Financial Management for Health-System Pharmacists, 2nd edition, serves as a guidebook to support the management of enterprise pharmacy finance across business and care continuums. The 2nd edition ...engages the reader with a mix of chapters, some new to this edition, along with a trove of new health-system pharmacy financial business cases. As leaders look to transform their organizations, the principles and practices provided give the reader the knowledge and guidance to craft a new path forward as they look to improve the provision of pharmacy and patient-care services.
Guidelines for conducting health economic evaluations have become increasingly standardized, however they don't address the unique concerns of the paediatric population. The challenges of measuring ...costs and consequences in children, from neonate to late adolescence, are numerous and complex. With the growing acceptance of economic evidence to guide decisions in health systems facing economic constraints, it is imperative that these challenges be considered so that this population is not left out of evidence-based decisions. The time has come for a textbook to address economic evaluation in child health. This book is divided into three sections: Methods, Applications, and Using evidence for decision-making, with chapters contributed by international experts. The Methods section presents detailed discussions of measuring lifetime costs and consequences, capturing productivity losses, obtaining unbiased self- and proxy reports, incorporating externalities, choosing valid outcome measures, assessing utility, and designing studies using value of information. The Applications section reviews economic evidence in common childhood conditions and areas of investigation, including newborn screening, harm prevention, mental health services, brain injury, asthma, and immunization. The final section explores the use of economic evidence in decision-making, and includes a description of the WHO-CHOICE approach, the role of clinical research, how to value health gains by children, and the emerging field of health technology assessment. In addition to an emphasis on methods, a deliberate effort was made to include issues relevant to developing countries, where the burden of childhood disease is greatest, and for whom high quality economic evidence is critical. Available in OSO: http://www.oxschol.com/oso/public/content/publichealthepidemiology/9780199547494/toc.html Contributors to this volume - Moses Aikins, Senior Lecturer, School of Public Health, Department of Health Policy, Planning and Management, College of Health Sciences, University of Ghana, Legon, Accra, Ghana Philippe Beutels, Senior Lecturer, Health Economics, Centre for Health Economics Research and Modeling Infectious Diseases (CHERMID), Centre for the Evaluation of Vaccination (CEV), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium Katherine B. Bevans, Assistant Research Professor, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, USA Robert E. Black, Edgar Berman Professor and Chair, Johns Hopkins Bloomberg School of Public Health, Department of International Health, Johns Hopkins University, Baltimore, USA Werner B.F. Brouwer, Department of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Medical Centre / Erasmus University, Rotterdam, The Netherlands Sarah Byford, Senior Lecturer, King's College London, Institute of Psychiatry, De Crespigny Park, London, UK Jonathan D. Campbell, Senior Post-Doctoral Fellow, Pharmaceutical Outcomes, Research and Policy Program, School of Pharmacy, University of Washington, Seattle, USA Vania Costa, Research Associate, Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada Gillian Currie, Assistant Professor, Faculty of Medicine, Departments of Paediatrics and Community Health Sciences, University of Calgary, Calgary, Canada Sarah Curtis, Assistant Professor, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Alberta, Edmonton, Canada Kim Dalziel, Senior Research Fellow, Health Economics and Policy Group, Division of Health Sciences, University of South Australia, Adelaide, Australia David B. Evans, Director, Department of Health Systems Financing, World Health Organization, Geneva, Switzerland Christopher B. Forrest, Mary D. Ames Professor of Pediatrics and Advocacy, The Children's Hospital of Philadelphia, Philadelphia, USA Tessa Tan-Torres Edejer, Coordinator, Costs, Effectiveness, Expediture and Priority Setting (CEP), Health System Financing, Health Systems and Services, World Health Organization, Geneva, Switzerland E. Michael Foster, Professor, Maternal and Child Health and Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill, USA Andreas Gerber, Institute for Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany Y. Ingrid Goh, Department of Pharmaceutical Science, University of Toronto, Division of Clinical Pharmacology & Toxicology, The Hospital for Sick Children, Toronto, Canada Scott D. Grosse, Senior Health Economist, Office of the Director, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, National Center on Birth Defects and Developmental Disabilities, Atlanta, USA Raymond Hutubessy, Economist, Initiative for Vaccine Research (IVR), World Health Organization (WHO), Geneva, Switzerland Terry Klassen, Professor and Chair, Regional Program Clinical Director Child Health, Capital Health, Department of Pediatrics, University of Alberta, Edmonton, Canada Gideon Koren, Senior Scientist and Director, The Motherisk Program, Professor of Medicine, Pediatrics and Physiology/Pharmacology, The University of Toronto, Ivey Chair in Molecular Toxicology, The University of Western Ontario, The Hospital for Sick Children, Toronto, Canada Stavros Petrou, Health Economist, National Perinatal Epidemiology Unit, University of Oxford (Old Road Campus), Oxford, England Ali I. Raja, Assistant Professor, Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, USA Leonie Segal, Professor, Health Economics, Health Economics and Policy Group, Division of Health Sciences, University of South Australia, Adelaide, Australia Donald S. Shepard, Professor, Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, USA Jose A. Suaya, Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, USA Sean D. Sullivan, Professor of Pharmacy, Public Health and Medicine; Director, Pharmacetical Outcomes Research and Policy Program, School of Pharmacy, University of Washington, Seattle, USA Lillian Sung, Scientist and Assistant Professor, Department of Paediatrics, University of Toronto, Department of Paediatric Haematology/Oncology, Division of Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada J. Mick Tilford, Associate Professor, Department of Pediatrics and Health Policy Management, College of Medicine, University of Arkansas for Medical Sciences, Center for Applied Research and Evaluation, Little Rock, USA Wendy J. Ungar, Senior Scientist, Associate Professor, The Hospital for Sick Children Research Institute, University of Toronto, Division of Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada N. Job A. van Exel, MSc, Health Economist, Department of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Medical Centre / Erasmus University, Rotterdam, The Netherlands Damian G. Walker, Professor, Health Economics, Health Systems Program, Bloomberg School of Public Health, Department of International Health, Johns Hopkins University, Baltimore, USA Andrew R. Willan, Senior Scientist and Professor, Public Health Sciences, University of Toronto, The Hospital for Sick Children Research Institute, Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada Lara J. Wolfson, Scientist, Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland
As health costs in the U.S. soar past $1.5 trillion, much evidence indicates that the nation does not get good value for its money. It is widely agreed that we could do better by using cost-effective ...analysis (CEA) to help determine which health care services are most worthwhile. American policy makers, however, have largely avoided using CEA, and researchers have devoted little attention to understanding why this is so. By considering the economic, social, legal, and ethical factors that contribute to the situation, and how they can be negotiated in the future, this book offers a unique perspective. It traces the roots of EA in health and medicine, describes its promise for rational resource allocation, and discusses the nature of the opposition to it, using Medicare and the Oregon health plans as examples. In exploring the disconnection between the promise of CEA and the persistent failure of rational intentions, the book seeks to find common ground and practical solutions. It analyzes the prospects for change and presents a roadmap for getting there. It offers pragmatic advice for cost-effectiveness analysts, discussing ways in which they can better translate their research findings into the basis for action. The book also offers advice for policy makers and politicians, including lessons from Europe, Canada, and Australia, and underlines the need for leadership to establish the conditions for change. Available in OSO: http://www.oxschol.com/oso/public/content/publichealthepidemiology/9780195171860/toc.html
The burden of skin disease in the United States Lim, Henry W., MD; Collins, Scott A.B., MD; Resneck, Jack S., MD ...
Journal of the American Academy of Dermatology,
05/2017, Letnik:
76, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Since the publication of the last US national burden of skin disease report in 2006, there have been substantial changes in the practice of dermatology and the US health care system. These include ...the development of new treatment modalities, marked increases in the cost of medications, increasingly complex payer rules and regulations, and an aging of the US population. Recognizing the need for up-to-date data to inform researchers, policy makers, public stakeholders, and health care providers about the impact of skin disease on patients and US society, the American Academy of Dermatology produced a new national burden of skin disease report. Using 2013 claims data from private and governmental insurance providers, this report analyzed the prevalence, cost, and mortality attributable to 24 skin disease categories in the US population. In this first of 3 articles, the presented data demonstrate that nearly 85 million Americans were seen by a physician for at least 1 skin disease in 2013. This led to an estimated direct health care cost of $75 billion and an indirect lost opportunity cost of $11 billion. Further, mortality was noted in half of the 24 skin disease categories.
Health care in the United States is more expensive than in other developed countries, costing $2.7 trillion in 2011, or 17.9 percent of the national gross domestic product. Increasing costs strain ...budgets at all levels of government and threaten the solvency of Medicare, the nation's largest health insurer. At the same time, despite advances in biomedical science, medicine, and public health, health care quality remains inconsistent. In fact, underuse, misuse, and overuse of various services often put patients in danger.
Many efforts to improve this situation are focused on Medicare, which mainly pays practitioners on a fee-for-service basis and hospitals on a diagnoses-related group basis, which is a fee for a group of services related to a particular diagnosis. Research has long shown that Medicare spending varies greatly in different regions of the country even when expenditures are adjusted for variation in the costs of doing business, meaning that certain regions have much higher volume and/or intensity of services than others. Further, regions that deliver more services do not appear to achieve better health outcomes than those that deliver less.
Variation in Health Care Spending investigates geographic variation in health care spending and quality for Medicare beneficiaries as well as other populations, and analyzes Medicare payment policies that could encourage high-value care. This report concludes that regional differences in Medicare and commercial health care spending and use are real and persist over time. Furthermore, there is much variation within geographic areas, no matter how broadly or narrowly these areas are defined. The report recommends against adoption of a geographically based value index for Medicare payments, because the majority of health care decisions are made at the provider or health care organization level, not by geographic units. Rather, to promote high value services from all providers, Medicare and Medicaid Services should continue to test payment reforms that offer incentives to providers to share clinical data, coordinate patient care, and assume some financial risk for the care of their patients.
Medicare covers more than 47 million Americans, including 39 million people age 65 and older and 8 million people with disabilities. Medicare payment reform has the potential to improve health, promote efficiency in the U.S. health care system, and reorient competition in the health care market around the value of services rather than the volume of services provided. The recommendations of Variation in Health Care Spending are designed to help Medicare and Medicaid Services encourage providers to efficiently manage the full range of care for their patients, thereby increasing the value of health care in the United States.
Now in its fourth edition, The Economics of Health Reconsidered presents an argument that still holds true: despite assertions to the contrary, neither economic theory nor evidence shows that ...reliance on market forces leads to superior outcomes in healthcare systems. Government plays a crucial role in making the healthcare sector not only more equitable but also more efficient. This book reconsiders the field of health economics as it is traditionally taught and practiced. It critically examines economic theory as applied to the health sector and questions the prevailing belief that a competitive healthcare marketplace results in the best outcomes. Fully revised and updated, this new edition incorporates information on the impact of the implementation of the Affordable Care Act as well as: A new chapter on healthcare expenditures, which examines healthcare spending in the United States and in other high-income countries, including the magnitude, growth, and causes of high expenditures and the different policies that have been used or proposed to help control them A new chapter that describes the various types of economic evaluation currently used in healthcare, discusses the issues that arise with the use of economic evaluations, and provides information on how to conduct an economic evaluation New and updated data throughout chapters and exhibits This book serves as an ideal stand-alone text for health economics and health policy courses and as a general reference for issues in health economics.
•R&D costs of 106 new drugs were obtained from a survey of 10 biopharmaceutical firms.•Costs for compounds that were abandoned were linked to costs of approved compounds.•Pre-tax out-of-pocket per ...approval is $1395 million (2013 dollars).•Pre-tax capitalized per approval is $2558 million (2013 dollars).•Total capitalized costs were found to have increased at a real annual rate of 8.5%.•With post-approval R&D costs the estimate increases to $2870 million (2013 dollars).
The research and development costs of 106 randomly selected new drugs were obtained from a survey of 10 pharmaceutical firms. These data were used to estimate the average pre-tax cost of new drug and biologics development. The costs of compounds abandoned during testing were linked to the costs of compounds that obtained marketing approval. The estimated average out-of-pocket cost per approved new compound is $1395 million (2013 dollars). Capitalizing out-of-pocket costs to the point of marketing approval at a real discount rate of 10.5% yields a total pre-approval cost estimate of $2558 million (2013 dollars). When compared to the results of the previous study in this series, total capitalized costs were shown to have increased at an annual rate of 8.5% above general price inflation. Adding an estimate of post-approval R&D costs increases the cost estimate to $2870 million (2013 dollars).
To estimate the proportion of healthcare-associated infections (HAIs) in US hospitals that are "reasonably preventable," along with their related mortality and costs.
To estimate preventability of ...catheter-associated bloodstream infections (CABSIs), catheter-associated urinary tract infections (CAUTIs), surgical site infections (SSIs), and ventilator-associated pneumonia (VAP), we used a federally sponsored systematic review of interventions to reduce HAIs. Ranges of preventability included the lowest and highest risk reductions reported by US studies of "moderate" to "good" quality published in the last 10 years. We used the most recently published national data to determine the annual incidence of HAIs and associated mortality. To estimate incremental cost of HAIs, we performed a systematic review, which included costs from studies in general US patient populations. To calculate ranges for the annual number of preventable infections and deaths and annual costs, we multiplied our infection, mortality, and cost figures with our ranges of preventability for each HAI.
As many as 65%-70% of cases of CABSI and CAUTI and 55% of cases of VAP and SSI may be preventable with current evidence-based strategies. CAUTI may be the most preventable HAI. CABSI has the highest number of preventable deaths, followed by VAP. CABSI also has the highest cost impact; costs due to preventable cases of VAP, CAUTI, and SSI are likely less.
Our findings suggest that 100% prevention of HAIs may not be attainable with current evidence-based prevention strategies; however, comprehensive implementation of such strategies could prevent hundreds of thousands of HAIs and save tens of thousands of lives and billions of dollars.
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