scholarly journals A call for harmonization of European kidney care: dialysis reimbursement and distribution of kidney replacement therapies

2020 ◽  
Vol 35 (6) ◽  
pp. 979-986 ◽  
Author(s):  
Arjan van der Tol ◽  
Vianda S Stel ◽  
Kitty J Jager ◽  
Norbert Lameire ◽  
Rachael L Morton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Expenditure ◽  
European Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Expenditure ◽  
Home Dialysis ◽  
Kidney Replacement Therapy ◽  
The Cost ◽  
The Impact

Abstract Background We compare reimbursement for haemodialysis (HD) and peritoneal dialysis (PD) in European countries to assess the impact on government healthcare budgets. We discuss strategies to reduce costs by promoting sustainable dialysis and kidney transplantation. Methods This was a cross-sectional survey among nephrologists conducted online July–December 2016. European countries were categorized by tertiles of gross domestic product per capita (GDP). Reimbursement data were matched to kidney replacement therapy (KRT) data. Results The prevalence per million population of patients being treated with long-term dialysis was not significantly different across tertiles of GDP (P = 0.22). The percentage of PD increased with GDP across tertiles (4.9, 8.2, 13.4%; P < 0.001). The HD-to-PD reimbursement ratio was higher in countries with the highest tertile of GDP (0.7, 1.0 versus 1.7; P = 0.007). Home HD was mainly reimbursed in countries with the highest tertile of GDP (15, 15 versus 69%; P = 0.005). The percentage of public health expenditure for reimbursement of dialysis decreased across tertiles of GDP (3.3, 1.5, 0.7%; P < 0.001). Transplantation as a proportion of all KRT increased across tertiles of GDP (18.5, 39.5, 56.0%; P < 0.001). Conclusions In Europe, dialysis has a disproportionately high impact on public health expenditure, especially in countries with a lower GDP. In these countries, the cost difference between PD and HD is smaller, and home dialysis and transplantation are less frequently provided than in countries with a higher GDP. In-depth evaluation and analysis of influential economic and political measures are needed to steer optimized reimbursement strategies for KRT.

scholarly journals Is an ounce of prevention worth a pound of cure? A cross-sectional study of the impact of English public health grant on mortality and morbidity

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036411
Author(s):  
Stephen Martin ◽  
James Lomas ◽  
Karl Claxton
Keyword(s):  
Public Health ◽  
Health Expenditure ◽  
Local Authority ◽  
Quality Adjusted Life Year ◽  
Cross Sectional ◽  
Public Health Expenditure ◽  
Mortality And Morbidity ◽  
Local Public Health ◽  
Additional Qaly ◽  
The Impact

ObjectivesThe UK government is proposing to cease cutting the local authority public health grant by reallocating part of the treatment budget to preventative activity. This study examines whether this proposal is evidenced based and, in particular, whether these resources are best reallocated to prevention, or whether this expenditure would generate more health gains if used for treatment.MethodsInstrumental variable regression methods are applied to English local authority data on mortality, healthcare and public health expenditure to estimate the responsiveness of mortality to variations in healthcare and public health expenditure in 2013/14. Using a well-established method, these mortality results are converted to a quality-adjusted life year (QALY) basis, and this facilitates the estimation of the cost per QALY for both National Health Service (NHS) healthcare and local public health expenditure.ResultsSaving lives and improving the quality of life requires resources. Our estimates suggest that each additional QALY costs about £3800 from the local public health budget, and that each additional QALY from the NHS budget costs about £13 500. These estimates can be used to calculate the number of QALYs generated by a budget boost. If we err on the side of caution and use the most conservative estimates that we have, then an additional £1 billion spent on public health will generate 206 398 QALYs (95% CI 36 591 to 3 76 205 QALYs), and an additional £1 billion spent on healthcare will generate 67 060 QALYs (95% CI 21 487 to 112 633 QALYs).ConclusionsAdditional public health expenditure is very productive of health and is more productive than additional NHS expenditure. However, both types of expenditure are more productive of health than the norms used by National Institute for Health and Care Excellence (£20 000–£30 000 per QALY) to judge whether new therapeutic technologies are suitable for adoption by the NHS.

scholarly journals Public Health Expenditures and Health Outcomes: New Evidence from Ghana

Economies ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 58 ◽  
Author(s):  
Micheal Kofi Boachie ◽  
K. Ramu ◽  
Tatjana Põlajeva
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Least Squares ◽  
Health Expenditure ◽  
Government Intervention ◽  
Health Sector ◽  
Health Expenditures ◽  
Public Health Expenditure ◽  
Life Expectancy At Birth ◽  
The Cost

The effect of government spending on population’s health has received attention over the past decades. This study re-examines the link between government health expenditures and health outcomes to establish whether government intervention in the health sector improves outcomes. The study uses annual data for the period 1980–2014 on Ghana. The ordinary least squares (OLS) and the two-stage least squares (2SLS) estimators are employed for analyses; the regression estimates are then used to conduct cost-effectiveness analysis. The results show that, aside from income, public health expenditure contributed to the improvements in health outcomes in Ghana for the period. We find that, overall, increasing public health expenditure by 10% averts 0.102–4.4 infant and under-five deaths in every 1000 live births while increasing life expectancy at birth by 0.77–47 days in a year. For each health outcome indicator, the effect of income dominates that of public spending. The cost per childhood mortality averted ranged from US$0.20 to US$16, whereas the cost per extra life year gained ranged from US$7 to US$593.33 (2005 US$) during the period. Although the health effect of income outweighs that of public health spending, high (and rising) income inequality makes government intervention necessary. In this respect, development policy should consider raising health sector investment inter alia to improve health conditions.

scholarly journals The Impact of Population Aging and Public Health Support on EU Labor Markets

2020 ◽  
Vol 17 (4) ◽  
pp. 1439 ◽  
Author(s):  
Mirela Cristea ◽  
Gratiela Georgiana Noja ◽  
Petru Stefea ◽  
Adrian Lucian Sala
Keyword(s):  
Public Health ◽  
Labor Market ◽  
Older People ◽  
Labor Markets ◽  
Health Expenditure ◽  
Population Aging ◽  
Public Health Expenditure ◽  
Eu Countries ◽  
Life Years ◽  
The Impact

Population aging and public health expenditure mainly dedicated to older dependent persons present major challenges for the European Union (EU) Member States, with profound implications for their economies and labor markets. Sustainable economic development relies on a well-balanced workforce of young and older people. As this balance shifts in favor of older people, productivity tends to suffer, on the one hand, and the older group demands more from health services, on the other hand. These requisites tend to manifest differently within developed and developing EU countries. This research aimed to assess population aging impacts on labor market coordinates (employment rate, labor productivity), in the framework of several health dimensions (namely, health government expenditure, hospital services, healthy life years, perceived health) and other economic and social factors. The analytical approach consisted of applying structural equation models, Gaussian graphical models, and macroeconometric models (robust regression and panel corrected standard errors) to EU panel data for the years 1995–2017. The results show significant dissimilarities between developed and developing EU countries, suggesting the need for specific policies and strategies for the labor market integration of older people, jointly with public health expenditure, with implications for EU labor market performance.

Education for nurses working in cardiovascular care: A European survey

2013 ◽  
Vol 13 (6) ◽  
pp. 532-540 ◽  
Author(s):  
◽  
Felicity Astin ◽  
Diane L Carroll ◽  
Sabina De Geest ◽  
Jan Martensson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Nursing Education ◽  
Nurse Education ◽  
Evaluation Methods ◽  
European Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Programme Content ◽  
Teaching Learning ◽  
The Impact

Background: Nurses represent the largest sector of the workforce caring for people with cardiovascular disease in Europe. Little is known about the post-registration education provided to nurses working within this specialty. The aim of this descriptive cross sectional survey was to describe the structure, content, teaching, learning, assessment and evaluation methods used in post-registration cardiovascular nurse education programmes in Europe. Method: A 24-item researcher generated electronic questionnaire was sent to nurse representatives from 23 European countries. Items included questions about cardiovascular registered nurse education programmes. Results: Forty-nine respondents from 17 European countries completed questionnaires. Respondents were typically female (74%) and educated at Masters (50%) or doctoral (39%) level. Fifty-one percent of the cardiovascular nursing education programmes were offered by universities either at bachelor or masters level. The most frequently reported programme content included cardiac arrhythmias (93%), heart failure (85%) and ischaemic heart disease (83%). The most common teaching mode was face-to-face lectures (85%) and/or seminars (77%). A variety of assessment methods were used with an exam or knowledge test being the most frequent. Programme evaluation was typically conducted through student feedback (95%). Conclusion: There is variability in the content, teaching, learning and evaluation methods in post-registration cardiovascular nurse education programmes in Europe. Cardiovascular nurse education would be strengthened with a stronger focus upon content that reflects current health challenges faced in Europe. A broader view of cardiovascular disease to include stroke and peripheral vascular disease is recommended with greater emphasis on prevention, rehabilitation and the impact of health inequalities.

scholarly journals The Impact of Public Health Expenditure on Economic Development – Evidence from Prefecture-Level Panel Data of Shandong Province

2017 ◽  
Vol 8 (2) ◽  
pp. 59 ◽  
Author(s):  
Lin Li ◽  
Maoguo Wu ◽  
Zhenyu Wu
Keyword(s):  
Public Health ◽  
Economic Development ◽  
Panel Data ◽  
Health Expenditure ◽  
Social Economic ◽  
Shandong Province ◽  
Quantitative Relation ◽  
Public Health Expenditure ◽  
Social Economic Development ◽  
The Impact

Public health expenditure is an indispensable part of social economy. The public has always paid close attention to public health expenditure. In order to study the quantitative relation between public health expenditure and social economic development, this paper investigates prefecture-level cities in Shandong Province, due to the unique characteristics of Shandong Province. Making theoretical and empirical contributions, this paper augments the Cobb-Douglas production function with public health expenditure and empirically analyzes economic development of prefecture- level cities in Shandong Province. A panel data set is established, followed by multivariate regression analysis. Empirical results find that public health expenditure per capita and coverage of medical insurance can significantly promote social economic development. However, the expansion and growth of the number of health institutions does not necessarily promote economic development. Instead, it may even hold back economic development by causing personnel redundancy and waste of resources. If the government transfers its investment focus from the scale and the speed of development of medical services to their fairness and efficiency, public health expenditure may vastly improve both public health and economic development.

scholarly journals Exploring the perspectives of members of international tuberculosis control and research networks on the impact of COVID-19 on tuberculosis services: a cross sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oluwatosin Nkereuwem ◽  
Esin Nkereuwem ◽  
Arnauld Fiogbe ◽  
Eno E. Usoroh ◽  
Abdou K. Sillah ◽  
...  
Keyword(s):  
Online Survey ◽  
West African ◽  
European Countries ◽  
Diagnosis And Treatment ◽  
Research Networks ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tb Control ◽  
Treatment Services ◽  
The Impact

Abstract Background The COVID-19 pandemic has caused major disruption to healthcare services globally and has impacted on tuberculosis (TB) patients and TB diagnosis and treatment services both in low- and high-income countries. We therefore explored the perspectives of members of regional and international TB control and research networks to further understand TB service disruptions and compared the experiences of members from West African and European countries. Methods This cross-sectional, explorative descriptive study was conducted from May to July 2020 using an open online survey with target respondents from both West African and European countries. The survey comprised discrete questions exploring challenges faced with TB screening, diagnosis, treatment, prevention, and changes implemented. Additionally, respondents were asked to provide recommendations for remedial actions. Results We analysed responses from 124 respondents based in 29 countries located in Europe and West Africa. About half of the respondents reported challenges in delivering routine TB services during the COVID-19 pandemic, with over one third reporting having some form of guidance issued regarding maintaining delivery of routine TB services. Respondents emphasised the need for strengthening TB services especially in light of COVID-19 pandemic. Considerable similarities were found between the challenges experienced by TB professionals in both West African and European settings. Responses also highlighted the hidden challenges faced in some countries prior to the COVID-19 pandemic, especially in some West African settings where staff shortages and laboratory issues predated COVID-19. Conclusions TB control and research professionals in West African and European settings experienced similar challenges to the delivery of TB diagnosis and treatment services due to the COVID-19 pandemic, and highlighted the need for clear communication of guidelines, prioritisation of routine TB service delivery, ongoing health education, and possible integration of TB and COVID-19 services to ensure that TB services are more resilient against the impact of the pandemic.

scholarly journals The Impact of Public Health Expenditure on Health Component of Human Capital

2020 ◽  
Vol 31 (3) ◽  
pp. 371-379
Author(s):  
Rasa Railaite ◽  
Rūta Čiutienė
Keyword(s):  
Public Health ◽  
Human Capital ◽  
Alcohol Consumption ◽  
Life Expectancy ◽  
Health Expenditure ◽  
Education Level ◽  
Panel Data Models ◽  
Age Dependency ◽  
Public Health Expenditure ◽  
The Impact

The analysis of the concept of human capital shows that this form of capital includes a set of different components that are used in economic activities and generates different kind of benefits. Health is one of the main components of human capital. Hence, considering its importance authors of this article tried to investigate the impact of public health expenditure on the health component of human capital. Ordinary least square, fixed and random effects panel data models for 28 European Union countries were used to reach this purpose. The main variables used in this study is life expectancy at birth (related to the health component of human capital) and general government health expenditure. It is known that there are other factors affecting health and human capital in general. Hence variables such as GDP grow, GINI coefficient, education level, alcohol consumption, old age dependency and urbanization rate were added in the models as explanatory variables. The results of the performed study show that public health expenditure has a positive and significant impact on the improvements of life expectancy. Selected fixed-effects panel data models also show significant and positive effects of the GDP growth, old age dependency while a negative effect is identified by alcohol consumption. The existing close relationship between health and education also is confirmed by this study. Results suggest that higher education level is positively and significantly related to life expectancy while a lower education has a negative impact on life expectancy.

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