The Impact of Reference Pricing on Switching Behaviour and Healthcare Utilisation: The Case of Statins in Germany

2010 ◽  
Author(s):  
Tom Stargardt
Keyword(s):  
Healthcare Utilisation ◽  
Reference Pricing ◽  
Switching Behaviour ◽  
The Impact

scholarly journals Understanding and responding to COVID-19 in Wales: protocol for a privacy-protecting data platform for enhanced epidemiology and evaluation of interventions

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e043010
Author(s):  
Jane Lyons ◽  
Ashley Akbari ◽  
Fatemeh Torabi ◽  
Gareth I Davies ◽  
Laura North ◽  
...  
Keyword(s):  
Policy Development ◽  
Healthcare Utilisation ◽  
Population Data ◽  
Population Level ◽  
Risk Groups ◽  
Service Utilisation ◽  
Natural Experiments ◽  
Spread Of Infection ◽  
The Impact

IntroductionThe emergence of the novel respiratory SARS-CoV-2 and subsequent COVID-19 pandemic have required rapid assimilation of population-level data to understand and control the spread of infection in the general and vulnerable populations. Rapid analyses are needed to inform policy development and target interventions to at-risk groups to prevent serious health outcomes. We aim to provide an accessible research platform to determine demographic, socioeconomic and clinical risk factors for infection, morbidity and mortality of COVID-19, to measure the impact of COVID-19 on healthcare utilisation and long-term health, and to enable the evaluation of natural experiments of policy interventions.Methods and analysisTwo privacy-protecting population-level cohorts have been created and derived from multisourced demographic and healthcare data. The C20 cohort consists of 3.2 million people in Wales on the 1 January 2020 with follow-up until 31 May 2020. The complete cohort dataset will be updated monthly with some individual datasets available daily. The C16 cohort consists of 3 million people in Wales on the 1 January 2016 with follow-up to 31 December 2019. C16 is designed as a counterfactual cohort to provide contextual comparative population data on disease, health service utilisation and mortality. Study outcomes will: (a) characterise the epidemiology of COVID-19, (b) assess socioeconomic and demographic influences on infection and outcomes, (c) measure the impact of COVID-19 on short -term and longer-term population outcomes and (d) undertake studies on the transmission and spatial spread of infection.Ethics and disseminationThe Secure Anonymised Information Linkage-independent Information Governance Review Panel has approved this study. The study findings will be presented to policy groups, public meetings, national and international conferences, and published in peer-reviewed journals.

scholarly journals Driving Factors for the Utilisation of Healthcare Services by People with Osteoarthritis: Results from A Nationwide Population-Based study

2021 ◽  
Author(s):  
Daniela Costa ◽  
Ana M Rodrigues ◽  
Eduardo B Cruz ◽  
Helena Canhão ◽  
Jaime da Cunha Branco ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Multinomial Logistic Regression ◽  
Healthcare Utilisation ◽  
Healthcare Services ◽  
Structured Interview ◽  
Population Based ◽  
Enabling Factors ◽  
Population Based Study ◽  
The Impact

Abstract Background: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods: We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt . Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables.Results: In our sample, a high proportion of participants are overweight or obese (82,6%, n=748) and physically inactive (20,6%, n=201) and a small proportion had physiotherapy management (14,4%, n=141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. "GPUsers" represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations ( p <0,05) with the higher utilisation of healthcare services profiles. Conclusions: Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.

scholarly journals H<sub>2</sub>S dosimeter with controllable percolation threshold based on semi-conducting copper oxide thin films

2017 ◽  
Vol 6 (1) ◽  
pp. 163-170 ◽  
Author(s):  
Christoph Seitz ◽  
Giuliana Beck ◽  
Jörg Hennemann ◽  
Christian Kandzia ◽  
Karl P. Hering ◽  
...  
Keyword(s):  
Thin Films ◽  
Copper Oxide ◽  
Percolation Threshold ◽  
Structural Parameters ◽  
Electrical Conductance ◽  
Copper Oxides ◽  
Island Growth ◽  
Switching Behaviour ◽  
The Impact ◽  
H2s Detection

Abstract. Copper oxides, such as CuO and Cu2O, are promising materials for H2S detection because of the reversible reaction with H2S to copper sulfides (CuS, Cu2S). Along with the phase change, the electrical conductance increases by several orders of magnitude. On CuOx films the H2S reaction causes the formation of statistically distributed CuxS islands. Continuous exposition to H2S leads to island growth and eventually to the formation of an electrical highly conductive path traversing the entire system: the so-called percolation path. The associated CuOx ∕ CuxS conversion ratio is referred to as the percolation threshold. This pronounced threshold causes a gas concentration dependent switch-like behaviour of the film conductance. However, to utilize this effect for the preparation of CuO-based H2S sensors, a profound understanding of the operational and morphological parameters influencing the CuS path evolution is needed.Thus, this article is focused on basic features of H2S detection by copper oxide films and the influence of structural parameters on the percolation threshold and switching behaviour. In particular, two important factors, namely the stoichiometry of copper oxides (CuO, Cu2O and Cu4O3) and surface morphology, are investigated in detail. CuOx thin films were synthesized by a radio frequency magnetron sputtering process which allows modification of these parameters. It could be shown that, for instance, the impact on the switching behaviour is dominated by morphology rather than stoichiometry of copper oxide.

scholarly journals The impact of demonetisation on the utilisation of hospital services, patient outcomes and finances: a multicentre observational study from India

2020 ◽  
Vol 5 (9) ◽  
pp. e002509
Author(s):  
Tarun K George ◽  
John Victor Peter ◽  
Lakshmanan Jeyaseelan ◽  
Bijesh Yadav ◽  
Shalom Patole ◽  
...  
Keyword(s):  
Observational Study ◽  
Control Period ◽  
Healthcare Utilisation ◽  
Bayesian Regression ◽  
Seasonal Effect ◽  
Variable Effect ◽  
For Profit ◽  
Tertiary Hospitals ◽  
Ed Visits ◽  
The Impact

BackgroundThis study assessed trends in healthcare utilisation in relation to the implementation of an economic policy in India wherein 500 and 1000 rupee notes were demonetised.MethodsIn this ambidirectional observational study of private not-for-profit hospitals, data on hospital outpatient and inpatient numbers, surgeries, emergency department (ED) visits, obstetric admissions and mortality were obtained for pre-demonetisation (September/October 2016), early (November/December 2016) and late demonetisation (January/February 2017), and post-demonetisation periods (March/April 2017) and compared with the control period (2015–2016) from 11 centres (three tertiary hospitals; eight secondary). A Bayesian regression analysis was performed to adjust for seasonal (winter) effect. Monthly financial data, including the proportion of cash versus non-cash transactions, were collected.FindingsOverall, at the pooled all-hospital level, Bayesian analysis showed non-significant increase in outpatients (535.4, 95% CI −7097 to 8116) and decrease in deaths (–6.3 per 1000 inpatients, 95% CI −15.45 to 2.75) and a significant decrease in inpatients (−145.6, 95% CI −286.4 to −10.63) during demonetisation. Analysis at the level of secondary and tertiary hospitals showed a variable effect. For individual hospitals, after adjusting for the seasonal effect, some hospitals observed a significant reduction in outpatient (n=2) and inpatient (n=3) numbers, ED visits (n=4) and mortality (n=2) during demonetisation, while others reported significantly increased outpatient numbers (n=3) and ED visits (n=2). Deliveries remained unchanged during demonetisation in the hospitals that provided the service. There was no significant reduction in hospital incomes during demonetisation. In tertiary hospitals, there was a significant increase in non-cash component of transactions from 35% to 60% (p=0.02) that persisted beyond the demonetisation period.ConclusionsThe effect of demonetisation on healthcare utilisation was variable. Some hospitals witnessed a significant reduction in utilisation in some areas, while others reported increased utilisation. There was an increase in non-cash transactions that persisted beyond the period of demonetisation.

scholarly journals Retrospective evaluation of healthcare utilisation and mortality of two post-discharge care programmes in Singapore

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027220 ◽  
Author(s):  
Ian Yi Han Ang ◽  
Chuen Seng Tan ◽  
Milawaty Nurjono ◽  
Xin Quan Tan ◽  
Gerald Choon-Huat Koh ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mortality Rate ◽  
Health System ◽  
Emergency Admission ◽  
Healthcare Utilisation ◽  
Lower Mortality ◽  
Post Discharge ◽  
Discharge Care ◽  
High Acuity ◽  
The Impact

ObjectiveTo evaluate the impact on healthcare utilisation frequencies and charges, and mortality of a programme for frequent hospital utilisers and a programme for patients requiring high acuity post-discharge care as part of an integrated healthcare model.DesignA retrospective quasi-experimental study without randomisation where patients who received post-discharge care interventions were matched 1:1 with unenrolled patients as controls.SettingThe National University Health System (NUHS) Regional Health System (RHS), which was one of six RHS in Singapore, implemented the NUHS RHS Integrated Interventions and Care Extension (NICE) programme for frequent hospital utilisers and the NUHS Transitional Care Programme (NUHS TCP) for high acuity post-discharge care. The programmes were supported by the Ministry of Health in Singapore, which is a city-state nation located in Southeast Asia with a 5.6 million population.ParticipantsLinked healthcare administrative data, for the time period of January 2013 to December 2016, were extracted for patients enrolled in NICE (n=554) or NUHS TCP (n=270) from June 2014 to December 2015, and control patients.InterventionsFor both programmes, teams conducted follow-up home visits and phone calls to monitor and manage patients’ post-discharge.Primary outcome measuresOne-year pre- and post-enrolment healthcare utilisation frequencies and charges of all-cause inpatient admissions, emergency admissions, emergency department attendances, specialist outpatient clinic (SOC) attendances, total inpatient length of stay and mortality rates were compared.ResultsPatients in NICE had lower mortality rate, but higher all-cause inpatient admission, emergency admission and emergency department attendance charges. Patients in NUHS TCP did not have lower mortality rate, but had higher emergency admission and SOC attendance charges.ConclusionsBoth NICE and NUHS TCP had no improvements in 1 year healthcare utilisation across various setting and metrics. Singular interventions might not be as impactful in effecting utilisation without an overhauling transformation and restructuring of the hospital and healthcare system.

scholarly journals Association between disease-modifying therapies for multiple sclerosis and healthcare utilisation on a population level: a retrospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033599 ◽  
Author(s):  
Lina Al-Sakran ◽  
Ruth Ann Marrie ◽  
David Blackburn ◽  
Katherine Knox ◽  
Charity Evans
Keyword(s):  
Multiple Sclerosis ◽  
Retrospective Cohort ◽  
Negative Binomial ◽  
Demyelinating Disease ◽  
Treatment Strategies ◽  
Cost Benefit ◽  
Healthcare Utilisation ◽  
Population Level ◽  
Disease Modifying ◽  
The Impact

ObjectiveDisease-modifying therapy (DMT) use in multiple sclerosis (MS) has increased significantly. However, the impact of DMTs on healthcare use is limited and conflicting, and rarely examined at a population level. This study examined the association between DMTs and healthcare utilisation at the population level.DesignRetrospective cohort.SettingHealth administrative data from Saskatchewan, Canada (1997–2016).ParticipantsTo test for associations at the population level, we identified two cohorts. The general population cohort included all Saskatchewan residents ≥18 years who were drug plan beneficiaries. The MS cohort included individuals ≥18 years, identified using a validated definition (≥3 hospital, physician or drug claims for MS).Main outcome measures and methodsTo test for an association between the total number of DMT dispensations per year and the total number of hospitalisations we used negative binomial regression fitted with generalised estimating equations (GEE); only hospitalisations that occurred after the date of MS diagnosis (date of first claim for MS or demyelinating disease) were extracted. To test for an association between the number of DMT dispensations and physician claims, negative binomial distributions with GEE were fit as above. Results were reported as rate ratios (RR), with 95% CIs, and calculated for every 1000 DMT dispensations.ResultsThe number of DMT dispensations was associated with a decreased risk for all-cause (RR=0.994; 95% CI 0.992 to 0.996) and MS-specific (RR=0.909; 95% CI 0.880 to 0.938) hospitalisations. The number of DMT dispensations was not associated with the number of all-cause (RR=1.006; 95% CI 0.990 to 1.022) or MS-specific (RR=0.962; 95% CI 0.910 to 1.016) physician claims.ConclusionIncreased DMT use in Saskatchewan was associated with a reduction in hospitalisations, but did not impact the number of physician services used. Additional research on cost-benefit and differing treatment strategies would provide further insight into the true impact of DMTs on healthcare utilisation at a population level.

Impact of advertising strategies on the cognitive and behavioral component of attitude of women consumers

2017 ◽  
Vol 11 (4) ◽  
pp. 413-433 ◽  
Author(s):  
Harminderjit Kaur ◽  
Bikramjit Singh Hundal
Keyword(s):  
Behavioural Change ◽  
Working Women ◽  
Research Paper ◽  
Marketing Strategies ◽  
Women Consumers ◽  
Content Type ◽  
Sexual Appeal ◽  
Switching Behaviour ◽  
The Mind ◽  
The Impact

Purpose The purpose of this paper is to cover the gap from the previous literature with regard to the cognitive and the behavioural component of attitude of consumers. The literature was scant in examining the influence of the mostly used traits on the purchase behaviour and the switching behaviour of consumers. Therefore, this research paper examines the impact of different marketing strategies used by the advertisers on the components of the attitude of the consumers. Design/methodology/approach First, the perception of the consumers towards the traits was measured by the factor analysis approach. Second, the impact of the traits on the purchase behaviour of consumers was scrutinized using regression analysis, and then descriptive statistics approach was used to analyse the switching behaviour and the most important tactic used in the advertisement. Findings The results indicate that repeated exposure, comparison of products and sexual appeals has a significant impact on the mind of consumers which determines the influence of advertising tactics. Further, the results evaluated that information, pricing element, image of company and sexual appeal are the other important traits influencing the cognitive attitude of consumers. The consumers switch to the advertised products which indicate the behavioural change with the impact of advertisement. Research limitations/implications This research paper is suffering from some limitations as the area of research is restrained to the urban population of three districts of Punjab only, i.e. Amritsar, Jalandhar and Ludhiana, because of which the results cannot be generalized for other areas. Due to the changing behaviour and the attitude, income level and media, the response of the consumers in the present study may not be relevant in the future period. The study was confined to the working women consumers only and does not represent the whole population. Practical implications This research paper provides an insight to the marketers. The managers can measure how by using appropriate tactics can they make their advertising more effective. In case of unfamiliar products, the attitude of consumers to accept or to avoid the product is influenced by the tactics used by the marketers. It was recommended that the marketers must use the appropriate tactics to make their products/brands more pertinent and important among the consumers. Originality/value This research paper examines the impact of TV advertisement of beauty products on the components of the attitude of the urban working women consumers. This study presents the influence of the various marketing strategies used in the advertisement to influence the purchase and the switching behaviour of consumers.

scholarly journals The Impact of Reference Pricing of Nonsteroidal Anti-Inflammatory Agents on the Use and Costs of Analgesic Drugs

2005 ◽  
Vol 40 (5p1) ◽  
pp. 1297-1317 ◽  
Author(s):  
Paul V. Grootendorst ◽  
John K. Marshall ◽  
Anne M. Holbrook ◽  
Lisa R. Dolovich ◽  
Bernie J. O'Brien ◽  
...  
Keyword(s):  
Analgesic Drugs ◽  
Reference Pricing ◽  
Anti Inflammatory ◽  
The Impact
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