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本文选取5种常见病治疗所需的23种药品,在调查其价格水平的基础之上,参考世界卫生组织(WHO)和国际健康行动机构(HAI)的标准药品价格调查方法,分析这23种药品费用的可负担性.结果得出2010年江苏省基本药物等效仿制药的可负担性水平较好,但原研药可负担性水平依旧较差,建议采取完善药品招标机制、规范药品合理使用和建立差异化的药品价格补偿机制等措施,进一步提高江苏省基本药物的可负担性. 相似文献
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Much recent research interest has focused on handling uncertainty in cost-effectiveness analysis and in particular the calculation of confidence intervals for incremental cost-effectiveness ratios (ICERs). Problems of interpretation when ICERs are negative have led to two important and related developments: the use of the net-benefit statistic and the presentation of uncertainty in cost-effectiveness analysis using acceptability curves. However, neither of these developments directly addresses the problem that decision-makers are constrained by a fixed-budget and may not be able to fund new, more expensive interventions, even if they have been shown to represent good value for money. In response to this limitation, the authors introduce the 'affordability curve' which reflects the probability that a programme is affordable for a wide range of threshold budgets. The authors argue that the joint probability an intervention is affordable and cost-effective is more useful for decision-making since it captures both dimensions of the decision problem faced by those responsible for health service budgets. 相似文献
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目的:通过对基本医疗的理论界定确定基本医疗保险和商业医疗保险覆盖范围,通过测算可承受的医疗费用标准,估算四川省可承受的商业保险费用总额方法:居民经济承受能力与医疗负担均衡模型,y1=a2+b1/(x+c1),y2=a2-b2/(x+c2),居民商业健康保险费用空间估算模型。结果:基本医疗卫生服务和非基本医疗服务界定可由居民经济承受能力,需求层次和技术的适宜性等属性区分;四川省有63%的人群具有购买商业保险的能力,可能具有的市场空间为1810亿元结论:相对现有百亿级的商业健康保险市场,四川省商业健康保险市场空间巨大,拓展这一市场的策略是做好特需服务领域和高新技术服务领域的保险产品设计。 相似文献
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Housing Circumstances are Associated with Household Food Access among Low-Income Urban Families 总被引:1,自引:0,他引:1
Household food insecurity is a pervasive problem in North America with serious health consequences. While affordable housing
has been cited as a potential policy approach to improve food insecurity, the relationship between conventional notions of
housing affordability and household food security is not well understood. Furthermore, the influence of housing subsidies,
a key policy intervention aimed at improving housing affordability in Western countries, on food insecurity is unclear. We
undertook a cross-sectional survey of 473 families in market rental (n = 222) and subsidized (n = 251) housing in high-poverty urban neighborhoods to examine the influence of housing circumstances on household food security.
Food insecurity, evident among two thirds of families, was inversely associated with income and after-shelter income. Food
insecurity prevalence did not differ between families in market and subsidized housing, but families in subsidized housing
had lower odds of food insecurity than those on a waiting list for such housing. Market families with housing costs that consumed
more than 30% of their income had increased odds of food insecurity. Rent arrears were also positively associated with food
insecurity. Compromises in housing quality were evident, perhaps reflecting the impact of financial constraints on multiple
basic needs as well as conscious efforts to contain housing costs to free up resources for food and other needs. Our findings
raise questions about current housing affordability norms and highlight the need for a review of housing interventions to
ensure that they enable families to maintain adequate housing and obtain their other basic needs. 相似文献
15.
Eman Hamid MD PhD Biniyam A. Ayele MD Daniel Gams Massi MD Samia Ben Sassi MD Houyam Tibar MD Emmanuel Epenge Djonga MD Sarah Misbah El-Sadig MD Wahiba AMER EL KHEDOUD MD Julien Razafimahefa MSc Ange Eric Kouame-Assouan MD Djibrilla Ben-Adji MD Yilédoma Thierry Modeste Lengané MD Abdu Kisekka Musubire MD Muhyadin Hassan Mohamed MSc Tiwonge Elisa Phiri MBBS FCN Nsengiyumva Nestor MD Wael Abdulgader Alwahchi MSc Saara Ndinelago Neshuku MBChB FCN MMed Cassandra Ocampo MD Foksouna Sakadi MD Moulid Ali Maidal MBBS Gift Wilson Ngwende MBChB MMed FCP Juzor Hooker MB ChB MMed DCN FCP Kigocha Okeng'o MD Med MSc Augustina Charway-Felli MD PhD FGCPS Masharip Atadzhanov PhD FRCP Jonathan Carr MBChB PhD Njideka U. Okubadejo MBChB FMCP FAAN Ali Shalash MD PhD 《Movement disorders》2021,36(10):2393-2407
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Emma Dalglish Deirdre McLaughlin Annette Dobson Coral Gartner 《Australian and New Zealand journal of public health》2013,37(4):371-376
Objective: To determine whether tobacco retailer density and cigarette prices differ between low and high socioeconomic status suburbs in South‐East Queensland. Methods: A survey of retail outlets selling cigarettes was conducted in selected suburbs over a two‐day period. The suburbs were identified by geographical cluster sampling based on their Index of Relative Socio‐economic Advantage and Disadvantage score and size of retail complex within the suburb. All retail outlets within the suburb were visited and the retail prices for the highest ranking Australian brands were recorded at each outlet. Results: A significant relationship was found between Index of Relative Socioeconomic Advantage and Disadvantage score (in deciles) and the number of tobacco retail outlets (r=0.93, p=0.003), with the most disadvantaged suburbs having a greater number of tobacco retailers. Results also demonstrate that cigarettes were sold in a broader range of outlets in suburbs of low SES. The average price of the packs studied was significantly lower in the most disadvantaged suburbs compared to the most advantaged. While cigarettes were still generally cheaper in the most disadvantaged suburbs, the difference was no longer statistically significant when the average price of cigarette packs was compared according to outlet type (supermarket, newsagent, etc). Conclusions: In South‐East Queensland, cigarettes are more widely available in the most disadvantaged suburbs and at lower prices than in the most advantaged suburbs. 相似文献
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RUTH R. FADEN KALIPSO CHALKIDOU JOHN APPLEBY HUGH R. WATERS JONATHON P. LEIDER 《The Milbank quarterly》2009,87(4):789-819
Context: This article compares the United Kingdom''s and the United States’ experiences with expensive cancer drugs to illustrate the challenges posed by new, extremely costly, medical technologies.Methods: This article describes British and American coverage, access, and cost-sharing policies with regard to expensive cancer drugs and then compares the costs of eleven such drugs to British patients, American Medicare beneficiaries, and American patients purchasing the drugs in the retail market. Three questions posed by these comparisons are then examined: First, which system is fairer? In which system are cancer patients better off? Assuming that no system can sustainably provide to everyone at least some expensive cancer drugs for some clinical indications, what challenges does each system face in making these difficult determinations?Findings: In both the British and American health care systems, not all patients who might benefit from or desire access to expensive cancer drugs have access to them. The popular characterization of the United States, where all cancer drugs are available for all to access as and when needed, and that of the British NHS, where top-down population rationing poses insurmountable obstacles to British patients’ access, are far from the reality in both countries.Conclusions: Key elements of the British system are fairer than the American system, and the British system is better structured to deal with difficult decisions about expensive end-of-life cancer drugs. Both systems face common ethical, financial, organizational, and priority-setting challenges in making these decisions. 相似文献