Cost, Economics and Databases of Pharmaceutical Drugs in Public Health

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Medication Management".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 17553

Special Issue Editor

Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 61-701 Poznań, Poland
Interests: pharmacology; pharmacoeconomics; medical and drug databases; quality of life; EBM; RWE; therapy costs
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Special Issue Information

Dear Colleagues,

Public health is not only about patients and medical procedures aimed at improving the health of the population, subpopulations, and target groups in diseases, or other further, but essential, aspects of it.

The quality of life, the costs of procedures, and disease prevention, as well as the costs of drugs, constitute critical elements of the national, continental and global strategy, as was perfectly demonstrated by the COVID-19 pandemic.

Pharmacoeconomics, health economics, and medical decision economics are just some of the essential elements of a health strategy, perceived differently in different countries.

This Special Issue entitled “Cost, Economic and Databases of Pharmaceutical Drugs in Public Health” is a unique opportunity to show the multifaceted nature of this issue, starting from costs and ending with the use of medical databases and systematic reviews in the effective use or allocation of resources for the treatment of patients (including drugs).

I cordially invite you and your staff to submit publications to this Special Issue.

Dr. Krzysztof Kus
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Databases
  • Quality of life
  • Real-World Evidence (RWE)
  • Evidence-Based Medicine (EBM)
  • Pharmacy Evidence-Based (PEB)
  • Therapy cost
  • Economics
  • Pharmacoeconomics
  • Health economics
  • Budget impact analyses

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Published Papers (13 papers)

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Research

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12 pages, 1110 KiB  
Article
Polish Adaptation and Psychometric Validation of the PREM-C9 Questionnaire for Patients with Chronic Obstructive Pulmonary Disease
by Iwona Damps-Konstańska, Weronika Ciećko, Ewa Jassem, Tomasz Bandurski, Dominika Bosek, Marzena Olszewska-Karaban and Ewa Bandurska
Healthcare 2023, 11(20), 2746; https://doi.org/10.3390/healthcare11202746 - 16 Oct 2023
Viewed by 724
Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The first PREM (patient-reported outcome measure)-type questionnaire that has been dedicated to assess the experience of care in COPD is the PREM-C9. Aim: The aim of this study [...] Read more.
Introduction: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The first PREM (patient-reported outcome measure)-type questionnaire that has been dedicated to assess the experience of care in COPD is the PREM-C9. Aim: The aim of this study was to create a Polish version of the PREM-C9 and determine its psychometric characteristics. Methods: The validation procedure involved forward and back translation. We included 42 patients with COPD. The psychometric properties were assessed using Cronbach’s alpha, Bartlett’s test, the Kaiser–Meyer–Olkin test, and Spearman’s correlation coefficient. The validity of the questionnaire was assessed using a principal component analysis for the extracted principal components. The validity of the factor analysis was demonstrated using Bartlett’s sphericity test and the Kaiser–Meyer–Olkin (KMO) test. A factor analysis was performed using the Oblimin and Varimax rotation. The reliability of the questionnaire was assessed using Cronbach’s alpha. Results: The Polish version of the analyzed questionnaire met all the validation criteria: face, translation, psychometric, functional, and reconstruction equivalence. Spearman’s correlation results between the Polish PREM-C9 and CAT were as follows: rho = 0.44, p = 0.003539; HADS-Anxiety: rho = 0.370864, p = 0.015612; and HADS-Depression: rho = 0.387405, p = 0.011253. Conclusions: The developed Polish PREM-C9 questionnaire is a reliable and valid tool that assesses Polish COPD patients’ experiences of their disease and the care they receive. Full article
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14 pages, 276 KiB  
Article
Opinion of Polish Patients with Epilepsy on Generic Medications
by Katarzyna Swakowska, Urszula Religioni and Anna Staniszewska
Healthcare 2023, 11(20), 2717; https://doi.org/10.3390/healthcare11202717 - 12 Oct 2023
Viewed by 598
Abstract
Aim: The majority of medicines used in Poland are generic drugs and substitutions of the originals. The objective of this study was to obtain information on the current knowledge about generic medicines among Polish patients with epilepsy. Material and Methods: The conducted study [...] Read more.
Aim: The majority of medicines used in Poland are generic drugs and substitutions of the originals. The objective of this study was to obtain information on the current knowledge about generic medicines among Polish patients with epilepsy. Material and Methods: The conducted study was based on a self-developed questionnaire. The questionnaire consisted of 26 questions, including the questions regarding the respondents’ knowledge about generics, their previous experience, and the factors behind these choices. Results: Overall, 1220 questionnaires were analyzed. Among all patients, 66.4% reportedly had heard about generics. Of these, 61.5% of patients had used generic drugs in the past. A significant proportion of participants had never been recommended to switch to a generic medicine by their healthcare professional (23% physicians and 13.9% pharmacists). Statistically, relevant differences were observed regarding the respondents’ kind and level of education, place of residence, and net income per household. Conclusions: Significant gaps were identified in the knowledge and perceptions among patients regarding generic medicines, especially in relation to their efficacy and safety. Efforts must be directed towards increasing public awareness of generic medicines and there should also be a focus on educating patients about generic medicines. Full article
20 pages, 1867 KiB  
Article
Awareness, Attitudes and Willingness to Donate Biological Samples to a Biobank: A Survey of a Representative Sample of Polish Citizens
by Łukasz Pronicki, Marcin Czech, Mariusz Gujski and Natalia D. Boguszewska
Healthcare 2023, 11(20), 2714; https://doi.org/10.3390/healthcare11202714 - 11 Oct 2023
Cited by 1 | Viewed by 776
Abstract
Biotechnology is developing at an ever-increasing pace, and the progressive computerization of health care and research is making it increasingly easy to share data. One of the fastest growing areas is biobanking. However, even with the best equipment and the best trained staff, [...] Read more.
Biotechnology is developing at an ever-increasing pace, and the progressive computerization of health care and research is making it increasingly easy to share data. One of the fastest growing areas is biobanking. However, even with the best equipment and the best trained staff, a biobank will be useless without donors. For this reason, we have decided to gauge Polish citizens’ awareness and attitudes towards biobanking and their willingness to donate biological samples. For this purpose the survey was conducted among a nationwide group of 1052 Poles aged 18 and over where the totals for gender, age and place of residence were selected according to their representation in the total population of adult Poles. The survey was conducted using the Computer Assisted Web Interview (CAWI) technique. Approximately two thirds of respondents N = 701 (66.6%) indicated that they had heard of scientific studies in which samples of biological material such as blood, saliva or urine are collected. More than half of respondents (N = 613, 58.3%) had a positive opinion regarding scientific research in which samples of biological material are taken. Only N = 220 (20.9%) of respondents had previously encountered the term biobanking. More than a half N = 687 (65.3%) of respondents would participate in a scientific study that biobanked biological material and health information. Almost half of the respondents (48.0%) would like specific consent to be used in biobanking. In our study we observed a negligible correlation between socio-demographic factors and a willingness to donate biological material to a biobank. Considering the results presented above, the level of knowledge and awareness of biobanks, and their role in scientific research and the health care system, among Polish citizens is low and requires education and information activities. Full article
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12 pages, 3803 KiB  
Article
Real World Evidence on the Effectiveness of Nusinersen within the National Program to Treat Spinal Muscular Atrophy in Poland
by Dominika Krupa, Marcin Czech, Ewa Chudzyńska, Beata Koń and Anna Kostera-Pruszczyk
Healthcare 2023, 11(10), 1515; https://doi.org/10.3390/healthcare11101515 - 22 May 2023
Cited by 1 | Viewed by 1526
Abstract
Background: Spinal muscular atrophy (SMA) is a debilitating neuromuscular disease resulting in children’s mortality and disability. Nusinersen is available to all SMA patients in Poland since 2019. Aim: To compare mortality or disease progression to mechanical ventilation in two patient cohorts before and [...] Read more.
Background: Spinal muscular atrophy (SMA) is a debilitating neuromuscular disease resulting in children’s mortality and disability. Nusinersen is available to all SMA patients in Poland since 2019. Aim: To compare mortality or disease progression to mechanical ventilation in two patient cohorts before and after the program’s introduction. Additionally, to describe the patient population treated with nusinersen and costs incurred by the public payer. Methods: We used the National Health Fund (NHF) database to identify patients born in either 2014 or 2019, who received at least two health services with an ICD10 G12 diagnosis. Outcomes were time to event: death or first mechanical ventilation. We identified all benefits received by nusinersen-treated patients, between 1 January 2019 and 31 May 2022. Results: Children with SMA born in 2019 had significantly lower mortality in the first years of their lives than children born in 2014. Approximately 875 patients (all age groups) were treated with nusinersen in the analysis period. The cost of causal drugs in this period amounted to €51.4 million. The cost of healthcare benefits amounted to €14.9 million. Conclusions: The drug program to treat SMA improved patient care in Poland. The NHF database was a reliable source to monitor resource-intensive therapies’ costs, demography, and selected patient outcomes. Full article
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11 pages, 1137 KiB  
Article
Economic Burdens of Type 2 Diabetes Hospital Visits with Hypoglycemic Episodes in the Tertiary Care Setting in Thailand
by Natapong Kosachunhanun, Danil Wongsa and Unchalee Permsuwan
Healthcare 2023, 11(7), 949; https://doi.org/10.3390/healthcare11070949 - 24 Mar 2023
Cited by 2 | Viewed by 1490
Abstract
This study aimed to estimate the economic burden of hypoglycemia among people with type 2 diabetes (T2D) treated in a tertiary care setting. An electronic database of the largest university-affiliated hospital in northern Thailand was retrieved from 2015 to 2020 using the International [...] Read more.
This study aimed to estimate the economic burden of hypoglycemia among people with type 2 diabetes (T2D) treated in a tertiary care setting. An electronic database of the largest university-affiliated hospital in northern Thailand was retrieved from 2015 to 2020 using the International Classification of Diseases 10th Revision (ICD-10) code E10.xx–E14.xx, or for patients receiving diabetes treatment at least twice for a 6-month period. All records were screened for hypoglycemia using an ICD-10 code E16.0–E16.2 or for having blood glucose <70 mg/dL. All costs related to outpatient visits or inpatient admissions were recorded. During the study period, T2D visits totaled 861,969. The annual incidence rate of hypoglycemia was 2.3 per 1000 visits, while the admission rate was 3.9 per 10,000 visits. The mean length of stay was 4.5 ± 10.1 days. The costs of hypoglycemia were USD 831.1 per admission and USD 182.2 per outpatient visit. The important cost driver for outpatients was drugs (USD 137.1), while for inpatients, this constituted services (USD 299.9). Hypoglycemia poses a substantial financial burden and increases the use of healthcare resources. Selecting the most cost-effective treatments with clinical evidence of the lower risk of hypoglycemia, especially newer insulin preparations, will provide the greatest likelihood of improving clinical outcomes and reducing the economic burden. Full article
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15 pages, 311 KiB  
Article
Association between Compliance with COVID-19 Restrictions and the Risk of SARS-CoV-2 Infection in Poland
by Karolina Hoffmann, Michał Michalak, Aleksandra Bońka, Wiesław Bryl, Wojciech Myśliński, Magdalena Kostrzewska, Dorota Kopciuch, Tomasz Zaprutko, Piotr Ratajczak, Elżbieta Nowakowska, Krzysztof Kus and Anna Paczkowska
Healthcare 2023, 11(6), 914; https://doi.org/10.3390/healthcare11060914 - 22 Mar 2023
Viewed by 1358
Abstract
During the coronavirus disease 19 (COVID-19) pandemic it has become very important to comply with preventive measures. We aimed to assess compliance with applicable restrictions and to explore the links between the level of compliance and the risk of COVID-19. This cross-sectional study [...] Read more.
During the coronavirus disease 19 (COVID-19) pandemic it has become very important to comply with preventive measures. We aimed to assess compliance with applicable restrictions and to explore the links between the level of compliance and the risk of COVID-19. This cross-sectional study included Polish adults who were asked to complete a validated questionnaire. The study period was from 1 November 2020 to 31 January 2021 and a computer-assisted web interview method was chosen to perform the survey. The study involved 562 women and 539 men. COVID-19 was reported in 11.26% of participants. A good level of compliance with the sanitary restrictions was reported for 38.87% of participants, an average level of compliance for 47.96%, and a low level of compliance for 13.17%. A reduced risk of COVID-19 was associated with the following preventive measures: regular use of protective masks, social and physical distancing in public places, regular use of hand sanitizers with high ethanol content, and the use of disposable gloves in public places. Our survey revealed satisfactory public compliance with the pandemic restrictions. Sanitary and epidemiologic measures to prevent the pandemic were shown to be adequate and effective. Full article
10 pages, 267 KiB  
Article
Compassion Fatigue and Perceived Social Support among Polish Nurses
by Paulina Pergol-Metko, Anna Staniszewska, Sebastian Metko, Zofia Sienkiewicz and Lukasz Czyzewski
Healthcare 2023, 11(5), 706; https://doi.org/10.3390/healthcare11050706 - 27 Feb 2023
Cited by 3 | Viewed by 1731
Abstract
Background: Social support has a vital role in preventing traumatic stress in nurses. Nurses are regularly exposed to contact with violence, suffering, and death. The situation worsened during the pandemic because they were also faced with the possibility of infection SARS-CoV-2 and death [...] Read more.
Background: Social support has a vital role in preventing traumatic stress in nurses. Nurses are regularly exposed to contact with violence, suffering, and death. The situation worsened during the pandemic because they were also faced with the possibility of infection SARS-CoV-2 and death from COVID-19. Many nurses are faced with increased pressure, stress, and other adverse effects on their mental health. The study aimed to measure the relationship between compassion fatigue and perceived social support in polish nurses. Methods: The study was conducted on 862 professionally active nurses in Poland using the CAWI method (Computer-Assisted Web Interview). The professional Quality of Life scale (ProQOL) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. StatSoft, Inc. (2014) was used for data analysis. For comparisons between the groups: Mann–Whitney U test, ANOVA Kruskal–Wallis test, and multiple comparisons (post-hoc). The relationships between variables were tested using Spearman’s rho, Tau Kendall, and the chi-square test. Results: The research showed the presence of compassion satisfaction, compassion fatigue, and burnout in the group of Polish hospital nurses. A higher level of perceived social support was associated with lower compassion fatigue (r = −0.35; p < 0.001). A higher level of social support was associated with higher job satisfaction (r = 0.40; p < 0.001). The study also found that a higher level of social support was associated with a lower risk of burnout (r = −0.41; p < 0.001). Conclusions: Preventing compassion fatigue and burnout should be a priority for healthcare managers. Notably, an essential predictor of compassion fatigue is that Polish nurses often work overtime. It is necessary to pay more attention to the crucial role of social support in preventing compassion fatigue and burnout. Full article
9 pages, 477 KiB  
Article
Sickness Presence among Teachers, Nurses and Private Sector Office Workers
by Dominik Olejniczak, Agata Olearczyk, Katarzyna Swakowska, Anna Staniszewska and Karolina Zakrzewska
Healthcare 2023, 11(4), 512; https://doi.org/10.3390/healthcare11040512 - 09 Feb 2023
Cited by 1 | Viewed by 1399
Abstract
Introduction: Sickness presence is used to denote an employee who feels unwell but still attends work, thus avoiding absence. The intention of this paper is to compare sickness presence in a group of the following professions: teachers, nurses and private sector office workers. [...] Read more.
Introduction: Sickness presence is used to denote an employee who feels unwell but still attends work, thus avoiding absence. The intention of this paper is to compare sickness presence in a group of the following professions: teachers, nurses and private sector office workers. Material and methods: For the purpose of this study, a survey based on the original PAPI form (Paper-and-Pen Personal Interview) was carried out. Non-probability sampling, the snowball method (N = 507: teachers n = 174, nurses n = 165 and private sector office workers n = 168), covering the whole of Poland, was adopted. Non-parametric hypotheses were verified using the chi-squared test with a statistical significance α = 0.05. Results: Compared to nurses and private sector office workers, teachers more frequently attended work when sick (p < 0.05). Out of the reported ailments that respondents worked with, teachers more often indicated rhinitis (p < 0.05), sore throat and cough (p < 0.05) and increased temperature (p < 0.05). This may be associated with a threat to the health of individuals in their charge. Teachers commonly complained about joint and bone pain (p < 0.05) and gastrointestinal disorders (p < 0.05). Contrary to nurses and private sector office workers, teachers did not point to ‘lack of a replacement’ as the reason for their presence at work when sick (p < 0.05). Exclusively, teachers added financial issues and difficulties in access to healthcare if they are working fewer hours to the list of reasons for attending work when sick. Conclusions: Results suggest that there is a need for further studies on the presence of sick employees in the workplace, especially for teachers. The sickness presence of teachers and nurses may be a threat from a public health perspective. The workplace itself is a significant place to prevent many diseases. Full article
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12 pages, 1515 KiB  
Article
How COVID-19 Broke the Barriers Related to the Implementation of Telecare—Patients’ Experiences with a New form of Providing Health Services in Primary Health Care
by Weronika Ciećko, Kinga Labunets, Małgorzata Wojnarowska, Dominika Bosek, Justyna Skwierawska, Tomasz Bandurski and Ewa Bandurska
Healthcare 2023, 11(4), 497; https://doi.org/10.3390/healthcare11040497 - 08 Feb 2023
Cited by 1 | Viewed by 1257
Abstract
Background: The COVID-19 pandemic has significantly contributed to accelerating the development of telemedicine and eHealth. The main aim of this study was to assess the attitudes of patients towards remote care implemented in general practice (GP) during the pandemic. Methods: The study was [...] Read more.
Background: The COVID-19 pandemic has significantly contributed to accelerating the development of telemedicine and eHealth. The main aim of this study was to assess the attitudes of patients towards remote care implemented in general practice (GP) during the pandemic. Methods: The study was a pilot study conducted in March–April 2021, considering technical aspects of using teleconsultations, and evaluating the difficulties, advantages and disadvantages for patients. When assessing opinions, a simple Likert scale was used, where a value of 1 meant the worst possible assessment or strong disagreement and the upper value the best or full agreement of the respondent. Results: The study covered 408 respondents. Their biggest organizational challenge reaching GPs by telephone, regardless of the patients’ home location (p = 0.23698). Obtaining e-documents was not problematic but was rated as worse by men (p = 0.048295). Respondents rated the overall effectiveness of teleconsultations more highly if they could speak directly with a doctor (p = 0.0005). There were no differences in willingness to recommend teleconsultations based on gender (p = 0.2432), place of residence (p = 0.7878), age (p = 0.290355) or education (p = 0.9109), but people assessing the overall effectiveness of telemedicine more highly were more willing to recommend it (p = 0.000). Conclusions: Respondents assess teleconsultations in a differentiated way, noticing both positive and negative features of the remote form of providing health services. Full article
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Review

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14 pages, 511 KiB  
Review
Cost-Effectiveness of Glucosamine in Osteoarthritis Treatment: A Systematic Review
by Nam Xuan Vo, Ngan Nguyen Hoang Le, Trinh Dang Phuong Chu, Huong Lai Pham, Khang Xuan An Dinh, Uyen Thi Thuc Che, Thanh Thi Thanh Ngo and Tien Thuy Bui
Healthcare 2023, 11(16), 2340; https://doi.org/10.3390/healthcare11162340 - 18 Aug 2023
Viewed by 1217
Abstract
Osteoarthritis (OA) is a chronic condition that most frequently affects older adults. It is currently the most common disability. The cost of treating an aging population places pressure on the healthcare budget. As a result, it is imperative to evaluate medicines’ cost-effectiveness and, [...] Read more.
Osteoarthritis (OA) is a chronic condition that most frequently affects older adults. It is currently the most common disability. The cost of treating an aging population places pressure on the healthcare budget. As a result, it is imperative to evaluate medicines’ cost-effectiveness and, accordingly, their influence on health resource allocation. Our study aims to summarize the cost and outcome of utilizing glucosamine in OA treatment. Databases like Medline, Cochrane, and Scopus were searched as part of the identification process up until April 2023. Our primary inclusion criteria centered on the economic evaluation of glucosamine in OA treatments, providing an incremental cost-effectiveness ratio (ICER). The Quality of Health Economic Studies (QHES) instrument was applied to grade the quality of the studies. Seven qualified studies that discussed the cost-effectiveness of glucosamine with or without other formulations were selected. All of them demonstrated that glucosamine was cost-effective. There was an increase in quality-adjusted life years (QALYs) when incorporating glucosamine in conventional care. Moreover, patented crystalline glucosamine sulfate (pCGS) was more cost-effective than the other formulations of glucosamine (OFG). Overall, utilizing pCGS was more beneficial than using OFG in terms both of cost and quality of life. Full article
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14 pages, 1170 KiB  
Review
The Voice of Patients Really Matters: Using Patient-Reported Outcomes and Experiences Measures to Assess Effectiveness of Home-Based Integrated Care—A Scoping Review of Practice
by Ewa Bandurska
Healthcare 2023, 11(1), 98; https://doi.org/10.3390/healthcare11010098 - 28 Dec 2022
Cited by 7 | Viewed by 2004
Abstract
Background: The aim of the study is to analyze the prevalence of using patients’ reported outcomes measures and experiences (PROMs and PREMs) in relation to integrated care (IC). Material and methods: To select eligible studies (<10 years, full-text), PubMed was used. The general [...] Read more.
Background: The aim of the study is to analyze the prevalence of using patients’ reported outcomes measures and experiences (PROMs and PREMs) in relation to integrated care (IC). Material and methods: To select eligible studies (<10 years, full-text), PubMed was used. The general subject of the articles referring to the type of disease was indicated on the basis of a review of all full-text publications discussing the effectiveness of IC (N = 6518). The final search included MeSH headings related to outcomes measures and IC. Full-text screening resulted in including 73 articles (23 on COPD, 40 on diabetes/obesity and 10 on depression) with 93.391 participants. Results: Analysis indicated that authors used multiple outcome measures, with 54.8% of studies including at least one patient reported. PROMs were more often used than PREMs. Specific (disease or condition/dimension) outcome measures were reported more often than general, especially those dedicated to self-assessment of health in COPD and depression. PROMs and PREMs were most commonly used in studies from the USA and Netherlands. Conclusion: Using PROMS/PREMS is becoming more popular, although it is varied, both due to the place of research and type of disease. Full article
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Other

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16 pages, 1494 KiB  
Systematic Review
Tozinameran (Pfizer, BioNTech) and Elasomeran (Moderna) Efficacy in COVID-19—A Systematic Review of Randomised Controlled Trial Studies
by Piotr Ratajczak, Zuzanna Banach, Dorota Kopciuch, Anna Paczkowska, Tomasz Zaprutko, Józef Krawczyk, Barbara Maciuszek-Bartkowska and Krzysztof Kus
Healthcare 2023, 11(11), 1532; https://doi.org/10.3390/healthcare11111532 - 24 May 2023
Cited by 3 | Viewed by 1207
Abstract
Background: The objective of this research was to test the efficacy and safety profile of tozinameran (30 μg, BNT162b2, Pfizer, BioNTech) and elasomeran (100 μg, mRNA-1273, Moderna) in COVID-19 prevention in ≥16-year-old patients vaccinated with two doses. Methods: A meta-analysis of the literature [...] Read more.
Background: The objective of this research was to test the efficacy and safety profile of tozinameran (30 μg, BNT162b2, Pfizer, BioNTech) and elasomeran (100 μg, mRNA-1273, Moderna) in COVID-19 prevention in ≥16-year-old patients vaccinated with two doses. Methods: A meta-analysis of the literature was conducted using the MEDLINE and EMBASE databases, following inclusion and exclusion criteria. Eight RCTs have been selected. The results were presented using the risk ratio (RR) with a 95% confidence interval (CI). A fixed-effect model or random-effect model was applied based on the heterogeneity of the results. Results: BNT162b2 and mRNA-1273 vaccines are efficient in preventing COVID-19 in comparison to a placebo (MH, RR 0.08 [0.07, 0.09] p < 0.00001 (95% CI)). It was found that administering the vaccines BNT162b2 and mRNA-1273 was associated with a higher proportion of adverse events in comparison to the placebo (IV, RR 2.14 [1.99, 2.29] p < 0.00001 (95% CI)). Administering the vaccines BNT162b2 and mRNA-1273 was associated with a higher proportion of serious adverse events in comparison to the placebo (MH, RR 0.98 [0.89, 1.08] p = 0.68 (95% CI)). Conclusions: Tozinameran and elasomeran are effective and safe in preventing the occurrence of COVID-19. Full article
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13 pages, 1129 KiB  
Case Report
Value-Based Integrated Care (VBIC) Concept Implementation in a Real-World Setting—Problem-Based Analysis of Barriers and Challenges
by Ewa Bandurska, Weronika Ciećko, Marzena Olszewska-Karaban, Iwona Damps-Konstańska, Dominika Szalewska, Piotr Janowiak and Ewa Jassem
Healthcare 2023, 11(8), 1110; https://doi.org/10.3390/healthcare11081110 - 12 Apr 2023
Viewed by 1402
Abstract
Healthcare effectiveness measurement and value in health have been common topics in public health literature since 2006 when value-based healthcare (VBHC) was first defined by Porter and Teisberg. The aim of this study was to identify the barriers and challenges related to the [...] Read more.
Healthcare effectiveness measurement and value in health have been common topics in public health literature since 2006 when value-based healthcare (VBHC) was first defined by Porter and Teisberg. The aim of this study was to identify the barriers and challenges related to the implementation of VBHC solutions in the example of Poland. A case presentation was used as a method. The national integrated care programs (KOS-Infarction, POZ-Plus, and comprehensive treatment of chronic wounds) were used to present general challenges, along with the Integrated Care Model (ICM) for patients with advanced chronic obstructive pulmonary disease (COPD), to determine specific difficulties. ICM has been operating since 2012 in Gdańsk and gradually adapted the value-based integrated care (VBIC) approach. An analysis of the available data showed that the greatest difficulties related to the implementation of the VBHC and VBIC concepts are a lack of legal and reimbursement solutions, staff shortages, a lack of educational standards for some members of the multidisciplinary team, and insufficient awareness of the role of integrated care. As the level of preparation to implement VBHC policies varies between individual countries, the conclusions drawn from the experience of ICM and other Polish projects may be a valuable voice in discussion. Full article
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