Abstract 207: Burden of Cardiovascular Disease (CVD) on Economic Cost. Comparison of Outcomes in US and Europe

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Dalia Giedrimiene ◽  
Rachel King
Keyword(s):  
Heart Disease ◽  
Economic Cost ◽  
Epidemiological Data ◽  
Study Data ◽  
Cost Comparison ◽  
World Health ◽  
Productivity Costs ◽  
The Us ◽  
Lost Productivity ◽  
The Uk

CVD is a major cause of morbidity and mortality worldwide, responsible for nearly a third of all deaths. In US, 85.6 million Americans are living with CVD, including 15.5 million with coronary heart disease (CHD). Heart disease (HD) specifically is responsible for approximately one in every seven American deaths, taking 370,213 lives per year. Perhaps even more striking than CHD’s mortality is its preventability. The CDC estimates that 34% of deaths caused by HD could potentially be prevented with modifiable risk factors including hypertension, hyperlipidemia, diabetes, smoking, poor diet, and sedentary lifestyle. By comparing the mortality of CVD and CHD in the US, Europe, and the United Kingdom (UK), we aim to gain a better understanding of the CVD burden and economic cost. Methods: We conducted a literature review of the most recent epidemiological data for US, Europe, and UK to compare mortality due to CVD and CHD between these three regions. Data sources for US include the AHA and CDC. Data for Europe was obtained from the European Society of Cardiology, following the World Health Organization’s definition of 53 states as the European region. The UK is included as it was considered independently in this study. Data for the UK was published by the British Heart Foundation. Results: The comparison of data shows that high mortality is evident in all represented countries and regions with a highest percent of CVD of total deaths in Europe as compared to US (45% vs 30.8%) and CHD (20% vs 14.2%). Very similar findings according annual mortality are evident comparing US to UK for CVD (30.8% vs 28%) and for CHD (14.2% vs 13%). The treatment for CVD is increasing over time, with prescriptions and operations costs around 6.8 billion in England, the majority spend on secondary care. CDC data in US show that Americans suffer 1.5 million heart attacks and strokes each year, which contributes more than $320 billion in annual healthcare costs and lost productivity. By 2030, this cost is projected to rise to $818 billion, while lost productivity costs to $275 billion. Conclusions: Although there is some variation between Europe as a group of 53 countries compared to the US and UK, it is clear that CVD has a major impact on mortality in all three regions studied. Improved prevention of CVD, including heart disease, has the potential to save lives around the globe and to reduce economic burden.

Client perspectives on choice of abortion method in England and Wales

2021 ◽  
pp. bmjsrh-2021-201242
Author(s):  
Rebecca Blaylock ◽  
Shelly Makleff ◽  
Katherine C Whitehouse ◽  
Patricia A Lohr
Keyword(s):  
Treatment Options ◽  
Medical Abortion ◽  
Study Data ◽  
World Health ◽  
Care Providers ◽  
Perceptions Of Risk ◽  
Surgical Methods ◽  
Appointment Availability ◽  
Health Organization ◽  
The Uk

IntroductionThe National Institute for Health and Care Excellence, the Royal College of Obstetricians and Gynaecologists and the World Health Organization recommend that services provide a choice between medical and surgical methods of abortion. We analysed qualitative study data to examine patient perspectives on abortion method choice and barriers to meeting them.MethodsIn-depth interviews with 24 clients who had an abortion at British Pregnancy Advisory Service clinics were carried out between December 2018 and July 2019 to examine perspectives of quality of abortion care. In this article we focus on client perspectives on choice of abortion method. We performed thematic analysis of data relating to choice of abortion method, refined the analysis, interpreted the findings, and organised the data into themes.ResultsParticipants’ preferences for abortion method were shaped by prior experience of abortion, accessibility and privacy, perceptions of risk and experiences of abortion method, and information gathering and counselling. Participants’ ability to obtain their preferred method was impacted by intersecting constraints such as appointment availability, service location and gestational age.ConclusionsOur findings show that many factors shape participants’ preferences for abortion method. In response to the COVID-19 pandemic, some abortion services have constrained abortion method choices, with an emphasis on medical abortion and ‘no-touch’ care. Providers in the UK and beyond should aim to restore and expand more treatment options when the situation allows.

scholarly journals Alcohol skin preparation causes surgical fires

2012 ◽  
Vol 94 (2) ◽  
pp. 87-89 ◽  
Author(s):  
B Rocos ◽  
LJ Donaldson
Keyword(s):  
Fire Risk ◽  
World Health ◽  
Training Curriculum ◽  
Skin Preparation ◽  
Us States ◽  
National Patient Safety Agency ◽  
The Us ◽  
National Patient ◽  
Health Organization ◽  
The Uk

INTRODUCTION Surgical fires are a rare but serious preventable safety risk in modern hospitals. Data from the US show that up to 650 surgical fires occur each year, with up to 5% causing death or serious harm. This study used the National Reporting and Learning Service (NRLS) database at the National Patient Safety Agency to explore whether spirit-based surgical skin preparation fluid contributes to the cause of surgical fires. METHODS The NRLS database was interrogated for all incidents of surgical fires reported between 1 March 2004 and 1 March 2011. Each report was scrutinised manually to discover the cause of the fire. RESULTS Thirteen surgical fires were reported during the study period. Of these, 11 were found to be directly related to spirit-based surgical skin preparation or preparation soaked swabs and drapes. CONCLUSIONS Despite manufacturer's instructions and warnings, surgical fires continue to occur. Guidance published in the UK and US states that spirit-based skin preparation solutions should continue to be used but sets out some precautions. It may be that fire risk should be included in pre-surgical World Health Organization checklists or in the surgical training curriculum. Surgical staff should be aware of the risk that spirit-based skin preparation fluids pose and should take action to minimise the chance of fire occurring.

scholarly journals Country differences in the diagnosis and management of coronary heart disease – a comparison between the US, the UK and Germany

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
Olaf von dem Knesebeck ◽  
Markus Bönte ◽  
Johannes Siegrist ◽  
Lisa Marceau ◽  
Carol Link ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Diagnosis And Management ◽  
The Us ◽  
Country Differences ◽  
The Uk

scholarly journals Clinical trial reporting performance of thirty UK universities on ClinicalTrials.gov—evaluation of a new tracking tool for the US clinical trial registry

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sarai Mirjam Keestra ◽  
Florence Rodgers ◽  
Daphne Lenz ◽  
Rhiannon Osborne ◽  
Till Bruckner ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Median Number ◽  
World Health ◽  
Trial Registry ◽  
Clinical Trial Registry ◽  
Link Type ◽  
The Us ◽  
Health Organization ◽  
The Uk

AbstractClinical trial transparency forms the foundation of evidence-based medicine, and trial sponsors, especially publicly funded institutions such as universities, have an ethical and scientific responsibility to make the results of clinical trials publicly available in a timely fashion. We assessed whether the thirty UK universities receiving the most Medical Research Council funding in 2017–2018 complied with World Health Organization best practices for clinical trial reporting on the US Clinical Trial Registry (ClinicalTrials.gov). Firstly, we developed and evaluated a novel automated tracking tool (clinical-trials-tracker.com) for clinical trials registered on ClinicalTrials.gov. This tracker identifies the number of due trials (whose completion lies more than 395 days in the past) that have not reported results on the registry and can now be used for all sponsors. Secondly, we used the tracker to determine the number of due clinical trials sponsored by the selected UK universities in October 2020. Thirdly, using the FDAAA Trials Tracker, we identified trials sponsored by these universities that are not complying with reporting requirements under the Food and Drug Administration Amendments Act 2007. Finally, we quantified the average and median number of days between primary completion date and results posting. In October 2020, the universities included in our study were sponsoring 1634 due trials, only 1.6% (n = 26) of which had reported results within a year of completion. 89.8% (n = 1468) of trials remained unreported, and 8.6% (n = 140) of trials reported results late. We also identified 687 trials that contained inconsistent data, suggesting that UK universities often fail to update their data adequately on ClinicalTrials.gov. The mean reporting delay after primary completion for trials that posted results was 981 days, the median 728 days. Only four trials by UK universities violated the FDAAA 2007. We suggest a number of reasons for the poor reporting performance of UK universities on ClinicalTrials.gov: (i) efforts to improve clinical trial reporting in the UK have to date focused on the European clinical trial registry (EU CTR), (ii) the absence of a tracking tool for timely reporting on ClinicalTrials.gov has limited the visibility of institutions’ reporting performance on the US registry and (iii) there is currently a lack of repercussions for UK sponsors who fail to report results on ClinicalTrials.gov which should be addressed in the future.

scholarly journals Creating Minimum Harm Practice (MiHaP): a concept for continuous improvement

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 276
Author(s):  
Ranjit Singh
Keyword(s):  
Healthcare Research ◽  
World Health ◽  
Institute Of Medicine ◽  
Team Members ◽  
Patient Protection ◽  
The Us ◽  
Health Organization ◽  
Uk National Health Service ◽  
The Uk ◽  
Systematic Appraisal

The author asks for the attention of leaders and all other stakeholders to calls of the World Health Organization (WHO), the Institute of Medicine (IOM), and the UK National Health Service (NHS) to promote continuous learning to reduce harm to patients. This paper presents a concept for structured bottom-up methodology that enables and empowers all stakeholders to identify, prioritize, and address safety challenges. This methodology takes advantage of the memory of the experiences of all persons involved in providing care. It respects and responds to the uniqueness of each setting by empowering and motivating all team members to commit to harm reduction. It is based on previously published work on “Best Practices Research (BPR)” and on “Systematic Appraisal of Risk and Its Management for Error Reduction (SARAIMER)”. The latter approach, has been shown by the author (with Agency for Healthcare Research and Quality (AHRQ) support), to reduce adverse events and their severity through empowerment, ownership and work satisfaction. The author puts forward a strategy for leaders to implement, in response to national and international calls for Better health, Better care, and Better value (the 3B’s of healthcare) in the US Patient Protection and Affordable Care Act.  This is designed to enable and implement “A promise to learn- a commitment to act”.  AHRQ has recently published “A Toolkit for Rapid-Cycle Patient Safety and Quality Improvement” that includes an adapted version of SARAIMER.

Cost-of-illness for Non-underweight Eating Disorders

2021 ◽  
Author(s):  
Paul Jenkins
Keyword(s):  
Eating Disorders ◽  
Binge Eating ◽  
Economic Impact ◽  
Indirect Costs ◽  
Economic Cost ◽  
Cost Effective ◽  
Level Of Evidence ◽  
Productivity Costs ◽  
Academic Impairment ◽  
The Uk

Abstract Purpose: This study examined economic costs associated with untreated eating disorders characterised by regular binge eating in the absence of low weight. Both direct and indirect costs were assessed, taking a partial societal perspective of economic impact.Methods: One-hundred and twenty-six adults seeking treatment for recurrent binge eating were asked to report impairment associated with an eating disorder. Total direct, indirect, and out-of-pocket costs were calculated using 2017 prices. Overall costs per individual were estimated, including an examination of variables correlated with costs.Results: Estimated costs for the year preceding assessment were £2,428.59 (€2,792.88) per person. Frequency of binge eating was associated with several elements of cost, and BMI was associated with productivity costs.Conclusion: The economic cost of eating disorders characterised by regular binge eating is significant, and underscores the need for efficacious and cost-effective treatments. Individuals with eating disorders report work impairment and healthcare usage that may cost the UK economy upwards of £2.6–3.5 billion (€3–4bn). Further studies should consider academic impairment and the economic impact on families.Level of evidenceLevel III: Evidence obtained from well-designed cohort or case-control analytic studies

scholarly journals Investigating the effect of e-cigarette use on quitting smoking in adults aged 25 years or more using the PATH study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1099 ◽  
Author(s):  
Peter N. Lee ◽  
John S. Fry
Keyword(s):  
Household Income ◽  
Epidemiological Data ◽  
Study Data ◽  
Sensitivity Analyses ◽  
Cigarette Use ◽  
The Us ◽  
Quitting Smoking ◽  
Recorded Data ◽  
Nationally Representative

Background: Part of the evidence on harms and benefits of e-cigarettes concerns whether using e-cigarettes encourages smokers to quit.  With limited results from controlled trials, and weaknesses in much epidemiological data, we addressed this using nationally representative prospective study data, with detailed accounting for factors associated with quitting. Methods: Analyses used data for adults aged 25+ years from Waves 1 to 3 of the US PATH study. Separate analyses concerned follow-up from Waves 1 to 2, 2 to 3 and 1 to 3.  The main analyses related baseline ever e-cigarette use (or e-product use at Wave 2) to having quit at follow-up, adjusting for predictors of quitting derived from 55 candidates.  Sensitivity analyses omitted adults who had never used other products, linked quitting to current rather than ever e-cigarette use, used modified values of some predictors using later recorded data, or (in Wave 1 to 3 analysis only) also adjusted for quitting by Wave 2. Results: In the main analyses, unadjusted odds ratios (ORs) of quitting for ever e-cigarette use were 1.29 (95% CI 1.01-1.66), 1.52 (1.26-1.83) and 1.47 (1.19-1.82) for the Wave 1 to 2, 2 to 3, and 1 to 3 analyses.  These estimates reduced after adjustment, to 1.23 (0.94-1.61), 1.51 (1.24-1.85) and 1.39 (1.11-1.74).  The final models, including between six and nine predictors, always included household income, everyday/someday smoking, wanting to smoke after waking and having tried quitting, with other variables included in specific analyses.  Quitting rates remained elevated in e-cigarette users in all sensitivity analyses. ORs were increased where other product users were omitted.  Adjusted ORs of quitting for current e-cigarette use were 1.41 (1.06-1.89), 1.30 (1.01-1.67) and 1.56 (1.21-2.00). Conclusions: The results suggest e-cigarettes may assist adult smokers to quit, particularly in individuals not using other nicotine products, and who are current e-cigarette users.

Selling safety

2021 ◽  
pp. 259-264
Author(s):  
Michael Obladen
Keyword(s):  
Infant Mortality ◽  
Mass Production ◽  
Third World ◽  
World Health ◽  
Early 20Th Century ◽  
The Third ◽  
The Us ◽  
Health Organization ◽  
The Uk ◽  
The Third World

Industrialized food production appeared in 1856, pioneered by Borden in the US, Liebig in Germany, Nestlé in Switzerland, and Mellin in the UK. Their products differed remarkably and deviated from human and cow’s milk while physicians discussed the importance of minute variations in protein, fat, or carbohydrates. Proprietary formulas were free of bacteria, and the companies prospered from mass production, international marketing, and aggressive advertising. From 1932 onwards, medical societies restricted advertising to the laity. In 1939, Williams in Singapore and in 1970, Jelliffe in Jamaica suspected that commercial formula may increase infant mortality in the Third World. Breastfeeding continued to decline during the early 20th century, falling below 10% in 1970 in the US. The Swiss ‘Third World Group’ and the US ‘Infant Formula Action Coalition’ linked infant mortality and industry marketing in the Third World. The controversy of 1970–1984 led to the World Health Organization Code, which regulated the advertising and marketing of baby food. This was one of several public health statements contributing to the resurgence of breastfeeding.

scholarly journals A four-compartment model for the COVID-19 infection—implications on infection kinetics, control measures, and lockdown exit strategies

2020 ◽  
Vol 3 (2) ◽  
pp. 104-112 ◽  
Author(s):  
Tianbing Wang ◽  
Yanqiu Wu ◽  
Johnson Yiu-Nam Lau ◽  
Yingqi Yu ◽  
Liyu Liu ◽  
...  
Keyword(s):  
Epidemiological Data ◽  
Compartment Model ◽  
Control Measures ◽  
Disease Suppression ◽  
Susceptible Population ◽  
Modifiable Factors ◽  
The Us ◽  
Exit Strategies ◽  
The Uk ◽  
The Impact

Abstract Objective To analyse the impact and repercussions of the surge in healthcare demand in response to the COVID-19 pandemic, assess the potential effectiveness of various infection/disease control measures, and make projections on the best approach to exit from the current lockdown. Design A four-compartment model was constructed for SARS-CoV-2 infection based on the Wuhan data and validated with data collected in Italy, the UK, and the US. The model captures the effectiveness of various disease suppression measures in three modifiable factors: (a) the per capita contact rate (β) that can be lowered by means of social distancing, (b) infection probability upon contacting infectious individuals that can be lowered by wearing facemasks, personal hygiene, etc., and (c) the population of infectious individuals in contact with the susceptible population, which can be lowered by quarantine. The model was used to make projections on the best approach to exit from the current lockdown. Results The model was applied to evaluate the epidemiological data and hospital burden in Italy, the UK, and the US. The control measures were identified as the key drivers for the observed epidemiological data through sensitivity analyses. Analysing the different lockdown exit strategies showed that a lockdown exit strategy with a combination of social separation/general facemask use may work, but this needs to be supported by intense monitoring which would allow re-introduction/tightening of the control measures if the number of new infected subjects increases again. Conclusions and relevance Governments should act early in a swift and decisive manner for containment policies. Any lockdown exit will need to be monitored closely, with regards to the potential of lockdown reimplementation. This mathematical model provides a framework for major pandemics in the future.

Abstract P364: Recent Trends In Mortality From Coronary Heart Disease Mortality And Its Risk Factors In Selected Developed Countries

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Akira Sekikawa ◽  
Katsuyuki Miura ◽  
Bradley Willcox ◽  
Kamal H Masaki ◽  
Russell P Tracy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Total Cholesterol ◽  
Developed Countries ◽  
Men And Women ◽  
The Us ◽  
Recent Trends ◽  
The Uk

Objectives: Mortality from coronary heart disease (CHD) in developed countries started to decline in the late 1960’s and early 1970’s and age-adjusted CHD mortality fell about 50%. This decline is attributed to favorable changes in risk factors in the general population, i.e., total cholesterol, blood pressure, smoking, etc., and improved treatment of CHD. We examined recent trends in CHD mortality and its risk factors in selected developed countries. Methods: We selected Australia, Canada, France, Italy, Japan, Spain, Sweden, the UK, and the US. Data on CHD mortality between 1980 and 2005-08 were obtained from the WHO Statistical Information System. To define CHD mortality, codes I20-25 in ICD-10 and corresponding codes in ICDs 8 and 9 were used. Data on risk factors, primarily total cholesterol and systolic blood pressure during the same period were obtained from national surveys as well as literature. Results: in 1980, there was a 2 to 3-fold difference in age-adjusted CHD mortality among these countries both in men and women, with the UK, the US and Canada being high and Japan and France being low. Although between 1980 and 2005-08, age-adjusted CHD mortality continuously declined in all these countries, a 2 to 3-fold difference in the mortality remained with the similar order among these countries. Between 1980 and 2008, age-adjusted mean levels of total cholesterol fell by 21 to 31 mg/dl in men and by 8 to 31 mg/dl in women in these countries except for Japan. Age-adjusted levels of total cholesterol in Japan have continuously increased by 16 mg/dl for both men and women during this period. Meanwhile, between 1980 and 2008 age-adjusted levels of systolic blood pressure fell by 5 to 8 mmHg in men and 6 to 13 mmHg in women in these countries without exception. In 1980, the rate of cigarette smoking in men in Japan was the highest among these countries. Although the rate of smoking in men fell in all these countries, the rates remained the higher in Japan. Conclusions: Age [[Unable to Display Character: –]]adjusted CHD mortality has continuously declined between 1980 and 2005-08 in these developed countries. The decline was accompanied by a constant decrease in population-levels of total cholesterol by 20 to 30 mg/dl except for Japan where levels of total cholesterol have increased by 16 mg/dl. The reasons for persistently low CHD mortality and its downward trend in Japan are unexplained by traditional risk factors. Identifying preventive factors that determine low CHD rates in the Japanese and implementing such factors to the US would eliminate most of CHD epidemics in the US.

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