616 research outputs found
Unmet need and met unneed in health care utilisation in Iran
No full textPurpose: This paper uses a unique nationwide survey data derived from the 2003 Utilisation of Health Services Survey (UHSS) in Iran (n=16,935) to analyse inequities of health care utilisation. Design/methodology/approach: Concentration indices are used to measure socioeconomic inequality in actual use of the five types of health services, and in unmet need for two of those types of service (any ambulatory care and hospital admissions). Horizontal inequity indices are employed to examine inequity in ambulatory and hospital care. Generalised linear model (GLM) was employed to investigate factors contributing to the phenomena of "unmet need" and "met unneed". Moreover, a decomposition analysis of inequality is performed to determine the contributions of each factor to the inequality of "unmet need". Findings: Results suggest that self-reported need for ambulatory and inpatient care is concentrated among the poor, whereas the utilisation of ambulatory and inpatient care were generally distributed proportionally. Results of horizontal inequity indices show that the distributions of any ambulatory care and hospital admissions are pro-rich. The probability of "unmet need" for ambulatory care was higher among wealthier individuals. The decomposition analysis demonstrates that the wealth index, health insurance, and region of residence are the most important factors contributing to the concentration of "unmet need" for ambulatory health care among the poor. Results also illustrate that higher wealth quintiles used more unneeded ambulatory care than their poorer counterparts. Originality/value: A special characteristic of the UHSS is that it contains questions about the need for medical services use and about actual services use. This characteristic provides an opportunity to measure the inequality of health care consumption against self-assessed treatment needs, as well as an analysis of which observables are associated with "unmet need". Moreover, the incidence of health care use when it is reported as not needed can be analysed with this dataset. The analysis of this phenomenon - which we refer to as "met unneed" - is another novel aspect of this work
Emerg Infect Dis
No full textMycobacterium ulcerans gives rise to severe skin ulceration that can be associated with considerable illness. The cost of diagnosis, treatment, and lost income has never been assessed in Australia. A survey of 26 confirmed cases of the disease in Victoria was undertaken. Data were collected on demographic details, diagnostic tests, treatment, time off work, and travel to obtain treatment. All costs are reported in Australian dollars in 1997-98 prices. The cost varies considerably with disease severity. For mild cases, the average direct cost is 6,803 Australian dollars, and for severe cases 27,681 Australian dollars. Hospitalization accounts for 61% to 90% of costs, and indirect costs amount to 24% of the total per case. M. ulcerans can be an expensive disease to diagnose and treat. Costs can be reduced by early diagnosis and definitive treatment. Research is needed to find cost-effective therapies for this disease
Instream effects of dunder application to canefields in the Sarina region, Queensland: continued monitoring
No full text[Extract]This report summarises the results of a six year ecological monitoring program in streams of the Sarina/Mackay region. The primary focus has been placed on the final four years of investigation since the results from the first two years were discussed in detail in our earlier report (Clayton and Pearson1992). The sampling regime and the amount of resultant data were much less extensive in the final four years than in the first two years because of an altered objective to concentrate on a small number of morphologically similar streams at the time of dunder distribution.
The background to this investigation has changed little since our first report (Clayton and Pearson 1992), although the amount of dunder sold by CSR Ltd. and the geographic extent of the dunder distribution area have both increased. In this report, therefore, introductory segments and general discussions regularly refer to the earlier report or include excerpts from it. This document can be considered the concluding volume of the investigation report and Clayton and Pearson (1992) should be referred to for detailed project background, site details and sampling/analysis methodology.
Much of the report is necessarily technical in nature; however, where possible we have attempted to write for the non-biologist, non-chemist and non-statistician. Data used for the analyses includes that collected in the first two years of the investigation for Plane Creek, Rock Creek, Bell Creek and Marion Creek.
The project was possible as a result of funding from CSR Ltd. and we wish to thank the staff of the Plane Creek mill and distillery for their support and assistance. We also thank the following staff from the Australian Centre for Tropical Freshwater Research who made significant contributions to the project: Jenny Holt, Niall Connolly, Michelle Reilly and staff of the ACTFR water analysis laboratory, including Barry Butler, John Faithful and Elizabeth O’Sullivan
Health Policy in Ageing Populations: Economic modeling of chronic disease policy options in Australia
No full textIn a global environment of rapid increases in health expenditures, health policies in Australia and in many other countries are currently undergoing major reforms. To contain future cost increases, accurate tools able to identify and rank ‘best value for money’ health investments are essential. In Australia non-communicable chronic diseases – e.g. diabetes, heart disease, cancer, arthritis and mental disorders – affect the majority of the elderly, account for 70% of health expenditures, and cause poor health, deteriorating quality of life and premature death. This book focuses on how to identify ‘best value for money’ health investments within the context of on-going and future health reforms, and on quantifying the major benefits that would flow from such investments in terms of longer and better lives. This book will be of interest to general readers, social and economic researchers, and students interested in health care in ageing populations
Cost-effectiveness analysis of germ-line BRCA testing in women with breast cancer and cascade testing in family members of mutation carriers
No full textPurpose:
To evaluate the cost-effectiveness of BRCA testing in women with breast cancer, and cascade testing in family members of BRCA mutation carriers.
Methods:
A cost-effectiveness analysis was conducted using a cohort Markov model from a health-payer perspective. The model estimated the long-term benefits and costs of testing women with breast cancer who had at least a 10% pretest BRCA mutation probability, and the cascade testing of first- and second-degree relatives of women who test positive.
Results:
Compared with no testing, BRCA testing of affected women resulted in an incremental cost per quality-adjusted life-year (QALY) gained of AU1,880; incremental QALY gain 0.10) with reductions of 0.04 breast and 0.01 ovarian cancer events. Testing affected women and cascade testing of family members resulted in an incremental cost per QALY gained of AU665; incremental QALY gain 0.07) with additional reductions of 0.06 breast and 0.01 ovarian cancer events.
Conclusion:
BRCA testing in women with breast cancer is cost-effective and is associated with reduced risk of cancer and improved survival. Extending testing to cover family members of affected women who test positive improves cost-effectiveness beyond restricting testing to affected women only.Griffith Health, School of MedicineNo Full Tex
Mycobacterium ulcerans Treatment Costs, Australia
No full textMycobacterium ulcerans gives rise to severe skin ulceration that can be associated with considerable illness. The cost of diagnosis, treatment, and lost income has never been assessed in Australia. A survey of 26 confirmed cases of the disease in Victoria was undertaken. Data were collected on demographic details, diagnostic tests, treatment, time off work, and travel to obtain treatment. All costs are reported in Australian dollars in 1997–98 prices. The cost varies considerably with disease severity. For mild cases, the average direct cost is 27,681. Hospitalization accounts for 61% to 90% of costs, and indirect costs amount to 24% of the total per case. M. ulcerans can be an expensive disease to diagnose and treat. Costs can be reduced by early diagnosis and definitive treatment. Research is needed to find cost-effective therapies for this disease
Financing Health Insurance in Asia Pacific Countries
No full textThe paper discusses models of health insurance, including compulsory (social) health insurance, voluntary insurance, and community-based financing schemes. It illustrates the features of these models in terms of coverage, funding, sustainability, payment mechanisms, public-private mix, risk protection, and cost-containment properties, and outlines some emerging challenges to health financing arrangements. Health financing systems used in Japan, Korea, Taiwan, ASEAN and China are discussed, and implications are drawn for the developing countries in the Asia Pacific contemplating health insurance reform. Copyright © 2007 The Authors Journal compilation © 2007 Crawford School of Economics and Government, The Australian National University and Blackwell Publishing Asia Pty Ltd. .
Economic model system of chronic diseases in Australia: a novel approach initially focusing on diabetes and cardiovascular disease
No full textThe short-term financial costs of abnormal Pap smears to women and government in Australia
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