A Temporal and Spatial Analysis of Relative Prices for General Practitioner and Specialist Services in Australia, 1984-1996

Australia's health care financing arrangements under Medicare involve Commonwealth subsidisation of private fee-for-service (FFS) medical services produced both in- and out-of-hospital. The Medicare institution, including those subsidy arrangements, operates in a uniform manner across geographical space. From time to time, since the introduction of Medicare on 1 February 1984, ad hoc reviews of the Medicare subsidy arrangements have been undertaken. This empirical study present the first examination of the price relativities of various specialist and general practitioner services that have arisen under Medicare over time, and across geographical space. The empirical work involves estimating and testing time-series relative price equations for ten groups of medical practitioner services, for each state and territory in Australia, on quarterly Health insurance Commission (HC) data. Seventy-two equations are estimated in total, on 49 quarterly observations from September, 1984 to September, 1996. The important conclusions of the work are that price outcomes under Medicare are characterised by spatial non-uniformity, despite the uniformity of the subsidy mechanism. A related conclusion is that institutional reforms to the subsidy arrangements under Medicare may, in some cases, prove blunt instruments if prices and their relativities are the relevant policy targets. The results inform a presently informed medico-legal debate about price relativities in the health sector under Medicare and service to caution the applications of institutional change as a tool for effecting relative price change

Critical appraisal of technologies to assess electrical activity during atrial fibrillation: a position paper from the European Heart Rhythm Association and European Society of Cardiology Working Group on eCardiology in collaboration with the Heart Rhythm Society, Asia Pacific Heart Rhythm Society, Latin American Heart Rhythm Society and Computing in Cardiology

We aim to provide a critical appraisal of basic concepts underlying signal recording and processing technologies applied for (i) atrial fibrillation (AF) mapping to unravel AF mechanisms and/or identifying target sites for AF therapy and (ii) AF detection, to optimize usage of technologies, stimulate research aimed at closing knowledge gaps, and developing ideal AF recording and processing technologies. Recording and processing techniques for assessment of electrical activity during AF essential for diagnosis and guiding ablative therapy including body surface electrocardiograms (ECG) and endo- or epicardial electrograms (EGM) are evaluated. Discussion of (i) differences in uni-, bi-, and multi-polar (omnipolar/Laplacian) recording modes, (ii) impact of recording technologies on EGM morphology, (iii) global or local mapping using various types of EGM involving signal processing techniques including isochronal-, voltage- fractionation-, dipole density-, and rotor mapping, enabling derivation of parameters like atrial rate, entropy, conduction velocity/direction, (iv) value of epicardial and optical mapping, (v) AF detection by cardiac implantable electronic devices containing various detection algorithms applicable to stored EGMs, (vi) contribution of machine learning (ML) to further improvement of signals processing technologies. Recording and processing of EGM (or ECG) are the cornerstones of (body surface) mapping of AF. Currently available AF recording and processing technologies are mainly restricted to specific applications or have technological limitations. Improvements in AF mapping by obtaining highest fidelity source signals (e.g. catheter–electrode combinations) for signal processing (e.g. filtering, digitization, and noise elimination) is of utmost importance. Novel acquisition instruments (multi-polar catheters combined with improved physical modelling and ML techniques) will enable enhanced and automated interpretation of EGM recordings in the near future

Measuring inequality: tools and an illustration

BACKGROUND: This paper examines an aspect of the problem of measuring inequality in health services. The measures that are commonly applied can be misleading because such measures obscure the difficulty in obtaining a complete ranking of distributions. The nature of the social welfare function underlying these measures is important. The overall object is to demonstrate that varying implications for the welfare of society result from inequality measures. METHOD: Various tools for measuring a distribution are applied to some illustrative data on four distributions about mental health services. Although these data refer to this one aspect of health, the exercise is of broader relevance than mental health. The summary measures of dispersion conventionally used in empirical work are applied to the data here, such as the standard deviation, the coefficient of variation, the relative mean deviation and the Gini coefficient. Other, less commonly used measures also are applied, such as Theil's Index of Entropy, Atkinson's Measure (using two differing assumptions about the inequality aversion parameter). Lorenz curves are also drawn for these distributions. RESULTS: Distributions are shown to have differing rankings (in terms of which is more equal than another), depending on which measure is applied. CONCLUSION: The scope and content of the literature from the past decade about health inequalities and inequities suggest that the economic literature from the past 100 years about inequality and inequity may have been overlooked, generally speaking, in the health inequalities and inequity literature. An understanding of economic theory and economic method, partly introduced in this article, is helpful in analysing health inequality and inequity

Review Article: The Rise of Studying Happiness, but what of the Shadow of Unhappiness from Mental Illness?

This essay is concerned with describing some issues associated with a relatively recent development in economics, viz. the economics of happiness literature. After providing a very brief account of the history of the concept of happiness, and the recent literature in economics, the focus turns to two issues that have been relatively neglected. First, there has been little attention in this recent literature to the concept of virtue or a flourishing life, or a moral disposition to happiness. Second, it is argued that the focus on aggregate happiness for a society in general may be misplaced: focus on subgroups, such as the mentally ill, may be more appropriate.economics, happiness, mental illness, unhappiness,