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  1. Article: Sociodemographic and health factors associated with the risk of financial catastrophe when informal care for patients with haematological neoplasms is replaced by formal care.

    Del Pozo-Rubio, Raúl / Ortega-Ortega, Marta

    Health economics review

    2022  Volume 12, Issue 1, Page(s) 20

    Abstract: Background: Cancer is one of the diseases with the highest incidence and mortality in the world, and one that requires greater care (formal and informal). At present, the traditional informal caregiver is disappearing. The objective is to analyse the ... ...

    Abstract Background: Cancer is one of the diseases with the highest incidence and mortality in the world, and one that requires greater care (formal and informal). At present, the traditional informal caregiver is disappearing. The objective is to analyse the sociodemographic and health factors associated with the possible catastrophic financial effect on households of replacing informal care by formal care for patients with blood cancer, during the different stages of treatment in Spain.
    Methods: A total of 139 patients with haematological neoplasm who underwent stem cell transplantation completed a longitudinal questionnaire during each of three treatment phases. Of this population, 88.49% received informal care. The households were classified into those where the replacement of informal care with formal care would impose a financial burden exceeding 40% of equivalent household income, versus those who would not suffer this consequence. Three logistic regression models (one for each treatment phase) were estimated and the corresponding marginal effects determined.
    Results: The factors associated with a higher probability of financial catastrophe were married marital status, low education level, fair to very poor self-perceived health status, the diagnosis of leukaemia in the pre-transplant and first-year post-transplant phases and of multiple myeloma disease in the final post-transplant phase.
    Conclusions: These findings reveal the need to design social policies to meet the care needs of patients with blood cancer which at present are covered by informal care. Given the foreseeable elimination of this option, these families must be protected from the financial burden incurred from the use of privately-contracted assistance.
    Language English
    Publishing date 2022-03-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2634483-X
    ISSN 2191-1991
    ISSN 2191-1991
    DOI 10.1186/s13561-022-00364-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Cancer Premature Mortality Costs in Europe in 2020: A Comparison of the Human Capital Approach and the Friction Cost Approach.

    Hanly, Paul / Ortega-Ortega, Marta / Soerjomataram, Isabelle

    Current oncology (Toronto, Ont.)

    2022  Volume 29, Issue 5, Page(s) 3552–3564

    Abstract: The inclusion of productivity costs can affect the outcome of cost-effectiveness analyses. We estimated the value of cancer premature mortality productivity costs for Europe in 2020 using the Human Capital Approach (HCA) and compared these to the ... ...

    Abstract The inclusion of productivity costs can affect the outcome of cost-effectiveness analyses. We estimated the value of cancer premature mortality productivity costs for Europe in 2020 using the Human Capital Approach (HCA) and compared these to the Friction Cost Approach (FCA). Cancer mortality data were obtained from GLOBOCAN 2020 by sex and five-year age groups. Twenty-three cancer sites for 31 European countries were included. The HCA and the FCA were valued using average annual gross wages by sex and age group and applied to Years of Potential Productive Life Lost. 2020 friction periods were calculated and all costs were in 2020 euros. Estimated cancer premature mortality costs for Europe in 2020 were EUR 54.0 billion (HCA) and EUR 1.57 billion (FCA). The HCA/FCA cost ratio for Europe was 34.4, but considerable variation arose across countries (highest in Ireland: 64.5 v lowest in Czech Republic: 11.1). Both the HCA and the FCA ranked lung, breast and colorectal as the top three most costly cancers in Europe, but cost per death altered rankings substantially. Significant cost differences were observed following sensitivity analysis. Our study provides a unique perspective of the difference between HCA and FCA estimates of productivity costs by cancer site and country in Europe.
    MeSH term(s) Cost of Illness ; Europe/epidemiology ; Friction ; Humans ; Mortality, Premature ; Neoplasms
    Language English
    Publishing date 2022-05-13
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1236972-x
    ISSN 1718-7729 ; 1198-0052
    ISSN (online) 1718-7729
    ISSN 1198-0052
    DOI 10.3390/curroncol29050287
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Catastrophic out-of-pocket payments for dental treatment: regional evidence from Spain.

    López-López, Samuel / Del Pozo-Rubio, Raúl / Ortega-Ortega, Marta / Escribano-Sotos, Francisco

    BMC health services research

    2023  Volume 23, Issue 1, Page(s) 784

    Abstract: Background: To estimate the incidence and concentration of catastrophic out-of-pocket payments for healthcare and dental treatment, by region in Spain (calculated as the proportion of households needing to exceed a given threshold of their income to ... ...

    Abstract Background: To estimate the incidence and concentration of catastrophic out-of-pocket payments for healthcare and dental treatment, by region in Spain (calculated as the proportion of households needing to exceed a given threshold of their income to make these payments) in 2008, 2011 and 2015.
    Methods: The data analysed were obtained from the Spanish Family Budget Survey reports for the years in question. The study method was that proposed by Wagstaff and van Doorslaer (2003), contrasting payments for dental treatment versus household income and considering thresholds of 10%, 20%, 30% and 40%, thus obtaining incidence rates. In addition, relevant sociodemographic variables were obtained for each household included in the study.
    Results: With some regional heterogeneity, on average 4.75% of Spanish households spend more than 10% of their income on dental treatment, and 1.23% spend more than 40%. Thus, 38.67% of catastrophic out-of-pocket payments for dental services in Spain corresponds to payments at the 10% threshold. This value rises to 55.98% for a threshold of 40%.
    Conclusions: An important proportion of catastrophic out-of-pocket payments for health care in Spain corresponds to dental treatment, a service that has very limited availability under the Spanish NHS. This finding highlights the need to formulate policies aimed at enhancing dental cover, in order to reduce inequalities in health care and, consequently, enhance the population's quality of life and health status.
    MeSH term(s) Humans ; Health Expenditures ; Spain/epidemiology ; Quality of Life ; Budgets ; Health Facilities
    Language English
    Publishing date 2023-07-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-023-09761-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Projected Impact on Labour Productivity Costs of Cancer-Related Premature Mortality in Europe 2018-2040.

    Ortega-Ortega, Marta / Hanly, Paul / Pearce, Alison / Soerjomataram, Isabelle / Sharp, Linda

    Applied health economics and health policy

    2023  Volume 21, Issue 6, Page(s) 877–889

    Abstract: Aim: To estimate the potential cost of lost labour productivity due to cancer-related premature mortality in Europe (EU-27 plus Norway, Switzerland, Iceland and United Kingdom) from 2018 to 2040.: Methods: Deaths and years of potential productive ... ...

    Abstract Aim: To estimate the potential cost of lost labour productivity due to cancer-related premature mortality in Europe (EU-27 plus Norway, Switzerland, Iceland and United Kingdom) from 2018 to 2040.
    Methods: Deaths and years of potential productive life lost due to 23 types of cancer were estimated for 2018-2040, for 31 European countries. The data were analysed by age groups, by sex and by year. Projected productivity costs were estimated by calculating gross earnings by country, gender and age group using the Human Capital Approach, adjusting for projected labour force participation and unemployment rates. Various data sources were used. Sensitivity analyses were conducted.
    Results: Between 2018 and 2040, cancer is expected to cause around eight million premature deaths (58% male). The cumulative projected productivity costs in this respect are €1.3 trillion, representing an annual average of €58.7 billion, or 0.43% of the EU-27 gross domestic product. Labour productivity costs are projected to decrease by 6% from 2018 to 2040. The highest cost region is Western Europe, where Germany and France will experience the highest cumulative losses (€288 and €192 billion, respectively). The most costly cancers, in terms of total costs related to productivity losses, are of the lung and colorectum (€264.4 and €116.3 billion, respectively). In terms of average productivity cost per death, the most costly forms of cancer are Hodgkin lymphoma (€301,157) and melanoma (€260,522).
    Conclusion: The novel information presented could help national policymakers anticipate possible areas for cost savings. Action should be taken on disease prevention, on reducing mortality and on delaying the age of death due to Hodgkin lymphoma, brain cancer, leukaemia and melanoma. Furthermore, the study findings enhance our understanding of macroeconomic variables and could be useful in determining a re-allocation of health expenditures.
    MeSH term(s) Humans ; Male ; Female ; Mortality, Premature ; Hodgkin Disease ; Europe ; Health Expenditures ; Melanoma ; Cost of Illness ; Efficiency
    Language English
    Publishing date 2023-08-08
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2171420-4
    ISSN 1179-1896 ; 1175-5652
    ISSN (online) 1179-1896
    ISSN 1175-5652
    DOI 10.1007/s40258-023-00824-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The cost of premature death from cancer attributable to alcohol: Productivity losses in Europe in 2018.

    Rumgay, Harriet / Ortega-Ortega, Marta / Sharp, Linda / Lunet, Nuno / Soerjomataram, Isabelle

    Cancer epidemiology

    2023  Volume 84, Page(s) 102365

    Abstract: Background: More than 1.9 million people die from cancer each year in Europe. Alcohol use is a major modifiable risk factor for cancer and poses an economic burden on society. We estimated the cost of productivity lost due to premature death (under 65 ... ...

    Abstract Background: More than 1.9 million people die from cancer each year in Europe. Alcohol use is a major modifiable risk factor for cancer and poses an economic burden on society. We estimated the cost of productivity lost due to premature death (under 65 years of age) from alcohol-attributable cancer in the European Union (EU) plus Iceland, Norway, Switzerland, and the United Kingdom (UK) in 2018.
    Methods: We estimated cancer deaths attributable to alcohol using a Levin-based population attributable fractions method and cancer deaths in 2018 from the Global Cancer Observatory. Lost productivity was estimated for all alcohol-attributable cancer deaths by sex, cancer site, and country. Productivity losses were valued using the human capital approach.
    Results: An estimated 23,300 cancer deaths among people aged less than 65 in the EU plus Iceland, Norway, Switzerland and the UK in 2018 were attributable to alcohol (18,200 males, 5100 females). This equated to €4.58 billion in total productivity losses in the region and 0.027 % of the European Gross Domestic Product (GDP). The average cost per alcohol-attributable cancer death was €196,000. Productivity lost to alcohol-attributable cancer per capita was highest in Western Europe. Hungary, Romania, Slovakia, Latvia, Lithuania, and Portugal had the highest rate of premature mortality from alcohol-attributable cancer and the highest productivity lost as a share of national GDP.
    Conclusion: Our study provides estimates of lost productivity from alcohol-attributable cancer death in Europe. Cost-effective strategies to prevent alcohol-attributable cancer deaths could result in economic benefits for society and must be prioritised.
    MeSH term(s) Male ; Female ; Humans ; Mortality, Premature ; Cost of Illness ; Europe/epidemiology ; Alcohol Drinking/adverse effects ; Alcohol Drinking/epidemiology ; Neoplasms
    Language English
    Publishing date 2023-04-12
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2508729-0
    ISSN 1877-783X ; 1877-7821
    ISSN (online) 1877-783X
    ISSN 1877-7821
    DOI 10.1016/j.canep.2023.102365
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Sociodemographic and health factors associated with the risk of financial catastrophe when informal care for patients with haematological neoplasms is replaced by formal care

    del Pozo-Rubio, Raúl / Ortega-Ortega, Marta

    2022  

    Abstract: Background: Cancer is one of the diseases with the highest incidence and mortality in the world, and one that requires greater care (formal and informal). At present, the traditional informal caregiver is disappearing. The objective is to analyse the ... ...

    Abstract Background: Cancer is one of the diseases with the highest incidence and mortality in the world, and one that requires greater care (formal and informal). At present, the traditional informal caregiver is disappearing. The objective is to analyse the sociodemographic and health factors associated with the possible catastrophic financial effect on households of replacing informal care by formal care for patients with blood cancer, during the different stages of treatment in Spain. Methods: A total of 139 patients with haematological neoplasm who underwent stem cell transplantation completed a longitudinal questionnaire during each of three treatment phases. Of this population, 88.49% received informal care. The households were classified into those where the replacement of informal care with formal care would impose a financial burden exceeding 40% of equivalent household income, versus those who would not suffer this consequence. Three logistic regression models (one for each treatment phase) were estimated and the corresponding marginal effects determined. Results: The factors associated with a higher probability of financial catastrophe were married marital status, low education level, fair to very poor self-perceived health status, the diagnosis of leukaemia in the pre-transplant and first-year post-transplant phases and of multiple myeloma disease in the final post-transplant phase. Conclusions: These findings reveal the need to design social policies to meet the care needs of patients with blood cancer which at present are covered by informal care. Given the foreseeable elimination of this option, these families must be protected from the financial burden incurred from the use of privately-contracted assistance.
    Keywords ddc:330 ; D63 ; I0 ; I38 ; Informal care ; Formal care ; Haematologic neoplasms ; Financial catastrophe
    Subject code 360
    Language English
    Publisher Heidelberg: Springer
    Publishing country de
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Friction Costs and the Chain of Vacancies Problem: A Novel Vacancy Multiplier Solution.

    Hanly, Paul / Ortega-Ortega, Marta / Sharp, Linda

    Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

    2020  Volume 24, Issue 4, Page(s) 548–555

    Abstract: Objectives: A key criticism of applying the friction cost approach (FCA) to productivity cost estimation is its focus on a single friction period. A more accurate estimate of the friction cost of worker absence requires consideration of the chain of ... ...

    Abstract Objectives: A key criticism of applying the friction cost approach (FCA) to productivity cost estimation is its focus on a single friction period. A more accurate estimate of the friction cost of worker absence requires consideration of the chain of secondary vacancies arising from the opening of a new primary vacancy. Currently, empirical evidence on this is almost absent. We suggest an original approach to empirically estimate productivity costs that include a chain of secondary vacancies.
    Methods: The vacancy multiplier is based on labor market flows and transition probabilities between states of employment, unemployment, and economic inactivity. It is a summed infinite geometric series using a common ratio e
    Results: The average multiplier across Europe is 2.21 (standard deviation [SD] = 0.40) in 2019, meaning that every new primary vacancy created a chain of secondary vacancies that increased the primary friction cost by a factor of 2.21. The equivalent multiplier is 1.99 (SD = 0.37) between 2011 and 2019. Romania had the lowest country-specific multiplier (1.11 in 2011), and Greece the highest (4.51 in 2011).
    Conclusions: Our results highlight the extent of underestimation of current FCA costs, comprise a resource for future researchers, and provide an implementable formula to compute the multiplier for other countries.
    MeSH term(s) Cost of Illness ; Decision Trees ; Efficiency, Organizational/economics ; Europe ; Humans ; Models, Econometric ; Personnel Turnover/economics ; Sick Leave/economics ; United States
    Language English
    Publishing date 2020-12-24
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 1471745-1
    ISSN 1524-4733 ; 1098-3015
    ISSN (online) 1524-4733
    ISSN 1098-3015
    DOI 10.1016/j.jval.2020.10.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Catastrophic household expenditure associated with out-of-pocket payments for dental healthcare in Spain.

    López-López, Samuel / Del Pozo-Rubio, Raúl / Ortega-Ortega, Marta / Escribano-Sotos, Francisco

    The European journal of health economics : HEPAC : health economics in prevention and care

    2022  Volume 23, Issue 7, Page(s) 1187–1201

    Abstract: Objective: To estimate the prevalence of catastrophic health expenditure due to dental healthcare (CHED) in Spain, quantify its intensity and examine the related sociodemographic household characteristics.: Methods: Data from the Spanish Household ... ...

    Abstract Objective: To estimate the prevalence of catastrophic health expenditure due to dental healthcare (CHED) in Spain, quantify its intensity and examine the related sociodemographic household characteristics.
    Methods: Data from the Spanish Household Budget Survey, which addresses more than 20,000 households each year for the period 2008-2015 were included, and the methodology proposed by Wagstaff and van Doorslaer was followed. The prevalence (number of households that devote more than a certain threshold of their income to such payments) and intensity (amount that exceeds a certain percentage of income) were estimated. Ordered logistic regression models were estimated to analyse the sociodemographic factors associated with the prevalence of catastrophic payments.
    Results: The prevalence and intensity remained stable during the period under analysis. In terms of prevalence, a mean proportion of 7.36% of the population dedicated, in terms of intensity, more than 10% of their resources to dental care payments [mean: €292.75 per year (SD €2144.14)] and 2.05% dedicated more than 40% [mean: €143.02 per year (SD €1726.42)]. This represents 36.32% and 51.34% (for the thresholds of 10% and 40%) of the total catastrophic expenditure derived from out-of-pocket payments for dental healthcare in Spain.
    Conclusion: This study shows that a significant proportion of catastrophic healthcare payments correspond to dental services. Being male, aged over 40 years, unattached (single, separated, divorced or widowed), having a low level of education, a low household income, being unemployed and living in an urban area are all associated with a greater risk of CHED. This finding highlights the need to establish policies aimed at increasing dental care coverage to mitigate related financial burdens on a large part of the Spanish population.
    MeSH term(s) Adult ; Catastrophic Illness ; Delivery of Health Care ; Family Characteristics ; Female ; Health Expenditures ; Humans ; Male ; Middle Aged ; Poverty ; Spain
    Language English
    Publishing date 2022-01-23
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2045253-6
    ISSN 1618-7601 ; 1618-7598
    ISSN (online) 1618-7601
    ISSN 1618-7598
    DOI 10.1007/s10198-021-01420-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Estimating Global Friction Periods for Economic Evaluation: A Case Study of Selected OECD Member Countries.

    Hanly, Paul / Ortega Ortega, Marta / Pearce, Alison / de Camargo Cancela, Marianna / Soerjomataram, Isabelle / Sharp, Linda

    PharmacoEconomics

    2023  Volume 41, Issue 9, Page(s) 1093–1101

    Abstract: Background: The friction cost approach (FCA) offers an alternative to the dominant human capital approach to value productivity losses. Application of the FCA in practice is limited largely due to data availability. Recent attempts have tried to ... ...

    Abstract Background: The friction cost approach (FCA) offers an alternative to the dominant human capital approach to value productivity losses. Application of the FCA in practice is limited largely due to data availability. Recent attempts have tried to standardise the estimation of friction periods across Europe, but to date, this has not been attempted elsewhere. Our aim was to estimate friction periods for 17 Organisation for Economic Co-operation and Development (OECD) member countries between 2010 and 2021 based on routinely published data.
    Methods: We derived friction period estimates for Australia, Austria, Canada, Czechia, Finland, Germany, Hungary, Japan, Korea, Luxembourg, Norway, Poland, Portugal, Sweden, Switzerland, the United Kingdom and the United States. Vacancy stock and flow data was sourced from the OECD's short-term labour situation database from 2010 to 2021, and included the impact of Covid-19 on the labour market. The estimated friction periods were applied to cost cancer-related premature mortality for the United States as an illustrative case.
    Results: The average friction period in the five non-European countries (Australia, Canada, Korea, Japan and the United States) was 61.0 days (SD 9.4) (range between 44.8 days in Korea and 82.2 days in Canada) and the average friction period in the 12 European countries was 60.6 days (SD 14.8) (range between 34.1 days in Switzerland and 137.3 days in Czechia). In both cases, the outbreak of Covid-19 increased the length of the friction period. Our illustrative case revealed that productivity costs in the US were over a third lower using the study-specific friction period (56 days) compared with the conventionally assumed 90-day friction period applied in the literature as a default measure.
    Conclusions: Our results expand the potential application of the FCA outside of Europe and will support greater utilisation of the FCA and wider inclusion of productivity costs in societal-based economic evaluations based on the use of widely available and updated key labour market variables in our selected countries.
    MeSH term(s) Humans ; United States ; Organisation for Economic Co-Operation and Development ; Friction ; COVID-19 ; Europe ; Cost of Illness
    Language English
    Publishing date 2023-04-10
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 1100273-6
    ISSN 1179-2027 ; 1170-7690
    ISSN (online) 1179-2027
    ISSN 1170-7690
    DOI 10.1007/s40273-023-01261-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain.

    López-López, Samuel / Del Pozo-Rubio, Raúl / Ortega-Ortega, Marta / Escribano-Sotos, Francisco

    International journal of environmental research and public health

    2021  Volume 18, Issue 3

    Abstract: Background: The financial effect of households' out-of-pocket payments (OOP) on access and use of health systems has been extensively studied in the literature, especially in emerging or developing countries. However, it has been the subject of little ... ...

    Abstract Background: The financial effect of households' out-of-pocket payments (OOP) on access and use of health systems has been extensively studied in the literature, especially in emerging or developing countries. However, it has been the subject of little research in European countries, and is almost nonexistent after the financial crisis of 2008. The aim of the work is to analyze the incidence and intensity of financial catastrophism derived from Spanish households' out-of-pocket payments associated with health care during the period 2008-2015.
    Methods: The Household Budget Survey was used and catastrophic measures were estimated, classifying the households into those above the threshold of catastrophe versus below. Three ordered logistic regression models and margins effects were estimated.
    Results: The results reveal that, in 2008, 4.42% of Spanish households dedicated more than 40% of their income to financing out-of-pocket payments in health, with an average annual gap of EUR 259.84 (DE: EUR 2431.55), which in overall terms amounts to EUR 3939.44 million (0.36% of GDP).
    Conclusion: The findings of this study reveal the existence of catastrophic households resulting from OOP payments associated with health care in Spain and the need to design financial protection policies against the financial risk derived from facing these types of costs.
    MeSH term(s) Delivery of Health Care ; Europe ; Financing, Personal ; Health Expenditures ; Poverty ; Spain
    Language English
    Publishing date 2021-01-21
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1660-4601
    ISSN (online) 1660-4601
    DOI 10.3390/ijerph18030932
    Database MEDical Literature Analysis and Retrieval System OnLINE

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