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OBJECTIVE: Complications contribute largely to the economic gravity of diabetes mellitus (DM). How they arise and are treated differs substantially between countries. This paper assesses the total annual, direct, and indirect cost of severe hypoglycemia events (SHEs) in nine European countries: Bulgaria, Croatia, the Czech Republic, Greece, Hungary, Macedonia/the former Yugoslav Republic of Macedonia (MK), Poland, Slovenia, and Spain. METHODS: Data was collected on epidemiology, treatment structure, SHE-driven resource consumption, and unit costs. Two systematic reviews-on the SHE rates and the resources used for treatment-and data on the days-of-work lost due to SHE along with salaries and employment rates were used. The total SHE cost in each country was calculated and how the differences are driven by individual parameters was analysed. RESULTS: The annual costs of SHEs varied in absolute terms from €379,951.25 in MK up to €58,429,684.40 in Spain, or-when expressed per one drug-treated DM patient-from €5.47 in Bulgaria up to €17.74 in Spain. Indirect cost constituted between 6.01% (MK) and 26.49% (Hungary) of the total cost. The differences between countries are driven mostly by the cost of treating a single event, and this is related to general differences in prices. LIMITATIONS: The main limitation is the lack of good quality data in some parts, and the necessity to use mean-value imputations, experts' opinions, etc. Additionally, we only considered DM treatment as the SHE driver, while other elements, e.g. style of living, may contribute substantially. CONCLUSIONS: A common framework can be applied to estimate the economic burden of SHE in various countries, allowing one to identify the drivers of differences in cost. Treating DM is complex, and so no resolute conclusions ought to be drawn as to whether SHE management is better in one country than another.
- Klíčová slova
- Diabetes mellitus, cost study, direct cost, indirect cost, severe hypoglycemia,
- MeSH
- hypoglykemie ekonomika patologie MeSH
- lidé MeSH
- náklady a analýza nákladů * MeSH
- náklady na zdravotní péči trendy MeSH
- osobní újma zaviněná nemocí * MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
Using western economic models evaluating cost/benefit in perinatal care, the author analyzed on examples of undesirable perinatal outcomes the health benefit as a result of extension of screening and therapeutic procedures in the Czech Republic in 1990-1996 as well as the efficacy, effectivity and efficiency of these procedures. The results of analyses provided evidence that extension of the above procedures led to a decline of undesirable outcomes, different for each of the five investigated types, but at the same time a considerable increase of costs was recorded which exceed resources available at present for health services in the Czech Republic. Further development of perinatal care which will have to overcome this discrepancy without jeopardizing the present high standard of perinatal care will have to consider a compromise which will achieve a balance between present professional knowledge and possibilities, the moral aspect, demands of society and available funds.
- MeSH
- analýza nákladů a výnosů MeSH
- ekonometrické modely MeSH
- lidé MeSH
- novorozenec MeSH
- perinatální péče ekonomika MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
The mutual cost-benefit relationship of any activity is the main principle of the market mechanism where both these variables are expressed in monetary terms. According to western economists this system cannot be applied, or if so only partly, in the sphere of health services because health benefit can be only in exceptional instances expressed in monetary terms. This is why they recommended for evaluation of health care, incl. perinatal care, other economic models where the health benefit is evaluated by saved lives or improvement of the health status. With this aspect in mind the author described five recommended models for the evaluation of alternative procedures and for evaluation of programmes in perinatology. Each of them is supplemented by examples from clinical practice. Most frequently different views are held on the effectivity of costly screening programmes for early detection of threatened foetuses and intensive care of these neonates, i.e. procedures which are the main cause of rising costs of perinatal care. The author discusses reasons for controversial views on contemporary economic problems in perinatology.
GOAL: To make the reader familiar with the term evidence based medicine (EBM), to explain the principle of cost-effectiveness analysis (price-profit), and to show its usefulness to compare the effectiveness of different medical procedures. METHOD: Based on few examples, in this article the relevance and calculation of important parameters of cost-effectiveness analysis (CE), as utility value (UV), quality adjusted life years (QALY) is explained. In addition, calculation of UV and QALY for the cataract surgery, including its complications, is provided. RESULTS: According to this method, laser photocoagulation and cryocoagulation of the early stages of retinopathy of prematurity, treatment of amblyopia, cataract surgery of one or both eyes, from the vitreoretinal procedures the early vitrectomy in cases of hemophtalmus in proliferative diabetic retinopathy or grid laser photocoagulation in diabetic macular edema or worsening of the visual acuity due to the branch retinal vein occlusion belong to highly effective procedures. On the other hand, to the procedures with low cost effectiveness belongs the treating of the central retinal artery occlusion with anterior chamber paracentesis, as well as with CO2 inhalation, or photodynamic therapy in choroidal neovascularization in age-related macular degeneration with visual acuity of the better eye 20/200. CONCLUSION: Cost-effectiveness analysis is a new perspective method evaluating successfulness of medical procedure comparing the final effect with the financial costs. In evaluation of effectiveness of individual procedures, three main aspects are considered: subjective feeling of influence of the disease on the patient's life, objective results of clinical examination and financial costs of the procedure. According to this method, the cataract surgery, as well as procedures in the pediatric ophthalmology belong to the most effective surgical methods.
- MeSH
- analýza nákladů a výnosů MeSH
- extrakce katarakty ekonomika MeSH
- kvalitativně upravené roky života * MeSH
- lidé MeSH
- medicína založená na důkazech * MeSH
- oftalmologické chirurgické výkony * ekonomika MeSH
- zraková ostrost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- práce podpořená grantem MeSH
The cost of salt fluoridation in a given country depends primarily on the number of salt factories and on the technical level available in the country. Equipment required may cost U.S. dollars 400,000 for large plants producing at least 20,000 tons/year providing salt for populations of several millions. Reliable batch mixers have been built locally for U.S. dollars 3000 to U.S. dollars 10,000, with one such mixer capable of producing 10 batches of one metric ton/day or 2000 to 3000 tons a year for a population of 350,000 to 500,000. Frequently 85-90% of the costs are devoted to infrastructure; in combination with salt iodization, the cost for fluoride equipment is 30-50% less. loIization is promoted by WHO, UNICEF, other international organizations and national aid agencies which can indirectly support salt fluoridation. With respect to running costs, the expense for the fluoride chemical is the major factor in small plants producing for example 6000 tons of salt, i. e U.S. dollars 0.015 to 0.03 per year and capita. The cost for personnel necessary for addition of fluoride and quality control is approximately U.S. dollars 0.008/capita/year in small plants and even less in large ones. With adequate implementation, salt fluoridation affords a cariostatic effectiveness equal to that of water fluoridation. When its cost is compared to that of water fluoridation, there may not be much difference regarding initial cost for equipment except in the case of small salt factories where local production of batch mixers may lower initial expenses substantially. Running costs for salt fluoridation are 10 to 100 times lower because the amount of fluoride chemical needed and its handling are up to 100 times less than with water fluoridation. In practice, the cost of salt fluoridation is often so low that many producers did not raise the price of fluoridated salt; this has been the case in Switzerland since 1955 and also in several countries in the Americas today.
- MeSH
- financování organizované MeSH
- fluoridace ekonomika MeSH
- fluoridy aplikace a dávkování ekonomika MeSH
- investiční náklady MeSH
- kariostatické látky aplikace a dávkování ekonomika MeSH
- kuchyňská sůl ekonomika MeSH
- lidé MeSH
- náklady a analýza nákladů MeSH
- náklady na zdravotní péči * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Amerika MeSH
- Česká republika MeSH
- Francie MeSH
- Švýcarsko MeSH
- Názvy látek
- fluoridy MeSH
- kariostatické látky MeSH
- kuchyňská sůl MeSH
UNLABELLED: Increasing treatment costs of HF patients affect the initiation of appropriate treatment method. Divergent approaches to measure the costs of treatment and the lack of common cost indicators impede the comparison of therapy settings. OBJECTIVES: In the context of the present meta-analysis, key cost indicators from the perspective of healthcare providers are to be identified, described, analyzed and quantified. This review helps narrowing down the cost indicators, which have the most significant economic impact on the total treatment costs of HF patients. Telemedical services are to be compared to standard therapy methods. METHODS: The identification process was based on several steps. For the quantitative synthesis, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. An additional set of criteria was defined for the following qualitative analysis. RESULTS: 5 key cost indicators were identified with significant economic impact on the treatment costs of HF patients. CONCLUSION: 95% of the reported treatment costs could be captured based on the identified cost indicators.
- Klíčová slova
- Cost comparison, cost effectiveness, economic evaluation, heart failure, telemedicine,
- MeSH
- analýza nákladů a výnosů MeSH
- chronická nemoc MeSH
- lidé MeSH
- náklady na zdravotní péči * MeSH
- srdeční selhání ekonomika terapie MeSH
- telemedicína MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
Ways of using different decision-aiding techniques for optimizing and evaluating radon remedial measures have been studied on a large set of data obtained from the remediation of 32 houses that had an original indoor radon level above 1000 Bq/m(3). Detailed information about radon concentrations before and after remediation, type of remedial measures and installation and operation costs were used as the input parameters for a comparison of costs and for determining the efficiencies, for a cost-benefit analysis and a cost-effectiveness analysis, in order to find out whether these criteria and techniques provide sufficient and relevant information for improving and optimizing remediation. Our study confirmed that the installation costs of remediation do not depend on the original indoor radon level, but on the technical state of the building. In addition, the study reveals that the efficiency of remediation does not depend on the installation costs. Cost-benefit analysis and cost-effectiveness analysis lead to the conclusion that remedial measures reducing the indoor radon concentration from values above 1000 Bq/m(3) are always acceptable and reasonable. On the other hand, these techniques can neither help the designer to choose the proper remedial measure nor provide information resulting in improved remediation.
- MeSH
- analýza nákladů a výnosů * MeSH
- radon izolace a purifikace MeSH
- regenerace a remediace životního prostředí metody MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- radon MeSH
BACKGROUND: When dealing with the replacement of one missing tooth, the patient has the option of choosing between different types of treatment interventions. Several important factors play a role in his decision-making process, including his limited financial means and his efforts to solve the problem of missing teeth as effectively as possible. The main goal of the study is the economic-clinical evaluation of implant treatment, as a surgical-prosthetic method in dentistry, in case of replacement of one missing tooth of the molar area. METHODS: Cost-utility analysis from the patient's perspective is used for evaluation. The selected comparator is a purely prosthetic solution with the help of a three-unit fixed dental prosthesis. Cost-utility analysis is modelled using Markov models, which consider a 30-year time horizon. RESULTS: Based on the results of modelling, the intervention evaluated by the patient, i.e. treatment with the help of implant-supported single crown, brings exactly 15.31 quality-adjusted prosthesis years (QAPY) after 30 years. The value of incremental cost-utility ratio amounted to USD - 1434. CONCLUSION: The results of the cost-utility analysis suggest that implant treatment with an implant-supported single crown is more cost-effective than treatment with the three-unit fixed dental prosthesis.
- Klíčová slova
- Cost-utility analysis, Fixed dental prosthesis, Implant, Implant treatment, Markov models,
- MeSH
- analýza nákladů a výnosů MeSH
- lidé MeSH
- moláry MeSH
- zubní implantáty * MeSH
- zubní korunky MeSH
- zubní náhrada ve spojení s implantáty MeSH
- zubní náhrady částečné fixní MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- zubní implantáty * MeSH
Unintentional and intentional injuries are a major cause of morbidity and mortality among children under the age of 19. The large number of premature death and disabilities due to injury and accompanying high economic cost, including public sector expenditures, emphasize the need to reduce the burden of injury. Productivity losses are greater from injury than from the three other leading causes of death--heart disease, stroke and cancer. Implementation of known injury-control interventions can substantially reduce the incidence, severity, and accompanying cost of injury. Because financial resources are limited, decision-makers need to consider the cost and effectiveness of alternative prevention strategies. Injury causes with the highest cost per injury could make a priority, especially within maternal and child health programs; as an alternative, projected total injury cost could determine program priority.
- MeSH
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- náklady a analýza nákladů * MeSH
- předškolní dítě MeSH
- rány a poranění * ekonomika epidemiologie prevence a kontrola MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Geografické názvy
- Spojené státy americké epidemiologie MeSH
The aim of this paper is to identify a break in the development trend of the time series of the number of fatal, light and heavy injuries in traffic accidents and compare the progress caused by the media campaign named "Think or you'll pay! "in the Czech Republic over the period 2000-2015. The campaign focuses on the age group of drivers under the age of 25 and the most common cause of their traffic accidents as the drivers in this age category are the most vulnerable group in road traffic. The campaign uses a method in which it tries to influence behaviour by negative action, or by causing negative emotions. The authors concentrate on the effects of mass media campaigns in the long-term development of accidents in the Czech Republic and a financial evaluation of the road safety campaign "Think or you'll pay! "by comparing the campaign costs, the cost of road fatalities, and the cost savings from the perspective of government expenditures. The secondary source data for the chart analysis and interpolation according to the criteria of analytical and mechanical balancing time series, the Chow test and Quandt Likelihood Ratio test, choosing the appropriate model trend of accidents and consequences of traffic accidents were obtained from the Czech Ministry of Transport, the database of The Losses due to Traffic Accident Rates (CZRSO) and the Czech Association of Victims of Traffic Accidents (CSODN, 2015) from period of 1990 till 2016. The impact of the media campaign "Think or you'll pay!", measured by enumerating the costs was compared with the number of fatalities in the years immediately after the campaign and the impact of the media campaign was evaluated and recognised. The conclusion and the highlights summarize the findings of research and the limits of media campaign evaluation approach.
- Klíčová slova
- Cost analysis, Road and traffic safety, Time series models, media campaign,
- MeSH
- analýza nákladů a výnosů * MeSH
- bezpečnost * MeSH
- databáze faktografické MeSH
- dopravní nehody prevence a kontrola MeSH
- dospělí MeSH
- emoce MeSH
- hromadné sdělovací prostředky * MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- náklady a analýza nákladů MeSH
- podpora zdraví * ekonomika MeSH
- přesvědčovací komunikace * MeSH
- rány a poranění etiologie MeSH
- riskování MeSH
- řízení motorových vozidel * MeSH
- vládní programy MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
