European Journal of Health Economics最新文献

{"title":"How perceptions of bone marrow donation costs affect donation behavior: survey evidence from a large donor registry.","authors":"Michael Haylock, Patrick Kampkötter, Mario Macis, Susanne Seitz, Robert Slonim, Edith Wienand, Daniel Wiesen, Alexander H Schmidt","doi":"10.1007/s10198-025-01785-4","DOIUrl":"https://doi.org/10.1007/s10198-025-01785-4","url":null,"abstract":"<p><p>Over the past three decades, advancements in collection methods for hematopoietic stem cell transplantation substantially reduced invasiveness and safety concerns. To what extent, however, registered donors are informed about extraction methods and how their beliefs drive their willingness to follow through with a donation is not well understood. Inaccurate beliefs about extraction methods may cause donors to overestimate their perceived cost, potentially reducing donations. In a survey with about 24,000 potential donors in Germany's largest stem-cell registry, we investigate how beliefs about extraction methods affect potential donors' willingness to follow through with a stem cell donation. We find widespread misconceptions about extraction methods, with many donors attributing a significant fraction of stem cell extractions to be coming from never-used methods. Importantly, a lack of knowledge and misconceptions about extraction methods persist among registered donors, often anchored to methods that prevailed at the time of registration. Exploring the link between donors' beliefs and their (stated) willingness to donate, we find that accurate beliefs about lower extraction costs correlate with a 2.2-2.9 percentage points higher willingness to donate, representing a 40% reduction in donor unavailability. Our results highlight the need for informational campaigns to correct donors' misconceptions and potentially save more lives among blood cancer patients.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investment gaps in antimicrobial resistance research & development: trends in Europe, 2017-2021.","authors":"Elisa Fabbro, Usha Lamichhane, Ralf Sudbrak, Lesley Ogilvie, Antonio Vitiello, Andrea Zovi, Michela Sabbatucci","doi":"10.1007/s10198-025-01796-1","DOIUrl":"https://doi.org/10.1007/s10198-025-01796-1","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance (AMR) remains one of the world's most pressing health, economic, and social challenges. To combat this crisis, innovative tools have been developed to enhance research and development (R&D) efforts like the Global AMR R&D Hub's Dynamic Dashboard. By aggregating data from projects worldwide, the Dynamic Dashboard highlights trends and gaps in AMR R&D investments, totalling more than 8.22 billion Euros in the period 2017-2021 across the One Health continuum - human, animal, plant and environment. Launched in March 2020, the Dynamic Dashboard supports global priority setting and decision-making in AMR research, fostering strategic planning to promote efficient use of international resources and cross sectoral collaboration in AMR R&D.</p><p><strong>Methods: </strong>Recognizing the urgent need for innovative diagnostics, treatments, and prevention strategies against AMR, here we presented a comprehensive analysis of public and philanthropic investments in AMR R&D obtained from January 2017 to December 2021 across Europe.</p><p><strong>Results: </strong>We calculated the investments by One Health sector, year of funding, gross domestic product (GDP), research area, type of project, and infectious agent to raise awareness and promote global visibility of the R&D landscape in Europe. Our analysis revealed limited AMR R&D investments in the non-human sectors and non-bacterial topics, geographical polarization of funders, and some unaligned trends between the amount of investments and number of projects funded over the study period.</p><p><strong>Discussion: </strong>Harnessing these data-driven insights, we aimed to inform stakeholders and optimize the allocation of economic resources for AMR R&D. Prioritizing unmet needs with the greatest potential for impact in this field will expedite the development of effective solutions to mitigate the global threat of AMR.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering the health divide: examining the influence of poverty risk and income inequality on health outcomes in over 300 Finnish municipalities.","authors":"Saqib Amin","doi":"10.1007/s10198-025-01780-9","DOIUrl":"https://doi.org/10.1007/s10198-025-01780-9","url":null,"abstract":"<p><p>The relationship between poverty, income inequality, and health outcomes has been extensively explored in the literature, primarily focusing on cross-country comparisons. However, findings from within-country analyses have yielded inconsistent results. This study investigates the association between poverty risk, income inequality, and health outcomes using Finnish municipality-level data from 1990 to 2023. Fixed-effect models are used to reveal a concerning interplay between these factors by utilizing measures of poverty risk, income inequality, and their synergistic effect, alongside a comprehensive set of health outcome indicators. The findings reveal a significant strong association between both poverty risk and income inequality with various health indicators. Moreover, the analysis also demonstrates a strong combined influence of poverty and inequality, indicating that their combined effect on negative health outcomes is more pronounced. These findings suggest that policies promoting social mobility and reducing income inequality may lead to a healthier Finnish population, particularly low-income residents, with a lower burden of chronic diseases and mortality.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economics of hypothalamic obesity in patients with craniopharyngioma and other rare sellar/suprasellar tumors.","authors":"Julian Witte, Nicolas Touchot, Bastian Surmann, Kylie Braegelmann, Mathias Flume, Julia Beckhaus, Carsten Friedrich, Hermann L Müller","doi":"10.1007/s10198-025-01786-3","DOIUrl":"https://doi.org/10.1007/s10198-025-01786-3","url":null,"abstract":"<p><strong>Background: </strong>Rapid and abnormal weight gain resulting in severe persistent obesity due to physical, tumor- and/or treatment-related damage to the hypothalamus, is called acquired hypothalamic obesity (aHO), and is often linked to craniopharyngioma and/or sellar/suprasellar tumors. Here, we examine the healthcare resource use (HCRU) and costs of aHO following treatment of these tumors.</p><p><strong>Methods: </strong>We used a retrospective matched cohort design with German statutory health insurance data on 5.42 million people from 2010 to 2021. We applied a novel three-step approach using diagnostic and prescription data to identify patients with treatment- or tumor-related (TTR)-aHO. We measured HCRU and costs across hospitalizations, outpatient visits, visits per specialist group, and outpatient prescription medications.</p><p><strong>Results: </strong>Compared to non-HO obesity, TTR-aHO is associated with increased hospitalizations, increased outpatient physician visits, and increased prescription use in the two years after incident tumor surgery/radiotherapy. Excess costs of TTR-aHO are €19,900 per patient in the first year and €10,700 in the second, driven by inpatient costs. Cost-intensive hormone replacement therapies like somatropin lead to a sharp increase in prescription costs in the second year.</p><p><strong>Conclusions: </strong>This study provides the first real-world analysis of TTR-aHO economics, emphasizing the importance of HCRU and costs for decision-making. Previously, economic evaluations have been missing due to the lack of a standard method to identify patients with aHO in retrospective studies. Using a new identification approach, the study reveals that TTR-aHO poses a significant burden in extensive treatment requirements for patients and high related costs for the healthcare system.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personnel shortages and the provision of long-term care: an empirical analysis of German nursing homes.","authors":"Dörte Heger, Annika Herr, Maximilian Lückemann, Arndt Reichert, Leonie Tycher","doi":"10.1007/s10198-025-01782-7","DOIUrl":"https://doi.org/10.1007/s10198-025-01782-7","url":null,"abstract":"<p><p>Amidst demographic shifts, advanced economies are facing critical nursing shortages. This study analyzes how long-term care in German nursing homes relate to these shortages using administrative data for the period 2007 to 2017. Our analysis reveals that higher nursing shortages correlate with decreased nurse-to-resident ratios, changes in the qualification mix of nurse personnel, and reduced occupancy rates. These findings suggest that nurse shortages might be a threat to the quality of care and the financial sustainability of nursing homes at the margin of being profitable.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and reforms in Spain's health technology assessment system: analysis of criteria influencing medicines' reimbursement decisions between 2019 and 2022 in Spain.","authors":"Pilar Pinilla-Dominguez, Jaime Pinilla-Dominguez","doi":"10.1007/s10198-025-01790-7","DOIUrl":"https://doi.org/10.1007/s10198-025-01790-7","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the criteria influencing medicines' reimbursement decisions in the Spanish National Health Service and assess the extent to which these decisions have been supported by health technology assessment (HTA), considering the ongoing HTA reform.</p><p><strong>Materials and methods: </strong>The sample includes all new medicines and new indications undergoing reimbursement between May 2019 and December 2022 in Spain. Criteria influencing the decision were derived from the Interministerial Pricing Committee for Medicines' reports. These were matched with the HTA reports obtained from the Spanish Medicines Agency's website. Spanish decisions are compared to those in France and England. The analyses include descriptive analysis, association statistical tests, sentiment text analysis, keyword extraction, decision analysis, and clustering.</p><p><strong>Results: </strong>Out of 477 therapeutic indications, 253 could be matched to a HTA report. Positive recommendations (n = 110) were statistically significantly associated with severity and therapeutic value (including clinical and cost effectiveness) criteria, whereas negative recommendations (n = 143) were mostly associated with criteria based on budget impact and availability of a cheaper alternative option (p < 0.05). The innovation criterion was not used to support any decision. Only 9.49% of reimbursement reports mentioned the HTA in the conclusions, and 21.74% of the HTAs included keywords aligned with the specific decision-making criteria.</p><p><strong>Conclusion: </strong>The criteria used to justify the reimbursement decisions of medicines in Spain do not align with the information included in the HTA. This discrepancy highlights the need for the ongoing HTA reform to develop an appraisal framework that aligns with the HTA assessment in a transparent, rigorous, and inclusive manner.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation on dental caries preventive interventions for Australian children using a priority-setting approach.","authors":"Tan Minh Nguyen, Long Khanh-Dao Le, Hanny Calache, Cathrine Mihalopoulos","doi":"10.1007/s10198-025-01787-2","DOIUrl":"https://doi.org/10.1007/s10198-025-01787-2","url":null,"abstract":"<p><p>This study aims to economically evaluate three preventive interventions for dental caries among Australian children from low household income. The interventions included: (1) anticipatory guidance provided by oral health therapists via 1a) home visits or 1b) telehealth consultations; (2) school-based dental screening and fluoride varnish program delivered by 2a) dental practitioners or 2b) non-dental health professionals (no screening); and (3) school-based fissure sealant program. The base-case scenario included intervention and dental treatment costs, with six-year (1a and 1b) and two-year (2a, 2b and 3) time horizons. Sensitivity analysis included other healthcare costs (e.g. pulp therapy, extractions, etc.). Additionally, extrapolation modelling extended the 12-year time horizon (all interventions). Probability for cost-effectiveness applied AUD$50,000 per disability-adjusted life year (DALY) averted, and AUD$28,033 per quality-adjusted life year (QALY) gained willingness-to-pay thresholds. Under the base-case scenario, none of the interventions were cost-effective. Cost-effectiveness results were sensitive when including other healthcare costs and the 12-year time horizon. Probability for cost-effectiveness (DALYs averted/QALYs gained) with extrapolation modelling in order of ranking were: (1) 91.5%/94.7% for fluoride varnish, (2) 43.9%/48.6% for dental screening and fluoride varnish, (3) 28.7%/29.8% for anticipatory guidance via telehealth, (4) 17.1%/20.0% for fissure sealant, and (5) 2.2%/2.2% for anticipatory guidance via home visits.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological distress and productivity loss: a longitudinal analysis of Australian working adults.","authors":"Syed Afroz Keramat, Tracy Comans, Alison Pearce, Rabeya Basri, Rubayyat Hashmi, Nadeeka N Dissanayaka","doi":"10.1007/s10198-025-01764-9","DOIUrl":"https://doi.org/10.1007/s10198-025-01764-9","url":null,"abstract":"<p><p>By 2030, it is anticipated that poor mental health will cost the global economy approximately $6 trillion per year, primarily due to productivity loss. It is crucial to understand how psychological distress contributes to productivity loss in the workplace. We aim to investigate the relationship between psychological distress and productivity loss in the Australian working population. We utilized eight waves of longitudinal data drawn from the Household, Income, and Labour Dynamics in Australia (HILDA) Survey (waves 7, 9, 11, 13, 15, 17, 19, and 21). We compiled an unbalanced panel data set comprising 70,973 person-year observations from 18,729 unique working adults. We used Fixed-effects Poisson regression and Fixed-effects logistic regression models to investigate the within-person differences in the relationship between psychological distress and productivity loss (measured through sickness absence, presenteeism, and underemployment). We found that moderate and high psychological distress is associated with a higher rate of sickness absence, presenteeism, and underemployment when a working adult shifted from low psychological distress after controlling socio-demographic, health, and employment-related characteristics. Our study demonstrated that moderate to high psychological distress adversely affected employees' job productivity through increased sickness absence, a higher likelihood of presenteeism, and greater levels of underemployment. Our findings also revealed that employees with moderate and high psychological distress incurred additional annual sickness absence costs of AUD 60.66 and AUD 99.26, respectively, compared to peers with low psychological distress. Additionally, our study found that employees with moderate and high levels of psychological distress experienced significantly higher levels of presenteeism, which resulted in additional annual costs of AUD 1,166.30 and AUD 3,656.05, respectively, compared to their counterparts with low psychological distress. Psychological distress imposed significant costs on Australian workplaces. Implementing workplace health promotion programs should be prioritized as a policy to address psychological distress among employees, enhance their well-being, and improve overall productivity.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compliance with clinical guidelines: the role of incentives and competition between practitioners.","authors":"Gianluca Fiorentini, Luke B Connelly","doi":"10.1007/s10198-025-01784-5","DOIUrl":"https://doi.org/10.1007/s10198-025-01784-5","url":null,"abstract":"<p><p>In this study we use a unit record, panel dataset, to examine the behaviour of clinicians under a chronic disease management program (CDMP) that is designed to improve care and slow the progression of chronic kidney disease (CKD). Using 8 years of quarterly data on the population of CKD patients (n = 44,686) in the Emilia-Romagna region of northern Italy, we analyse a setting where medical practitioners are agents who respond to the demands of two principals: their patient and the third-party payer. Exploiting detailed information on specialist visits and the concentration of general practitioners (GP) in local areas, as well as disease severity, we study how GPs on one side, and specialist nephrologists and cardiologists on the other comply with the CDMP guidelines, as may be predicted on the basis of a dual-agency approach. Our application of both multiple-treatment differences-in-differences (DID_M) and panel fixed-effects linear probability models produces evidence coherent with income-maximizing and, to a lower extent, effort-reducing strategies on the part of the GPs, as well as with strategic behaviour by some specialists. We also produce evidence that specialists who practice in hub facilities with a leading role in CDMP implementation, also for reputational reasons, exhibit referral practices that are more closely related to the CDMP guidelines.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of myelodysplastic syndromes: a systematic literature review of economic burden.","authors":"Preston Tse, Shitong Xie, Jiajun Yan, Brittany Humphries, Feng Xie","doi":"10.1007/s10198-025-01779-2","DOIUrl":"https://doi.org/10.1007/s10198-025-01779-2","url":null,"abstract":"<p><strong>Objective: </strong>To identify and synthesize available evidence on the economic burden for myelodysplastic syndromes (MDS).</p><p><strong>Methods: </strong>A systematic search was conducted in EMBASE and MEDLINE on July 13, 2021 to identify studies that report original data on the economic burden of MDS. Included studies were reviewed independently and in duplicate by two reviewers. Data on study design, patient characteristics and economic burden were extracted using a standardized form developed by the team. All costs were converted to 2023 USD and then a descriptive analysis was conducted.</p><p><strong>Results: </strong>77 publications from 61 unique studies reporting the economic burden of MDS were identified. Most were database studies (n = 34, 55.7%) and were conducted in the United States (n = 34, 55.7%). The most common outcome considered was total costs for MDS (n = 32, 52.5%). Total annual costs ranged from $6777 to $521,141 and differed according to treatment modality [best supportive care versus hypomethylating agents (HMAs)] and patient status (risk status and transfusion dependent). Broadly, costs were greater among patients with high-risk MDS compared to low-risk patients as well as those receiving HMAs and transfusions. Other costs and resource use outcomes (outpatient, inpatient costs, etc.) were not directly comparable across studies due to heterogeneity and lack of reporting of cost components.</p><p><strong>Conclusion: </strong>This systematic literature review provides insight into the economic burden of MDS, which can be substantial. More research is needed to explore specific cost components as well as economic outcomes among subgroups of patients, such as newly diagnosed patients or patients classified as high risk.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}