Global variation in the cost of a nutrient-adequate diet by population group: an observational study

Abstract More than five years since the global commitment to the 2030 Agenda for Sustainable Development, 690 million people lack sufficient food and economic projections suggest that the COVID-19 pandemic may add an additional 83 to 132 million people to the ranks of the undernourished. Meanwhile, 1.3 billion tons of food are wasted globally each year, utilizing 38% of total energy consumption in the global food system. Child and adult overweight and obesity are increasing in almost all countries, and on a global level the cost of a healthy diet is 60% higher than the cost of a nutrient adequate diet, and almost 5 times the cost of an energy sufficient diet. The Mediterranean Diet is one of the recognized models of healthy and sustainable diets. This model has proven to promote longevity and well-being, not only by considering specific food items and dietary patterns, but also taking into account the culture and the history of populations living in that region, as well as social aspects such as tradition and conviviality. Moreover, it is strongly tied to a gastronomic background that links health with enjoyment. This may be extremely important for the implementation of feasible programs for the prevention of chronic non communicable diseases. In fact, long lasting lifestyle changes are difficult to achieve and, although health motivations may lead to satisfactory dietary compliance in the short term, pleasure remains an important determinant of any dietary change that is intended to last. While keeping traditional dietary habits at European level, the main principles of the Mediterranean diet could be taken into account to identify key features that ensure both health benefits and sustainable impact on environment. Assessing the sustainability of these products can be an effective operational approach for preserving and promoting a Mediterranean-type dietary pattern in the European region.

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Evaluasi Peresepan Terapi Bronkopneumonia Anak di Unit Rawat Jalan Rumah Sakit Umum Daerah Bangkalan, Indonesia

Journal of Pharmacy and Science ◽

10.53342/pharmasci.v4i2.138 ◽

2019 ◽

Vol 4 (2) ◽

pp. 67-70

Author(s):

Ilil Maidatuz Zulfa ◽

Fitria Dewi Yunitasari ◽

Nisa Dwi Ratnadi

Keyword(s):

Observational Study ◽

Cost Effective ◽

Retrospective Observational Study ◽

National Formulary ◽

Prescribing Indicators ◽

The Cost ◽

Effective Drugs

ABSTRAKBronkopneumonia adalah salah satu manifestasi klinik dari pneumonia yang paling sering muncul pada anak. Obat yang diresepkan seringkali mengkombinasikan antibiotik dengan obat-obat simtomatis dan tidak sedikit yang berupa polifarmasi. Peresepan polifarmasi berpotensi pada kurang efisiennya pengobatan. Peresepan yang kurang efisien akan berakibat pada efektivitas dan keamanan terapi, eksaserbasi atau perpanjangan gejala dan penyakit, serta tingkat keamanan pada pasien, serta peningkatan biaya terapi. Tujuan dari penelitian ini adalah untuk mengevaluasi peresepan terapi bronkopneumonia pada anak. Studi observasional secara retrospektif dilakukan pada peresepan bronkopneumonia anak usia 0-14 tahun di Unit Rawat Jalan Rumah Sakit Umum Daerah Syarifah Ambami Rato Ebu Bangkalan, Indonesia selama tahun 2016. Evaluasi peresepan mengacu pada WHO prescribing indicator yang terdiri dari 5 poin. Hasil evaluasi pada penelitian ini menunjukkan bahwa rata-rata jumlah obat yang diresepkan adalah 4,60 item per kunjungan, obat generik diresepkan sebanyak 53,88%, antibiotik sebesar 69,31%, obat injeksi sebesar 0,99%, dan obat dalam Formularium Nasional tahun 2017 sebesar 48,28% dalam satu tahun periode peresepan. Sehingga, terdapat empat indikator yang belum sesuai dengan yang ditentukan WHO. Walaupun pemberian antibiotik sangat disarankan pada terapi bronkopneumonia, peresepan antibiotik masih memerlukan evaluasi lebih lanjut terkait rasionalitasnya. Selain itu, rendahnya peresepan berdasarkan Formularium Nasional tahun 2017 menunjukkan masih relatif rendahnya optimasi penggunaan obat yang cost-effective menurut kebijakan nasional.Kata kunci: Bronkopneumonia, Peresepan, Rawat Jalan.ABSTRACTBronchopneumonia is one of pneumonia manifestations commonly occur in children.The treatments usually combine antibiotics and symptomatic drugs in the form of polypharmacy.Polypharmacy can leads to inefficient treatmentsthat can cause ineffective and unsafe treatment, exacerbation or prolongation of illness, distress, harm to the patient and increasing the cost therapy.The aim of the study was to evaluate the prescribing for bronchopneumonia treatment in children. A retrospective observational study was conducted on prescriptions written for children with bronchopneumonia age 0-14 y.o in outpatient departement of Rumah Sakit Umum Daerah Syarifah Ambami Rato Ebu Bangkalan, Indonesia during 2016.WHO prescribing indicators was used to evaluate the prescribing. The result showed that the average number of medicine per encounter was 4.60 items, including medicine prescribed by generic name was 53.88%, antibiotics prescribed was 69.31%, injection prescribed was 0.99%, and medicines prescribed from National Formulary 2017 was 48.28%. Hence, there were four indicators found to be innapproppriate to WHO recomendation. Although antibiotics are highly recommended in bronchopneumonia, the usage of antibiotics still need an assessment related to its rationality. In addition, low percentage of medicines National Formulary showed low usage of cost-effective drugs based on the goverments policy.Keywords: Bronchopneumonia, Prescribing, Outpatients.

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Commentary: Causal Inference for Social Exposures

Annual Review of Public Health ◽

10.1146/annurev-publhealth-040218-043735 ◽

2019 ◽

Vol 40 (1) ◽

pp. 7-21 ◽

Cited By ~ 5

Author(s):

Jay S. Kaufman

Keyword(s):

Observational Study ◽

Causal Inference ◽

Human Health ◽

Social Epidemiology ◽

Social Institutions ◽

Causal Effects ◽

Advantages And Disadvantages ◽

The Cost

Social epidemiology seeks to describe and quantify the causal effects of social institutions, interactions, and structures on human health. To accomplish this task, we define exposures as treatments and posit populations exposed or unexposed to these well-defined regimens. This inferential structure allows us to unambiguously estimate and interpret quantitative causal parameters and to investigate how these may be affected by biases such as confounding. This paradigm has been challenged recently by some critics who favor broadening the exposures that may be studied beyond treatments to also consider states. Defining the exposure protocol of an observational study is a continuum of specificity, and one may choose to loosen this definition, incurring the cost of causal parameters that become commensurately more vague. The advantages and disadvantages of broader versus narrower definitions of exposure are matters of continuing debate in social epidemiology as in other branches of epidemiology.

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Number of Unused Medications at the Time of Last Admission: A Prospective Observational Study in a Single Palliative Care Unit

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118784004 ◽

2018 ◽

Vol 35 (12) ◽

pp. 1498-1504

Author(s):

Takahito Omae ◽

Nobuyuki Yotani ◽

Akihiro Sakashita ◽

Yoshiyuki Kizawa

Keyword(s):

Palliative Care ◽

Observational Study ◽

Anticancer Drugs ◽

Prospective Observational Study ◽

Low Cost ◽

Palliative Care Unit ◽

Opioid Use ◽

Patients With Cancer ◽

Unused Medications ◽

The Cost

Background: Unused medications (UM) are an important issue, with the waste associated with UM a burden to the health-care system. The aims of this study were to clarify the amount and costs of UM in patients with advanced cancer at the time of their last admission to a palliative care unit and to explore the factors contributing to the cost of UM and how patients dealt with UM. Methods: A prospective observational study was conducted in single palliative care unit. Unused medications were classified into 6 categories and the number and cost of UM by category calculated per patient. Patients were classified into 2 cost groups (high and low) based on the total cost of UM, and the number and cost of UM by category were compared between these 2 groups. Results: Of 194 consecutive hospitalized patients, data were analyzed for 90. The mean number and cost of UM per patient was 440 and US$301, respectively. Opioids accounted for 47% of the cost of UM. Comparing costs by UM category, the proportion of opioids (51% vs 21%; P < .0001) and oral anticancer drugs (14% vs 3%; P = .02) was higher in the high- than in the low-cost group. Conclusion: Based on the results of the present study, the estimated annual waste cost of UM for patients with cancer who died in Japan was approximately US$110 million. Interventions to educate patients regarding UM and to eliminate barriers to opioid use may help reduce the cost of UM, particularly opioids and anticancer drugs.

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Adaptive capacity of the Adjusted Clinical Groups Case-Mix System to the cost of primary healthcare in Catalonia (Spain): a observational study

BMJ Open ◽

10.1136/bmjopen-2012-000941 ◽

2012 ◽

Vol 2 (3) ◽

pp. e000941 ◽

Cited By ~ 2

Author(s):

Antoni Sicras-Mainar ◽

Soledad Velasco-Velasco ◽

Ruth Navarro-Artieda ◽

Alexandra Prados-Torres ◽

Buenaventura Bolibar-Ribas ◽

...

Keyword(s):

Observational Study ◽

Adaptive Capacity ◽

Primary Healthcare ◽

Case Mix ◽

The Cost ◽

Adjusted Clinical Groups

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PMDE2: THE COST OF GLAUCOMA TREATMENT IN POLAND-RESULTS FROM OBSERVATIONAL STUDY

Value in Health ◽

10.1016/s1098-3015(11)70820-8 ◽

2000 ◽

Vol 3 (5) ◽

pp. 375

Author(s):

E Orlewska ◽

K Czechowicz-Janicka ◽

Z Tobota

Keyword(s):

Observational Study ◽

Glaucoma Treatment ◽

The Cost

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Brief interventions for obesity when patients are asked to pay for weight loss treatment: an observational study in primary care with an embedded randomised trial

British Journal of General Practice ◽

10.3399/bjgp20x708797 ◽

2020 ◽

Vol 70 (694) ◽

pp. e348-e355 ◽

Cited By ~ 1

Author(s):

Kate Tudor ◽

Susan A Jebb ◽

Indrani Manoharan ◽

Paul Aveyard

Keyword(s):

Primary Care ◽

Weight Loss ◽

Observational Study ◽

Brief Intervention ◽

Randomised Trial ◽

Cost Effective ◽

Cost Comparison ◽

West Midlands ◽

Weight Loss Programme ◽

The Cost

BackgroundA brief intervention whereby GPs opportunistically facilitate an NHS-funded referral to a weight loss programme is clinically and cost-effective.AimTo test the acceptability of a brief intervention and attendance at a weight loss programme when GPs facilitate a referral that requires patients to pay for the service.Design and settingAn observational study of the effect of a GP encouraging attendance at a weight loss programme requiring self-payment in the West Midlands from 16 October 2018 to 30 November 2018, to compare with a previous trial in England in which the service was NHS-funded.MethodSixty patients with obesity who consecutively attended primary care appointments received an opportunistic brief intervention by a GP to endorse and offer a referral to a weight loss programme at the patient’s own expense. Participants were randomised to GPs who either stated the weekly monetary cost of the programme (basic cost) or who compared the weekly cost to an everyday discretionary item (cost comparison). Participants were subsequently asked to report whether they had attended a weight loss programme.ResultsOverall, 47% of participants (n = 28) accepted the referral; 50% (n = 15) in the basic cost group and 43% (n = 13) in the cost comparison group. This was significantly less than in a previous study when the programme was NHS-funded (77%, n = 722/940; P<0.0001). Most participants reported the intervention to be helpful/very helpful and appropriate/very appropriate (78%, n = 46/59 and 85%, n = 50/59, respectively) but scores were significantly lower than when the programme was NHS-funded (92% n = 851/922 and 88% n = 813/922, respectively; P = 0.004). One person (2%) attended the weight loss programme, which is significantly lower than the 40% of participants who attended when the programme was NHS-funded (P<0.0001).ConclusionGP referral to a weight loss programme that requires patients to pay rather than offering an NHS-funded programme is acceptable; however, it results in almost no attendance.

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