Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.934
Filtrar
2.
Medicine (Baltimore) ; 98(49): e18082, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804317

RESUMO

OBJECTIVES: Our study provides phase-specific cost estimates for pancreatic cancer based on stage and treatment. We compare treatment costs between the different phases and within the stage and treatment modality subgroups. METHODS: Our cohort included 20,917 pancreatic cancer patients from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database diagnosed between 2000 and 2011. We allocated costs into four phases of care-staging (or surgery), initial, continuing, and terminal- and calculated the total, cancer-attributable, and patient-liability costs in 2018 US dollars. We fit linear regression models using log transformation to determine whether costs were predicted by age and calendar year. RESULTS: Monthly cost estimates were high during the staging and surgery phases, decreased over the initial and continuing phases, and increased during the three-month terminal phase. Overall, the linear regression models showed that cancer-attributable costs either remained stable or increased by year, and either were unaffected by age or decreased with older age; continuing phase costs for stage II patients increased with age. CONCLUSIONS: Our estimates demonstrate that pancreatic cancer costs can vary widely by stage and treatment received. These cost estimates can serve as an important baseline foundation to guide resource allocation for cancer care and research in the future.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Neoplasias Pancreáticas/economia , Neoplasias Pancreáticas/terapia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Lineares , Masculino , Medicare/estatística & dados numéricos , Modelos Econométricos , Estadiamento de Neoplasias , Programa de SEER , Assistência Terminal/economia , Estados Unidos
3.
BMC Public Health ; 19(1): 1449, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31684951

RESUMO

BACKGROUND: Road traffic injuries (RTIs) have been one of the most critical public health problems in Thailand for decades. The objective of this study was to examine to what extent provincial economy was associated with RTIs, road traffic deaths and case fatality rate in Thailand. METHODS: A secondary data analysis on time-series data was applied. The unit of analysis was a panel of 77 provinces during 2012-2016. Data were obtained from relevant public authorities, including the Ministry of Public Health. Descriptive statistics and econometric models, using negative binomial (NB) regression, negative binomial regression with random-effects (RE) model, and spatial Durbin model (SDM) were employed. The main predictor variable was gross domestic product (GDP) per capita and the outcome variables were incidence proportion of RTIs, traffic deaths and case fatality rate. The analysis was adjusted for key covariates. RESULTS: The incidence proportion of RTIs rose from 449.0 to 524.9 cases per 100,000 population from 2012 till 2016, whereas the incidence of traffic fatalities fluctuated between 29.7 and 33.2 deaths per 100,000 population. Case fatality rate steadily stood at 0.06-0.07 deaths per victim. RTIs and traffic deaths appeared to be positively correlated with provincial economy in the NB regression and the RE model. In the SDM, a log-Baht increase in GDP per capita (equivalent to a growth of GDP per capita by about 2.7 times) enlarged the incidence proportion of injuries and deaths by about a quarter (23.8-30.7%) with statistical significance. No statistical significance was found in case fatality rate by the SDM. The SDM also presented the best model fitness relative to other models. CONCLUSION: The incidence proportion of traffic injuries and deaths appeared to rise alongside provincial prosperity. This means that RTIs-preventive measures should be more intensified in economically well-off areas. Furthermore, entrepreneurs and business sectors that gain economic benefit in a particular province should share responsibility in RTIs prevention in the area where their businesses are running. Further studies that explore others determinants of road safety, such as patterns of vehicles used, attitudes and knowledge of motorists, investment in safety measures, and compliance with traffic laws, are recommended.


Assuntos
Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Desenvolvimento Econômico/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Análise de Dados , Feminino , Produto Interno Bruto/estatística & dados numéricos , Humanos , Incidência , Masculino , Modelos Econométricos , Análise Espacial , Tailândia/epidemiologia , Ferimentos e Lesões/mortalidade , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-31514367

RESUMO

Reducing carbon emissions is crucial to the sustainable development of tourism. However, there are no consistent conclusions about the nexus between tourism and carbon emissions. Considering the possible nonlinear and spatial effects of tourism on carbon emissions, this paper employed spatial econometric models combined with quadratic terms of explanatory variables to explore the nexus between them using Chinese provincial panel data from 2003 to 2016. The main results are as follows: (1) There is a significant inverse U-shaped relationship between tourism development and carbon emissions. In the provinces whose tourism receipts are relatively low, the effects of tourism on carbon emissions are positive but decrease gradually as the tourism receipts increase and then shifts to negative and continues decreasing gradually when the tourism receipts beyond the critical value. (2) For the geographical proximity and industrial relevance, one province's tourism development not only affects its carbon emissions but also affects its neighbors' carbon emissions through spatial lag effect (indirect effect) which is also inverse U-shaped. (3) Carbon reduction policies, sustainable education, and transportation infrastructure all have significant moderating effects on the relationship between tourism and carbon emissions, but the moderating effect of the management efficiency of tourism is not statistically significant. Furthermore, improvements to the sustainable education and transportation infrastructure not only strengthen the direct negative effect of tourism on carbon emissions but also strengthen the indirect negative effect of tourism on carbon emissions. This study not only advances the existing literature but is also of considerable interest to policymakers.


Assuntos
Poluição do Ar/estatística & dados numéricos , Dióxido de Carbono , Carbono , Modelos Econométricos , Viagem , China , Indústrias , Transportes , Emissões de Veículos
5.
Environ Sci Pollut Res Int ; 26(29): 30145-30153, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31418148

RESUMO

This study empirically investigates the role of eco-innovation on the reduction of carbon dioxide emissions (CO2) in an extended version of the environmental Kuznets curve (EKC). Under dynamic framework, second-generation panel econometric techniques such as the CADF and the CIPS unit root tests, DSUR cointegrating test, and DH panel causality test are employed over the period 2007-2016 for the case of top 20 refined oil exporting countries. Results reveal that eco-innovation (i.e. research and development) exerts a negative and significant long-term effect on carbon emissions (CO2). This result indicates that the extended version of EKC and the Porter hypotheses are validated for the selected countries. The findings, which show heterogeneity and cross-sectionally dependence in the panel time-series framework, suggest that rising levels of carbon emissions and real income may encourage more research and development (i.e. eco innovation) and lower energy consumption.


Assuntos
Dióxido de Carbono/análise , Desenvolvimento Econômico/tendências , Política Ambiental/economia , Modelos Econométricos , Indústria de Petróleo e Gás/economia , Desenvolvimento Econômico/estatística & dados numéricos , Renda , Indústria de Petróleo e Gás/estatística & dados numéricos
6.
BMC Public Health ; 19(1): 982, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337363

RESUMO

BACKGROUND: Inverse probability weighting (IPW) methods can be used to estimate the total number of cases from the sample collected through sentinel surveillance. Central to these methods are the inverse weights which can be derived in several ways and, in this case, represent the probability that laboratory (lab) sentinel surveillance detects a lab-confirmed case. METHODS: We compare different weights in a simulation study. Weights are obtained from the proportion of participating labs over all labs. We adjust these weights for attractiveness and density of labs over population. The market share of sentinel labs, as estimated by the econometric Huff-model, is also considered. Additionally, we investigate the effect of not recognizing sentinel labs as sentinel labs when they report no cases. We estimate the bias associated with the different weights as the difference between the simulated number of cases and the estimate of this total from the sentinel sample. As motivating data examples, we apply an extended Huff-model to four pathogens under laboratory sentinel surveillance in Belgium between 2010 and 2015 and discuss the model fit. We estimate the total number of lab-confirmed cases associated with Rotavirus, influenza virus, Y. enterocolitica and Campylobacter spp.. The extended Huff-model takes the lab-concept, the number of reimbursements and the number of departments, lab-density, regional borders, distance and competition between labs in account. RESULTS: Estimates obtained with the Huff-model were most accurate in the more complex simulation scenarios as compared to other weights. In the data examples, several significant coefficients are identified, but the fit of the Huff-model to the Belgian sentinel surveillance data leaves much variability in market shares unexplained. CONCLUSION: The Huff-model allows for estimation of the spatial and population coverage of sentinel surveillance and through IPW-methods also for the estimation of the total number of cases. The Huff-model's gravity function allows us to differentiate inside an area while estimating from the full dataset. Our data examples show that additional data on the participation to surveillance and practices of labs is necessary for a more accurate estimation.


Assuntos
Laboratórios , Vigilância de Evento Sentinela , Bélgica/epidemiologia , Campylobacter/isolamento & purificação , Humanos , Incidência , Modelos Econométricos , Orthomyxoviridae/isolamento & purificação , Probabilidade , Reprodutibilidade dos Testes , Rotavirus/isolamento & purificação , Yersinia enterocolitica/isolamento & purificação
7.
Environ Sci Pollut Res Int ; 26(26): 27128-27137, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31317431

RESUMO

The purpose of this study is to explore the empirical relationship between foreign direct investment (FDI), population, energy production, and water resources in South Asia. The newly developed approach dynamic common correlated effects (DCCE) by Chudik and Pesaran (Journal of Econometrics 188:393-420, 2015a) for measuring co-integration has been applied in the present study. This procedure provides significant robust outcomes in the presence of cross-sectional dependence among the cross-sectional units. The findings confirmed that earlier models, such as mean group (MG), pooled mean group (PMG), and augmented mean group (AMG), which have been used in the literature for long data, provide misleading results in the presence of cross-sectional dependence among the cross-sectional units. A statistically significant and negative result has been observed between FDI, population, energy production, and water resources in South Asia. The governments of South Asian economies must encourage green FDI initiatives for water management, ensuring water security, securing natural resources for enhancing the sustainable development of regional economies.


Assuntos
Fontes Geradoras de Energia , Investimentos em Saúde , Recursos Hídricos , Ásia , Fontes Geradoras de Energia/estatística & dados numéricos , Humanos , Internacionalidade , Investimentos em Saúde/estatística & dados numéricos , Modelos Econométricos , Densidade Demográfica
8.
Environ Sci Pollut Res Int ; 26(26): 26982-26990, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31313229

RESUMO

This study focuses on whether information and communication technology (ICT) contributes to economic growth in countries with better human development index as compared to those with a lower index. The study uses panel data estimation methods those are robust to dependencies across countries and heterogeneity from 1990 to 2016 in developing Asian countries. The results documented that countries with better human development index and mobile phone usage promote economic growth, whereas Internet users do not seem to do so. Despite that, human development index itself is a critical factor that contributes to economic growth in Asian countries. Finally, both mobile phone usages contribute to economic growth, but Internet usage does not seem to do. These new findings recommend that whereas better human development is regarded as crucial for mobile phone usage, it appears to be inappropriate for Internet usage. An additional feature is that the study uses the most robust panel data estimation method that produces more effective and reliable estimates.


Assuntos
Desenvolvimento Econômico , Tecnologia da Informação , Modelos Econométricos , Ásia , Telefone Celular/estatística & dados numéricos , Países em Desenvolvimento , Humanos , Tecnologia da Informação/estatística & dados numéricos , Internet/estatística & dados numéricos , Fatores Socioeconômicos
9.
Artigo em Inglês | MEDLINE | ID: mdl-31266268

RESUMO

Econometrics and input-output models have been presented to construct a joint model (i.e., an EC + IO model) in the paper, which is characterized by incorporating the uncertainty of the real economy with the detailed departmental classification structure, as well as adding recovery period variables in the joint model to make the model dynamic. By designing and implementing a static model, it is estimated that the indirect economic loss for the transportation sector caused by representative haze pollution of Beijing in 2013 was 23.7 million yuan. The industrial-related indirect losses due to the direct economic losses incurred by haze pollution reached 102 million yuan. With the constructed dynamic model, the cumulative economic losses for the industrial sectors have been calculated for the recovery periods of different durations. The results show that: (1) the longer the period that an industrial department returns to normal output after haze pollution has impacted, the greater the cumulative economic loss will be; (2) when the recovery period is one year, the cumulative economic loss value computed by the dynamic EC + IO model is much smaller than the loss value obtained by the static EC + IO model; (3) the recovery curves of industrial sectors show that the recovery rate at the early stage is fast, while it is slow afterwards. Therefore, the governance work after the occurrence of haze pollution should be launched as soon as possible. This study provides a theoretical basis for evaluating the indirect economic losses of haze pollution and demonstrates the value of popularization and application.


Assuntos
Poluição do Ar/economia , Modelos Econométricos , Pequim , Indústrias , Transportes
10.
Environ Sci Pollut Res Int ; 26(25): 25775-25788, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31267389

RESUMO

In recent years, as environmental degradation has become more and more serious, the Chinese government has formulated a series of environmental policies and regulations aimed at improving environmental quality. Does environmental regulation significantly inhibit environmental pollution? Environmental regulation will not only directly affect environmental pollution but also have an indirect impact on environmental pollution. This paper uses Bayesian posterior probability, the optimal model structure selection method, based on join 112 kinds of spatial econometric model structure, and the panel data of 30 provinces in China from 2003 to 2016 to study the effects of environmental regulation on environmental pollution base on the industrial agglomeration mechanism of synergy effect. The research covers the national level and four regions, including the eastern, central, western, and northeastern regions of China. The research shows that: (1) environmental regulation at the national level and in the eastern, central and northeastern regions can significantly curb environmental pollution, but the environmental pollution in the western region shows a significant trend of enhancement. (2) Increased industrial agglomeration across China has significantly worsened environmental pollution. (3) Environmental regulation and industrial agglomeration form a significant synergy effect, which has a significant positive impact on environmental pollution in regions other than northeast China, and a significant negative impact on environmental pollution intensity in northeast China.


Assuntos
Política Ambiental/economia , Poluição Ambiental/legislação & jurisprudência , Teorema de Bayes , China , Indústrias , Modelos Econométricos
11.
Medicine (Baltimore) ; 98(23): e15841, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169687

RESUMO

OBJECTIVE: The aim of the study was to determine whether exclusive breastfeeding or exclusive formula feeding is more cost-effective when a Canadian mother with HIV is adherent to antiretroviral therapy and has full virologic suppression. DESIGN: Current Canadian guidelines recommend that mothers with HIV practice exclusive formula feeding. This contradicts the updated World Health Organization (WHO) guidelines which recommend that mothers with HIV should breastfeed for ≥12 months while receiving support for antiretroviral therapy adherence. Due to the economic and health risks and benefits associated with each modality, there remains expert disagreement on whether the WHO recommendations should be adopted in high-income countries. METHODS: A microsimulation model was developed to estimate lifetime costs and effectiveness (i.e., infant's quality-adjusted life years) of a hypothetical group of 1,000,000 initially healthy, HIV-negative infants, if the mother with HIV was on antiretroviral therapy with full virologic suppression and either exclusive breastfeeding or exclusive formula feeding. The model was developed from the economic perspective of the Ontario Ministry of Health, taking into account direct costs associated with infant feeding modality as well as related indirect costs born out of the child's lifetime health outcomes. Uncertainties related to model parameters were evaluated using one-way and probabilistic sensitivity analyses. RESULTS: In comparison to exclusive formula feeding, exclusive breastfeeding was the dominant feeding modality (i.e., less costly and more effective) yielding cost-savings of $13,812 per additional quality-adjusted life year gained. Neither one-way nor probabilistic sensitivity analyses altered the conclusions. CONCLUSIONS: Despite the risk of HIV transmission, exclusive breastfeeding was more cost-effective than exclusive formula feeding. These findings merit review of current infant feeding guidelines for mothers with HIV living in high-income countries.


Assuntos
Antirretrovirais/uso terapêutico , Aleitamento Materno/economia , Fórmulas Infantis/economia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Mães , Resposta Viral Sustentada , Antirretrovirais/administração & dosagem , Canadá , Simulação por Computador , Análise Custo-Benefício , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Metanálise como Assunto , Modelos Econométricos , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Anos de Vida Ajustados por Qualidade de Vida , Literatura de Revisão como Assunto
12.
Artigo em Inglês | MEDLINE | ID: mdl-31234521

RESUMO

Industrial pollution control is a difficult problem in China's current economic transformation, and the Chinese government has implemented many measures to deal with it. However, little research has focused on the relationship between land policy and industrial pollution. Based on the theoretical discussion of the mechanism influencing the market-oriented reform of industrial land (mainly refer to the marketization of land conveyance price and the openness of land conveyance process) on urban industrial pollution, we constructed an analytical framework by linking land policy with industrial pollution. Then, we constructed an econometric model and chose the statistical data of 104 large- and medium-sized cities in mainland China from 2003 to 2016. The results indicate that with the marketization of the industrial land conveyance price, urban industrial pollution is presenting an inverted U-shaped change trend. For cities in different development stages of industrialization, there is no difference in the impact of industrial land conveyance price on urban industrial pollution. However, the openness of industrial land conveyance promotes and inhibits the urban industrial pollution in the stages of industrialization and post-industrialization, respectively. Finally, this paper puts forward some suggestions on how to control industrial pollution from the perspective of further improving the industrial land conveyance mechanism.


Assuntos
Poluição Ambiental/prevenção & controle , Desenvolvimento Industrial , Modelos Econométricos , China , Cidades , Comércio , Indústrias
13.
BMC Infect Dis ; 19(1): 517, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185927

RESUMO

BACKGROUND: Although Option B+ may be more costly than Options B, it may provide additional health benefits that are currently unclear in Yunnan province. We created deterministic models to estimate the cost-effectiveness of Option B+. METHODS: Data were used in two deterministic models simulating a cohort of 2000 HIV+ pregnant women. A decision tree model simulated the number of averted infants infections and QALY acquired for infants in the PMTCT period for Options B and B+. The minimum cost was calculated. A Markov decision model simulated the number of maternal life year gained and serodiscordant partner infections averted in the ten years after PMTCT for Option B or B+. ICER per life year gained was calculated. Deterministic sensitivity analyses were conducted. RESULTS: If fully implemented, Option B and Option B+ averted 1016.85 infections and acquired 588,01.02 QALYs.The cost of Option B was US$1,229,338.47, the cost of Option B+ was 1,176,128.63. However, when Options B and B+ were compared over ten years, Option B+ not only improved mothers'ten-year survival from 69.7 to 89.2%, saving more than 3890 life-years, but also averted 3068 HIV infections between serodiscordant partners. Option B+ yielded a favourable ICER of $32.99per QALY acquired in infants and $5149per life year gained in mothers. A 1% MTCT rate, a 90% coverage rate and a 20-year horizon could decrease the ICER per QALY acquired in children and LY gained in mothers. CONCLUSIONS: Option B+ is a cost-effective treatment for comprehensive HIV prevention for infants and serodiscordant partners and life-long treatment for mothers in Yunnan province, China. Option B+ could be implemented in Yunnan province, especially as the goals of elimination mother-to-child transmission of HIV and "90-90-90" achieved, Option B+ would be more attractive.


Assuntos
Controle de Doenças Transmissíveis , Infecções por HIV , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/economia , Complicações Infecciosas na Gravidez/terapia , Planos Governamentais de Saúde , Síndrome de Imunodeficiência Adquirida/economia , Síndrome de Imunodeficiência Adquirida/terapia , Síndrome de Imunodeficiência Adquirida/transmissão , Adulto , China/epidemiologia , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Análise Custo-Benefício , Árvores de Decisões , Feminino , HIV , Infecções por HIV/economia , Infecções por HIV/terapia , Infecções por HIV/transmissão , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/economia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Masculino , Modelos Econométricos , Mães/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Planos Governamentais de Saúde/economia , Planos Governamentais de Saúde/organização & administração , Planos Governamentais de Saúde/normas , Resultado do Tratamento , Adulto Jovem
14.
Environ Sci Pollut Res Int ; 26(24): 24482-24488, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31230247

RESUMO

This paper represents a new proposed trade model of "Intercountries Trade Force (ITF)" which is inspired by Intermolecular Interaction Forces in chemical sciences, and has potential to compensate for the deficiencies of the gravity trade model proposed by Jan Tinbergen in 1962. The main differences between our new model and the earlier gravity trade theory are (i) there is a time-variant variable called the gravity index (GI) which means that the earlier gravity theory was treated as only a variable in our new proposed model and (ii) our new proposed trade model has a higher chance of adoption in the real trade world rather than the earlier gravity trade model which always needs to be expanded by scholars. In order to empirically test our new proposed trade model, we applied it in an empirical econometric model to analyze the Russian gas export to the EU member states, not explored earlier. Results revealed that our new trade proposed model adjusts with the empirical energy trade pattern.


Assuntos
Modelos Econométricos , Gás Natural/economia , União Europeia , Federação Russa
15.
Environ Sci Pollut Res Int ; 26(18): 18790-18803, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31065984

RESUMO

This paper first visits the clean energy consumption for 21 OECD countries and 14 Emerging market countries through a panel unit root test with both sharp and smooth breaks covering the period from 1965 to 2016. The time-varying fitted intercepts of the estimation could better fit the path of clean energy consumption for selected countries. The empirical results suggest that not only sharp breaks should be considered, but also smooth breaks. The economic implications are insightful for the convergence of clean energy consumption for 22 of 35 countries. For USA, Canada, Austria, Germany, Greece, Ireland, UK, Australia, New Zealand, South Korea, Hungary, China, Philippines, and Thailand, the clean energy consumption is divergence. Policy encouragement policy would permanently affect not only clean energy consumption path, but also aggregate economic sectors related to consume clean energy.


Assuntos
Desenvolvimento Econômico/tendências , Modelos Econométricos , Energia Renovável/economia , Dióxido de Carbono/análise , Países Desenvolvidos , Países em Desenvolvimento , Método de Monte Carlo , Energia Renovável/estatística & dados numéricos , Crescimento Sustentável
16.
PLoS One ; 14(5): e0216620, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31075148

RESUMO

This paper examines the levels of health system efficiency and their possible determinants across Latin American and Caribbean (LAC) countries using national-level data for those countries, as well as for other emerging and developed countries. The data are analyzed using data envelopment analyses and econometric advances that yield reliable estimations of the relationship between system efficiency and its potential determinants. We find that there is substantial room for efficiency improvements in the health system of most LAC countries. For example, LAC countries could improve life expectancy at birth by about five years on average at current public spending levels if they followed best practices. Furthermore, the paper assesses what factors amenable to policy act as the main possible levers for some countries to be able to translate a given level of health financing into better performance on access to care and health outcomes. Our econometric analyses suggest that efforts to increase health system efficiency could be focused in a few key policy areas associated with broader access to health services and better outcomes. These areas include general governance aspects, in addition to improvements in specific dimensions of the quality of health system institutions, notably stronger reliance on results-based management in the production of healthcare goods and services.


Assuntos
Serviços de Saúde/economia , Região do Caribe , Acesso aos Serviços de Saúde , Financiamento da Assistência à Saúde , Humanos , América Latina , Expectativa de Vida , Modelos Econométricos
17.
Environ Sci Pollut Res Int ; 26(19): 19843-19858, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31090009

RESUMO

Globalization has led countries to a strong interdependence among them, which is reflected in trade and capital flows. Simultaneously, in recent decades, the world is rapidly urbanizing. This dynamic has generated a process of economic growth with serious consequences for the environment, particularly in air quality. In this context, the objective of this research is to examine the causal link among carbon dioxide emissions per capita as a measure of air pollution, real per capita output, FDI, trade openness, and urbanization in 100 countries during 1980-2017. First, we used the cointegration test of Pedroni (JAMA 61:653-670, 1999) and Westerlund (JAMA 69:709-748, 2007) to find the equilibrium long and short term, respectively, and the Dumitrescu and Hurlin (JAMA 29:1450-1460, 2012) test to verify the direction of causality among the series. Second, we estimate the strength of the cointegration vector for individual countries through a dynamic ordinary least squares model (DOLS), and for country groups using a dynamic panel model with ordinary least squares (PDOLS). The results found indicate the existence of short- and long-term equilibrium among the variables globally and by groups of countries. The strength of the cointegration vector is strong in high and middle-high-income countries. At a global level, the results of the causality test suggest the existence of a unidirectional causal relationship that goes from output, urbanization, and FDI to air pollution, and a bidirectional relationship among trade and air pollution. These results are sensitive to the inclusion of the level of development of the countries. Our results suggest that the mechanisms to increase output, along with commercial and FDI flows, and urbanization are factors that play a relevant role in the determination of air pollution. Consequently, public policies should take these aspects into account in efforts to mitigate air pollution.


Assuntos
Poluição do Ar/análise , Dióxido de Carbono/análise , Comércio , Desenvolvimento Econômico , Investimentos em Saúde , Urbanização , Análise dos Mínimos Quadrados , Modelos Econométricos
18.
Int J Technol Assess Health Care ; 35(3): 237-242, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31131776

RESUMO

OBJECTIVES: There is little evidence in China regarding the cost-effectiveness of non-invasive prenatal testing (NIPT) for Down syndrome (DS). This study aims to evaluate the cost-effectiveness of NIPT and provide evidence to inform decision-making. METHODS: To determine the cost-effectiveness of NIPT for DS, a decision-analytic model was developed using the TreeAge Pro software from a societal perspective in a simulated cohort of 10 000 pregnant women. Main indicators were based on field surveys from sampled hospitals in four locations in China and a literature review. RESULTS: The conventional maternal serum screening (CMSS) strategy, contingent screening strategy (NIPT delivered to high risk pregnant women after CMSS), and universal screening strategy could prevent 3.02, 7.53, and 9.97 DS births, respectively. NIPT would decrease unnecessary invasive procedures, resulting in fewer procedure-related miscarriages. The cost-effectiveness ratio of the contingent screening strategy was the lowest. When compared with the CMSS strategy, the incremental cost per DS birth averted by the contingent screening strategy and universal screening strategy were USD 20,160 and 352,388, respectively. One-way sensitivity analysis showed that, if the cost of NIPT could be decreased to USD 76.92, the cost-effectiveness ratio of the universal screening strategy would be lower than the CMSS strategy. CONCLUSIONS: Although NIPT has the merits of greater effectiveness and safety, CMSS is unlikely to be replaced by NIPT at this time because of NIPT's higher cost. Contingent screening may be an appropriate strategy to balance the effectiveness and cost factors of the new genetic testing technology.


Assuntos
Síndrome de Down/diagnóstico , /métodos , China , Análise Custo-Benefício , Técnicas de Apoio para a Decisão , Humanos , Modelos Econométricos , Sensibilidade e Especificidade
19.
Environ Sci Pollut Res Int ; 26(17): 17021-17031, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30989608

RESUMO

Hydroelectricity is playing a significant role in lowering CO2 emissions as it contributes a desirable platform to fulfill the growing energy demand while releasing fewer GHGs in comparison to other fossil fuels. Utilizing the trans-log production model, this study is an endeavor to investigate the potential inter-fuel substitution by estimating the substitution elasticity between pairs of coal, natural gas, petroleum, and hydroelectricity to suggest policy for Pakistan to achieve higher economic growth, environmental sustainability, and increased energy access by its citizens. Over the period 1980-2013, the ridge regression was approved to estimate the model's parameters. The findings show that the output elasticity of hydroelectricity is the highest and all the factor inputs are substitutes; whereas, the elasticity of substitution between coal vs. natural gas is the highest, thus suggesting an increased focus on the coal extraction to switch from the alternative usage of gas. Moreover, encouragement of energy subsidy programs, coupled with taxes and infrastructural developments, can be adapted to redirect technology towards hydroelectricity. Hence, the result that hydroelectricity is substituted for all fuels submit that Pakistan has the potential to switch from petroleum to cleaner energy; therefore, reducing the adverse environmental implications and to retain the ability to fuel its energy sector.


Assuntos
Carvão Mineral/economia , Desenvolvimento Econômico , Modelos Econométricos , Gás Natural/economia , Petróleo/economia , Centrais Elétricas/economia , Dióxido de Carbono/análise , Paquistão
20.
J Orthop Surg Res ; 14(1): 93, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30940168

RESUMO

BACKGROUND: Venous thromboembolism (VTE) is a complication following surgery. Low-molecular-weight heparin (LMWH) or direct oral anticoagulants (DOACs) are efficacious but come with inherent bleeding risk. Mechanical prophylaxis, such as intermittent pneumatic compression (IPC), does not induce bleeding but may be difficult to implement beyond the immediate post-operative period. This study compared the cost and quality-adjusted life years (QALYs) saved of commonly used VTE prophylaxis regimens after lower limb arthroplasty. METHODS: A previously published cost-utility model considering major efficacy and safety endpoints was updated to estimate the 1-year cost-effectiveness of different VTE prophylaxis regimens. The VTE strategies assessed included apixaban, dabigatran, rivaroxaban, LMWH, IPC, IPC + LMWH and IPC + apixaban. Efficacy data were derived from studies in PubMed, and cost data came from the 2017 Australian AR-DRG and PBS pricing schemes. RESULTS: Costs for VTE prophylaxis including treatment of its associated complications over the first year after surgery ranged from AUD $644 (IPC) to AUD $956 (rivaroxaban). Across 500 simulations, IPC was the cheapest measure in 73% of simulations. In 97% of simulations, a DOAC was associated with the highest resulting QALYs. Compared to IPC, apixaban was cost-effective in 76.4% of simulations and apixaban + IPC in 87.8% of simulations. For VTE events avoided, the DOACs and IPC were on par. LMWH and LMWH + IPC were negatively dominated. CONCLUSIONS: Apixaban, IPC or a sequential/simultaneous combination of both is currently the most cost-effective VTE prophylaxis regimens. The choice between them is best guided by the relative VTE and bleeding risks of individual patients.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Custos de Cuidados de Saúde/estatística & dados numéricos , Tromboembolia Venosa/prevenção & controle , Idoso , Anticoagulantes/efeitos adversos , Anticoagulantes/economia , Anticoagulantes/uso terapêutico , Austrália , Terapia Combinada/economia , Análise Custo-Benefício , Feminino , Humanos , Dispositivos de Compressão Pneumática Intermitente/economia , Masculino , Pessoa de Meia-Idade , Modelos Econométricos , Cuidados Pós-Operatórios/economia , Cuidados Pós-Operatórios/métodos , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/prevenção & controle , Anos de Vida Ajustados por Qualidade de Vida , Tromboembolia Venosa/economia , Tromboembolia Venosa/etiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA