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Nkemgha GZ, Tékam HO, Belek A. Healthcare expenditure and life expectancy in Cameroon. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01181-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ambade PN, Katragadda C, Sun D, Bootman JL, Abraham I. Why health policies should be transnational: A case for East Asia Pacific countries. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2019; 30:101-125. [PMID: 31282430 DOI: 10.3233/jrs-199001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper argues that health policies should transcend national boundaries yet should not reach the supranational level. Along with multinational global health efforts, such cross-national health policies are essential to leverage joint efforts by countries learning from their peers that experience similar health system challenges. In our analysis, we used World Bank Health, Nutrition, and Population (HNP) data from 1995 to 2014 for East Asia Pacific (EAP) countries to explore health system comparability across member nations. We applied a hierarchical cluster analysis using Ward's method and a squared Euclidean distance approach to classify 24 EAP countries into four relatively stable clusters based on their (dis)similarities over nine selected health expenditure and health system performance related indicators. One-way analysis of variance (ANOVA) was used to assess the discreteness of the formed clusters. Each cluster had unique characteristics based on the included indicators and health system performance of the member countries. We present transnational health policy recommendations for the EAP region based on both our use of robust methodology and the resulting comparative clusters.
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Affiliation(s)
- Preshit Nemdas Ambade
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Chinmayee Katragadda
- Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson, AZ, USA
| | - Diana Sun
- Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson, AZ, USA
| | - J Lyle Bootman
- Department of Pharmacy Practice & Science, Center for Health Outcomes & Pharmacoeconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Ivo Abraham
- Department of Pharmacy Practice & Science, Center for Health Outcomes & Pharmacoeconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA.,Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
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Lopreite M, Mauro M. The effects of population ageing on health care expenditure: A Bayesian VAR analysis using data from Italy. Health Policy 2017; 121:663-674. [PMID: 28392027 DOI: 10.1016/j.healthpol.2017.03.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 01/14/2017] [Accepted: 03/25/2017] [Indexed: 11/25/2022]
Abstract
Currently, the dynamics of the population have raised concerns about the future sustainability of Italy's national health system. The increasing proportion of people over the age of 65 could lead to a higher incidence of chronic-degenerative diseases and a greater demand for health and social care with a consequent impact on health spending. Although in recent years the quantity and quality of works on the relationship between ageing and health expenditure has increased substantially these works do not always obtain similar results. Starting from this point, we use a B-VAR model and Eurostat data to investigate over the period 1990-2013 the impact of demographic changes on health expenditure in Italy. We estimate these models using impulse-response analysis and variance decomposition. The results show that health expenditure in Italy reacts more to the ageing population compared with life expectancy and per capita GDP. In response to these findings, we conclude that the impact of the increase in the elderly population with disabilities will fall on the long-term care sector. Effective health interventions, such as health-promotion and disease-prevention programs that target the main causes of morbidity, could help to minimize the cost pressures associated with ageing by ensuring that the population stays healthy in old age. We consider the implications of this work for health care policy suggestions and for future research.
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Affiliation(s)
- Milena Lopreite
- Scuola Superiore Sant'Anna di Pisa, Institute of Economics, Piazza dei Martiri della Libertà, 3-56127 Pisa, Italy.
| | - Marianna Mauro
- University Magna Graecia of Catanzaro, Department of Clinical and Experimental Medicine, Viale Europa, 88100 Germaneto, Italy
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Tashobya CK, Dubourg D, Ssengooba F, Speybroeck N, Macq J, Criel B. A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda. Health Policy Plan 2016; 31:217-28. [PMID: 26024882 PMCID: PMC4748130 DOI: 10.1093/heapol/czv045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2015] [Indexed: 12/21/2022] Open
Abstract
In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards' method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences.
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Affiliation(s)
- Christine K Tashobya
- Quality Assurance Department, Ministry of Health, Kampala, Uganda, Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium, School of Public Health, Makerere University, Kampala, Uganda and
| | - Dominique Dubourg
- Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Niko Speybroeck
- Institute of Health and Society, Catholic University of Louvain, Brussels, Belgium
| | - Jean Macq
- Institute of Health and Society, Catholic University of Louvain, Brussels, Belgium
| | - Bart Criel
- Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium
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Tanaka H, Miyachi M, Murakami H, Maeda S, Sugawara J. Attenuated Age-Related Increases in Arterial Stiffness in Japanese and American Women. J Am Geriatr Soc 2015; 63:1170-4. [DOI: 10.1111/jgs.13433] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Hirofumi Tanaka
- Department of Kinesiology and Health Education; University of Texas at Austin; Austin Texas
| | - Motohiko Miyachi
- Department of Health Promotion and Exercise; National Institute of Health and Nutrition; Tokyo Japan
| | - Haruka Murakami
- Department of Health Promotion and Exercise; National Institute of Health and Nutrition; Tokyo Japan
| | - Seiji Maeda
- Faculty of Health and Sport Sciences; University of Tsukuba; Ibaraki Japan
| | - Jun Sugawara
- National Institute of Advanced Industrial Science and Technology; Ibaraki Japan
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Campbell M, Bowie C, Kingham S, McCarthy JP. Painting a picture of trans-Tasman mortality. Public Health 2015; 129:396-402. [PMID: 25746155 DOI: 10.1016/j.puhe.2015.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 12/31/2014] [Accepted: 01/17/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The determinants of health and mortality inequalities in New Zealand and Australia have been subjected to research, with the influence of a range of socio-economic and demographic influences (deprivation, social class, ethnicity) receiving notable attention. Both countries are considered privileged, positioned amongst the world leaders in rankings of mortality and life expectancy. This paper reports on observed rates of mortality and views how the countries have fared over time with respect to one another. STUDY DESIGN, OBSERVATIONAL, METHODS This study derives comparable rates of mortality for both New Zealand and Australia, disaggregated by age and sex for the time period 1948-2008. The age-standardised rates are visualised using the Lexis mapping software program, showing the relative differences between the countries over time whilst simultaneously highlighting age, period and cohort effects. RESULTS Relative to Australia, New Zealand had advantageous rates of mortality across almost all age groups between the years 1948 and 1980 (approximately). For both sexes, a dramatic reversal of fortunes in New Zealand has followed relative to Australia. For example, for younger males in New Zealand, the reversal is startling. Over the time period observed, males aged 10-20 years in New Zealand have moved from an advantageous position of having a mortality rate 20% lower than Australia to a relative position of 50% higher. CONCLUSIONS The social and economic forces in both New Zealand and Australia which may have driven the divergence require further scrutiny. It is argued here, that the changing fortunes of the populations are linked to the process of selective migration and the large-scale population movements between the countries facilitated by the Trans-Tasman Travel Arrangement. These findings have important implications for policy formation and service planning, if the inequality in mortality between the areas of study is to be addressed.
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Affiliation(s)
- M Campbell
- Department of Geography, University of Canterbury, New Zealand
| | - C Bowie
- Department of Geography, University of Canterbury, New Zealand
| | - S Kingham
- Department of Geography, University of Canterbury, New Zealand
| | - J P McCarthy
- Department of Geography, University of Canterbury, New Zealand.
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Son LH. Enhancing clustering quality of geo-demographic analysis using context fuzzy clustering type-2 and particle swarm optimization. Appl Soft Comput 2014. [DOI: 10.1016/j.asoc.2014.04.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chondur R, Li SQ, Guthridge S, Lawton P. Does relative remoteness affect chronic disease outcomes? Geographic variation in chronic disease mortality in Australia, 2002-2006. Aust N Z J Public Health 2013; 38:117-21. [DOI: 10.1111/1753-6405.12126] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Shu Qin Li
- Health Gains Planning Branch, Department of Health, Northern Territory
| | - Steven Guthridge
- Health Gains Planning Branch, Department of Health, Northern Territory
- Centre for Remote Health, Flinders University and Charles Darwin University
- Centre of Research Excellence in Rural and Remote Primary Health Care
| | - Paul Lawton
- Menzies School of Health Research, Northern Territory
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Beckfield J, Olafsdottir S, Sosnaud B. Healthcare Systems in Comparative Perspective: Classification, Convergence, Institutions, Inequalities, and Five Missed Turns. ANNUAL REVIEW OF SOCIOLOGY 2013; 39:127-146. [PMID: 28769148 PMCID: PMC5536857 DOI: 10.1146/annurev-soc-071312-145609] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This essay reviews and evaluates recent comparative social science scholarship on healthcare systems. We focus on four of the strongest themes in current research: (1) the development of typologies of healthcare systems, (2) assessment of convergence among healthcare systems, (3) problematization of the shifting boundaries of healthcare systems, and (4) the relationship between healthcare systems and social inequalities. Our discussion seeks to highlight the central debates that animate current scholarship and identify unresolved questions and new opportunities for research. We also identify five currents in contemporary sociology that have not been incorporated as deeply as they might into research on healthcare systems. These five "missed turns" include an emphasis on social relations, culture, postnational theory, institutions, and causal mechanisms. We conclude by highlighting some key challenges for comparative research on healthcare systems.
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Postoperative radiotherapy after radical prostatectomy: indications and open questions. Prostate Cancer 2012; 2012:963417. [PMID: 22530131 PMCID: PMC3316943 DOI: 10.1155/2012/963417] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 12/14/2011] [Accepted: 12/15/2011] [Indexed: 11/18/2022] Open
Abstract
Biochemical relapse after radical prostatectomy occurs in approximately 15–40% of patients within 5 years. Postoperative radiotherapy is the only curative treatment for these patients. After radical prostatectomy, two different strategies can be offered, adjuvant or salvage radiotherapy. Adjuvant radiotherapy is defined as treatment given directly after surgery in the presence of risk factors (R1 resection, pT3) before biochemical relapse occurs. It consists of 60–64 Gy and was shown to increase biochemical relapse-free survival in three randomized controlled trials and to increase overall survival after a median followup of 12.7 years in one of these trials. Salvage radiotherapy, on the other hand, is given upon biochemical relapse and is the preferred option, by many centers as it does not include patients who might be cured by surgery alone. As described in only retrospective studies the dose for salvage radiotherapy ranges from 64 to 72 Gy and is usually dependent on the absence or presence of macroscopic recurrence. Randomized trials are currently investigating the role of adjuvant and salvage radiotherapy. Patients with biochemical relapse after prostatectomy should at the earliest sign of relapse be referred to salvage radiotherapy and should preferably be treated within a clinical trial.
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Abstract
In the wake of the report of the World Health Organisation's Commission on the Social Determinants of Health, Closing the gap in a generation (Marmot 2008), this invited commentary considers the scope for geographical research on global health. We reflect on current work and note future possibilities, particularly those that take a critical perspective on the interplay of globalisation, security and health.
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Koh HK, Oppenheimer SC, Massin-Short SB, Emmons KM, Geller AC, Viswanath K. Translating research evidence into practice to reduce health disparities: a social determinants approach. Am J Public Health 2010; 100 Suppl 1:S72-80. [PMID: 20147686 PMCID: PMC2837437 DOI: 10.2105/ajph.2009.167353] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2009] [Indexed: 11/04/2022]
Abstract
Translating research evidence to reduce health disparities has emerged as a global priority. The 2008 World Health Organization Commission on Social Determinants of Health recently urged that gaps in health attributable to political, social, and economic factors should be closed in a generation. Achieving this goal requires a social determinants approach to create public health systems that translate efficacy documented by research into effectiveness in the community. We review the scope, definitions, and framing of health disparities and explore local, national, and global programs that address specific health disparities. Such efforts translate research evidence into real-world settings and harness collaborative social action for broad-scale, sustainable change.
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Affiliation(s)
- Howard K Koh
- Division of Public Health Practice, Harvard School of Public Health, Boston, MA 02115, USA
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Simoes EJ, Sumaya CV. Protecting and Enhancing Health: Community Engagement, Collaborations, and Incentives for Prevention. J Prim Prev 2010; 31:21-9. [DOI: 10.1007/s10935-010-0201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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