Publications
5 results found
Smith L, van Blankenstein E, Fox G, et al., 2023, Effect of national guidance on survival for babies born at 22 weeks’ gestation in England and Wales: population based cohort study, BMJ Medicine, Vol: 2, ISSN: 2754-0413
Objectives To explore the effect of changes in national clinical recommendations in 2019 that extended provision of survival focused care to babies born at 22 weeks’ gestation in England and Wales.Design Population based cohort study.Setting England and Wales, comprising routine data for births and hospital records.Participants Babies alive at the onset of care in labour at 22 weeks+0 days to 22 weeks+6 days and at 23 weeks+0 days to 24 weeks+6 days for comparison purposes between 1 January 2018 and 31 December 2021.Main outcome measures Percentage of babies given survival focused care (active respiratory support after birth), admitted to neonatal care, and surviving to discharge in 2018-19 and 2020-21.Results For the 1001 babies alive at the onset of labour at 22 weeks' gestation, a threefold increase was noted in: survival focused care provision from 11.3% to 38.4% (risk ratio 3.41 (95% confidence interval 2.61 to 4.45)); admissions to neonatal units from 7.4% to 28.1% (3.77 (2.70 to 5.27)), and survival to discharge from neonatal care from 2.5% to 8.2% (3.29 (1.78 to 6.09)). More babies of lower birth weight and early gestational age received survival focused care in 2020-21 than 2018-19 (46% to 64% at <500g weight; 19% to 31% at 22 weeks+0 days to 22 weeks+3 days).Conclusions A change in national guidance to recommend a risk based approach was associated with a threefold increase in 22 weeks’ gestation babies receiving survival focused care. The number of babies being admitted to neonatal units and those surviving to discharge increased.
Martínez-Jiménez M, 2023, Parental nonemployment in childhood and children's health later in life, Economics and Human Biology, Vol: 49, Pages: 1-23, ISSN: 1570-677X
While the effects of joblessness on the health of the non-employed are well-documented, its long-term spillover consequences on the health of their relatives, especially children, remain poorly understood. This research explores the long-term associations of parental nonemployment spells experienced during early, mid and late childhood on children's mental and physical health. The analysis exploits data drawn from the British Household Panel Survey (BHPS) and the UK Household Longitudinal Study (UKHLS), linking detailed parental socioeconomic information with their children between the years 1993 and 2013. This paper employs a Correlated Random Effects (CRE) probit model that allows accounting for unobserved heterogeneity as well as a non-linear Generalized Estimating Equations (GEE) random effects estimator accounting in addition for the dependency structure of the data. Results indicate that experiencing parental nonemployment during early and late childhood has a negative association on the children's likelihood of suffering from long-standing illnesses later in life, while experiencing parental nonemployment during middle childhood negatively affects the young adult's mental health. Moreover, experiencing parental nonemployment during late childhood increases the probability of both reporting poor or fair self-assessed health and the likelihood of consuming prescribed medicines in early adulthood. However, there seems to be a considerable effect heterogeneity by family socioeconomic status, parents' gender, and frequencies of parental nonemployment spells. Current adulthood circumstances, such as level of educational attainment, job situation and household demographics, are used to explore the potential mechanisms affecting results. These findings may help policymakers shape appropriate responses to mitigate the psychological and physical burden derived from parental nonemployment, especially among already disadvantaged households.
Cacace M, Boecken J, Edquist K, et al., 2023, Coping with COVID-19: the role of hospital care structures and capacity expansion in five countries, Health Economics, Policy and Law, ISSN: 1744-1331
This contribution examines the responses of five health systems in the first wave of the COVID-19 pandemic: Denmark, Germany, Israel, Spain and Sweden. The aim is to understand to what extent this crisis response of these countries was resilient. The study focuses on hospital care structures, considering both existing capacity before the pandemic and the management and expansion of capacity during the crisis. Evaluation criteria include flexibility in the use of existing resources and response planning, as well as the ability to create surge capacity. Data were collected from country experts using a structured questionnaire. Main findings are that not only the total number but also the availability of hospital beds is critical to resilience, as is the ability to mobilise (highly) qualified personnel. Indispensable for rapid capacity adjustment is the availability of data. Countries with more centralised hospital care structures, more sophisticated concepts for providing specialised services and stronger integration of the inpatient and outpatient sectors have clear structural advantages. A solid digital infrastructure is also conducive. Finally, a centralised governance structure is crucial for flexibility and adaptability. In decentralised systems, robust mechanisms to coordinate across levels are important to strengthen health care system resilience in pandemic situations and beyond.
Martínez-Jiménez M, García-Gómez P, Puig-Junoy J, 2021, The effect of changes in cost sharing on the consumption of prescription and over-the-counter medicines in Catalonia, International Journal of Environmental Research and Public Health, Vol: 18, Pages: 2562-2562, ISSN: 1660-4601
Many universal health care systems have increased the share of the price of medicines paid by the patient to reduce the cost pressure faced after the Great Recession. This paper assesses the impact of cost-sharing changes on the propensity to consume prescription and over-the-counter medicines in Catalonia, a Spanish autonomous community, affected by three new cost-sharing policies implemented in 2012. We applied a quasi-experimental difference-in-difference method using data from 2010 to 2014. These reforms were heterogeneous across different groups of individuals, so we define three intervention groups: (i) middle-income working population—co-insurance rate changed from 40% to 50%; (ii) low/middle-income pensioners—from free full coverage to 10% co-insurance rate; (iii) unemployed individuals without benefits—from 40% co-insurance rate to free full coverage. Our control group was the low-income working population whose co-insurance rate remained unchanged. We estimated the effects on the overall population as well as on the group with long-term care needs. We evaluated the effect of these changes on the propensity to consume prescription or over-the-counter medicines, and explored the heterogeneity effects across seven therapeutic groups of prescription medicines. Our findings showed that, on average, these changes did not significantly change the propensity to consume prescription or over-the-counter medicines. Nonetheless, we observed that the propensity to consume prescription medicines for mental disorders significantly increased among unemployed without benefits, while the consumption of prescribed mental disorders medicines for low/middle-income pensioners with long-term care needs decreased after becoming no longer free. We conclude that the propensity to consume medicines was not affected by the new cost-sharing policies, except for mental disorders. However, our results do not preclude potential changes in the quantity of medicines indiv
Martínez-Jiménez M, Vall Castelló J, 2020, Effects of macroeconomic fluctuations on mental health and psychotropic medicine consumption, International Journal of Health Economics and Management, Vol: 20, Pages: 277-297, ISSN: 2199-9023
Our aim in this paper is to understand the impact of macroeconomic fluctuations on mental health and psychotropic medicine consumption. In order to do that we exploit differences in the fluctuations of business cycle conditions across regional units in Catalonia. Our findings suggest that, in general, economic fluctuations at the local level had no significant effect on the consumption of psychotropic medicines. However, we show that a deterioration in local labour market conditions is associated with a reduction in the consumption of anxiolytics medicines. We also report an increase in the consumption of anxiolytics in regions with a softer deterioration in the economic situation. Although we report mild improvements in both mental and physical health for some sub-groups of the population, we also find significant reductions on the probability of sleeping 6 h or more. Thus, these elements point towards potential negative effects of local labour market conditions on health in the medium/long term.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.