Health care system efficiency and life expectancy: A 140-country study.

Despite the evidence of links between health expenditure and health care efficiency, it is still unclear why countries with similar levels of health expenditures experience different outputs in terms of life expectancy at birth. Health care system efficiency might shed some light on the question. Using output-oriented data envelopment analysis, we compared the health systems of 140 countries in terms of attained life expectancy. Efficiency is determined by the distance from the closest country on the best practice frontier, which identifies the highest attainable life expectancy observed for any given level of health care spending. By using national data form the Human Development Data, we built the efficiency frontier and computed the potential life expectancy increase for each country. The potential improvement was, on average, 5.47 years [95%CI: 4.71-6.27 years]. The least efficient countries (10th percentile of the efficiency score) could improve by 11.78 years, while the most efficient countries (90th percentile of the efficiency score) could only improve by 0.83 years. We then analyzed, with regression analysis stratified by average education level, and by the role of health-related variables in differentiating efficient and inefficient countries from each other. The results suggest that, among countries with lower levels of education, decreasing unemployment and income inequality increases average life expectancy, without increasing health expenditure levels

СОВЕРШЕНСТВОВАНИЕ МЕТОДИКИ РАСЧЕТОВ ПЕРЕВОДНЫХ КОЭФФИЦИЕНТОВ ПРИ СОСТАВЛЕНИИ БАЛАНСА РЫБЫ И РЫБОПРОДУКТОВ ДЛЯ ОПРЕДЕЛЕНИЯ СРЕДНЕДУШЕВОГО УРОВНЯ ИХ ПОТРЕБЛЕНИЯ

The article focuses on ways to improve methodological approaches to the calculation of conversion factors for fish products, in accordance with the classifier HS Customs Union for the formation of officialstatistical information in terms of calculating the average per capita consumption of fish and fish products of the Russian Federation population. The error of the mean and statistical evaluation of the distribution of the values of the conversion factors were carried out taking into account the inter-annual changes in average values of differential factors, changes in the average values of the coefficient error for a range of products, followed by an error estimate for the average commodity group rates. Improving equipment and production technology have the greatest impact on the value of the raw material flow rates. The conducted study was used as a basis for determining the frequency of updating the conversion factors for commodity groups. The authors established that the determination of the consumption of fish and fish products by the population of the Russian Federation should be carried out with the use of differentiated coefficients, with regard to the mathematical weight (share) of the range of products produced.Статья посвящена вопросам, касающимся развития методики расчетов коэффициентов расхода сырья (переводных коэффициентов) для рыбной продукции в соответствии с классификатором ТН ВЭД Таможенного союза. Данная методика может быть использована для совершенствования официальной статистической информации и определения уровня среднедушевого потребления населением Российской Федерации рыбы и рыбопродуктов. Погрешность среднего и статистическую оценку распределения значений коэффициентов пересчета проводили с учетом межгодовых изменений средних значений дифференцированных коэффициентов, изменения погрешности средних значений коэффициентов для одного ассортимента продукции с последующей оценкой погрешности среднего для коэффициентов товарной группы. Было обнаружено, что совершенствование техники и технологии производства продукции оказывает наиболее сильное влияние на изменение значений коэффициентов расхода сырья. На основании проведенных исследований выявлена периодичность актуализации переводных коэффициентов для товарных групп.Авторами установлено, что определение уровня потребления населением Российской Федерации рыбы и рыбной продукции необходимо проводить, используя дифференцированные коэффициенты и учитывая математический вес (долю) выпускаемого ассортимента продукции

Health-related quality of life in people with advanced dementia: a comparison of EQ-5D-5L and QUALID instruments

© 2018, Springer Nature Switzerland AG. Background: Assessing health-related quality of life (HRQOL) in people with advanced dementia is challenging but important for informed decision-making. Proxy measurement of this construct is difficult and is often rated lower than self-report. Accurate proxy rating of quality of life in dementia is related to identification of concepts important to the person themselves, as well as the sensitivity of the measures used. The main aim of this study was to compare the performance of two instruments—QUALID and EQ-5D-5L—on measuring HRQOL in people with advanced dementia. Methods: In a sub-study nested within a cluster-RCT we collected proxy(nurse)-completed EQ-5D-5L and QUALID measures at baseline, 3, 6, 9 and 12 months’ follow-up for people with advanced dementia, residing in 20 nursing homes across Australia. Spearman’s rank correlations, partial correlations and linear regressions were used to assess the relationship between the HRQOL instrument scores and their changes over time. Results: The mean weight from 284 people for the EQ-5D-5L and QUALID at baseline were 0.004 (95% CI − 0.026, 0.033) and 24.98 (95% CI 24.13, 25.82), respectively. At 12 months’ follow-up, 115 participants remained alive. EQ-5D-5L weights and QUALID scores at baseline and at follow-up were moderately correlated (r = − 0.437; p < 0.001 at 12 months). Changes within QUALID and EQ-5D-5L across the same follow-up periods were also correlated (r = − 0.266; p = 0.005). The regression analyses support these findings. Conclusion: Whilst these quality of life instruments demonstrated moderate correlation, the EQ-5D-5L does not appear to capture all aspects of quality of life that are relevant to people with advanced dementia and we cannot recommend the use of this instrument for use within this population. The QUALID appears to be a more suitable instrument for measuring HRQOL in people with severe dementia, but is not preference-based, which limits its application in economic evaluations of dementia care

Features of physical development of schoolchildren in the conditions of specialized training

The article presents a comparative analysis of physical development of 13-year-olds and cadet basic profile of teaching in urban schools in the parameters of somatometry and visiometry characterizing physical development, functional state, adaptation of the heart and body to current training loads. Coming of puberty is marked by intense growth of the body with heterochronous changes in the proportions and dimensions of its muscular skeletal system and the structure of internal organs. During this period, the role of mechanisms for self-regulation of heart activity and, in general, autonomous regulation of the functions of the cardiovascular system increase

Trifolium Repense L. breeding in the central Chernozem region: main directions and methods of work

Varieties and breeding samples of creeping clover Trifolium repense L. of lawn direction were studied in the nursery of competitive varietal trials. Using the methods of recurrent breeding involving local populations of creeping clover growing on chalk outcrops as initial forms, two varieties 'Krasnoyaruzhsky' and 'Ilyok' were obtained, as well as a new breeding sample PO 17/0