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PloS One 2014Brain disorders represent a high burden in Europe and worldwide. The objective of this study was to provide specific estimates of the economic costs of brain disorders... (Review)
Review
BACKGROUND
Brain disorders represent a high burden in Europe and worldwide. The objective of this study was to provide specific estimates of the economic costs of brain disorders in Spain, based on published epidemiological and economic evidence.
METHODS
A cost-of-illness study with a societal perspective of 19 brain disorders was carried out. Cost data published between 2004 and 2012 was obtained from a systematic literature review. Direct healthcare, direct non-medical and indirect costs were considered, prioritizing bottom-up information. All costs were converted to Euro and to year 2010. The missing values were imputed with European estimates. Sensitivity analyses based on qualitative assessment of the literature and on a Monte Carlo simulation were performed.
RESULTS
The review identified 33 articles with information on costs for 11 disorders (8 neurological, 3 mental). The average per-patient cost ranged from 36,946 € for multiple sclerosis to 402 € for headache. The societal cost of the 19 brain disorders in Spain in 2010 was estimated in 84 € billion. Societal costs ranged from 15 € billion for dementia to 65 € million for eating disorders. Mental disorders societal cost were 46 € billions (55% of the total), while neurological disorder added up to 38 € billion. Healthcare costs represented 37% of the societal costs of brain disorders, whereas direct non-medical constituted 29% and indirect costs 33%.
CONCLUSION
Brain disorders have a substantial economic impact in Spain (equivalent to almost 8% of the country's GDP). Economic data on several important brain disorders, specially mental disorders, is still sparse.
Topics: Brain Diseases; Cost of Illness; Delivery of Health Care; Health Care Costs; Humans; Spain
PubMed: 25133395
DOI: 10.1371/journal.pone.0105471 -
Journal of Vascular Surgery Mar 2015Peripheral arterial disease is common and is associated with significant morbidity and mortality. (Review)
Review
BACKGROUND
Peripheral arterial disease is common and is associated with significant morbidity and mortality.
METHODS
We conducted a systematic review to identify randomized trials and systematic reviews of patients with intermittent claudication to evaluate surgery, endovascular therapy, and exercise therapy. Outcomes of interest were death, amputation, walking distance, quality of life, measures of blood flow, and cost.
RESULTS
We included eight systematic reviews and 12 trials enrolling 1548 patients. Data on mortality and amputation and on cost-effectiveness were sparse. Compared with medical management, each of the three treatments (surgery, endovascular therapy, and exercise therapy) was associated with improved walking distance, claudication symptoms, and quality of life (high-quality evidence). Evidence supporting superiority of one of the three approaches was limited. However, blood flow parameters improved faster and better with both forms of revascularization compared with exercise or medical management (low- to moderate-quality evidence). Compared with endovascular therapy, open surgery may be associated with longer length of hospital stay and higher complication rate but resulted in more durable patency (moderate-quality evidence).
CONCLUSIONS
In patients with claudication, open surgery, endovascular therapy, and exercise therapy were superior to medical management in terms of walking distance and claudication. Choice of therapy should rely on patients' values and preferences, clinical context, and availability of operative expertise.
Topics: Amputation, Surgical; Cardiovascular Agents; Combined Modality Therapy; Cost-Benefit Analysis; Endovascular Procedures; Exercise Therapy; Exercise Tolerance; Health Care Costs; Humans; Intermittent Claudication; Length of Stay; Limb Salvage; Lower Extremity; Peripheral Arterial Disease; Quality of Life; Recovery of Function; Risk Factors; Time Factors; Treatment Outcome; Vascular Patency; Vascular Surgical Procedures; Walking
PubMed: 25721067
DOI: 10.1016/j.jvs.2014.12.007 -
The Laryngoscope Jul 2015The objective of this systematic review was to summarize the literature evaluating the costs associated with the management of adult chronic rhinosinusitis (CRS) using... (Review)
Review
OBJECTIVE/STUDY DESIGN
The objective of this systematic review was to summarize the literature evaluating the costs associated with the management of adult chronic rhinosinusitis (CRS) using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
METHODS
Two separate authors systematically searched eight commonly used medical databases. Included articles were categorized into seven domains: 1) overall healthcare cost (direct and indirect), 2) resource utilization, 3) medical management strategies, 4) overall procedure cost of endoscopic sinus surgery (ESS), 5) intraoperative technologies, 6) ESS litigation, and 7) CRS diagnostics. To maintain a common currency for comparison, all costs were converted to 2014 United States dollars (USD) using an inflation calculator in September 2014.
RESULTS
Forty-four studies were identified for inclusion. The range for overall CRS-related healthcare costs was $6.9 to $9.9 billion 2014 USD per year. Indirect costs were estimated as $13 billion 2014 USD per year. Annual medication costs prior to ESS ranged between $1,547 and $2,700 2014 USD per patient, with a uniform reduction in costs after ESS. The overall US cost of outpatient ESS ranged from $8,200 to $10,500 2014 USD per case. The overall annual economic burden of CRS in the United States was estimated to be $22 billion 2014 USD (direct and indirect costs).
CONCLUSION
The results of this systematic review have demonstrated substantial direct and indirect costs associated with the management of adult CRS. Future research should continue to improve the costing data, which can be used to improve the value of care provided for this chronic inflammatory disease.
Topics: Adult; Chronic Disease; Cost of Illness; Cost-Benefit Analysis; Health Care Costs; Humans; Rhinitis; Sinusitis; United States
PubMed: 25640115
DOI: 10.1002/lary.25180 -
Value in Health Regional Issues Jan 2023We performed a systematic review of studies estimating the cost of illness of lung cancer to compare costs between studies and examine cost drivers, emphasizing...
OBJECTIVES
We performed a systematic review of studies estimating the cost of illness of lung cancer to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices.
METHODS
A systematic search on studies published in English on cost of illness of lung cancer was performed in MEDLINE (PubMed), Embase, Web of Science, and Scopus. Databases were searched in January 2017, and records were screened based on eligibility criteria. The systematic search was updated on May 7, 2020. The quality of included studies was appraised using a modified Drummond checklist.
RESULTS
Of the 4891 records screened, 19 records were included. Most of the studies were cross-sectional and retrospective and used a prevalence-based approach and a bottom-up approach. Direct medical costs ranged from 4484.13 US dollars purchasing power parity to 45 364.48 US dollars purchasing power parity. Total medical costs as a percentage of total gross domestic product (GDP) ranged from 0.00248 to 0.1326 (median 0.0217), and total medical costs as a percentage of total health expenditure ranged from 0.038 to 0.836 (median 0.209).
CONCLUSIONS
There was considerable methodological heterogeneity that made it difficult to compare results between studies. The costs of lung cancer are substantial and impose a substantial economic burden on patients, healthcare systems, and societies. By comparing cancer costs with total health expenditures and GDP per capita, it can be concluded that lung cancer imposes a considerable economic burden on patients and healthcare systems in countries with lower GDP per capita and higher incidence rate.
Topics: Humans; Cost of Illness; Retrospective Studies; Health Expenditures; Delivery of Health Care; Lung Neoplasms
PubMed: 36201970
DOI: 10.1016/j.vhri.2022.07.007 -
Brain Sciences Feb 2021This systematic review was carried out to compile and assess original studies that included economic evaluations of neurological physiotherapy interventions. A thorough... (Review)
Review
This systematic review was carried out to compile and assess original studies that included economic evaluations of neurological physiotherapy interventions. A thorough search of PubMED, Cochrane and Embase was developed using keywords such as health economics, neurological physiotherapy and cost analysis, and studies published during the last six-year term were selected. A total of 3124 studies were analyzed, and 43 were eligible for inclusion. Among the studies analyzed, 48.8% were interventions for stroke patients, and 13.9% were focused on Parkinson's disease. In terms of the countries involved, 46.5% of the studies included were developed in the UK, and 13.9% were from the USA. The economic analysis most frequently used was cost-utility, implemented in 22 of the studies. A cost-effectiveness analysis was also developed in nine of those studies. The distribution of studies including an economic evaluation in this discipline showed a clear geographic dominance in terms of the pathology. A clear upward trend was noted in the economic evaluation of interventions developed in neurological physiotherapy. However, these studies should be promoted for their use in evidence-based clinical practice and decision-making.
PubMed: 33669731
DOI: 10.3390/brainsci11020265 -
Yearbook of Medical Informatics Aug 2018Clinical decision support (CDS) systems can improve safety and facilitate evidence-based practice. However, clinical decisions are often affected by the cognitive... (Review)
Review
BACKGROUND
Clinical decision support (CDS) systems can improve safety and facilitate evidence-based practice. However, clinical decisions are often affected by the cognitive biases and heuristics of clinicians, which is increasing the interest in behavioral and cognitive science approaches in the medical field.
OBJECTIVES
This review aimed to identify decision biases that lead clinicians to exhibit irrational behaviors or responses, and to show how behavioral economics can be applied to interventions in order to promote and reveal the contributions of CDS to improving health care quality.
METHODS
We performed a systematic review of studies published in 2016 and 2017 and applied a snowball citationsearch method to identify topical publications related to studies forming part of the BEARI (Application of Behavioral Economics to Improve the Treatment of Acute Respiratory Infections) multisite, cluster-randomized controlled trial performed in the United States.
RESULTS
We found that 10 behavioral economics concepts with nine cognitive biases were addressed and investigated for clinician decision-making, and that the following five concepts, which were actively explored, had an impact in CDS applications: social norms, framing effect, status-quo bias, heuristics, and overconfidence bias.
CONCLUSIONS
Our review revealed that the use of behavioral economics techniques is increasing in areas such as antibiotics prescribing and preventive care, and that additional tests of the concepts and heuristics described would be useful in other areas of CDS. An improved understanding of the benefits and limitations of behavioral economics techniques is also still needed. Future studies should focus on successful design strategies and how to combine them with CDS functions for motivating clinicians.
Topics: Acute Disease; Bias; Decision Support Systems, Clinical; Economics, Behavioral; Humans; Quality of Health Care; Respiratory Tract Infections
PubMed: 30157514
DOI: 10.1055/s-0038-1641221 -
International Journal of Public Health Jan 2017To identify practices for conducting international short-term medical missions (STMMs) recommended in the literature and examine how these link STMMs to recipient... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To identify practices for conducting international short-term medical missions (STMMs) recommended in the literature and examine how these link STMMs to recipient countries' existing health systems.
METHODS
Systematic review of PubMed-indexed articles on STMMs and their bibliographies using preferred reporting items for systematic reviews and meta-analyses guidelines. Recommendations were organized using the World Health Organization Health Systems Framework.
RESULTS
In 92 publications, 67 % offered at least one recommendation that would link STMMs to the recipient country's health system. Among these recommendations, most focused on service delivery and few on health financing and governance. There is a lack of consensus around a proper standard of care, patient selection, and trip duration.
CONCLUSIONS
Comprehensive global standards are needed for STMM work to ensure that services are beneficial both to patients and to the broader healthcare systems of recipient countries. By providing an overview of the current recommendations and important gaps where practice recommendations are needed, this study can provide relevant input into the development of global standards for STMMs.
Topics: Delivery of Health Care; Developing Countries; Global Health; Humans; Medical Missions; Patient Selection; Standard of Care
PubMed: 27592359
DOI: 10.1007/s00038-016-0889-6 -
Environmental Science and Pollution... Dec 2020Green consumption can facilitate sustainable industrial development and improve the overall efficiency of resource utilization. In response to rapid economic development... (Meta-Analysis)
Meta-Analysis Review
Green consumption can facilitate sustainable industrial development and improve the overall efficiency of resource utilization. In response to rapid economic development and increasing environmental emissions, it is critical to promote green consumption so that the whole society can move toward sustainable development. This study aims to systematically review studies on green consumption by means of meta-analysis, bibliometric analysis, and social network analysis. The results show that green consumption is an interdisciplinary research field, involving environmental science, social science, medical science, economics, and other disciplines. Most productive countries, institutions, authors are identified so that the new researchers in this field can find their research partners. Keywords analysis results help identify the research hotpots in this field. It is suggested that future green consumption research should focus on behavior mechanism, stakeholder coordination, and policy evaluation. In general, the results obtained from this study provide valuable information for researchers and practitioners to promote green consumption research.
Topics: Bibliometrics; Efficiency; Knowledge; Sustainable Development
PubMed: 33001398
DOI: 10.1007/s11356-020-11029-y -
Vaccine Nov 2015The economic burden of seasonal influenza outbreaks as well as influenza pandemics in lower- and middle-income countries (LMIC) has yet to be specifically systematically... (Review)
Review
OBJECTIVES
The economic burden of seasonal influenza outbreaks as well as influenza pandemics in lower- and middle-income countries (LMIC) has yet to be specifically systematically reviewed. The aim of this systematic review is to assess the evidence of influenza economic burden assessment methods in LMIC and to quantify the economic consequences of influenza disease in these countries, including broader opportunity costs in terms of impaired social progress and economic development.
METHODS
We conducted an all language literature search across 5 key databases using an extensive list of key words for the time period 1950-2013. We included studies which explored direct costs (medical and non-medical), indirect costs (productivity losses), and broader economic impact in LMIC associated with different influenza outcomes such as confirmed seasonal influenza infection, influenza-like illnesses, and pandemic influenza.
RESULTS
We included 62 full-text studies in English, Spanish, Russian, Chinese languages, mostly from the countries of Latin American and the Caribbean and East Asia and Pacific with pertinent cost data found in 39 papers. Estimates for direct and indirect costs were the highest in Latin American and the Caribbean. Compared to high-income economies, direct costs in LMIC were lower and productivity losses higher. Evidence on broader impact of influenza included impact on the wider national economy, security dimension, medical insurance policy, legal frameworks, distributional impact, and investment flows.
CONCLUSION
The economic burden of influenza in LMIC encompasses multiple dimensions such as direct costs to the health service and households, indirect costs due to productivity losses as well as broader detriments to the wider economy. Evidence from sub-Saharan Africa and in pregnant women remains very limited. Heterogeneity of methods used to estimate cost components makes data synthesis challenging. There is a strong need for standardizing research, data collection and evaluation methods for both direct and indirect cost components.
Topics: Caribbean Region; Cost of Illness; Developing Countries; Asia, Eastern; Female; Global Health; Health Expenditures; Humans; Income; Influenza, Human; Poverty; Pregnancy
PubMed: 26597032
DOI: 10.1016/j.vaccine.2015.10.066 -
Acta Tropica Jan 2017Taenia solium is a zoonotic parasite prevalent in many low income countries throughout Latin America, Asia and sub-Saharan Africa, including Tanzania. The parasite is... (Review)
Review
Taenia solium is a zoonotic parasite prevalent in many low income countries throughout Latin America, Asia and sub-Saharan Africa, including Tanzania. The parasite is recognized as a public health threat; however the burden it poses on populations of Tanzania is unknown. The aim of this study was to estimate the societal cost of T. solium cysticercosis in Tanzania, by assessing both the health and economic burden. The societal cost of T. solium cysticercosis was assessed in humans and pigs based on data obtained by a systematic review. Experts' opinion was sought in cases where data were not retrievable. The health burden was assessed in terms of annual number of neurocysticercosis (NCC) associated epilepsy incident cases, deaths and disability-adjusted life years (DALYs), while the economic burden was assessed in terms of direct and indirect costs imposed by NCC-associated epilepsy and potential losses due to porcine cysticercosis. Based on data retrieved from the systematic review and burden assessments, T. solium cysticercosis contributed to a significant societal cost for the population. The annual number of NCC-associated epilepsy incident cases and deaths were 17,853 (95% Uncertainty Interval (UI), 5666-36,227) and 212 (95% UI, 37-612), respectively. More than 11% (95% UI, 6.3-17) of the pig population was infected with the parasite when using tongue examination as diagnostic method. For the year 2012 the number of DALYs per thousand person-years for NCC-associated epilepsy was 0.7 (95% UI, 0.2-1.6). Around 5 million USD (95% UI, 797,535-16,933,477) were spent due to NCC-associated epilepsy and nearly 3 million USD (95% UI, 1,095,960-5,366,038) were potentially lost due to porcine cysticercosis. Our results show that T. solium imposes a serious public health, agricultural and economic threat for Tanzania. We urge that a One Health approach, which involves the joint collaboration and effort of veterinarians, medical doctors, agricultural extension officers, researchers and relevant governmental agencies, is taken to find sustainable solutions for prevention, control and elimination of T. solium.
Topics: Animal Husbandry; Animals; Cost of Illness; Employment; Epilepsy; Health Care Costs; Hospitalization; Humans; Neurocysticercosis; Prevalence; Public Health; Quality-Adjusted Life Years; Sus scrofa; Swine; Swine Diseases; Taenia solium; Tanzania
PubMed: 26756713
DOI: 10.1016/j.actatropica.2015.12.021