Analysis of the health economics portfolio funded by the National Institutes of Health in response to published guidance.

Health services, economics, and outcomes research (referred to as health economics research hereinafter) is one of the interdisciplinary sciences that the National Institutes of Health (NIH) supports in order to pursue its overall mission to improve health. In 2015, NIH guidance was published to clarify the type of health economics research that NIH would continue to fund. This analysis aimed to determine if there were changes in the number of health economics applications received and funded by NIH after the release of the guidance. Health economics applications submitted to NIH both before and after publication of the guidance were identified using a machine learning approach with input from subject matter experts. Application and funding trends were examined by fiscal year, method of application (solicited vs. unsolicited), and activity code. This study found that application and funding rates of health economics research were decreasing prior to guidance. Following publication of this guidance, the application and funding rate of health economics applications increased.

The government subsidy design considering the reference price effect in a green supply chain.

This paper constructs a green supply chain with a manufacturer and a retailer. Taking into account the reference price effect of consumers based on the mental accounting theory, we investigate the following government incentive policies: R&D (research and development) subsidy, consumption subsidy, and dual subsidy. For manufacturer-led (M-led) and retailer-led (R-led) supply chains, we evaluate the optimal wholesale price, sales price, green degree of product, and the optimal subsidy of the government aiming to improve the environmental benefit or social welfare. We find that the government goal, power structure and reference price effect impact the design of subsidy mechanisms significantly. First, for M-led supply chain, the government concerned with the environmental benefit goal should only provide R&D subsidy for the manufacturer when the reference price effect is low; otherwise, the government would offer subsidy both for the manufacturer and consumers. However, the government will only offer R&D subsidy when the social welfare goal is adopted. Second, for R-led supply chain, the government aiming to improve the environmental benefit prefers dual subsidy when the reference price effect is low; otherwise, consumption subsidy is preferable. Surprisingly, under the social welfare goal, no subsidy for R-led supply chain tends to be the best option. Intriguingly, embracing the social welfare goal can result in more economic and environmental benefits for M-led supply chain, although the subsidy strategy is less effective than the environmental benefit goal. Our research can provide inspirations and references for designing government subsidy mechanisms in practice.

Progressive Massive Fibrosis Identified at Federally Funded Black Lung Clinics in the US.

This study of US Black Lung Clinics (established to treat coal miners) reports the prevalence of progressive massive fibrosis identified through June 2023.

Green credit policy, government subsidy, and enterprises "shifting from virtual to real".

Taking the green credit policy in 2012 as a quasi-natural experiment, this paper uses the difference-in-differences method to explore the impact of green credit policy on enterprises' financial asset allocation and the moderating effect of government subsidy. We find that green credit policy significantly promotes the financial asset allocation of heavy-polluting enterprises, which is mainly reflected in short-term liquid financial investment, thus supporting the precautionary motivation of holding financial assets. The mechanism analysis shows that green credit policy promotes the financial asset allocation of heavy-polluting enterprises by reducing the scale of debt financing and increasing the financing cost. Government subsidy can significantly weaken the promoting effect of green credit policy on enterprises' financial asset allocation, and there is heterogeneity due to the regional environmental regulation intensity and financial development level. Further analysis shows that the negative moderating effect of government subsidy on green credit policy and enterprises' financial asset allocation significantly promotes the "shifting form virtual to real" of heavy polluting enterprises by reducing financial asset allocation. This paper discusses the impact of green credit policy on financial asset allocation of heavy-polluting enterprises in China and further clarifies the significant role of government subsidy in the process, so as to provide suggestions for government to control the "shifting from real to virtual" of enterprises. The results also provide an important reference for countries, especially developing countries, to implement green credit policy and government subsidy to achieve sustainable economic development.

Conocimiento y uso de los recursos dirigidos a los familiares de personas con discapacidad / Knowledge and Use of Resources for Family Members of Persons with Disabilities

Las políticas sociales buscan relevar a la familia de las personas con discapacidad y dependencia en su papel de cuidadores. Sin embargo, en numerosas ocasiones, estas familias no disponen de todos los recursos necesarios para afrontar estas situaciones de cuidado. El objetivo general del presente trabajo es conocer la percepción sobre los recursos de los que disponen los familiares de personas con discapacidad. Se trata de un estudio cualitativo mediante entrevista estructurada, no experimental ex post facto, de carácter descriptivo y de tipo transversal. La muestra total fueron 27 personas familiares de personas con discapacidad. Para el análisis de las respuestas se empleó el programa JASP y se realizó estadística descriptiva y correlacional. Los resultados indican que el recurso más reconocido y utilizado es el referido a las prestaciones económicas, así como la atención temprana y los colegios de educación especial. Las mujeres son mayoritarias en el cuidado de estas personas, señalando estas mujeres un gasto de energía, por lo que podría ser recomendable mejorar la eficiencia y la eficacia de los programas de respiro familiar. (AU)

Social policies seek to relieve the family of people with disabilities and dependency in their role as caregivers. However, on numerous occasions, these families do not have all the necessary resources to deal with these care situations. The general objective of this study is to find out the perception of the resources available to family members of people with disabilities in Spain. This is a qualitative study using a structured interview, non-experimental ex post facto, descriptive and cross-sectional in nature. The total sample consisted of 27 relatives of people with disabilities. The JASP programme was used to analyse the responses, and descriptive and correlational statistics were performed. The results indicate that the most recognized and used resource is the one referred to economic benefits, as well as early care and special education schools. Women are in the majority in the care of these people, who report an expenditure of energy, so it could be advisable to improve the efficiency and effectiveness of family respite programmes. (AU)

Federal and Provincial Governments Need To Be Transparent about Trade-Offs When They Buy Healthcare.

Spending on healthcare is carefully scrutinized by the public, the media and academics because the amounts are so large and represent a very significant proportion of provincial budgets. Some quarters are calling for increases in spending, whereas others are focused on restraint owing to perceived inefficiencies and ineffectiveness. The debate over healthcare spending has continued for decades and is likely to heat up as new provincial labour agreements have locked in annual healthcare spending increases of at least five percent for 2023 (BC Nurses' Union 2023; ONA 2023).

The impact of industry-university-research projects on biopharmaceutical companies' innovation performance: moderating roles of government subsidies for innovation.

Innovation holds paramount importance for both nations and businesses. This article presents a panel regression model designed to assess the fixed effects of industry-university-research (IUR) cooperation projects on innovation performance. Furthermore, it examines the moderating impact of government innovation subsidies by utilizing data spanning from 2007 to 2021, encompassing 326 listed Chinese biopharmaceutical firms. Our findings reveal that industry-university-research-cooperation projects have the potential to significantly enhance innovation performance across three key metrics: input, output, and quality for firms. The presence of government innovation subsidies as a moderator is found to have a positive influence on IUR-cooperation projects and their innovative inputs. However, it can yield adverse effects on IUR-cooperation projects with respect to innovation outputs and quality. The insights presented in this paper introduce innovative recommendations for elevating corporate innovation quality and refining the policies governing IUR cooperation.

Spatiotemporal patterns of healthy life expectancy and the effects of health financing in West African countries, 1995-2019: A Spatial Panel Modelling Study.

Background: Health financing produce a broad range of healthy life expectancy (HLE) disparities. In West Africa, limited research exists on the association between health financing and HLE at ecological level during a consecutive period of time from the spatial perspectives. This study aimed to determine the existence, quantify the magnitude, and interpret the association between health financing and HLE. Methods: A Dynamic Spatial Durbin model was used to explain the association between HLE and health financing level and structure during 1995-2019 in West Africa. Spatial spillover effects were introduced to interpret the direct and indirect effects caused by health financing level and structure on HLE during the long and short terms. Results: Spatial dependence and clustering on HLE were observed in West Africa. Although the overall level of total health spending, government health spending, out-of-pocket health spending, and development assistance for health (DAH) increased from 1995 to 2019, government health spending per person experienced a declining trend. Out-of-pocket health spending per total health spending was the highest among other sources of health financing, decreasing from 57% during 1995-1999 to 42% during 2015-2019. Total health spending and out-of-pocket health spending affected HLE positively and negatively in the long term, respectively. Government health spending and prepaid private health spending per person had positive effects on local and adjacent country HLE in the short-term, while DAH had negative effects on the same. The short-term spatial spillover effects of government health spending, DAH, and prepaid private health spending per person were more pronounced than the long-term effects. Conclusions: Spatial variations of HLE existed at country-level in West Africa. Health financing regarding government, non-government, as well as external assistance not only affected HLE disparities at local scale but also among nearby countries. Policymakers should optimise supportive health financing transition policies and narrow the national gap to reduce health disparities and increase HLE. Externalities of policy of those health financing proxies should be took into consideration to promote health equity to improve global health governance.

Carbon Trading in China Reduces the Dependence of Household Waste Electrical and Electronic Equipment Recycling on Government Subsidies.

China's enterprises of waste electrical and electronic equipment (WEEE) recycling suffer from low profitability that is highly dependent on government subsidies. This low economic gain impedes the sustainable growth of China's WEEE-recycling sector and also adds to the government's financial burden. Prior life-cycle studies have approved the carbon reduction potentials or net carbon credit of recycling WEEE. However, policymakers fail to know whether the revenue from selling carbon credits can offset the government's financial subsidy. We performed life-cycle and cost-benefit analyses for a case recycling enterprise that processes six categories of household appliances. The results show that the reduction potentials of greenhouse gases range from 930-3450 kgCO2e by recycling per ton of household appliances and materials substitution. The recycling enterprise would gain extra revenue ranging from 32 to 160 RMB per ton of appliance if the carbon credits were sold at China's current carbon price, i.e., 45-60 RMB tCO2e-1. Recycling waste refrigerators exhibits the highest carbon revenue, offsetting 6-17% of the government's financial subsidy. Microcomputers, by contrast, indicate the lowest carbon revenue, equivalent to 1-3% of its highest government subsidy. For each household appliance category, when the carbon price reaches 270-600 RMB tCO2e-1, selling carbon credits can fully offset the government's financial subsidy. Constrained by the processing capacity of the case enterprise, optimizations for appliance-recycling composition contribute a 15-25% profit growth to the current economic gains. Interpreting the specific profit depends on the predefined scenarios of carbon price and the substitution rate of the regenerated materials for the virginal ones. Our findings show that raising the profitability of WEEE recycling enterprises through the carbon trading policy contributes to the sustainable growth of China's WEEE-recycling sector while alleviating the government's financial burden.

Financial subsidies, tax incentives, and new energy vehicle enterprises' innovation efficiency: Evidence from Chinese listed enterprises.

Financial subsidies and tax incentives play essential roles in the innovation efficiency of enterprises. This paper selects Chinese listed NEV enterprises from 2010 to 2022 as a research sample and investigates various impacts under various circumstances. We find that both financial subsidies and tax incentives can promote the innovation efficiency of NEV enterprises. Compared to financial subsidies, tax incentives are more effective; the interaction between financial subsidies and tax incentives has a weaker impact on the innovation efficiency of NEV enterprises. Both financial subsidies and tax incentives have more potent innovation effects on enterprises with higher financing constraints. In addition, financial subsidies and tax incentives have a stronger innovation efficiency effect on private enterprises than state-owned enterprises. Further research shows that marketization and market distortion affect the innovation efficiency of NEV enterprises. This study provides a new perspective for understanding the effects of financial subsidies, tax incentives, and innovation efficiency of NEV enterprises, and the conclusions and suggestions are relevant references for the government to improve the quality of policy-making.

Cost-effectiveness of seasonal influenza vaccination of children in China: a modeling analysis.

BACKGROUND: China has a high burden of influenza-associated illness among children. We aimed to evaluate the cost-effectiveness of introducing government-funded influenza vaccination to children in China (fully-funded policy) compared with the status quo (self-paid policy). METHODS: A decision tree model was developed to calculate the economic and health outcomes, from a societal perspective, using national- and provincial-level data. The incremental cost-effectiveness ratio (ICER) [incremental costs per quality-adjusted life year (QALY) gained] was used to compare the fully-funded policy with the self-paid policy under the willingness-to-pay threshold equivalent to national and provincial GDP per capita. Sensitivity analyses were performed and various scenarios were explored based on real-world conditions, including incorporating indirect effect into the analysis. RESULTS: Compared to the self-paid policy, implementation of a fully-funded policy could prevent 1,444,768 [95% uncertainty range (UR): 1,203,446-1,719,761] symptomatic cases, 92,110 (95% UR: 66,953-122,226) influenza-related hospitalizations, and 6494 (95% UR: 4590-8962) influenza-related death per season. The fully-funded policy was cost-effective nationally (7964 USD per QALY gained) and provincially for 13 of 31 provincial-level administrative divisions (PLADs). The probability of a funded vaccination policy being cost-effective was 56.5% nationally, and the probability in 9 of 31 PLADs was above 75%. The result was most sensitive to the symptomatic influenza rate among children under 5 years [ICER ranging from - 25,612 (cost-saving) to 14,532 USD per QALY gained]. The ICER of the fully-funded policy was substantially lower (becoming cost-saving) if the indirect effects of vaccination were considered. CONCLUSIONS: Introducing a government-funded influenza policy for children is cost-effective in China nationally and in many PLADs. PLADs with high symptomatic influenza rate and influenza-associated mortality would benefit the most from a government-funded influenza vaccination program.

The political economy of financing traditional vaccines and vitamin A supplements in six African countries.

Vaccines and vitamin A supplementation (VAS) are financed by donors in several countries, indicating that challenges remain with achieving sustainable government financing of these critical health commodities. This qualitative study aimed to explore political economy variables of actors' interests, roles, power and commitment to ensure government financing of vaccines and VAS. A total of 77 interviews were conducted in Burundi, Comoros, Ethiopia, Madagascar, Malawi and Zimbabwe. Governments and development partners had similar interests. Donor commitment to vaccines and VAS was sometimes dependent on the priorities and political situation of the donor country. Governments' commitment to financing vaccines was demonstrated through policy measures, such as enactment of immunization laws. Explicit government financial commitment to VAS was absent in all six countries. Some development partners were able to influence governments directly via allocation of health funding while others influenced indirectly through coordination, consolidation and networks. Government power was exercised through multiple systemic and individual processes, including hierarchy, bureaucracy in governance and budgetary process, proactiveness of Ministry of Health officials in engaging with Ministry of Finance, and control over resources. Enablers that were likely to increase government commitment to financing vaccines and VAS included emerging reforms, attention to the voice of citizens and improvements in the domestic economy that in turn increased government revenues. Barriers identified were political instability, health sector inefficiencies, overly complicated bureaucracy, frequent changes of health sector leadership and non-health competing needs. Country governments were aware of their role in financing vaccines, but only a few had made tangible efforts to increase government financing. Discussions on government financing of VAS were absent. Development partners continue to influence government health commodity financing decisions. The political economy environment and contextual factors work together to facilitate or impede domestic financing.

International practices in health technology assessment and public financing of digital health technologies: recommendations for Hungary.

Background: Evaluating and integrating digital health technologies is a critical component of a national healthcare ecosystem in the 2020s and is expected to even increase in significance. Design: The paper gives an overview of international practices on public financing and health technology assessment of digital health technologies (DHTs) in five European Union (EU) countries and outlines recommendations for country-level action that relevant stakeholders can consider in order to support uptake of digital health solutions in Hungary. A scoping review was carried out to identify and gather country-specific classifications and international practices on the financing DHTs in five pioneering EU countries: Germany, France, Belgium, the United Kingdom and Finland. Results: Several frameworks have been developed for DHTs, however there is no single, unified framework or method for classification, evaluation, and financing of digital health technologies in European context. European countries apply different taxonomy, use different assessment domains and regulations for the reimbursement of DHTs. The Working Group of the Hungarian Health Economic Society recommends eight specific points for stakeholders, importantly taking active role in shaping common clinical evidence standards and technical quality criteria across in order for common standards to be developed in the European Union single market. Conclusion: Specificities of national healthcare contexts must be taken into account in decisions to allocate public funds to certain therapies rather than others.

PEPFAR Reauthorization by Congress Urgent for Global Health.

This Viewpoint discusses the importance of the US Congress reauthorizing funding for the President's Emergency Plan for AIDS Relief, a program developed in 2003 that has played a critical role in fighting HIV/AIDS worldwide as well as other emerging infections and noncommunicable diseases.

Lineamientos técnicos para el pago de aportes patronales por subsidios de incapacidades sin goce de sueldo por enfermedad de los empleados del Ministerio de Salud / Technical Guidelines for the Payment of Employer's Contributions for Disability Benefits without Sick Pay of Ministry of Health Employees

Los presentes lineamientos técnicos, responden a la necesidad de facilitar la tramitología institucional aplicable a la elaboración de planilla y el pago del aporte patronal en casos de subsidios del personal por enfermedad sin goce de sueldo, en el Ministerio de Salud, cumpliendo con los requisitos y condiciones que exige la Ley Integral de Sistema de Pensiones; y con ello facilitar la obtención de tales ingresos por parte del personal del Ministerio de Salud. Lo anterior permitirá que se elaboren las planillas del subsidio que a los servidores públicos del MINSAL, que, por enfermedad, no pueden brindar sus servicios institucionales, y es necesario solventar el pago del aporte patronal de ellos. La razón de ser de los presentes lineamientos técnicos es servir de instrumento procedimental para la gestión adecuada y oportuna del aporte patronal para el personal institucional, en los casos antes mencionados

These technical guidelines respond to the need to facilitate the institutional procedures applicable to the preparation of the payroll and the payment of the employer's contribution in cases of sickness benefits without pay, in the Ministry of Health Complying with the requirements and conditions required by the Comprehensive Law on the Pension System; and thus facilitating the collection of such income by the staff of the Ministry of Health. This will make it possible to draw up the subsidy sheets for MINSAL public servants, who, because of illness, cannot provide their institutional services, and it is necessary to pay their employer's contribution. The rationale behind these technical guidelines is to serve as a procedural tool for the proper and timely management of the employer's contribution to institutional staff, in the cases mentioned above.

The effectiveness of Japanese public funding to generate emerging topics in life science and medicine.

Understanding the effectiveness of public funds to generate emerging topics will assist policy makers in promoting innovation. In the present study, we aim to clarify the effectiveness of grants to generate emerging topics in life sciences and medicine since 1991 with regard to Japanese researcher productivity and grants from the Japan Society for the Promotion of Science. To clarify how large grant amounts and which categories are more effective in generating emerging topics from both the PI and investment perspectives, we analyzed awarded PI publications containing emerging keywords (EKs; the elements of emerging topics) before and after funding. Our results demonstrated that, in terms of grant amounts, while PIs tended to generate more EKs with larger grants, the most effective investment from the perspective of investor side was found in the smallest amount range for each PI (less than 5 million JPY /year). Second, in terms of grant categories, we found that grant categories providing smaller amounts for diverse researchers without excellent past performance records were more effective from the investment perspective to generate EK. Our results suggest that offering smaller, widely dispersed grants rather than large, concentrated grants is more effective in promoting the generation of emerging topics in life science and medicine.

Inclusion of abortion-related care in national health benefit packages: results from a WHO global survey.

INTRODUCTION: Service inclusion in a country's health benefit package (HBP) is an important milestone towards universal health coverage. This study aimed to explore HBP inclusion of abortion interventions globally. METHODS: Secondary analysis of the WHO HBP survey, in which officially nominated survey focal points were asked which interventions were included within the HBP of their country or area's largest government health financing scheme. Abortion inclusion was compared by region, income, legal status of abortion and HBP design process variables. Abortion inclusion was compared with other sexual and reproductive health (SRH) services. RESULTS: Below half (45%) reported that abortion is included, but treatment of complications from unsafe abortion was more commonly included (63%). Fewer fully included essential abortion medications (22% mifepristone, 42% misoprostol). Abortion was less commonly included than any other SRH service in the survey. Unlike most SRH services, higher cost, higher technology care to treat complications of unsafe abortion was more commonly included than the relatively lower cost, lower technology service of induced abortion. Higher-income contexts and less restrictive legal environments had higher abortion inclusion. Some contexts had additional restrictions, with abortion inclusion dependent on the patient's reason for seeking care. CONCLUSION: This global survey finds that abortion services and medications are often not included within HBPs, while treatment of complications from unsafe abortion is more commonly included. There are opportunities to improve HBP abortion inclusion across different legal contexts, which can improve health outcomes and reduce the need for higher cost treatment of complications from unsafe abortion.