Preferences and values for government policies on infectious disease outbreaks and epidemics for the Japanese population: a conjoint analysis.

AIMS: To investigate the preferences of the Japanese population for government policies expected to address infectious disease outbreaks and epidemics. METHODS: We performed a conjoint analysis based on survey data in December 2022 (registration number: UMIN000049665). The attributes for the conjoint analysis were policies: tests, vaccines, therapeutic drugs, behavior restrictions (e.g. self-restraint or restrictions on the gathering or travel of individuals and the hours of operation or serving of alcoholic beverages in food/beverage establishments), and entry restrictions (from abroad), and monetary attribute: an increase in the consumption tax from the current 10%, to estimate the monetary value of the policies. A logistic regression model was used for the analysis. RESULTS: Data were collected from 2,185 respondents. The accessibility of tests, vaccines, and therapeutic drugs was preferred regardless of the accessibility level. The value for accessibility of drugs to anyone at any medical facility was estimated at 4.80% of a consumption tax rate, equivalent to JPY 10.5 trillion, which was the highest among the policies evaluated in this study. The values for implementing behavior or entry restrictions were negative or lower than those for tests, vaccines, and drugs. LIMITATIONS: Respondents chosen from an online panel were not necessarily representative of the Japanese population. Because the study was conducted in December 2022, a period during the coronavirus disease 2019 (COVID-19) pandemic, the results may reflect the situation at that time and potentially be subject to rapid change. CONCLUSIONS: Among the policy options evaluated in this study, the most preferred option was easily accessible therapeutic drugs and their monetary value was substantial. Wider accessibility of tests, vaccines, and drugs was preferred over behavior and entry restrictions. We believe that the results provide information for policymaking to prepare for future infectious disease epidemics and for assessing the response to COVID-19 in Japan.

COVID-19 and culture

The USA has been particularly hard hit by the COVID-19 pandemic and a wide spatial variation can be seen in its spread and mortality. This raises the question of why some regions are more resilient to the pandemic than others? We hypothesize that the individualism-collectivism cleavage explains the disparity in COVID-19 cases observed across sub-national units in the USA. Cultural disparity among different groups of people leads to differences in how they perceive health crises and thereby shapes the way they respond to pandemics. A heightened sense of obligation and responsibility increases in-group sociability and interdependence and raises the perceived vulnerability towards disease transmission among collectivistic individuals, and this leads to greater adherence to containment measures and social distancing rules. Our results provide evidence that more individualistic states tend to have more COVID-19 cases across the USA.

Burden of illness associated with overweight and obesity in patients hospitalized with COVID-19 in the United States: analysis of the premier healthcare database from April 1, 2020 to October 31, 2020.

BACKGROUND: SARS-CoV-2 (COVID-19) continues to be a major public health issue. Obesity is a major risk factor for disease severity and mortality associated with COVID-19. OBJECTIVE: This study sought to estimate the healthcare resource use and cost outcomes in patients hospitalized with COVID-19 in the United States (US) according to body mass index (BMI) class. METHODS: Retrospective cross-sectional study analyzing data from the Premier Healthcare COVID-19 database for hospital length-of-stay (LOS), intensive care unit (ICU) admission, ICU LOS, invasive mechanical ventilator use, invasive mechanical ventilator use duration, in-hospital mortality, and total hospital costs from hospital charge data. RESULTS: After adjustment for patient age, gender, and race, patients with COVID-19 and overweight or obesity had longer durations for mean hospital LOS (normal BMI = 7.4 days, class 3 obesity = 9.4 days, p < .0001) and ICU LOS (normal BMI = 6.1 days, class 3 obesity = 9.5 days, p < .0001) than patients with normal weight. Patients with normal BMI had fewer days on invasive mechanical ventilation compared to patients with overweight and obesity classes 1-3 (6.7 days vs. 7.8, 10.1, 11.5, and 12.4, respectively, p < .0001). The predicted probability of in-hospital mortality was nearly twice that of patients with class 3 obesity compared to patients with normal BMI (15.0 vs 8.1%, p < .0001). Mean (standard deviation) total hospital costs for a patient with class 3 obesity is estimated at $26,545 ($24,433-$28,839), 1.5 times greater than the mean for a patient with a normal BMI at $17,588 ($16,298-$18,981). CONCLUSIONS: Increasing levels of BMI class, from overweight to obesity class 3, are significantly associated with higher levels of healthcare resource utilization and costs in adult patients hospitalized with COVID-19 in the US. Effective treatment of overweight and obesity are needed to reduce the burden of illness associated with COVID-19.

The COVID-19 pandemic has caused many people to be seriously ill. People who are overweight are more likely to get sicker from COVID-19 infection and to require hospitalization.In our study, we compared patients who have normal weight to people who have overweight or obesity to understand how excess weight affects their experiences with COVID-19. We looked at: (1) how overweight and obesity is related to how long patients with COVID-19 stay in the hospital, (2) if they stayed in the intensive care unit (ICU) and how long they spent there, (3) whether they needed help breathing with the use of a ventilator and how long they needed a ventilator, (4) if they died during their hospital stay, and (5) how much their hospital stay cost.We found that people who have overweight or obesity stayed in the hospital longer, were more likely to need to stay in the ICU, and were in the ICU longer. They were also more likely to need help breathing with the use of a ventilator and needed that help for a longer time. People who have overweight or obesity died during their hospital stay more often than people with a normal BMI. The costs associated with people who have overweight or obesity were higher than people who have a normal BMI.Overall, this study shows that having overweight or obesity is a significant risk factor for poor outcomes from COVID-19 infection. Treatment for obesity and overweight is needed to help improve outcomes from future pandemics.

Influence of health-conscious consumer behaviour on consumer ethnocentrism during the COVID-19 pandemic

The aim of the article is fourfold: (1) to identify the level of health consciousness during the pandemic in Slovakia and Croatia, and to point out the possible influence of selected demographic factors on this rate, (2) to identify the degree of consumer ethnocentrism during the pandemic in Slovakia and Croatia and to examine the impact of selected demographic factors to this extent, (3) to examine the link between health consciousness as a factor affecting consumer ethnocentrism and (4) to identify differences in the studied variables of Croatia and Slovakia. The article is supported by a primary survey based on 459 respondents in Croatia and 429 respondents in Slovakia. Whilst referring to our aims, we formulated research questions and hypotheses, in order to answer and verify them we chose ANOVA test and regression analysis. The results point to a high level of respondents' health awareness and an average (in the case of Slovakia) and above-average (in the case of Croatia) rate of consumer ethnocentrism. The results indicate a low relationship between the variables examined. Results can be applied both in theory and in practice in various fields. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Healthcare resource utilization and costs among patients with psoriasis treated with ixekizumab or adalimumab over 2 years of follow-up in real-world settings.

AIMS: To compare long-term healthcare resource utilization (HCRU) and costs among patients who initiated ixekizumab (IXE) or adalimumab (ADA) for treatment of psoriasis in the United States. METHODS: Adult patients with psoriasis who had ≥1 claim for IXE or ADA were identified from IBM MarketScan claims databases prior to the COVID-19 pandemic (1 March 2016-31 October 2019). The index date was the date of first claim for the index drug of interest. Inverse probability of treatment weighting was employed to balance treatment cohorts. All-cause and psoriasis-related HCRU and costs were examined for 24 months of follow-up. Costs were reported as per patient per month. Costs of psoriasis-related biologics were adjusted using published Institute for Clinical and Economic Review (ICER) discount factors. Index drug costs were adjusted for adherence and ICER discount rates. RESULTS: The analyses included 407 IXE and 2,702 ADA users. IXE users had significantly higher inpatient admission rate (all-cause HCRU: 14.9% vs. 11.0%; p =0.012) and greater mean length of stay per admission (days, 6.6 vs. 4.1; p =0.004) than ADA users. ICER-adjusted costs were significantly higher in IXE than ADA users (all-cause costs: $4,132 vs. $3,610; p <0.001; psoriasis-related costs $3,077 vs. $2,700; p <0.001). After adjusting for ICER and adherence, IXE and ADA drug costs were comparable ($3,636 vs. $3,677; p =0.714). LIMITATIONS: Study relied on administrative claims data, subjected to data coding limitations and data entry errors. Rebates, patient assistance programs, and commission to wholesalers are not always captured in claims. Adjustment made by ICER discount factors may lead to double-discounting if the discounts have been applied in claim payments. CONCLUSIONS: All-cause HCRU was higher in IXE than ADA users. Healthcare costs were also higher in IXE than ADA users after ICER adjustment, over 24 months. Cost differences were largely driven by higher treatment adherence associated with IXE. Index drug costs were comparable after ICER and adherence adjustments.

Weather, mobility and the evolution of the Covid-19 pandemic

Purpose The authors investigate the effect of weather and mobility on the spread of the Covid-19 pandemic. Design/methodology/approach The authors first estimate the effective reproduction number (Rt) as a proxy of the spread of the Covid-19 pandemic and then study the relationship between the latter and weather and mobility in a panel data framework. The authors use US daily infections data between February and September of 2020 at the county level. Findings The authors find that lower temperatures are associated with a higher Rt, and this effect is greater at temperatures below 0 degrees C. In addition, mobility reductions related to certain types of locations (retail and recreation, transit stations and workplaces) are effective at reducing Rt, but it is an increase in the time spent in parks that most helps reduce the spread of the pandemic. Originality/value The estimates imply that a 20 degrees C fall in temperature from summer to winter would increase Rt by +0.35, which can be the difference between a well-controlled evolution and explosive behavior of the spread of the virus. Applying these coefficients estimated with US county data to aggregate series from other countries helps explain the resurgence of the pandemic in the Northern Hemisphere during the winter of 2020. The results show that mobility reduction and social distance are best policies to cope with the Covid-19 outbreak. This strong policy lesson will help facing similar outbreaks in the future.

Higher order risk attitudes in the time of COVID-19: an experimental study

The coronavirus disease (COVID-19) represents a large increase in background risk for individuals. Like the COVID-19 pandemic, extreme events (e.g. financial downturns, natural disasters, and war) have been shown to change attitudes towards risk. Using a risk apportionment approach, we examine whether risk aversion as well as higher order risk attitudes (HORAs) (prudence and temperance) have changed during COVID-19. This methodology allows us to measure model-free HORAs. We include prudence and temperance as higher order measures, as these two have been largely understudied under extreme events but are determinants of decisions related to the health and financial domains. Once we account for socio-demographic characteristics, we find an overall increase in risk aversion during COVID-19. We also find similar results using a hypothetical survey question which measures willingness to take risks. We do not find changes in prudence and temperance using the risk apportionment methodology.