Value in health regional issues最新文献

{"title":"Estimating the Costs of End-of-Life Care in Patients With Advanced Cancer From the Perspective of an Insurance Organization: A Cross-Sectional Study in Iran","authors":"Ali Zafari MD ,&nbsp;Parisa Mehdizadeh PhD ,&nbsp;Mohammadkarim Bahadori PhD ,&nbsp;Nooredin Dopeykar MSc ,&nbsp;Ehsan Teymourzadeh PhD ,&nbsp;Ramin Ravangard PhD","doi":"10.1016/j.vhri.2023.11.006","DOIUrl":"10.1016/j.vhri.2023.11.006","url":null,"abstract":"<div><h3>Objectives</h3><p><span>Cancers are significant medical conditions that contribute to the rising costs of healthcare systems and chronic diseases. This study aimed to estimate the average costs of medical services provided to patients with advanced cancers at the </span>end of life (EOL).</p></div><div><h3>Methods</h3><p>We analyzed data from the Sata insurance claim database and the Health Information System of Baqiyatallah hospital in Iran. The study included all adult decedents who had advanced cancer without comorbidities, died between March 2020 and September 2020, and had a history of hospitalization in the hospital. We calculated the average total cost of healthcare services per patient during the EOL period, including both cancer-related and noncancer-related costs.</p></div><div><h3>Results</h3><p>A total of 220 patients met the inclusion criteria. The average duration of the EOL period for these patients was 178 days, with an average total cost of $8278 (SD $5698) for men and $9396 (SD $6593) for women. Cancer-related costs accounted for 64.42% of the total costs, including inpatient and outpatient services. Among these costs, hospitalization was the primary cost driver and had the greatest impact on EOL costs. This observation was supported by the multiple linear regression<span> model, which suggested that hospitalization in the final days of life could potentially drive costs in these patients. Notably, no specialized palliative care was provided to the patients included in this study.</span></p></div><div><h3>Conclusions</h3><p>The results demonstrate that there is a significant rise in costs of care in patients receiving routine cancer care rather than optimized EOL care.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Evaluation of Neoadjuvant Versus Adjuvant Chemotherapy in Cancer Treatment: A Systematic Review and Meta-Analysis","authors":"Dongdong Wu PhD ,&nbsp;Na Wang PhD ,&nbsp;Rufu Xu PhD ,&nbsp;Guoqiong Huang PhD ,&nbsp;Ying Li PhD ,&nbsp;Chunji Huang PhD","doi":"10.1016/j.vhri.2023.11.005","DOIUrl":"10.1016/j.vhri.2023.11.005","url":null,"abstract":"<div><h3>Objectives</h3><p><span><span>In the absence of evidence on whether neoadjuvant (NAC) or adjuvant chemotherapy (AC) is more beneficial for various </span>tumor treatments<span>, economic evaluation (EE) can assist medical decision making. There is limited evidence on their cost-effectiveness and their prospective evaluation is less likely in the future. Therefore, a </span></span>systematic review<span><span> and meta-analysis about EE for NAC versus AC in </span>solid tumor help compare these therapies from various perspectives.</span></p></div><div><h3>Methods</h3><p>Various databases were searched for studies published from inception to 2021. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines and economic-specific guidelines. The data were pooled using a random effects model when possible.</p></div><div><h3>Results</h3><p><span>The retrieval identified 15 EE studies of NAC versus AC in 8 types of cancer. NAC is the dominant strategy for pancreatic, head and neck, rectal, prostate cancers and </span>colorectal liver metastases. For ovarian cancer, NAC is cost-effective with a lower cost and higher or similar quality-adjusted life-year. There were no significant differences in cost and outcomes for lung cancer. For stage IV or high-risk patients with ovarian or prostate cancer, NAC was cost-effective but not for patients who were not high risk.</p></div><div><h3>Conclusions</h3><p>The EEs results for NAC versus AC were inconsistent because of their different model structures, assumptions, cost inclusions, and a shortage of studies. There are multiple sources of heterogeneity across EEs evidence synthesis. More high-quality EE studies on NAC versus AC in initial cancer treatment are necessary.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Toxicity Experiences of Patients With Cancer in Indonesia: An Interpretive Phenomenological Analysis","authors":"Stevanus Pangestu MBA ,&nbsp;Enggar Putri Harjanti MA ,&nbsp;Ika Hana Pertiwi MA ,&nbsp;Fanni Rencz MD, PhD ,&nbsp;F.A. Nurdiyanto MA","doi":"10.1016/j.vhri.2023.11.007","DOIUrl":"10.1016/j.vhri.2023.11.007","url":null,"abstract":"<div><h3>Objectives</h3><p>Financial toxicity (FT) is an important adverse effect of cancer. Recent systematic reviews have shown that FT may lead to treatment nonadherence and impaired health-related quality of life, both of which may adversely influence the survival rates of patients. However, less is known about how patients endure FT, particularly in low- and middle-income countries. The purpose of this study was to explore how patients with cancer experience and cope with FT in Indonesia.</p></div><div><h3>Methods</h3><p>Semistructured in-depth interviews were conducted to explore the experiences of Indonesian patients with cancer. Qualitative data were analyzed using interpretive phenomenological analysis approach. We purposefully recruited 8 patients undergoing active treatment (aged 27-69 years) who had been diagnosed of cancer over 5 years before and possessed health insurance at the time of diagnosis.</p></div><div><h3>Results</h3><p>We identified 2 main themes: (1) the experienced financial burden, with subthemes underinsurance, out-of-pocket nonhealthcare cancer-related costs, and negative income effect from employment disruption, and (2) the financial coping strategies, with subthemes reallocating household budget, seeking family support, rationalizing treatment decisions, and topping up insurance for family members.</p></div><div><h3>Conclusions</h3><p>This is the first interpretive phenomenological study on FT in the literature and the first qualitative FT study in Indonesia. Our findings provide insight into the occurrence of FT and coping strategies used by Indonesian patients with cancer. The subjective experiences of patients may be considered to further improve oncology care, support the need for measurement of FT, and provide mitigation programs for patients.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001310/pdfft?md5=1ebaa4776c46e4bad2aa3d4e3c1200a2&pid=1-s2.0-S2212109923001310-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking to the Future: A Vision for Value in Health Regional Issues","authors":"Manuel A. Espinoza MD, MSc, PhD","doi":"10.1016/j.vhri.2023.11.008","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.11.008","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001322/pdfft?md5=bddfd5c10fbe493d5f5ffe680eca530a&pid=1-s2.0-S2212109923001322-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138656825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Comprehensive Genomic Profiling in Patients With Non–Small Cell Lung Cancer for the Colombian Health System","authors":"Oscar Gamboa MD, MSc ,&nbsp;Carlos Eduardo Bonilla MD ,&nbsp;David Quitian MSc ,&nbsp;Gabriel Fernando Torres MD, MSc ,&nbsp;Giancarlo Buitrago MD, MSc, PhD ,&nbsp;Andrés F. Cardona MD, MSc, PhD, MBA","doi":"10.1016/j.vhri.2023.08.006","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.08.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The use of comprehensive genomic profiling (CGP) and target therapies is associated with substantial improvements in clinical outcomes among patients with non–small cell lung cancer (NSCLC). However, the costs of CGP may increase the financial pressures of NSCLC on health systems worldwide, especially in low- and middle-income countries. This study aimed to estimate the cost-effectiveness of CGP compared with current genomic tests in patients with NSCLC from the perspective of the Colombian Health System.</p></div><div><h3>Methods</h3><p>To estimate the costs and benefits of CGP and its comparators, we developed a 2-stage cohort model with a lifetime horizon. In the first stage, we made up a decision tree that calculated the probability of receiving each therapy as result of identifying a specific, actionable target. In the second stage, we developed a partitioned survival model that estimated the time spent at each health state. Incremental cost-effectiveness ratios were calculated for life-years (LYs) and quality-adjusted LYs gained. All costs were expressed in 2019 international dollars (INT$).</p></div><div><h3>Results</h3><p>CGP is associated with gains of 0.06 LYs and 0.04 quality-adjusted LYs compared with current genomic tests. Incremental cost-effectiveness ratios for CGP ranged from INT$861 to INT$7848, depending on the outcome and the comparator. Sensitivity analyses show that the cost-effectiveness decision was sensitive to prices of CGP above INT$7170 per test. These results are robust to most deterministic and probabilistic sensitivity analyses.</p></div><div><h3>Conclusions</h3><p>CGP may be cost-effective in patients with NSCLC from the perspective of the Colombian Health System (societal willingness-to-pay threshold of INT$15 630 to INT$46 890).</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923000833/pdfft?md5=2525e36a2908ad4c914d869b62f44145&pid=1-s2.0-S2212109923000833-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138657140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central America and the Dominican Republic at Crossroads: The Importance of Regional Cooperation and Health Economic Research to Address Current Health Challenges","authors":"Jose Miranda PhD ,&nbsp;Oscar Morales Barahona PhD ,&nbsp;Alejandro Barahona Krüger MSc ,&nbsp;Pilar Lagos MSc ,&nbsp;Rodrigo Moreno-Serra PhD","doi":"10.1016/j.vhri.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.11.001","url":null,"abstract":"<div><h3>Objectives</h3><p>We discuss key health challenges currently faced by countries in the Central America and Dominican Republic region after the COVID-19 pandemic. We highlight the influence of socioeconomic determinants for the challenging public health dynamics observed and the crucial roles that regional cooperation and health economic research can have for tackling such challenges.</p></div><div><h3>Methods</h3><p>We present a descriptive overview of the current situation of public finances and its effect on government capacity to improve social expenditure. We also discuss the impact of the COVID-19 pandemic crisis on social dynamics and living conditions in the region.</p></div><div><h3>Results</h3><p>Our analysis suggests that the interplay between all these factors is likely to have important consequences for health systems and population health in the post-pandemic period. Previous examples of successful cross-country cooperation in the region indicate the great potential that these initiatives have for supporting health system resilience against current challenges. Technical cooperation must be informed by (currently unavailable) research evidence that can guide decision making, especially health economic research to support national health resource allocation policies. Areas identified as priorities for applied health economic research include both macro and microeconomic analyses.</p></div><div><h3>Conclusions</h3><p>Central America and the Dominican Republic face significant health challenges post-pandemic. Our article emphasizes the great potential that regional technical cooperation, informed by further health economic research, has to improve public policies and health governance in the region.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221210992300122X/pdfft?md5=a09a54c0e13bec7e1b73d4196bd00f7c&pid=1-s2.0-S221210992300122X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138570299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forging Partnership Between Health Economics Researchers and Policy Makers: Better Methods, Better Policy, Better Health","authors":"Paul Revill MSc ,&nbsp;Manuel A. Espinoza MD, MSc, PhD","doi":"10.1016/j.vhri.2023.11.002","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.11.002","url":null,"abstract":"","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001231/pdfft?md5=7aece29777c5c25cda6a2cb167ad4019&pid=1-s2.0-S2212109923001231-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138548837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping Review of Health Economics Research on Refugee Health in Sub-Saharan Africa","authors":"Wiktoria Tafesse PhD ,&nbsp;Julie Jemutai PhD ,&nbsp;Chrispus Mayora PhD ,&nbsp;Federica Margini MSc Public Health","doi":"10.1016/j.vhri.2023.10.008","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.10.008","url":null,"abstract":"<div><h3>Objectives</h3><p>Most refugees and internally displaced people (IDP) stay in low- and middle-income settings. A substantial proportion are hosted by countries in sub-Saharan African (SSA), which puts significant pressure on limited government healthcare budgets. As health economics may guide more optimal healthcare decision making, we scope the health economics literature on forcibly displaced populations in SSA to identify the nature and range of health economics evidence.</p></div><div><h3>Methods</h3><p>We conducted a scoping review of peer-reviewed and gray literature in English published from 2000 to 2021. Our search terms comprised a combination of keywords related to refugees, SSA, and health economics. We followed a stepwise methodology consisting of the identification and selection of studies, extraction and charting of data.</p></div><div><h3>Results</h3><p>We identified 29 health economics studies on refugees and IDPs in SSA covering different providers, interventions, and delivery platforms. Twenty-one articles studied the determinants of health, followed by 5 on the supply of healthcare and 2 concerned with economic evaluation and the demand for healthcare, respectively. We found an equal division of articles focusing on refugees and IDPs, as well as by settlement type. Mental health was the most frequently studied health area and Uganda was the most studied destination country.</p></div><div><h3>Conclusions</h3><p>The health economics literature on refugees in SSA remains limited. Our scoping review encourages future research to study a larger variety of healthcare systems and health economic topics such as economic evaluations, health financing and whole health systems to support resource allocation decisions and sustainable long-term solutions.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001218/pdfft?md5=e5280509f1669d3fcc1b544f2fbb262d&pid=1-s2.0-S2212109923001218-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138549986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Vulnerability Index for Mitigation and Prevention of Diabetes Growth in India: A Disaggregated Analysis","authors":"Sujata Sujata PhD ,&nbsp;Gayathri B. PhD ,&nbsp;Ramna Thakur PhD","doi":"10.1016/j.vhri.2023.09.009","DOIUrl":"https://doi.org/10.1016/j.vhri.2023.09.009","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to provide a vulnerability index (VI) for identifying vulnerable regions in different states of India, which may serve as a tool for state- and district-level planning for mitigation and prevention of diabetes growth in the country.</p></div><div><h3>Methods</h3><p>Using data on 13 indicators under 4 domains, we generated domain-specific and overall VIs at state (36 states/union territories) and district levels (640 districts) using the percentile ranking method. The association of diabetes with individuals’ socioeconomic status at different levels of regional vulnerability has also been observed through multivariable logistic regression models.</p></div><div><h3>Results</h3><p>On a scale of 0 to 1, there are 13 states with an overall VI of &gt;0.70, of which 5 states are from southern regions of India. A low VI has been achieved by socioeconomically backward states. We observed that prevalence rates and vulnerability levels for most of the top and bottom 11 states are in the same line. District-level analysis showed that the 20 most vulnerable and least vulnerable districts are mostly from coastal and socioeconomically backward states of the country, respectively. Furthermore, logistic regression revealed that rural adults and females are less likely to be diabetic in all vulnerability quartiles. The oldest, Muslims, wealthiest, widowed/deserted/separated, and those with schooling ≤12 years are significantly more likely to be diabetic than their counterparts.</p></div><div><h3>Conclusion</h3><p>The constructed VI is vital for identifying vulnerable areas and planners and policy-makers may use this comprehensive index and domain-specific VIs to prioritize resource allocation.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138548838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Utility Analysis of Continuous Positive Airway Pressure Therapy Compared With Usual Care for Obstructive Sleep Apnea in the Public Health System in Brazil","authors":"Daniela V. Pachito PhD ,&nbsp;Alan L. Eckeli PhD ,&nbsp;Luciano F. Drager PhD","doi":"10.1016/j.vhri.2023.10.006","DOIUrl":"10.1016/j.vhri.2023.10.006","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to conduct a cost-utility analysis of continuous positive airway pressure (CPAP) therapy compared with usual care as treatment of moderate to severe cases of obstructive sleep apnea (OSA) in Brazil, where decentralized policies of CPAP provision are in place.</p></div><div><h3>Methods</h3><p>Markov cohort model comparing CPAP therapy with usual care, that is, no specific treatment for OSA, for moderate to severe cases was used. The payer perspective from the Unified Health System, Brazil, was adopted. Effectiveness parameters and costs related to health states were informed by literature review. Resource use related to CPAP therapy was defined by specialists and costs informed by recent purchase and leasing contracts. Incremental cost-effectiveness ratios were generated for purchase and leasing contracts to reflect current practices. A conservative willingness-to-pay threshold was set at 1 gross domestic product per capita per quality-adjusted life-year (QALY) (Brazilian reais [BRL] 40 712/QALY). Uncertainties were explored in deterministic and probabilistic sensitivity analyses.</p></div><div><h3>Results</h3><p>Incremental cost-effectiveness ratio for the purchase modality was 8303 BRL/QALY and for leasing 45 192 BRL/QALY. Considering the adopted willingness-to-pay threshold, provision of CPAP by the purchase modality was considered cost-effective but not the leasing modality. The parameter related to the greatest uncertainty was the reduction in the risk of having a stroke attributable to CPAP. Probabilistic analysis confirmed the robustness of results.</p></div><div><h3>Conclusions</h3><p>CPAP therapy is a cost-effective alternative compared with usual care for moderate to severe OSA for the purchase modality. These results should help underpinning the decision making related to a uniform policy of CPAP provision across the country.</p></div>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212109923001152/pdfft?md5=4f792c3eb3609947978b28df0890629f&pid=1-s2.0-S2212109923001152-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}