ORCID Profile
0000-0001-5455-0735
Current Organisation
Macquarie University
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Health Policy | Social Policy | Policy and Administration
Human Capital Issues | Health Policy Economic Outcomes | Health Policy Evaluation |
Publisher: Springer Science and Business Media LLC
Date: 05-12-2011
Publisher: Informa UK Limited
Date: 03-2013
DOI: 10.1080/13607863.2012.727381
Abstract: Mental health conditions are associated with lower standards of living. This study quantifies the relationship between employment, depression and other mental health conditions and being in income poverty. Cross-sectional analysis was undertaken using the 2003 Survey of Disability, Ageing and Carers data for Australians aged 45-64 years. Those not in the labour force due to depression and other mental health conditions are significantly more likely (odds ratio (OR) 12.53, 95% CI: 12.20-12.86, p < 0.0001 OR 20.10, 95% CI: 19.67-20.54, p < 0.0001) to be in income poverty than those not in the labour force with no chronic health condition. Amongst those with depression and other mental health conditions, those who were in employment were significantly less likely to be in income poverty than those who have had to retire because of the condition. Due to the association between leaving the workforce due to mental health problems and poverty status, efforts to increase the employment of in iduals with mental health conditions, or prevent the onset of the conditions, will likely improve living standards.
Publisher: Public Library of Science (PLoS)
Date: 11-2013
Publisher: American Medical Association (AMA)
Date: 09-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2012
DOI: 10.1016/J.PAIN.2012.06.020
Abstract: There are few studies that have looked at the occurrence of co-morbid conditions amongst patients with back problems. This study assesses the association between of a range of co-morbidities and the labour force participation rates of 45- to 64-year-old Australians with back problems. Logistic regression models were applied to the 2003 Survey of Disability, Ageing and Carers (SDAC) data to look at the relationship between chronic back problems, labour force participation and comorbidities. For some conditions, there is a significant increase in the chance of an in idual being out of the labour force, relative to those with back problems alone. For ex le, an in idual with back problems and heart disease is more than 10 times more likely to be out of the labour force than those with back problems alone (OR=10.90, 95% CI=2.91-40.79, P=.0004). Amongst conditions that have a significant impact on labour force participation rates, back problems and multiple co-morbidities are significantly more likely to cause persons with these conditions to be out of the labour force than those with back problems alone or those with no chronic health condition. It is important to consider which co-morbidities an in idual has when assessing the impact of back problems on labour force participation, as co-morbid conditions vary in their association with labour force participation.
Publisher: Royal College of Psychiatrists
Date: 02-2011
DOI: 10.1192/BJP.BP.110.081679
Abstract: In addition to the health burden caused by mental illnesses, these conditions contribute to economic disadvantage because of their impact on labour force participation. To quantify the cost of lost savings and wealth to Australians aged 45–64 who retire from the labour force early because of depression or other mental illness. Cross-sectional analysis of the base population of Health& WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. People who are not part of the labour force because of depression or other mental illness have 78% (95% CI 92.2–37.1) and 93% (95% CI 98.4–70.5) less wealth accumulated respectively, compared with people of the same age, gender and education who are in the labour force with no chronic health condition. People who are out of the labour force as a result of depression or other mental illness are also more likely to have the wealth that they do have in cash assets, rather than higher-growth assets such as superannuation, home equity and other financial investments. This lower accumulated wealth is likely to result in lower living standards for these in iduals in the future. This will compound the impact of their condition on their health and quality of life, and put a large financial burden on the state as a result of the need to provide financial assistance for these in iduals.
Publisher: Japanese Circulation Society
Date: 2014
Abstract: Few studies have assessed the effect of multiple health conditions among patients with heart disease, particularly the economic implications of having multiple conditions. This study used a microsimulation model, Health&WealthMOD, to assess the effect of comorbidities on the labor force participation of 45-64-year-old Australians with heart disease, and the indirect economic costs to these in iduals and government. For most comorbid conditions, there is a significant increase in the chance of an in idual being out of the labor force, relative to those with heart disease alone. For ex le, in iduals with heart disease and arthritis have more than 6-fold the odds of being out of the labor force relative to those with heart disease alone (OR 6.64, 95% CI: 2.46-17.95). People with heart disease and ≥1 comorbidities also receive a significantly lower income, pay less in taxation and receive more in government transfer payments than those with heart disease alone. It is important to consider whether an in idual with heart disease also has other health conditions, as in iduals with comorbidities have inferior financial situations and are a greater burden on government finances than those with only heart disease. (Circ J 2014 78: 644-648).
Publisher: Public Library of Science (PLoS)
Date: 22-07-2019
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.JPSYCHIRES.2013.02.014
Abstract: It is known that people with depression often have other co-morbid conditions however this is rarely acknowledged in studies that access the economic impacts of depression. This paper aims to quantify the association between co-morbid health conditions and labour force status and economic circumstances of people with depression. This study undertakes cross-sectional analysis using a dataset that is representative of the 45-64 year old Australian population with depression. The probability of being out of the labour force increases with increasing number of co-morbidities, and the amount of weekly income received by people with depression decreased with increasing numbers of co-morbidities. Those with depression and three or more co-morbidities were 4.31 times more likely to be out of the labour force (95% CI: 1.74-10.68), and received a weekly private income 88% lower (95% CI: -94%, -75%) than people with depression alone. It is important to consider the co-morbid conditions an in idual has when assessing the impact of depression on labour force participation and economic circumstances.
Publisher: Elsevier BV
Date: 04-2013
Publisher: Elsevier BV
Date: 11-2020
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.SPINEE.2012.09.036
Abstract: Spinal disorders can reduce an in idual's ability to participate in the labor force, and this can lead to considerable impacts on both the in idual and the state. This study was aimed to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefits payments, and lost gross domestic product (GDP) as a result of early retirement because of spinal disorders in Australians aged 45 to 64 years in 2009. This was done using cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers, and STINMOD, an income and savings microsimulation model. Linear regression models were used to examine the relationship between spinal disorders, labor force participation, income, taxation, and government support payments. It was found that in iduals aged 45 to 64 years who have retired early because of spinal disorders have significantly lower income (79% less 95% confidence interval [CI], -84.7, -71.1 p<.0001), pay significantly less taxation (100% less 95% CI, -100.0, 99.9 p<.0001), and receive significantly more in government support payments (21,000% more 95% CI, 12,767.0, 35,336.4 p<.0001) than those employed full time with no health condition. In iduals who have retired early because of spinal disorders have a median value of total weekly income of only AU$310, whereas those who are employed full time are likely to receive four times this. This has a large national aggregate impact, with AU$4.8 billion lost in annual in idual earnings, AU$622 million in additional welfare payments, AU$497 million lost in taxation revenue for governments, and AU$2.9 billion in lost GDP: all attributable to spinal disorders through their impact on labor force participation. Although the in idual has to bear the economic costs of lost income in addition to the burden of the condition itself, the state experiences the impacts of loss of productivity from reduced workforce participation, lost income taxation revenue, and increasing government support payments.
Publisher: Wiley
Date: 23-04-2014
DOI: 10.1111/COB.12057
Publisher: Elsevier BV
Date: 03-2023
Publisher: BMJ
Date: 11-2013
Publisher: Elsevier BV
Date: 2011
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2012
Publisher: Royal College of Psychiatrists
Date: 05-2019
DOI: 10.1192/BJO.2019.26
Abstract: The impact of mental disorders has been assessed in relation to longevity and quality of life however, mental disorders also have an impact on productive life-years (PLYs). To quantify the long-term costs of Australians aged 45–64 having lost PLYs because of mental disorders. The Survey of Disability, Ageing and Carers 2003, 2009 formed the base population of Health& WealthMOD2030 – a microsimulation model integrating output from the Static Incomes Model, the Australian Population and Policy Simulation Model, the Treasury and the Australian Burden of Disease Study. For depression, in iduals incurred a loss of AU$1062 million in income in 2015, projected to increase to AU$1539 million in 2030 (45% increase). The government is projected to incur costs comprising a 22% increase in social security payments and a 45% increase in lost taxes as a result of depression through its impact on PLYs. Effectiveness of mental health programmes should be judged not only in terms of healthcare use but also quality of life and economic well-being. None.
Publisher: Elsevier BV
Date: 03-2022
Publisher: BMJ
Date: 2017
Publisher: Informa UK Limited
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 21-06-2019
Publisher: Elsevier BV
Date: 05-2023
Publisher: Elsevier BV
Date: 05-2012
Publisher: Elsevier BV
Date: 04-2017
Abstract: To estimate the long-term productivity impacts of all-cause premature mortality in Australia by age, sex and cause of death. Using a human capital approach, a model was developed to estimate both the working years and present value of lifetime income (PVLI) lost due to premature deaths that occurred in 2003. Outcomes were modelled on in idual level data to the year 2030. A discount rate of 3% was applied and results are presented in 2015 Australian dollars. Premature deaths occurring in 2003 accounted for about 284,000 working years lost and $13.8 billion in PVLI lost when modelled to 2030. Deaths from cancer and cardiovascular disease accounted for more than half the total PVLI impact. Injuries and mental disorders were associated with the highest average PVLI loss per death. The productivity-related impacts of premature mortality are substantial. This study provides an assessment of relative impact of these costs across specific age, sex and cause of death categories. Policies and interventions that prevent premature mortality would improve both health and economic outcomes. An awareness of the productivity costs associated with all-cause mortality may assist decision makers in identifying population and disease subgroups where cost-effective health care investment can achieve the greatest economic gains to society.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-12-2020
DOI: 10.1097/J.PAIN.0000000000001788
Abstract: This study models the economic costs of informal caring for people with back pain, using a microsimulation model, Care& WorkMOD, from 2015 to 2030. Care& WorkMOD was based on 3 national Australian Surveys of Disability, Ageing and Carers (2003, 2009, 2012) data sets for in iduals aged 15 to 64 years. Estimated national income loss due to caring for people with back pain was AU$258 million in 2015, increasing to $398 million in 2030 (54% increase). Lost income tax revenue to the Australian government due to informal care of people with back pain was estimated to be AU$78 million in 2015, increasing to AU$118 million in 2030 (50% increase), and additional welfare payments were estimated to rise from $132 million in 2015 to AU$180 in 2030 (36% increase). Larger growth in lost income, compared with the increase in welfare payments, means that there would be an increasing income gap between those out of the labour force providing informal care and noncarers who are in the labour force, leading to increased inequality. Informal carers are defined as providers of informal, unpaid assistance to someone with a health condition, for at least 6 months. Informal carers of people with back pain who are out of the labour force incur substantial economic costs. Furthermore, back pain is a large economic burden on national governments. Policies addressing back pain prevention and treatment, and supporting carers, may offset government welfare expenditure, while improving the socioeconomic well-being of carers and patients.
Publisher: Informa UK Limited
Date: 09-2012
Publisher: Springer Science and Business Media LLC
Date: 06-2011
Publisher: Public Library of Science (PLoS)
Date: 20-02-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-06-2023
Publisher: Elsevier BV
Date: 10-2013
Publisher: Springer Science and Business Media LLC
Date: 06-01-2012
Publisher: Royal College of Psychiatrists
Date: 16-09-2019
DOI: 10.1192/BJP.2019.204
Abstract: Intellectual disability and autism spectrum disorder (ASD) influence the interactions of a person with their environment and generate economic and socioeconomic costs for the person, their family and society. To estimate costs of lost workforce participation due to informal caring for people with intellectual disability or autism spectrum disorders by estimating lost income to in iduals, lost taxation payments to federal government and increased welfare payments. We used a microsimulation model based on the Australian Bureau of Statistics' Surveys of Disability, Ageing and Carers (population surveys of people aged 15–64), and projected costs of caring from 2015 in 5-year intervals to 2030. The model estimated that informal carers of people with intellectual disability and/or ASD in Australia had aggregated lost income of AU$310 million, lost taxation of AU$100 million and increased welfare payments of AU$204 million in 2015. These are projected to increase to AU$432 million, AU$129 million and AU$254 million for income, taxation, and welfare respectively by 2030. The income gap of carers for people with intellectual disability and/or ASD is estimated to increase by 2030, meaning more financial stress for carers. Informal carers of people with intellectual disability and/or ASD experience significant loss of income, leading to increased welfare payments and reduced taxation revenue for governments these are all projected to increase. Strategic policies supporting informal carers wishing to return to work could improve the financial and psychological impact of having a family member with intellectual disability and/or ASD. None.
Publisher: Informa UK Limited
Date: 10-2012
DOI: 10.1080/08959420.2012.735177
Abstract: Using the newly created Freedom Poverty Measure, a multidimensional measure of poverty, it can be seen that there were 534,700 in iduals who were in freedom poverty, who had either poor health or poor education in addition to having low incomes. This multidimensional disadvantage would not normally be captured by single measures of poverty, such as income poverty measures. Men were significantly less likely to be in freedom poverty than women (OR = 0.63, 95% CI: 0.54-0.74, p < .0001), and the proportion of in iduals in freedom poverty increased with age, with those older than 85 being 2.3 times more likely to be in freedom poverty than those aged 65 to 69 years (95% CI: 1.73-3.11, p < .0001). Policy responses to address the marginalization of disadvantaged older people should take a multidisciplinary approach, addressing health inequalities in particular, not just low income.
Publisher: International Microsimulation Association
Date: 30-04-2021
DOI: 10.34196/IJM.00230
Publisher: Springer Science and Business Media LLC
Date: 29-01-2015
DOI: 10.1007/S00296-015-3224-2
Abstract: The objective of this study was to quantify the impact that having arthritis has on income poverty status and accumulated wealth in Australia. Cross-sectional analysis of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. Across all categories of labour force participation status (employed full time, part time or not in the labour force at all), those with arthritis were significantly more likely to be in poverty. Those employed full time with no health condition had 0.82 times the odds of being in income poverty (95 % CI 0.80-0.84) compared with those employed full time with arthritis. Those not in the labour force with no chronic health conditions had 0.36 times the odds of being in income poverty compared with those not in the labour force due to arthritis (95 % CI 0.36-0.37). For people not in the labour force with no long-term health condition, the total value of their wealth was 211 % higher (95 % CI 38-618 %) than the amount of wealth accumulated by those not in the labour force due to arthritis. Similarly, those employed part time with no chronic health condition had 50 % more wealth than those employed part time with arthritis (95 % CI 3-116 %). Arthritis has a profound impact upon the economic circumstances of in iduals, which adds a further dimension to the detrimental living standards of older in iduals suffering from the condition.
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/OPENHRT-2018-000939
Abstract: Cardiovascular disease (CVD) is the single largest contributor to global mortality. Premature mortality due to CVD results in a loss of productivity, with associated economic and policy implications that are often overlooked. A human capital approach was adopted to project the long-term impacts of Australian CVD deaths in 2003 on labour force participation and the present value of lifetime income (PVLI) forgone. Impacts were modelled to the year 2030 and accounted for in idual characteristics at the time of death including age, sex and socioeconomic status. Premature deaths due to CVD in 2003 accounted for 51 659 working years and $2.69 billion in PVLI forgone when modelled to 2030 (95% CI $2.63 billion to $2.75 billion). The labour force impacts were highest for in iduals aged between 35 and 64 at the time of death, and male deaths accounted for 87% of the total PVLI loss. The most costly disease type was ischaemic heart disease, followed by stroke and inflammatory heart disease. Deaths occurring in in iduals residing in the most socioeconomically disadvantaged areas at the time of death had a disproportionately large impact on the total PVLI loss. This study quantifies the relative productivity costs of CVD mortality across a range of disease types and socioeconomic groups. The magnitude of these costs highlights the scope for investments in effective healthcare interventions to provide positive economic returns and may assist decision makers in allocating resources among competing priorities.
Publisher: Wiley
Date: 03-04-2018
Publisher: Public Library of Science (PLoS)
Date: 23-02-2015
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.IJCARD.2011.03.020
Abstract: In addition to being the leading cause of death, cardiovascular disease (CVD) also impacts upon the ability of in iduals to function normally in everyday activities, which is likely to affect in iduals' employment. This paper will quantify the relationship between labour force participation, CVD and being in poverty. The 2003 Survey of Disability, Ageing and Carers (SDAC) data were used to assess the impact of having CVD on being in poverty amongst the older working aged (aged 45 to 64) population in Australia. Those not in the labour force with no chronic health condition are 93% less likely to be in poverty than those not in the labour force due to CVD (OR 0.07, 95%CI: 0.07-0.07, p<.0001). The likelihood of being in poverty varies with labour force status for those with CVD: those who were either in full time (OR 0.04, 95% CI: 0.04-0.05, p<.0001) or part time (OR 0.19, 95% CI: 0.18-0.19) employment are significantly less likely to be in poverty than those who have had to retire because of the condition. The efforts to increase the labour force participation of in iduals with CVD, or ideally prevent the onset of the condition will likely improve their living standards. This study has shown that having CVD and not being in the labour force because of the condition drastically increases the chances of living in poverty.
Publisher: Public Library of Science (PLoS)
Date: 12-12-2016
Publisher: SAGE Publications
Date: 25-11-2015
Abstract: Depression has economic consequences not only for the health system, but also for in iduals and society. This study aims to quantify the potential economic impact of five-yearly screening for sub-syndromal depression in general practice among Australians aged 45-64 years, followed by a group-based psychological intervention to prevent progression to depression. We used an epidemiological simulation model to estimate reductions in prevalence of depression, and a microsimulation model, Health& WealthMOD2030, to estimate the impact on labour force participation, personal income, savings, taxation revenue and welfare expenditure. Group therapy is estimated to prevent around 5,200 prevalent cases of depression (2.2%) and add about 520 people to the labour force. Private incomes are projected to increase by $19 million per year, tax revenues by $2.4 million, and transfer payments are reduced by $2.6 million. Group-based psychological intervention to prevent depression could result in considerable economic benefits in addition to its clinical effects.
Publisher: Informa UK Limited
Date: 07-2011
DOI: 10.1080/13607863.2011.556599
Abstract: To estimate the extent to which those who exit the workforce early due to mental health problems have less savings by the time they reach retirement age. Using Health & WealthMOD--a microsimulation model of Australians aged 45-64 years that predicts accumulated savings at age 65, regression models were used to analyse the differences between the projected savings and the retirement incomes of people at age 65 for those currently working with no chronic condition, and people not in the labour force due to mental health problems. Females who retire early due to depression have a median value of total savings by the time they are 65 of $300. For those with other mental health problems the median figure was $0. This is far lower than the median value of $227,900 for females with no chronic condition who remained employed full-time. Males showed similar differences. Both males and females who were out of the labour force due to depression or other mental health problems had at least 97% (95% CI: -99.9% to -68.7%) less savings and retirement income by age 65 that those who remained employed full-time. People who retire from the labour force early due to mental health problems will face long term financial disadvantage compared to people who are able to remain in employment.
Publisher: Springer Science and Business Media LLC
Date: 05-06-2014
Publisher: Informa UK Limited
Date: 12-10-2017
DOI: 10.1080/08959420.2016.1246319
Abstract: This article examines the relationship between health and workforce participation beyond the age of 65 years in Australia. This study found that people with a chronic health condition were less likely to be employed than those without a health condition (OR, 0.59 95% CI [0.38, 0.92]). Among those with a chronic health condition, those in income quartile 2 (OR, 0.27 95% CI [0.11, 0.67]) and 3 (OR, 0.38 95% CI, [0.15-0.93]) were significantly less likely to be employed relative to those in income quartile 4. Older workers with a chronic health condition were less likely to work beyond the age of 65 however, among those with a chronic health condition, those with very high income and those with very low income were the most likely to keep working.
Publisher: Elsevier BV
Date: 2019
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.SPINEE.2014.06.018
Abstract: Studies assessing the economic burden of back problems have given little consideration to the presence of comorbidities. To assess the difference in the value of wealth held by Australians who have back problems and varying numbers of chronic comorbidities. A cross-sectional study. In iduals aged 45 to 64 years in 2009: 4,388 with no chronic health conditions, 1,405 with back problems, and 3,018 with other health conditions. Total wealth (cash, shares, superannuation, investment property, and owner occupied home). Using a microsimulation model (Health&WealthMOD), logistic regression models were used to assess the odds of having any wealth. Linear regression models were used to assess the difference in the value of this wealth. Those with back problems and two comorbidities had 0.16 (95% confidence interval [CI]: 0.06-0.42) times the odds and those with back problems and three or more comorbidities had 0.20 (95% CI: 0.11-0.38) times the odds of having accumulated some wealth than those with no chronic health conditions. Those with back problems and three or more comorbidities had a median value of total wealth of around $150,000, whereas those with back problems only and back problems and one comorbidity had a median value of total wealth of around $250,500. There was no significant difference in the amount of wealth accumulated by those with back problems and at least one comorbidity and those with other health conditions and the same number of comorbidities. However, those with only one health condition (excluding back problems) had 65% more wealth than those with back problems only (95% CI: 5.1-161.2). This study highlights the importance of considering multiple morbidities when discussing the relationship between back problems and economic circumstances.
Publisher: Elsevier BV
Date: 11-2019
Publisher: Hindawi Limited
Date: 30-10-2019
DOI: 10.1111/HSC.12670
Abstract: We estimated the economic costs of informal care in the community from 2015 to 2030, using an Australian microsimulation model, Care&WorkMOD. The model was based on data from three Surveys of Disability, Ageing, and Carers (SDACs) for the Australian population aged 15-64 years old. Estimated national income lost was AU$3.58 billion in 2015, increasing to $5.33 billion in 2030 (49% increase). Lost tax payments were estimated at AU$0.99 billion in 2015, increasing to AU$1.44 billion in 2030 (45% increase), and additional welfare payments were expected to rise from $1.45 billion in 2015 to AU$1.94 in 2030 (34% increase). There are substantial economic costs both to informal carers and the government due to carers being out of the labour-force to provide informal care for people with chronic diseases. Health and social policies supporting carers to remain in the labour force may allow governments to make substantial savings, while improving the economic situation of carers.
Publisher: Springer Science and Business Media LLC
Date: 22-01-2012
Publisher: Wiley
Date: 08-02-2018
DOI: 10.1111/CGE.13199
Abstract: Uptake of next-generation sequencing (NGS) has increased dramatically due to significant cost reductions and broader community acceptance of NGS. To systematically review the evidence on both the clinical effectiveness and the cost-effectiveness of applying NGS to cancer care. A systematic search for full-length original research articles on the clinical effectiveness and cost-effectiveness of NGS in MEDLINE and EMBASE. Articles that focussed on cancer care and involved the application of NGS were included for the review of clinical effectiveness. For the cost-effectiveness review, we only included the articles with economic evaluations of NGS in cancer care. We report the rate of successfully detecting mutations from the clinical studies. The incremental cost-effectiveness ratio and sensitivity analysis outcomes are reported for the cost-effectiveness articles. Fifty-six articles reported that sequencing patient s les using targeted gene panels, and 83% of the successfully sequenced patients harboured at least 1 mutation. Only 6 studies reported on the cost-effectiveness of the application of NGS in cancer care. NGS is an effective tool for identifying mutation in cancer patients. However, more rigorous cost-effectiveness studies of NGS applied to cancer management are needed to determine whether NGS can improve patient outcomes cost-effectively.
Publisher: Springer Science and Business Media LLC
Date: 28-04-2011
Publisher: BMJ
Date: 2013
Publisher: International Microsimulation Association
Date: 2020
DOI: 10.34196/IJM.00212
Publisher: Springer Science and Business Media LLC
Date: 24-05-2018
Publisher: International Microsimulation Association
Date: 31-08-2022
DOI: 10.34196/IJM.00265
Publisher: Wiley
Date: 10-2007
Abstract: The Intergenerational Report (IGR) released by the Department of the Treasury of the Commonwealth of Australia in 2002 highlighted pressures that in the future would threaten the sustainability of the Australian government's budget balance. These pressures result from the growing needs of an aging population and labor shortages that will limit economic growth and taxation revenue. The IGR has become a driving force in planning government policy. The Treasurer has recently said that "the whole economic agenda of the government at the moment is drawn from the IGR." In response, the Prime Minster and Treasurer have promoted deferred or gradual retirement as part of the solution. However, about 50% of men and 20% of women retire early as a result of ill health, indicating that poor health is potentially a limiter of economic growth. This paper reports lower labor force participation among persons with poorer health and that these persons move out of the labor force at a faster rate as they age. A range of measures suggests some decline in health in the pre-retirement age group (those aged from 40 to 64 years). This indicates that better health may be a facilitator of greater labor force participation in the baby boomer cohort. However, there is evidence that improving economic conditions in Australia leading to low unemployment has created an environment more favorable to the employment of older workers with health problems as there has been a rise in labor force participation in these groups, and measures to prevent chronic disease may further increase the employment prospects.
Publisher: AMPCo
Date: 09-2015
DOI: 10.5694/MJA15.00132
Abstract: To estimate (1) productive life years (PLYs) lost because of chronic conditions in Australians aged 45-64 years from 2010 to 2030, and (2) the impact of this loss on gross domestic product (GDP) over the same period. A microsimulation model, Health&WealthMOD2030, was used to project lost PLYs caused by chronic conditions from 2010 to 2030. The base population consisted of respondents aged 45-64 years to the Australian Bureau of Statistics Survey of Disability, Ageing and Carers 2003 and 2009. The national impact of lost PLYs was assessed with Treasury's GDP equation. Lost PLYs due to chronic disease at 2010, 2015, 2020, 2025 and 2030 (ie, whole life years lost because of chronic disease) the national impact of lost PLYs at the same time points (GDP loss caused by PLYs) the effects of population growth, labour force trends and chronic disease trends on lost PLYs and GDP at each time point. Using Health&WealthMOD2030, we estimated a loss of 347,000 PLYs in 2010 this was projected to increase to 459,000 in 2030 (32.28% increase over 20 years). The leading chronic conditions associated with premature exits from the labour force were back problems, arthritis and mental and behavioural problems. The percentage increase in the number of PLYs lost by those aged 45-64 years was greater than that of population growth for this age group (32.28% v 27.80%). The strongest driver of the increase in lost PLYs was population growth (accounting for 89.18% of the increase), followed by chronic condition trends (8.28%). Our study estimates an increase of 112 000 lost PLYs caused by chronic illness in older workers in Australia between 2010 and 2030, with the most rapid growth projected to occur in men aged 55-59 years and in women aged 60-64 years. The national impact of this lost labour force participation on GDP was estimated to be $37.79 billion in 2010, increasing to $63.73 billion in 2030.
Publisher: American Chemical Society (ACS)
Date: 23-07-2015
DOI: 10.1021/ACS.LANGMUIR.5B01858
Abstract: Microelectromechanical sensors based on surface acoustic wave (SAW) and quartz crystal microbalance (QCM) transducers possess substantial potential as online elemental mercury (Hg(0)) vapor detectors in industrial stack effluents. In this study, a comparison of SAW- and QCM-based sensors is performed for the detection of low concentrations of Hg(0) vapor (ranging from 24 to 365 ppbv). Experimental measurements and finite element method (FEM) simulations allow the comparison of these sensors with regard to their sensitivity, sorption and desorption characteristics, and response time following Hg(0) vapor exposure at various operating temperatures ranging from 35 to 75 °C. Both of the sensors were fabricated on quartz substrates (ST and AT cut quartz for SAW and QCM devices, respectively) and employed thin gold (Au) layers as the electrodes. The SAW-based sensor exhibited up to ∼111 and ∼39 times higher response magnitudes than did the QCM-based sensor at 35 and 55 °C, respectively, when exposed to Hg(0) vapor concentrations ranging from 24 to 365 ppbv. The Hg(0) sorption and desorption calibration curves of both sensors were found to fit well with the Langmuir extension isotherm at different operating temperatures. Furthermore, the Hg(0) sorption and desorption rate demonstrated by the SAW-based sensor was found to decrease as the operating temperature increased, while the opposite trend was observed for the QCM-based sensor. However, the SAW-based sensor reached the maximum Hg(0) sorption rate faster than the QCM-based sensor regardless of operating temperature, whereas both sensors showed similar response times (t90) at various temperatures. Additionally, the sorption rate data was utilized in this study in order to obtain a faster response time from the sensor upon exposure to Hg(0) vapor. Furthermore, comparative analysis of the developed sensors' selectivity showed that the SAW-based sensor had a higher overall selectivity (90%) than did the QCM counterpart (84%) while Hg(0) vapor was measured in the presence of ammonia (NH3), humidity, and a number of volatile organic compounds at the chosen operating temperature of 55 °C.
Publisher: Springer Science and Business Media LLC
Date: 22-02-2014
DOI: 10.1007/S00296-014-2967-5
Abstract: Few studies have assessed the impact of co-morbid conditions amongst patients with arthritis. This study will quantify the impact co-morbid health conditions have on the labour force status and economic circumstances of people with arthritis. This study uses a microsimulation model, Health&WealthMOD, to quantify the impact of co-morbidities on the labour force participation and economic circumstances of 45- to 64-year-old Australians with arthritis. The results show that the probability of being out of the labour force increases with increasing number of co-morbidities. However, there was no statistically significant difference in the amount of weekly private income received by people with arthritis and no co-morbidities, and people with arthritis and one or two co-morbidities. However, those with arthritis and three or more co-morbidities received a weekly private income 72 % lower than people with arthritis alone (95 % CI -82, -57). People with arthritis and co-morbidities paid less in tax and received more in government transfer payments. As such, it is important to consider the co-morbid conditions an in idual has when assessing the impact of arthritis on labour force participation and economic circumstances. People with arthritis that have multiple co-morbid conditions are likely to have their labour force participation and economic circumstances interrupted much more than those with arthritis only.
Publisher: Wiley
Date: 17-06-2216
DOI: 10.1002/MGG3.355
Publisher: Springer Science and Business Media LLC
Date: 15-08-2022
DOI: 10.1038/S41431-022-01162-2
Abstract: Whole genome sequencing (WGS) improves Mendelian disorder diagnosis over whole exome sequencing (WES) however, additional diagnostic yields and costs remain undefined. We investigated differences between diagnostic and cost outcomes of WGS and WES in a cohort with suspected Mendelian disorders. WGS was performed in 38 WES-negative families derived from a 64 family Mendelian cohort that previously underwent WES. For new WGS diagnoses, contemporary WES reanalysis determined whether variants were diagnosable by original WES or unique to WGS. Diagnostic rates were estimated for WES and WGS to simulate outcomes if both had been applied to the 64 families. Diagnostic costs were calculated for various genomic testing scenarios. WGS diagnosed 34% (13/38) of WES-negative families. However, contemporary WES reanalysis on average 2 years later would have diagnosed 18% (7/38 families) resulting in a WGS-specific diagnostic yield of 19% (6/31 remaining families). In WES-negative families, the incremental cost per additional diagnosis using WGS following WES reanalysis was AU$36,710 (£19,407 US$23,727) and WGS alone was AU$41,916 (£22,159 US$27,093) compared to WES-reanalysis. When we simulated the use of WGS alone as an initial genomic test, the incremental cost for each additional diagnosis was AU$29,708 (£15,705 US$19,201) whereas contemporary WES followed by WGS was AU$36,710 (£19,407 US$23,727) compared to contemporary WES. Our findings confirm that WGS is the optimal genomic test choice for maximal diagnosis in Mendelian disorders. However, accepting a small reduction in diagnostic yield, WES with subsequent reanalysis confers the lowest costs. Whether WES or WGS is utilised will depend on clinical scenario and local resourcing and availability.
Publisher: Wiley
Date: 21-05-2009
DOI: 10.1111/J.1440-1584.2009.01057.X
Abstract: To quantify the financial impact of rural clinical placements on medical, nursing and allied health students in rural Australia. The Careers in Health Tracking Survey provided data on whether students were employed, usual weekly hours of employment and a range of covariates, such as age, sex, course of study, marital status, dependents and rural or urban origin. A total of 121 students from a range of health professions completed the Careers in Health Tracking Survey while on rural placement at the Northern Rivers University Department of Rural Health. Survey data. Forty-one per cent of respondents were working immediately before their clinical placements. Nursing students worked the longest hours by far and were significantly more financially disadvantaged than both medical and allied health students (P < 0.01). Scholarship support was unevenly distributed, with nursing and allied health students being relatively under-supported in relation to lost earnings. Recruitment of students can be an effective strategy to address the rural health workforce shortage throughout Australia. However, there are a number of financial disincentives for students to undertake rural clinical placements. Additional support for some disciplines is needed to provide equitable distribution of scholarship support to offset this financial burden. Establishing an employment scheme for students on rural clinical placements and a scholarship for income replacement where employment is not available would also alleviate income loss.
Publisher: Elsevier BV
Date: 04-2014
Publisher: Elsevier BV
Date: 12-2011
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-08-2023
DOI: 10.1097/J.PAIN.0000000000003010
Abstract: Graded exposure treatment (GET) is a theory-driven pain treatment that aims to improve functioning by exposing patients to activities previously feared and avoided. Combining key elements of GET with acceptance-based exposure, GET Living (GL) was developed for adolescents with chronic pain (GL). Based on robust treatment effects observed in our single-case experimental design pilot trial of GL (NCT01974791), we conducted a 2-arm randomized clinical trial comparing GL with multidisciplinary pain management (MPM) comprised of cognitive behavioral therapy and physical therapy for pain management (NCT03699007). A cohort of 68 youth with chronic musculoskeletal pain (M age 14.2 years 81% female) were randomized to GL or MPM. Owing to COVID-19 restrictions, 54% of participants received zoom video delivered care. Assessments were collected at baseline, discharge, as well as at 3-month and 6-month follow-up. Primary outcomes were self-reported pain-related fear and avoidance. Secondary outcomes were child functional disability and parent protective responses to child pain. As hypothesized, GL improved in primary and secondary outcomes at 3-month follow-up. Contrary to our superiority hypothesis, there was no significant difference between GL and MPM. Patients reported both GL and MPM (in person and video) as credible and were highly satisfied with the treatment experience. Next steps will involve examining the single-case experimental design data embedded in this trial to facilitate an understanding of in idual differences in treatment responses (eg, when effects occurred, what processes changed during treatment within the treatment arm). The current findings support GET Living and MPM for youth with chronic pain.
Publisher: Elsevier BV
Date: 2019
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.IJCARD.2011.10.088
Abstract: It is recognised that CVD affects an in idual's financial situation, placing them in income poverty. However, recent developments in poverty measurement practice recognises other forms of disadvantage other than low income, such as poor health and insufficient education also affect living standards. Using the Freedom Poverty Measure, the multiple forms of disadvantage experienced by those with no health condition, heart disease, other diseases of the circulatory system, and all other health conditions was assessed using data on the adult Australian population contained in the 2003 Survey of Disability, Ageing and Carers. 24% of those with heart disease and 23% of those with other diseases of the circulatory system were in freedom poverty, suffering from multiple forms of disadvantage. Those with heart disease and those with other diseases of the circulatory system were around three times more likely to be in freedom poverty (OR 3.02, 95% CI: 2.29-3.99, p<.0001 OR 2.78, 95% CI: 1.94-3.98, p<.0001) than those with no health condition. Recognising the multiple forms of disadvantage suffered by those with CVD provides a clearer picture of their living standards than just looking at their income alone and the high proportion of in iduals with CVD that are suffering from multiple forms of disadvantage should make them a target for policy makers wishing to improve living standards.
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.IJCARD.2010.10.046
Abstract: Cardiovascular disease (CVD) has significant economic costs, however these are generally estimated for the present-time and little consideration is given to the long term economic consequences. This study estimates the value of savings those who retire early due to CVD will have accumulated by the time they reach the traditional retirement age of 65 years, and how much lower the value of these savings are compared to those who remained healthy and in the workforce. Using Health&WealthMOD - a microsimulation model of Australians aged 45 to 64 years, regression models were used to analyse the differences between the projected savings and the retirement incomes of people by the time they reach age 65 for those currently working with no chronic condition, and people not in the labour force due to CVD. Over 99% of in iduals who are employed full-time will have accumulated some savings at age 65 whereas only 77% of those who are out of the labour force due to CVD will have done so. Those who retire early due to CVD will have a median value of total savings by the time they are 65 of $1833. This is far lower than the expected median value of savings for those who remained in the labour force full-time, who will have $281841 of savings. Not only will early retirement due to cardiovascular disease limit the immediate income and wealth available to in iduals, but also reduce their long term financial capacity by reducing their savings.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1038/GIM.2016.221
Abstract: To undertake the first prospective cost-effectiveness study of whole-exome sequencing (WES) as an early, routine clinical test for infants with suspected monogenic disorders. Cost data for diagnosis-related investigations and assessments were collected for a prospective, sequential clinical cohort of infants (N = 40) who underwent singleton WES in parallel to usual diagnostic care. We determined costs per patient, costs per diagnosis, and incremental costs per additional diagnosis for three alternative strategies for integrating WES into the diagnostic trajectory. We performed a sensitivity analysis to examine the robustness of estimates and bootstrapping (500 replications) to examine their distributions. Standard care achieved an average cost per diagnosis of AU$27,050 (US$21,099) compared with AU$5,047 (US$3,937) for singleton WES. If WES had been performed after exhaustive standard investigation, then there would have been an incremental cost per additional diagnosis of AU$8,112 (US$ 6,327). Using WES to replace some investigations decreases this incremental cost to AU$2,622 (US$2,045), whereas using it to replace most investigations results in a savings per additional diagnosis of AU$2,182 (US$1,702). Use of WES early in the diagnostic pathway more than triples the diagnostic rate for one-third the cost per diagnosis, providing strong support for reimbursement as a clinical test.Genet Med advance online publication 26 January 2017.
Publisher: Springer Science and Business Media LLC
Date: 16-09-2012
Publisher: Wiley
Date: 29-12-2023
DOI: 10.1002/ACR.25037
Abstract: To evaluate the effectiveness and health costs of a new primary care service delivery model (the Optimising Primary Care Management of Knee Osteoarthritis [PARTNER] model) to improve health outcomes for patients with knee osteoarthritis (OA) compared to usual care. This study was a 2‐arm, cluster, superiority, randomized controlled trial with randomization at the general practice level, undertaken in Victoria and New South Wales, Australia. We aimed to recruit 44 practices and 572 patients age ≥45 years with knee pain for months. Professional development opportunities on best practice OA care were provided to intervention group general practitioners (GPs). All recruited patients had an initial GP visit to confirm knee OA diagnosis. Control patients continued usual GP care, and intervention patients were referred to a centralized care support team (CST) for 12‐months. Via telehealth, the CST provided OA education and an agreed OA action plan focused on muscle strengthening, physical activity, and weight management. Primary outcomes were patient self‐reported change in knee pain (Numerical Rating Scale [range 0–10 higher score = worse]) and physical function (Knee Injury and Osteoarthritis Outcome Score activities of daily living subscale [range 0–100 higher score = better] at 12 months. Health care cost outcomes included costs of medical visits and prescription medications over the 12‐month period. Recruitment targets were not reached. A total of 38 practices and 217 patients were recruited. The intervention improved pain by 0.8 of 10 points (95% confidence interval [95% CI] 0.2, 1.4) and function by 6.5 of 100 points (95% CI 2.3, 10.7), more than usual care at 12 months. Total costs of medical visits and prescriptions were $3,940 (Australian) for the intervention group versus $4,161 for usual care. This difference was not statistically significant. The PARTNER model improved knee pain and function more than usual GP care. The magnitude of improvement is unlikely to be clinically meaningful for pain but is uncertain for function.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2012
DOI: 10.1016/J.PAIN.2011.10.018
Abstract: This study undertook an economic analysis of the costs of early retirement due to back problems, with the aim of quantifying how much lower the value of accumulated wealth of in iduals who exit the workforce early due to back problems is by the time they reach the traditional retirement age of 65 years--compared to those who remained in the workforce. This was done using the output dataset of the microsimulation model Health&WealthMOD. It was found that over 99% of in iduals who are employed full time will have accumulated some wealth at age 65 years, whereas as little as 74% of those who are out of the labour force due to back problems will have done so. Those who retire from the labour force early due to back problems will have a median value of total accumulated wealth by the time they are 65 of as little as $3708 (for women aged 55-64 years). This is far lower than the median value of accumulated wealth for those women aged 55-64 years who remained in the labour force full time, who will have $214,432 of accumulated wealth at age 65 years. Not only will early retirement due to back problems limit the immediate income available to in iduals, but it will also reduce their long-term financial capacity by reducing their wealth accumulation. Maintaining the labour force participation of those with back problems, or preventing the onset of the disease, should be a priority in order to maintain living standards comparable with others who do not suffer from this condition.
Publisher: BMJ
Date: 09-2016
Publisher: Springer Science and Business Media LLC
Date: 28-08-2012
DOI: 10.1038/IJO.2012.139
Publisher: Springer Science and Business Media LLC
Date: 03-03-2017
DOI: 10.1038/S41525-017-0006-7
Abstract: Childhood-onset muscle disorders are genetically heterogeneous. Diagnostic workup has traditionally included muscle biopsy, protein-based studies of muscle specimens, and candidate gene sequencing. High throughput or massively parallel sequencing is transforming the approach to diagnosis of rare diseases however, evidence for cost-effectiveness is lacking. Patients presenting with suspected congenital muscular dystrophy or nemaline myopathy were ascertained over a 15-year period. Patients were investigated using traditional diagnostic approaches. Undiagnosed patients were investigated using either massively parallel sequencing of a panel of neuromuscular disease genes panel, or whole exome sequencing. Cost data were collected for all diagnostic investigations. The diagnostic yield and cost effectiveness of a molecular approach to diagnosis, prior to muscle biopsy, were compared with the traditional approach. Fifty-six patients were analysed. Compared with the traditional invasive muscle biopsy approach, both the neuromuscular disease panel and whole exome sequencing had significantly increased diagnostic yields (from 46 to 75% for the neuromuscular disease panel, and 79% for whole exome sequencing), and reduced the cost per diagnosis from USD$16,495 (95% CI: $12,413–$22,994) to USD$3706 (95% CI: $3086–$4453) for the neuromuscular disease panel and USD$5646 (95% CI: $4501–$7078) for whole exome sequencing. The neuromuscular disease panel was the most cost-effective, saving USD$17,075 (95% CI: $10,654–$30,064) per additional diagnosis, over the traditional diagnostic pathway. Whole exome sequencing saved USD$10,024 (95% CI: $5795–$17,135) per additional diagnosis. This study demonstrates the cost-effectiveness of investigation using massively parallel sequencing technologies in paediatric muscle disease. The findings emphasise the value of implementing these technologies in clinical practice, with particular application for diagnosis of Mendelian diseases, and provide evidence crucial for government subsidy and equitable access.
Publisher: SAGE Publications
Date: 11-2010
Abstract: To quantify the impact of early retirement due to diabetes on the level and type of savings among those aged 45–64 years in Australia, the output dataset of the microsimulation model, Health& WealthMOD was analysed. Compared with those who are in full-time employment with no health condition, those who have retired early due to diabetes have significantly lower odds of owning any wealth (odds ratio 0.03, 95% confidence interval 0.00–0.30). Among those with any accumulated wealth, the value of this wealth is 90% less for people who are out of the labour force due to diabetes relative to those in full-time employment, after adjusting for age, sex and education (p=0.037). Retiring from the labour force early due to diabetes is likely to cause large financial stress in the future as not only have retired in iduals lost an income stream from paid employment, but they also have little or no savings to draw upon.
Publisher: Oxford University Press (OUP)
Date: 05-09-2015
Abstract: There has been little research on the economic status of those with multiple health conditions, particularly on the relationship between multiple health conditions and wealth. This paper will assess the difference in the value and type of wealth assets held by Australians who have multiple chronic health conditions. Using Health&WealthMOD, a microsimulation model of the 45-64-year-old Australian population in 2009, a counterfactual analysis was undertaken. The actual proportion of people with different numbers of chronic health conditions with any wealth, and the value of this wealth was estimated. This was compared with the counterfactual values had the in iduals had no chronic health conditions. There was no change in the proportion of people with one health condition who actually had any wealth, compared to the counterfactual proportion had they had no chronic health conditions. Ninety-four percent of those with four or more health conditions had some accumulated wealth however, under the counterfactual, 100% would have had some accumulated wealth. There was little change in the value of non-income-producing assets under the counterfactual, regardless of number of health conditions. Those with four or more chronic health conditions had a mean value of $17 000 in income-producing assets under the counterfactual, the average would have been $78 000. This study has highlighted the variation in the value of wealth according to number of chronic health conditions, and hence the importance of considering multiple morbidities when discussing the relationship between health and wealth.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.IJCARD.2011.09.066
Abstract: CVD has the ability to interrupt an in idual's ability to participate in the labour force, and this can have considerable follow-up on impacts to both the in idual and the state. This study aimed to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefit payments and lost GDP as a result of early retirement due to CVD in Australians aged 45-64 in 2009. Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. In iduals aged 45 to 64 years who have retired early due to CVD have a median value of total weekly income of only $268 whereas those who are employed full time are likely to have almost five times this. The national aggregate impact of CVD through the loss of labour force participation amongst 45 to 64 year olds, equated to around AU$1.1 billion in lost income, $AU225 million in lost income taxation revenue, AU$85 million in additional government benefit payments, and AU$748 million in lost GDP, in 2009 alone. The costs of CVD to both in iduals and the state are considerable. Whilst in iduals bear the economic costs of lost income in addition to the burden of the condition itself, the state impacts are loss of productivity from reduced workforce participation, lost income taxation revenue, and increasing government support payments - in addition to direct health care costs.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1038/GIM.2018.39
Abstract: Whole-exome sequencing (WES) has revolutionized Mendelian diagnostics, however, there is no consensus on the timing of data review in undiagnosed in iduals and only preliminary data on the cost-effectiveness of this technology. We aimed to assess the utility of WES data reanalysis for diagnosis in Mendelian disorders and to analyze the cost-effectiveness of this technology compared with a traditional diagnostic pathway. WES was applied to a cohort of 54 patients from 37 families with a variety of Mendelian disorders to identify the genetic etiology. Reanalysis was performed after 12 months with an improved WES diagnostic pipeline. A comparison was made between costs of a modeled WES pathway and a traditional diagnostic pathway in a cohort with intellectual disability (ID). Reanalysis of WES data at 12 months improved diagnostic success from 30 to 41% due to interim publication of disease genes, expanded phenotype data from referrer, and an improved bioinformatics pipeline. Cost analysis on the ID cohort showed average cost savings of US$586 (AU$782) for each additional diagnosis. Early application of WES in Mendelian disorders is cost-effective and reanalysis of an undiagnosed in idual at a 12-month time point increases total diagnoses by 11%.
Publisher: Springer Science and Business Media LLC
Date: 29-05-2023
DOI: 10.1186/S13023-023-02746-X
Abstract: Mitochondrial diseases present as multi-system disorders requiring a comprehensive multidisciplinary approach. The data on healthcare resource utilization associated with mitochondrial diseases and the clinical drivers of these costs are limited including for the out-patient setting where the majority of the clinical care for mitochondrial disease patients occurs. We performed a cross-sectional retrospective study of out-patient healthcare resource utilization and costs for patients with a confirmed diagnosis of mitochondrial disease. We recruited participants from the Mitochondrial Disease Clinic in Sydney and stratified them into three groups: those with mitochondrial DNA (mtDNA) mutations (Group 1), those with nuclear DNA (nDNA) mutations and the predominant phenotype of chronic progressive external ophthalmoplegia (CPEO) or optic atrophy (Group 2) and those without a confirmed genetic diagnosis but clinical criteria and muscle biopsy findings supportive of a diagnosis of mitochondrial disease (Group 3). Data was collected through retrospective chart review and out-patient costs were calculated using the Medicare Benefits Schedule. We analyzed the data from 91 participants and found that Group 1 had the greatest average out-patient costs per person per annum ($838.02 SD 809.72). Neurological investigations were the largest driver of outpatient healthcare costs in all groups (average costs per person per annum:—Group 1: $364.11 SD 340.93, Group 2: $247.83 SD 113.86 and Group 3: $239.57 SD 145.69) consistent with the high frequency (94.5%) of neurological symptoms. Gastroenterological and cardiac-related out-patient costs were also major contributors to out-patient healthcare resource utilization in Groups 1 and 3. In Group 2, ophthalmology was the second-most resource intensive specialty ($136.85 SD 173.35). The Group 3 had the greatest average healthcare resource utilization per person over the entire duration of out-patient clinic care ($5815.86 SD 3520.40) most likely due to the lack of a molecular diagnosis and a less customized management approach. The drivers of healthcare resource utilization are dependent on the phenotype–genotype characteristics. Neurological, cardiac, and gastroenterological costs were the top three drivers in the out-patient clinics unless the patient had nDNA mutations with predominant phenotype of CPEO and/or optic atrophy wherein ophthalmological-related costs were the second most resource intensive driver.
Publisher: Springer Science and Business Media LLC
Date: 03-03-2013
Abstract: The costs of arthritis to the in iduals and the state are considerable. Cross-sectional analysis of the base population of Health& WealthMOD, a microsimulation model of 45 to 64 year old Australians built on data from the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. In iduals aged 45 to 64 years who had retired early due to arthritis had a median value of AU$260 in total weekly income whereas those who were employed full time were likely to average more than five times this. The large national aggregate impact of early retirement due to arthritis includes AU$9.4 billion in lost GDP, attributable to arthritis through its impact on labour force participation. When looking at the ongoing impact of being out of the labour force those who retired from the labour force early due to arthritis were estimated to have a median value of total savings by the time they are 65 of as little as $300 (for males aged 45–54). This is far lower than the median value of savings for those males aged 45–54 who remained in the labour force full time, who would have an estimated $339 100 of savings at age 65. The costs of arthritis to the in iduals and the state are considerable. The impacts on the state include loss of productivity from reduced workforce participation, lost income taxation revenue, and increased government support payments – in addition to direct health care costs. In iduals bear the economic costs of lost income and the reduction of their savings over the long term.
Publisher: Wiley
Date: 10-06-2023
DOI: 10.5694/MJA2.51997
Abstract: To estimate the health care and societal costs of inherited retinal diseases (IRDs) in Australia. Microsimulation modelling study based on primary data — collected in interviews of people with IRDs who had ophthalmic or genetic consultations at the Children's Hospital at Westmead or the Save Sight Institute (both Sydney) during 1 January 2019 – 31 December 2020, and of their carers and spouses — and linked Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Schedule (PBS) data. Annual and lifetime costs for people with IRDs and for their carers and spouses, grouped by payer (Australian government, state governments, in iduals, private health insurance) and type (health care costs societal costs: social support, National Disability Insurance Scheme (NDIS), income and taxation, costs associated with caring for family members with IRDs) estimated annual national cost of IRDs. Ninety‐four people (74 adults, 20 people under 18 years 55 girls and women [59%]) and 30 carers completed study surveys (participation rate: adults, 66% children, 66% carers, 63%). Total estimated lifetime cost was $5.2 million per person with an IRD, of which 87% were societal and 13% health care costs. The three highest cost items were lost income for people with IRDs ($1.4 million), lost income for their carers and spouses ($1.1 million), and social spending by the Australian government (excluding NDIS expenses: $1.0 million). Annual costs were twice as high for people who were legally blind as for those with less impaired vision ($83 910 v $41 357 per person). The estimated total annual cost of IRDs in Australia was $781 million to $1.56 billion. As the societal costs associated with IRDs are much larger than the health care costs, both contributors should be considered when assessing the cost‐effectiveness of interventions for people with IRDs. The increasing loss of income across life reflects the impact of IRDs on employment and career opportunities.
Publisher: Wiley
Date: 08-03-2012
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-09-2016
DOI: 10.1097/J.PAIN.0000000000000715
Abstract: This study projected the indirect costs of back problems through lost productive life years (PLYs) from the in idual's perspective (lost disposable income), the governmental perspective (reduced taxation revenue, greater welfare spending), and the societal perspective (lost gross domestic product, GDP) from 2015 to 2030, using Health& WealthMOD2030—Australia's first microsimulation model on the long-term impacts of ill-health. Quantile regression analysis was used to examine differences in median weekly income, welfare payments, and taxes of people unable to work due to back problems with working full-time without back problems as comparator. National costs and lost GDP resulting from missing workers due to back problems were also projected. We projected that 90,000 people have lost PLYs due to back problems in 2015, increasing to 104,600 in 2030 (16.2% increase). People with lost PLYs due to back problems are projected to receive AU$340.91 less in total income and AU$339.77 more in welfare payments per week than full-time workers without back problems in 2030 and pay no income tax on average. National costs consisted of a loss of AU$2931 million in annual income in 2015, increasing to AU$4660 million in 2030 (60% increase). For government, extra annual welfare payments are projected to increase from AU$1462 million in 2015 to AU$1709 million in 2030 (16.9% increase), and lost annual taxation revenue to increase from AU$671 million in 2015 to $961 million in 2030 (43.2% increase). We projected losses in GDP of AU$10,543 million in 2015, increasing to AU$14,522 million in 2030 due to back problems.
Publisher: Royal College of Psychiatrists
Date: 07-2022
DOI: 10.1192/BJO.2022.540
Abstract: Mental illness has a significant impact not only on patients, but also on their carers’ capacity to work. To estimate the costs associated with lost labour force participation due to the provision of informal care for people with mental illness in Australia, such as income loss for carers and lost tax revenue and increased welfare payments for government, from 2015 to 2030. The output data of a microsimulation model Care& WorkMOD were analysed to project the financial costs of informal care for people with mental illness, from 2015 to 2030. Care& WorkMOD is a population-representative microsimulation model of the Australian population aged between 15 and 64 years, built using the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers data and the data from other population-representative microsimulation models. The total annual national loss of income for all carers due to caring for someone with mental illness was projected to rise from AU$451 million (£219.6 million) in 2015 to AU$645 million (£314 million) in 2030 in real terms. For the government, the total annual lost tax revenue was projected to rise from AU$121 million (£58.9 million) in 2015 to AU$170 million (£82.8 million) in 2030 and welfare payments to increase from AU$170 million (£82.8 million) to AU$220 million (£107 million) in 2030. The costs associated with lost labour force participation due to the provision of informal care for people with mental illness are projected to increase for both carers and government, with a widening income gap between informal carers and employed non-carers, putting carers at risk of increased inequality.
Publisher: Wiley
Date: 03-10-2012
Publisher: Springer Science and Business Media LLC
Date: 04-03-2014
Start Date: 2020
End Date: 2022
Funder: Australian Research Council
View Funded ActivityStart Date: 2017
End Date: 2022
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2018
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2012
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2015
End Date: 2020
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 03-2020
End Date: 12-2024
Amount: $444,353.00
Funder: Australian Research Council
View Funded Activity