Survival in bladder and upper urinary tract cancers in Finland and Sweden through 50 years

Survival has improved in bladder cancer but few studies have considered extended periods or covered populations for which medical care is essentially free of charge. We analyzed survival in urothelial cancer (UC, of which vast majority are bladder cancers) in Finland and Sweden over a 50-year period (1967–2016) using data from the NORDCAN database. Finland and Sweden are neighboring countries with largely similar health care systems but higher economic resources and health care expenditure in Sweden. We present results on 1- and 5-year relative survival rates, and additionally provide a novel measure, the difference between 1- and 5-year relative survival, indicating how well survival was maintained between these two periods. Over the 50-year period the median diagnostic age has increased by several years and the incidence in the very old patients has increased vastly. Relative 1- year survival rates increased until early 1990s in both countries, and with minor gains later reaching about 90% in men and 85% in women. Although 5-year survival also developed favorably until early 1990s, subsequent gains were small. Over time, age specific differences in male 1-year survival narrowed but remained wide in 5-year survival. For women, age differences were larger than for men. The limitations of the study were lack of information on treatment and stage. In conclusion, challenges are to improve 5-year survival, to reduce the gender gap and to target specific care to the most common patient group, those of 70 years at diagnosis. The most effective methods to achieve survival gains are to target control of tobacco use, emphasis on early diagnosis with prompt action at hematuria, upfront curative treatment and awareness of high relapse requiring regular cystoscopy follow up.

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Progress in survival in renal cell carcinoma through 50 years evaluated in Finland and Sweden

PLoS ONE ◽

10.1371/journal.pone.0253236 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253236

Author(s):

Kari Hemminki ◽

Asta Försti ◽

Akseli Hemminki ◽

Börje Ljungberg ◽

Otto Hemminki

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Health Care Systems ◽

Clinical Stage ◽

Survival Rates ◽

Relative Survival ◽

Cancer Registries ◽

Old Patients ◽

The Difference

Global survival studies have shown favorable development in renal cell carcinoma (RCC) treatment but few studies have considered extended periods or covered populations for which medical care is essentially free of charge. We analyzed RCC survival in Finland and Sweden over a 50-year period (1967–2016) using data from the NORDCAN database provided by the local cancer registries. While the health care systems are largely similar in the two countries, the economic resources have been stronger in Sweden. In addition to the standard 1- and 5-year relative survival rates, we calculated the difference between these as a measure of how well survival was maintained between years 1 and 5. Relative 1- year survival rates increased almost linearly in both countries and reached 90% in Sweden and 80% in Finland. Although 5-year survival also developed favorably the difference between 1- and 5-year survival rates did not improve in Sweden suggesting that the gains in 5-year survival were entirely due to gains in 1-year survival. In Finland there was a gain in survival between years 1 and 5, but the gain in 1-years survival was the main contributor to the favorable 5-year survival. Age group specific analysis showed large survival differences, particularly among women. Towards the end of the follow-up period the differences narrowed but the disadvantage of the old patients remained in 5-year survival. The limitations of the study were lack of information on performed treatment and clinical stage in the NORDCAN database. In conclusion, the available data suggest that earlier diagnosis and surgical treatment of RCC have been the main driver of the favorable change in survival during the past 50 years. The main challenges are to reduce the age-specific survival gaps, particularly among women, and push survival gains past year 1.

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The Effect of Health Expenditure and Immunisation on Under-Five Mortality Rate in Selected African Countries.

10.21203/rs.3.rs-540865/v1 ◽

2021 ◽

Author(s):

Alfred EBOH ◽

Steve METIBOBA

Keyword(s):

Health Care ◽

Mortality Rate ◽

Health Expenditure ◽

Health Care Systems ◽

Health Care Expenditure ◽

African Countries ◽

Under Five ◽

Significant Negative Effect ◽

Negative Effect ◽

The Impact

Abstract Background: As a way of tackling child mortality, many countries in the world depend on their respective health-care system. But governments of most countries in Africa are yet to provide robust funding of their health-care systems as many people still depend on the out-of-pocket payment to receive health services. Against this backdrop, this study used annual panel data to assess the effect of health-care expenditure and immunisation on the under-five mortality rate in 30 selected African countries for the period 2000-2017. Methods: Multiple regression technique was adopted for the data analysis and the robust fixed regression estimator was preferred to the random effects as determined by Hausman test.Results: The findings indicated that domestic government general health expenditure had a significant negative effect on the under-five mortality rate. However, the effect of domestic private health expenditure on under-five mortality was not significant while external health expenditure had a significant negative effect on under-five mortality rate. The impact of diphtheria immunisation on under-five mortality was significant. Conclusions: Except domestic private health expenditure, government and external forms of health expenditure coupled with diphtheria immunisation were significant factors for the reduction of the under-five mortality in the selected countries.

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A win-win for health care: promoting co-leadership and increasing women’s representation at the top

Gender in Management An International Journal ◽

10.1108/gm-06-2020-0176 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Alan T. Belasen ◽

Anat M. Belasen ◽

Abigail R. Belasen ◽

Ariel R. Belasen

Keyword(s):

Health Care ◽

Gender Gap ◽

Health Care Systems ◽

Quality Care ◽

Health Care Leadership ◽

Leadership Model ◽

Content Type ◽

Gender Parity ◽

Senior Health Care ◽

Senior Health

Purpose This paper aims to contribute to the growing body of research on health-care leadership by demonstrating the value of dyads and triads in strengthening capabilities of health-care settings and providing action pathways to accelerate gender parity in senior health-care positions. Design/methodology/approach The paper reviews the evidence that when single-leadership models are used and women are under-represented in leadership, the health-care industry may miss out on opportunities to increase efficiency and quality of care. Next, the paper describes a co-leadership model with distinct and overlapping roles, which promotes women’s participation and inspires administrative and clinical leaders to collaborate and achieve optimal performance. Findings The dyad as the enabling track for women in health-care leadership creates opportunities for health-care systems to bridge the gender gap in senior positions as well as improve the delivery of cost-effective quality care. Practical implications The inclusive co-leadership model with distinct and overlapping roles is a promising pathway for increasing health-care system efficiency and for promoting women to senior roles by tapping into the leadership skills and expertise that women bring to these roles. Originality/value The current paper demonstrates the dual effects of using co-leadership in senior health-care positions and fixing the gender imbalance. It has significant implications for advancing similar pathways in other industries as a means for accelerating gender parity in senior management.

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Health Status, Health Care and Inequality: Canada vs. the U.S.

Forum for Health Economics & Policy ◽

10.2202/1558-9544.1094 ◽

2008 ◽

Vol 10 (1) ◽

Cited By ~ 5

Author(s):

June E O'Neill ◽

Dave M O'Neill

Keyword(s):

Health Care ◽

Health Outcomes ◽

Unmet Needs ◽

Waiting Times ◽

Survival Rates ◽

Health Resources ◽

Relative Survival ◽

Chronically Ill ◽

The U.S

It is often alleged that Canada's publicly-funded, single payer health care system, delivers better health outcomes, and distributes health resources more fairly than the mainly private U.S. multi-payer system. Our findings contradict these allegations. Differences between the U.S. and Canada in infant mortality and life expectancy --the two indicators most commonly used as evidence of better health outcomes in Canadacannot be attributed to differences in the effectiveness of the two health care systems because they are strongly influenced by differences in cultural and behavioral factors such as the relatively high U.S. incidence of obesity and of accidents and homicides. Moreover, direct measures of the effectiveness of medical care, show that five-year relative survival rates for individuals diagnosed with various types of cancer are higher in the U.S. than in Canada as are infant survival rates of low-birth weight babies. These successes are consistent with the greater U.S. availability of high level technology, higher rates of screening for cancers, and higher treatment rates of the chronically ill. The need to ration when care is delivered "free" ultimately leads to long waits. Waiting times for medical services are a major problem in Canada and a source of unmet needs. In the U.S. costs are more often cited as a source of unmet needs. Nonetheless, with respect to the issue of inequality, we find that the health-income gradient is at least as prominent in Canada as it is in the U.S. When asked about satisfaction with health services and the ranking of the quality of services recently received, more U.S. residents than Canadians respond that they are fully satisfied and rank quality of care as excellent. To address these issues we use the Joint Canada/ U.S. Survey of Health (JCUSH) along with other data sources.

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HEALTH CARE FINANCING IN THE EUROPEAN UNION COUNTRIES – STRUCTURE AND CHANGES

Acta Scientiarum Polonorum - Oeconomia ◽

10.22630/aspe.2020.19.1.8 ◽

2020 ◽

Vol 19 (1) ◽

pp. 71-80

Author(s):

Michał Wielechowski ◽

Łukasz Grzęda

Keyword(s):

Health Care ◽

European Union ◽

Health Care Systems ◽

Health Care Expenditure ◽

Health Care Financing ◽

Data Availability ◽

The European Union ◽

European Union Countries ◽

Care Systems ◽

The Eu

The aim of the paper was to present health care systems and assess the recent trend in health care expenditure in the European Union countries. The data source was the World Bank and European Statistical Office (Eurostat). The adopted research period covered the years 2000–2016, due to data availability. The methodology of the study was based on an analysis of data indicator series related to health care expenditure, which evaluate the national health care system performance. The research results were presented using primarily Japanese candlestick charting. The study showed that health care expenditure represented an ever-increasing burden for all the EU economies, both in absolute values and in relation to GDP. However, substantial differentiations in the amount and structure of health care expenditure were observed at the country level, having roots in the level of a country’s economic development and diverse post-war economic and political evolution. The analysis of health care expenditure structure confirmed that all three types of health care systems (Beveridge, Bismarck and mixed one) were observed in the EU, but the last one had a marginal importance. The form of system did not determine its effectiveness. On average, more than three-fourths of health care expenses were financed by general government expenditure. Out-of-pocket spending varied widely among the analysed EU member states.

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Business: The Electronic Health Record: Front Line Experience

Perspectives on Administration and Supervision ◽

10.1044/aas21.1.18 ◽

2011 ◽

Vol 21 (1) ◽

pp. 18-22

Author(s):

Rosemary Griffin

Keyword(s):

Health Care ◽

Information Technology ◽

Electronic Health Record ◽

Financial Incentives ◽

Best Practice ◽

Health Care Systems ◽

The United States ◽

Health Record ◽

Health Trends ◽

Electronic Health

National legislation is in place to facilitate reform of the United States health care industry. The Health Care Information Technology and Clinical Health Act (HITECH) offers financial incentives to hospitals, physicians, and individual providers to establish an electronic health record that ultimately will link with the health information technology of other health care systems and providers. The information collected will facilitate patient safety, promote best practice, and track health trends such as smoking and childhood obesity.

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