RESUMO
OBJETIVO: Determinar la carga económica anual del asma, desde una perspectiva institucional y con base en la clasificación recomendada por GINA, en una cohorte retrospectiva de adultos atendidos en el Instituto Nacional de Enfermedades Respiratorias (INER) de México. MÉTODOS: Estudio observacional, longitudinal y retrospectivo, llevado a cabo a partir de la información recabada de 247 pacientes femeninas con asma. Se estimaron los costos directos anuales: visitas, pruebas de laboratorio, tratamiento farmacológico y de las crisis o exacerbaciones, para determinar la carga anual de la enfermedad desde una perspectiva institucional, y según la clasificación de la Iniciativa Global para el Asma. RESULTADOS: El costo promedio anual fue de $43,813,92, que aumentó en relación con la necesidad de aumento de dosis de corticoides inhalados y beta-agonistas de acción prolongada. El costo promedio de la consulta médica fue de $2004.57, $982.82 por gestión de crisis y $2645.95 por pruebas de laboratorio. El tratamiento farmacológico representó la principal carga económica, con un costo promedio anual de $38,180.58. CONCLUSIONES: Los resultados resaltan una carga económica del asma estimada en un costo anual por paciente de $43,813.92 MXN (DE=93,348.85), en el contexto del tercer nivel de atención en el sistema de salud público mexicano. La gravedad del asma, los tratamientos y los biológicos fueron los principales factores que aumentaron los costos directos de la atención.
OBJECTIVE: Determine the annual economic burden of the disease from an institutional perspective and based on GINA's recommended classification in a retrospective cohort of adults treated at Instituto Nacional de Enfermedades Respiratorias (INER) of Mexico City. METHODS: A retrospective, longitudinal observational study comprised by data from 247 female asthma patients, annual direct costs were estimated including: visits, laboratory tests, pharmacological treatment and management of crisis or exacerbations, to determine the annual burden of the disease from an institutional perspective and according to Global Initiative for Asthma classification. RESULTS: The average annual cost was $43,813.92, which increased in relation to the need of inhaled corticosteroids and long-acting beta agonists dosage increase. The average doctor's appointment cost was $2,004.57, $982.82 for crisis management and $2,645.95 for laboratory testing. Pharmacological treatment represented the main economic burden with an annual average cost of $38,180.58. CONCLUSIONS: The results highlight an economic burden of asthma estimated at an annual cost per patient of $43,813.92 MXN (SD=93,348.85) in the context of the third level of care in the Mexican public health system. The asthma severity and treatments such as biologics were the main factors that increased direct costs of care.
Assuntos
Asma , Efeitos Psicossociais da Doença , Humanos , Asma/economia , Asma/tratamento farmacológico , Asma/terapia , México , Estudos Retrospectivos , Feminino , Adulto , Pessoa de Meia-Idade , Estudos Longitudinais , Academias e Institutos/economia , Adulto Jovem , Adolescente , IdosoAssuntos
Academias e Institutos , Biologia , RNA , Pesquisadores , Academias e Institutos/economia , Academias e Institutos/legislação & jurisprudência , Academias e Institutos/normas , Biologia/economia , Biologia/normas , Racismo/legislação & jurisprudência , Pesquisadores/economia , Pesquisadores/legislação & jurisprudênciaAssuntos
Academias e Institutos , Internacionalidade , Política Pública , Pesquisadores , Apoio à Pesquisa como Assunto , Índia , Academias e Institutos/economia , Academias e Institutos/legislação & jurisprudência , Academias e Institutos/normas , Apoio à Pesquisa como Assunto/economia , Apoio à Pesquisa como Assunto/legislação & jurisprudência , Política Pública/economia , Política Pública/legislação & jurisprudênciaAssuntos
Anticorpos/química , Biologia Computacional/métodos , Gástrula/citologia , Análise de Célula Única/métodos , Software , Academias e Institutos/economia , Animais , Encéfalo/citologia , Encéfalo/virologia , Brasil , Núcleo Celular/metabolismo , Custos e Análise de Custo , Metilação de DNA , Gástrula/fisiologia , Humanos , Análise de Sequência de RNA , Análise de Célula Única/economia , Fator de Transcrição RelA/imunologia , Fator de Transcrição RelA/metabolismo , Infecção por Zika virus/patologiaRESUMO
BACKGROUND: The National Institute for Health and Care Excellence (NICE) makes recommendations on the reimbursement of new drugs utilizing an Incremental Cost-Effectiveness Ratio (ICER) threshold range that has been in use since 2004 and has remained unchanged. RESEARCH DESIGN AND METHODS: To model how the NICE cost-effectiveness thresholds would vary if inflation was accounted for and their potential effects on appraisal outcomes, all single technology appraisal (STA) recommendations published in 2019 were identified. The outcome and most plausible ICERs were then evaluated against thresholds, after taking inflation into account. RESULTS: 41 STAs with base-case ICERs were identified. For general STAs, 46% of ICERs were ≤£20,000/QALY, 27% were £20,000-£30,000/QALY and 27% >£30,000/QALY. Cumulatively, there was a 43% decrease in the purchasing power of the pound from 2004 to 2019 due to inflation. To compensate, the NICE ICER threshold would have to increase to £28,584-£42,876/QALY. Using inflation-adjusted thresholds led to an absolute increase of 18% and 12% of STAs whose ICERs fell below the lower and upper bounds of this threshold range, respectively. CONCLUSION: By not adjusting for inflation, the NICE ICER thresholds have declined in real terms. Whether ICER thresholds should be dynamic to reflect factors like inflation requires further research.
Assuntos
Academias e Institutos , Inflação , Medicina Estatal , Academias e Institutos/economia , Análise Custo-Benefício , Humanos , Medicina Estatal/economia , Reino UnidoAssuntos
Academias e Institutos , Pesquisa Biomédica , Cardiologia , Doenças Cardiovasculares , Academias e Institutos/economia , Academias e Institutos/tendências , Pesquisa Biomédica/economia , Pesquisa Biomédica/tendências , Cardiologia/economia , Cardiologia/tendências , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/terapia , Comportamento Cooperativo , Difusão de Inovações , Previsões , Humanos , Cultura Organizacional , Parcerias Público-Privadas , Apoio à Pesquisa como Assunto , Espanha , Local de TrabalhoAssuntos
Academias e Institutos/economia , COVID-19/economia , Sociedades Científicas/economia , Orçamentos , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Países em Desenvolvimento/economia , Humanos , Cooperação Internacional , SARS-CoV-2/genética , Reino Unido/epidemiologiaAssuntos
Academias e Institutos , Indústrias , Colaboração Intersetorial , Neoplasias , Parcerias Público-Privadas , Apoio à Pesquisa como Assunto , Academias e Institutos/economia , Academias e Institutos/organização & administração , Difusão de Inovações , Apoio Financeiro , Humanos , Indústrias/economia , Indústrias/organização & administração , Neoplasias/diagnóstico , Neoplasias/economia , Neoplasias/terapia , Parcerias Público-Privadas/economia , Parcerias Público-Privadas/organização & administração , Apoio à Pesquisa como Assunto/economia , Apoio à Pesquisa como Assunto/organização & administraçãoRESUMO
Umbilical cord blood is an important graft source in the treatment of many genetic, hematologic, and immunologic disorders by hematopoietic stem cell transplantation. Millions of cord blood units have been collected and stored for clinical use since the inception of cord blood banking in 1989. However, the use of cord blood in biomedical research has been limited by access to viable samples. Here, we present a cost-effective, self-sustaining model for the procurement of fresh umbilical cord blood components for research purposes within hospital-affiliated academic institutions.
Assuntos
Pesquisa Biomédica/organização & administração , Bancos de Sangue/organização & administração , Sangue Fetal , Modelos Organizacionais , Academias e Institutos/economia , Academias e Institutos/organização & administração , Academias e Institutos/normas , Pesquisa Biomédica/economia , Pesquisa Biomédica/métodos , Pesquisa Biomédica/normas , Bancos de Sangue/economia , Bancos de Sangue/normas , Coleta de Amostras Sanguíneas/economia , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/normas , California , Análise Custo-Benefício , Feminino , Sangue Fetal/citologia , Sangue Fetal/transplante , Transplante de Células-Tronco Hematopoéticas/economia , Transplante de Células-Tronco Hematopoéticas/métodos , Transplante de Células-Tronco Hematopoéticas/normas , Humanos , Recém-Nascido , GravidezAssuntos
Academias e Institutos/legislação & jurisprudência , Academias e Institutos/organização & administração , Medicina Regenerativa/economia , Medicina Regenerativa/legislação & jurisprudência , Governo Estadual , Pesquisa com Células-Tronco/economia , Pesquisa com Células-Tronco/legislação & jurisprudência , Academias e Institutos/economia , Academias e Institutos/ética , California , Conflito de Interesses , Organização do Financiamento/ética , Humanos , Defesa do Paciente , Medicina Regenerativa/tendênciasAssuntos
Academias e Institutos/economia , Fundações/economia , Células HeLa , Racismo , Feminino , Organização do Financiamento/economia , História do Século XX , História do Século XXI , Humanos , Racismo/economia , Racismo/história , Racismo/prevenção & controle , Sífilis/história , Estados UnidosAssuntos
Academias e Institutos/tendências , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças , Técnicas de Diagnóstico Molecular/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Academias e Institutos/economia , COVID-19 , Infecções por Coronavirus/epidemiologia , Genoma Viral/genética , Humanos , Técnicas de Diagnóstico Molecular/economia , Técnicas de Diagnóstico Molecular/tendências , Pneumonia Viral/epidemiologia , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Strengthening research capacity in low-and-middle-income countries is essential to drive socioeconomic development and to achieve the Sustainable Development Goals. Understanding strengths and weaknesses in institutions' research capacity can guide effective targeting of investments and resources. This study assessed the capacity of institutions undertaking research in natural science topics in Africa to identify priority capacity gaps for future investment. METHODS: Assessments were conducted in eight African institutions that were partners in a UK-Africa programme to strengthen research capacity in renewable energy, soil-related science, and water and sanitation. Assessments involved eighty-six interviews and three focus group discussions to identify institutions' research capacity strengths and gaps against an evidence-informed benchmark. Use of the same interview guides and data collection processes across all institutions meant that findings could be compared. RESULTS: Common research capacity gaps were: lack of, or poorly maintained, equipment; unreliable, slow procurement systems; insufficient opportunities for developing the skills of research support staff such as administrators and technicians; dysfunctional institutional email communication systems; insufficient focus on the development of 'soft' researcher skills such as ethics, academic writing and, in non-Anglophone countries, English language. Programme strengths were the South-South and South-North partnerships for sharing and cascading expertise and resources, joint writing of proposals and publications, and improved individual and institutional visibility. CONCLUSION: There were many similarities in research capacity gaps irrespective of the institutions' natural sciences research focus, and these were similar to those reported in the health sector. Common capacity needs are improving the skills of technicians and administrators to support research activities, soft skills training for researchers, and more effective pan-institutional e-communication systems. These could be strategic investment targets for the joint efforts of national governments and international organisations that fund programmes for strengthening research capacity in low- and middle-income countries.
Assuntos
Pesquisadores/psicologia , Pesquisa , Academias e Institutos/economia , Academias e Institutos/organização & administração , África , Fortalecimento Institucional , Grupos Focais , Humanos , Entrevistas como AssuntoRESUMO
In this essay, the author analyzes contributions from the American Academy of Family Physician's (AAFP's) political action committee (FamMedPAC) during the 2018 election cycle. The author highlights discrepancies between explicit AAFP legislative priorities and the voting records and public positions of Congressional members who received FamMedPAC support during the election cycle. The analysis raises questions about FamMedPAC's decision-making process for allocating support to candidates. The author posits that consistency between AAFP positions and those of candidates receiving FamMedPAC contributions is essential to preserve both public trust in family physicians and family physicians' trust in the AAFP.