BACKGROUND U.S. occupational lead standards have not changed for decades, while knowledge about lead's health effects has grown substantially. OBJECTIVE The objective of this analysis was twofold: to estimate the attributable annual societal costs of health damages associated with occupationally lead-exposed U.S. workers and, more broadly, to develop methods for a fuller valuation of health d...

Until 1984, when the Deficit Reduction Act (DRA) was passed, hospitals and their clinical laboratories were fully reimbursed for nearly all test analyses that were performed. The DRA established a Medicare system that indirectly pays for laboratory tests as part of a total-care reimbursement fee based on the diagnosis-related group (DRG) that classifies the patient’s clinical condition. Under t...

BACKGROUND Household food insecurity, a measure of income-related problems of food access, is growing in Canada and is tightly linked to poorer health status. We examined the association between household food insecurity status and annual health care costs. METHODS We obtained data for 67 033 people aged 18-64 years in Ontario who participated in the Canadian Community Health Survey in 2005, ...

BACKGROUND The pricing mechanism of orphan drugs appears arbitrary and has been referred to as a "black box". Therefore, the aim of this study is to investigate how drug- and disease-specific variables relate to orphan drug prices. Additionally, we aim to explore if certain country-specific pricing and reimbursement policies affect the price level of orphan drugs. METHODS Annual treatment cos...

BACKGROUND Studies into the costs of syndromic surveillance systems are rare, especially for estimating the direct costs involved in implementing and maintaining these systems. An Integrated Surveillance System in rural China (ISSC project), with the aim of providing an early warning system for outbreaks, was implemented; village clinics were the main surveillance units. Village doctors express...

OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent mental disorders in children in the United States and often persists into adulthood with associated symptomatology and impairments. This article comprehensively reviews studies reporting ADHD-related incremental (excess) costs for children/adolescents and adults and presents estimates of annual national incre...

More than 60% of the United States population is overweight or obese, and if the current trajectory continues, 50% of the population will be obese by 2030. There is no question that being obese or overweight, is more costly than being of normal weight. Using existing literature, we have detailed the costs incurred due to overweight and obesity that affect working-age adults at the individual le...

BACKGROUND Reliable estimates of the impacts of chronic kidney disease (CKD) stage, with and without cardiovascular disease, on hospital costs are needed to inform health policy. METHODS The Study of Heart and Renal Protection (SHARP) randomized trial prospectively collected information on kidney disease progression, serious adverse events and hospital care use in a cohort of patients with mo...

The present paper proposes a concept of Reliability Based Optimization (RBO) for quality assurance. In general the RBO approach is viewed as a minimization of the expected total cost of the structure including initial costs and costs due to failure, weight minimization with respect to reliability constraints, etc. The aim of the reliability based optimization is to find the best compromise betw...

Coastal aquatic ecosystems are increasingly affected by diffuse source nutrient water pollution from agricultural activities in coastal catchments, even though these ecosystems are important from a social, environmental and economic perspective. To warrant sustainable economic development of coastal regions, we need to balance marginal costs from coastal catchment water pollution abatement and ...