scholarly journals Trends in the kidney cancer mortality-to-incidence ratios according to health care expenditures of 56 countries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wen-Wei Sung ◽  
Po-Yun Ko ◽  
Wen-Jung Chen ◽  
Shao-Chuan Wang ◽  
Sung-Lang Chen

AbstractThe incidence and mortality rates in kidney cancer (KC) are increasing. However, the trends for mortality have varied among regions over the past decade, which may be due to the disparities in medical settings, such as the availability of frequent imaging examinations and effective systemic therapies. The availability of these two medical options has been proven to be positively correlated with a favorable prognosis in KC and may be more common in countries with better health care systems and greater expenditures. The delicate association between the trends in clinical outcomes in KC and health care disparities warrant detailed observation. We applied a delta-mortality-to-incidence ratio (δMIR) for KC to compare two years as an index for the improvement in clinical outcomes and the mortality-to-incidence ratio (MIR) of a single year to evaluate their association with the Human Development Index (HDI), current health expenditure (CHE) per capita, and CHE as a percentage of gross domestic product (CHE/GDP) by using linear regression analyses. A total of 56 countries were included based on data quality reports and missing data. We discovered that the HDI, CHE per capita, and CHE/GDP were negatively correlated with the MIRs for KC (p < 0.001, p < 0.001, and p < 0.001, respectively). No significant association was observed between the δMIRs and the HDI, CHE per capita, and CHE/GDP among the included countries, and only the CHE/GDP shows a trend toward significance. Interestingly, the δMIRs related with an increase in relative health care investment include δCHE per capita and δCHE/GDP.

2018 ◽  
Author(s):  
Curtis L Petersen ◽  
William B Weeks ◽  
Olof Norin ◽  
James N Weinstein

BACKGROUND Caring for individuals with chronic conditions is labor intensive, requiring ongoing appointments, treatments, and support. The growing number of individuals with chronic conditions makes this support model unsustainably burdensome on health care systems globally. Mobile health technologies are increasingly being used throughout health care to facilitate communication, track disease, and provide educational support to patients. Such technologies show promise, yet they are not being used to their full extent within US health care systems. OBJECTIVE The purpose of this study was to examine the use of staff and costs of a remote monitoring care model in persons with and without a chronic condition. METHODS At Dartmouth-Hitchcock Health, 2894 employees volunteered to monitor their health, transmit data for analysis, and communicate digitally with a care team. Volunteers received Bluetooth-connected consumer-grade devices that were paired to a mobile phone app that facilitated digital communication with nursing and health behavior change staff. Health data were collected and automatically analyzed, and behavioral support communications were generated based on those analyses. Care support staff were automatically alerted according to purpose-developed algorithms. In a subgroup of participants and matched controls, we used difference-in-difference techniques to examine changes in per capita expenditures. RESULTS Participants averaged 41 years of age; 72.70% (2104/2894) were female and 12.99% (376/2894) had at least one chronic condition. On average each month, participants submitted 23 vital sign measurements, engaged in 1.96 conversations, and received 0.25 automated messages. Persons with chronic conditions accounted for 39.74% (8587/21,607) of all staff conversations, with higher per capita conversation rates for all shifts compared to those without chronic conditions (P<.001). Additionally, persons with chronic conditions engaged nursing staff more than those without chronic conditions (1.40 and 0.19 per capita conversations, respectively, P<.001). When compared to the same period in the prior year, per capita health care expenditures for persons with chronic conditions dropped by 15% (P=.06) more than did those for matched controls. CONCLUSIONS The technology-based chronic condition management care model was frequently used and demonstrated potential for cost savings among participants with chronic conditions. While further studies are necessary, this model appears to be a promising solution to efficiently provide patients with personalized care, when and where they need it.


Author(s):  
Cheng-Yu Huang ◽  
Kwong-Kwok Au ◽  
Sung-Lang Chen ◽  
Shao-Chuan Wang ◽  
Chi-Yu Liao ◽  
...  

The mortality-to-incidence ratio (MIR) is associated with the clinical outcome of cancer treatment. For several cancers, countries with relatively good health care systems have favorable MIRs. However, the association between lung cancer MIR and health care expenditures or rankings has not been evaluated. We used linear regression to analyze the correlation between lung cancer MIRs and the total expenditures on health/gross domestic product (e/GDP) and the World Health Organization (WHO) rankings. We included 57 countries, for which data of adequate quality were available, and we found high rates of incidence and mortality but low MIRs in more developed regions. Among the continents, North America had the highest rates of incidence and mortality, whereas the highest MIRs were in Africa, Asia, Latin America, and the Caribbean. Globally, favorable MIRs correlated with high e/GDP and good WHO ranking (regression coefficient, −0.014 and 0.001; p = 0.004, and p = 0.014, respectively). In conclusion, the MIR for lung cancer in different countries varies with the expenditure on health care and health system rankings.


2016 ◽  
Vol 47 (2) ◽  
pp. 333-351 ◽  
Author(s):  
Paul Barker ◽  
John Church

Twenty years ago, many of Canada’s provinces began to introduce regional health authorities to address problems with their health care systems. With this action, the provinces sought to achieve advances in community decision-making, the integration of health services, and the provision of care in the home and community. The authorities were also to help restrict health care costs. An assessment of the authorities indicates, however, that over the past two decades they have been unable to meet their objectives. Community representatives continue to play little role in determining the appropriate health services for their regions. Gains have been made towards integrating health services, but the plan for a near seamless set of health services has not been realized. Funding for health services remains focused on hospital and physician care, and health care expenditures have until very recently been little affected by regional authorities. This disappointing performance has caused some provinces to abandon their regional authorities, but this article argues that the provision of greater autonomy and a better public appreciation of their role and potential may lead to more successful regional authorities. Accordingly, the objective of this article is to reveal the shortcomings of regional health authorities in Canada while at the same time arguing that changes can be made to increase the chances of more workable authorities.


2014 ◽  
Vol 5 (2) ◽  
pp. 117-128
Author(s):  
Rina Samant ◽  
Sonia Samant

The purpose of this research is to examine the effect of health risk factors and health care systems on child mortality and life expectancy in Latin America and the Caribbean (LAC). Cross-sectional multiple regression and Analysis of Variance (ANOVA) are used to study the association between health risk factors such as incidence of tuberculosis and diabetes, and health care systems such as number of hospital beds per capita, and number of physicians per capita on life expectancy and child mortality. Data are obtained from the World Bank. For the purpose of this study, the LAC region is defined as the area from Mexico to the southern end of South America, as well as islands in the Caribbean Sea and the Gulf of Mexico. The conclusions of the study are that higher life expectancy is associated with higher per capita incomes and health expenditures. On the other hand, higher child mortality is associated with greater prevalence of communicable diseases and poor maternal pre-natal conditions. The macro policy implication is to focus on economic development and health care expenditure. The micro policy implication is to allocate more resources for maternal care, preventive care and eradication of communicable diseases. 


2007 ◽  
Vol 227 (5-6) ◽  
Author(s):  
Florian Buchner ◽  
Rebecca Deppisch ◽  
Jürgen Wasem

SummaryHealth care systems are financed through a mixture of different components: taxes, contributions to social health insurance, premiums to private health insurance, out of pocket payments by patients. These components can be combined differently leading to specific effects of interpersonal redistribution. This can be compared between different countries. In such a comparison the redistributional impact of the German health care systems is rather regressive - which is basically caused by the opportunity for people with high income to leave social health insurance. In comparison to a health insurance system with risk rated premiums, financing of the German social health insurance leads to interpersonal redistribution from higher to lower income, from the young to the elderly, from healthy to sick and from singles to families with children. The pay-as-you-go character of the system leads especially in combination with an aging population and technological change to burden for future generations. In comparison to a system in which each region finances its own health care expenditures, there are also considerable interregional redistributions. The financing system in Germany is not conceptually consistent. Reform proposals (unified health insurance for all; flat rate premiums) tackle these inconsistencies.


2003 ◽  
Vol 17 (2) ◽  
pp. 27-48
Author(s):  
Kwangho Jung

There is a growing interest in the comparison of international health care data with the hope that such studies will enable individual systems to learn from other systems. There are, however, few rigorous comparative studies of health care systems. There is little evidence to suggest which model is to be preferred in what circumstances. This paper attempts to compare health care systems in three developed countries, including Germany, Sweden and the United States in terms of access, cost and quality. This paper suggests potential policies for population health in developed countries. They include universal health care coverage, the reduction of poverty and income inequality and the reallocation from health care expenditures to non-health care expenditures.


BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Wen-Wei Sung ◽  
Shao-Chuan Wang ◽  
Tzuo-Yi Hsieh ◽  
Cheng-Ju Ho ◽  
Cheng-Yu Huang ◽  
...  

2008 ◽  
Vol 1;11 (1;1) ◽  
pp. 13-42
Author(s):  
Laxmaiah Manchikanti

It is often claimed that American health care provides good medical care, but the system through which that care is financed is falling apart. In 1994, Joseph A. Califano, Jr., former Secretary of Health, Education and Welfare reported that the American health care system was in such turmoil, that it needed radical surgery. Health care in the United States is different from other countries. Health care costs in America have skyrocketed and in 2006 occupied 16% of the Gross Domestic Product (GDP) with a budget of over $2 trillion. Health care expenditures per capita in the United States are higher than 13 other countries utilized in a sample by the Organisation for Economic Co-operation and Development. Estimated spending according to wealth was utilized to measure each country’s health care spending in comparison to each other. This measure, including various parameters (undoubtedly some have been missed), largely showed that after adjusting to its higher per capita income levels, the United States spends $477 billion - $1,645 per capita more on health care than any other peer country. Many health care proposals have been forwarded since 1965, when Lyndon Johnson succeeded in enacting Medicare. These come from Republicans, Democrats, Independents, physicians, insurers, non-partisan and partisan groups. However, none has been able to provide a guaranteed proposal to fix the health care ills and also provide reasonable coverage. This manuscript will review escalating national health care expenditures, factors contributing to health care increases, health care systems in many other countries, and various proposals. Key words: Health care reform, Organisation for Economic Co-Operation and Development, Estimated Spending According to Wealth (ESAW), Centers for Medicare and Medicaid (CMS), universal health care, managed health care reform


2004 ◽  
Vol 171 (4S) ◽  
pp. 42-43 ◽  
Author(s):  
Yair Latan ◽  
David M. Wilhelm ◽  
David A. Duchene ◽  
Margaret S. Pearle

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