Monitoring and Evaluating Progress towards Universal Health Coverage in Estonia

<p>Monitoring and Evaluating Progress towards Universal Health Coverage in Estonia</p

Monitoring and Evaluating Progress towards Universal Health Coverage in Estonia - Figure 1

<p>Out-of-pocket payments as a proportion of total household expenditure by quintiles <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001677#pmed.1001677-Vrk1" target="_blank">[8]</a>.</p

Monitoring and Evaluating Progress towards Universal Health Coverage in Estonia - Figure 2

<p>Life expectancy change in Estonia between 2000 and 2008 by cause of death <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001677#pmed.1001677-WHO1" target="_blank">[6]</a>.</p

Infectious diseases for which burden estimates were derived in the BCoDE project.

<p>STEC/VTEC, shigatoxin-producing <i>E. coli</i>/verocytotoxin-producing <i>E. coli</i>.</p

An outcome tree linking exposure, infection and all sequelae.

<p>The outcome tree displays how individuals may progress through various stages of infection, disease, and death. The process can be quantified by attaching proportions to the arrows depicting transitions, and durations to the various health outcomes. “R” denotes full recovery from infection and/or disease.</p

The Lexis diagram shows events by age and time.

<p>(A) This Lexis diagram shows the occurrence of infection, disease, and death in individual life histories in the time–age plane. An epidemic outbreak affects several cohorts of individuals at a specific time, but may cause disease burden at different times later on. An age-specific intervention starts at a certain time and affects all cohorts reaching the specific age from that time onward. It does not prevent disease burden from earlier infections. Incidence may cause burden within a time window of observation, but also at later times within the life histories of the affected individuals. (B) Here the Lexis diagram shows the occurrence of influenza cases within the time period of one year. All burden generated by morbidity (red) occurs also within that time period. Burden due to mortality is from deaths occurring in the same year as infection. (C) The Lexis diagram for hepatitis B shows that the burden due to morbidity is spread out over many years following the incident infections in the year starting at time <i>t</i>.</p

Preliminary estimates of the burden of disease in terms of DALYs per 100,000 individuals per year for selected infections in four European countries.

<p>The differences seen between countries (A–D) may be due to differences in surveillance and/or to differences in the (distribution of) incidence of infections in populations. STEC/VTEC, shigatoxin-producing <i>Escherichia coli</i>/verocytotoxin-producing <i>E. coli</i>; YLD, number of life years lost due to disability; YLL, number of life years lost due to premature death.</p

Assuming a downwards time trend for an infection having symptoms in the same years (a) and for an infection where symptoms occur only after 10 years (b). Note:

<p>Blue rectangles represent the number of infections in the year of infection (exposure to an infection). Green “cans” represent the number of cases with symptoms; where these symptomatic cases occur in the same year as the infection (a.) or a few years later (b.) as indicated by the dashed arrow. The long-term average (e.g. 10-year average) is highlighted by a light blue oval for incidence, and by a light green oval for prevalence. The short-term average (e.g. 3-year average) is represented by a dark blue oval for incidence and purple oval for prevalence.</p

The undiscounted average burden of <i>Campylobacter</i> spp.

<p>(a) and <i>Salmonella</i> spp. (b) in the Netherlands (average of 2005–2007) in DALY per year, subdivided in YLL and YLD for acute illness, sequelae and total. The 95% uncertainty range is shown using error bars.</p

The undiscounted average burden of <i>Campylobacter</i> spp. and <i>Salmonella</i> spp.

<p>in the Netherlands (average of 2005–2007) in DALY per year, for base case and scenario analysis. DALY are subdivided in YLL and YLD for actue illness, sequelae and total. The 95% uncertainty range is shown using error bars. <b>Note:</b> “Base case” represents a situation where only severe GE cases are at risk to develop reactive arthritis (ReA). “SA: ReA” represents the scenario analysis where all GE cases are at risk to develop ReA.</p