Wilm Quentin

Diagnosis related groups in Europe : moving towards transparency, efficiency, and quality in hospitals?

Hospitals in most European countries are paid on the basis of diagnosis related groups. Reinhard Busse and colleagues find much variation within and between systems and argue that they could be improved if countries learnt from each other

Cost‐of‐illness studies of dementia: a systematic review focusing on stage dependency of costs

Quentin W, Riedel‐Heller SG, Luppa M, Rudolph A, König H‐H. Cost‐of‐illness studies of dementia: a systematic review focusing on stage dependency of costs.

DRG-Based Hospital Payment Systems and Technological Innovation in 12 European Countries

OBJECTIVES To assess how diagnosis-related group-based (DRG-based) hospital payment systems in 12 European countries participating in the EuroDRG project pay and incorporate technological innovation. METHODS A standardized questionnaire was used to guide comprehensive DRG system descriptions. Researchers from each country reviewed relevant materials to complete the questionnaire and drafted standardized country reports. Two characteristics of DRG-based hospital payment systems were identified as particularly important: the existence of short-term payment instruments encouraging technological innovation in different countries, and the characteristics of long-term updating mechanisms that assure technological innovation is ultimately incorporated into DRG-based hospital payment systems. RESULTS Short-term payment instruments and long-term updating mechanisms differ greatly among the 12 European countries included in this study. Some countries operate generous short-term payment instruments that provide additional payments to hospitals for making use of technological innovation (e.g., France). Other countries update their DRG-based hospital payment systems very frequently and use more recent data for updates. CONCLUSIONS Generous short-term payment instruments to promote technological innovation should be applied carefully as they may imply rapidly increasing health-care expenditures. In general, they should be granted only if rigorous analyses have demonstrated their benefits. If the evidence remains uncertain, coverage with evidence development frameworks or frequent updates of the DRG-based hospital systems may provide policy alternatives. Once the data and evidence base is substantially improved, future research should empirically investigate how different policy arrangements affect the adoption and use of technological innovation and health-care expenditures.

Advertising bans as a means of tobacco control policy: a systematic literature review of time-series analyses

SummaryObjectives:This paper reviews the international literature that employed time-series analysis to evaluate the effects of advertising bans on aggregate consumption of cigarettes or tobacco.Methods:A systematic search of the literature was conducted. Three groups of studies representing analyses of advertising bans in the USA, in other countries and in 22 OECD countries were defined. The estimated effects of advertising bans and their significance were analysed.Results:24 studies were identified. They used a wide array of explanatory variables, models, estimating methods and data sources. 18 studies found a negative effect of an advertising ban on aggregate consumption, but only ten of these studies found a significant effect. Two studies using data from 22 OECD countries suggested that partial bans would have little or no influence on aggregate consumption, whereas complete bans would significantly reduce consumption.Conclusions:The results imply that advertising bans have a negative but sometimes only narrow impact on consumption. Complete bans let expect a higher effectiveness. Because of methodological restrictions of analysing advertising bans’ effects by time series approaches, also different approaches should be used in the future.

Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

BackgroundCervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program.MethodsWe first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI).ResultsTotal economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US

Hospital payment based on diagnosis-related groups differs in Europe and holds lessons for the United States.

349,400 (including a vaccine price of US

Costs of cervical cancer screening and treatment using visual inspection with acetic acid (VIA) and cryotherapy in Ghana: the importance of scale

5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US

Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries

1.3 million. Economic scaled-up costs per fully-immunized girl were US

A systematic review of randomized controlled trials of mHealth interventions against non-communicable diseases in developing countries

26.41, including HPV vaccine at US

Public reporting on quality, waiting times and patient experience in 11 high-income countries.

5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US