OBJECTIVE: To provide an overview of recent literature on the cost-effectiveness of mental health screening for women during pregnancy. RESULTS: 1,988 publications were retrieved from databases, of which four were included in the systematic review. Models of care with screening are cost-effective compared with standard care without screening. Multi-level screening models are more cost-effective than single-level models. Effectiveness is affected by the number of false-positive cases, which decreases in multi-level models. CONCLUSION: Mental health screening in pregnancy appears to be cost-effective. We recommend its use in comprehensive health care for pregnant women in our country.

• Klíčová slova
• cost effectiveness, mental health, prenatal care, prenatal screening,
• MeSH
• analýza nákladů a výnosů MeSH
• duševní poruchy * diagnóza   ekonomika   MeSH
• komplikace těhotenství * diagnóza   ekonomika   MeSH
• lidé MeSH
• plošný screening * ekonomika   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH

BACKGROUND: Understanding population health trends and their key determinants is essential for planning health services and implementing effective interventions. One of these determinants may be national cultural characteristics that are related to various health outcomes and health-related behaviours. However, little is known about their potential association to overall burden of disease. Thus, this study examined whether cultural characteristics expressed by Hofstede indexes are associated with the burden of disease. METHODS: We used data from open-source databases - Hofstede's Cultural Index, the Global Burden of Diseases (GBD) and the Human Development Index (HDI). The final sample comprised 69 countries covering all the continents. The burden of disease was measured using disability-adjusted life years (DALYs), years lived with disabilities (YLD), and years of life lost (YLL). National cultural characteristics were measured using Hofstede's dimensions. Bayesian correlation analyses were conducted to assess the relationships between cultural dimensions and health outcomes, stratified by countries' HDI levels. RESULTS: In countries with a very high HDI, there was strong evidence (Bayes Factor > 10) of a positive correlation of Power distance with the total disability-adjusted life years (r = 0.448) and years of life lost (r = 0.528), and Individualism (r = 0.667) and Indulgence (r = 0.494) with years lived with disabilities. In contrast, Long-term orientation negatively correlated of with years lived with disabilities (r = -0.527) and Indulgence with disability-adjusted life years (r = -0.437) and years of life lost (r = -0.537). Further, Power distance and Indulgence were correlated with the majority of the GBD indicators and Individualism with a few GBD indicators. In countries with a high and medium HDI, strong evidence of the associations was found in only a few cases. CONCLUSION: We found a correlation between national cultural characteristics and burden of disease. Policy-makers should consider integrating cultural factors into public health strategies to better align healthcare interventions with the local population's values and behaviours. Moreover, cross-cultural research and collaboration should increase to understand how cultural influences can be used to mitigate disease burdens and improve health outcomes globally. This study also opens a potentially new research area within population health research.

• Klíčová slova
• Burden of disease, Cultural characteristics, Hofstede’s index, Population health,
• MeSH
• Bayesova věta MeSH
• globální zátěž nemocemi * MeSH
• kulturní charakteristiky * MeSH
• lidé MeSH
• osobní újma zaviněná nemocí * MeSH
• počet let života s onemocněním MeSH
• zdravotní stav populace * statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND AND OBJECTIVE: Bladder cancer (BCa) imposes a substantial economic burden on health care systems and patients. Understanding these financial implications is crucial for effective resource allocation and optimization of treatment cost effectiveness. Here, we aim to systematically review and analyze the financial burden of BCa from the health care and patient perspectives. METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant systematic review was conducted, searching PubMed/Medline, Embase, and public sources for studies evaluating the financial impact of BCa, encompassing costs, cost effectiveness, and financial toxicity (FT). KEY FINDINGS AND LIMITATIONS: Non-muscle-invasive BCa (NMIBC) incurs significant costs for surveillance and treatment, with costs exceeding $200 000 after 5 yr for high-risk NMIBC patients progressing after bacillus Calmette-Guerin (BCG) treatment (including inpatient, outpatient, and physician service expenses). Muscle-invasive BCa generates substantial costs from radical cystectomy (RC) and neoadjuvant chemotherapy, averaging $30 000-40 000 from surgical costs of RC, with additional expenses in case of complications. Trimodal therapy has higher costs (1-yr management cost >$200 000) than RC because of higher outpatient, radiology, and medication costs. Metastatic BCa incurs the highest financial burden, with systemic therapy costs ranging from $40 000 to over $100 000 per five-cycle course, increasing further with combination therapies (ie, enfortumab vedotin and pembrolizumab), treatment-related toxicity, and supportive care. FT is particularly prevalent among younger, less educated, and minority populations. CONCLUSIONS AND CLINICAL IMPLICATIONS: BCa treatment, particularly in advanced stages, imposes a substantial economic burden. Innovations in care, while improving oncologic outcomes, necessitate detailed cost-effectiveness assessments. Addressing these economic challenges is essential for optimizing BCa management, targeting patients at a higher risk of FT, and improving patient quality of life.

• Klíčová slova
• Cost effectiveness, Financial burden, Financial toxicity, Metastatic bladder cancer, Muscle-invasive bladder cancer, Non–muscle-invasive bladder cancer, cost,
• MeSH
• analýza nákladů a výnosů MeSH
• cystektomie ekonomika   škodlivé účinky   MeSH
• lidé MeSH
• metastázy nádorů MeSH
• nádory močového měchýře * ekonomika   terapie   patologie   MeSH
• náklady na zdravotní péči * MeSH
• osobní újma zaviněná nemocí * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH

OBJECTIVE: Diabetic foot (DF), especially DF ulcers (DFUs) are a relatively frequent and financially burdensome late-stage complication of diabetes. However, data on the costs of podiatric care in the Czech Republic are scarce. The aim of this prospective multicenter study was to determine the total costs associated with long-term podiatric care in selected foot clinics across the Czech Republic. RESEARCH DESIGN AND METHODS: A total of 119 patients with DFUs (mean age of 68 ± 11 years, diabetes duration of 19 ± 11 years, HbA1c level of 62 ± 14 mmol/mol, composite WIfI score of 3 ± 2, 33 % had new DFUs, 37 % previous amputations, and 50 % had peripheral artery disease (PAD)) from 10 podiatric foot clinics in the Czech Republic were enrolled in our financial analysis. Direct and indirect costs associated with podiatric care - diagnostic and treatment methods - including angiological, radiological, and microbiological examinations, blood sampling, prescribed materials for local therapy, antibiotics, surgical procedures, offloading devices, hospital services and additional expenses such as patient transportation, doctors' visits, home care assistance, and work incapacity - were monitored over a 6-month period using an electronic database. RESULTS: The average cost of podiatric care per patient over a 6-month period was €2,506 with median €1,320. The largest expenses were spent on therapeutic procedures (51.4 %). Costs for patients hospitalized during the study period were significantly higher than for outpatients (€7,923 vs. €1,304 on average; P < 0.001). Among hospitalized patients, the main costs were hospital services (32 %), therapeutic procedures (26 %), and antibiotic and local therapies (20 %). Among outpatients, therapeutic procedures accounted for 74 % of the total costs. Newly developed DFUs or PAD were not linked to significantly increased costs. The composite WIfI score, primarily the wound component, was the only parameter that significantly positively correlated with the total podiatric costs (r = 0.434; 95 % CI 0.279-0.559; P < 0.0001). Other patient characteristics such as age, diabetes duration, DFU duration, and HbA1c level did not show significant cost correlations. CONCLUSIONS: On average, podiatric care for patients with DFUs in the Czech Republic is 3 to 9 times more expensive than standard diabetes healthcare. The expenses for hospitalized patients are almost 6 times higher than for outpatients. The composite WIfI score was the most significant indicator of podiatric financial burden.

• Klíčová slova
• Costs, Diabetic foot, Diabetic foot ulcers, Economy, Epidemiology,
• MeSH
• diabetická noha * ekonomika   terapie   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náklady na zdravotní péči * MeSH
• osobní újma zaviněná nemocí * MeSH
• podiatrie * ekonomika   MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVES: This study aimed to provide the first evidence of the socioeconomic burden of cystic fibrosis (CF) in Czechia. METHODS: In a cross-sectional questionnaire-based primary data collection conducted from 2020 to 2021 among Czech patients with CF, we collected demographic, clinical, and healthcare resource use data, out-of-pocket and social transfer costs, and questionnaires: Cystic Fibrosis Questionnaire-Revised, Work Productivity and Activity Impairment, EQ-5D, and Zarit Burden Interview. Productivity loss/costs were assessed using the human capital approach with patient patient-assumed life expectancy of 45 years and caregiver retirement age of 64 years and discounted by 3%. RESULTS: A total of 257 patients completed the questionnaires (37% of the Czech CF population). The average age was 17 years; most were females (59%), and the average forced expiratory volume in 1 second was 81.4% (SD 25.4%). A total of 107 patients had caregivers with an average age of 39 years and a significant caregiver time burden (extra 4.6 hours/day). The average Zarit Burden Interview score (25.4) was comparable with advanced cancer, dementia, or Duchenne muscular dystrophy. The proportion of unemployed caregivers was 10× higher than the general population (31% vs 3.2%). Total out-of-pocket family costs related to CF were €278/month, mainly for medicines (€105), foods (€73), and transport (€59); 25% received a disability pension and 18% other social security benefits. The work impairment of employed patients and caregivers was 25% and 15%, respectively, mostly due to presenteeism. Total lifetime productivity costs extrapolated to all Czech patients with CF (n = 687) and their caregivers were €155 181 286 (€225 883/person). CONCLUSIONS: The societal burden imposed on Czech patients with CF and their caregivers is significant. Caregivers seem to be affected by higher disease activity more than patients.

• Klíčová slova
• caregiver burden, cystic fibrosis, productivity costs, quality of life, societal burden,
• MeSH
• cystická fibróza * ekonomika   psychologie   epidemiologie   MeSH
• dospělí MeSH
• kvalita života psychologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• osobní újma zaviněná nemocí * MeSH
• osoby pečující o pacienty * psychologie   statistika a číselné údaje   ekonomika   MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• socioekonomické faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

INTRODUCTION: The objective of this study was to assess the impact of the Enhanced Recovery After Surgery (ERAS) programme implementation on treatment costs at a university-type centre, using the DRG scheme. MATERIALS AND METHODS: Retrospective analysis of patients' data in a group of 604 individuals enroled in the study. We evaluated three groups of patients according to the ERAS clinical protocol (CP): (1) CP oncogynaecology, (2) CP simple hysterectomy, (3) CP laparoscopy. The study aimed to evaluate the impact on the length of stay (LOS), savings in bed-days, and the reduction in direct treatment costs. Three parameters-antibiotic consumption, blood derivative consumption and laboratory test costs-were chosen to compare direct treatment costs. The statistical significance of the difference in the observed parameters was tested by a two-sample unpaired t test with unequal variances at the 0.05 significance level. RESULTS: We analysed data from 604 patients. In all three groups, the length of stay (LOS) was significantly reduced. The most significant reduction was observed in the CP oncogynaecology group, where the LOS was reduced from 11.1 days to 6.8 days (2022) and 7.6 days (2023) compared to 2019 (p < 0.05). Furthermore, there was a notable reduction in inpatient bed-days, which resulted in the capacity being made available to admit additional patients. A statistically significant reduction in direct costs was observed in the group of CP hysterectomy (antibiotic use) and in the CP laparoscopy (laboratory test costs). CONCLUSIONS: The implementation of the ERAS principles resulted in a number of significant positive economic impacts-reduction in the LOS and a corresponding increase in bed capacity for new patients. Additionally, direct treatment costs, including those related to antibiotic use or laboratory testing were reduced. The Czech Republic's acute healthcare system, like the majority of European healthcare systems, is financed by the DRG system. This flat-rate payment per patient encourages hospital management to seek cost-reduction strategies. The results of our study indicate that fast-track protocols represent a potential viable approach to reducing the cost of treatment while simultaneously meeting the recommendations of evidence-based medicine.

• Klíčová slova
• diagnosis related groups, enhanced recovery after surgery, gynaecologic oncology, gynaecologic surgical procedures, health care costs, outcome assessment,
• MeSH
• délka pobytu statistika a číselné údaje   ekonomika   MeSH
• dospělí MeSH
• gynekologické chirurgické výkony * ekonomika   MeSH
• hysterektomie ekonomika   MeSH
• klasifikační systém DRG MeSH
• laparoskopie ekonomika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náklady na zdravotní péči * statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• urychlená pooperační rehabilitace * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Decision-analytic models assessing the value of emerging Alzheimer's disease (AD) treatments are challenged by limited evidence on short-term trial outcomes and uncertainty in extrapolating long-term patient-relevant outcomes. To improve understanding and foster transparency and credibility in modeling methods, we cross-compared AD decision models in a hypothetical context of disease-modifying treatment for mild cognitive impairment (MCI) due to AD. METHODS: A benchmark scenario (US setting) was used with target population MCI due to AD and a set of synthetically generated hypothetical trial efficacy estimates. Treatment costs were excluded. Model predictions (10-year horizon) were assessed and discussed during a 2-day workshop. RESULTS: Nine modeling groups provided model predictions. Implementation of treatment effectiveness varied across models based on trial efficacy outcome selection (clinical dementia rating - sum of boxes, clinical dementia rating - global, mini-mental state examination, functional activities questionnaire) and analysis method (observed severity transitions, change from baseline, progression hazard ratio, or calibration to these). Predicted mean time in MCI ranged from 2.6 to 5.2 years for control strategy and from 0.1 to 1.0 years for difference between intervention and control strategies. Predicted quality-adjusted life-year gains ranged from 0.0 to 0.6 and incremental costs (excluding treatment costs) from -US$66 897 to US$11 896. CONCLUSIONS: Trial data can be implemented in different ways across health-economic models leading to large variation in model predictions. We recommend (1) addressing the choice of outcome measure and treatment effectiveness assumptions in sensitivity analysis, (2) a standardized reporting table for model predictions, and (3) exploring the use of registries for future AD treatments measuring long-term disease progression to reduce uncertainty of extrapolating short-term trial results by health-economic models.

• Klíčová slova
• Alzheimer’s disease, cross-validation, decision-analytic modeling, health-economic evaluation,
• MeSH
• Alzheimerova nemoc * ekonomika   farmakoterapie   terapie   MeSH
• analýza nákladů a výnosů * MeSH
• ekonomické modely MeSH
• kognitivní dysfunkce * ekonomika   farmakoterapie   MeSH
• kvalitativně upravené roky života MeSH
• lidé MeSH
• metody pro podporu rozhodování * MeSH
• progrese nemoci MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Unequal access to healthcare and inadequate financing have highlighted the need for healthcare reform to increase efficiency while ensuring equity in healthcare financing worldwide. Our study evaluates the capacity of Kazakhstan's healthcare system reform, transitioning from a tax-financed system to compulsory social health insurance (CSHI), to address equity in healthcare financing. Using quarterly Household Budget Surveys from 2017-Q1 to 2020-Q4 in a staggered difference-in-difference estimation technique, we analyze the impact of the transition on the incidence and intensity of catastrophic health expenditure (CHE) and impoverishment. Our findings show that while the transition from a tax-financed to a CSHI system in the short run lowers both the incidence and intensity of catastrophic health expenditure, it does not alleviate impoverishment. In particular, the reform predominantly benefits wealthier households, with no effect on the relatively poor population. We speculate that the positive outcomes observed from the reform in the short run are largely attributed to the exceptionally high insurance coverage during the transition period. The success of the transition from a tax-based to an insurance-based system is heavily dependent on the rate of insurance coverage of the population, as well as the quality of healthcare services and available finances.

• Klíčová slova
• Catastrophic health expenditure, Health insurance, Impoverishment, Inequity, Kazakhstan,
• MeSH
• financování zdravotní péče * MeSH
• lidé MeSH
• reforma zdravotní péče * ekonomika   metody   statistika a číselné údaje   MeSH
• vážná nemoc * ekonomika   epidemiologie   MeSH
• výdaje na zdravotnictví * statistika a číselné údaje   trendy   MeSH
• zdravotní pojištění ekonomika   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Kazachstán MeSH

The epidemiological transition has been characterized by demographic, societal and health changes in societies. Presuming that acute diseases, mostly of communicable etiology, are more important in terms of early-life mortality, whereas chronic diseases are responsible for a greater burden of disease throughout the life course, we attempt to develop an index to measure the stage of the epidemiological transition. Using Global Burden of Diseases, Risk Factors and Injuries (GBD) data available at https://vizhub.healthdata.org/gbd-compare/ on 04/04/2024 to calculate the Epidemiologic Transition Estimate (ETE) index as a ratio of YLD/YLL for the time period of 1990-2019. The values of the index ranged from 0.131 to 1.067 and 0.180 to 2.108 for males and females, respectively, across the 195 included countries. The transition process seems to be faster to females compared to males. The index shows consistently increasing values for five SDI-based country groups, with clear differences among the groups. Although more research and validation studies are needed despite all the uncertainties, the index seems to be robust to assess the progress in epidemiological transition. These findings can help to predict future social care and health system needs to address causes leading to YLD or YLL.

• Klíčová slova
• Burden of disease, Epidemiologic transition, Global health,
• MeSH
• celosvětové zdraví MeSH
• chronická nemoc epidemiologie   MeSH
• dítě MeSH
• dospělí MeSH
• globální zátěž nemocemi * trendy   MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• osobní újma zaviněná nemocí * MeSH
• předškolní dítě MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Applications like drug development need simple and streamlined methods to process samples from 96-well cell culture plates for gene expression measurements. Unfortunately, current options are expensive for such processing. Therefore, our aim was to develop a method that would allow streamlined analysis of mRNA from 96-well cell culture plates while being relatively cheap and simple. We developed a method based on the qPCR 'Cells-to-cDNA' approach and validated it against commercially available kits using the same approach or spin columns-based RNA purification. For this purpose, we conducted a series of comparisons of gene expression from peripheral blood mononuclear cells, SK-HEP-1 and U-87 cell cultures in 96-well plates. Our final method involved lysing cells with 25-100 µl solution of 0.5% SDS, 10 mM DTT, 1 mg ml-1 proteinase K dissolved in water, 1 h incubation at 50°C, followed by proteinase K inactivation at 90°C for 5 min and lysate neutralization with 1 : 1 dilution by 20% Tween 20 solution. Reverse transcription and qPCR were carried out using standard methods. This method showed a mean reduction of Ct ± s.d. value by 2.4 ± 1.3 compared with the 'Cells-to-cDNA' kit and by 1.4 ± 0.5 compared with the RNA purification kit with lower variability.

• Klíčová slova
• RNA isolation, cell lysis, in vitro, mRNA, peripheral blood mononuclear cells, proteinase k, qPCR,
• MeSH
• analýza nákladů a výnosů MeSH
• buněčné kultury * metody   MeSH
• komplementární DNA * genetika   biosyntéza   MeSH
• kvantitativní polymerázová řetězová reakce metody   MeSH
• leukocyty mononukleární metabolismus   MeSH
• lidé MeSH
• messenger RNA genetika   MeSH
• stanovení celkové genové exprese metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• komplementární DNA * MeSH
• messenger RNA MeSH