The direct and indirect costs of breast cancer in Poland : estimates for 2017 - 2019

Background: In Poland, breast cancer (BC) is the most frequently diagnosed cancer in women and the second most common cause of death after lung cancer. This disease has important economic implications for patients, public payers, and the whole Polish economy. This study aimed to estimate the total National Health Fund (NHF) expenditures on the diagnosis and treatment of patients with breast cancer. In addition, the costs of productivity losses were also calculated. Methods: Cost estimation was prepared using a top-down approach. Direct cost calculations were based on data reported by NHF for patients with the diagnosis of breast cancer. Medical care costs included the following components: screening program, oncological package, surgical treatment, hospitalization, drug program, chemotherapy, radiotherapy, and outpatient care. Indirect costs in the form of absenteeism costs were calculated based on data from Statistics Poland (gross domestic product, number of employees) and the Social Insurance Institution database (the number of sick leave days). Results: Total expenditures for BC including direct costs and indirect costs amounted to EUR 305,371, EUR 332,998, and EUR 344,649, respectively in 2017, 2018, and 2019. Total healthcare costs in 2019 were EUR 4114 lower than in 2018, which resulted from the reduction in expenditure on the drug program (decrease of EUR 13,527), despite the observed increase in all remaining resources. From direct costs, the highest expense was spent on the drug program (nearly 50% of total direct costs), but this expense dropped significantly in 2019. For the remaining parameters, the costs increased year by year, of which the most expensive were surgical treatment (15%), radiotherapy (12%), and the screening program (10%). BC generated over EUR 120 thousand of social costs in 2019 and compared to 2017, there was an increase in productivity loss by 26%. Conclusions: Our results from 2017–2019 demonstrated that total expenditure for BC in Poland increased from year to year. Breast cancer generated almost EUR 345 thousand expenses in 2019, which translates into a significant burden on the public payer’s budget and the society in Poland

The performance of a global and mesoscale model over the central Arctic Ocean during late summer

Measurements of turbulent fluxes, clouds, radiation, and profiles of mean meteorological parameters, obtained over an ice floe in the central Arctic Ocean during the Arctic Ocean Experiment 2001, are used to evaluate the performance of U.K. Met Office Unified Model (MetUM) and Coupled Ocean/Atmosphere Mesoscale Prediction System (COAMPS) in the lower atmosphere during late summer. Both the latest version of the MetUM and the version operational in 2001 are used in the comparison to gain an insight as to whether updates to the model have improved its performance over the Arctic region. As with previous model evaluations over the Arctic, the pressure, humidity, and wind fields are satisfactorily represented in all three models. The older version of the MetUM underpredicts the occurrence of low-level Arctic clouds, and the liquid and ice cloud water partitioning is inaccurate compared to observations made during SHEBA. In the newer version, simulated ice and liquid water paths are improved, but the occurrence of low-level clouds are overpredicted. Both versions overestimate the amount of radiative heat absorbed at the surface, leading to a significant feedback of errors involving the surface albedo, which causes a large positive bias the surface temperature. Cloud forcing in COAMPS produces similar biases in the downwelling shortwave and longwave radiation fluxes to those produced by UM(G25). The surface albedo parameterization is, however, more realistic, and thus, the total heat flux and surface temperature are more accurate for the majority of the observation period