scholarly journals Modelling Potential Health Gains and Health System Savings Associated with Vaporised Nicotine Products in Canada

Qeios ◽  
2021 ◽  
Author(s):  
Pierre Emmanuel Paradis ◽  
Cristina Ruscio
Keyword(s):  
Health System ◽  
Potential Health ◽  
Health Gains

‘Money up in smoke’: The financial benefits of smoking cessation may be more motivating to people who are homeless than potential health gains

2021 ◽  
Author(s):  
Cheneal Puljević ◽  
Aaron Snoswell ◽  
Lorena Rivas ◽  
Mohammed M. Ali ◽  
Wouter de Greef ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Potential Health ◽  
Health Gains ◽  
Financial Benefits

scholarly journals Socioeconomic Inequalities in the Prevalence and Management of Childhood Diarrhoea: Potential Health Gains to be Achieved

2009 ◽  
Vol 3 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Birger C. Forsberg ◽  
Davidson Gwatkin ◽  
Goran Tomson ◽  
Peter Allebeck ◽  
Max G. Petzold
Keyword(s):  
Socioeconomic Inequalities ◽  
Potential Health ◽  
Childhood Diarrhoea ◽  
Health Gains

scholarly journals An Alternative Mathematical Modeling Approach to Estimating a Reference Life Expectancy

2019 ◽  
Vol 4 (1) ◽  
pp. 238146831881476 ◽  
Author(s):  
Elizabeth R. Stevens ◽  
Qinlian Zhou ◽  
Glen B. Taksler ◽  
Kimberly A. Nucifora ◽  
Marc Gourevitch ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Life Expectancy ◽  
White Women ◽  
Policy Decision ◽  
The United States ◽  
Population Characteristics ◽  
Potential Health ◽  
Health Gains ◽  
Health Policy Decision

Background. Reference life expectancies inform frequently used health metrics, which play an integral role in determining resource allocation and health policy decision making. Existing reference life expectancies are not able to account for variation in geographies, populations, and disease states. Using a computer simulation, we developed a reference life expectancy estimation that considers competing causes of mortality, and is tailored to population characteristics. Methods. We developed a Monte Carlo microsimulation model that explicitly represented the top causes of US mortality in 2014 and the risk factors associated with their onset. The microsimulation follows a birth cohort of hypothetical individuals resembling the population of the United States. To estimate a reference life expectancy, we compared current circumstances with an idealized scenario in which all modifiable risk factors were eliminated and adherence to evidence-based therapies was perfect. We compared estimations of years of potential years life lost with alternative approaches. Results. In the idealized scenario, we estimated that overall life expectancy in the United States would increase by 5.9 years to 84.7 years. Life expectancy for men would increase from 76.4 years to 82.5 years, and life expectancy for women would increase from 81.3 years to 86.8 years. Using age-75 truncation to estimate potential years life lost compared to using the idealized life expectancy underestimated potential health gains overall (38%), disproportionately underestimated potential health gains for women (by 70%) compared to men (by 40%), and disproportionately underestimated the importance of heart disease for white women and black men. Conclusion. Mathematical simulations can be used to estimate an idealized reference life expectancy among a population to better inform and assess progress toward targets to improve population health.

scholarly journals Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care

2020 ◽  
Vol 30 (11) ◽  
pp. 1748-1756
Author(s):  
Charles H Norell ◽  
John Butler ◽  
Rhonda Farrell ◽  
Alon Altman ◽  
James Bentley ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Clinical Practice ◽  
Health System ◽  
Cancer Treatment ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Patterns Of Care ◽  
Debulking Surgery ◽  
Potential Health ◽  
International Differences

IntroductionThe International Cancer Benchmarking Partnership demonstrated international differences in ovarian cancer survival, particularly for women aged 65–74 with advanced disease. These findings suggest differences in treatment could be contributing to survival disparities.ObjectiveTo compare clinical practice guidelines and patterns of care across seven high-income countries.MethodsA comparison of guidelines was performed and validated by a clinical working group. To explore clinical practice, a patterns of care survey was developed. A questionnaire regarding management and potential health system-related barriers to providing treatment was emailed to gynecological specialists. Guideline and survey results were crudely compared with 3-year survival by ‘distant’ stage using Spearman’s rho.ResultsTwenty-seven guidelines were compared, and 119 clinicians completed the survey. Guideline-related measures varied between countries but did not correlate with survival internationally. Guidelines were consistent for surgical recommendations of either primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery with the aim of complete cytoreduction. Reported patterns of surgical care varied internationally, including for rates of primary versus interval debulking, extensive/‘ultra-radical’ surgery, and perceived barriers to optimal cytoreduction. Comparison showed that willingness to undertake extensive surgery correlated with survival across countries (rs=0.94, p=0.017). For systemic/radiation therapies, guideline differences were more pronounced, particularly for bevacizumab and PARP (poly (ADP-ribose) polymerase) inhibitors. Reported health system-related barriers also varied internationally and included a lack of adequate hospital staffing and treatment monitoring via local and national audits.DiscussionFindings suggest international variations in ovarian cancer treatment. Characteristics relating to countries with higher stage-specific survival included higher reported rates of primary surgery; willingness to undertake extensive/ultra-radical procedures; greater access to high-cost drugs; and auditing.

scholarly journals SEEP-CI: A Structured Economic Evaluation Process for Complex Health System Interventions

2020 ◽  
Vol 17 (18) ◽  
pp. 6780
Author(s):  
Jason Madan ◽  
Meghan Bruce Kumar ◽  
Miriam Taegtmeyer ◽  
Edwine Barasa ◽  
Swaran Preet Singh
Keyword(s):  
Quality Improvement ◽  
Economic Evaluation ◽  
Health System ◽  
Health Program ◽  
Health Gain ◽  
Complex Interventions ◽  
Evaluation Process ◽  
Threshold Effect ◽  
Health Gains ◽  
Community Health Program

The economic evaluation of health system interventions is challenging, and methods guidance on how to respond to these challenges is lacking. The REACHOUT consortium developed and evaluated complex interventions for community health program quality improvement in six countries in Africa and Asia. Reflecting on the challenges we faced in conducting an economic evaluation alongside REACHOUT, we developed a Structured Economic Evaluation Process for Complex Health System Interventions (SEEP-CI). The SEEP-CI aims to establish the threshold effect size that would justify investment in a complex intervention, and provide an assessment to a decision-maker of how likely it is that the intervention can achieve this impact. We illustrate how the SEEP-CI could have been applied to REACHOUT to identify outcomes where the intervention might have impact and causal mechanisms, through which that impact might occur, guide data collection by focusing on proximal outcomes most likely to illustrate the effectiveness of the intervention, identify the size of health gain required to justify investment in the intervention, and indicate the assumptions required to accept that such health gains are credible. Further research is required to determine the feasibility and acceptability of the SEEP-CI, and the contexts in which it could be used.

scholarly journals Potential health gains in West and Central Africa through savings from lower cost HIV treatment

AIDS ◽  
2020 ◽  
Vol 34 (3) ◽  
pp. 439-446 ◽  
Author(s):  
Robyn M. Stuart ◽  
Sherrie L. Kelly ◽  
Rowan Martin-Hughes ◽  
David P. Wilson
Keyword(s):  
Lower Cost ◽  
Central Africa ◽  
Hiv Treatment ◽  
Potential Health ◽  
Health Gains ◽  
West And Central Africa

An equity - effectiveness framework linking health programs and healthy life expectancy

2011 ◽  
Vol 17 (4) ◽  
pp. 309 ◽  
Author(s):  
David Banham ◽  
John Lynch ◽  
Jon Karnon
Keyword(s):  
Life Expectancy ◽  
Health System ◽  
Population Health ◽  
South Australia ◽  
Relevant Information ◽  
Intervention Programs ◽  
Health Programs ◽  
Healthy Life Expectancy ◽  
Healthy Life ◽  
Health Gains

South Australia’s Strategic Plan includes a target to improve the population’s healthy life expectancy. A common question among health policy and service planners is: ‘How do health programs and services in the community relate to healthy life expectancy?’ In response, this paper outlines an effectiveness and equity framework (EEF) for evaluating health interventions in applied settings. Using the example of coronary heart disease (CHD) management in general practice in South Australia, the EEF: (1) applies an internally consistent approach to accounting for population healthy life expectancy at state and smaller geographic levels; (2) estimates average population health gains from health programs, and gains across different socioeconomic subgroups within the community; (3) conducts economic evaluation by equating health gains against health system costs in population subgroups; (4) summarises relevant information about candidate intervention programs within a multi-criteria performance matrix for presentation to decision makers; (5) reassesses outcomes (and processes) following the implementation of a program and iteratively adds to the relevant knowledge and evidence base. The EEF offers a practical approach to selecting and evaluating intervention programs. The challenge is to develop system culture and data capture methods clearly focussed on linking health system activities to population health outcomes.

scholarly journals Gastroenterology visitation and reminders predict surveillance uptake for patients with adenomas with high-risk features

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anthony Myint ◽  
Edgar Corona ◽  
Liu Yang ◽  
Bao Sean Nguyen ◽  
Christina Lin ◽  
...  
Keyword(s):  
High Risk ◽  
Health System ◽  
Population Surveillance ◽  
Colorectal Adenomas ◽  
Screening Colonoscopy ◽  
High Risk Population ◽  
Tubular Adenoma ◽  
Surveillance Colonoscopy ◽  
Potential Health ◽  
Increased Risk

AbstractIndividuals diagnosed with colorectal adenomas with high-risk features during screening colonoscopy have increased risk for the development of subsequent adenomas and colorectal cancer. While US guidelines recommend surveillance colonoscopy at 3 years in this high-risk population, surveillance uptake is suboptimal. To inform future interventions to improve surveillance uptake, we sought to assess surveillance rates and identify facilitators of uptake in a large integrated health system. We utilized a cohort of patients with a diagnosis of ≥ 1 tubular adenoma (TA) with high-risk features (TA ≥ 1 cm, TA with villous features, TA with high-grade dysplasia, or ≥ 3 TA of any size) on colonoscopy between 2013 and 2016. Surveillance colonoscopy completion within 3.5 years of diagnosis of an adenoma with high-risk features was our primary outcome. We evaluated surveillance uptake over time and utilized logistic regression to detect factors associated with completion of surveillance colonoscopy. The final cohort was comprised of 405 patients. 172 (42.5%) patients successfully completed surveillance colonoscopy by 3.5 years. Use of a patient reminder (telephone, electronic message, or letter) for due surveillance (adjusted odds = 1.9; 95%CI = 1.2–2.8) and having ≥ 1 gastroenterology (GI) visit after diagnosis of an adenoma with high-risk features (adjusted odds = 2.6; 95%CI = 1.6–4.2) significantly predicted surveillance colonoscopy completion at 3.5 years. For patients diagnosed with adenomas with high-risk features, surveillance colonoscopy uptake is suboptimal and frequently occurs after the 3-year surveillance recommendation. Patient reminders and visitation with GI after index colonoscopy are associated with timely surveillance completion. Our findings highlight potential health system interventions to increase timely surveillance uptake for patients diagnosed with adenomas with high-risk features.

Health Impact and Cost-Effectiveness of Achieving the National Salt and Sugar Reduction Initiative Voluntary Sugar Reduction Targets in the United States: A Micro-Simulation Study

Circulation ◽  
2021 ◽  
Author(s):  
Siyi Shangguan ◽  
Dariush Mozaffarian ◽  
Stephen Sy ◽  
Yujin Lee ◽  
Junxiu Liu ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Sensitivity Analyses ◽  
Potential Health ◽  
Added Sugar ◽  
Health Gains ◽  
Life Years ◽  
Sugar Reduction

Background: High intake of added sugar is linked to weight gain and cardiometabolic risk. In 2018, the US National Salt and Sugar Reduction Initiative (NSSRI) proposed government supported voluntary national sugar reduction targets. This intervention's potential health and equity impacts, and cost-effectiveness are unclear. Methods: A validated microsimulation model, CVD-PREDICT, coded in C++, was used to estimate incremental changes in type 2 diabetes, cardiovascular disease (CVD), quality-adjusted life-years (QALYs), costs and cost-effectiveness of the NSSRI policy. The model was run at the individual-level, incorporating the annual probability of each person's transition between health status based on their risk factors. The model incorporated national demographic and dietary data from the National Health and Nutrition Examination Survey across 3 cycles (2011-2016), added sugar-related diseases from meta-analyses, and policy costs and health-related costs from established sources. A simulated nationally representative US population was created and followed until age 100 years or death, with 2019 as the year of intervention start. Findings were evaluated over 10 years and a lifetime from healthcare and societal perspectives. Uncertainty was evaluated in a one-way analysis by assuming 50% industry compliance, and probabilistic sensitivity analyses via a second-order Monte Carlo approach. Model outputs included averted diabetes cases, CVD events and CVD deaths, QALYs gained, and formal healthcare cost savings, stratified by age, race, income and education. Results: Achieving the NSSRI sugar reduction targets could prevent 2.48 million CVD events, 0.49 million CVD deaths, and 0.75 million diabetes cases; gain 6.67 million QALYs; and save $160.88 billion net costs from a societal perspective over a lifetime. The policy became cost-effective (<150K/QALYs) at 6 years, highly cost-effective (< 50K/QALYs) at 7 years, and cost-saving at 9 years. Results were robust from a healthcare perspective, with lower (50%) industry compliance, and in probabilistic sensitivity analyses. The policy could also reduce disparities, with greatest estimated health gains per million adults among Black and Hispanic, lower income, and less educated Americans. Conclusions: Implementing and achieving the NSSRI sugar reformation targets could generate substantial health gains, equity gains and cost-savings.

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