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3.
J Gambl Stud ; 35(3): 875-886, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31300931

RESUMO

A recent systematic review of the responsible gambling research suggests that there are no significant differences between gambling industry and non-industry funded research with regard to research design and outcomes. This study empirically synthesizes the outcomes of a larger sample of the scientific gambling literature to determine the generalizability of these original results. Our goal was to determine the extent to which funding sources might differentially influence characteristics of research design and outcomes. We conducted a comprehensive review of 18 research databases and examined studies published between January 2008 and August 2018. For four gambling-related journals, we reviewed all of the available studies. For 14 addiction-related journals, we examined only studies that examined gambling-related outcomes. To be included in this study, publications had to be quantitative and include a clear gambling-related hypothesis. After retrieving 1731 gambling studies, we applied the inclusion criteria and retained 720 studies for our final analytic sample. We used hypothesis confirmation and funding source information to determine the presence or absence of funding bias. Gambling industry funded studies were no more likely than studies not funded by the gambling industry to report either confirmed, partially confirmed, or rejected hypotheses. Nonetheless, studies funded by the gambling industry were more likely than other types of funding sources to include a conflict of interest statement. Studies with disclosed funding sources were more likely than those with undisclosed funding sources to include a conflict of interest statement. These findings highlight the importance of transparency and disclosure during research dissemination.


Assuntos
Organização do Financiamento/economia , Jogo de Azar/economia , Apoio à Pesquisa como Assunto/economia , Viés , Ensaios Clínicos como Assunto/economia , Jogo de Azar/psicologia , Humanos , Projetos de Pesquisa
5.
Int J Health Policy Manag ; 8(6): 329-336, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31256565

RESUMO

BACKGROUND: In planning for universal health coverage, many countries have been examining their fiscal decentralization policies with the goal of increasing efficiency and equity via "additionalities." The concept of "additionality," when the government of a lower administrative level increases the funding allocated to a particular issue when extra funds are present, is often used in these contexts. Although the definition of "additionality" can be used more broadly, for the purposes of this paper we focus narrowly on the additional allocation of primary healthcare expenditures. This paper explores this idea by examining the impact of central level primary healthcare expenditure, on individual state level contributions to primary healthcare expenditure within 16 Indian states between 2005 and 2013. METHODS: In examining 5 main variables, we compared differences between government expenditures, contributions, and revenues for Empowered Action Group (EAG) states, and non-EAG states. EAG states are normally larger states that have weaker public health infrastructure and hence qualify for additional funding. Finally, using a model that captured the quantity of central level primary healthcare expenditure distributions to these states, we measured its impact on each state's own contributions to primary healthcare spending. RESULTS: Our results show that, at the state level, growth in per capita central level primary healthcare expenditure has increased by 110% from 2005-2013, while state's own contributions to primary healthcare expenditure per capita increased by 32%. Further analyses show that a 1% change disbursement from the central level leads to a -0.132%, although not significant, change by states in their own expenditure. The effect for wealthier states is -0.151% and significant and for poorer states the effect is smaller at -0.096% and not significant. CONCLUSION: This analysis suggests that increases in central level primary healthcare expenditure to states have an inverse relationship with primary healthcare expenditures by the state level. Furthermore, this effect is more pronounced in wealthier Indian states. This finding has policy implications on India's decision to increase block grants to states in place of targeted program expenditures.


Assuntos
Organização do Financiamento/economia , Recursos em Saúde/economia , Acesso aos Serviços de Saúde/economia , Cobertura Universal do Seguro de Saúde/economia , Gastos em Saúde , Humanos , Índia , Atenção Primária à Saúde/economia , Saúde Pública/economia , Fatores Socioeconômicos
8.
PLoS One ; 14(4): e0207046, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30986207

RESUMO

BACKGROUND: This study aimed to investigate the distribution of European Union (EU) healthcare research grants across EU countries, and to study the effect of the potential influencing factors on grant allocation. METHODS: We analysed publicly available data on healthcare research grants from the 7th Framework Programme and the Horizon 2020 Programme allocated to beneficiaries between 2007 and 2016. Grant allocation was analysed at the beneficiary-, country-, and country group-level (EU-15 versus newer Member States, defined as EU-13). The investigated country-level explanatory variables included GDP per capita, population size, overall disease burden, and healthcare research excellence. Grant amounts per 100,000 inhabitants were used as an outcome variable in the regression analyses. RESULTS: Research funds were disproportionally allocated to EU-15 versus the EU-13, as 96.9% of total healthcare grants were assigned to EU-15 countries. At the beneficiary level, EU funding was positively influenced by participating in previous grants. The average grant amount per beneficiary was higher for EU-15 organizations. In the multiple regression analysis GDP per capita (p = 0.002) and research excellence (p<0.001) had a significant positive association with EU funding. Population size had an inverted U-shaped relationship with EU funding for healthcare research, having the largest per capita funding in second and the third quartiles (p = 0.03 and p = 0.02). CONCLUSION: The uneven allocation of healthcare research funds across EU countries was influenced by GDP per capita, medical research excellence and population size. Wealthier countries with an average population size and strong research excellence in healthcare had more EU funding for healthcare research. Higher disease burden apparently was not associated with more EU research funding. While our findings are in line with analyses on previous periods, they suggest that the EU did not implement any effective policy measures to improve the unfair allocation of research grants.


Assuntos
União Europeia/economia , Organização do Financiamento/economia , Pesquisa sobre Serviços de Saúde/economia , Alocação de Recursos , Humanos
11.
Int J Radiat Oncol Biol Phys ; 104(4): 756-764, 2019 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-30885776

RESUMO

PURPOSE: To quantify the effects of opening a proton center (PC) on an academic medical center (AMC)/radiation oncology department. METHODS AND MATERIALS: Radiation treatment volume and relative value units from fiscal year 2015 (FY15) to FY17 were retrospectively analyzed at the AMC and 2 community-based centers. To quantify new patient referrals to the AMC, we reviewed the electronic medical record for all patients seen at the PC since consults were initiated in November 2015 (n = 1173). Patients were excluded if the date of entry into the AMC electronic medical record predated their PC consultation. Hospital resource use and professional and technical charges were obtained for these patients. Academic growth, philanthropy, and resident education were evaluated based on grant submissions, clinical trial enrollment, philanthropy, and pediatric case exposure, respectively, from PC opening through FY17. RESULTS: From FY15 to FY17, radiation fractions at the AMC and the 2 community sites decreased by 14% (95% confidence interval [CI], 12%-16%, P < .001) and increased by 19% (95% CI, 16%-23%, P < .001) and 2% (95% CI, -1.1 to 4.3%, P = NS), respectively; the number of new starts decreased by 3% (95% CI, -13% to 7%, P = NS) and 2% (95% CI, -20% to 16%, P = NS) and increased by 13% (95% CI -2% to 27%, P = NS), respectively. At the AMC, technical and professional relative value units decreased by 5% and 14%, respectively. The PC made 561 external referrals to the AMC, which resulted in $2.38 million technical and $2.13 million professional charges at the AMC. Fifteen grant submissions ($12.83 million) resulted in 6 awards ($3.26 million). Twenty-two clinical trials involving proton therapy were opened, on which a total of 5% (n = 54) of patients enrolled during calendar years 2017 and 2018. The PC was involved in gift donations of $1.6 million. There was a nonsignificant 37% increase in number of pediatric cases. CONCLUSIONS: Despite a slight decline in AMC photon patient volumes and relative value units, a positive downstream effect was associated with the addition of a PC, which benefited the AMC.


Assuntos
Centros Médicos Acadêmicos/estatística & dados numéricos , Institutos de Câncer/estatística & dados numéricos , Centros Comunitários de Saúde/estatística & dados numéricos , Terapia com Prótons/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Centros Médicos Acadêmicos/economia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Institutos de Câncer/economia , Criança , Pré-Escolar , Ensaios Clínicos como Assunto/estatística & dados numéricos , Centros Comunitários de Saúde/economia , Intervalos de Confiança , Eficiência Organizacional , Registros Eletrônicos de Saúde , Feminino , Organização do Financiamento/economia , Organização do Financiamento/estatística & dados numéricos , Obtenção de Fundos/economia , Obtenção de Fundos/estatística & dados numéricos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fótons/uso terapêutico , Terapia com Prótons/economia , Radioterapia (Especialidade)/economia , Radioterapia (Especialidade)/educação , Encaminhamento e Consulta/economia , Escalas de Valor Relativo , Estudos Retrospectivos , Adulto Jovem
18.
Alzheimers Dement ; 15(1): 42-54, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30314799

RESUMO

Neurodegenerative diseases encompass a range of diagnoses, such as Alzheimer's disease and Parkinson's disease. Despite decades of advancements in understanding the neurobiology of individual diseases, this class has few disease-modifying therapeutics and a paucity of biomarkers for diagnosis or progression. However, tau protein aggregation has emerged as a potential unifying factor across several neurodegenerative diseases, which has prompted a rapid growth in tau-related funding. In spite of this growth, research funding in this area is not in line with the immense magnitude of disease burden, and drug discovery and clinical research remain underfunded. Coordinated, collaborative efforts are key to making an impact, which can and should be led by the major funding bodies within the tau space. Here we describe the development and analysis of a tau-focused neurodegeneration funding database, which captures data from 2040 grants from 2006 to 2016. This database was developed as a public resource to allow funders, researchers, and policy makers to better understand tau funding patterns and to identify key funders and potential collaborations. This database can be used in conjunction with other neurodegenerative disease databases, such as the International Alzheimer's Disease Research Portfolio to gain specific insight into tau-research funding. Over the study period, overall tau funding rose dramatically; however, changes in capital distribution also changed. Specifically, the field experienced a strong bias toward funding tau in the context of Alzheimer's disease, while at the same time generally decreasing the overall proportion of funding for basic research, treatment development, and evaluation. As funding organizations look forward, this resource can both inform future funding strategies and priority areas and identify potential collaborative efforts with complementary funding organizations.


Assuntos
Organização do Financiamento/economia , Apoio à Pesquisa como Assunto , Pesquisa/tendências , Tauopatias , Doença de Alzheimer/tratamento farmacológico , Biomarcadores , Bases de Dados Factuais , Humanos , Doença de Parkinson/tratamento farmacológico
19.
Acad Med ; 94(5): 708-714, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30520806

RESUMO

PURPOSE: This analysis examined the role of a National Institutes of Health (NIH) individual Mentored Career Development Award (K01, K08, K23) on launching and sustaining independent research careers for early-career scientists, and investigated the effects of these awards during and after the doubling of the NIH budget. METHOD: The authors used grants data from the NIH covering the period 1990 through 2016, and compared success in receipt of R01 equivalent awards (R01 Eq.) and Research Project Grants (RPGs) for K awardees and K applicants who did not receive funding. The analysis combined regression discontinuity design with coarsened exact matching, and regression. RESULTS: Overall, receipt of K award was associated with a 24.1% increase in likelihood of first independent NIH award (P < .01), and a larger number of R01 Eq. and RPG awards. After accounting for first major independent awards, K awards were uncorrelated with receiving second major independent research awards. Comparing different funding periods, K01 awards were predictive of subsequent R01 Eq. and RPG awards after but not during the NIH doubling, K08 awards were predictive only during the NIH doubling, and K23 awards were predictive during both periods. CONCLUSIONS: Receipt of Mentored Career Development Awards was linked to increased likelihood that early-career scientists successfully transitioned to an independent research career. These findings indicate that extending funding to additional K award applicants with meritorious scores could significantly strengthen the pipeline of biomedical researchers. In addition, enhancing K awards may be relevant to sustaining research careers for clinician scientists.


Assuntos
Pesquisa Biomédica/economia , Escolha da Profissão , Educação Médica/organização & administração , Organização do Financiamento/economia , National Institutes of Health (U.S.)/economia , Pesquisadores/economia , Apoio à Pesquisa como Assunto/economia , Adulto , Pesquisa Biomédica/estatística & dados numéricos , Educação Médica/estatística & dados numéricos , Feminino , Humanos , Masculino , Mentores/estatística & dados numéricos , National Institutes of Health (U.S.)/estatística & dados numéricos , Pesquisadores/estatística & dados numéricos , Estados Unidos
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