional data from the China Migrants Dynamic [...] Read more.

Managing the health of migrants has become a crucial aspect of promoting social harmony and cohesion in China. This study investigates the impact of public health education on the health status of migrants in China using cross-sectional data from the China Migrants Dynamic Survey 2017. A total of 169,989 migrants in China were selected as samples for empirical test. Data were analyzed using descriptive statistics, logistic regression, and the structural equation model. The findings show that health education significantly influences the health status of migrants in China. Specifically, health education related to occupational diseases, venereal diseases/AIDS, and self-rescue in public emergencies had a significant positive impact on migrants’ health, while health education regarding chronic diseases had a significant negative impact. Health education delivered through lectures and bulletin boards had a significant positive impact on migrants’ health, but online education had a significant negative effect on the health status of migrants. The effects of health education differ by gender and age, with a stronger positive impact on female migrants and elderly migrants aged 60 and above. The mediating effect of health behaviors was significant only in the total effect. In conclusion, health education can effectively enhance the health status of migrants in China by modifying their health behaviors. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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13 pages, 918 KiB

Open AccessArticle

The Effects of Repeated Attachment Security Priming on Social Anxiety and Attention Bias: A Randomized Controlled Trial

by Shuang Zhang, Yanqiang Tao, Yunxiang Chen, Peng Zhang and Xiangping Liu

Behav. Sci. 2023, 13(5), 420; https://doi.org/10.3390/bs13050420 - 16 May 2023

Viewed by 2368

Abstract

Background: Although the clinical utility of attachment security priming has been suggested in recent years, the effect of attachment security priming on social anxiety and its core symptoms (i.e., attention bias) remains unspecified. Therefore, the present study explored the potential effectiveness of repeated [...] Read more.

Background: Although the clinical utility of attachment security priming has been suggested in recent years, the effect of attachment security priming on social anxiety and its core symptoms (i.e., attention bias) remains unspecified. Therefore, the present study explored the potential effectiveness of repeated attachment security priming in alleviating social anxiety and attention bias among Chinese college students. Methods: Fifty-six college students with high social anxiety were randomly assigned to the attachment security priming group (n = 30) or control group (n = 26). The priming group completed seven attachment security priming sessions over 2 weeks (every 2 days), and the control group was assigned to a waitlist for 2 weeks. Results: The results revealed that individuals in the priming group reported less social anxiety after 2 weeks of security attachment priming, and those in the control group did not change significantly. The results also showed that there was no significant change in the attention bias of individuals with social anxiety before and after the intervention. Conclusions: Our findings indicate that attachment security priming is a promising alternative intervention option for social anxiety. The potential clinical implications of security attachment priming are discussed. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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14 pages, 2501 KiB

Open AccessArticle

The Effect of Fangcang Shelter Hospitals under Resource Constraints on the Spread of Epidemics

by Guangyu Li, Haifeng Du, Jiarui Fan, Xiaochen He and Wenhua Wang

Int. J. Environ. Res. Public Health 2023, 20(10), 5802; https://doi.org/10.3390/ijerph20105802 - 12 May 2023

Cited by 2 | Viewed by 1716

Abstract

Since the outbreak of the COVID-19 pandemic, Fangcang shelter hospitals have been built and operated in several cities, and have played a huge role in epidemic prevention and control. How to use medical resources effectively in order to maximize epidemic prevention and control [...] Read more.

Since the outbreak of the COVID-19 pandemic, Fangcang shelter hospitals have been built and operated in several cities, and have played a huge role in epidemic prevention and control. How to use medical resources effectively in order to maximize epidemic prevention and control is a big challenge that the government should address. In this paper, a two-stage infectious disease model was developed to analyze the role of Fangcang shelter hospitals in epidemic prevention and control, and examine the impact of medical resources allocation on epidemic prevention and control. Our model suggested that the Fangcang shelter hospital could effectively control the rapid spread of the epidemic, and for a very large city with a population of about 10 million and a relative shortage of medical resources, the model predicted that the final number of confirmed cases could be only 3.4% of the total population in the best case scenario. The paper further discusses the optimal solutions regarding medical resource allocation when medical resources are either limited or abundant. The results show that the optimal allocation ratio of resources between designated hospitals and Fangcang shelter hospitals varies with the amount of additional resources. When resources are relatively sufficient, the upper limit of the proportion of makeshift hospitals is about 91%, while the lower limit decreases with the increase in resources. Meanwhile, there is a negative correlation between the intensity of medical work and the proportion of distribution. Our work deepens our understanding of the role of Fangcang shelter hospitals in the pandemic and provides a reference for feasible strategies by which to contain the pandemic. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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21 pages, 3870 KiB

Open AccessArticle

Environmental Governance, Public Health Expenditure, and Economic Growth: Analysis in an OLG Model

by Zhao Zhang, Caoyuan Ma and Aiping Wang

Int. J. Environ. Res. Public Health 2023, 20(4), 3033; https://doi.org/10.3390/ijerph20043033 - 9 Feb 2023

Cited by 4 | Viewed by 2265

Abstract

This article studies the relationship between environmental governance, public health expenditure, and economic growth by introducing human health status into a three-period overlapping generation dynamic general equilibrium (OLG-DGE) model and conducting a policy simulation analysis in a Chinese scenario. The main findings are [...] Read more.

This article studies the relationship between environmental governance, public health expenditure, and economic growth by introducing human health status into a three-period overlapping generation dynamic general equilibrium (OLG-DGE) model and conducting a policy simulation analysis in a Chinese scenario. The main findings are generalized as follows: (i) The increase in pollution emissions per unit of output will not only lead to the deterioration of public health but also hinder long-term economic growth, while the efficiency of pollution control will improve health and output per labor unit; (ii) Although levying environmental tax will improve health status and life expectancy, it has a non-linear impact on pollution emissions and output per labor unit, which means that there are trade-offs among environmental governance, public health improvement, and economic output; and (iii) Although the increase in the proportion of public health expenditure will improve health status, its impact on life expectancy and economic output is affected by the level of environmental tax. Only when the environmental tax rate is relatively low, will increasing the proportion of public health expenditure extend life expectancy and output per labor unit. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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19 pages, 3188 KiB

Open AccessArticle

Healthcare Systems across Europe and the US: The Managed Entry Agreements Experience

by Michele Ciulla, Lisa Marinelli, Giuseppe Di Biase, Ivana Cacciatore, Fiorenzo Santoleri, Alberto Costantini, Marilisa Pia Dimmito and Antonio Di Stefano

Healthcare 2023, 11(3), 447; https://doi.org/10.3390/healthcare11030447 - 3 Feb 2023

Cited by 15 | Viewed by 5189

Abstract

This systematic study aims at analyzing the differences between the approach of the European healthcare systems to the pharmaceutical market and the American one. This paper highlights the opportunities and the limitations given by the application of managed entry agreements (MEAs) in European [...] Read more.

This systematic study aims at analyzing the differences between the approach of the European healthcare systems to the pharmaceutical market and the American one. This paper highlights the opportunities and the limitations given by the application of managed entry agreements (MEAs) in European countries as opposed to the American market, which does not regulate pharmaceutical prices. Data were collected from the Organisation for Economic Co-operation and Development (OECD), the European Medicines Agency, and the national healthcare agencies of US and European countries. A literature review was undertaken in PubMed, Scopus, MEDLINE, and Google for a period ten years (2010–2019). The period 2020–2021 was considered to compare health expenditure before and after the SARS-CoV-2 pandemic. Scarce information from national agencies has been given in terms of MEAs related to the COVID-19 pandemic. The comparison between the United States approach and the European one shows the importance of a market access regulation to reduce the cost of therapies, increasing the efficiency of national healthcare systems and the advantages in terms of quality and accessibility to the final users: patients. Nevertheless, it seems that the golden age of MEAs for Europe was during the examined period. Except for Italy, countries will move to other forms of reimbursements to obtain higher benefits, reducing the costs of an inefficient implementation and outcomes in the medium term. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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20 pages, 1570 KiB

Open AccessSystematic Review

Effectiveness and Cost-Effectiveness of Mental Health Interventions Delivered by Frontline Health Care Workers in Emergency Health Services: A Systematic Review and Meta-Analysis

by Min Peng, Tao Xiao, Ben Carter, Pan Chen and James Shearer

Int. J. Environ. Res. Public Health 2022, 19(23), 15847; https://doi.org/10.3390/ijerph192315847 - 28 Nov 2022

Cited by 3 | Viewed by 3279

Abstract

This systematic review is to evaluate the effectiveness and cost-effectiveness of mental health interventions delivered by frontline health care workers in disasters and public health emergencies. Six databases and trial registries were searched, and manual searches were conducted. Of the 221 studies identified, [...] Read more.

This systematic review is to evaluate the effectiveness and cost-effectiveness of mental health interventions delivered by frontline health care workers in disasters and public health emergencies. Six databases and trial registries were searched, and manual searches were conducted. Of the 221 studies identified, 21 were included. Meta-analyses assessed differences between the intervention and control in terms of PTSD outcomes. Eleven studies of 1802 participants were incorporated in the meta-analysis. Interventions delivered or prompted by specialist health care workers showed significant and large effects in improving PTSD-related symptoms with a SMD = 0.99 (95% CI: 0.42–1.57, p = 0.0007). Interventions delivered or prompted by frontline non-specialist health care workers showed significant but small effects in improving PTSD-related symptoms with SMD of 0.25 (95% CI: 0.11–0.39; p = 0.0007). The results showed that most mental health interventions delivered by frontline health care workers effectively supported affected people. Mental health interventions delivered by mental health care professionals are effective in reducing PTSD-related disorders in natural disasters. Future adequately powered RCTs are needed to evaluate the effectiveness of mental health interventions delivered by trained non-specialists. Economic modelling may be useful to estimate cost effectiveness in low- and middle-income countries given the difficulties of conducting studies in disaster and emergency settings. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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13 pages, 4426 KiB

Open AccessArticle

Exploring Dental Health and Its Economic Determinants in Romanian Regions

by Andor Toni Cigu and Elena Cigu

Healthcare 2022, 10(10), 2030; https://doi.org/10.3390/healthcare10102030 - 14 Oct 2022

Cited by 3 | Viewed by 2403

Abstract

Sustainable dental health is reflected in the high quality of the medical act and the high quality of the medical service, which cannot be achieved without considering the existing social context, especially the economic development of a state, where certain economic variables can [...] Read more.

Sustainable dental health is reflected in the high quality of the medical act and the high quality of the medical service, which cannot be achieved without considering the existing social context, especially the economic development of a state, where certain economic variables can become real levers of influence. The goal of this paper is twofold—theoretical and empirical. Firstly, at the theoretical level, we provide the context and the development of the health legal framework and the state of the Oral Health System and the provision of dental medical services in the eight Romanian Regions of Development. The second aim is to evaluate the relationship between dental health and well-being for the case of regions of Romania over the period 2001–2015. To review the dental health care in Romania, we will use descriptive analysis as the methodology, and to explore the relationship between dental health and economic determinants, we will use an econometric model, the OLS model. Our working hypothesis is that dental health care is influenced by the economic variables in a country. The results show a positive and significant relationship between dental health care and the most important indicator of well-being, the level of income. Of course, an important role is played by the complexity of education, expressed by research and development, which determines a significant positive relationship with dental health in the development regions of Romania. Full article

(This article belongs to the Topic Economics of Public Health: Assessment of Health Interventions)

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