Bruce Hollingsworth

Minimum pricing of alcohol versus volumetric taxation: Which policy will reduce heavy consumption without adversely affecting light and moderate consumers?

Publisher: Public Library of Science (PLoS)

Date: 22-01-2014

DOI: 10.1371/JOURNAL.PONE.0080936

Economic implications of obesity among people with atherothrombotic disease

Publisher: Springer Science and Business Media LLC

Date: 02-03-2010

DOI: 10.1038/IJO.2010.42

Abstract: The purpose of this study was to ascertain the impact of obesity on the cost of disease management in people with or at high risk of atherothrombotic disease from a governmental perspective using a bottom-up approach to cost estimation. In addition, the aim was also to explore the causes of any differences found. The health-care costs of obesity were estimated from 2819 participants recruited into the nationwide Australian REACH Registry with established atherothrombotic disease or at least three risk factors for atherothrombosis. Enrollment was in 2004, through primary care general practices. Information was collected on the use of cardiovascular drugs, hospitalizations and ambulatory care services. 'Bottom-up' costing was undertaken by assigning unit costs to each health-care item, based on Australian Government-reimbursed figures 2006-2007. Linear-mixed models were used to estimate associations between direct medical costs and body mass index (BMI) categories. Annual pharmaceutical costs per person increased with increasing BMI category, even after adjusting for gender, age, living place, formal education, smoking status, hypertension and diabetes. Adjusted annual pharmaceutical costs of overweight and obese participants were higher ($7 (P=0.004) and $144 (<0.001), respectively) than those of the normal weight participants. This was due to participants in higher BMI categories receiving more pharmaceuticals than normal weight participants. There was no significant change across the BMI categories in annual ambulatory care costs and annual hospital costs. In these participants with or at high risk of atherothrombotic disease, annual pharmaceutical costs were greater in participants of higher BMI category, but there was not such a gradient in the annual hospital or ambulatory care costs. The greater cardiovascular pharmaceutical costs for participants of higher BMI categories remained even after adjusting for a range of demographic factors and comorbidities. Our results suggest that these costs are explained by the higher number of drugs used among people with atherothrombotic disease. Further investigation is needed to understand the reasons for this level of drug use.

Differential item functioning in quality of life measurement: An analysis using anchoring vignettes

Publisher: Elsevier BV

Date: 10-2017

DOI: 10.1016/J.SOCSCIMED.2017.08.033

Abstract: Systematic differences in the ways that people use and interpret response categories (differential item functioning, DIF) can introduce bias when using self-assessments to compare health or quality of life across heterogeneous groups. This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify DIF in a commonly used measure for assessing health-related quality of life - namely the EQ-5D. Using data from a bespoke (i.e. custom) survey that recruited a representative s le of 4300 respondents from the general Australian population in 2014 and 2015, we find that the assumptions of response consistency (RC) and vignette equivalence (VE) hold in a sub-s le of respondents aged 55-65 years (n = 914), which demonstrates that vignettes can appropriately identify DIF in EQ-5D reporting for this age group. We find that the EQ-5D is indeed subject to DIF, and that failure to account for DIF can lead to conclusions that are misleading when using the instrument to compare health or quality of life across heterogeneous groups. We also provide several important insights in terms of the identifying assumptions of RC and VE. We conclude that the implications of DIF could be of considerable importance, not only for outcomes research, but for funding decisions in healthcare more broadly given the strong reliance on patient-reported outcome measures in economic evaluations for health technology assessment.

Response to comment by robone: Practical advice for the implementation of anchoring vignettes

Publisher: Wiley

Date: 10-10-2017

DOI: 10.1002/HEC.3433

Is It Cost‐Effective To Increase Aspirin Use in Outpatient Settings for Primary or Secondary Prevention? Simulation Data from the REACH Registry Australian Cohort

Publisher: Wiley

Date: 07-2011

DOI: 10.1111/J.1755-5922.2011.00291.X

Abstract: To describe aspirin use in primary and secondary prevention and to determine the incremental costs-effectiveness ratio (ICER) per life year gain (LYG) of aspirin use among subjects with, or at high risk of atherothrombotic disease. To project the cost-effectiveness of aspirin over 5 years of follow-up, a Markov state transition model was developed with yearly cycles and the following health states: "Alive" (post-CAD) and "Dead." The model compared current coverage observed among 2361 subjects using the prospective Australian subset of Reduction of Atherothrombosis for continued Health (REACH) registry, and hypothetical situation whereby all subjects assumed to be treated. Costs were calculated based on the Australian government reimbursed data for 2010. ICER per LYG for increased use of aspirin. The use of aspirin in current group varied from 67% to 70%. The base-case analysis showed that increasing aspirin use among subjects with existing CAD in outpatient settings was cost saving, while increasing use of aspirin in primary prevention equated to an ICER of AUD 7126 per LYG. Among subjects with existing CAD aspirin use was shown to be a dominant choice of treatment. However, among patients without existing cardiovascular disease (primary prevention), increased uptake of aspirin was cost effective but with uncertain benefit, with two hemorrhagic bleeding events occurring for every life saved.

Response-Scale Heterogeneity in the EQ-5D

Publisher: Wiley

Date: 12-01-2017

DOI: 10.1002/HEC.3313

Abstract: This paper discusses two types of response-scale heterogeneity, which may impact upon the EQ-5D. Response-scale heterogeneity in reporting occurs when in iduals systematically differ in their use of response scales when responding to self-assessments. This type of heterogeneity is widely observed in relation to other self-assessed measures but is often overlooked with regard to the EQ-5D. Analogous to this, preference elicitation involving the EQ-5D could be subject to a similar type of heterogeneity, where variations across respondents may occur in the interpretations of the levels (response categories) being valued. This response-scale heterogeneity in preference elicitation may differ from variations in preferences for health states, which have been observed in the literature. This paper explores what these forms of response-scale heterogeneity may mean for the EQ-5D and the potential implications for researchers who rely on the instrument as a measure of health and quality of life. We identify situations where they are likely to be problematic and present potential avenues for overcoming these issues. Copyright © 2016 John Wiley & Sons, Ltd.

Inflated Responses in Measures of Self-Assessed Health

Publisher: University of Chicago Press

Date: 11-2015

DOI: 10.1162/AJHE_A_00026

The scale of hospital production in different settings: one size does not fit all

Publisher: Springer Science and Business Media LLC

Date: 17-01-2013

DOI: 10.1007/S11123-012-0332-9

Systematic voiding programme in adults with urinary incontinence following acute stroke: the ICONS-II RCT

Publisher: National Institute for Health and Care Research

Date: 07-2022

DOI: 10.3310/EFTV1270

Abstract: Urinary incontinence affects around half of stroke survivors in the acute phase, and it often presents as a new problem after stroke or, if pre-existing, worsens significantly, adding to the disability and helplessness caused by neurological deficits. New management programmes after stroke are needed to address urinary incontinence early and effectively. The Identifying Continence OptioNs after Stroke (ICONS)-II trial aimed to evaluate the clinical effectiveness and cost-effectiveness of a systematic voiding programme for urinary incontinence after stroke in hospital. This was a pragmatic, multicentre, in idual-patient-randomised (1 : 1), parallel-group trial with an internal pilot. Eighteen NHS stroke services with stroke units took part. Participants were adult men and women with acute stroke and urinary incontinence, including those with cognitive impairment. Participants were randomised to the intervention, a systematic voiding programme, or to usual care. The systematic voiding programme comprised assessment, behavioural interventions (bladder training or prompted voiding) and review. The assessment included evaluation of the need for and possible removal of an indwelling urinary catheter. The intervention began within 24 hours of recruitment and continued until discharge from the stroke unit. The primary outcome measure was severity of urinary incontinence (measured using the International Consultation on Incontinence Questionnaire) at 3 months post randomisation. Secondary outcome measures were taken at 3 and 6 months after randomisation and on discharge from the stroke unit. They included severity of urinary incontinence (at discharge and at 6 months), urinary symptoms, number of urinary tract infections, number of days indwelling urinary catheter was in situ, functional independence, quality of life, falls, mortality rate and costs. The trial statistician remained blinded until clinical effectiveness analysis was complete. The planned s le size was 1024 participants, with 512 allocated to each of the intervention and the usual-care groups. The internal pilot did not meet the target for recruitment and was extended to March 2020, with changes made to address low recruitment. The trial was paused in March 2020 because of COVID-19, and was later stopped, at which point 157 participants had been randomised (intervention, n = 79 usual care, n = 78). There were major issues with attrition, with 45% of the primary outcome data missing: 56% of the intervention group data and 35% of the usual-care group data. In terms of the primary outcome, patients allocated to the intervention group had a lower score for severity of urinary incontinence (higher scores indicate greater severity in urinary incontinence) than those allocated to the usual-care group, with means (standard deviations) of 8.1 (7.4) and 9.1 (7.8), respectively. The trial was unable to recruit sufficient participants and had very high attrition, which resulted in seriously underpowered results. The internal pilot did not meet its target for recruitment and, despite recruitment subsequently being more promising, it was concluded that the trial was not feasible owing to the combined problems of poor recruitment, poor retention and COVID-19. The intervention group had a slightly lower score for severity of urinary incontinence at 3 months post randomisation, but this result should be interpreted with caution. Further studies to assess the effectiveness of an intervention starting in or continuing into the community are required. This trial is registered as ISRCTN14005026. This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment Vol. 26, No. 31. See the NIHR Journals Library website for further project information.

Costs and drivers of complementary and alternative medicine (CAM) use in people with type 2 diabetes or cardiovascular disease

Publisher: Elsevier BV

Date: 02-2013

DOI: 10.1016/J.EUJIM.2012.08.003

Predictors of Annual Pharmaceutical Costs in Australia for Community-Based Individuals with, or at Risk of, Cardiovascular Disease

Publisher: Springer Science and Business Media LLC

Date: 04-2010

DOI: 10.2165/11530670-000000000-00000

Abstract: Cardiovascular disease (CVD) remains a leading cause of death across the world and poses a significant economic burden. Research regarding per-person use and cost of cardiovascular pharmaceuticals in Australia, as well as potential predictors of pharmaceutical costs in populations using the 'bottom up' costing approach, is limited. Previous studies have adopted 'top down' costing approaches and have been based largely on hypothetical ex les and considered only inpatient settings. To determine the distribution of pharmaceutical costs (from a governmental perspective) related to each cardiovascular risk factor for in iduals with, or at high risk of, CVD by analysing data for Australian participants enrolled in the Reduction of Atherothrombosis for Continued Health (REACH) Registry. 2873 participants were recruited for the REACH Registry through 273 general (primary care) practices in Australia. Included among data collected at baseline was a cardiovascular medicines review. Average weighted costs per person were estimated using Government-reimbursed prices (2007). Annual costs were stratified by sex, age, disease group and other co-morbidities. A multivariate linear regression model was utilized to reveal the predictors of the pharmaceutical costs. The average annual median cost of cardiovascular pharmaceuticals per person was Australian dollars ($A)1310. Use of lipid-lowering agents, non-aspirin (acetylsalicylic acid) antiplatelet agents and thiazolidinediones (glitazones) added significantly to the average annual per-person costs. The multivariate regression model showed that the predictors of annual pharmaceutical costs were dyslipidemia (beta coefficient value [marginal annual cost associated with a condition] $A691 p < 0.001), hypertension ($A346 p < 0.001), vascular disease ($A340 p < 0.001), diabetes mellitus ($A298 p < 0.001), and obesity ($A52 p = 0.03). The same predictors, together with sex, were shown to have an impact on the number of medicines used. Among community-based Australians with, or at risk of, CVD, independent drivers of annual cardiovascular pharmaceutical costs are dyslipidemia (which accounts for half of per-person costs), followed by hypertension, established CVD, and diabetes. Obesity also independently adds to the cost of cardiovascular pharmaceuticals in community-based Australians with, or at risk of, CVD.

Complementary and alternative medicine (CAM) use and quality of life in people with type 2 diabetes and/or cardiovascular disease

Publisher: Elsevier BV

Date: 02-2014

DOI: 10.1016/J.CTIM.2013.11.007

Abstract: To quantify the association between complementary and alternative medicine (CAM) use and quality of life in a population with type 2 diabetes and/or cardiovascular disease, accounting for demographics, socioeconomic status, health and lifestyle factors. Data are from a purpose-designed survey of 2915 in iduals aged 18 years and over, all with type 2 diabetes and/or cardiovascular disease (CVD), collected in 2010. Key variables are compared for comparability with nationally representative data. It was hypothesised that CAM use would be associated with higher quality of life, as measured by the Assessment of Quality of Life-4 dimension (AQoL-4D) instrument. Three key variables are used for CAM use in the previous twelve months. In the robustness analysis, CAM use is further disaggregated into the types of practitioner or product used, the frequency of use, the reason for use and expenditure on CAM. CAM use is not associated with higher QoL for this sub-population, and in fact intensive use of CAM practitioners is associated with significantly lower QoL. It is important not to assume that patients have sufficient information with which to make optimal choices regarding CAM use in the absence of accessible and relevant evidence-based guidance.

Are the economics of complementary and alternative medicine different to conventional medicine?

Publisher: Informa UK Limited

Date: 02-2009

DOI: 10.1586/14737167.9.1.1

A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare'): Study protocol

Publisher: Springer Science and Business Media LLC

Date: 25-02-2011

DOI: 10.1186/1471-2261-11-8

A latent class model for obesity

Publisher: Elsevier BV

Date: 04-2014

DOI: 10.1016/J.ECONLET.2014.01.004

The cost effectiveness of intracyctoplasmic sperm injection (ICSI)

Publisher: Springer Science and Business Media LLC

Date: 16-11-2007

DOI: 10.1007/S10815-007-9175-0

The efficiency of immunization of infants by local government

Publisher: Informa UK Limited

Date: 12-2002

DOI: 10.1080/00036840210147158

The 1st Australasian Workshop on Econometrics and Health Economics.

Publisher: Wiley

Date: 08-2011

DOI: 10.1002/HEC.1718

The relationship between smoking, quitting smoking and obesity in Australia: a seemingly unrelated probit approach

Publisher: Informa UK Limited

Date: 06-2013

DOI: 10.1080/00036846.2012.657353

Cross-country comparisons of technical efficiency of health production: a demonstration of pitfalls

Publisher: Informa UK Limited

Date: 02-2009

DOI: 10.1080/00036840701604354

THE 2ND AUSTRALASIAN WORKSHOP ON ECONOMETRICS AND HEALTH ECONOMICS

Publisher: Wiley

Date: 03-05-2012

DOI: 10.1002/HEC.2825

Cost-Effectiveness of Optimizing Use of Statins in Australia: Using Outpatient Data From the REACH Registry

Publisher: Elsevier BV

Date: 10-2011

DOI: 10.1016/J.CLINTHERA.2011.08.004

Abstract: Although few cardiovascular registries report the costs of illness or cost-effectiveness of health interventions, such information is critical to inform the effective and cost-effective management of cardiovascular disease, particularly if drawn from population-based registries, which more accurately reflect clinical practice and follow up patients for much longer than clinical trials. The goal of this study was to estimate the cost-effectiveness of closing the statin "treatment gap" in the secondary prevention of coronary artery disease (CAD) in Australia. A decision analysis Markov model was developed with yearly cycles and the health states of alive or dead. Using data from the Australian Reduction of Atherothrombosis for Continued Health Registry, the model compared current statin coverage (82%) in the secondary prevention of CAD (the current group) with a hypothetical situation of 100% coverage (the improved group). The 18% gap was filled with use of generic statins. Data from a recent meta-analysis were used to estimate the benefits of statin use in terms of reducing recurrent cardiovascular events and death. Government reimbursement data from 2011 were used to calculate direct health care costs. The cost of the intervention to improve statin coverage was assumed to be $250 per person. Years of life lived and costs were discounted at 5% annually. All values are given in Australian dollars. Among the 2058 subjects in the current group, the model estimated that there would be 106 nonfatal myocardial infractions, 68 nonfatal strokes, and 275 deaths over 5 years. In the improved group, all of whom took statins, the corresponding numbers were 101, 65, and 259, equating to numbers needed to treat of 426, 639, and 127, respectively. Over the 5 years, there would be 0.018 life-years gained (discounted) at a net cost of $546 (discounted) per person. These equated to an incremental cost-effectiveness ratio of $29,717 per life-year gained. The results suggest that for patients with CAD, maximizing coverage with statins, in line with evidence-based recommendations, represents a cost-effective means of secondary prevention.

Employment patterns and changes in body weight among young women

Publisher: Elsevier BV

Date: 05-2011

DOI: 10.1016/J.YPMED.2011.03.006

Abstract: To investigate the influence of employment patterns on weight gain and weight loss in young adult women. Study s le is 5164 participants in the Australian Longitudinal Study on Women's Health who completed surveys in 2003 and 2006. Logistic regression was used to estimate odds ratios of weight change. The adjusted odds of gaining weight, compared with women in stable full-time work (49.7%), were lower for women in stable part-time work (47.3%, OR = 0.74, CI: 0.58-0.94), or who transitioned from not in the labour force (NILF) to part-time (42.8%, OR = 0.68, CI: 0.47-0.99) or full-time (37.5%, OR = 0.54, CI: 0.34-0.85) work. Heavy weight gain (>10 kg) was less likely among women in stable part-time work (6.4%, OR=0.59, CI: 0.37-0.93) compared with those in stable full-time work (8.1%). The likelihood of weight loss compared with women in stable full-time employment (22.4%) was higher among stable part-time workers (28.4% OR = 1.34, CI: 1.02-1.75) and those who transitioned from full-time to part-time work (24.8%, OR = 1.30, CI: 1.01-1.67). The lower likelihood of heavy weight gain associated with fewer work hours suggests more time spent at work may contribute to weight gain. Young women in full-time employment may benefit from workplace interventions supporting healthier lifestyles.

The socioeconomic gradient in physical inactivity: Evidence from one million adults in England

Publisher: Elsevier BV

Date: 12-2014

DOI: 10.1016/J.SOCSCIMED.2014.10.039

Abstract: Understanding the socioeconomic gradient in physical inactivity is essential for effective health promotion. This paper exploits data on over one million in iduals (1,002,216 people aged 16 and over) in England drawn from the Active People Survey (2004-11). We identify the separate associations between a variety of measures of physical inactivity with education and household income. We find high levels of physical inactivity. Further, both education and household income are strongly associated with inactivity even when controlling for local area deprivation, the availability of physical recreation and sporting facilities, the local weather and regional geography. Moreover, the gap in inactivity between those living in high and low income households is already evident in early adult life and increases up until about age 85. Overall, these results suggest that England is building up a large future health problem and one that is heavily socially graded.

Overview of pharmacoeconomic modelling methods

Publisher: Wiley

Date: 15-03-2013

DOI: 10.1111/J.1365-2125.2012.04421.X

Outcomes and Excess Costs among Patients with Cardiovascular Disease

Publisher: Elsevier BV

Date: 09-2013

DOI: 10.1016/J.HLC.2013.02.002

Abstract: To report on two-year cardiovascular (CV) event rates and quantify the cost of cardiovascular disease using the Australian Reduction of Atherothrombosis for Continued Health (REACH) registry. Prospective registry of 2873 patients with multiple risk factors (MRF), coronary artery disease (CAD), cerebrovascular disease (CerVD) and peripheral artery disease (PAD), recruited through 273 Australian general practitioners. Government reimbursement data from 2011 was used to calculate direct health care costs (pharmaceuticals, outpatient and hospitalisation costs). The main outcome of interest was two-year rates and associated excess costs of cardiovascular death, myocardial infarction, stroke, and hospitalisation for cardiovascular procedures. The two year follow-up data were available for 2856 (99.4%) patients. Incidence of any hospitalisation and cardiovascular death was highest among those with previous history of PAD at baseline 49% (n=126), and 5.1% (n=13). Non-fatal cardiovascular events were highest among the PAD and CAD groups (21.8% (n=56) and 14.1% (n=297) respectively). Those with previous history of PAD and CerVD at baseline had the highest likelihood of CV death (OR=2.53 (95% CI: 1.58-4.08) and OR=1.61 (1.05-2.46) respectively) in comparison to other groups. Patients with PAD had the highest likelihood of vascular interventions OR=3.11 (95% CI: 2.09-4.63) at two years. Overall, the mean (SD) direct expenditure over two years of follow-up per person was A$7544 (A$10,758). In the adjusted model, patients with CAD and PAD incurred A$1093 (95% CI A$24 - A$2072) and A$4890 (95% CI A$3105 - A$6869) more in mean total costs compared to patients with MRF. Patients with PAD had the highest likelihood of vascular interventions and CV death, and incurred high excess costs in comparison to other groups.

The determinants of dentists' productivity and the measurement of output

Publisher: Elsevier BV

Date: 2015

DOI: 10.1016/J.SOCSCIMED.2014.11.020

Abstract: Improving the productivity of the healthcare system, for ex le by taking advantage of scale economies or encouraging substitution of expensive specialist personnel with less expensive workers, is often seen as an attractive way to meet increasing demand within a constrained budget. Using data on 558 dentists participating in the Longitudinal Study of Dentists' Practice Activity (LSDPA) survey between 1993 and 2003 linked to patient data and average fee schedules, we estimate production functions for private dental services in Australia to quantify the contribution of different capital and labour inputs and identify economies of scale in the production of dental care. Given the challenges in measuring output in the healthcare setting, we discuss three different output measures (raw activity, time-, and price-weighted activity) and test the sensitivity of results to the choice of measure. Our results suggest that expansion of the scale of dental services is unlikely to be constrained by decreasing returns to scale. We note that conclusions about the contribution of in idual input factors and the estimated returns to scale are sensitive to the choice of output measure employed.

Role of age, sex, and obesity in the higher prevalence of arthritis among lower socioeconomic groups: A population-based survey

Publisher: Wiley

Date: 2007

DOI: 10.1002/ART.22686

Abstract: To compare the prevalence of arthritis among population groups based on demographic, socioeconomic, and body mass index (BMI) characteristics to investigate the combined influence of these factors on arthritis and to assess the relationship between self-reported health and psychological distress and arthritis. Data from the Victorian Population Health Survey (n = 7,500) were used in the study. Psychological distress was assessed using the Kessler Psychological Distress scale, and self-reported health was assessed by a single item. Multiple logistic regression was used to investigate the combined influence of demographic and socioeconomic factors and BMI on arthritis. Overall, 23% of Victorian adults (20% men and 26% women) reported having arthritis. The presence of arthritis was associated with high psychological distress (odds ratio [OR] 1.2 95% confidence interval [95% CI] 1.1-1.4) and poor self-reported health (OR 1.9 95% CI 1.7-2.1). Increased prevalence of arthritis was found in older age groups, lower education and income groups, and in people who were overweight or obese. Women had higher risk of arthritis, even after adjustment for age, residence, education, occupation, income, and BMI. Age and BMI independently predicted arthritis for men and women. For men, higher risk of arthritis was also associated with lower income. Arthritis is a highly prevalent condition associated with poor health and high psychological distress. Prevalence of arthritis is disproportionately high among women and in iduals from lower socioeconomic backgrounds. As the prevalence of arthritis is predicted to increase, careful consideration of causal factors, and setting priorities for resource allocation for the treatment and prevention of arthritis are required.

Heterogeneity in ordered choice models: A review with applications to self-assessed health

Publisher: Wiley

Date: 06-12-2014

DOI: 10.1111/JOES.12002

Measuring the Efficiency of Health Services in Lower-income Countries: The Case of Papua New Guinea

Publisher: Wiley

Date: 03-02-2014

DOI: 10.1111/DPR.12054

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study

Publisher: Elsevier BV

Date: 10-2020

DOI: 10.1016/S0140-6736(20)30750-9

THE EFFECTS OF TAXING SUGAR‐SWEETENED BEVERAGES ACROSS DIFFERENT INCOME GROUPS

Publisher: Wiley

Date: 04-06-2014

DOI: 10.1002/HEC.3070

Abstract: This paper investigates the impact of sugar-sweetened beverages (SSB) taxes on consumption, bodyweight and tax burden for low-income, middle-income and high-income groups using an Almost Ideal Demand System and 2011 Household level scanner data. A significant contribution of our paper is that we compare two types of SSB taxes recently advocated by policy makers: A 20% flat rate sales (valoric) tax and a 20 cent/L volumetric tax. Censored demand is accounted for using a two-step procedure. We find that the volumetric tax would result in a greater per capita weight loss than the valoric tax (0.41 kg vs. 0.29 kg). The difference between the change in weight is substantial for the target group of heavy purchasers of SSBs in low-income households, with a weight reduction of up to 3.20 kg for the volumetric and 2.06 kg for the valoric tax. The average yearly per capita tax burden on low-income households is $17.87 (0.21% of income) compared with $15.17 for high-income households (0.07% of income) for the valoric tax, and $13.80 (0.15%) and $10.10 (0.04%) for the volumetric tax. Thus, the tax burden is lower, and weight reduction is higher under a volumetric tax.

Economic Evaluation of Prenatal Population Screening for Fragile X Syndrome

Publisher: S. Karger AG

Date: 2005

DOI: 10.1159/000084773

Abstract: i Objectives: /i This paper models costs and benefits of a population screening programme for pregnant women to detect fragile X syndrome. Given the high lifetime costs of fragile X and the high sensitivity and specificity of testing, such a programme may seem attractive. i Methods: /i Economic evaluation. i Results: /i Our base case results indicate that such a programme seems close to cost neutral, so may indeed seem attractive for this reason. However, sensitivity analysis shows that assumptions regarding lifetime costs are crucial to results our results suggest if lifetime costs are under AUD 2.5 million, costs of screening will exceed future costs avoided. i Conclusions: /i Economic modelling of screening programmes reveals valuable information which might have an influence on the debate on the social value of a population screening programme for fragile X in pregnant women.

Policy Implications of Complementary and Alternative Medicine Use in Australia: Data from the National Health Survey

Publisher: Mary Ann Liebert Inc

Date: 04-2012

DOI: 10.1089/ACM.2010.0817

Abstract: The objective of this study was to investigate the drivers of complementary and alternative medicine (CAM) use in the general population in Australia and to identify key policy implications. The National Health Survey 2007/2008, a representative survey of the Australian population, provides information on CAM use (practitioners and products) in the last 12 months. All adult respondents (N=15,779) aged 18 years or older are included in this study. Logistic regression is employed to determine the effect of socio-economic, condition-specific, health behavior variables, and private health insurance status on CAM use. In addition to socio-economic variables known to affect CAM use, in iduals who have a chronic condition, particularly a mental health condition, are more likely to use CAM. There does not appear to be a correlation between CAM use and more frequent General Practitioner use however, ancillary private health insurance is correlated with a greater likelihood of CAM use, as expected. The Australian government does not currently intervene in the CAM market in a systematic way. CAM is clearly considered to be a legitimate and important component of health care for many Australians, despite the limited availability of clinical evidence for its efficacy and safety. Policy interventions may include the regulation of CAM products, practitioners, and information as well as providing subsidies for cost-effective modalities.

Invisible work: Child work in households with a person living with HIV/AIDS in Central Uganda

Publisher: Informa UK Limited

Date: 2017

DOI: 10.1080/17290376.2017.1379429

Cluster randomised controlled trial of a peer-led lifestyle intervention program: study protocol for the Kerala diabetes prevention program

Publisher: Springer Science and Business Media LLC

Date: 04-11-2013

DOI: 10.1186/1471-2458-13-1035

HEALTH INVESTMENT AND ECONOMIC OUTPUT IN REGIONAL CHINA

Publisher: Wiley

Date: 23-06-2013

DOI: 10.1111/COEP.12022

A conceptual model of the economic impact of international movements in the health labour force

Publisher: Informa UK Limited

Date: 25-03-2009

DOI: 10.1080/13504850701206494

Efficiency Measurement in Health and Health Care

Publisher: Routledge

Date: 07-02-2008

DOI: 10.4324/9780203486566

The economic consequences of introducing deep brain stimulation for the treatment of advanced Parkinson's disease in Australia

Publisher: Wiley

Date: 09-2003

DOI: 10.1111/J.1741-6612.2003.TB00482.X

THE CYCLICAL BEHAVIOUR OF PUBLIC AND PRIVATE HEALTH EXPENDITURE IN CHINA

Publisher: Wiley

Date: 08-07-2013

DOI: 10.1002/HEC.2957

Abstract: This paper studies short-run cyclical behaviour of public (government and social) and private health expenditure and GDP using both time series and panel data techniques. First, national time series data have been used within a multivariate Beveridge-Nelson decomposition framework to construct the permanent and cyclical components. The correlation analysis results for the cyclical components suggest that current public health expenditure is pro-cyclical while there is no clear evidence of a correlation between cycles in private health expenditure and in GDP growth. Next, using an instrumental variable method and the generalised method of moments estimator, provincial-level panel data analyses confirm pro-cyclical impacts of government spending on health. The provincial analysis also suggests that private health expenditure in urban China has a pro-cyclical association with GDP growth, but a lack of good instruments makes it difficult to identify a clear causal link between cycles in income growth and private health expenditure. The results suggest two policy recommendations relevant to public health expenditure, in line with China's current health reforms.

Employment, work hours and weight gain among middle-aged women

Publisher: Springer Science and Business Media LLC

Date: 19-06-2012

DOI: 10.1038/IJO.2012.92

Abstract: To investigate the influence of employment and work hours on weight gain and weight loss among middle-aged women. Quantile regression techniques were used to estimate the influence of employment and hours worked on percentage weight change over 2 years across the entire distribution of weight change in a cohort of middle-aged women. A range of controls was included in the models to isolate the effect of work status. A total of 9276 women aged 45-50 years at baseline who were present in both the 1996 and 1998 surveys of the Australian Longitudinal Study of Women's Health. The women were a representative s le of the Australian population. Being out of the labour force or unemployed was associated with lower weight gain and higher weight loss than being employed. The association was stronger at low to moderate levels of weight gain. Among employed women, working regular (35-40), long (41-48) or very long (49+) hours was associated with increasingly higher levels of weight gain compared with working part-time hours. The association was stronger for women with greater weight gain overall. The association between unemployment and weight change became insignificant when health status was controlled for. Employment was associated with more weight gain and less weight loss. Among the employed, working longer hours was associated with more weight gain, especially at the higher levels of weight gain where the health consequences are more serious. These findings suggest that as women work longer hours they are more likely to make lifestyle choices that are associated with weight gain.

The economic implications of treating atherothrombotic disease in australia, from the government perspective

Publisher: Elsevier BV

Date: 2010

DOI: 10.1016/J.CLINTHERA.2010.01.009

Abstract: The management of atherothrombotic disease is responsible for a large proportion of direct medical costs in most countries, imposing a substantial financial burden on health care payers. There is limited knowledge about direct per-person medical costs using a "bottom-up" approach. This study was designed to estimate the per-person direct medical costs incurred by communitybased subjects in Australia who have or are at high risk for atherothrombotic disease. The perspective was a governmental one, at the federal level for pharmaceuticals and at the state level for hospitalizations. One-year follow-up data were obtained for Australian participants in the international REACH (Reduction of Atherothrombosis for Continued Health) Registry who were aged >or=45 years and had either established atherothrombotic disease (coronary artery disease, cerebrovascular disease, or peripheral artery disease [PAD]) or >or=3 risk factors for atherothrombotic disease. Information was extracted on the use of cardiovascular medications, hospitalizations, general practice visits, clinical pathology and imaging studies, and use of rehabilitation services. Bottom-up costing was undertaken by assigning unit costs to each health care item, based on Australian government reimbursement data for 2006-2007. Costs were estimated in Australian dollars. Data for 2873 Australian participants in the REACH Registry were included in the analysis. Mean (SD) annual pharmaceutical costs per person were A$1388 (A$645). Mean ambulatory care costs per person were A$704 (A$492), and mean hospitalization costs were A$10,711 (A$10,494). Compared with participants with >or=3 risk factors (adjusted for age and sex), participants with 2 to 3 affected vascular territories incurred A$160 more in mean pharmaceutical costs (95% CI, 78 to 256) and A$181 more in ambulatory care costs (95% CI, 107 to 252). Mean ambulatory care costs were A$132 greater among participants with PAD only relative to those with >or=3 risk factors (95% CI, 19 to 272). Hospital costs were not significantly increased with an increasing number of affected vascular territories. The greatest difference in direct hospital costs (A$943) was between participants with PAD relative to those with >or=3 risk factors (95% CI, -564 to 3545). From the government perspective, management of atherothrombotic disease in Australia was costly during the period studied, particularly among those with PAD only or disease affecting 2 to 3 vascular territories. Hospitalization accounted for the majority of health care expenditure associated with atherothrombotic disease, although the number of hospitalized participants was relatively small.

Lancaster University

Location: United Kingdom of Great Britain and Northern Ireland

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Discovery Projects - Grant ID: DP120102252

Start Date: 2012

End Date: 12-2015

Amount: $300,000.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP0878765

Start Date: 01-2008

End Date: 11-2011

Amount: $176,500.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP0772235

Start Date: 01-2007

End Date: 11-2011

Amount: $230,000.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP110101426

Start Date: 2011

End Date: 12-2014

Amount: $476,020.00

Funder: Australian Research Council