Cross-Section Analysis of Health Spending with Special Regard to Trends in Austria

During the 90s the increase in health spending which compared to the overall growth had taken place at a rather rapid pace experienced a worldwide slow-down. In relation to overall economic growth and the expansion of other countries' health care systems, Austria's system grew below average- a fact which holds particularly true for the years between 1990 and 1997. This development may largely be due to a constant consolidation of budget and relatively high prices for private households which are possibly overestimated, however. This overestimation of prices are probably caused by unascertained productivity improvements which may have occurred in the acute care sectors. Within our observation period of 16 years, the private households' expenditure reached a peak with spending on physician services experiencing the fastest increase. Although overestimated, the high prices in the health sector together with sharply rising consumption expenditure on health care constitute an increased burden on households.Oesterreich, Health Expenditures, Cross Section, Estimation of, European Union, Austria

HEALTH SYSTEM WATCH SPRING/1999: CROSS-SECTION ANALYSIS OF HEALTH SPENDING WITH SPECIAL REGARD TO TRENDS IN AUSTRIA

The richer a country, the higher its expenditure on health care. The increase in health spending which compared to the overall growth had taken place at a rather rapid pace experienced a worldwide slow-down during the 90s. In relation to overall economic growth and the expansion of other countries’ health care systems, Austria’s system grew below average- a fact which holds particularly true for the years between 1990 and 1997. This development may largely be due to a constant consolidation of budget, relatively high prices for private households, which, however, are possibly overestimated and still unascertained but highly probable improvements in productivity in the main fields of health care. Within our observation period of 16 years, the privat households’ expenditure reached a peak with private health spending experiencing the quickest increase. Although overestimated, these relatively high prices together with a sharply rising consumption expenditure on health care constitute an increased burden on private households. While social insurance companies in their function as bulk purchasers have had the power to reject excessive prices, private customers were charged above average during the last few years. This development has to be closely scrutinized in order to ensure public welfare and the maintenance of a social health care system in future.health economics

Semi-parametric Regression under Model Uncertainty: Economic Applications

Economic theory does not always specify the functional relationship between dependent and explanatory variables, or even isolate a particular set of covariates. This means that model uncertainty is pervasive in empirical economics. In this paper, we indicate how Bayesian semi-parametric regression methods in combination with stochastic search variable selection can be used to address two model uncertainties simultaneously: (i) the uncertainty with respect to the variables which should be included in the model and (ii) the uncertainty with respect to the functional form of their effects. The presented approach enables the simultaneous identification of robust linear and nonlinear effects. The additional insights gained are illustrated on applications in empirical economics, namely willingness to pay for housing, and cross-country growth regression

Cost-effectiveness analysis of ferric carboxymaltose in iron-deficient patients with chronic heart failure in Sweden.

OBJECTIVE: Iron deficiency is a common but treatable comorbidity in chronic heart failure (CHF) that is associated with impaired health-related quality-of-life (HRQoL). This study evaluates the cost-effectiveness of the intravenous iron preparation ferric carboxymaltose (FCM) for the treatment of iron deficiency in CHF from a Swedish healthcare perspective. METHODS: A cost-effectiveness analysis with a time horizon of 24 weeks was performed to compare FCM treatment with placebo. Data on health outcomes and medical resource use were mainly taken from the FAIR-HF trial and combined with Swedish cost data. An incremental cost-effectiveness ratio (ICER) was calculated as well as the change in per-patient costs for primary care and hospital care. RESULTS: In the FCM group compared with placebo, quality-adjusted life years (QALYs) are higher (difference = 0.037 QALYs), but so are per-patient costs [(difference = SEK 2789 (€303)]. Primary care and hospital care equally share the additional costs, but within hospitals there is a major shift of costs from inpatient care to outpatient care. The ICER is SEK 75,389 (€8194) per QALY. The robustness of the result is supported by sensitivity analyses. CONCLUSIONS: Treatment of iron deficiency in CHF with FCM compared with placebo is estimated to be cost-effective. The ICER in the base case scenario is twice as high as previously thought, but noticeably below SEK 500,000 (€54,300) per QALY, an informal average reference value used by the Swedish Dental and Pharmaceutical Benefits Agency. Increased HRQoL and fewer hospitalizations are the key drivers of this result

MOJ Public Health Personalized Medicine Takes Foresight and Smart Public Policies

Abstract Governments and health care payers everywhere seek ways how to design public funding policies for high-cost drugs, which are increasingly personalized and often only effective in small population groups or sub-groups. Access to drugs is usually preceded by health technology assessment. Challenges for access to effective drugs at the patient level remain, as the current reimbursement environment is not ready to encompass the complexity of Personalized Medicine. A high level of uncertainty remains as to how, for whom and which type of Personalized Medicine should unfold in the future. Foresight modeling may come into play here. Foresight is a systematic approach to look into the longer-term future of science and technologies and their potential impacts on society. It aims at identifying research and development areas likely to generate future economic, environmental and social benefits

Health system performance assessment landscape at the EU level: a structured synthesis of actors and actions

Background: Many policy makers and other stakeholders in the EU have expressed interest in better understanding the performance of their own health systems to identify opportunities for improvement in effectiveness, efficiency and equity. Health system performance assessment (HSPA) has received considerable attention at EU level as an instrument to improve transparency and accountability. This is equally important for population health and sustainable health spending. The goal of this paper is to synthesise and map the current state and developments in the field of HSPA relevant in the EU context and by this aid the navigation in the growing HSPA system, understand the available tools and identify opportunities for improvement. Methods: Structured synthesis of the literature on initiatives in the field of HSPA at EU level was carried out. Key literature was identified by a focused review performed between October 2015 and June 2016 on websites of key institutions including the EU, OECD and WHO and Google engine. We used six predefined criteria for identifying key literature. Identified initiatives were classified according to analytical and conceptual output or whether a guiding or advisory role was resumed. A visual map of the relationships between the different actions and actors involved in HSPA was developed. In addition, expert opinion was sought to refine the map. Results: We identified a total of 64 relevant initiatives and their relationships in the field of HSPA. These include institutions such as the European Commission (73%), European Council (8%), OECD (9%) and WHO-EUR (9%). 24 initiatives produced analytical outputs, four developed conceptual outputs and six had a guiding role. The role of the EU in HSPA and collaboration with other key actors have intensified considerably since the adoption of the EU Health Strategy in 2013. The EU HSPA landscape is complex with seemingly few streamlining activities. Conclusions: Knowledge transfer and exchange of expertise are key to HSPA. While cooperation between the key actors have intensified recently and clearly reflect the "Health in all Policies" (HIAP) approach, there is considerable room for improved streamlining activities to share knowledge and avoid overlapping efforts, especially within the European Commission

Semantic HELM: A Human-Readable Memory for Reinforcement Learning

Reinforcement learning agents deployed in the real world often have to cope with partially observable environments. Therefore, most agents employ memory mechanisms to approximate the state of the environment. Recently, there have been impressive success stories in mastering partially observable environments, mostly in the realm of computer games like Dota 2, StarCraft II, or MineCraft. However, existing methods lack interpretability in the sense that it is not comprehensible for humans what the agent stores in its memory. In this regard, we propose a novel memory mechanism that represents past events in human language. Our method uses CLIP to associate visual inputs with language tokens. Then we feed these tokens to a pretrained language model that serves the agent as memory and provides it with a coherent and human-readable representation of the past. We train our memory mechanism on a set of partially observable environments and find that it excels on tasks that require a memory component, while mostly attaining performance on-par with strong baselines on tasks that do not. On a challenging continuous recognition task, where memorizing the past is crucial, our memory mechanism converges two orders of magnitude faster than prior methods. Since our memory mechanism is human-readable, we can peek at an agent's memory and check whether crucial pieces of information have been stored. This significantly enhances troubleshooting and paves the way toward more interpretable agents.Comment: To appear at NeurIPS 2023, 10 pages (+ references and appendix), Code: https://github.com/ml-jku/hel

Improved health system performance through better care coordination

This report attempts to assess whether – and to what degree – better care coordination can improve health system performance in terms of quality and cost-efficiency. See also the annex (PDF) to this paper

Tatvertising

Die vorliegende Arbeit beschäftigt sich mit der Frage nach der Darstellung von Tätowierungen und tätowierten Menschen in der Printwerbung. Als Untersuchungs-zeitraum wurden die Jahre 1998 bis 2010 gewählt, insgesamt flossen 83 verschiedene Anzeigen aus unterschiedlichen Ländern in die Untersuchung ein. Die nach definierten Kriterien ausgewählten Anzeigen wurden je nach ihrem Erscheinungsland dem asiatischen, europäischen oder angloamerikanischen Raum zugeordnet. Es wurde dabei der Frage nachgegangen, ob das Stereotyp des „Knastbruders“ durch die Werbung vermittelt wird, wie sich die Zahl der Anzeigen während des Untersuchungszeitraumes verändert hat, wie die Geschlechterzusammensetzung aussieht, für welche Warengruppen geworben wird und welche Funktion die Tätowierung in den Anzeigen erfüllt. Dabei wird auf Unterschiede und Gemeinsamkeiten der Untersuchungsräume eingegangen, mögliche Erklärungsansätze werden angeboten. Außerdem werden Besonderheiten jedes Untersuchungsraumes qualitativ herausgearbeitet, spezielle Aufmerksamkeit erhält die Darstellung von Tätowierungen und Tätowierten in österreichischen Printanzeigen.This paper is about the depiction of tattoos and tattooed people in print advertising. The sample period covers the years 1998-2010, a total of 83 different print ads from different countries were investigated. Depending on the country of their first publishing, every ad was attributed to either the Asian, European or Angloamerican area. The analysis tries to answer the question if the “jailbird”-stereotype is used and how, how the amount of the ads changes from year to year and which genders were shown. It investigates for which product groups advertisers used tattoos and which functions tattoos have to fulfil. Not only differences between the defined areas, but also similarities were found. Possible reasons for these findings are provided in this work. Specifics of each area are mentioned, as well as possible approaches of explanation. Special attention is paid to the depiction of tattoos and tattooed people in Austrian print ads