Deep vein thrombosis and air travel: record linkage study.

OBJECTIVE: To investigate the time relations between long haul air travel and venous thromboembolism. DESIGN: Record linkage study using the case crossover approach. SETTING: Western Australia. PARTICIPANTS: 5408 patients admitted to hospital with venous thromboembolism and matched with data for arrivals of international flights during 1981-99. RESULTS: The risk of venous thromboembolism is increased for only two weeks after a long haul flight; 46 Australian citizens and 200 non-Australian citizens had an episode of venous thromboembolism during this so called hazard period. The relative risk during this period for Australian citizens was 4.17 (95% confidence interval, 2.94 to 5.40), with 76% of cases (n = 35) attributable to the preceding flight. A "healthy traveller" effect was observed, particularly for Australian citizens. CONCLUSIONS: The annual risk of venous thromboembolism is increased by 12% if one long haul flight is taken yearly. The average risk of death from flight related venous thromboembolism is small compared with that from motor vehicle crashes and injuries at work. The individual risk of death from flight related venous thromboembolism for people with certain pre-existing medical conditions is, however, likely to be greater than the average risk of 1 per 2 million for passengers arriving from a flight. Airlines and health authorities should continue to advise passengers on how to minimise risk.

A review of cost-of-illness studies on obesity.

This paper reviews the published cost-of-illness studies on obesity. The medical literature has demonstrated that obesity is an independent risk factor for a number of medical conditions, including diabetes mellitus, hypertension, coronary heart disease, elevated cholesterol levels, depression, musculoskeletal disorders, gallbladder disease, and several cancers. Since these conditions can be costly to treat, obesity clearly has a substantial economic impact. Epidemiologic estimates of the aggregate economic costs associated with specific obesity-related diseases in the United States indicate that the annual burden to society totals in the billions of dollars, representing 5.5% to 7.8% of total health-care expenditures. Although estimates of the costs attributable to obesity differ across studies, the one common finding is that these costs are substantial from a health-policy perspective. The objective of this paper is to identify and review the obesity cost-of-illness literature, address study limitations, and identify key areas for future economic research. This review indicates that the economic burden of obesity has been estimated using a prevalence-based cost-of-illness framework. Areas for future research include estimating the economic burden of obesity using an incidence-based cost-of-illness framework and modeling the association between health-care expenditure and level of obesity using individual-level data, such as medical and pharmacy claims data.

The economics of benign prostatic hyperplasia treatment: a literature review.

Benign prostatic hyperplasia (BPH) is one of the most common benign neoplasms in elderly men in the United States; it has been estimated that the annual costs of caring for these men exceed $4 billion. This condition is rarely life threatening, but often affects the individual's quality of life in varying degrees. There are several treatments for this condition, including surgery, with the most common procedure being transurethral resection of the prostate. Other treatment options include medication (such as finasteride and terazosin), balloon dilation, and watchful waiting. The cost associated with BPH depends on the severity of the disease and the appropriate course of treatment. The objective of this paper is to identify and evaluate the economic research papers that have considered either the economic burden or costs associated with alternative BPH therapy options and to identify key areas for future economic research. This review indicates that the economic studies of BPH are diverse in nature and greater attention needs to be placed on the societal appraisal of competing BPH therapies. Other research areas include the economic analysis of both short- and long-run BPH treatment options, increased cost-utility analysis, and the use of retrospective claims database analysis using regression techniques.