Public Attitudes Toward Incentives for Organ Donation: A National Study of Different Racial/Ethnic and Income Groups

Attitudes toward monetary and nonmonetary incentives for living (LD) and deceased donation (DD) among the U.S. general public and different racial/ethnic and income groups have not been systematically studied. We studied attitudes via a telephone questionnaire administered to persons aged 18-75 in the continental United States. Among 845 participants (85% of randomized households), less than one-fifth participants were in favor of incentives for DD (range 7-17%). Most persons were in favor of reimbursement of medical costs (91%), paid leave (84%) and priority on the waiting list (59%) for LD. African Americans and Hispanics were more likely than Whites to be in favor of some incentives for DD. African Americans were more likely than Whites to be in favor of monetary incentives for LD. Whites with incomes less than $20 000 were more likely than Whites with greater incomes to be in favor of reimbursement for deceased donors' funeral expenses or medical expenses. The U.S. public is not generally supportive of incentives for DD, but is supportive of limited incentives for LD. Racial/ethnic minorities are more supportive than Whites of some incentives. Persons with low income may be more accepting of certain monetary incentives.     

Depression Following Spinal Cord Injury: Its Relationship to Demographic and Socioeconomic Indicators

Background:

Depression is a common psychological problem that decreases life satisfaction and quality of life in people with spinal cord injury (SCI).

Objective:

The aim of this study was to investigate the prevalence of depression after SCI and its association with pathophysiological, demographic, and socioeconomic factors, including sex, age, level of injury, financial status, and suicidal thoughts.

Methods:

This was a cross-sectional study of 134 adults (≥18 years old) with SCI who were referred to the Brain and Spinal Cord Injury Research Center (BASIR) clinic, Tehran University of Medical Sciences, for outpatient rehabilitation. The Beck Depression Inventory (BDI-II Persian), a 21-question multiple-choice inventory, was used to measure the presence and severity of depression. Data were collected by interview.

Results:

Sixty-six (49.3%) participants had mild to severe depression. There was a higher probability of depression in individuals with SCI who were female, had tetraplegia, had suicidal thoughts, had a history of suicide attempt, had a low education level, or were taken cared for by a family member other than a spouse or parents.

Conclusion:

Depression was highly prevalent in individuals with SCI and was related to some demographic, pathophysiological, and socioeconomic indicators. The primary predictive indicators and the factors influencing depression should be determined to provide early detection and timely treatment to prevent more complications and improve quality of life for individuals with SCI.     

Quality improvement training for burn care in low-and middle-income countries: A pilot course for nurses

BackgroundThere is an urgent need to empower practitioners to undertake quality improvement (QI) projects in burn services in low-middle income countries (LMICs). We piloted a course aimed to equip nurses working in these environments with the knowledge and skills to undertake such projects.MethodsEight nurses from five burns services across Malawi and Ethiopia took part in this pilot course, which was evaluated using a range of methods, including interviews and focus group discussions.ResultsCourse evaluations reported that interactive activities were successful in supporting participants to devise QI projects. Appropriate online platforms were integral to creating a community of practice and maintaining engagement. Facilitators to a successful QI project were active individuals, supportive leadership, collaboration, effective knowledge sharing and demonstrable advantages of any proposed change. Barriers included: staff attitudes, poor leadership, negative culture towards training, resource limitations, staff rotation and poor access to information to guide practice.ConclusionsThe course demonstrated that by bringing nurses together, through interactive teaching and online forums, a supportive community of practice can be created. Future work will include investigating ways to scale up access to the course so staff can be supported to initiate and lead quality improvement in LMIC burn services.     

应用因素分析法分析门诊业务收人的增长因素

[目的]了解门诊人次、人均药费、人均检治费对医院2001～2006年门诊业务收入的影响及程度.[方法] 运用因素分析法分析我院2001～2006年门诊业务收入增长的原因.[结果]影响门诊业务收入增长的根本原因是由于门急诊人次和人均费用中人均检治费的增加.[结论]医院在今后应进一步加强专科、专家、特色门诊的建设,以吸 引更多患者就诊,同时控制好人均费用的合理增长,有效地利用好医疗卫生资源,使医院运营良好,持续稳步发展.     

中国健康人力资本对收入的影响分析——来自纵贯数据的证据

采用中国健康营养调查（CHNS）1997-2004年的面板数据，利用GLS、FE、HT三种模型分析了健康人力资本对收入的影响。在控制了健康等变量的内生性问题后，研究发现：HT模型是比传统的FE模型更为有效的模型，能够更为精确地反映健康对收入的影响；健康对男性收入有显著的正向影响，对女性收入虽有正向影响，但是并不显著。     

Redistributive effects of the Swedish social insurance system

BACKGROUND: Four principles are used to distribute payments via the Swedish social-insurance system in cases of temporary or permanent illness and death. This paper studies the redistributive effects on income of these four principles. METHODS: The analysis is based on aggregate social-insurance data from the 25 municipalities that comprise Stockholm County in Sweden. For nine different types of social-insurance payments based on the four principles, the degree of income redistribution is measured according to concentration indexes and differences between Gini coefficients with social-insurance payments excluded and included. RESULTS: The concentration indexes for payments from the nine social-insurance schemes in total is -0.0469. The Gini coefficient falls from 0.0437 excluding insurance payments (i.e. for income only from gainful work, IGW) to 0.0379 when including insurance payments with income from gainful work (IGW + TP). That is, the Gini coefficient is 15% lower when insurance payments are included. Decomposition by payment shows that the largest redistribution effect on income inequality is made by disability pension. CONCLUSION: Municipalities with low average income are favoured by the Swedish social-insurance system. Payment principles can be ranked according to their redistributive capacity: mix of compensating-lost-income and flat-rate, compensating-lost-income, means-testing, flat-rate, and need-based respectively. The nine social-insurance schemes contribute very differently to income redistribution. Disability pension and sickness allowance contribute most to income redistribution and reducing income inequality.     

Income inequality and mortality in Italy

BACKGROUND: The relationship between income inequality and health remains controversial in terms of whether or not it exists and, if so, its extent and the mechanisms involved. This study examines the relationship between income inequality, as indicated by the Gini coefficient, and mortality in Italy. METHODS: Cross-sectional ecological study on the 57,138,489 inhabitants living in the 95 provinces existing in Italy in 1994. Multivariate weighted regression analysis of total and age-specific mortality, income inequality, gender, and interaction between income inequality and median income or geographical area. RESULTS: A positive association between income inequality and total mortality was observed for both genders in provinces with a low per capita income and in Southern and Central Italy. The effect was present for infants and for persons over 24 years of age; it was marked for the elderly, particularly women. A negative association with mortality was observed for males living in the North-west. Interactions between income inequality and median income, and between income inequality and geographical area were found. CONCLUSION: In Italy, the relationship between income inequality and health is mixed and not universal, in so far as a positive association was observed only in provinces with lower absolute income. Elderly persons living in Southern Italy represent the population subgroup most vulnerable to unequal income distribution. Income inequality can, in part, explain the historically higher mortality among women in Southern Italy compared to women in the North. These results indicate that income inequality affects the health of population subgroups differentially.     

Associations of physique with the socioeconomic factors of family and regional origin in Chinese university students

Objectives The purpose of this study is to define and clarify the causes of differences in physique between urban students and rural students in China. Methods Subjects are 2,524 students (male, 838; female, 1686) who entered K University in Shanghai in September, 2001. The data used in this study is based upon K university’s Yearly Health Check Record and Students’ Family Condition Record. Correlation analysis, analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were applied to analyze the relationships between physique and gross family income, family income per capita, latitude, air temperature, precipitation or altitude. Results Urban students’ height and weight are significantly greater than rural students’ in both males and females. Both male students and female students are significantly taller and heavier in accordance with per capita increases in students’ family income. The height and weight of male and female students whose parents are peasant farmers are least. With regard to the relationship between physique and urban-rural factors, the F value decreases clearly when family income per capita is taken as a covariate, while the F values slightly decrease also when factors of latitude etc. are taken as covariates. The main cause of differing family income is occupational difference between urban areas and rural ones. Conclusion Students born in urban areas are taller and heavier than those born in rural areas. The main cause of these differences is family income per capita. The main cause of variations in family income is the income difference in occupations.     

Is Health Care a Luxury? New Evidence from OECD Data

Most research using cross-country data find income elasticities equal to or exceeding unity with respect to health expenditure. These conclusions might be confounded due to omitted variables bias and the presence of unobserved country and year specific determinants of per capita health expenditures. I obtain results supporting these hypotheses using recent (1990–98) data from fifteen OECD countries. Specifically, OLS coefficient estimates drop by more than 50% with the use of two-way fixed effects models and the inclusion of various demand and supply based determinants of per capita health expenditures, implying income elasticities of between 0.21 and 0.51. Weighted Least Squares (WLS), Generalized Least Squares (GLS) and Instrumental Variables (IV) estimation yield similar results.JEL classification: I18