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Health Economists (health + economist)
Selected AbstractsTHE LONG-TERM ECONOMIC GAIN FROM NEW MODELS OF HEALTHCARE PROVISION: THE OPPORTUNITIES FOR PHARMACEUTICAL COMPANIESECONOMIC AFFAIRS, Issue 3 2006Nick Bosanquet The case for competition in healthcare has become much stronqer. Health economists have failed to notice the erosion of the old arguments for state monopoly. [source] Comparing alternative models: log vs Cox proportional hazard?HEALTH ECONOMICS, Issue 8 2004Anirban Basu Abstract Health economists often use log models (based on OLS or generalized linear models) to deal with skewed outcomes such as those found in health expenditures and inpatient length of stay. Some recent studies have employed Cox proportional hazard regression as a less parametric alternative to OLS and GLM models, even when there was no need to correct for censoring. This study examines how well the alternative estimators behave econometrically in terms of bias when the data are skewed to the right. Specifically we provide evidence on the performance of the Cox model under a variety of data generating mechanisms and compare it to the estimators studied recently in Manning and Mullahy (2001). No single alternative is best under all of the conditions examined here. However, the gamma regression model with a log link seems to be more robust to alternative data generating mechanisms than either OLS on ln(y) or Cox proportional hazards regression. We find that the proportional hazard assumption is an essential requirement to obtain consistent estimate of the E(y,x) using the Cox model. Copyright © 2004 John Wiley & Sons, Ltd. [source] A framework for evidence-based mental health care and policyACTA PSYCHIATRICA SCANDINAVICA, Issue 2006L. Salvador-Carulla Objective:, Care planning integrates a growing number of disciplines, research fields and analysis techniques. A framework of the main areas of interest with regard to evidence-based health care in mental health is provided here. Method:, The framework is based on the experience of working with data analysts and health and social decision makers at the PSICOST/RIRAG network, a Spanish research association which includes psychiatrists, health economists and health policy experts, as well as on a review of the literature. Results:, Three main areas have been identified and described here: outcomes management, knowledge discovery from data, and decision support systems. Their use in mental health care is reviewed. Conclusion:, It is important to promote bridging strategies among these new fields in order to enhance communication and information transfer between the different parts involved in mental health decision making: i) clinicians and epidemiologists, ii) data analysts, iii) care policy makers and other end-users. [source] Estimating the monetary value of health care: lessons from environmental economicsHEALTH ECONOMICS, Issue 1 2003Nick Hanley In the recent past, considerable effort in health economics has been made on applying stated preference methods such as contingent valuation and choice experiments. Despite this increased use, there is still considerable scepticism concerning the value of these approaches. The application of contingent valuation in environmental economics has a long history and has been widely accepted. Whilst choice experiments were introduced to the environmental and health economics literature at a similar time, the wider acceptance of monetary measures of benefit in environmental economics has meant that they have also been more widely applied. The purpose of this paper is to identify some of the key issues and debates that have taken place in the environmental economics literature, summarise the state of the art with respect to these issues, and consider how health economists have addressed these issues. Important areas for future research in health economics are identified. Copyright © 2002 John Wiley & Sons, Ltd. [source] Review Article: Economic evaluation of prostate cancer screening with prostate-specific antigenINTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2008Tomoaki Imamura Abstract: Economic issues cannot be ignored in conducting prostate cancer screening using prostate-specific antigen (PSA). Through an electronic search, we reviewed five descriptive cost studies and nine cost-effectiveness/cost-utility analyses concerning PSA screening. Most of the existing evidence was based on mathematical model analysis and the results are enormously disparate. The cost per quality-adjusted life years (QALY) gained was estimated to be $US 63.37 to $68.32, and $8400 to $23 100, respectively, or was dominated by no screening. Economic studies evaluating PSA screening are still far from sufficient. Urologists, epidemiologists and health economists must jointly conduct further studies on not only mortality but also quality of life assessment and economic evaluation, using randomized clinical trials, for a strict evaluation of the actual efficacy of PSA screening. At present, patients should be thoroughly informed of the limitations of PSA screening and, in consultation with urological specialists, make the personal decision of whether to receive it. [source] Economic analysis for clinical practice , the case of 31 national consensus guidelines in the NetherlandsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2007Louis W. Niessen MD Abstract Rationale, aims and objective, Evidence on the cost-effectiveness of health interventions in the development of practice guidelines has become of interest in many countries. Challenges are the quality of economic data, the use of cost-effectiveness criteria, and the consensus process. Our paper aims to assess the quality and use of economic information in the formulation of consensus guidelines in a Dutch pilot programme and to recommend improvements. Methods, ,Retrospective qualitative review of economic evaluations and formulated recommendations, using a checklist based on international standards. Results, The national programme to support the development of guidelines with economic analysis in multidisciplinary consensus groups run from 1998 to 2002. It has included 31 medical guidelines, addressing 23 conditions across seven International Classification of Diseases (ICD)-disease groups. Experts in health technology assessment have participated in the guidelines groups. Economic information in all guidelines varies by all criteria in the level of evidence used. Information on quality-adjusted life years gained is limited as is statistical analysis in most studies. Highest cost-effectiveness ratios reported are between ,20 000 and ,30 000. However, there is no uniformity in the definitions of acceptable cost-effectiveness ratios. Conclusions, Economic recommendations can be included in guidelines. Interaction between clinicians and health economists promotes a balance between medical and economic arguments. Among panellists there appears to be agreement on the level of the cost-effectiveness ratios that is acceptable. It is recommended that economic analysis is used to strengthen the evidence-base of guidelines. An evidence-grading system should include the quality of economic evaluation. Roles of policymakers and providers need to be defined. [source] Employers' Benefits from Workers' Health InsuranceTHE MILBANK QUARTERLY, Issue 1 2003Ellen O'Brien Most nonelderly americans receive their health insurance coverage through their workplace. Almost all large firms offer a health insurance plan, and even though they face greater barriers to providing coverage, so do the majority of very small firms. These employment-based plans cover two-thirds of nonelderly Americans and pay most of working families' expenses for health care and about one-quarter of national health spending. Despite employers' role in the health insurance market, however, very little attention has been paid to employers' motivations for providing health insurance to workers. Why do employers offer health insurance to workers? Is it because workers want it? Because their unions demand it? Or do employers offer health benefits to workers because their productivity and profitability depend on it? The standard economic theory of the availability of employer-provided health insurance focuses on worker demand (Cutler 1997; Pauly 1997; Summers 1989). Even though many employers believe that health insurance and health affect employees' productivity and firms' performance, health economists typically overlook and rarely measure firms' returns on health-related investments. Some research, however, suggests that firms may benefit economically by providing health insurance coverage for workers and their families. For example, health coverage may help employers recruit and retain high-quality workers. Health may contribute to productivity by reducing the costs of absenteeism and turnover and by increasing workers' productivity. This article reviews the evidence and proposes an agenda for future research. A better understanding of the benefits to employers of offering health coverage to workers may help clarify employers' behavior and help private employers and public officials make appropriate investments in health. [source] A place to play: Socioeconomic and spatial factors in children's physical activityAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2008Jenny Ziviani Background and aims:,Concerns about physical inactivity in children and growing levels of obesity are expressed by politicians, health economists and those involved with the health and well-being of children. As this has the potential to be a major health issue, the aim of this investigation was to explore any contributing socioenvironmental considerations. Methods and results:,Census-matched survey data were analysed from 318 parents of 6- to 7-year-old children, revealing that family socioeconomic status (SES) influenced the places where children engaged in physical activity. Children from low SES backgrounds spent significantly more time playing close to their homes, and their families were less able to afford access to commercial physical-activity facilities, than those from middle and high SES families. Although neighbourhood-based activities are generally associated with more spontaneous free play, such activities may not provide the same opportunities for supervision and physical skill building available through commercial-based activities. Conclusions:,Given that access to ,enriching' physical-activity spaces may be limited by the capacity to pay, these findings have implications for professionals such as occupational therapists who can take on a role in advocating for equity in access and promotion of a more engaging urban design. Dialogue with urban planners is central to this process. [source] | ||||||||||