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4.
J Health Care Poor Underserved ; 35(2): 532-544, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38828580

RESUMEN

The Department of Veterans Affairs provides a shallow subsidy (i.e., subsidizing 50% of an individual's rent for two years) to Veterans experiencing housing instability. We sought to describe the characteristics of Veterans who received these subsidies. Methods. We conducted a retrospective cohort study of Veterans between 10/2019-9/2021. We identified Veteran-level characteristics associated with receiving a shallow subsidy using a multivariable two-part regression model. We also conducted qualitative interviews to identify how shallow subsidies are allocated. Results Black race, higher income, more education, and older age were positively associated with receiving a shallow subsidy; previous homelessness, prior VA outpatient cost, and participating in permanent supportive housing were negatively associated with receiving a shallow subsidy. Interviews revealed that income was the most influential determinant of whether to give shallow subsidies. Discussion Our mixed methods findings were consistent, indicating that socioeconomic stability is an important driver of shallow subsidy allocation decisions.


Asunto(s)
United States Department of Veterans Affairs , Veteranos , Humanos , Veteranos/estadística & datos numéricos , Veteranos/psicología , Estados Unidos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Femenino , Anciano , Vivienda/economía , Adulto , Factores Socioeconómicos , Personas con Mala Vivienda
5.
PLoS One ; 19(6): e0304973, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38838022

RESUMEN

Cities are commonly recognized as the immediate hinterland of ports and play a crucial role in fostering the sustainable development of ports. Therefore, it is imperative to investigate the influence of cities on ports. By employing panel data from 2001 to 2021 for both ports and cities in the Bohai Rim region, this study examines the spatial spillover effect of urban economy on port efficiency using the spatial error model (SEM). The findings show that urban economies have a significant spatial spillover effect on port efficiency, but this effect diminishes across different spatial matrices. In particular, the geographical matrix demonstrates a stronger spatial spillover effect of the urban economy on port efficiency. These research findings help to establish a collaborative mechanism for port-city development and provide useful insights for government management decision-making.


Asunto(s)
Ciudades , Humanos , China , Desarrollo Sostenible/economía
6.
PLoS One ; 19(6): e0304911, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38838040

RESUMEN

Retailers have been using promotion as a differentiation strategy that influences consumers' expenditures and their shopping basket budgetary allocation. This study assessed the effect of retail promotions on total shopping basket expenditure and determined whether promotions provoke a reallocation of the shopping budget. The analysis was performed on a chain of supermarkets in Catalonia, Spain using a consumer scanner data set from Kantar Worldpanel for 2017. The methodological approach had two steps: prediction of the effect of promotion on household expenditures using an expenditure regression model and estimation of the promotion own- and cross-effect using the censored Exact Affine Stone Index. Promotion had a positive own-effect and mostly a negative asymmetric cross-effect, implying a small but significant budget reallocation.


Asunto(s)
Presupuestos , Comportamiento del Consumidor , Humanos , España , Comportamiento del Consumidor/economía , Composición Familiar , Comercio/economía , Supermercados , Alimentos/economía
9.
Glob Health Res Policy ; 9(1): 19, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38840125

RESUMEN

In Namibia, the Value Added Tax (VAT) Amendment Act 2022, which reclassified the supply of sanitary pads as zero-rated, has significant implications for adolescent girls' menstrual health and education. The policy change responds to the need to address period poverty by making essential menstrual products more accessible and affordable. Menstruation is a normal biological process, and access to sanitary products is a human right. Taxing menstrual products reinforces gender inequalities and raises concerns about the basic rights and dignity of women and girls. The VAT-free policy creates a system to reduce the financial burden on girls and women, making it easier for them to manage their periods safely and with dignity. It has the potential to reduce absenteeism from school, ultimately improving educational outcomes for adolescent girls. However, VAT exemptions alone are insufficient to address the broader accessibility issues that impact menstrual hygiene. Evidence-based policies that focus on the availability and affordability of a full range of sanitary products, in conjunction with regulatory mechanisms for price and quality control, are necessary to ensure that menstrual products are safe, affordable, and accessible for all.


Asunto(s)
Productos para la Higiene Menstrual , Menstruación , Humanos , Femenino , Adolescente , Productos para la Higiene Menstrual/provisión & distribución , Productos para la Higiene Menstrual/economía , Productos para la Higiene Menstrual/estadística & datos numéricos , Impuestos , Namibia , Política de Salud/legislación & jurisprudencia , Salud del Adolescente
10.
Front Public Health ; 12: 1358730, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38841673

RESUMEN

Introduction: The synergy of green taxation, public health expenditures, and life expectancy emerges as a compelling narrative in the intricate symphony of environmental responsibility and public well-being. Therefore, this study examine the impact of green taxation on life expectancy and the moderating role of public health expenditure on the said nexus, particularly in the context of China, an emerging economy. Methods: Statistical data is collected from the National Bureau of Statistics of China to empirically examine the proposed relationships. The dataset contains provincial data across years. Results: Using fixed-effect and system GMM regression models alongwith control variables, the results found a positive and statistically significant influence of green taxation on life expectancy. Moreover, public health expenditures have a positive and statistically significant partial moderating impact on the direct relationship. Discussion: These findings suggest that the higher cost of pollution encourages individuals and businesses to shift to less environmentally harmful alternatives, subsequently improving public health. Moreover, government investment in the health sector increases the availability and accessibility of health facilities; thus, the positive impact of green taxation on public health gets more pronounced. The findings significantly contribute to the fields of environmental and health economics and provide a new avenue of research for the academic community and policymakers.


Asunto(s)
Gastos en Salud , Esperanza de Vida , Impuestos , China , Humanos , Impuestos/estadística & datos numéricos , Impuestos/economía , Gastos en Salud/estadística & datos numéricos , Salud Pública/economía
11.
Front Public Health ; 12: 1363764, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38841669

RESUMEN

Alleviating health inequality among different income groups has become a significant policy goal in China to promote common prosperity. Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) covering the period from 2013 to 2018, this study empirically examines the impact of Integrated Medical Insurance System (URRBMI) on the health and health inequality of older adult rural residents. The following conclusions are drawn: First, URRBMI have elevated the level of medical security, reduced the frailty index of rural residents, and improved the health status of rural residents. Second, China exhibits "pro-rich" health inequality, and URRBMI exacerbates health inequality among rural residents with different incomes. This result remains robust when replacing the frailty index with different health modules. Third, the analysis of influencing mechanisms indicates that the URRBMI exacerbate inequality in the utilization of medical services among rural residents, resulting in a phenomenon of "subsidizing the rich by the poor" and intensifying health inequality. Fourth, in terms of heterogeneity, URRBMI have significantly widened health inequality among the older adult and in regions with a higher proportion of multiple-tiered medical insurance schemes. Finally, it is suggested that China consider establishing a medical financing and benefit assurance system that is related to income and age and separately construct a unified public medical insurance system for the older adult population.


Asunto(s)
Disparidades en el Estado de Salud , Seguro de Salud , Población Rural , Humanos , China , Población Rural/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Estudios Longitudinales , Anciano , Masculino , Persona de Mediana Edad , Femenino , Beneficios del Seguro/estadística & datos numéricos , Beneficios del Seguro/economía , Factores Socioeconómicos
12.
Front Public Health ; 12: 1381079, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38841679

RESUMEN

Introduction: Overweight and obesity are a global health epidemic and many attempts have been made to address the rising prevalence. In March 2021 the UK government announced £100 million of additional funding for weight management provisions. Of this, £30.5 million was split across local authorities in England to support the expansion of tier two behavioural weight management services for adults. The present work aimed to explore how this funding was used within the Yorkshire and Humber region to consolidate learning, collate best practice, and provide recommendations for future funding use. Method: One-hour semi-structured interviews were conducted with 11 weight management service commissioners representing 9 of the 15 local authorities in the region. Interviews were recorded, transcribed and analysed using an established health inequality framework. From this, recommendations were co-developed with the commissioner group to establish best practice for future funding use. Results: Commissioners recognised that targeted weight management services were only one small piece of the puzzle for effectively managing obesity. Therefore, recommendations include targeting underserved communities, focussing on early prevention, addressing weight management in a whole systems context, and embracing innovative and holistic approaches to weight management. Discussion: Current short-term funding and restrictive commissioning processes of tier two services prevents sustainable and innovative weight management practice which is detrimental to patients, falls short of addressing health inequalities and negatively impacts staff health and wellbeing.


Asunto(s)
Obesidad , Humanos , Obesidad/prevención & control , Inglaterra , Adulto , Entrevistas como Asunto , Programas de Reducción de Peso/economía , Sobrepeso/economía , Financiación Gubernamental , Investigación Cualitativa
13.
Front Public Health ; 12: 1335865, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38841683

RESUMEN

Alcohol is a favorite psychoactive substance of Canadians. It is also a leading risk factor for death and disability, playing a causal role in a broad spectrum of health and social issues. Alcohol: No Ordinary Commodity is a collaborative, integrative review of the scientific literature. This paper describes the epidemiology of alcohol use and current state of alcohol policy in Canada, best practices in policy identified by the third edition of Alcohol: No Ordinary Commodity, and the implications for the development of effective alcohol policy in Canada. Best practices - strongly supported by the evidence, highly effective in reducing harm, and relatively low-cost to implement - have been identified. Measures that control affordability, limit availability, and restrict marketing would reduce population levels of alcohol consumption and the burden of disease attributable to it.


Asunto(s)
Consumo de Bebidas Alcohólicas , Política de Salud , Humanos , Canadá , Consumo de Bebidas Alcohólicas/epidemiología , Bebidas Alcohólicas/economía
14.
Am Soc Clin Oncol Educ Book ; 44(3): e431272, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38843475

RESUMEN

The worldwide cancer burden is growing, and populations residing in low- and middle-income countries (LMICs) are experiencing a disproportionate extent of this growth. Breast, colorectal, and cervical cancers are among the top 10 most frequently diagnosed malignancies, and they also account for a substantial degree of cancer mortality internationally. Effective screening strategies are available for all three of these cancers. Individuals from LMICs face substantial cost and access barriers to early detection programs, and late stage at diagnosis continues to be a major cause for cancer mortality in these communities. This chapter will review the epidemiology of breast, colorectal, and cervical cancers, and will explore prospects for improving global control through novel approaches to screening in cost-constrained environments.


Asunto(s)
Países en Desarrollo , Detección Precoz del Cáncer , Humanos , Detección Precoz del Cáncer/economía , Neoplasias/epidemiología , Neoplasias/diagnóstico , Femenino , Tamizaje Masivo/economía , Tamizaje Masivo/métodos , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/diagnóstico , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/diagnóstico
15.
N Z Med J ; 137(1596): 72-85, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38843551

RESUMEN

AIM: Regulations announced in mid-2023 aimed to reduce youth vaping by curtailing the availability of cheap high-nicotine e-cigarettes (vapes). This study tested compliance with the new regulations for single-use vapes, which came into force on 21 December 2023. METHODS: A 20-year-old "mystery shopper" visited 96% of specialist vape retailers (SVRs) in Wellington, Porirua, Lower Hutt and Upper Hutt (N=74) in January 2024, and observed i) R18 signage, ii) age verification practices, and ii) prices and brands of the cheapest available vaping products. Low-price vapes were purchased and inspected for compliance with new nicotine limits and safety regulations. RESULTS: All but three stores (96%) displayed an R18 sign; however, signage in 29 stores (39%) was suboptimal. Only one store (1.4%) requested age identification (ID) on entry to the R18 premises. In 50% of stores, ID was requested when a purchase was made; however, a third of those retailers proceeded with the sale despite the buyer not providing ID. Single-use vapes remained available for NZ$10 or less in most stores, and reusable starter kits were also widely available for NZ$10-20. Discounted high-nicotine products were sold for as little as NZ$2.50 each. Most low-price products did not comply with the updated regulations. CONCLUSION: Cheap, high-nicotine vaping products remained widely available following the introduction of stricter regulations in December 2023; products for sale included discounted and non-compliant vapes. The majority of SVRs had poor age verification practices. There is an urgent need to clarify rules, increase enforcement efforts and disallow discounting and giveaways of vapes.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Vapeo , Sistemas Electrónicos de Liberación de Nicotina/economía , Vapeo/legislación & jurisprudencia , Humanos , Nueva Zelanda , Comercio/legislación & jurisprudencia , Adulto Joven , Adhesión a Directriz
16.
J Med Econ ; 27(1): 797-799, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38847361

RESUMEN

AIMS AND BACKGROUND: The current report details transition of outsourced conventional dialysis therapy in the ICU services to an in-house prolonged intermittent renal replacement therapy (PIRRT) service model as a quality improvement project using the Tablo Hemodialysis System, Outset Medical, Inc. The goals were aimed at maintaining or improving clinical outcomes, while also reducing dialysis-related nursing staff burden and dialysis-related treatment costs. METHODS: A descriptive comparative analysis was conducted of renal replacement therapy (RRT) of ≥6 hours in duration performed in the 1 year prior and 1 year after the ICU's in-house program launch using a PIRRT model including sequential 24-h treatments when medically necessary. RESULTS: Overall, there were 145 intensive care unit (ICU) stays among 145 patients with 13,641 h of conventional ICU dialysis in the year prior to program transition. In the year post, there were 116 ICU stays among 116 patients with 5,098 h of PIRRT. By employing a PIRRT and sequential 24-h treatment strategy vs. the prior outsourced model, the mean dialysis treatment hours per patient were reduced (Pre, 94.1 h with 214 treatment starts; Post, 43.9 h with 370 treatment starts), increasing ICU nurse productivity by 50.2 h per patient. Overall, ICU length of stay and ICU mortality declined post-service transition by 4.8 days and 9.8 percentage points (pp), respectively, overall, and in the non-COVID subset by 1.6 days and 3.1 pp, respectively. CONCLUSIONS: Insourcing RRT with an innovative technology that can provide both PIRRT and 24-h sequential treatments can maintain or improve clinical outcomes in critically ill patients requiring RRT in the ICU, while reducing dialysis-related costs.


Asunto(s)
Unidades de Cuidados Intensivos , Tiempo de Internación , Mejoramiento de la Calidad , Humanos , Unidades de Cuidados Intensivos/economía , Masculino , Femenino , Persona de Mediana Edad , Anciano , Diálisis Renal/economía , Calidad de la Atención de Salud , Terapia de Reemplazo Renal Intermitente , Control de Costos/métodos , Adulto
17.
Indian J Public Health ; 68(1): 9-14, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38847626

RESUMEN

BACKGROUND: Despite advancement in methods and application of economic evaluations (EEs), there are several uncertainties. OBJECTIVES: To assess the impact of alternate methodological and structural assumptions for four key principles of EE, on the results of cost-effectiveness analysis. MATERIALS AND METHODS: Three previously published model-based EEs were used: (1) Integrated Management of Neonatal and Childhood Illnesses (IMNCIs) intervention; (2) intervention for multiple myeloma, and (3) safety-engineered syringes (SES) intervention. A series of empirical analyses was undertaken to assess the impact of alternate assumptions for discount-rate, time-horizon, study perspective, and health outcome measure, on incremental cost-effectiveness ratio (ICER), and interpretation of cost-effectiveness. RESULTS: Increasing discount rate resulted in an increase in ICERs, for all three case-studies; however, there was no change in the conclusions. Using shorter time-horizons resulted in a significant increase in ICERs, the multiple myeloma intervention remained cost-ineffective, SES intervention became cost-ineffective, whereas IMNCI intervention remained cost-effective, despite a three-fold increase in ICER. On using disability adjusted life years instead of quality adjusted life years, ICERs increased to 0.04, 2 and 4 times for SES, IMNCI and multiple myeloma interventions, respectively. On analyzing results from a societal perspective, a decline in ICERs was observed. The decline was significant for IMNCI where the intervention turned dominant/cost-saving. In the other two case-studies decline in ICERs was modest, 32% for multiple myeloma, and 4% for SES. CONCLUSION: We observed a significant impact of using alternate assumptions on ICERs which can potentially impact resource-allocation decisions. Our findings provide strong argument in favor of standardization of processes and development of country-specific guidelines for conduct of EE.


Asunto(s)
Análisis Costo-Beneficio , Mieloma Múltiple , Humanos , India , Mieloma Múltiple/economía , Mieloma Múltiple/terapia , Años de Vida Ajustados por Calidad de Vida , Análisis de Costo-Efectividad
18.
Indian J Public Health ; 68(1): 44-49, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38847632

RESUMEN

BACKGROUND: There is mixed evidence on the extent of association between the allocation of public revenue for healthcare and its indicators of need. OBJECTIVE: In this study, we examined the relationship between allocations through state health financing (SHF) and the Central Government with infant mortality. MATERIALS AND METHODS: District-wise infant mortality rate (IMR) was computed using National Family Health Survey-4 data. State-wise data for health budgets through SHF and National Health Mission (NHM, a Centrally Sponsored Scheme), were obtained for the year 2015-16. We used a multivariable analysis through generalized linear model method using identity-link function. RESULTS: We found per capita SHF (₹3169) to be more than 12 times that of public health spending per capita through NHM (₹261). IMR was lower in districts with higher SHF allocation, although statistically insignificant. The allocation through NHM was higher in districts with higher IMR, which is statistically significant. Every unit percentage increase in per capita net state domestic product and female literacy led to 0.31% and 0.54% decline, while a 1% increase in under-five diarrhoea prevalence led to 0.17% increase in IMR. CONCLUSION: The NHM has contributed to enhancing vertical equity in health-care financing. The States' need to be more responsive to the differences in districts while allocating health-care resources. There needs to be a focus on spending on social determinants, which should be the cornerstone for any universal health coverage strategy.


Asunto(s)
Mortalidad Infantil , Humanos , India , Estudios Transversales , Lactante , Mortalidad Infantil/tendencias , Financiación Gubernamental/estadística & datos numéricos , Femenino , Gastos en Salud/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud/economía , Gastos Públicos , Masculino , Factores Socioeconómicos
19.
J Agric Food Chem ; 72(23): 12871-12895, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38829927

RESUMEN

Polyphenols are natural secondary metabolites found in plants endowed with multiple biological activities (antioxidant, anti-inflammatory, antimicrobial, cardioprotective, and anticancer). In view of these properties, they find many applications and are used as active ingredients in nutraceutical, food, pharmaceutical, and cosmetic formulations. In accordance with green chemistry and circular economy strategies, they can also be recovered from agroindustrial waste and reused in various sectors, promoting sustainable processes. This review described structural characteristics, methods for extraction, biological properties, and applications of polyphenolic extracts obtained from two selected plant materials of the Mediterranean area as olive (Olea europaea L.) and pomegranate (Punica granatum L.) based on recent literature, highlighting future research perspectives.


Asunto(s)
Tecnología Química Verde , Residuos Industriales , Olea , Extractos Vegetales , Polifenoles , Polifenoles/química , Extractos Vegetales/química , Residuos Industriales/análisis , Residuos Industriales/economía , Olea/química , Granada (Fruta)/química , Humanos , Antioxidantes/química , Animales
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