Estimating Global Friction Periods for Economic Evaluation: A Case Study of Selected OECD Member Countries.

BACKGROUND: The friction cost approach (FCA) offers an alternative to the dominant human capital approach to value productivity losses. Application of the FCA in practice is limited largely due to data availability. Recent attempts have tried to standardise the estimation of friction periods across Europe, but to date, this has not been attempted elsewhere. Our aim was to estimate friction periods for 17 Organisation for Economic Co-operation and Development (OECD) member countries between 2010 and 2021 based on routinely published data. METHODS: We derived friction period estimates for Australia, Austria, Canada, Czechia, Finland, Germany, Hungary, Japan, Korea, Luxembourg, Norway, Poland, Portugal, Sweden, Switzerland, the United Kingdom and the United States. Vacancy stock and flow data was sourced from the OECD's short-term labour situation database from 2010 to 2021, and included the impact of Covid-19 on the labour market. The estimated friction periods were applied to cost cancer-related premature mortality for the United States as an illustrative case. RESULTS: The average friction period in the five non-European countries (Australia, Canada, Korea, Japan and the United States) was 61.0 days (SD 9.4) (range between 44.8 days in Korea and 82.2 days in Canada) and the average friction period in the 12 European countries was 60.6 days (SD 14.8) (range between 34.1 days in Switzerland and 137.3 days in Czechia). In both cases, the outbreak of Covid-19 increased the length of the friction period. Our illustrative case revealed that productivity costs in the US were over a third lower using the study-specific friction period (56 days) compared with the conventionally assumed 90-day friction period applied in the literature as a default measure. CONCLUSIONS: Our results expand the potential application of the FCA outside of Europe and will support greater utilisation of the FCA and wider inclusion of productivity costs in societal-based economic evaluations based on the use of widely available and updated key labour market variables in our selected countries.

Working From Home During the COVID-19 Pandemic: The Association With Work Productivity Loss Among Patients and Caregivers.

OBJECTIVE: The aim of this study was to measure the association of working from home (WFH) with work productivity loss due to caregiving responsibilities or health problems during the COVID-19 pandemic. METHODS: We conducted an online survey of family/friend caregivers (n = 150 WFH/75 non-WFH) and patients (n = 95/91) who worked during the past 7 days in May and July 2020, respectively. Absenteeism and presenteeism were measured using the Valuation of Lost Productivity questionnaire. RESULTS: Working from home was associated with higher odds of absenteeism (odds ratio, 2.53; 95% confidence interval, 1.11 to 5.77) and presenteeism (2.79; 1.26 to 6.18) among caregivers and higher odds of presenteeism among patients (2.78; 1.13 to 6.84). However, among caregivers with absenteeism more than 0 days, WFH was significantly associated with fewer absent workdays. CONCLUSIONS: Working from home was not associated with overall absenteeism and presenteeism in caregivers or patients. Working from home allows a more flexible and inclusive workplace without impacting productivity, although further research is needed.

Facilitating regional education in paediatric palliative care: a digital success

To explore the requirements, then create and deliver education in children’s palliative care within the Managed Clinical Network (MCN) for Buckinghamshire Oxfordshire and Berkshire, considering continued restrictions on face-to-face group size due to COVID-19 and increasing need for virtual methods of education that facilitate learning.Two groups were identified to run pilot education programmes within the region.The first was a group of three Band 6/7 outreach nurses in paediatric palliative care working towards specialist level/prescriber status through Helen and Douglas House Hospice. A curriculum was devised based on national guidance and self-identified learning needs covering over 20 divided into mini-series of 2-5 sessions. Teaching is delivered weekly for 30-45 minutes, facilitated through a virtual meeting room using Microsoft Teams and interactive worksheets through a Moodle platform course.The second was the development of a series of five ‘webinar’ style sessions to introduce the concepts of paediatric palliative care, delivered to interested nurses from acute, ward and community teams across the region. This identified learning need came through a local collaboration group comprising paediatric and neonatal intensive care, oncology, hospice and child mortality members. Webinars were run for 1 hour in the evening every 6-8 weeks using Microsoft Teams and PowerPoint with integrated videos detailing family/patient stories and experiences, and a facilitated Q&A session. Further series will be hosted by the neonatal and children’s intensive care teams.ResultsOutreach nurses consistently reported 5/5 on a Likert scale of usefulness for each mini-series developed. They enjoyed the mixture of learning styles, including case discussion, communication skills, short videos, interactive elements and using resources to answer specific questions. It was an advantage to get instant feedback on correct or ‘ideal’ answers. They felt that weekly sessions of 30-45 minutes with group size of 5 or fewer participants was optimal for learning.About half of those who signed up to the webinar series pilot attended the event in person, with a further percentage accessing recorded material post-event. It was well-received as an introductory series level with 88% giving it a 4 or 5* rating for usefulness, and 84% saying they would be likely to join for further sessions (the remaining 16% were ‘not sure’ depending on specific topic or timings). Attendees enjoyed the ‘chunk-style’ of information rather than a more overwhelming full day, use of patient stories and case discussion. They found the length of session and evening timing acceptable.ConclusionThe project has attracted Hospice UK funding as part of an MCN grant and is being presented as an option for education on a wider regional footprint through NHS-South-East England.Multi-media and innovative approaches enhance the digital education experience for the learner, meaning they are more engaged despite the virtual environment. Targeted paediatric palliative care education can be meaningfully delivered in mini-series delivered in short sessions. Further development of a virtual platform to enable education to a wider reach across the region is desired, with a blended approach of virtual face-to-face and supporting resources.

Lundgren Tours: Out of the Frying Pan and into the Fire. A young entrepreneur survives and thrives after the ‘double-whammy’ of Brexit and Coronavirus

Lundgren Tours (LT) is an awarding-winning regional tour company founded by a student entrepreneur in 2016. In 2020, the UK left the EU and the country's first Covid-19 patients were identified, leading to international anti-coronavirus restrictions and the cancellation of tours for 12 months. The case considers several aspects (explained in ?Themes?) of the catastrophe through the founder's eyes, revealing the influence of entrepreneurial psychological capital and how striving to survive disaster can lead to new strengths and opportunities.