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Health care economics costs

Does this call for a cancellation of antiviral interventions Definitely not But it calls for a courageous long-term analysis of the COl of AIDS and of the cost-ejfectiveness of certain interventions, and it calls for the political will to reallocate public budgets towards the health care sector, as the highest socio-economic costs are most likely still to come. [Pg.370]

Rice DP, Hodgson TA, Kopstein AN (1985) The economic costs ofUlness a replication and update. Health Care Financ Rev 7 61-80... [Pg.373]

Over time, of course, such awareness has continued to grow, although so too has the realization that it should not be cost that drives macro or micro decision-making, but cost-effectiveness. That is, the health-care system needs to achieve a good balance between the resources it uses (the costs) and the outcomes it achieves (the effectiveness). More recent developments, such as the establishment of the National Institute for Clinical Excellence, make abundantly clear both the enduring relevance of economic considerations when deciding how to use health service resources and the pervasive need to balance economic with clinical (and related) objectives. [Pg.2]

The production of welfare approach assumes that the final outcomes of a mental health-care intervention will be influenced ( produced ) by the nature of the services provided, the types, levels and mixes of resources employed, the social environment of the care setting and other non-resource factors. This core theme of the production of welfare model is obviously not built up from economic theory as such, but it is a logical corollary of theory and evidence from psychology, psychiatry and certain other disciplines. However, the formalization of the links between intervention characteristics, resource inputs and patient and family outcomes owes much to economic theories of cost and production relations and their... [Pg.7]

The simplest economic theories assume— somewhat unrealistically—that markets work sufficiendy well to ensure that society s scarce resources are allocated efficiendy. Of course, few markets are as well-behaved as in the elementary textbook, but nevertheless market forces can often be relied upon to allocate goods and services reasonably well between competing demands. If this is the case, then the need for economic evaluation of the costs and outcomes flowing from alternative uses of scarce resources is lessened. Mental health-care services in Britain are purchased and provided within internal markets (quasi-markets) within the state sector (mainly), and these muted market forces have clearly had some influence over allocations. Market forces have a more overt role in countries such as the USA, strongly influencing who obtains what service and at what cost to different parties. However, it is difficult to imagine circumstances in which techniques such as... [Pg.7]

Beecham J (1995). Collecting and estimating costs. In Knapp MRJ, ed. T e Economic Evaluation of Mental Health Care. Aldershot Arena,... [Pg.17]

Health-care decision-makers may be required not only to make economic choices between conventional and atypical drugs, but also between individual atypical agents. There are few direct comparisons of atypical drugs. This is probably a result of the marketing aims of pharmaceutical manufacturers each has sought to establish the cost-effectiveness of their product compared with conventional... [Pg.34]

Various forms of psychotherapy are regarded as effective interventions in mild to moderate depression, but studies comparing the economics of psychotherapy and pharmacotherapy are few (Rosenbaum and Hylan, 1999). One study found that the total health-care costs for patients who received psychotherapy were no different from those for patients who received an antidepressant. However, no efficacy measure was used (Edgell and Hylan, 1997). A randomized, prospective study which evaluated the treatment of depression with nortriptyline, interpersonal therapy or treatment as usual, with outcomes expressed in quality-adjusted life years, found that nortriptyline but not interpersonal therapy was a cost-effective alternative to treatment as usual (Lave et al, 1998). [Pg.51]

Further detailed analyses of the ECA data have been extrapolated to USA national costs (Rice and Miller, 1998). It was calculated that the economic costs of mental disorders in 1990 in the USA totalled US 147.8 billion. Anxiety disorders were the most cosdy, amounting to 46.6 billion, just under a third of the total. Direct costs spent on mental health care totalled 67 billion, of which anxiety disorders accounted for only 11 billion (16.5%). Drug costs were 2191 million, of which anxiety disorders accounted for 1167 million—over half Morbidity costs—the value of goods and services not produced because of mental disorders — amounted to 63.1 billion, with anxiety disorders accounting for 34.2 billion, 54.2% of the total. This reflects the high prevalence of anxiety disorders in the community and the high associated rate of lost productivity. In contrast, patients with affective disorders appeared better able to function (Rice and Miller, 1995). In summary, anxiety disorders are common, disruptive and costly to society drug treatment is a substantial element of treatment costs (11%) compared with, say, schizophrenia (2.2%). [Pg.60]

Economic studies should consider the costs of all the resources and services used in the process of care. In addition, the outcomes that are a consequence of the health or social care interventions evaluated need to be included. For dementia, these include the costs of hospital inpatient and out-patient care, primary and community-based health-care services, social welfare services, and care provided by voluntary agencies or by femily and friends. Ideally, a broad perspective reflecting the costs and outcomes to society should be adopted. As a minimum, the perspective of the analysis should include the costs and outcomes to key health and social care providers or funders and to patients and their families. [Pg.81]

Several issues have to be kept in mind when reading this chapter. First, there are vast differences between the economically disadvantaged countries (Sartorius, 2001). In most of them, however, the gap between the richest and poorest parts of the population has grown over the past few decades and continues to grow. The health care for the poorest groups in the population has also become weaker and of poorer quality. In relation to pharmacotherapy this means that even when low-cost medications are made available the poor do not benefit from this, because the weakness of the health system makes it impossible for them to get to health care staff who could advise them and guide them in taking these medications. [Pg.151]


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