Subjects -> HEALTH AND SAFETY (Total: 1562 journals)
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HEALTH FACILITIES AND ADMINISTRATION (390 journals)                  1 2 | Last

Showing 1 - 200 of 397 Journals sorted alphabetically
ACI Open     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Administration and Policy in Mental Health and Mental Health Services Research     Partially Free   (Followers: 22)
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access   (Followers: 1)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 17)
Advances in Dual Diagnosis     Hybrid Journal   (Followers: 48)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
Advances in Medical Education and Practice     Open Access   (Followers: 34)
Advances in Mental Health and Intellectual Disabilities     Hybrid Journal   (Followers: 89)
Advances in Nursing Science     Hybrid Journal   (Followers: 43)
Advances in Simulation     Open Access   (Followers: 7)
African Journal of Primary Health Care & Family Medicine     Open Access   (Followers: 6)
AIDS and Behavior     Hybrid Journal   (Followers: 18)
American Journal of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 48)
American Journal of Managed Care     Full-text available via subscription   (Followers: 13)
Analytical Methods     Full-text available via subscription   (Followers: 14)
Anthropologie et santé     Open Access   (Followers: 5)
Applied Clinical Informatics     Hybrid Journal   (Followers: 5)
Applied Health Economics and Health Policy     Full-text available via subscription   (Followers: 24)
Applied Research in Quality of Life     Hybrid Journal   (Followers: 13)
Archives of Public Health     Open Access   (Followers: 13)
Asian Journal of Health     Open Access   (Followers: 4)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian and New Zealand Journal of Public Health     Hybrid Journal   (Followers: 17)
Australian Health Review     Hybrid Journal   (Followers: 7)
Australian Journal of Primary Health     Hybrid Journal  
Australian Journal of Rural Health     Hybrid Journal   (Followers: 18)
Autism     Hybrid Journal   (Followers: 350)
Avicenna     Open Access   (Followers: 3)
Balint Journal     Hybrid Journal   (Followers: 2)
Bereavement Care     Hybrid Journal   (Followers: 13)
BJR     Hybrid Journal   (Followers: 21)
BMC Medical Informatics and Decision Making     Open Access   (Followers: 25)
BMC Oral Health     Open Access   (Followers: 7)
BMJ Leader     Hybrid Journal  
BMJ Quality & Safety     Hybrid Journal   (Followers: 69)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 50)
British Journal of Healthcare Assistants     Full-text available via subscription   (Followers: 33)
British Journal of Healthcare Management     Full-text available via subscription   (Followers: 19)
British Journal of Hospital Medicine     Full-text available via subscription   (Followers: 18)
British Journal of Nursing     Full-text available via subscription   (Followers: 297)
British Journal of School Nursing     Full-text available via subscription   (Followers: 14)
Bruce R Hopkins' Nonprofit Counsel     Hybrid Journal   (Followers: 2)
Building Better Healthcare     Full-text available via subscription   (Followers: 1)
Canadian Nurse     Full-text available via subscription   (Followers: 8)
Cardiac Electrophysiology Clinics     Full-text available via subscription   (Followers: 1)
Children and Schools     Hybrid Journal   (Followers: 8)
Chinese Medical Record English Edition     Hybrid Journal  
CIN : Computers Informatics Nursing     Hybrid Journal   (Followers: 11)
Clinical Audit     Open Access   (Followers: 4)
Clinics and Practice     Open Access  
Cognition, Technology & Work     Hybrid Journal   (Followers: 14)
Communication & Medicine     Hybrid Journal   (Followers: 5)
Community Based Medical Journal     Open Access  
Conflict and Health     Open Access   (Followers: 8)
Contemporary Nurse : A Journal for the Australian Nursing Profession     Hybrid Journal   (Followers: 7)
Critical Public Health     Hybrid Journal   (Followers: 26)
Culture, Health & Sexuality: An International Journal for Research, Intervention and Care     Hybrid Journal   (Followers: 17)
Current Opinion in Supportive and Palliative Care     Hybrid Journal   (Followers: 28)
Das Gesundheitswesen     Hybrid Journal   (Followers: 10)
Death Studies     Hybrid Journal   (Followers: 22)
Dental Nursing     Full-text available via subscription   (Followers: 3)
Disaster Health     Hybrid Journal   (Followers: 1)
DoctorConsult - The Journal. Wissen für Klinik und Praxis     Full-text available via subscription  
Droit, Déontologie & Soin     Full-text available via subscription   (Followers: 3)
E-Health Telecommunication Systems and Networks     Open Access   (Followers: 2)
East and Central African Journal of Surgery     Open Access  
Éducation thérapeutique du patient     Full-text available via subscription   (Followers: 1)
eGEMs     Open Access  
Emergency Radiology     Hybrid Journal   (Followers: 10)
Enfermería Clínica     Full-text available via subscription   (Followers: 3)
Epidemiologic Methods     Hybrid Journal   (Followers: 4)
Ergonomics     Hybrid Journal   (Followers: 24)
Escola Anna Nery     Open Access   (Followers: 1)
Ethnicity & Health     Hybrid Journal   (Followers: 15)
European Journal of Public Health     Hybrid Journal   (Followers: 27)
European Journal of Work and Organizational Psychology     Hybrid Journal   (Followers: 35)
European Research in Telemedicine / La Recherche Européenne en Télémédecine     Full-text available via subscription   (Followers: 2)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 11)
Evidence-Based Nursing     Hybrid Journal   (Followers: 74)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Expert Opinion on Therapeutic Patents     Hybrid Journal   (Followers: 12)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family Practice Management     Full-text available via subscription   (Followers: 5)
Focus on Health Professional Education : A Multi-disciplinary Journal     Full-text available via subscription   (Followers: 7)
Frontiers in Public Health Services and Systems Research     Open Access   (Followers: 5)
Future Hospital Journal     Full-text available via subscription   (Followers: 2)
Gastrointestinal Nursing     Full-text available via subscription   (Followers: 5)
Geron     Full-text available via subscription  
Global & Regional Health Technology Assessment     Open Access   (Followers: 1)
Global Health Action     Open Access   (Followers: 12)
Global Health Management Journal (GHMJ)     Open Access   (Followers: 1)
Global Health Research and Policy     Open Access   (Followers: 4)
Global Journal of Hospital Administration     Open Access   (Followers: 1)
Global Public Health: An International Journal for Research, Policy and Practice     Hybrid Journal   (Followers: 21)
Globalization and Health     Open Access   (Followers: 9)
Handbook of Practice Management     Hybrid Journal   (Followers: 2)
Health     Open Access   (Followers: 5)
Health & Social Care In the Community     Hybrid Journal   (Followers: 54)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 16)
Health and Interprofessional Practice     Open Access   (Followers: 6)
Health and Technology     Hybrid Journal   (Followers: 4)
Health Care Analysis     Hybrid Journal   (Followers: 17)
Health Care Management Review     Hybrid Journal   (Followers: 16)
Health Economics     Hybrid Journal   (Followers: 59)
Health Expectations     Open Access   (Followers: 16)
Health Facilities Management     Free   (Followers: 10)
Health Informatics Journal     Hybrid Journal   (Followers: 28)
Health Information : Jurnal Penelitian     Open Access   (Followers: 5)
Health Information Science and Systems     Open Access   (Followers: 4)
Health Policy and Management     Open Access   (Followers: 7)
Health Policy and Planning     Hybrid Journal   (Followers: 27)
Health Professions Education     Open Access   (Followers: 3)
Health Promotion International     Hybrid Journal   (Followers: 28)
Health Promotion Practice     Hybrid Journal   (Followers: 18)
Health Psychology     Full-text available via subscription   (Followers: 62)
Health Psychology Review     Hybrid Journal   (Followers: 46)
Health Reform Observer : Observatoire des Réformes de Santé     Open Access   (Followers: 2)
Health Research Policy and Systems     Open Access   (Followers: 16)
Health Science Journal of Indonesia     Open Access   (Followers: 2)
Health Services Research and Managerial Epidemiology     Open Access   (Followers: 3)
Health, Risk & Society     Hybrid Journal   (Followers: 14)
Healthcare : The Journal of Delivery Science and Innovation     Full-text available via subscription   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Management Forum     Hybrid Journal   (Followers: 8)
Healthcare Policy / Politiques de Santé     Full-text available via subscription   (Followers: 5)
Healthcare Quarterly     Full-text available via subscription   (Followers: 10)
Healthcare Risk Management     Full-text available via subscription   (Followers: 5)
HealthcarePapers     Full-text available via subscription   (Followers: 2)
Hispanic Health Care International     Full-text available via subscription  
História, Ciências, Saúde - Manguinhos     Open Access   (Followers: 2)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 3)
Hospital     Open Access   (Followers: 3)
Hospital a Domicilio     Open Access  
Hospital Medicine Clinics     Full-text available via subscription   (Followers: 2)
Hospital Peer Review     Full-text available via subscription   (Followers: 1)
Hospital Pharmacy     Partially Free   (Followers: 18)
Hospital Practice     Hybrid Journal   (Followers: 2)
Hospital Practices and Research     Open Access  
Housing, Care and Support     Hybrid Journal   (Followers: 9)
Human Factors : The Journal of the Human Factors and Ergonomics Society     Full-text available via subscription   (Followers: 39)
Human Resources for Health     Open Access   (Followers: 12)
ICU Director     Hybrid Journal  
Ids Practice Papers     Hybrid Journal  
IEEE Pulse     Hybrid Journal   (Followers: 5)
IISE Transactions on Healthcare Systems Engineering     Hybrid Journal   (Followers: 2)
Independent Nurse     Full-text available via subscription   (Followers: 3)
Index de Enfermeria     Open Access   (Followers: 7)
Indian Journal of Public Health     Open Access   (Followers: 1)
Informatics for Health and Social Care     Hybrid Journal   (Followers: 10)
Innovation and Entrepreneurship in Health     Open Access   (Followers: 1)
INQUIRY : The Journal of Health Care Organization, Provision, and Financing     Open Access   (Followers: 1)
Interface - Comunicação, Saúde, Educação     Open Access   (Followers: 1)
International Archives of Health Sciences     Open Access  
International Journal for Equity in Health     Open Access   (Followers: 9)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 41)
International Journal of Care Coordination     Hybrid Journal   (Followers: 7)
International Journal of Computers in Healthcare     Hybrid Journal   (Followers: 3)
International Journal of Electronic Healthcare     Hybrid Journal   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 27)
International Journal of Health Administration and Education Congress (Sanitas Magisterium)     Open Access  
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 15)
International Journal of Health Economics and Management     Hybrid Journal   (Followers: 12)
International Journal of Health Governance     Hybrid Journal   (Followers: 27)
International Journal of Health Planning and Management     Hybrid Journal   (Followers: 6)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services Research and Policy     Open Access   (Followers: 1)
International Journal of Health System and Disaster Management     Open Access   (Followers: 3)
International Journal of Healthcare     Open Access   (Followers: 1)
International Journal of Healthcare Technology and Management     Hybrid Journal   (Followers: 7)
International Journal of Hospital Research     Open Access  
International Journal of Human Factors and Ergonomics     Hybrid Journal   (Followers: 20)
International Journal of Human Rights in Healthcare     Hybrid Journal   (Followers: 5)
International Journal of Medicine and Public Health     Open Access   (Followers: 6)
International Journal of Migration, Health and Social Care     Hybrid Journal   (Followers: 12)
International Journal of Occupational and Environmental Medicine, The     Open Access   (Followers: 16)
International Journal of Palliative Nursing     Full-text available via subscription   (Followers: 32)
International Journal of Positive Behavioural Support     Full-text available via subscription   (Followers: 38)
International Journal of Prisoner Health     Hybrid Journal   (Followers: 14)
International Journal of Privacy and Health Information Management     Full-text available via subscription   (Followers: 3)
International Journal of Public and Private Healthcare Management and Economics     Full-text available via subscription   (Followers: 4)
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 22)
International Journal of Reliable and Quality E-Healthcare     Full-text available via subscription   (Followers: 1)
International Journal of Research in Nursing     Open Access   (Followers: 12)
International Journal of Technology Assessment in Health Care     Hybrid Journal   (Followers: 16)
International Journal of Telemedicine and Clinical Practices     Hybrid Journal   (Followers: 5)
International Journal of Telework and Telecommuting Technologies     Full-text available via subscription  
International Journal of Therapy and Rehabilitation     Full-text available via subscription   (Followers: 42)
International Journal of User-Driven Healthcare     Full-text available via subscription   (Followers: 1)
International Journal on Disability and Human Development     Hybrid Journal   (Followers: 23)
Irish Journal of Paramedicine     Open Access   (Followers: 3)
JAAPA     Hybrid Journal   (Followers: 3)
Jaffna Medical Journal     Open Access  
Joint Commission Journal on Quality and Patient Safety     Hybrid Journal   (Followers: 41)
Journal for Healthcare Quality     Hybrid Journal   (Followers: 28)
Journal of Advanced Nursing     Hybrid Journal   (Followers: 252)
Journal of Advances in Medical Education & Professionalism     Open Access   (Followers: 10)
Journal of Aging and Health     Hybrid Journal   (Followers: 27)
Journal of Ambulatory Care Management, The     Hybrid Journal   (Followers: 4)
Journal of Applied Arts and Health     Hybrid Journal   (Followers: 1)

        1 2 | Last

Similar Journals
Journal Cover
Applied Health Economics and Health Policy
Journal Prestige (SJR): 0.991
Citation Impact (citeScore): 2
Number of Followers: 24  
  Full-text available via subscription Subscription journal
ISSN (Print) 1175-5652 - ISSN (Online) 1179-1896
Published by Adis Homepage  [21 journals]
  • Authors’ Reply to Sprengholz and Betsch: “Willingness to Pay for a
           COVID-19 Vaccine”
    • PubDate: 2021-05-11
  • Comment on: “Willingness to Pay for a COVID-19 Vaccine”
    • PubDate: 2021-05-11
  • Systematic Literature Review of Guidelines on Budget Impact Analysis for
           Health Technology Assessment
    • Abstract: Objectives The objective of this systematic review was to review the recommendations for the conduct of a budget impact analysis in national or organisational guidelines globally. Methods We searched several databases including MELDINE, EMBASE, The Cochrane Library, National Guideline Clearinghouse, HTA Database (International Network of Agencies for Health Technology Assessment), Econlit and IDEAS Database (RePEc, Research Papers in Economics). The OVID platform was used to run the search in all databases simultaneously. In addition, a search of the grey literature was also conducted. The timeframe was set from 2000 to 2020 with language of publication restricted to English. Results A total of 13 publications were selected. All the countries where financing of health is predominantly tax funded with public provisioning recommend a healthcare payer (government) perspective. However, countries where a healthcare payer includes a mix of federal government, communities, hospital authorities and patient communities recommend a complementary analysis with a wider societal perspective. While four guidelines prefer a simple cost calculator for costing, the rest rely on a decision modelling approach. None of the guidelines recommend discounting except the Polish guidelines, which recommend discounting at 5%. Only two countries, Belgium and Poland, mention that indirect costs, if significant, should be included in addition to direct costs. Conclusions The comparative cross-country analysis shows that a standard set of recommendations cannot be directly useful for all as there are contextual differences. Thus, budget impact analysis guidelines must be carefully contextualised in the policy environment of a country so as to reflect the dynamics of health systems.
      PubDate: 2021-05-06
  • Correction to: Translating Research to Policy: Setting Provider Payment
           Rates for Strategic Purchasing under India’s National Publicly Financed
           Health Insurance Scheme
    • Abstract: A correction to this paper has been published:
      PubDate: 2021-05-01
  • Price Reduction of Anticancer Drugs from 2007 to 2019 in South Korea: The
           Impact of Pharmaceutical Cost-Containment Policies
    • Abstract: Objectives To assess price reductions of anticancer drugs in South Korea over 12 years and analyze the association between price reduction, drug characteristics, and repricing mechanisms. Methods We constructed a dataset based on the Health Insurance Review and Assessment Service (HIRA) price log of anticancer drugs from January 2007 to June 2019. We investigated each mechanism that resulted in a price reduction, including actual transaction price (ATP), voluntary reduction by a manufacturer, price-volume agreement, expansion of indication or reimbursement scope, price cut at generic entry, lump price cut in April 2012, and re-evaluation. The price reduction rate per year was estimated by dividing the total number of price reduction events by the total period for which the products were on the market. A Poisson regression model was used to estimate the characteristics-adjusted incidence rate ratio of the price reduction. Price reduction per event was also determined across originator and generic products. Data analysis was performed using R (version 3.5.1). Results Five hundred price reductions occurred in 439 new anticancer drugs, with a reduction rate per 100 product-years of 23. ATP was the most frequent cause (39.2%) but had minimal impact (average reduction per event of 3%), followed by lump price cut (19.2%) and voluntary reduction (10.2%). Generic entries and lump price cut had the greatest impact (16–29% reduction per event). ATP was the most frequently occurring mechanism, followed by generic entry, voluntary reduction, and the lump price-cut in April 2012. Conclusions The incidence of price reduction of anticancer drugs increased gradually due to various repricing mechanisms. Although these mechanisms are effective, improvements can be made. Well-designed mechanisms that actively regulate price adjustment are needed to establish repricing policies that adequately reflect changes in the value of drugs over their entire life cycle.
      PubDate: 2021-05-01
  • Cost-Effectiveness Analysis of Oral Direct-Acting Antivirals for Chinese
           Patients with Chronic Hepatitis C
    • Abstract: Background and Objective All oral direct-acting antivirals (DAAs) have shown excellent efficacy and safety in Chinese patients with chronic hepatitis C (CHC). However, the cost of DAAs used to be expensive; therefore, large numbers of patients had no access to DAAs in China. Recently, prices have been greatly reduced. The objective of this study was to evaluate the cost-effectiveness of ledipasvir/sofosbuvir (LDV/SOF), sofosbuvir/velpatasvir (SOF/VEL), elbasvir/grazoprevir (EBR/GZR) and glecaprevir/pibrentasvir (GLE/PIB) in Chinese CHC patients stratified by hepatitis C virus (HCV) genotype (GT), cirrhosis status, and treatment history. Methods On the basis of a Chinese healthcare perspective, a Markov model was constructed to estimate the lifetime costs and health outcomes of patients treated with different DAA regimens. Chinese-specific clinical, cost, and utility inputs were obtained or calculated from published sources and expert opinions. Costs, life-years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were reported as primary outcomes. Base-case analysis and sensitivity analysis were conducted. Results At a willing-to-pay (WTP) threshold of US$30,081/QALY (calculated by three times the GDP per capita in China), SOF/VEL was cost-effective in patients with HCV GT 1, 3, and 6 infections, and the probabilities that SOF/VEL was cost-effective were 9.7–75.7%, 39.1–63.9%, and 35.6–88.0%, respectively. For GT2 patients, noncirrhotic patients, treatment-naïve patients, and treatment-experienced patients, LDV/SOF was the most cost-effective regimen, and the probabilities of cost-effectiveness for each of these groups was 92.1–99.8%, 89.9–99.0%, 61.6–91.2%, and 99.3–100.0%, respectively below the WTP threshold. The GLE/PIB regimen (12-week duration) was the most cost-effective in cirrhotic patients, whereas the probability of its cost-effectiveness varied with that of EBR/GZR (4.1–93.8% versus 6.2–93.3%) below the WTP threshold. Conclusions Overall, SOF/VEL and LDV/SOF regimens are more likely to be cost-effective among various subgroups of Chinese patients with CHC.
      PubDate: 2021-05-01
  • The Indirect Cost Burden of Cancer Care in Canada: A Systematic Literature
    • Abstract: Background and objectives Cancer poses a substantial health and economic burden on patients and caregivers in Canada. Previous reviews have estimated the indirect cost burden as work-related productivity losses associated with cancer. However, these estimates require updating and complementing with more comprehensive data that include relevant dimensions beyond labor market costs, such as patient time, lost leisure time and home productivity losses. Methods A systematic review of the literature was conducted to identify studies published from 2006 to 2020 that measured and reported the indirect costs borne by cancer patients and their caregivers in Canada, from the patient, caregiver, employer, and societal perspectives. Study characteristics and cost estimation methods were extracted from relevant studies. Costs estimates were reported and converted to 2020 CAD for the following categories: lost earnings, caregiving time costs, home production losses, patient time (leisure), morbidity-, disability-, premature mortality-related costs, friction costs, and overall productivity losses. A quality assessment of individual studies was conducted for included studies using the Newcastle–Ottawa Assessment Tool. Results In total, 3980 studies were identified, of which 18 Canadian studies met the inclusion criteria for review. One-third of the studies used or developed prediction models, 38% enrolled patient cohorts, and 27% used administrative databases. Over one-third of the studies were conducted at a national level (38%). All studies employed the human capital approach to estimate costs, and 16% also used the friction cost approach. Lost earnings were higher among self-employed patients (43% vs 24% among employees) and females ($8200 vs $3200 for males). Caregiver costs ranged from $15,786 to $20,414 per patient per year. Household productivity losses were estimated to be up to $238,904 per household per year. Patient time (leisure) costs were estimated to be between $13,000 and $18,704 per patient per year. Premature annual mortality costs were estimated to be $2.98 billion overall in Quebec. Friction costs incurred by employers were estimated between $6400 and $23,987 per patient per year. Societal productivity losses associated with cancer were estimated between $75 million to $317 million, annually. Conclusions This review suggests that the indirect cost burden of cancer is considerable from the patient, caregiver, employer, and societal perspectives. This up-to-date review of the literature provides a comprehensive understanding of the indirect cost burden by including non-labor market activity costs and by examining all relevant perspectives. These results provide a strong case for the government and employers to ensure there are supports in place to help patients and caregivers buffer the impact of cancer so they can continue to engage in productive activities and enjoy leisure time.
      PubDate: 2021-05-01
  • Potential Unintended Consequences of National Infectious Disease Screening
           Strategies in Deceased Donor Kidney Transplantation: A Cost-Effectiveness
    • Abstract: Background In order to counter the lack of sufficient kidney donors, there has been interest in expanding the utilization of organs from increased infectious-risk donors. Negative nucleic acid testing of increased infectious-risk organs has been shown to increase their use as compared to only enzyme-linked immunosorbent assay negativity. However, it is not known how the expanded use of nucleic acid testing on a national scale might affect total donor utilization. Objective The objective of this paper was to determine if a national screening policy requiring the use of nucleic acid testing in both increased infectious-risk and non-increased infectious-risk renal transplant donors would increase the donor organ pool. Methods This study used decision-tree analysis to determine the cost-effectiveness of four US national screening policies based on an increasingly expansive use of nucleic acid testing for increased infectious-risk and non-increased infectious-risk kidneys. Parameters were taken from the literature. All costs were reported in 2020 US dollars using a Medicare payer perspective and a life-time horizon. Results The use of nucleic acid screening solely for increased infectious-risk organs was the dominant strategy. Our results were robust to deterministic and probabilistic sensitivity analyses. One of the main driving factors of cost-effectiveness was the false-positive rate of nucleic acid testing. Conclusion Before implementing nucleic acid screening outside of increased infectious-risk organs, its false-positivity rate should be directly studied to ensure that its use does not detrimentally affect transplantation numbers, quality-adjusted life-years, and costs.
      PubDate: 2021-05-01
  • Copula Models for Addressing Sample Selection in the Evaluation of Public
           Health Programmes: An Application to the Leeds Let’s Get Active Study
    • Abstract: Sample selectivity is a recurrent problem in public health programmes and poses serious challenges to their evaluation. Traditional approaches to handle sample selection tend to rely on restrictive assumptions. The aim of this paper is to illustrate a copula-based selection model to handle sample selection in the evaluation of public health programmes. Motivated by a public health programme to promote physical activity in Leeds (England), we describe the assumptions underlying the copula selection, and its relative advantages compared with commonly used approaches to handle sample selection, such as inverse probability weighting and Heckman’s selection model. We illustrate the methods in the Leeds Let’s Get Active programme and show the implications of method choice for estimating the effect on individual’s physical activity. The programme was associated with increased physical activity overall, but the magnitude of its effect differed according to adjustment method. The copula selection model led to a similar effect to the Heckman’s approach but with relatively narrower 95% confidence intervals. These results remained relatively similar when different model specifications and alternative distributional assumptions were considered. The copula selection model can address important limitations of traditional approaches to address sample selection, such as the Heckman model, and should be considered in the evaluation of public health programmes, where sample selection is likely to be present.
      PubDate: 2021-05-01
  • Translating Research to Policy: Setting Provider Payment Rates for
           Strategic Purchasing under India's National Publicly Financed Health
           Insurance Scheme
    • Abstract: Background In 2018, the Government of India launched Ayushman Bharat Pradhan Mantri-Jan Aarogya Yojana (AB PM-JAY), a large tax-funded health insurance scheme. In this paper, we present findings of the Costing of Health Services in India (CHSI) study, describe the process of use of cost evidence for price-setting under AB PM-JAY, and estimate its fiscal impact. Methods Reference costs were generated from the first phase of CHSI study, which sampled 11 tertiary public hospitals from 11 Indian states. Cost for Health Benefit Packages (HBPs) was estimated using mixed (top-down and bottom-up) micro-costing methods. The process adopted for price-setting under AB PM-JAY was observed. The cost of each HBP was compared with AB PM-JAY prices before and after the revision, and the budgetary impact of this revision in prices was estimated. Findings Following the CHSI study evidence and price consultations, 61% of AB PM-JAY HBP prices were increased while 18% saw a decline in the prices. In absolute terms, the mean increase in HBP price was ₹14,000 (₹450–₹1,65,000) and a mean decline of ₹6,356 (₹200–₹74,500) was observed. Nearly 42% of the total HBPs, in 2018, had a price that was less than 50% of the true cost, which declined to 20% in 2019. The evidence-informed revision of HBP prices is estimated to have a minimal fiscal impact (0.7%) on the AB PM-JAY claims pay-out. Interpretation Evidence-informed price-setting helped to reduce wide disparities in cost and price, as well as aligning incentives towards broader health system goals. Such strategic purchasing and price-setting requires the creation of systems of generating evidence on the cost of health services. Further research is recommended to develop a cost-function to study changes in cost with variations in time, region, prices, skill-mix and other factors.
      PubDate: 2021-05-01
  • Which Criteria are Considered and How are They Evaluated in Health
           Technology Assessments' A Review of Methodological Guidelines Used in
           Western and Asian Countries
    • Abstract: Objectives This study aimed to provide an exhaustive description of criteria and methodological recommendations for evaluating them in health technology assessment (HTA) in Western and Asian countries. Methods We conducted a system literature review of HTA-related guidelines by searching the websites of HTA agencies and related data sources. The guidelines, reports, or recommendations introducing the HTA evaluation methods, processes, decision-making frameworks, and criteria for priority setting were eligible to be included. The review was limited to guidelines from countries belonging to the European Network for Health Technology Assessment (EUnetHTA) and HTAsiaLink organisations and other countries with well-established available guidelines. Results A total of 52 guidelines from 24 countries were identified, including 13 countries from the EUnetHTA organisation, 9 countries from the HTAsiaLink organisation and 2 other countries (Canada and the USA). A strong consensus was observed among the HTA agencies on the core set of criteria including efficacy or effectiveness, cost-effectiveness, safety, and budget impact. More similarities were observed than differences in methodological recommendations for clinical and economic evaluations among the agencies. Conclusions Substantial convergence is seen in the criteria included in the HTA process, as well as the methods to evaluate and quantify them. Further efforts are needed to verify whether the criteria identified from the guidelines are incorporated in real HTA decisions, and how they are assessed and weighted in practice.
      PubDate: 2021-05-01
  • Prescription Drug Monitoring Programs and Opioid Prescriptions for
           Disability Conditions
    • Abstract: Background There are variants of prescription drug monitoring programs (PDMPs) and different groups of patients who are prescribed opioids. Patients with disabilities and those with chronic conditions might have different experiences in physician prescribing practices for opioids, when compared to a comparison group without these conditions. Objective To determine differences in opioid prescriptions related to PDMPs for people without cancer-related pain and with disability conditions compared to other adult opioid users without cancer, using a national database. Method Opioid users were identified from the US Medical Expenditure Panel Survey. Disability groups were defined by diagnosis codes related to longstanding physical disability and inflammatory conditions. Our analyses used an event study framework and a difference-in-differences approach. Results During a two-year panel period, PDMPs did not reduce opioid prescriptions for individuals with disabilities who use opioids. Our data show that individuals with disabilities who use opioids, on average, have a higher incidence of continuous opioid use and significantly greater amounts prescribed compared to other adults who have opioid prescriptions. Conclusion PDMPs do not appear to affect prescribers’ initial or ongoing use of opioids for individuals with longstanding physical disabilities and those with inflammatory conditions. Thus, these adults have greater exposure to opioids, compared to other adults who were prescribed opioids.
      PubDate: 2021-05-01
  • Management of Chest Indrawing Pneumonia in Children Under Five Years at
           the Outpatient Health Facilities in Nigeria: An Economic Evaluation
    • Abstract: Background The recommendation of the World Health Organization (WHO) for the management of children aged < 5 years with chest indrawing pneumonia with oral amoxicillin dispersible tablets (DT) at the outpatient health facilities is imperative, especially in a high pneumonia mortality and low-resource setting like Nigeria. However, this recommendation has not been widely adopted in Nigeria due to poor access to healthcare and sub-optimal outpatient management and follow-up system to ensure patients’ safety and management effectiveness. This study aimed to evaluate the cost effectiveness and the cost benefit of the WHO recommendation relative to usual practices in Nigeria. The outcome of this study will provide supporting evidence to healthcare providers and inform their management decisions. Methods A cost-effectiveness and cost-benefit analyses of this study used a Markov cohort model from the healthcare provider perspective for a time horizon of five years. Three approaches were compared: a conventional approach (base-comparator); the amoxicillin DT (WHO) approach; and a parenteral approach. Bottom-up costing method was used. Health outcome was expressed as disability-adjusted life years averted and converted to monetary terms (benefit). Results The incremental cost-effectiveness ratio (ICER) and the benefit-cost ratio (BCR) of the amoxicillin DT approach dominate the conventional approach. The parenteral approach was more effective and more beneficial than the amoxicillin DT approach but the ICER and BCR were $75,655/DALY averted and 0.035, respectively. Conclusions The use of amoxicillin DT proves to be the optimal choice with high benefit and low cost. The opportunity cost of not adopting an approach more effective than amoxicillin DT will be offset by the cost saved. Its use in chest indrawing pneumonia management needs to be scaled up.
      PubDate: 2021-05-01
  • The Cost-Effectiveness of Pulmonary Rehabilitation for COPD in Different
           Settings: A Systematic Review
    • Abstract: Background Chronic obstructive pulmonary disease (COPD) has high morbidity and mortality rates. COPD impairs body functioning, reduces quality of life, and creates a great economic burden for society. Pulmonary rehabilitation (PR) has become an important nonpharmacological treatment for COPD. This paper systematically reviews economic evaluations of PR in COPD patients in different settings. Objectives We aimed to understand the cost-effectiveness of PR in different settings for COPD to provide economic evidence for decision-makers. Methods We searched eight databases from their inception to 23 November 2019. The results were presented in terms of an incremental cost-effectiveness ratio (ICER), and the decision uncertainty was expressed by cost-effectiveness acceptability curves (CEACs). We used the Consensus on Health Economic Criteria to assess study quality. Results This review included ten studies that matched the selection criteria. Five studies compared PR with usual care in primary healthcare or outpatient departments. Two studies compared community-based PR with hospital PR or usual care. In the other studies, PR was mainly carried out at home. Compared with usual care, PR was cost-effective in primary healthcare institutions or outpatient departments. According to CEACs, community-based PR had a 50% probability of cost-effectiveness at £30,000/quality-adjusted life year (QALY) compared with hospital PR in the UK. Based on the ICER, community-based PR was “moderately” cost-effective, with a ratio of €32,425/QALY compared with usual care in the Netherlands. Home-based PR was dominant compared with usual care, and tele-rehabilitation was dominant compared with traditional home PR. Conclusions PR conducted in different settings can potentially be cost-effective, as measured using QALY or the Chronic Respiratory Questionnaire (CRQ).
      PubDate: 2021-05-01
  • What is the Impact of the Analysis Method Used for Health State Utility
           Values on QALYs in Oncology' A Simulation Study Comparing
           Progression-Based and Time-to-Death Approaches
    • Abstract: Background Health state utility values (‘utilities’) are an integral part of health technology assessment. Though traditionally categorised by disease status in oncology (i.e. progression), several recent assessments have adopted values calculated according to the time that measures were recorded before death. We conducted a simulation study to understand the limitations of each approach, with a focus on mismatches between the way utilities are generated, and analysed. Methods Survival times were simulated based on published literature, with permutations of three utility generation mechanisms (UGMs) and utility analysis methods (UAMs): (1) progression based, (2) time-to-death based, and (3) a ‘combination approach’. For each analysis quality-adjusted life-years (QALYs) were estimated. Goodness of fit was assessed via percentage mean error (%ME) and mean absolute error (%MAE). Scenario analyses were performed varying individual parameters, with complex scenarios mimicking published studies. The statistical code is provided for transparency and to aid future work in the area. Results %ME and %MAE were lowest when the correct analysis form was specified (i.e. UGM and UAM aligned). Underestimates were produced when a time-to-death element was present in the UGM but not included in the UAM, while the ‘combined’ UAM produced overestimates irrespective of the UGM. Scenario analysis demonstrated the importance of the volume of available data beyond the initial time period, for example follow-up. Conclusions We show that the use of an incorrectly or over-specified UAM can result in substantial bias in the estimation of utilities. We present a flowchart to highlight the issues that may be faced.
      PubDate: 2021-05-01
  • Comment on: “Disease-Specific Out-of-Pocket Payments, Catastrophic
           Health Expenditure and Impoverishment Effects in India: An Analysis of
           National Health Survey Data”
    • PubDate: 2021-04-27
  • The PLASMA System for Transurethral Resection of the Prostate: A NICE
           Medical Technologies Guidance Update
    • Abstract: Lower urinary tract symptoms (LUTS) in men commonly occur as a consequence of benign prostatic hyperplasia (BPH), also known as prostate enlargement. Treatments for this can involve electrosurgical removal of a section of the prostate via transurethral resection of the prostate (TURP). This can be performed using either monopolar or bipolar electrosurgery. Bipolar TURP uses saline for irrigation rather than glycine, which drastically reduces the risk of TUR syndrome complications, thus allowing for increased procedure time if needed. The PLASMA system (formally known as TURis) is a bipolar TURP electrosurgery system used to treat LUTS secondary to BPH. National guidance recommending the use of TURis in the UK NHS was issued in 2014 by NICE and we now report the updated contribution from Cedar that was included in the update of that guidance for 2021. The evidence in this review suggests that the PLASMA system could be beneficial to patients in relation to hospitalisation and catheterisation time compared with monopolar TURP (mTURP). However, it appears to be comparable to mTURP for urological outcomes and worse for post-operative haematology outcomes such as decline in sodium and haemoglobin levels. Adverse events, however, occurred much less with PLASMA use.
      PubDate: 2021-04-26
  • Consumers' Preferences and Willingness to Pay for Personalised Nutrition
    • Abstract: Introduction Personalised nutrition (PN) has great potential for disease prevention, particularly if coupled with the power and accessibility of mobile technology. However, success of PN interventions will depend on the willingness of users to subscribe. This study investigates the factors associated with potential users' perceived value of PN and heterogeneity in these values. Methods A discrete choice experiment was carried out in a representative sample (N = 429 valid responses) from the adult population in Spain. The results were analysed in line with McFadden's Random Utility Theory, using conditional and mixed logit models in addition to a latent class logit model. Results The conditional and mixed logit models revealed the existence of a significant preference and willingness to pay for personalised nutrition, but the effect on average was not large for the highest level of personalisation. The latent class logit revealed four classes of respondent: those who would be likely to pay for a high level of personalised nutrition service, those who would use it if it were heavily subsidised, those who would use only a basic nutrition service, and those who would not be willing to engage. These results could be useful for the design and targeting of effective personalised nutrition services. Conclusions Over half of adults currently perceive some individual benefit in a high level of PN, which may justify some degree of public subsidy in investment and delivery of such a service.
      PubDate: 2021-04-26
  • Incorporating Process Utility into Cost-Effectiveness Analysis via a
           Bolt-On Domain to the SF-6D: An Exploratory Study
    • Abstract: Background Within the UK, standard methods of economic evaluation centre on the maximisation of the quality-adjusted life-year (QALY). However, preference-based measures used to estimate QALYs may not be suited to all economic evaluations, as they routinely measure only health outcomes. Aim This study used an economic evaluation alongside a clinical trial (EEACT) comparing patients’ preferences for a telephone versus a face-to-face consultation to incorporate process utility into cost-effectiveness analyses. Methods An EEACT is described that generates QALYs using Short-form 6-dimension version 1 (SF-6Dv1) responses. These results exclude specific consideration of process utility. A health state valuation study is then reported that bolts a process domain onto the SF-6Dv1 using data obtained from the EEACT. These results therefore include the consideration of process utility. The results of the EEACT with and without process utility are then compared. Results This study shows that the QALY, in its current form, does not capture patient benefits associated with the process of receiving healthcare. The EEACT illustrates this, showing a statistically significant difference between control and intervention groups for the patient experience questionnaire communication domain, indicating that patients preferred the intervention. This preference was not identified in the cost-effectiveness outcomes, and the point estimates lie in the north-west quadrant of the cost-effectiveness plane. The preference is captured after adding a communication domain. The point estimate moves to the north-east quadrant, where the intervention is more effective and more costly than the control. Conclusion This study indicates that it is possible to capture patients’ preferences for processes associated with care, in a format compatible with the QALY.
      PubDate: 2021-03-30
  • Willingness to Pay for a COVID-19 Vaccine
    • Abstract: Background The coronavirus disease (COVID-19) pandemic has considerably affected the lives of people worldwide, impacting their health and economic welfare, and changing the behavior of our society significantly. This situation may lead to a strong incentive for people to buy a vaccine. Therefore, a relevant study to assess individuals’ choices and the value of change in welfare from a COVID-19 vaccine is essential. Objective This study aimed to estimate the willingness-to-pay (WTP) value for a vaccine for COVID-19. We also identify the variables that influence individual vaccination decisions, which could be used in the design of vaccination promotion strategies. Methods We use the contingent valuation method in its double-bounded dichotomous choice format. The estimation coefficients are calculated according to the maximum likelihood method under the assumption of a probit distribution. The sample consisted of 531 individuals, mainly from middle- and high-income socioeconomic groups from Chile between enrolled between 10 July and 10 August 2020. Results The results show a high WTP for the COVID-19 vaccine, with a value up to US$232. Income and education levels and having family members with COVID-19 increased the likelihood of persons paying for a vaccine. There is also a greater fear as the pandemic progresses that people will get sick from COVID-19. Conclusions The high WTP value creates an opportunity for formulating public health policy. The results of this study suggest that governments can provide the vaccine free to low-income groups and allow those with higher incomes to acquire the vaccine through the private sector by paying. This will be useful especially for countries with economic difficulties.
      PubDate: 2021-02-23
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762

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