American Journal of Health Economics
By Tara Templin
Why health care process performance measures can have different relationships to outcomes for patients and hospitals: Understanding the ecological fallacy.
Background: The potential to save money within a short time frame provides a more compelling "business case" for quality improvement than merely demonstrating cost-effectiveness. Our objective was to demonstrate the potential for cost savings from improved control in patients anticoagulated for atrial fibrillation.
Abstract HIV-2 group A is predominant in different parts of the world, especially Africa, Portugal, Spain, France, the United Kingdom, the United States, Korea, and India. Among the Asian countries, India accounts for about 95% of all HIV-2 infections. The prevalence of HIV-2 has been reported from various states of India such as Maharashtra, Goa, Tamil Nadu, West Bengal, and Uttar Pradesh.
Effects of rural status on health outcomes in pediatric liver transplantation: a single center analysis of 388 patients.
Systematic Review: Benefits and Harms of In-Hospital Use of Recombinant Factor VIIa for Off-Label Indications
Background:Recombinant factor VIIa (rFVIIa), a hemostatic agent approved for hemophilia, is increasingly used for off-label indications.
Purpose:To evaluate the benefits and harms of rFVIIa use for 5 off-label, in-hospital indications: intracranial hemorrhage, cardiac surgery, trauma, liver transplantation, and prostatectomy.
BACKGROUND: The recent RV144 clinical trial showed that an ALVAC/AIDSVAX prime-boost HIV vaccine regimen may confer partial immunity in recipients and reduce transmission by 31%. Trial data suggest that efficacy may initially exceed 70% but decline over the following 3.5 years. Estimating the potential health benefits associated with a one-time vaccination campaign, as well as the projected benefits of repeat booster vaccination, may inform future HIV vaccine research and licensing decisions.
Parenteral nutrition (PN), containing fat emulsions derived from soybean, has been implicated in the progression of PN-associated liver disease and cholestasis, particularly in infants with short bowel syndrome. Clinical use of Omegaven, a parenteral fish-oil emulsion, has been shown in recent studies to be a promising therapy to reverse liver disease and cholestasis. This review summarizes the rationale, relevant clinical investigations and future direction of Omegaven therapy for PN-dependent infants.
Background: Research on the relationship between substance use disorders (SUDs) and older adults' health care costs is equivocal. A large-scale study comparing health care costs among older adults with and without SUDs has never been conducted.
Effect of Treatment Interruption and Intensification of Antiretroviral Therapy on Health-related Quality of Life in Patients with Advanced HIV
Background. The effect of antiretroviral therapy (ART) interruption or intensification on health-related quality of life (HRQoL) in advanced HIV patients is unknown.
Objective. To assess the impact of temporary treatment interruption and intensification of ART on HRQoL.
Design. A 2 x 2 factorial open label randomized controlled trial.
Setting. Hospitals in the United States, Canada, and the United Kingdom.
Comparison of screening using OGTT alone or in combination with the Indian Diabetes Risk Score or genotyping to detect undiagnosed type 2 diabetes in Asian Indians
Effectiveness and Cost Effectiveness of Expanding Harm Reduction Programs and HIV Antiretroviral Therapy in a Mixed HIV epidemic: An Analysis for Ukraine
Background Injection drug use (IDU) and heterosexual virus transmission both contribute to the growing mixed HIV epidemics in Eastern Europe and Central Asia. In Ukraine—chosen in this study as a representative country—IDU-related risk behaviors cause half of new infections, but few injection drug users (IDUs) receive methadone substitution therapy. Only 10% of eligible individuals receive antiretroviral therapy (ART). The appropriate resource allocation between these programs has not been studied.
Results of Antiretroviral Treatment Interruption and Intensification in Advanced Multi-drug Resistant HIV Infection from the OPTIMA trial
Background Guidance is needed on best medical management for advanced HIV disease with multidrug resistance (MDR) and limited retreatment options. We assessed two novel antiretroviral (ARV) treatment approaches in this setting.
Obesity – and its related illnesses – endangers the lives of millions across the world. While healthier, more physically active lifestyles can mitigate this, the question remains of how policymakers can get people to switch from being couch potatoes to keen runner beans. This column presents new evidence suggesting that for many even a nudge may suffice.
Diagnostic Imaging for Low Back Pain: Advice for High-value Health Care from the American College of Physicians
Diagnostic imaging is indicated for patients with low back pain only if they have severe progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition. In other patients, evidence indicates that routine imaging is not associated with clinically meaningful benefits but can lead to harms. Addressing inefficiencies in diagnostic testing could minimize potential harms to patients and have a large effect on use of resources by reducing both direct and downstream costs. In this area, more testing does not equate to better care.
High-value, Cost-Conscious Health Care: Concepts for Clinicians to Evaluate Benefits, Harms, and Costs of Medical Interventions
Health care costs in the United States are increasing unsustainably, and further efforts to control costs are inevitable and essential. Efforts to control expenditures should focus on the value, in addition to the costs, of health care interventions. Whether an intervention provides high value depends on assessing whether its health benefits justify its costs. High-cost interventions may provide good value because they are highly beneficial; conversely, low-cost interventions may have little or no value if they provide little benefit.
Diabetes Mellitus and Tuberculosis in Countries with High Tuberculosis Burdens: Individual Risks and Social Determinants
Effectiveness and Cost-effectiveness of HIV Antiretroviral Regimens Recommended in the World Health Organization’s Guidelines for Resource-limited Settings
Objective: The World Health Organization (WHO) recently changed its first-line antiretroviral treatment guidelines in resource-limited settings. The cost-effectiveness of the new guidelines is unknown.
Design: Comparative effectiveness and cost-effectiveness analysis using a model of HIV disease progression and treatment.