Multiplier Effects and Compensation Mechanisms for Inclusion in Health Economic Evaluation:A Systematic Review

Background: Compensation mechanisms and multiplier effects may affect productivity losses due to illness, disability, or premature death of individuals. Hence, they are important in estimating productivity losses and productivity costs in the context of economic evaluations of health interventions. This paper presents a systematic literature review of papers focusing on compensation mechanisms and multiplier effects, as well as whether and how they are included in health economic evaluations. Methods: The systematic literature search was performed covering EconLit and PubMed. A data-extraction form was developed focusing on compensation mechanisms and multiplier effects. Results: A total of 26 studies were included. Of these, 15 were empirical studies, three studies were methodological studies, two studies combined methodological research with empirical research, four were critical reviews, one study was a critical review combined with methodological research, and one study was a cost–benefit analysis. No uniform definition of compensation mechanisms and multiplier effects was identified. The terminology used to describe compensation mechanisms and multiplier effects varied as well. While the included studies suggest that both multipliers as well as compensation mechanisms substantially impact productivity cost estimates, the available evidence is scarce. Moreover, the generalizability as well as validity of assumptions underlying the calculations are unclear. Available measurement methods for compensation mechanisms and multiplier effects differ in approaches and are hardly validated. Conclusion: While our review suggests that compensation mechanisms and multiplier effects may have a significant impact on productivity losses and costs, much remains unclear about their features, valid measurement, and correct valuation. This hampers their current inclusion in economic evaluation, and therefore, more research into both phenomena remains warranted.</p

Development of the Treatment Inventory of Costs in Psychiatric Patients: TIC-P Mini and Midi

AbstractBackgroundMedical costs of (psychiatric) illness can be validly measured with patient report questionnaires. These questionnaires comprise many detailed items resulting in lengthy administrations.ObjectivesWe set out to find the minimal number of items needed to retrieve 80% and 90% of the costs as measured by the Treatment Inventory of Costs in Patients with psychiatric disorders (TIC-P).MethodsThe TIC-P is a validated patient-reported outcome measure concerning the utilization of medical care and productivity losses. The present study focused on direct medical costs. We applied data of 7756 TIC-P administrations from three studies in patients with mental health care issues. Items that contribute least to the total cost were eliminated, providing that 80% and 90% of the total cost was retained.ResultsAverage medical costs per patient were €658 over the last 4 weeks. The distribution of cost was highly skewed, and 5 of the 14 items of the TIC-P accounted for less than 10% of the total costs. The 80% Mini version of the TIC-P required five items: ambulatory services, private practice, day care, general hospital, and psychiatric clinic. The TIC-P Midi 90% inventory required eight items. Both had variance between the three samples in the optimal choice of the items.ConclusionsThe number of items of the TIC-P can be reduced considerably while maintaining 80% and 90% of the medical costs estimated by the complete TIC-P. The reduced length makes the questionnaire more suitable for routine outcome monitoring

Hydrogeological challenges in a low carbon economy

Hydrogeology has traditionally been regarded as the province of the water industry, but it is increasingly finding novel applications in the energy sector. Hydrogeology has a longstanding role in geothermal energy exploration and management. Although aquifer management methods can be directly applied to most high-enthalpy geothermal reservoirs, hydrogeochemical inference techniques differ somewhat owing to peculiarities of high-temperature processes. Hydrogeological involvement in the development of ground-coupled heating and cooling systems using heat pumps has led to the emergence of the sub-discipline now known as thermogeology. The patterns of groundwater flow and heat transport are closely analogous and can thus be analysed using very similar techniques. Without resort to heat pumps, groundwater is increasingly being pumped to provide cooling for large buildings; the renewability of such systems relies on accurate prediction and management of thermal breakthrough from reinjection to production boreholes. Hydrogeological analysis can contribute to quantification of accidental carbon emissions arising from disturbance of groundwater-fed peatland ecosystems during wind farm construction. Beyond renewables, key applications of hydrogeology are to be found in the nuclear sector, and in the sunrise industries of unconventional gas and carbon capture and storage, with high temperatures attained during underground coal gasification requiring geothermal technology transfer

Initial Stages of Bose-Einstein Condensation

We present the quantum theory for the nucleation of Bose-Einstein condensation in a dilute atomic Bose gas. This quantum theory comfirms the results of the semiclassical treatment, but has the important advantage that both the kinetic and coherent stages of the nucleation process can now be described in a unified way by a single Fokker-Planck equation.Comment: Four pages of ReVTeX and no figure

Systematic review of available evidence on 11 high-priced inpatient orphan drugs

__Background__: Attention for Evidence Based Medicine (EBM) is growing, but evidence for orphan drugs is argued to be limited and inferior. This study systematically reviews the available evidence on clinical effectiveness, costeffectiveness and budget impact for orphan drugs. __Methods__: A systematic review was performed in PubMed, Embase, NHS EED and HTA databases for 11 inpatient orphan drugs listed on the Dutch policy rule on orphan drugs. For included studies, we determined the type of study and various study characteristics. __Results__: A total of 338 studies met all inclusion criteria. Almost all studies (96%) focused on clinical effectiveness of the drug. Of these studies, most studies were case studies (41%) or observational studies (39%). However, for all orphan diseases at least one experimental or quasi-experimental study was found, and a randomized clinical trial was available for 60% of the orphan drugs. Eight studies described the cost-effectiveness of an orphan drug; an equal number described an orphan drug’s budget impact. __Conclusions__: Despite the often heard claim that RCTs are not feasible for orphan drugs, we found that an RCT was available in 60% of o