Global tobacco economics consortium : overview of research program

Details of the research program objectives are provided: 1) to synchronize and strengthen local expertise and research capacity regarding tobacco usage data and tobacco control policy and initiatives; 2) to conduct subnational extended cost-effectiveness analyses (ECEAs); 3) to deepen, evolve, expand ECEA; 4) generate tax diagnostics for use as policy tools; and 5) to engage more effectively with decision makers

Specialist palliative care: Current and future service challenges

Introduction/Background: Those working in palliative care face several current challenges, including: to reach beyond cancer and the physical to other dimensions of care; to start much earlier than at terminal stages of illness; to extend from specialist services to generalists; and to support primary carers. Research Question: How well does the Calvary Health Care Bethlehem (CHCB) model of specialist palliative care tackle these challenges? Methodology: We conducted a mixed‐method, multi‐perspective study in which thirty palliative care patients and their nominated carers and health care professionals (HCPs) were interviewed over a six month period. HCPs also participated in focus groups. Results were analysed using a thematic content analysis framework. HCP accounts of the CHCB service were used to construct a narrative description of the CHCB model of specialist palliative care. Policy Implications: Recent policy reports from the National Health and Hospitals Reform Commission and the Productivity Commission’s draft report Caring for Older Australians advocated greater use of coordination and teamwork in palliative care. This study helps define what this might mean in practice

The Health of Senior Australians and the Out-of-Pocket Healthcare Costs They Face

This report, authored by researchers from the Australian National University, sought to examine the prevalence of chronic conditions among mature age people and how this relates to burdensome out-of-pocket health care costs. Results show that 570,000 people aged 55 years and over spend more than 10% of their income on health and about 250,000 spend over 20%

The Health of Senior Australians and the Out-of-Pocket Healthcare Costs They Face

This report, authored by researchers from the Australian National University, sought to examine the prevalence of chronic conditions among mature age people and how this relates to burdensome out-of-pocket health care costs. Results show that 570,000 people aged 55 years and over spend more than 10% of their income on health and about 250,000 spend over 20%

A patient-centred approach to health service delivery: improving health outcomes for people with chronic illness

BACKGROUND The Wagner Model provides a framework that can help to facilitate health system transition towards a chronic care oriented model. Drawing on elements of this framework as well as health policy related to patient centred care, we describe the health needs of patients with chronic illness and compare these with services which should ideally be provided by a patient-centred health system. This paper aims to increase understanding of the challenges faced by chronically ill patients and family carers in relation to their experiences with the health care system and health service providers. METHOD We interviewed patients, carers and health care professionals (HCPs) about the challenges faced by people living with complicated diabetes, chronic heart failure or chronic obstructive pulmonary disease. RESULTS Patients indicated that they had a range of concerns related to the quality of health care encounters with health care professionals (HCPs), with these concerns being expressed as needs or wants. These included: 1) the need for improved communication and information delivery on the part of HCPs; 2) well organised health services and reduced waiting times to see HCPs; 3) help with self care; 4) greater recognition among professionals of the need for holistic and continuing care; and 5) inclusion of patients and carers in the decision making processes. CONCLUSIONS In order to address the challenges faced by people with chronic illness, health policy must be more closely aligned with the identified needs and wants of people affected by chronic illness than is currently the case.he Serious and Continuing Illnesses Policy and Practice Study (SCIPPS) is a National Health and Medical Council of Australia (NHMRC) funded program (no: 402793) conducted at the University of Sydney and The Australian National University and administered by the Menzies Centre for Health Policy

Multisite prospective investigation of psychological outcomes following cataract surgery in Vietnam

Copyright © 2017 BMJ Global Health. All rights reserved. Background: Cataract surgery is a low-cost and effective intervention. There is increasing evidence to suggest that cataract surgery is associated with improvements in mobility, overall functioning and reductions in psychological distress. Within lowincome and middle-income countries, cataract surgery has also been documented to lead to reductions in psychological distress; however, differences in economic activity and engagement in paid and domestic work in these countries may moderate such reductions. We aimed to examine the psychological outcomes following cataract surgery among a diverse Vietnamese sample. Methods: We report findings from the VISIONARY study, a 12-month multisite prospective study of cataract surgery outcomes conducted in Vietnam (N=462). Generalised estimating equations (GEEs) were used to identify the variables which were associated with reduced psychological distress. Results: A high proportion of participants (56.6%) reported psychological distress before surgery and severity of psychological distress had decreased by 12 months following surgery (95% CI (4.13 to 4.95)). There were regional differences in the extent of improvement in psychological distress and change in paid and unpaid work. The extent of improvement in visual acuity, male gender, and increase in paid and unpaid work hours were significant predictors of reductions in psychological distress. Conclusions: Cataract surgery appears to result in the greatest reductions in psychological distress in communities where work engagement is highest. Funding: The VISIONARY study was funded by a grant provided by the Fred Hollows Foundation, Australia. During the course of this work, BME was in receipt of an Ian Potter Foundation Fellowship and a National Health and Medical Research Council (NHMRC) fellowship (1072148), SJ received an NHMRC Senior Research Fellowship, MLH was in receipt of a National Heart Foundation Future Leader Fellowship 100034

The household economic burden of eating disorders and adherence to treatment in Australia

© 2014 Gatt et al.; licensee BioMed Central Ltd. Background: This study investigated the household economic burden of eating disorders and cost-related non-adherence to treatment in Australia. Methods: Multi-centre prospective observational study using a structured questionnaire. Ninety participants were recruited from two clinic settings in New South Wales, Australia and from the community using social media. The primary outcome measures were household economic burden of illness measured in terms of out-of-pocket expenditure, household economic hardship and cost-related non-adherence. Results: The pattern of out-of-pocket expenditure varied by diagnosis, with Bulimia Nervosa associated with the highest total mean expenditure (per three months). Economic hardship was reported in 96.7% of participants and 17.8% reported cost-related non-adherence. Those most likely to report cost-related non-adherence had a longer time since diagnosis. Cost-related non-adherence and higher out-of-pocket expenditure were associated with poorer quality of life, a more threatening perception of the impact of the illness and poor self-reported health. Conclusions: This study is the first to empirically and quantitatively examine the household economic burden of eating disorders from the patient perspective. Results indicate that households experience a substantial burden associated with the treatment and management of an eating disorder. This burden may contribute to maintaining the illness for those who experience cost-related non-adherence and by negatively influencing health outcomes. Current initiatives to implement sustainable and integrated models of care for eating disorders should strive to minimise the economic impact of treatment on families

The Indirect Cost Burden of Cancer Care in Canada : A Systematic Literature Review

BACKGROUND AND OBJECTIVES: Cancer poses a substantial health and economic burden on patients and caregivers in Canada. Previous reviews have estimated the indirect cost burden as work-related productivity losses associated with cancer. However, these estimates require updating and complementing with more comprehensive data that include relevant dimensions beyond labor market costs, such as patient time, lost leisure time and home productivity losses. METHODS: A systematic review of the literature was conducted to identify studies published from 2006 to 2020 that measured and reported the indirect costs borne by cancer patients and their caregivers in Canada, from the patient, caregiver, employer, and societal perspectives. Study characteristics and cost estimation methods were extracted from relevant studies. Costs estimates were reported and converted to 2020 CAD for the following categories: lost earnings, caregiving time costs, home production losses, patient time (leisure), morbidity-, disability-, premature mortality-related costs, friction costs, and overall productivity losses. A quality assessment of individual studies was conducted for included studies using the Newcastle-Ottawa Assessment Tool. RESULTS: In total, 3980 studies were identified, of which 18 Canadian studies met the inclusion criteria for review. One-third of the studies used or developed prediction models, 38% enrolled patient cohorts, and 27% used administrative databases. Over one-third of the studies were conducted at a national level (38%). All studies employed the human capital approach to estimate costs, and 16% also used the friction cost approach. Lost earnings were higher among self-employed patients (43% vs 24% among employees) and females ($8200 vs$3200 for males). Caregiver costs ranged from $15,786 to$20,414 per patient per year. Household productivity losses were estimated to be up to $238,904 per household per year. Patient time (leisure) costs were estimated to be between$13,000 and $18,704 per patient per year. Premature annual mortality costs were estimated to be$2.98 billion overall in Quebec. Friction costs incurred by employers were estimated between $6400 and$23,987 per patient per year. Societal productivity losses associated with cancer were estimated between $75 million to$317 million, annually. CONCLUSIONS: This review suggests that the indirect cost burden of cancer is considerable from the patient, caregiver, employer, and societal perspectives. This up-to-date review of the literature provides a comprehensive understanding of the indirect cost burden by including non-labor market activity costs and by examining all relevant perspectives. These results provide a strong case for the government and employers to ensure there are supports in place to help patients and caregivers buffer the impact of cancer so they can continue to engage in productive activities and enjoy leisure time