Freely accessible software for recruitment prediction and recruitment monitoring of clinical trials: A systematic review.

Background: The successful completion of clinical trials ultimately depends on realistic recruitment predictions. Statistical methods for recruitment prediction implemented in a free-of-charge open-source software could be routinely used by researchers worldwide to design clinical trials. However, the availability of such software implementations is currently unclear. Methods: Two independent reviewers conducted a systematic review following PRISMA guidelines. Eligible articles included English publications focused on statistical methods for recruitment prediction and monitoring that referred to software implementations. The list of articles retrieved from well-established data bases was enriched by backtracking of references provided by eligible articles. The current software availability and open-source status were tabulated. Results: We found 21 eligible articles, 7 of which (33 %) provide freely accessible software. Ultimately, only one article provides a link to an easy-to-comprehend, well-documented, and currently directly applicable free-of-charge open-source software. The lack of availability is mainly caused by blocked access and outdated links. Conclusions: While several software implementations exist for recruitment prediction, only a small fraction is freely accessible. These results highlight the need for future efforts to achieve free access to well-documented software implementations supporting researchers in routinely using statistical methods to arrive at realistic recruitment predictions in clinical trials.

Willingness to Pay for COVID-19 Vaccines in Japan.

More than 80% of the Japanese population had received the coronavirus disease 2019 (COVID-19) vaccination by the end of April 2023; however, this vaccination rate continues to decline along with the need for booster shots. Further, the vaccines may not permanently be available free of charge. This study conducted a survey to determine the public's willingness to pay for the COVID-19 vaccine in Japan. Using an internet research panel, the questionnaire collected data on various sociodemographic variables and the respondents' willingness to pay for COVID-19 vaccines. Descriptive statistics and logistic regression analysis were used to evaluate the respondents' answers. The results showed that of 1100 respondents, 55.2% would not want to receive the vaccine if it was paid for. A total of 44.8% respondents expressed willingness to pay, with most (170 respondents) willing to pay for 1000-1999 JPY (7.1-14.2 USD). Logistic regression analysis revealed that age, educational status, history of contracting COVID-19, and COVID-19 vaccination frequency were significantly associated with those who were willing to receive the COVID-19 vaccine if it was free (p < 0.05). These findings provide valuable insights for the Japanese government in determining appropriate pricing strategies to promote COVID-19 vaccination effectively.

Additional payment despite free health care in Burkina Faso / Paiement additionnel malgré la gratuité des soins au Burkina Faso

Introduction: Free health care for children under five years of age in Burkina Faso was introduced in 2016 in order to remove the financial barrier to accessing care. Additional health expenses remain despite this free health care, which may compromise access to health services for the poorest patients. Methods: This partial medico-economic evaluation included a descriptive study of additional health expenses paid by parents. Payment receipts and parents' declarations were consulted. Results: The average monthly income of the parents was 73,026.79 FCFA ($132) with 5.08% of the parents having no income. The total direct cost was 6,043,785 FCFA ($10939). The total additional direct cost was 2,181,150 FCFA ($3,950) or 36.09% of the total direct cost. The average percentage of free care was 65.50%. 7.7% of parents were dissatisfied with the free schooling. 34.48% were unprepared for additional expenses, 43.97% of parents had difficulty paying the additional costs and of these 80% reported that they had exhausted their savings to meet the prescriptions. Conclusions: Additional health expenses remain high despite free care. This can compromise the care of the poorest patients. A reorganization of free health care is necessary.

Introduction: La gratuité des soins chez les enfants de moins de 5 ans au Burkina Faso a été introduite en 2016 afin de lever la barrière financière dans l'accès aux soins. Des dépenses de santé additionnelles subsisteraient malgré cette gratuité, ce qui peut compromettre l'accès aux services de santé des patients les plus démunis. Méthodes: Il s'agit d'une évaluation médico-économique partielle, notamment l'étude descriptive des dépenses de santé additionnelles payées par les parents. Nous avons consulté les reçus de paiement et les déclarations des parents. Résultats: Le revenu mensuel des parents était en moyenne de 73 026,79 FCFA (132 $) avec 5,08 % des parents qui n'ont pas de revenu. Le coût direct total était de 6 043 785 FCFA (10 939 $). Le coût direct total additionnel était de 2 181 150 FCFA (3 950 $), soit 36,09 % du coût direct total. Le pourcentage moyen de prise en charge de la gratuité était de 65,50 %. Près de 10 % (7,7 %) des parents étaient insatisfaits de la gratuité ; ils étaient 34,48 % à ne pas être préparés à honorer des dépenses supplémentaires, 43,97 % avaient eu du mal à payer les frais supplémentaires et parmi ces derniers, 80 % ont déclaré avoir épuisé leur économie pour honorer les prescriptions. Conclusions: Les dépenses de santé additionnelles restent élevées malgré la gratuité des soins. Cela peut compromettre la prise en charge des patients les plus pauvres. Une réorganisation de la gratuité des soins s'avère nécessaire.

The impact of free farmland transfer on the adoption of conservation tillage technology -- empirical evidence from rural China.

At present, there are a large number of free farmland transfer without monetary or physical rents in rural China. It is relatively worthwhile to verify whether the transferees who transfer in farmland for free, the actual operators of farmland, would adopt the conservation tillage technology (CTT), which is crucial in protecting farmland quality and improving agricultural production efficiency. Based on the data of 527 plots surveyed by China Land Economic Survey (CLES) in Jiangsu Province in 2020, this paper employs Negative Binomial Regression (NBR), Poisson Regression with Endogenous Treatment Effects (ETPR) and Endogenous Switching Regression (ESR). Results show that: (1) Compared with the transferees who transfer into farmland with compensation, the free transfer is not conducive to the transferees' adoption of CTTs such as straw mechanical returning, soil testing and formulated fertilization. Specifically, the total number of technology adoptions by transferees who transfer in farmland without compensation is decreased by 39.54%. The result is still robust after replacing the dependent variable. (2) Further heterogeneity analysis results of different types of technologies show that the number of labor-saving CTTs such as straw mechanical returning adopted by the transferees of free transfer decreases by 11.55%, and the number of labor-intensive tillage technologies such as soil testing and formulated fertilization decreases by 83.20%. Thus, free transfer has a stronger inhibitory effect on the transferees' adoption of labor-intensive CTTs. Therefore, for the most developing countries including China, the governments should continue to improve the farmland factor market oriented by price mechanism and implement targeted conservation tillage technology according to the different degree of transfer marketization in different places.

Sobre la gestación por sustitución. Otra vuelta de tuerca / Sobre la gestació per substitució. Una altra volta de rosca / On Surrogacy. Another turn of phrase

El autor vuelve a insistir, a propósito de una reciente sentencia del Tribunal Supremo español, en tres tesis sobre la gestación por sustitución que ya había defendido en otras ocasiones: no se trata de una práctica prohibida en nuestro Derecho (la nulidad no es lo mismo que la ilicitud); no atenta, en sí misma considerada, contra la dignidad humana, de la mujer gestante o del niño; y su regulación no tiene por qué exigir la gratuidad por parte de la mujer gestante, si bien la remuneración que esta pudiera recibir no debe quedar librada a las leyes del mercado.(AU)

L'autor torna a insistir, a propòsit d'una recent sentència del TribunalSuprem espanyol, en tres tesis sobre la gestació per substitució que ja havia defensat en altres ocasions: no es tracta d'una pràctica prohibida en el nostre Dret (la nul·litat no és el mateix que la il·licitud); no atempta, en si mateixa considerada, contra la dignitat humana, de la dona gestant o del nen; i la seva regulació no té per què exigir la gratuïtat per part de la dona gestant, si bé la remuneració que aquesta pogués rebre no ha de quedar lliurada a les lleis del mercat.(AU)

The author insists, with regard to a recent Spanish Supreme Court ruling, on three theses on surrogacy that he has already defended: it is not a practice prohibited in our law (nullity is not the same as illegality); it is not, in itself considered, against the human dignity of the pregnant woman or the child; and its regulation does not necessarily have to require the pregnant woman to do it for free, although the remuneration that she may receive should not be left to the laws of the market.(AU)

Free-of-charge dispensing of antipsychotics for schizophrenia in Denmark: Impact on the nationwide prescription registry and redemption of somatic medications.

OBJECTIVE: Free-of-charge dispensing of antipsychotics for schizophrenia was introduced in Denmark around 2008. However, free-of-charge dispensing is not recorded in the Danish National Prescription Register (DNPR), potentially introducing bias and misclassification. METHODS: We identified all 30 275 individuals with a first-episode schizophrenia diagnosis in Denmark between 1 January 1999 and 1 March 2017 including all redeemed prescriptions registered in the DNPR during the 2 years after the schizophrenia diagnosis. For each calendar year, we calculated the proportion of individuals who had filled ≥1 prescription for psychotropic and/or somatic medications within the first 2 years after the schizophrenia diagnosis. RESULTS: From 2007 to 2017, the proportion of individuals with prescription-records for any psychotropic medication during the 2 years after the schizophrenia diagnosis decreased from 88% to 74%, particularly antipsychotics (from 83% to 61%) and antidepressants (from 49% to 35%). This was particularly observed among those aged 18-30 years at the schizophrenia diagnosis. A similar decrease was not observed for prescription-records of somatic medications. CONCLUSION: The introduction of free-of-charge antipsychotics has affected the redemption of specific psychotropic drugs in the DNPR in first-episode schizophrenia. This limitation needs to be considered in register-based studies and emphasizes the need to identify solutions.

Free-of-charge medicine schemes in the NHS: A local and regional drug and therapeutic committee's experience.

INTRODUCTION: Free-of-charge (FoC) medicine schemes are increasingly available and allow access to investigational treatments outside clinical trials or in advance of licensing or NHS commissioning. METHODS: We retrospectively reviewed FoC medicine schemes evaluated between 2013 and 2019 by a single NHS trust and a regional drug and therapeutics committee (DTC). The details of each locally reviewed FoC scheme, and any nationally available Medicines and Healthcare products Regulatory Agency Early Access to Medicines Scheme (MHRA EAMS) in the same period, were recorded and categorised. RESULTS: Most FoC schemes (95%) allowed access to medicines intended to address an unmet clinical need. Over 7 years, 90% were company-FoC schemes and 10% were MHRA EAMS that were locally reviewed. Phase 3 clinical trial data were available for 44% of FoC schemes, 37% had phase 2 data and 19% were supported only by phase 1 data, retrospective observational studies or preclinical data. Utilisation of company-FoC schemes increased on average by 50% per year, while MHRA EAMS schemes showed little growth. CONCLUSION: Company-FoC medicine schemes are increasingly common. This may indicate a preference for pharmaceutical companies to independently co-ordinate schemes. Motivations for company-FoC schemes remain unclear and many provide access to treatments that are yet to be evaluated in appropriately conducted clinical trials, and whose efficacy and risk of harm remain uncertain. There is no standardisation of this practice and there is no regulatory oversight. Moreover, no standardised data collection framework is in place that could demonstrate the utility of such programmes in addressing unmet clinical need or to allow generation of further evidence.

Predictors of choosing long-acting reversible contraceptive methods when provided free-of-charge - A prospective cohort study in Finland.

OBJECTIVE: To identify factors associated with choosing long-acting reversible contraception (LARC) (intrauterine device or contraceptive implant), when provided free-of-charge. STUDY DESIGN: This register-based cohort study comprises all women living in the city of Vantaa in the Helsinki metropolitan area during 2013-2014, with information on LARC initiations retrieved from electronic health records. Since January 2013, women in Vantaa can receive their first LARC method free-of-charge at public contraceptive clinics. We performed multivariable regression to assess seven predictors based on literature and four predictors based on gynecological history for association with choosing LARC in this population. RESULTS: In 2013-2014, 9669 women entitled to a free-of-charge method visited a public clinic and 2035 (21.0%) women initiated LARC. Factors most associated with LARC initiation included history of delivery (odds ratio [OR] 5.4, 95% confidence intervals [CI] 4.7-6.2) and induced abortion (OR 1.4, 95%CI 1.2-1.6), and no previous visit at the clinic (OR 1.3, 95%CI 1.2-1.5). Previous delivery was associated with LARC initiation in all age-groups (OR, 95%CI by age-group; 15-19 years: 10.8, 5.1-23.4; 20-24 years: 6.4, 4.9-8.3; 25-29 years: 6.7, 5.2-8.6; 30-44 years: 3.6, 2.9-4.6). CONCLUSION: History of delivery and induced abortion were strongly associated with choosing a LARC method, even though all women in the population were entitled to their first free-of-charge LARC method. The association was particularly strong among women less than 25 years of age. IMPLICATIONS STATEMENT: Untargeted provision of free-of-charge LARC in public contraceptive services reached women with previous delivery or abortion well during the programs first years. However, as LARCs are recommended to all women, future research should focus on how uptake evolves and how to reach all women in need of long-term, effective contraception.

Effect of Free Healthcare Policy for Children under Five Years Old on the Incidence of Reported Malaria Cases in Burkina Faso by Bayesian Modelling: "Not only the Ears but also the Head of the Hippopotamus".

Burkina Faso has recently implemented an additional strategy, the free healthcare policy, to further improve maternal and child health. This policy targets children under five who bear the brunt of the malaria scourge. The effects of the free-of-charge healthcare were previously assessed in women but not in children. The present study aims at filling this gap by assessing the effect of this policy in children under five with a focus on the induced spatial and temporal changes in malaria morbidity. We used a Bayesian spatiotemporal negative binomial model to investigate the space-time variation in malaria incidence in relation to the implementation of the policy. The analysis relied on malaria routine surveillance data extracted from the national health data repository and spanning the period from January 2013 to December 2018. The model was adjusted for meteorological and contextual confounders. We found that the number of presumed and confirmed malaria cases per 1000 children per month increased between 2013 and 2018. We further found that the implementation of the free healthcare policy was significantly associated with a two-fold increase in the number of tested and confirmed malaria cases compared with the period before the policy rollout. This effect was, however, heterogeneous across the health districts. We attributed the rise in malaria incidence following the policy rollout to an increased use of health services combined with an increased availability of rapid tests and a higher compliance to the "test and treat" policy. The observed heterogeneity in the policy effect was attributed to parallel control interventions, some of which were rolled out at different paces and scales. Our findings call for a sustained and reinforced effort to test all suspected cases so that, alongside an improved case treatment, the true picture of the malaria scourge in children under five emerges clearly (see the hippopotamus almost entirely).

[The development of territorial program of mandatory medical insurance: calculation of standards of out-patient care volume].

The article presents technique of calculation of the planned volume of outpatient care consumed by population of the subject of the Russian Federation considering demographic structure and level of morbidity. The formulas are presented developed for calculating financial costs of outpatient care and treatment in day hospital to be included into of mandatory health insurance program.

[Postoperative complications and free caesarean section in Mali = case of a health district]. / Complications post cesarienne et gratuite de la cesarienne au Mali = cas d'un centre de sante de district.

Our study aimed to assess the impact of free caesarean section on emergency obstetric care. This was a descriptive cross-sectional study that took place over a period of eight months during the period of June 1st, 2007 to January 31th, 2008. The study included 262 parturients admitted from August 1st, 2004 to July 31th, 2006. Among the 262 parturients 43.13% were recorded before and 56.87% after the implementation of the free of charge caesarean. Caesarean section was performed in 46.90% of parturients before and at 60.40% after the implementation of the free of charge caesarean. The age group 20 to 35 years was the most represented with 58.40%. Complications were present in 37.74% of women delivered by cesarean section before the implementation of the free of charge caesarean and in 20% after its implementation. The infection was seen in 70% of women delivered by cesarean section before the implementation of the free of charge caesarean and 61.11% after its implementation. Among deaths, 5.66% were recorded before and 1.11% after the implementation of the free of charge caesarean. The heavy bleeding was seen in 37.50% cases. Stillbirths recorded before the implementation of the free of charge caesarean were 62.83% and after its implementation, they were of 20.13%. In 18.81% of stillbirths were associated with fetopelvic disproportion.The implementation of the free of charge cesarean helped increase the frequency caesarean section and the reduction of stillbirth in the health district of San.

Notre étude avait pour but d'évaluer l'impact de la gratuité de la césarienne sur les soins obstétricaux d'urgence. Il s'agissait d'une étude transversale descriptive qui s'est déroulée sur huit mois du 1er juin 2007 au 31 janvier 2008. Etaient concernées par l'étude 262 parturientes admises du 1er Août 2004 au 31juillet 2006. Parmi les 262 parturientes 43,13% étaient enregistrés avant la gratuité et 56,87% après la gratuité. La césarienne était réalisée chez 46,90% des parturientes avant la gratuité et chez 60,40% après la gratuité. La tranche d'âge de 20 à 35 ans était la plus représentée avec 58,40%. Les complications étaient présentes chez 37,74% des femmes césarisées avant la gratuité et chez 20% après la gratuité. L'infection était retrouvée chez 70% des femmes césarisées avant la gratuité et 61,11% après la gratuité. Parmi les décès, 5,66% étaient enregistrés avant la gratuite et 1,11% après la gratuité. L'hémorragie était retrouvée dans 37,50% des cas. Les mort-nés enregistrés avant la gratuité étaient de 62,83% et après la gratuité, ils étaient de 20,13%. Dans 18,81% des cas, les mort-nés étaient liés à la disproportion fœto-pelvienne. La gratuité de la césarienne a contribué à l'augmentation de la fréquence des césariennes et à la réduction de la mortinatalité dans le district sanitaire de San.

Comparison of Nutrient Intake and Meal Service Satisfaction of Elderly at the Local Community Centers:Free and Reduced Meal Service Charge / 대한지역사회영양학회지

The purpose of this study was to compare the nutrient intake and foodservice satisfaction of homebound elderly had lunch at the local community centers by the difference of meal service charge. Two local community center with congregate meal service program located in Daegu and Gyongsan were selected; one with free of meal service charge (F), and the other with 500-1,000 won for meal service charge (K). According to the dietary assessment, energy and nutrient intakes of the 156 elderly subjects were as a whole under the Korean Recommended Dietary Allowance (RDA). Elderly of F service center showed higher % RDA for the selected nutrients and MAR (mean adequacy ratio) than those of K service center (p<0.001). Participants were satisfied with most of the congregation meal service from community center with different reasons such as 'tasty (K service center)' and 'free of charge (F service center)'. In conclusion, elderly had the lunch at the community center with free of meal service charge was poor nutrition status and lower socioeconomic level than the other type of community center in this area. Therefore, healthy menu for elderly should be developed and managed by professional dietitian, as well as its impact on health status of this group, and congregate meal service system might be extended to the homebound elderly of whole community with free of charge.

Comparison of Nutrient Intake and Meal Service Satisfaction of Elderly at the Local Community Centers:Free and Reduced Meal Service Charge / 대한지역사회영양학회지

The purpose of this study was to compare the nutrient intake and foodservice satisfaction of homebound elderly had lunch at the local community centers by the difference of meal service charge. Two local community center with congregate meal service program located in Daegu and Gyongsan were selected; one with free of meal service charge (F), and the other with 500-1,000 won for meal service charge (K). According to the dietary assessment, energy and nutrient intakes of the 156 elderly subjects were as a whole under the Korean Recommended Dietary Allowance (RDA). Elderly of F service center showed higher % RDA for the selected nutrients and MAR (mean adequacy ratio) than those of K service center (p<0.001). Participants were satisfied with most of the congregation meal service from community center with different reasons such as 'tasty (K service center)' and 'free of charge (F service center)'. In conclusion, elderly had the lunch at the community center with free of meal service charge was poor nutrition status and lower socioeconomic level than the other type of community center in this area. Therefore, healthy menu for elderly should be developed and managed by professional dietitian, as well as its impact on health status of this group, and congregate meal service system might be extended to the homebound elderly of whole community with free of charge.