Health Economics Review最新文献

{"title":"Catastrophic health expenditures and food insecurity among older cancer survivors in the United States.","authors":"Tae-Young Pak","doi":"10.1186/s13561-025-00596-w","DOIUrl":"10.1186/s13561-025-00596-w","url":null,"abstract":"<p><strong>Background: </strong>Cancer patients face a costly trade-off between medical care and basic necessities including food. This study aims to explore whether catastrophic health expenditures lead to food insecurity among older cancer survivors in the US.</p><p><strong>Methods: </strong>Longitudinal study of individuals aged 50 or older who were diagnosed with cancer during 2000-2020 and their follow-up measurements selected from the Health and Retirement Study. Data consists of 2505 cancer survivors and 11,614 person-year observations for an average of 4.6 observations per participant. Catastrophic health expenditures were defined as out-of-pocket costs exceeding 5%, 10%, or 15% of household income. Participants were classified as food insecure if they experienced insufficient access to food due to financial limitations. This study utilized fixed effects ordered logistic regression to implement a within-subject research design.</p><p><strong>Results: </strong>Of the 2505 cancer survivors, 77 (3.1%) were moderately food insecure and 73 (2.9%) were severely food insecure. In ordered logistic regression, all three measures of catastrophic health expenses were associated with a higher odds of food insecurity. These associations were more pronounced for males, ethnic minorities, survivors without college education, those in fair or poor health, retirees, and survivors with below-median income.</p><p><strong>Conclusions: </strong>The prevalence of food insecurity among older cancer survivors was relatively low, with 6% of the sample experiencing food insecurity. Multivariate regression analyses revealed that a major predictor of food insecurity among older cancer survivors is catastrophic health costs. Given the health benefits of secure food access, older cancer survivors should consult care providers about their financial capacity to afford recommended cancer treatments while maintaining healthy diets. Policymakers should also consider interventions to reduce out-of-pocket financial burden on older cancer survivors, as improved financial security may enhance treatment outcomes and lower cancer-related mortality.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"22"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study \"myo-inositol is a cost-saving strategy for controlled ovarian stimulation in non-polycystic ovary syndrome art patients.\"","authors":"Cesare Aragona, Michele Russo, Samuel H Myers, Maria Salomé Bezerra Espinola, Gabriele Bilotta, Vittorio Unfer","doi":"10.1186/s13561-025-00609-8","DOIUrl":"10.1186/s13561-025-00609-8","url":null,"abstract":"<p><strong>Background: </strong>Fertility care represents a financial burden on patients and healthcare services alike and can represent a barrier to entry for many couples. Controlled ovarian stimulation (COH) is routinely used as part of in vitro fertilization and intracytoplasmic sperm injection (ICSI) procedures, as such the use of gonadotropins is a major contributing factor to the cost of the procedure. Recent studies have shown that myo-Inositol (myo-ins) may reduce the amount of gonadotrophins required in assisted reproductive technology (ART) procedures. This retrospective study measured the effect of myo-ins on the number of recombinant follicular stimulating hormone (rFSH) units used in IVF and ICSI and the relative cost to verify if this may be a cost saving strategy. We also investigated the oocyte and embryo quality, implantation rate, abortion rate, clinical pregnancy, and ovarian hyperstimulation syndrome.</p><p><strong>Methods: </strong>A total of 300 women undergoing either IVF or ICSI were distributed between two distinct and equal patient groups of 150 women. In control group (group A), folic acid (FA) alone was prescribed, meanwhile the treated group (group B) were prescribed FA, myo-Inositol (myo-ins) and alpha-lactalbumin (α-LA), both groups started this oral treatment in the middle of the luteal phase.</p><p><strong>Results: </strong>Myo-Ins supplementation in the treatment group significantly reduced the number of units of rFSH used in COH vs. the control group (2526 vs. 1647, p < 0.05); however, no changes were seen in other measured outcomes, likely due to the short treatment period.</p><p><strong>Conclusions: </strong>The use of myo-Ins presents a safe method for reducing the amount and subsequent costs of rFSH usage in ART protocols.</p><p><strong>Trial registration: </strong>The trial was retrospectively registered with the Institutional Review Board of ALMA RES IVF Center, trial number n°2/2024.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"20"},"PeriodicalIF":2.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of combination therapies involving novel agents for first/second-relapse patients with multiple myeloma: a Markov model approach with calibration techniques.","authors":"Weijia Wu, Fengyuan Tang, Yannan Wang, Wenqianzi Yang, Zixuan Zhao, Yuan Gao, Hengjin Dong","doi":"10.1186/s13561-025-00611-0","DOIUrl":"10.1186/s13561-025-00611-0","url":null,"abstract":"<p><strong>Background: </strong>As the number of randomized clinical trials (RCTs) demonstrating the survival benefits of combination therapies in previously treated multiple myeloma (MM) patients increases, it is essential to determine the most cost-effective treatment through robust economic evaluation. This study aims to assess the cost-effectiveness of combination therapies for first/second-relapse MM patients from the perspective of the Chinese healthcare system.</p><p><strong>Methods: </strong>A Markov model was developed to evaluate three combination therapy groups based on primary drugs (bortezomib, lenalidomide, and carfilzomib). The economic evaluation was conducted within each group individually, rather than across different groups. Clinical inputs for the model were derived from RCT reports, while healthcare costs were sourced from the Zhejiang Province bidding database and a retrospective analysis. Utility values were obtained through an on-site survey using the Chinese version of the EuroQoL Five-dimensional Five-level Questionnaire. One-way and probabilistic sensitivity analyses were performed to assess the robustness of the base-case results.</p><p><strong>Results: </strong>In the bortezomib group, bortezomib-dexamethasone (Vd) yielded 2.42 quality-adjusted life years (QALYs) at a cost of ¥783,775. With a willingness-to-pay (WTP) threshold of three times the 2023 per capita GDP in China (¥258,074), pomalidomide-bortezomib-dexamethasone was the most cost-effective therapy (¥86,129/QALY) in this group. In the lenalidomide group, lenalidomide-dexamethasone (Rd) resulted in 3.06 QALYs at a cost of ¥840,509. Compared to Rd, the incremental cost-effectiveness ratios (ICERs) of elotuzumab-lenalidomide-dexamethasone (¥5,095,300/QALY), ixazomib-lenalidomide-dexamethasone (¥1,605,712/QALY), carfilzomib-lenalidomide-dexamethasone (¥955,255/QALY), and daratumumab-lenalidomide-dexamethasone (¥851,933/QALY) all exceeded the WTP threshold. In the carfilzomib group, carfilzomib-dexamethasone (Kd) resulted in 3.19 QALYs at a cost of ¥1,961,624. Compared to Kd, the ICERs of daratumumab-carfilzomib-dexamethasone (¥2,250,821/QALY) and isatuximab-carfilzomib-dexamethasone (¥4,977,964/QALY) also exceeded the WTP. Sensitivity analyses confirmed the robustness of the base-case results.</p><p><strong>Conclusions: </strong>Although this study did not fully account for the heterogeneity of subsequent treatment regimens among first/second-relapse MM patients, it highlights that the substantial financial burden associated with combination therapies involving novel agents poses a significant challenge in justifying their economic value.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"21"},"PeriodicalIF":2.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the impact of social safety net program on health care utilization in Togo.","authors":"Yaovi Tossou","doi":"10.1186/s13561-025-00597-9","DOIUrl":"10.1186/s13561-025-00597-9","url":null,"abstract":"<p><strong>Background: </strong>The use of health care services by the most vulnerable households in low-and middle-income countries is a major challenge. This includes ensuring access to health services and protecting households from the financial risks of unaffordable medical care. In 2008, Togo put in place a social safety net program which aims to help vulnerable households benefit from cash transfers, free health care services, donated bed nets and food supplements.</p><p><strong>Methods: </strong>The data come from recent national household surveys in Togo. These are the 2018 Harmonized Household Living Conditions Survey (EHCVM). The sample size of the EHCVM survey is 6171 households. Using propensity scores (PSM) and the endogenous switching regression (ESR) model, we find that basic social nets have little direct effect on health care utilization.</p><p><strong>Results: </strong>These results show that households that are beneficiaries of the social safety nets would have had less -80.52% (-0.413/0.5129) use of health care services than if they had not participated in the social safety nets. These results show the indirect effect of the mitigation of social safety nets by policy makers to avoid hunger, malnutrition, poverty, unemployment. All of these strengthen the health status of households by avoiding certain diseases that may lead them to use health care services.</p><p><strong>Conclusion: </strong>This paper provides new evidence on the impact of social safety net programs on household health care utilization. Given the voluntary nature of participation in social safety nets by households, we exploit the uneven deployment of the program in rural areas as a natural experiment to explore causal inference. However, they do ensure good health status of households through different transmission channels, which reduces health care utilization. Policy makers should be encouraged to expand this program to other non-beneficiary groups.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"19"},"PeriodicalIF":2.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of health care utilization, social care utilization and costs for individuals discharged from inpatient geriatric care in Sweden - a registry data study.","authors":"Carl Willers, Rikard Lindqvist, Stefan Fors, Amelie Lindh Mazya, Gunnar H Nilsson, Anne-Marie Boström, Elisabeth Rydwik","doi":"10.1186/s13561-025-00610-1","DOIUrl":"10.1186/s13561-025-00610-1","url":null,"abstract":"<p><strong>Background: </strong>Individuals receiving geriatric care are often frail and afflicted with multiple chronic conditions demanding care from several medical disciplines, and from several different care providing units across the health systems.</p><p><strong>Objective: </strong>To explore the six-month service utilization and direct costs attributed to individuals receiving geriatric inpatient care.</p><p><strong>Methods: </strong>Health care utilization- in terms of inpatient care, outpatient visits with different health care professions- and social care utilization- in terms of social services, and stay at residential care facility (RCF)- were quantified based on registry data, for a cohort admitted to geriatric inpatient care in Stockholm, Sweden during 2016.</p><p><strong>Results: </strong>On average, individuals admitted to geriatric inpatient care in Stockholm had 12.8 inpatient care days, 32.1 visits in outpatient care, 432 h of home care and 28.8 days of staying at RCF, during the first six months after discharge. This amounted to an average cost of 722 thousand Swedish kronor (SEK), € 64 900, in 2023 monetary value. Costs were on average 37% attributable to inpatient care including the initial inpatient stay, 12% to outpatient visits, 38% to social services at home, and 13% to stay at residential care facility (whereof 11% short-term, 89% long-term). Total costs differed significantly between groups based on function, age and main diagnosis.</p><p><strong>Conclusion: </strong>Costs of care for individuals treated at geriatric department are substantial. The variation of cost is also significant; higher age and lower function were associated with higher health care and social care costs. Major cost buckets were inpatient health care (region-financed) and social care at home (municipality-financed).</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"18"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of health insurance reimbursement rates on middle-aged and elderly people's hospital choices: evidence from China.","authors":"Biao Li, Xiang Liang, Xiulin Qi","doi":"10.1186/s13561-025-00606-x","DOIUrl":"10.1186/s13561-025-00606-x","url":null,"abstract":"<p><strong>Background: </strong>Adjusting the health insurance reimbursement rate is essential to optimize the allocation of medical resources. This paper investigates the effect of health insurance reimbursement rates on middle-aged and elderly people's choice of hospitals in China.</p><p><strong>Methods: </strong>This study is conducted using the China Health and Retirement Longitudinal Study (CHARLS) database. This paper uses the widely used ordered logit model for estimation. We build three types of instrumental variables, Bartik instrumental variable, per capita financial income, and health risk perception bias, with the help of the propensity score matching method, aiming at the cleanest possible identification of causal relationship. Furthermore, we use a mediating effects model to investigate the specific mechanism by which the reimbursement rate influences patients' choice of hospitals.</p><p><strong>Results: </strong>Our findings reveal that the higher a hospital's reimbursement rate, the more likely a patient is to choose to seek care. This paper further calculates the marginal effects based on the benchmark regression. For every 1% increase in health insurance reimbursement rates, the probability of patients choosing primary hospitals decreases by 5.75%, choosing secondary hospitals decreases by 1.47%, and choosing tertiary hospitals increases by 7.22%. According to mechanistic analysis, this paper reveals for the first time that health signals from medical checkups significantly impact patients' health care choices. In addition, we discuss the heterogeneity of hospital choices by region, age, and health status.</p><p><strong>Conclusions: </strong>The results mean that when individuals are faced with a multitude of hospitals and are overwhelmed with choices, some small institutional designs can act as a nudge to help policymakers achieve a desirable outcome. The government should fully utilize health insurance's benefit adjustment role and implement a differentiated reimbursement strategy.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"17"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pilot public hospital reform on efficiencies: a DEA analysis of county hospitals in East China, 2009-2015.","authors":"Wei Jiang, Xuyan Lou, Qiulin Chen, Lina Song, Zhuo Chen","doi":"10.1186/s13561-025-00600-3","DOIUrl":"10.1186/s13561-025-00600-3","url":null,"abstract":"<p><strong>Background: </strong>China started a pilot public hospital reform in 2012 to improve governance and efficiency in healthcare services delivery among county-level hospitals. This study aims to investigate the impact of the pilot reform on hospital efficiency and productivity by using a unique dataset of county hospitals in East China during 2009-2015.</p><p><strong>Methods: </strong>A three-stage approach is used. First, this study uses the output-oriented data envelopment analysis (DEA) to estimate hospital efficiency with variable returns to scale. Second, propensity score matching is used to address potential biases associated with the selection of counties for the pilot program. In the third stage, we assess the impact of the pilot reform on efficiency by using a Tobit Difference-in-Differences approach.</p><p><strong>Results: </strong>The average level of hospital efficiency for the whole sample experienced a rapid drop in 2013, then returned to a peak in 2014. Except in the reform year (2012), the overall hospital efficiency for the post-reform period is higher than that for the pre-reform period. The baseline model results show that the pilot reform is associated with a 3% decline in pure technical efficiency and a 2.3% increase in hospital scale efficiency, respectively. Our findings are robust when we apply bootstrapped DEA efficiency scores and use different specifications.</p><p><strong>Conclusion: </strong>The findings of this study suggest no improvements in overall hospital efficiency associated with the pilot reform, possibly due to the combined effects of inefficient governance and hospital scale expansion. This study suggests that further efforts are needed to increase county hospital performance by strengthening management and optimizing resource utiliziation.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"16"},"PeriodicalIF":2.7,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catastrophic and impoverishing out-of-pocket health expenditure in Ethiopia: evidence from the Ethiopia socioeconomic survey.","authors":"Yamlak Bereket Tadiwos, Meseret Molla Kassahun, Anagaw Derseh Mebratie","doi":"10.1186/s13561-025-00602-1","DOIUrl":"10.1186/s13561-025-00602-1","url":null,"abstract":"<p><strong>Background: </strong>Out-of-pocket payment remains one of the ways to finance health care in Ethiopia accounting 31%. These out-of-pocket health expense leads citizens' face catastrophic and impoverishing expenditure. The most recent survey-based study of catastrophic and impoverishing health expenditure was done from the 2015/16 consumption and expenditure survey with finding of 2.1% and 1% respectively.</p><p><strong>Objective: </strong>To assess catastrophic and impoverishing out-of-pocket health expenditure and the determinant factors of catastrophic health expenditure in Ethiopia, 2023 from the 2018/19 socioeconomic survey.</p><p><strong>Methodology: </strong>A secondary data from Ethiopian socioeconomic survey 2018/19 conducted by Ethiopia's Central Statistical Agency and World Bank was used to assess the catastrophic and impoverishing health expenditure at the national and subnational level by the Wagstaff and Van Doorslaer and Xu et al. methodology. Then binary logistic regression was computed by the STATA (ver.12) software to assess the determinant factors of catastrophic health expenditure.</p><p><strong>Result: </strong>From 6770 households 1.49% and 0.89% of them in Ethiopia faced catastrophic and impoverishing health expenditure respectively at 10% threshold level and households having a member with more facility visit had increased likelihood of facing catastrophic health expenditure (AOR = 2.45, 95%CI; 1.6-3.8) and also having member being hospitalized in the household had increased odds of facing catastrophic health expenditure (Adjusted odds ratio, AOR = 1.9, 95% confidence interval, CI; 1.19- 3.16). On the contrary, there is a decreased likelihood of facing catastrophic health expenditure among those who were insured for health (AOR = 0.58, 95%CI; 0.35- 0.97) and was in the richest consumption quintile group (AOR = 0.6, 95%CI; 0.47- 0.65).</p><p><strong>Conclusion and recommendation: </strong>The finding indicates that there are still notable households facing catastrophic and impoverishing out-of-pocket health expenditure in Ethiopia especially in the lower consumption quintiles indicating inequity. In addition it is found that those with health insurance coverage, lower hospitalization and health service utilization had lower chance of facing catastrophic health payment. So it is suggested that activities that reduce hospitalization rate, increase insurance coverage and addressing the poor must be in place so that the catastrophic health cost incurred can be lowered at national level.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"15"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What can we learn about the impact of cancelled planned operations on waiting times? A case study using the 2017/18 winter flu postponement policy in England.","authors":"Maria Ana Matias, Rita Santos, Nils Gutacker, Anne Mason, Nigel Rice","doi":"10.1186/s13561-025-00603-0","DOIUrl":"10.1186/s13561-025-00603-0","url":null,"abstract":"<p><strong>Background: </strong>Cancelled operations can potentially impact both health and patient experience through their effect on waiting times. However, identifying causal relationships is challenging. One possible solution is to consider 'exogenous shocks' to the system as a type of natural experiment to quantify impacts. In this study, we investigate the 2017/18 national cancellation policy in the English National Health Service (NHS), introduced to alleviate winter pressures due to influenza related admissions. Our aim is to see whether this policy can be used to isolate the impact of changes in the supply of care on waiting times and so inform system recovery from major exogenous shocks, such as the coronavirus pandemic.</p><p><strong>Methods: </strong>To assess the impact of cancellations on hospital activity and waiting times, we use aggregate quarterly hospital-level data on planned admissions and last-minute planned operations (2013/14 to 2019/20); and individual-level data on waiting times for planned care (2015/16 to 2018/19). We analyse trends in volume of activity and waiting times, and examine waiting times distributions for patients who were admitted for planned surgery from the waiting list before and after the 2017/18 cancellation policy.</p><p><strong>Results: </strong>The final quarter of 2017/18 had the highest number of cancelled planned operations since 2013/14 and the lowest number of planned admissions since 2015/16. However, the trend in mean and median waiting times was similar across the study period. Therefore, the 2017/18 national postponement policy had no identifiable impact on waiting times trends.</p><p><strong>Conclusions: </strong>Despite the high numbers of cancelled planned operations in 2017/18, we could not identify an impact on waiting times. A plausible explanation is that hospital managers routinely anticipate winter pressures and reduce planned activity to manage bed occupancy. Therefore, the 2017/18 national postponement policy merely reinforced existing local decisions. The lack of a suitable counterfactual from which to infer what would have happened in 2017/18 in the absence of a postponement policy makes it impossible to isolate the impact on waiting times. This means that previous NHS cancellation policies are of limited use for informing system recovery from major exogenous shocks, such as the coronavirus pandemic.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"14"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling epidemiological and economics processes - the case of cervical cancer.","authors":"Franziska Taeger, Lena Mende, Steffen Fleßa","doi":"10.1186/s13561-024-00589-1","DOIUrl":"10.1186/s13561-024-00589-1","url":null,"abstract":"<p><p>Different types of mathematical models can be used to forecast the development of diseases as well as associated costs and analyse the cost-effectiveness of interventions. The set of models available to assess these parameters, reach from simple independent equations to highly complex agent-based simulations. For many diseases, it is simple to distinguish between infectious diseases and chronic-degenerative diseases. For infectious diseases, dynamic models are most appropriate because they allow for feedback from the number of infected to the number of new infections, while for the latter Markov models are more appropriate since this feedback is not required. However, for some diseases, the aforementioned distinction is not as clear. Cervical cancer, for instance, is caused by a sexually transmitted virus, and therefore falls under the definition of an infectious disease. However, once infected, the condition can progress to a chronic disease. Consequently, cervical cancer could be considered an infectious or a chronic-degenerative disease, depending on the stage of infection. In this paper, we will analyse the applicability of different mathematical models for epidemiological and economic processes focusing on cervical cancer. For this purpose, we will present the basic structure of different models. We will then conduct a literature analysis of the mathematical models used to predict the spread of cervical cancer. Based on these findings we will draw conclusions about which models can be used for which purpose and which disease. We conclude that each type of model has its advantages and disadvantages, but the choice of model type often seems arbitrary. In the case of cervical cancer, homogenous Markov models seem appropriate if a cohort of newly infected is followed for a shorter period, for instance, to assess the impact of screening programs. For long-term consequences, such as the impact of a vaccination program, a feedback loop from former infections to the future likelihood of infections is required. This can be done using system dynamics or inhomogeneous Markov models. Discrete event or agent-based simulations can be used in the case of cervical cancer when small cohorts or specific characteristics of individuals are required. However, these models require more effort than Markov or System Dynamics models.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"13"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}