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Journal of Medical Toxicology :... Oct 2020
Topics: Developing Countries; Education, Medical; Global Health; Healthcare Disparities; Humans; Income; Poisoning; Toxicology
PubMed: 32495115
DOI: 10.1007/s13181-020-00787-3 -
Value in Health : the Journal of the... May 2023
Topics: Humans; Economics, Medical; Outcome Assessment, Health Care; Economics
PubMed: 36914093
DOI: 10.1016/j.jval.2023.03.002 -
Journal of the National Cancer... Jul 2022The goals of the "Future of Cancer Health Economics Research" virtual conference were to identify challenges, gaps, and unmet needs for conducting cancer health...
The goals of the "Future of Cancer Health Economics Research" virtual conference were to identify challenges, gaps, and unmet needs for conducting cancer health economics research; and develop suggestions and ideas to address these challenges and to support the development of this field. The conference involved multiple presentations and panels featuring several key themes, including data limitations and fragmentation; improving research methods; role and impacts of structural and policy factors; and the transdisciplinary nature of this field. The conference also highlighted emerging areas such as communicating results with nonresearchers; balancing data accessibility and data security; emphasizing the needs of trainees; and including health equity as a focus in cancer health economics research. From this conference, it is clear that cancer health economics research can have substantial impacts on how cancer care is delivered and how related health-care policies are developed and implemented. To support further growth and development, this field should continue to welcome individuals from multiple disciplines and enhance opportunities for training in economics and in analytic methods and perspectives from across the social and clinical sciences. Researchers should continue to engage with diverse stakeholders throughout the cancer community, building collaborations and focusing on the goal of improving health and well-being.
Topics: Economics, Medical; Health Policy; Humans; Neoplasms
PubMed: 35788382
DOI: 10.1093/jncimonographs/lgac005 -
Journal of Nuclear Cardiology :... Jun 2022The procedural numbers and medical costs of percutaneous coronary intervention (PCI), mainly elective PCI, have been increasing in Japan. Owing to increased interest in... (Review)
Review
Health economics-based verification of functional myocardial ischemia evaluation of stable coronary artery disease in Japan: A long-term longitudinal study using propensity score matching.
BACKGROUND
The procedural numbers and medical costs of percutaneous coronary intervention (PCI), mainly elective PCI, have been increasing in Japan. Owing to increased interest in the appropriateness of coronary revascularization, we conducted this medical economics-based evaluation of testing and diagnosis of stable coronary artery disease (CAD).
METHODS AND RESULTS
We reviewed patients' medical insurance data to identify stable CAD patients who underwent coronary computed tomography angiography, cardiac single-photon emission computed tomography, coronary angiography, or fractional flow reserve. Subjects were divided into anatomical and functional evaluation groups according to the modality of testing, and background factors were matched by propensity score. The endpoints were major adverse cardiovascular events (MACE), life years (LYs), medical costs, and cost-effectiveness analysis (CEA). The observations were performed for 36 months. MACE, medical costs, and CEA of the functional group in the overall category were trending to be better than the anatomical group (MACE, P = .051; medical costs: 3,105 US$ vs 4,430 US$, P = .007; CEA: 2,431 US$/LY vs 2,902 US$/LY, P = .043).
CONCLUSIONS
The functional evaluation approach improved long-term clinical outcomes and reduced cumulative medical costs. As a result, the modality composition of functional myocardial ischemia evaluation was demonstrated to offer superior cost-effectiveness in stable CAD.
Topics: Coronary Angiography; Coronary Artery Disease; Economics, Medical; Fractional Flow Reserve, Myocardial; Humans; Japan; Longitudinal Studies; Myocardial Ischemia; Percutaneous Coronary Intervention; Propensity Score; Treatment Outcome
PubMed: 33462786
DOI: 10.1007/s12350-020-02502-9 -
BMC Medical Ethics Mar 2020While there has been much discussion of how the scientific establishment's culture can engender research misconduct and scientific irreproducibility, this has been... (Review)
Review
While there has been much discussion of how the scientific establishment's culture can engender research misconduct and scientific irreproducibility, this has been discussed much less frequently with respect to the medical profession. Here the authors posit that a lack of self-criticism, an encouragement of novel scientific research generated by the recruitment policies of the UK Royal Training Colleges along with insufficient training in the sciences are core reasons as to why research misconduct and dishonesty prevail within the medical community. Furthermore, the UK General Medical Council's own data demonstrates a historic inattentiveness to the ease with which doctors can engage in research misconduct. Suggestions are made as to how these issues can be investigated and alternative incentives for career advancement are adumbrated.
Topics: Economics, Medical; Ethics, Medical; Humans; Medicine; Scientific Misconduct
PubMed: 32183809
DOI: 10.1186/s12910-020-0461-z -
Health Services Research Dec 2020
Topics: Cost-Benefit Analysis; Economics, Medical; Efficiency, Organizational; Health Care Rationing; Health Equity; Humans; Insurance, Health; State Medicine
PubMed: 33258128
DOI: 10.1111/1475-6773.13589 -
Value in Health : the Journal of the... 2016Patient-centered care has become increasingly important and relevant for informed health care decision making. (Review)
Review
BACKGROUND
Patient-centered care has become increasingly important and relevant for informed health care decision making.
OBJECTIVE
Our study aimed to perform a systematic review of health economic evaluation studies from the patient's perspective.
METHODS
PubMed, EMBASE, and Cochrane Central databases were searched through May 2014 for cost-effectiveness, cost-utility, and cost-benefit studies using the patient's perspective in their analysis. The reporting quality of the studies was evaluated on the basis of Consolidated Health Economic Evaluation Reporting Standards.
RESULTS
We identified 30 health economic evaluations using the patient's perspective, of which 7 were conducted in the United States, 9 in Europe, and 14 in Asian or other countries. Seventeen of 23 health conditions evaluated were chronic in nature. Among 12 studies that justified the use of the patient's perspective, patient's financial burden associated with medical treatment was the most commonly cited rationale. A total of 29, 17, and 15 studies examined direct medical, direct nonmedical, and indirect costs, respectively. Seventeen studies also included societal, governmental or payer's, and/or provider's perspective(s) in their analyses. Based on Consolidated Health Economic Evaluation Reporting Standards, more than 20% of the reporting items in these studies were either partially satisfied or not satisfied.
CONCLUSIONS
There is a paucity of health economic evaluations conducted from the patient's perspective in the literature. For those studies using the patient's perspective, the true patient costs were not fully explored and study reporting quality was not optimal. With the increasing focus on patient-centered outcomes in health policy research, more frequent use of the patient's perspective in economic studies should be advocated.
Topics: Economics, Medical; Health Knowledge, Attitudes, Practice; Humans; Patient-Centered Care; Patients; Research
PubMed: 27712720
DOI: 10.1016/j.jval.2016.05.010 -
PloS One 2017Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited.... (Review)
Review
BACKGROUND
Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited. In this systematic review the body of evidence related to economic evaluations of mHealth interventions is assessed and summarized.
METHODS
Seven electronic bibliographic databases, grey literature, and relevant references were searched. Eligibility criteria included original articles, comparison of costs and consequences of interventions (one categorized as a primary mHealth intervention or mHealth intervention as a component of other interventions), health and economic outcomes and published in English. Full economic evaluations were appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and The PRISMA guidelines were followed.
RESULTS
Searches identified 5902 results, of which 318 were examined at full text, and 39 were included in this review. The 39 studies spanned 19 countries, most of which were conducted in upper and upper-middle income countries (34, 87.2%). Primary mHealth interventions (35, 89.7%), behavior change communication type interventions (e.g., improve attendance rates, medication adherence) (27, 69.2%), and short messaging system (SMS) as the mHealth function (e.g., used to send reminders, information, provide support, conduct surveys or collect data) (22, 56.4%) were most frequent; the most frequent disease or condition focuses were outpatient clinic attendance, cardiovascular disease, and diabetes. The average percent of CHEERS checklist items reported was 79.6% (range 47.62-100, STD 14.18) and the top quartile reported 91.3-100%. In 29 studies (74.3%), researchers reported that the mHealth intervention was cost-effective, economically beneficial, or cost saving at base case.
CONCLUSIONS
Findings highlight a growing body of economic evidence for mHealth interventions. Although all studies included a comparison of intervention effectiveness of a health-related outcome and reported economic data, many did not report all recommended economic outcome items and were lacking in comprehensive analysis. The identified economic evaluations varied by disease or condition focus, economic outcome measurements, perspectives, and were distributed unevenly geographically, limiting formal meta-analysis. Further research is needed in low and low-middle income countries and to understand the impact of different mHealth types. Following established economic reporting guidelines will improve this body of research.
Topics: Cell Phone; Cost-Benefit Analysis; Economics, Medical; Humans; Telemedicine
PubMed: 28152012
DOI: 10.1371/journal.pone.0170581 -
Value in Health : the Journal of the... Jan 2022
Topics: Cost-Benefit Analysis; Economics, Medical; Humans; Publishing
PubMed: 35031087
DOI: 10.1016/j.jval.2021.11.1350 -
Annals of Agricultural and... 2015The article presents a paradigm current in contemporary medical anthropology - Critical Medical Anthropology (CMA), which merges political-economic approaches with a... (Review)
Review
The article presents a paradigm current in contemporary medical anthropology - Critical Medical Anthropology (CMA), which merges political-economic approaches with a culturally sensitive analysis of human behaviour grounded in anthropological methods. It is characterized by a strongly applied orientation and a devotion to improving population health and promoting health equity. The beginning of CMA dates back to the 1970s when the interdisciplinary movement called the political economy of health was developed. Today, CMA has grown into one of three major perspectives used in anthropological research devoted to health, illness and wellbeing. The author discusses the origins, key concepts and CMA's usefulness for social research, and its significance for the design of effective policies in the realm of public health. Examplary interventions and ethnographic researches are introduced and wider usage is advocated of such works and methods by bureaucrats and medical staff for understanding the patients' behavior, and the influence of social, economic and political factors on the workings of particular health systems.
Topics: Anthropology, Medical; Delivery of Health Care; Health Equity; History, 20th Century; History, 21st Century; Humans; Public Health
PubMed: 26094543
DOI: 10.5604/12321966.1152099