19th Annual International Conference on Health Economics, Management & Policy
Program (Athens Local Time)
(*In the program presentations are included from all the subjects scheduled to be presented in parallel)(Note: each presentation includes at least 10 minutes for questions and discussions if available)
Monday 22 June 2020
11.00-11.45 Opening and Welcoming Remarks:
Gregory T. Papanikos, President, ATINER
12.00-12.45 Andriana Margariti, Senior Lecturer, Centre for Experimental Medicine, Queen’s University Belfast, UK. Title: Patient Specific Blood Vessels Organoids are Shaping the Future of Health and Medical Studies Providing Opportunities for Teaching and Research
In context of the 2010-2012 European Committee of Senior Labor Inspectors (SLIC) Campaign on psychosocial risks, Austria amended its Occupational Health and Safety Act in 2013 forcing all companies to evaluate and reduce psychosocial stressors. To comply with this law more than 300 companies evaluated the psychosocial risks with the Module2 of Psychosocial Stressors (PBM2). 41 of these companies with about 21.216 employees already evaluated the effects of their risk reducing measures. Data of sickness leave days and the PBM2 before and after intervention were available for 25 companies with about 12.048 employees. All 25 companies were able to improve their working conditions and reduce work related distress. The average improvement was 8% (on a 100% scale). The best overall development was made in the work environment, with 13%, followed by social climate with 10%, the job requirements with 8% and finally work organization with 4%. The sickness leave days before the intervention were 11,8 days, (Austrian average 2018: 13,1 days) and reduced by 0,9 days per employee after intervention The average annual sickness leave related cost reduction was about € 69.937,- per company. Interventions in the context of the mandatory psychosocial risk assessment for Austrian companies lead to significant reductions in psychosocial risks and sickness leave days in 25 companies. The changes in the Austrian law and consequent implementation by the labor inspectorate improved the working conditions significantly and also lead to sickness absence cost reductions in these companies.
14:00-14:45 Gregory T. Papanikos, President, ATINER. Title: Do National Health Expenditures Matter for the COVID-19? Evidence from the European Union. (PowerPoint)
Health Expenditures provide necessary resources to prepare a national health sector to cope with health emergency situations such as the current pandemic. Rich countries have the convenience to spend more on public and private provision of health services. This paper examines whether this simple logic has applied to current pandemic. Do countries with higher health expenditures (total, per capita and as percentage of GDP) show a better performance in terms of total and per capita deaths or in terms of number of people (total and per capita) infected? One expects that this would have been the case but the descriptive evidence of this paper shows that the association is exactly the opposite. Rich countries had more deaths and more cases than poor countries. Data from the 27 European Union countries are used to demonstrate that this was the case.
15:00-15:45 Jordan Utley, Associate Professor, University of St. Augustine for Health Sciences, USA. Title: Global Health Crisis: Building Interprofessional Teams through Online Education.
Background: Dental caries is a multifactorial disease that requires detailed understanding of possible determinants as well as their effect on the population. Aim: The aim of this study was to investigate affecting factors associated with the prevalence of dental caries and high frequency of DMFT to assess the dental health for better development of preventive methods. Methods: We examined 2149 schoolchildren from 4 regions of Kazakhstan. The cohort consists of a random cluster sample of children aged 11–15 years. All children were given questionnaires containing questions about socioeconomic status, oral health behaviors, practices and dietary habits. In a descriptive analysis, primary data were presented for each studied variable (unadjusted frequencies). Caries experience measured using DMFT (decayed, missing, and filled teeth) index. Possible risk factors associated with caries were assessed using logistic regression after adjustment for sex and age. Results: Analysis of the study population revealed a high prevalence of caries. The prevalence of dental caries among all ages and all cities was 73.6%. The highest prevalence of dental caries was observed among 15-year-olds – 77.9% compare to 11-year-olds-68.3%. Our study showed that mean DMFT index was 3.09 among all children, the lowest mean DMFT index was among boys – 2.97 compared to girls– 3.19. The distribution of DMFT index, depending on the region of residence, had highest frequency of affected teeth among the children living in Semey city (4.8), and Oskemen city – (3.29), in Nur-Sultan city (capital city) – 2.45 affected teeth and the lowest frequency of DMFT was among the children from Kokshetau city (1.88). Statistical analyses showed that most common risk factor among all children significantly associated with caries was high daily consumption of sugar-containing drinks (p=0.030). We found significant association of caries with age of starting tooth brushing and brushing frequency (p=0.041). Unsurprisingly, the study revealed association of caries with age (p<0.0001) and gender, girls were more likely to have caries compared to boys (p<=0.001). We identified that caries was significantly higher among the children residing in the city of Semey (p<0.0001) compared to other cities. Conclusion: We observed a high prevalence of dental caries in all children residing in the four investigated areas of Kazakhstan. It is highly important to develop and implement the countrywide program for intensive promotion of the oral health to reduce the high prevalence of dental caries and possible affecting factors. This program should become as a part of the school health policy which will include the instructions and education about oral health and harmful dietary practices.
12:00-12:45 Kristina Ndreu, Community Pharmacist, University of Medicine, Tirana, Albania. Title: Cost-Effectiveness Evaluation of Bortezomib vs Vincristine Based Treatment for Multiple Myeloma.
INTRODUCTION Multiple myeloma (MM) is a malignant pathology that affects the B cells of the immune system. The asymptomatic progress makes it difficult to diagnose in early stages.
OBJECTIVES The growing incidence and the great cost for the medical treatment of this pathology led us to perform the pharmacoeconomic evaluation of the cost and the effectiveness for the two main schemes based on Bortezomib (VED) and Vincristine (VAD), applied in previously untreated patients with MM, in QSUT hospital. METHODOLOGY A retrospective study was performed for the pharmacoeconomic evaluation of cost-effectiveness for the two treatment schemes (VED, VAD). The study period was from March 2015 to March 2016 and included all the patients of the Rebuplic treated in the Heamatology clinic of QSUT hospital in Tirana. Effectiveness was evaluated through the following criteria: 1. RBC, PLT and Cr levels in the beginning and in the end of the treatment, general physical state of patients following treatment and survival. Costs evaluation included direct medical cost for the treatment. RESULTS The number of patients eligible for the study was 46, 24 (52.2%) for VAD scheme dhe 22 (47.8%) for VED. DMC on average was 1724075.6 ±522985.6 lekë for VED scheme and 84785.8±15465.0 lekë for VAD scheme, respectively. The levels of the clinical indicators on average after the conclusion of chemotherapy were: 1. RBC 3.9±0.7×106/mm3 for VAD and 3.7±1.0×106/ mm3 for VED, 2. PLT 262.3±85.5×103/mm3 for VAD and 240.8±88.7×103/mm3 for VAD, 3. Creatinine 1.2±0.6 mg/dL for VAD and 1.2±1.1 mg/dL for VED. The general physical state following treatment was similar for both study groups, as was survival. CONCLUSION Through the analysis of the clinical data and indicators gathered in the study period, in addition to the analysis of the costs, it results that: VAD scheme is more cost effective than VED scheme for the treatment of MM.
13:00-13:45 Elizabeth Ekirapa-Kiracho, Senior Lecturer, Makerere University, Uganda. Title: Cost Effectiveness of a Facility Based vs Facility + Community and Usual Care Strategy for Type 2 Diabetes Management.
Although it is known that interventions such as reducing obesity, increasing physical activity and increasing access to quality care, have the potential to improve the prevention and management of diabetes, the cost of implementing such interventions are not explicit especially in developing countries. The SMART 2 D study funded by SIDA implemented a randomized control trial that aimed at increasing the control of type 2 diabetes using facility and community based strategies. The study was implemented in Iganga and Mayuge Districts in Uganda.
Objectives The main objectives of this paper are to determine the incremental costs of providing care for diabetes using “facility only” strategies compared to “facility + community” strategies, and “usual care” and to determine the incremental cost-effectiveness of providing diabetes care “facility only” strategies compared to “facility + community” strategies, and “usual care.”
Methods A cost analysis was undertaken to estimate the incremental costs using an ingredients approach to costing. The costing was done from a provider’s perspective and only financial costs were captured. The costs were categorized according to the type of inputs. These were grouped into recurrent and capital inputs. Adjustments were made for inflation and capital costs were annualized. Data on costs and effects was collected using a combination of methods that included a facility survey, exit interviews, observations and record reviews.
Results The annualized total annual costs for the facility, facility + community and the usual arm were USD 26,173, 28,882 and 22,372 respectively . The main cost drivers were supplies (62%), personnel (18%) and then drugs (11.5%). The results indicate that the facility based strategy was more cost effective than the facility + community arm and usual care because its cost per patient treated (147 $) was lower than that for the other two arms. The cost per patient controlled ( 934$) was lower than that for the facility + community arm (1108$) and the usual arm (1864$). The facility arm also had a lower incremental cost effectiveness ratio (237 $) compared to the facility+ community arm 461$. The annual cost of scaling up the intervention to all lower level facilities (1725 facilities) was 8,193,085 $ while the annual Cost of scaling up only to some of the lower level facilities (HC III (1510) was 4,631,214 $. Conclusions and recommendations The facility based arm was more cost effective than the Facility + community arm when compared with usual care. It had the lowest average cost-effectiveness, for both treated and controlled patients and a lower ICER than the facility and community arm. Management of patients with diabetes should focus on controlling the blood glucose of the patients rather than just treating them. This would help to reduce the unit cost per patient controlled. To enhance early and appropriate treatment so as to reduce complications and lost productivity due to diabetes the Government of Uganda should consider scaling up the facility strategy in a phased manner to HC III level.
14.00-14:45 Nikolaos Liodakis, Associate Professor, Wilfrid Laurier University, Canada. Title: Assessing Canada’s Response to the COVID-19 Pandemic.(PowerPoint)
* ATINER does not have the administration and infrastructure capacity to organize separate online conferences for each one that is planned every week. Instead, an attempt has been made to have one online event for the given week.