Direct healthcare cost of schizophrenia – European overview

2018 ◽  
Vol 48 (1) ◽  
pp. 79-92 ◽  
Author(s):  
G. Kovács ◽  
T. Almási ◽  
A. Millier ◽  
M. Toumi ◽  
M. Horváth ◽  
...  
Keyword(s):  
Healthcare System ◽  
Healthcare Cost ◽  
Direct Healthcare Cost ◽  
Antipsychotic Therapy ◽  
Substantial Impact ◽  
Cochrane Database ◽  
Specific Symptoms ◽  
The Impact ◽  
Pharmaceutical Prices ◽  
Working Out

AbstractPurposeTo provide an overview on the magnitude of the impact of schizophrenia on the healthcare system in Europe and to gain a better understanding on the most important factors influencing the variation of costs.MethodsStudies reporting costs and healthcare utilization among patients with schizophrenia were searched in MEDLINE (via Scopus), EMBASE (via Scopus) and Cochrane Database of Systematic Reviews on 19th January 2017.ResultsTwenty-three studies, from the 1075 references initially identified, were included in this review. The annual cost per patient ranged from €533 in Ukraine to €13,704 in the Netherlands. Notably drug costs contributed to less than 25% of the direct healthcare cost per patient in every country, which might be explained by similar pharmaceutical prices among countries due to the reference pricing system applied in Europe. Inpatient costs were the largest component of health service costs in the majority of the countries. Despite methodological heterogeneity across studies, four major themes could be identified (age, severity of symptoms, continuation of treatment/persistence, hospitalization) that have substantial impact on the costs of schizophrenia.ConclusionsSchizophrenia represents a substantial cost for the healthcare system in Europe driven by the high cost per patient. Substantial savings could potentially be achieved by increasing investment in the following areas: (1) reducing the number of hospitalizations e.g. by increasing the efficiency of outpatient care; (2) working out interventions targeted at specific symptoms; (3) improving patient persistence and adherence in antipsychotic therapy.

NICE's evaluations of medicines authorized by EMA with conditional marketing authorization or under exceptional circumstances

2020 ◽  
Vol 36 (4) ◽  
pp. 426-433
Author(s):  
Pilar Pinilla-Dominguez ◽  
Huseyin Naci ◽  
Leeza Osipenko ◽  
Elias Mossialos
Keyword(s):  
Data Collection ◽  
Healthcare System ◽  
Clinical Data ◽  
Risk Mitigation ◽  
Marketing Authorization ◽  
European Medicines Agency ◽  
Substantial Impact ◽  
Early Access ◽  
The Status ◽  
The Impact

ObjectivesTo investigate the impact of the uncertainty stemming from products with European conditional marketing authorization (CMA) or authorization in exceptional circumstances (AEC) on the National Institute for Health and Care Excellence's (NICE) recommendations.MethodsProducts which received CMA/AEC by European Medicines Agency (EMA) up to 1 December 2016 were identified and matched with corresponding NICE decisions issued by August 2017, the status of which was then traced to August 2019. We assessed whether the conversion of CMA to full marketing authorization triggered a review of a NICE decision. The odds of a recommendation carrying a commercial arrangement for products with and without CMA/AEC were calculated.ResultsFifty-four products were granted CMA/AEC by EMA. NICE conducted thirty evaluations of products with CMA/AEC. Twelve products were recommended by NICE by August 2017 and fourteen by August 2019. All recommendations had an associated commercial arrangement. The odds of carrying a commercial arrangement were higher for products with CMA/AEC compared to those with full authorization. Conversions from conditional to full authorization among products not recommended by NICE did not trigger an appraisal review.ConclusionsUncertainty, stemming from the lack of robust clinical data of products authorized with CMA/AEC, has a substantial impact on HTA recommendations, frequently requiring risk mitigation mechanisms such as commercial and data collection arrangements. Further analyses should be conducted to assess whether the benefits of early access strategies outweigh the risks for patients and the healthcare system.

The Digital Divide and K-12 Student Computer Use

10.28945/2926 ◽  
2005 ◽  
Author(s):  
James N. Morgan ◽  
Craig A. VanLengen
Keyword(s):  
Digital Divide ◽  
Computer Use ◽  
Census Data ◽  
Internet Access ◽  
Demographic Characteristics ◽  
The Internet ◽  
Substantial Impact ◽  
Limited Basis ◽  
K 12 ◽  
The Impact

The divide between those who have computer and Internet access and those who do not appears to be narrowing, however overall statistics may be misleading. Measures of computer availability in schools often include cases where computers are only available for administration or are available only on a very limited basis (Gootman, 2004). Access to a computer and the Internet outside of school helps to reinforce student learning and emphasize the importance of using technology. Recent U.S. statistics indicate that ethnic background and other demographic characteristics still have substantial impact on the availability and use of computers by students outside of the classroom. This paper examines recent census data to determine the impact of the household on student computer use outside of the classroom. Encouragingly, the findings of this study suggest that use of a computer at school substantially increases the chance that a student will use a computer outside of class. Additionally, this study suggests that computer use outside of the classroom is positively and significantly impacted by being in a household with adults who either use a computer at work or work in an industry where computers are extensively used.

scholarly journals Review on Urban Heat Island in China: Methods, Its Impact on Buildings Energy Demand and Mitigation Strategies

2021 ◽  
Vol 13 (2) ◽  
pp. 762
Author(s):  
Liu Tian ◽  
Yongcai Li ◽  
Jun Lu ◽  
Jue Wang
Keyword(s):  
Energy Consumption ◽  
Urban Heat Island ◽  
Building Energy ◽  
Design Stage ◽  
Heat Island ◽  
Building Energy Consumption ◽  
Rapid Urbanization ◽  
Substantial Impact ◽  
Urban Heat ◽  
The Impact

High population density, dense high-rise buildings, and impervious pavements increase the vulnerability of cities, which aggravate the urban climate environment characterized by the urban heat island (UHI) effect. Cities in China provide unique information on the UHI phenomenon because they have experienced rapid urbanization and dramatic economic development, which have had a great influence on the climate in recent decades. This paper provides a review of recent research on the methods and impacts of UHI on building energy consumption, and the practical techniques that can be used to mitigate the adverse effects of UHI in China. The impact of UHI on building energy consumption depends largely on the local microclimate, the urban area features where the building is located, and the type and characteristics of the building. In the urban areas dominated by air conditioning, UHI could result in an approximately 10–16% increase in cooling energy consumption. Besides, the potential negative effects of UHI can be prevented from China in many ways, such as urban greening, cool material, water bodies, urban ventilation, etc. These strategies could have a substantial impact on the overall urban thermal environment if they can be used in the project design stage of urban planning and implemented on a large scale. Therefore, this study is useful to deepen the understanding of the physical mechanisms of UHI and provide practical approaches to fight the UHI for the urban planners, public health officials, and city decision-makers in China.

scholarly journals The Impact of the Coronavirus Disease (COVID-19) on the Health and Social Needs of Sex Workers in Singapore

2021 ◽  
Author(s):  
Rayner Kay Jin Tan ◽  
Vanessa Ho ◽  
Sherry Sherqueshaa ◽  
Wany Dee ◽  
Jane Mingjie Lim ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Sex Work ◽  
Sex Workers ◽  
Social Needs ◽  
Medical Services ◽  
Substantial Impact ◽  
Sex Worker ◽  
Permanent Resident ◽  
The Impact ◽  
Depth Interviews

AbstractWe evaluated the impact of the coronavirus disease (COVID-19) on the sex work industry and assessed how it has impacted the health and social conditions of sex workers in Singapore. We conducted a sequential exploratory mixed methods study amidst the COVID-19 pandemic from April to October 2020, including in-depth interviews with 24 stakeholders from the sex work industry and surveyor-administered structured surveys with 171 sex workers. COVID-19 had a substantial impact on sex workers' income. The illegality of sex work, stigma, and the lack of work documentation were cited as exclusionary factors for access to alternative jobs or government relief. Sex workers had experienced an increase in food insecurity (57.3%), housing insecurity (32.8%), and sexual compromise (8.2%), as well as a decrease in access to medical services (16.4%). Being transgender female was positively associated with increased food insecurity (aPR = 1.23, 95% CI [1.08, 1.41]), housing insecurity (aPR = 1.28, 95% CI [1.03, 1.60]), and decreased access to medical services (aPR = 1.74, 95% CI [1.23, 2.46]); being a venue-based sex worker was positively associated with increased food insecurity (aPR = 1.46, 95% CI [1.00, 2.13]), and being a non-Singaporean citizen or permanent resident was positively associated with increased housing insecurity (aPR = 2.59, 95% CI [1.73, 3.85]). Our findings suggest that COVID-19 has led to a loss of income for sex workers, greater food and housing insecurity, increased sexual compromise, and reduced access to medical services for sex workers. A lack of access to government relief among sex workers exacerbated such conditions. Efforts to address such population health inequities should be implemented.

scholarly journals Impact of the COVID-19 Vaccine on Asymptomatic Infection Among Patients Undergoing Pre-Procedural COVID-19 Molecular Screening

2021 ◽  
Author(s):  
Aaron J Tande ◽  
Benjamin D Pollock ◽  
Nilay D Shah ◽  
Gianrico Farrugia ◽  
Abinash Virk ◽  
...  
Keyword(s):  
United States ◽  
Relative Risk ◽  
Healthcare System ◽  
The United States ◽  
Asymptomatic Infection ◽  
Screening Tests ◽  
Molecular Screening ◽  
Molecular Tests ◽  
Asymptomatic Individuals ◽  
The Impact

Abstract Background Several vaccines are now clinically available under emergency use authorization in the United States and have demonstrated efficacy against symptomatic COVID-19. The impact of vaccines on asymptomatic SARS-CoV-2 infection is largely unknown. Methods We conducted a retrospective cohort study of consecutive, asymptomatic adult patients (n = 39,156) within a large United States healthcare system who underwent 48,333 pre-procedural SARS-CoV-2 molecular screening tests between December 17, 2020 and February 8, 2021. The primary exposure of interest was vaccination with at least one dose of an mRNA COVID-19 vaccine. The primary outcome was relative risk of a positive SARS-CoV-2 molecular test among those asymptomatic persons who had received at least one dose of vaccine, as compared to persons who had not received vaccine during the same time period. Relative risk was adjusted for age, sex, race/ethnicity, patient residence relative to the hospital (local vs. non-local), healthcare system regions, and repeated screenings among patients using mixed effects log-binomial regression. Results Positive molecular tests in asymptomatic individuals were reported in 42 (1.4%) of 3,006 tests performed on vaccinated patients and 1,436 (3.2%) of 45,327 tests performed on unvaccinated patients (RR=0.44 95% CI: 0.33-0.60; p<.0001). Compared to unvaccinated patients, the risk of asymptomatic SARS-CoV-2 infection was lower among those >10 days after 1 st dose (RR=0.21; 95% CI: 0.12-0.37; p<.0001) and >0 days after 2 nd dose (RR=0.20; 95% CI: 0.09-0.44; p<.0001) in the adjusted analysis. Conclusions COVID-19 vaccination with an mRNA-based vaccine showed a significant association with a reduced risk of asymptomatic SARS-CoV-2 infection as measured during pre-procedural molecular screening. The results of this study demonstrate the impact of the vaccines on reduction in asymptomatic infections supplementing the randomized trial results on symptomatic patients.

scholarly journals Acute Management Should Be Optimized in Patients with Less Specific Stroke Symptoms: Findings from a Retrospective Observational Study

2021 ◽  
Vol 10 (5) ◽  
pp. 1143
Author(s):  
Simona Halúsková ◽  
Roman Herzig ◽  
Dagmar Krajíčková ◽  
Abduljabar Hamza ◽  
Antonín Krajina ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Intravenous Thrombolysis ◽  
National Institutes Of Health ◽  
Vascular Territory ◽  
Anterior Circulation ◽  
Point Increase ◽  
Single Center Study ◽  
Mouth Corner ◽  
Specific Symptoms ◽  
The Impact

Anterior circulation stroke (ACS) is associated with typical symptoms, while posterior circulation stroke (PCS) may cause a wide spectrum of less specific symptoms. We aim to assess the correlation between the initial presentation of acute ischemic stroke (AIS) symptoms and the treatment timeline. Using a retrospective, observational, single-center study, the set consists of 809 AIS patients treated with intravenous thrombolysis (IVT) and/or endovascular treatment (EVT). We investigate the impact of baseline clinical AIS symptoms and the affected vascular territory on recanalization times in patients treated with IVT only and EVT (±IVT). Regarding the IVT-only group, increasing the National Institutes of Health Stroke Scale (NIHSS) score on admission and speech difficulties are associated with shorter (by 1.59 ± 0.76 min per every one-point increase; p = 0.036, and by 24.56 ± 8.42 min; p = 0.004, respectively) and nausea/vomiting with longer (by 43.72 ± 13.13 min; p = 0.001) onset-to-needle times, and vertigo with longer (by 8.58 ± 3.84 min; p = 0.026) door-to-needle times (DNT). Regarding the EVT (±IVT) group, coma is associated with longer (by 22.68 ± 6.05 min; p = 0.0002) DNT, anterior circulation stroke with shorter (by 47.32 ± 16.89 min; p = 0.005) onset-to-groin time, and drooping of the mouth corner with shorter (by 20.79 ± 6.02 min; p = 0.0006) door-to-groin time. Our results demonstrate that treatment is initiated later in strokes with less specific symptoms than in strokes with typical symptoms.

scholarly journals Use of Artificial Intelligence to understand adults’ thoughts and behaviours relating to COVID-19

2021 ◽  
pp. 175791392097933
Author(s):  
SW Flint ◽  
A Piotrkowicz ◽  
K Watts
Keyword(s):  
Artificial Intelligence ◽  
Online Survey ◽  
Severe Illness ◽  
Free Text ◽  
Community Recovery ◽  
Substantial Impact ◽  
Lifestyle Behaviours ◽  
Artificial Intelligence Methods ◽  
High Concern ◽  
The Impact

Aims: The outbreak of severe acute respiratory syndrome coronavirus 2 (COVID-19) is a global pandemic that has had substantial impact across societies. An attempt to reduce infection and spread of the disease, for most nations, has led to a lockdown period, where people’s movement has been restricted resulting in a consequential impact on employment, lifestyle behaviours and wellbeing. As such, this study aimed to explore adults’ thoughts and behaviours in response to the outbreak and resulting lockdown measures. Methods: Using an online survey, 1126 adults responded to invitations to participate in the study. Participants, all aged 18 years or older, were recruited using social media, email distribution lists, website advertisement and word of mouth. Sentiment and personality features extracted from free-text responses using Artificial Intelligence methods were used to cluster participants. Results: Findings demonstrated that there was varied knowledge of the symptoms of COVID-19 and high concern about infection, severe illness and death, spread to others, the impact on the health service and on the economy. Higher concerns about infection, illness and death were reported by people identified at high risk of severe illness from COVID-19. Behavioural clusters, identified using Artificial Intelligence methods, differed significantly in sentiment and personality traits, as well as concerns about COVID-19, actions, lifestyle behaviours and wellbeing during the COVID-19 lockdown. Conclusions: This time-sensitive study provides important insights into adults’ perceptions and behaviours in response to the COVID-19 pandemic and associated lockdown. The use of Artificial Intelligence has identified that there are two behavioural clusters that can predict people’s responses during the COVID-19 pandemic, which goes beyond simple demographic groupings. Considering these insights may improve the effectiveness of communication, actions to reduce the direct and indirect impact of the COVID-19 pandemic and to support community recovery.

scholarly journals Factors Impacting Pharmaceutical Prices and Affordability: Narrative Review

Pharmacy ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Kah Seng Lee ◽  
Yaman Walid Kassab ◽  
Nur Akmar Taha ◽  
Zainol Akbar Zainal
Keyword(s):  
Narrative Review ◽  
Financial Advisors ◽  
Cost Information ◽  
Electronic Prescription ◽  
Related Information ◽  
Pharmaceutical Distribution ◽  
Out Of Pocket Expenses ◽  
Additional Charges ◽  
The Impact ◽  
Pharmaceutical Prices

Increasing prescription drug pricing often reflects additional work stress on medical professionals because they function as financial advisors for patients and help them manage out-of-pocket expenses. Providers or prescribers wish to help patients with prescription costs but often lack related information. Healthcare plan providers try to display prescription and drug cost information on their websites, but such data may not be linked to electronic prescription software. A mark-up is defined as the additional charges and costs that are applied to the price of a product for the purpose of covering overhead costs, distribution charges, and profit. Therefore, the policies implemented in the pharmaceutical distribution chain might include the regulation of wholesale and retails mark-ups and pharmaceutical remuneration. If mark-ups are regulated, countries are highly recommended to use regressive mark-ups rather than fixed percentage mark-ups. This narrative review provides insights into the framework of pharmaceutical mark-up systems by describing different factors impacting pharmaceutical prices and affordability. These include the interplay of medicine pricing and the supply chain, the impact of pertinent laws and regulation and out-of-pocket expenditure.

Sign in / Sign up

Export Citation Format

Share Document