scholarly journals Estimating the Impact of Medical Innovation: A Case Study of HIV Antiretroviral Treatments

2008 ◽  
Vol 11 (2) ◽  
Author(s):  
Mark G Duggan ◽  
William N Evans
Keyword(s):  
Health Care ◽  
Good Alternative ◽  
Care Utilization ◽  
Short Term ◽  
Fda Approval ◽  
New Treatments ◽  
The Cost ◽  
The Impact ◽  
Average Health

As health care consumes a growing share of GDP, the demand for better evidence regarding the effects of health care treatments and how these vary across individuals is increasing. Estimating this with observational data is difficult given the endogeneity of treatment decisions. But because the random assignment clinical trials (RACTs) used in the FDA approval process only estimate average health effects and do not consider spending, there is no good alternative. In this study we use administrative data from California's Medicaid program to estimate the impact of HIV antiretroviral treatments (ARVs). We use data on health care utilization to proxy for health status and exploit the rapid takeup of ARVs following their FDA approval. Our estimate of a 68 percent average mortality rate reduction is in line with the results from RACTs. We also find that the ARVs lowered short-term health care spending by reducing expenditures on other categories of medical care. Combining these two effects we estimate the cost per life year saved at $19,000. Our results suggest an alternative method for estimating the real-world effects of new treatments that is especially well-suited to those treatments that diffuse rapidly following their approval.

Reflections on the Cost Consequences of the New Gene Technology for Health Policy

1994 ◽  
Vol 10 (4) ◽  
pp. 546-561 ◽  
Author(s):  
Pauline Vaillancourt Rosenau
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Subjective Assessment ◽  
Genetically Engineered ◽  
Gene Technology ◽  
Short Term ◽  
New Gene ◽  
The Cost ◽  
The Impact ◽  
Care Costs

AbstractThis article presents a preliminary and necessarily tentative and subjective assessment of the impact of new gene technology on health care costs. In the short term, diagnosis and treatment of genetic disease are likely to increase costs. Treatment with nongene therapy will continue to be far less expensive than gene therapy where it is available. Research developments to monitor as indicators of forthcoming cost reductions in genetic therapy are set forth. Some forms of genetic screening may soon reduce health care costs, and an example is provided. Genetically engineered Pharmaceuticals are described and their impact on costs reviewed. Conditions under which they are likely to reduce health care costs are indicated.

The impact of Airbnb on a non-touristic city. A Case study of short-term rentals in Santa Cruz de Tenerife (Spain)

Erdkunde ◽  
2020 ◽  
Vol 74 (3) ◽  
pp. 191-204
Author(s):  
Marcus Hübscher ◽  
Juana Schulze ◽  
Felix zur Lage ◽  
Johannes Ringel
Keyword(s):  
Santa Cruz ◽  
Short Term ◽  
Rental Market ◽  
Rural Space ◽  
Use Of Data ◽  
Web Scraping ◽  
Per Capita ◽  
Per Se ◽  
The Impact

Short-term rentals such as Airbnb have become a persistent element of today’s urbanism around the globe. The impacts are manifold and differ depending on the context. In cities with a traditionally smaller accommodation market, the impacts might be particularly strong, as Airbnb contributes to ongoing touristification processes. Despite that, small and medium-sized cities have not been in the centre of research so far. This paper focuses on Santa Cruz de Tenerife as a medium-sized Spanish city. Although embedded in the touristic region of the Canary Islands, Santa Cruz is not a tourist city per se but still relies on touristification strategies. This paper aims to expand the knowledge of Airbnb’s spatial patterns in this type of city. The use of data collected from web scraping and geographic information systems (GIS) demonstrates that Airbnb has opened up new tourism markets outside of the centrally established tourist accommodations. It also shows that the price gap between Airbnb and the housing rental market is broadest in neighbourhoods that had not experienced tourism before Airbnb entered the market. In the centre the highest prices and the smallest units are identified, but two peripheral quarters stand out. Anaga Mountains, a natural and rural space, has the highest numbers of Airbnb listings per capita. Suroeste, a suburban quarter, shows the highest growth rates on the rental market, which implies a linkage between Airbnb and suburbanization processes.

scholarly journals An Input–Output Ex Ante Regional Model to Assess the Short-Term Net Effects of the 16 April 2016 Earthquake in Ecuador

2021 ◽  
Author(s):  
Jorge Salgado ◽  
José Ramírez-Álvarez ◽  
Diego Mancheno
Keyword(s):  
Natural Hazard ◽  
National Accounts ◽  
Input Output ◽  
Short Term ◽  
Ex Ante ◽  
The Impact ◽  
Consumption Demand ◽  
Two Sectors ◽  
Positive Effect

AbstractThe 16 April 2016 earthquake in Ecuador exposed the significant weaknesses concerning the methodological designs to compute—from an economic standpoint—the consequences of a natural hazard-related disaster for productive exchanges and the accumulation of capital in Ecuador. This study addressed one of these challenges with an innovative ex ante model to measure the partial and net short-term effects of a natural hazard-related catastrophe from an interregional perspective, with the 16 April 2016 earthquake serving as a case study. In general, the specified and estimated model follows the approach of the extended Miyazawa model, which endogenizes consumption demand in a standard input–output model with the subnational interrelations and resulting multipliers. Due to the country’s limitations in its regional account records the input–output matrices for each province of Ecuador had to be estimated, which then allowed transactions carried out between any two sectors within or outside a given province to be identified by means of the RAS method. The estimations provide evidence that the net short-term impact on the national accounts was not significant, and under some of the simulated scenarios, based on the official information with respect to earthquake management, the impact may even have had a positive effect on the growth of the national product during 2016.

The Impact of Behavioral Feeding Intervention on Health Care Utilization

2011 ◽  
Vol 40 (4) ◽  
pp. 282-296 ◽  
Author(s):  
Nancy F. Bandstra ◽  
William B. Crist ◽  
Anne Napier-Phillips ◽  
Gordon Flowerdew
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
The Impact

scholarly journals P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S102
Author(s):  
S.W. Kirkland ◽  
A. Soleimani ◽  
B.H. Rowe ◽  
A.S. Newton
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Services ◽  
Grey Literature ◽  
Study Data ◽  
Care Utilization ◽  
Alternative Source ◽  
Increased Risk ◽  
The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

scholarly journals PRS14 THE IMPACT OF ASTHMA ON HEALTH CARE UTILIZATION AND EXPENDITURE OF PEDIATRIC PATIENTS

2010 ◽  
Vol 13 (3) ◽  
pp. A198
Author(s):  
X Song ◽  
R Shenolikar ◽  
LA Costa ◽  
J Anderson ◽  
BC Chu
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Pediatric Patients ◽  
Care Utilization ◽  
The Impact

scholarly journals Blockchain in Health Care Innovation: Literature Review and Case Study From a Business Ecosystem Perspective (Preprint)

2020 ◽  
Author(s):  
Shuchih Ernest Chang ◽  
YiChian Chen
Keyword(s):  
Health Care ◽  
Life Cycle ◽  
Literature Review ◽  
Case Studies ◽  
Paradigm Shift ◽  
Potential Health ◽  
Business Ecosystem ◽  
Blockchain Technology ◽  
The Impact

BACKGROUND Blockchain technology is leveraging its innovative potential in various sectors and its transformation of business-related processes has drawn much attention. Topics of research interest have focused on medical and health care applications, while research implications have generally concluded in system design, literature reviews, and case studies. However, a general overview and knowledge about the impact on the health care ecosystem is limited. OBJECTIVE This paper explores a potential paradigm shift and ecosystem evolution in health care utilizing blockchain technology. METHODS A literature review with a case study on a pioneering initiative was conducted. With a systematic life cycle analysis, this study sheds light on the evolutionary development of blockchain in health care scenarios and its interactive relationship among stakeholders. RESULTS Four stages—birth, expansion, leadership, and self-renewal or death—in the life cycle of the business ecosystem were explored to elucidate the evolving trajectories of blockchain-based health care implementation. Focused impacts on the traditional health care industry are highlighted within each stage to further support the potential health care paradigm shift in the future. CONCLUSIONS This paper enriches the existing body of literature in this field by illustrating the potential of blockchain in fulfilling stakeholders’ needs and elucidating the phenomenon of coevolution within the health care ecosystem. Blockchain not only catalyzes the interactions among players but also facilitates the formation of the ecosystem life cycle. The collaborative network linked by blockchain may play a critical role on value creation, transfer, and sharing among the health care community. Future efforts may focus on empirical or case studies to validate the proposed evolution of the health care ecosystem.

scholarly journals Impact of COVID-19 on social determinants of health for adults with cystic fibrosis

2021 ◽  
Vol 15 ◽  
pp. 175346662110374
Author(s):  
Dana Albon ◽  
Heather Bruschwein ◽  
Morgan Soper ◽  
Rhonda List ◽  
Deirdre Jennings ◽  
...  
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Issues ◽  
Determinants Of Health ◽  
Care Utilization ◽  
Health Questionnaire ◽  
Improvement Project ◽  
The Impact

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.

Sign in / Sign up

Export Citation Format

Share Document