Why Perspective Matters In Health Outcomes Research Analyses

Health outcomes research typically uses cost-effectiveness or cost-utility analysis. These approaches take a narrow perspective of the individual effects, typically from the payer or the provider point-of-view. However, using these narrow perspectives misses macro-level, or societal level, benefits and costs that could significantly alter whether an intervention is considered beneficial or cost-effective. The societal perspective accounts for all the effects impacting patients, their families, the public, and government expenditures for a healthcare intervention. Such a perspective is vital for healthcare interventions for illnesses where morbidity and long absences from work are probable. A cost-benefit analysis would account for all the societal benefits and costs, allowing policy-makers to observe an outcomes analysis more closely reflective of the real impacts. This paper clearly presents why a societal perspective using cost-benefit analysis should be the preferred method of health outcomes research. An example of breast cancer interventions is used to illustrate this point

In vivo cholinesterase sensitivity of gilthead seabream (Sparus aurata) exposed to organophosphate compounds: Influence of biological factors

Two cholinesterases have been found in vertebrates, acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). These enzymes are present in the gilthead seabream, AChE in the brain and muscle and BChE in the muscle. Cholinesterases have been used as biomarker of effect in environmental monitoring studies. However, there are few studies about the influence of biometric parameters on ChE. This paper studies the possible influence of biological factors on brain and muscle cholinesterase (ChE) in Sparus aurata. Our results show that ChE activity in brain and muscle tissues changes depending on several biological variables. ChE activity in these tissues decreased when the age (48-152 week), body length (14.15-28.95 cm) and body weight (42.73-380.74 g) of the fishes studied increased. The relationships between brain and muscle ChE activity and several biometric factors were curvilinear

Assessment of Macro-Level Socioeconomic Factors That Impact Waterborne Diseases: The Case of Jordan

The Hashemite Kingdom of Jordan is an example of a country that suffers from high water scarcity. Additionally, due to the economic drivers in the country, such as phosphate and potash extraction and pharmaceutical production, the little fresh water that remains is generally polluted. The infrastructure, often antiquated in urban areas and non-existent in rural areas, also contributes to poor water conditions and to the spread of waterborne diseases. This paper examines the socioeconomic factors that contribute to diarrhea and hepatitis A on a macro level in Jordan and discusses the public-policies that government officials could use to abate those problems. Ordinary least squares time series models are used to understand the macro-level variables that impact the incidence of these diseases in Jordan. Public health expenditure has a significant impact on reducing their incidence. Furthermore, investment in sanitation facilities in rural regions is likely to reduce the number of cases of hepatitis A. Perhaps the most surprising outcome is that importation of goods and services likely results in a decrease in cases of hepatitis A. However, income has little impact on the incidence of diarrhea and hepatitis A