658 research outputs found

    Unit costs in health economic evaluations: quo vadis, Austria?

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    Evidence-informed healthcare decision-making relies on high quality data inputs, including robust unit costs, which in many countries are not readily available. The objective of the Department of Health Economics’ Unit Cost Online Database, developed based on systematic reviews of Austrian costing studies, is to make conducting economic evaluations from healthcare and societal perspectives more feasible with publicly available unit cost information in Austria. This article aims to describe trends in unit cost data sources and reporting using this comprehensive database as a case study to encourage relevant national and international methodological discussions. Database analysis and synthesis included publication/study characteristics and costing reporting details in line with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS 2022) with the year of the database launch as the cut-off point to assess how the methods have developed over time. Forty-two full economic evaluations and 278 unit costs were analyzed (2004–2016: 34 studies/232 unit costs, 2017–2022: 8 studies/46 unit costs). Although the reporting quality of costing details including the study perspective, unit cost sources and years has improved since 2017, the unit cost estimates and sources remained heterogeneous in Austria. While methodologically standardized national-level unit costs would be the gold standard, a systematically collated list of unit costs is a first step towards supporting health economic evaluations nationally

    Bäuerliche Experimente in Österreich – Beurteilung von Video als möglicher Auslöser der Experimentiertätigkeit von Biobäuerinnen und Biobauern

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    Farmers’ experiments are an integral element of agricultural practice, contribute to the development of local knowledge and form the precondition for local innovations. This study addresses organic farmers’ experiments in Austria, and specifically video as tool for capturing and sharing lessons learned from farmers’ experimentation, as well as the potential of video to trigger farmers’ experiments. For 85 % of the surveyed organic farmers (n=34) farmers’ experiments were considered to have high relevance in the course of their farming activities. The elaborated videos stimulated 71 % of the farmers to conduct experiments. The videos were successfully applicable in adult and student agricultural education. After watching them, 12 of 16 students (75 %) came up with ideas for experiments they would like to try at their parents’ farms

    Harmonization issues in unit costing of service use for multi-country, multi-sectoral health economic evaluations: a scoping review

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    Background: Valuation is a critical part of the costing process in health economic evaluations. However, an overview of specific issues relevant to the European context on harmonizing methodological requirements for the valuation of costs to be used in health economic evaluation is lacking. We aimed to inform the development of an international, harmonized and multi-sectoral costing framework, as sought in the European PECUNIA (ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions) project. Methods: We conducted a scoping review (information extraction 2008–2021) to a) to demonstrate the degree of heterogeneity that currently exists in the literature regarding central terminology, b) to generate an overview of the most relevant areas for harmonization in multi-sectoral and multi-national costing processes for health economic evaluations, and c) to provide insights into country level variation regarding economic evaluation guidance. A complex search strategy was applied covering key publications on costing methods, glossaries, and international costing recommendations augmented by a targeted author and reference search as well as snowballing. Six European countries served as case studies to describe country-specific harmonization issues. Identified information was qualitatively synthesized and cross-checked using a newly developed, pilot-tested data extraction form. Results: Costing methods for services were found to be heterogeneous between sectors and country guidelines and may, in practice, be often driven by data availability and reimbursement systems in place. The lack of detailed guidance regarding specific costing methods, recommended data sources, double-counting of costs between sectors, adjustment of unit costs for inflation, transparent handling of overhead costs as well as the unavailability of standardized unit costing estimates in most countries were identified as main drivers of country specific differences in costing methods with a major impact on valuation and cost-effectiveness evidence. Conclusion: This review provides a basic summary of existing costing practices for evaluative purposes across sectors and countries and highlights several common methodological factors influencing divergence in cost valuation methods that would need to be systematically incorporated and addressed in future costing practices to achieve more comparable, harmonized health economic evaluation evidence

    Research for transition: Europeans deserve a better agricultural and food policy

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    Research is a key element in the exploration of new pathways in farming systems. Organic farming relies on specific methods and a strict regulation. By design, organic farming harmonizes the environmental and productive dimensions of farming systems. The report covers four sections. 1. Funding of organic farming research is low both at EU and national levels, but at the EU and national levels, statistics on the financial support to the different models of agriculture are neither precise nor comprehensive. This lack of transparency impairs any comparative analysis. 2. Several countries have specific programmes for organic farming research The total amounts of money are limited but in most cases the programmes are multi-annual and help to build long-term expertise for the sector. Countries with long-term programmes include Denmark, France, Germany and Sweden 3. Organic farming provides better answer to sustainability challenges than conventional farming. Funding of organic farming research is important because organic farming represents an efficient pathway to sustainable agriculture. A comparison of organic and conventional farming for the different dimensions of sustainability has been compiled based on scientific publications. This assessment does not claim to be fully comprehensive in all areas but it may serve to illustrate he potential of organic farming. 4. Inspiring case studies. By design, organic farming is multi-functional and based on an ecosystem approach rather than the use of artificial inputs that boost production. This is also reflected in the organisation of knowledge exchanges. Most organic farmers are in favour of a participatory vision of research, with active exchange of experience between scientists and practitioners, a collective assessment of problems and a co-design of solutions. Programmes such as the European Innovation Partnership are in line with this research and innovation process. Experience in organic farming shows the potential of such an approach. Case studies at meso and micro levels illustrate new ways of producing knowledge in a participatory way

    The impact of emotions on polarization. Anger polarizes attitudes towards vaccine mandates and increases affective polarization

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    When does anger lead to greater polarization? As societal polarization and political polarization increase so does academic interest in its antecedents. One important cause of polarization appears to be anger. However, existing research linking anger and political polarization has focused primarily on the context of partisanship and did not distinguish between different types of anger nor different forms of polarization. To address this gap in the literature, we analyze how generalized versus issue-specific anger amplify issue-based and affective polarization in the highly charged context of the COVID-19 pandemic. We test these relationships through a survey experiment embedded in a national German sample (n = 2857) and show that anger is linked to polarization. However, we also show that different forms of anger influence different aspects of polarization. Issue polarization is driven primarily by generalized anger, while corona-specific anger increases affective polarization. Together, these results underline the importance of understanding the emotional nuances of polarization. More generally, the results illustrate the problems policy makers face when navigating heavily contested and emotionally charged topics. While increased anger may be helpful for mobilizing support among already supportive citizens, it does little to convince skeptical citizens and carries the cost of increasing societal polarization

    Establishing a comprehensive list of mental health-related services and resource use items in Austria: a national-level, cross-sectoral country report for the PECUNIA project

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    Background: A comprehensive, comparable assessment of the economic disease burden and the value of relevant care forms a major challenge in the case of mental diseases. This study aimed to inform the development of a resource use measurement (RUM) instrument and harmonized reference unit costs valid for multi-sectoral and multi-national cost assessments for mental health diseases as part of the European PECUNIA project. Methods: An iterative, multi-methods approach was applied. Systematic literature reviews appended with national grey literature searches in six European countries were conducted to generate preliminary, literature-based, international, mental health-related service and resource use lists for all investigated sectors in 2018. As part of a multi-national expert survey, these lists were reviewed by 18 Austrian sector-specific experts regarding the clarity, relevance, comprehensiveness and availability in the Austrian context. Results: Out of 295 items included in the preliminary, international, sector-specific lists (health and social care—201 items, criminal justice—35 items, education—39 items; patient, family and informal care—20 items), a total of 261 items and descriptions (88%) were considered clear by all experts. 42 items (14%) were considered not existing in Austria, and 111 items (38%) were prioritized regarding their relevance in the national context. Thirteen additional items (4%) were suggested to be added to accommodate for Austria-specific features of the individual sectors. Major typological difficulties based on item names were observed. Conclusions: The identified country-specific variations and general typological bias and their potential contributions to service and resource use cost variations across countries and sectors call for further systematic investigation. Next, PECUNIA will develop internationally harmonized and comparable definitions of the listed items and their units of analysis based on a new conceptual multi-sectoral costing framework. The developed lists will require consolidation and further prioritization for the development of a patient-reported RUM instrument and consequent reference unit cost valuation
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