This article aimed to show ideas about the themes: body suffering, nursing and Medical care, and Health Economics. To this end, we tried to put together a kaleidoscope of references that converged on the promotion of ...This article aimed to show ideas about the themes: body suffering, nursing and Medical care, and Health Economics. To this end, we tried to put together a kaleidoscope of references that converged on the promotion of autonomy and empowerment and, as a strategy for action, and then we can think of what to do to alleviate the suffering of patients.展开更多
Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and re...Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and resulting long-term antibiotics resistance. Overuse of antimicrobials is a major cause of emerging resistance to antimicrobials. There are multiple factors in the community that influence the physician’s antibiotic prescriptions. Methods: This is a systematic case-control study on antibiotics prescription for paediatric patients attending Latifa Hospital for Women and Children (LWCH), Dubai Health Authority, to know the effects of behavioral interventions on rates of inappropriate antimicrobials prescription by doctors in the Paediatric Emergency Department. Results: The results of our study showed the effectiveness of behavioral insights by peer comparison in antibiotic use among paediatricians in Latifa Hospital had a statistical significance (P = 0.0038). The rate of the prescription decreased from 41% to 21%, a difference of 20%. Conclusion: The study concluded behavioural intervention is an effective measure in reducing the improper prescription of antibiotics in the hospital setting.展开更多
Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of c...Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori(H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.展开更多
The market for active implants and biosensors is of high economic and medical interest. As health economic considerations get into focus in terms of business planning and reimbursement, valid and flexible economic fea...The market for active implants and biosensors is of high economic and medical interest. As health economic considerations get into focus in terms of business planning and reimbursement, valid and flexible economic feasibility studies get more important. Unfortunately, literature mostly provides only single economic views on specific aspects like cost savings from reduced rehabilitation in a special patient cohort. To make planning and technology value negotiation more effective and more valid, a methodology to collect relevant data from different studies and normalize it to a common set of parameters was developed for the field of cardiac monitoring in a mixed example population with an approach of simple external weight, ECG and blood-pressure measurement or implanted devices for cardiac monitoring. The target entities taken into account by the simulation model were the impacts on heart attack, stroke, heart failure and the process of implant monitoring. Simulation took place at an example population of 500 patients with specific morbidity criteria. The health economic value was calculated over a period of three years and was split into a technology effectiveness measurement in Quality-adjusted-Lifetime-Years (QALYs) and a “cost- saving-part”. QALYs were chosen as technology effectiveness parameter for a combined and weighted mortality- and morbidity-reduction. Allocating 24.000 Euro to a saved QALY, 42% of the cost would be allocated to QALYs meaning money being spent for gained lifetime-years. The remaining 58% would be the different real cost savings: a per patient gross saving of 3.308 € per year would result for that part (21% on heart attack, 3% on stroke, 68% on heart failure and 8% on implant monitoring). Up-to-date studies do not provide a simple mechanism to allow custom-tailored health economic feasibility study results in terms of other specific population mixes or outcome parameters. Target audiences for the methodology of the described simulation are payors and solution providers targeting a specific patient population or specific telemedical situations. This way product development can address market-related needs more specific and healthcare providers can compare different outcome parameters in the given entities.展开更多
The strategic role of health care within the Brazilian development agenda has been increasingly recognized and institutionalized. Aside from its importance as a structural element of the Welfare State, health care pla...The strategic role of health care within the Brazilian development agenda has been increasingly recognized and institutionalized. Aside from its importance as a structural element of the Welfare State, health care plays a leading role in generating innovation. Despite this, the productive base of Brazil’s health care system is extremely fragile, jeopardizing both the universal provision of health care services and the country’s competitive insertion in the globalized environment. This suggests the need for a more systematic analysis of the complex relationships that exist between the technological and the social interests involved in the productive base of health care provision in Brazil. Therefore, the purpose of this article is to enhance our understanding of the productive base of health care, especially given its potential to contribute to a socially inclusive development model, which is the ultimate goal in Brazil.展开更多
Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct soc...Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct societal costs of healthcare interventions related to vocational rehabilitation and indirect societal costs related to production loss. Method: Identified interventions in 45 patients with ABI who were discharged from a vocational rehabilitation program between 2010 and 2011 were documented, classified and translated into costs. Expenses associated with production loss were calculated by comparing sick leave production loss at first contact with the team, with sick leave production loss at discharge. Health related QoL and overall health, was measured at first contact and at discharge by using the EQ5D. Results: For vocational rehabilitation interventions, mean costs were €6303/individual/month. At first contact with the team, mean production loss was estimated to be €4409/individual/month compared;at discharge to be €2446. QoL ratings increased from first contact to discharge, although estimated health did not change. At discharge, significant correlations were found between QoL ratings and estimated health and the extent of production loss展开更多
Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including b...Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including both men and women of different ages.The model cycle was one year and the simulation time was 60 years.The cost-effectiveness of electronic gastroscopy in detecting gastric cancer of general population in China was analyzed from the perspective of the whole society,and the stability of the results was verified by sensitivity analysis.Results and Conclusion For the general population,the incremental cost-effectiveness ratio(ICER)of gastric cancer screening from the age of 50 is 50143 yuan/QALY(quality-adjusted life-year),which is less than two times of per capita gross domestic product(GDP)compared with the screening from the age of 55.For men who start gastric cancer screening at the age of 50,the ICER is 38525 yuan/QALY,which is less than two times of per capita GDP,and it is economical.For women who start the screening from the age of 55,the ICER is 47814 yuan/QALY,which is less than two times of per capita GDP,so it is economical.The results of sensitivity analysis are consistent with the conclusions of basic analysis,and the results of basic analysis are stable.For the general population,it is more economical to start gastric cancer screening from the age of 50,while for men and women,it is more economical to start gastric cancer screening from the age of 50 and 55,respectively.展开更多
Though China’s economy is breathing a sigh of relief after several nervous months,it is still not time to sit back and relax.Much needs to be done to ensure the sustainability of growth momentum.Guo Tianyong,Director...Though China’s economy is breathing a sigh of relief after several nervous months,it is still not time to sit back and relax.Much needs to be done to ensure the sustainability of growth momentum.Guo Tianyong,Director of the Research Center of the China Banking Industry of the Central University of Finance and Economics,discussed this issue in an article recently published in the Shanghai Securities Journal.Edited excerpts follow:展开更多
Professor Xiao Zhuoji, an economist at the prestigious Peking University, has always been optimistic about the stability of the Chinese economy. In an exclusive interview with People's Daily, he shares his views o...Professor Xiao Zhuoji, an economist at the prestigious Peking University, has always been optimistic about the stability of the Chinese economy. In an exclusive interview with People's Daily, he shares his views on "hot spots" in China's economic growth.展开更多
The aim of this study was to explore the optimal timing of holmium laser enucleation of the prostate(HoLEP)in patients presenting benign prostatic hyperplasia(BPH)with lower urinary tract symptoms(LUTS).A retrospectiv...The aim of this study was to explore the optimal timing of holmium laser enucleation of the prostate(HoLEP)in patients presenting benign prostatic hyperplasia(BPH)with lower urinary tract symptoms(LUTS).A retrospective analysis was conducted based on the perioperative and postoperative outcome data of 1212 patients who underwent HoLEP in Shanghai Ninth People’s Hospital(Shanghai,China)between January 2009 and December 2018.According to the preoperative International Prostate Symptom Score(IPSS),all patients whom we analyzed were divided into Group A(IPSS of 8–18)and Group B(IPSS of 19–35).Peri-and postoperative outcome data were obtained during the 1-year follow-up.IPSS changes were the main postoperative outcomes.The postoperative IPSS,quality of life,peak urinary flow rate,postvoid residual,and overactive bladder symptom score(OABSS)improved significantly.The IPSS improved further in the group with severe LUTS symptoms,but the postoperative IPSS was still higher than that in the moderate LUTS group.OABSSs showing moderate and severe cases after follow-up were more frequent in Group B(9.1%)than in Group A(5.2%)(P<0.05).There were no significant intergroup differences in the intraoperative American Society of Anesthesiologists or hospitalization expense scores,and the medication costs,as well as the total costs,were significantly higher in Group B.In this retrospective study,HoLEP was an effective treatment for symptomatic BPH.For patients with LUTS,earlier surgery in patients with moderate severity may result in a marginally better 12-month IPSS than that in men with severe symptoms.展开更多
文摘This article aimed to show ideas about the themes: body suffering, nursing and Medical care, and Health Economics. To this end, we tried to put together a kaleidoscope of references that converged on the promotion of autonomy and empowerment and, as a strategy for action, and then we can think of what to do to alleviate the suffering of patients.
文摘Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and resulting long-term antibiotics resistance. Overuse of antimicrobials is a major cause of emerging resistance to antimicrobials. There are multiple factors in the community that influence the physician’s antibiotic prescriptions. Methods: This is a systematic case-control study on antibiotics prescription for paediatric patients attending Latifa Hospital for Women and Children (LWCH), Dubai Health Authority, to know the effects of behavioral interventions on rates of inappropriate antimicrobials prescription by doctors in the Paediatric Emergency Department. Results: The results of our study showed the effectiveness of behavioral insights by peer comparison in antibiotic use among paediatricians in Latifa Hospital had a statistical significance (P = 0.0038). The rate of the prescription decreased from 41% to 21%, a difference of 20%. Conclusion: The study concluded behavioural intervention is an effective measure in reducing the improper prescription of antibiotics in the hospital setting.
基金supported in part by the Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (No. ZLRK202325)a grant from National Key R&D Program of China (No. 2018YFC 1313105)。
文摘Gastric cancer is a global public health burden, nearly one million new cases are diagnosed per year worldwide, of which 44% of cases occur in China. The prognosis of gastric cancer varies remarkably by the stage of cancer, and most of the patients in China are diagnosed at advanced stages, resulting in poor prognoses. Effective strategies to reduce the burden of gastric cancer include primary prevention through testing and treatment of Helicobacter pylori(H. pylori) and secondary prevention by screening and early detection. Although many countries have issued management guidelines and consensus reports concerning these strategies, the limited availability of healthcare resources often precludes their widespread implementation. Therefore, assessing the costs, benefits, and harms of population-based intervention measures through health economic evaluation is necessary for informed health policy decisions. Accordingly, we synthesize management approaches from different countries on H. pylori eradication and endoscopic screening, and also summarize recent advancements in health economic evaluations on population-based preventive strategies. The goal of the review is to provide empirical evidence supporting optimal resource allocation, maximizing benefits for the population, and ultimately reducing the burden of gastric cancer.
文摘The market for active implants and biosensors is of high economic and medical interest. As health economic considerations get into focus in terms of business planning and reimbursement, valid and flexible economic feasibility studies get more important. Unfortunately, literature mostly provides only single economic views on specific aspects like cost savings from reduced rehabilitation in a special patient cohort. To make planning and technology value negotiation more effective and more valid, a methodology to collect relevant data from different studies and normalize it to a common set of parameters was developed for the field of cardiac monitoring in a mixed example population with an approach of simple external weight, ECG and blood-pressure measurement or implanted devices for cardiac monitoring. The target entities taken into account by the simulation model were the impacts on heart attack, stroke, heart failure and the process of implant monitoring. Simulation took place at an example population of 500 patients with specific morbidity criteria. The health economic value was calculated over a period of three years and was split into a technology effectiveness measurement in Quality-adjusted-Lifetime-Years (QALYs) and a “cost- saving-part”. QALYs were chosen as technology effectiveness parameter for a combined and weighted mortality- and morbidity-reduction. Allocating 24.000 Euro to a saved QALY, 42% of the cost would be allocated to QALYs meaning money being spent for gained lifetime-years. The remaining 58% would be the different real cost savings: a per patient gross saving of 3.308 € per year would result for that part (21% on heart attack, 3% on stroke, 68% on heart failure and 8% on implant monitoring). Up-to-date studies do not provide a simple mechanism to allow custom-tailored health economic feasibility study results in terms of other specific population mixes or outcome parameters. Target audiences for the methodology of the described simulation are payors and solution providers targeting a specific patient population or specific telemedical situations. This way product development can address market-related needs more specific and healthcare providers can compare different outcome parameters in the given entities.
文摘The strategic role of health care within the Brazilian development agenda has been increasingly recognized and institutionalized. Aside from its importance as a structural element of the Welfare State, health care plays a leading role in generating innovation. Despite this, the productive base of Brazil’s health care system is extremely fragile, jeopardizing both the universal provision of health care services and the country’s competitive insertion in the globalized environment. This suggests the need for a more systematic analysis of the complex relationships that exist between the technological and the social interests involved in the productive base of health care provision in Brazil. Therefore, the purpose of this article is to enhance our understanding of the productive base of health care, especially given its potential to contribute to a socially inclusive development model, which is the ultimate goal in Brazil.
文摘Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct societal costs of healthcare interventions related to vocational rehabilitation and indirect societal costs related to production loss. Method: Identified interventions in 45 patients with ABI who were discharged from a vocational rehabilitation program between 2010 and 2011 were documented, classified and translated into costs. Expenses associated with production loss were calculated by comparing sick leave production loss at first contact with the team, with sick leave production loss at discharge. Health related QoL and overall health, was measured at first contact and at discharge by using the EQ5D. Results: For vocational rehabilitation interventions, mean costs were €6303/individual/month. At first contact with the team, mean production loss was estimated to be €4409/individual/month compared;at discharge to be €2446. QoL ratings increased from first contact to discharge, although estimated health did not change. At discharge, significant correlations were found between QoL ratings and estimated health and the extent of production loss
文摘Objective To evaluate the economy of detecting gastric cancer by electronic gastroscope in Chinese natural population of different ages and genders.Methods A Markov model was constructed for the population,including both men and women of different ages.The model cycle was one year and the simulation time was 60 years.The cost-effectiveness of electronic gastroscopy in detecting gastric cancer of general population in China was analyzed from the perspective of the whole society,and the stability of the results was verified by sensitivity analysis.Results and Conclusion For the general population,the incremental cost-effectiveness ratio(ICER)of gastric cancer screening from the age of 50 is 50143 yuan/QALY(quality-adjusted life-year),which is less than two times of per capita gross domestic product(GDP)compared with the screening from the age of 55.For men who start gastric cancer screening at the age of 50,the ICER is 38525 yuan/QALY,which is less than two times of per capita GDP,and it is economical.For women who start the screening from the age of 55,the ICER is 47814 yuan/QALY,which is less than two times of per capita GDP,so it is economical.The results of sensitivity analysis are consistent with the conclusions of basic analysis,and the results of basic analysis are stable.For the general population,it is more economical to start gastric cancer screening from the age of 50,while for men and women,it is more economical to start gastric cancer screening from the age of 50 and 55,respectively.
文摘Though China’s economy is breathing a sigh of relief after several nervous months,it is still not time to sit back and relax.Much needs to be done to ensure the sustainability of growth momentum.Guo Tianyong,Director of the Research Center of the China Banking Industry of the Central University of Finance and Economics,discussed this issue in an article recently published in the Shanghai Securities Journal.Edited excerpts follow:
文摘Professor Xiao Zhuoji, an economist at the prestigious Peking University, has always been optimistic about the stability of the Chinese economy. In an exclusive interview with People's Daily, he shares his views on "hot spots" in China's economic growth.
基金This research was supported by grant from the multi-center clinical research project of Shanghai Jiao Tong University School of Medicine(grant No.DLY201809)grant from the 2021 Shanghai Science and Technology Innovation Cooperation Program of Science and Technology Commission of Shanghai Municipality(grant No.21015801700)。
文摘The aim of this study was to explore the optimal timing of holmium laser enucleation of the prostate(HoLEP)in patients presenting benign prostatic hyperplasia(BPH)with lower urinary tract symptoms(LUTS).A retrospective analysis was conducted based on the perioperative and postoperative outcome data of 1212 patients who underwent HoLEP in Shanghai Ninth People’s Hospital(Shanghai,China)between January 2009 and December 2018.According to the preoperative International Prostate Symptom Score(IPSS),all patients whom we analyzed were divided into Group A(IPSS of 8–18)and Group B(IPSS of 19–35).Peri-and postoperative outcome data were obtained during the 1-year follow-up.IPSS changes were the main postoperative outcomes.The postoperative IPSS,quality of life,peak urinary flow rate,postvoid residual,and overactive bladder symptom score(OABSS)improved significantly.The IPSS improved further in the group with severe LUTS symptoms,but the postoperative IPSS was still higher than that in the moderate LUTS group.OABSSs showing moderate and severe cases after follow-up were more frequent in Group B(9.1%)than in Group A(5.2%)(P<0.05).There were no significant intergroup differences in the intraoperative American Society of Anesthesiologists or hospitalization expense scores,and the medication costs,as well as the total costs,were significantly higher in Group B.In this retrospective study,HoLEP was an effective treatment for symptomatic BPH.For patients with LUTS,earlier surgery in patients with moderate severity may result in a marginally better 12-month IPSS than that in men with severe symptoms.
