High Precision Bone Cutting by Er: YAG Lasers Might Minimize the Invasiveness of Navigated Brain Biopsies.

Biopsies of brain tissue are sampled and examined to establish a diagnosis and to plan further treatment, e.g. for brain tumors.

Soy flour as an alternative to purified lipoxygenase for the enzymatic synthesis of resolvin analogues.

Specialized pro-resolving mediators are lipid signaling molecules synthesized from omega-3 and -6 polyunsaturated fatty acids, which promote the resolution of the inflammatory response. They are potential drug targets for the treatment of numerous conditions linked with uncontrolled inflammation. Many of these mediators can be effectively synthesized using enzymes, such as lipoxygenases.

The Health Burden of Invasive Meningococcal Disease: A Systematic Review.

Of Key Points: Although relatively rare, invasive meningococcal disease continues to be a health concern, especially in young children. This systematic review clearly delineates both the near- and long-term morbidities that can occur after, and persist beyond, the period of acute illness.

Background: Although rare, invasive meningococcal disease (IMD) continues to be a health concern in high-income countries because of its severe morbidity and relatively high case fatality rate, especially in young children.

Economic evaluation of meningococcal serogroup B childhood vaccination in Ontario, Canada.

Objective: Invasive Neisseria meningitidis serogroup B (MenB) disease is a low incidence but severe infection (mean annual incidence 0.19/100,000/year, case fatality 11%, major long-term sequelae 10%) in Ontario, Canada. This study assesses the cost-effectiveness of a novel MenB vaccine from the Ontario healthcare payer perspective.

Early economic evaluation of emerging health technologies: protocol of a systematic review.

Background: The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice.

Economic evaluations of hepatitis A vaccination in middle-income countries.

Economic evaluations of hepatitis A vaccination are important to assist national and international policy makers in different jurisdictions on making effective decisions. Up to now, a comprehensive review of the potential health and economic benefits on hepatitis A vaccination in middle-income countries (MICs) has not been performed yet. In this study, we reviewed the literature on the cost-effectiveness of hepatitis A vaccination in MICs.

Cost-effectiveness of rotavirus immunization in Indonesia: taking breastfeeding patterns into account.

Objective: This study aims to assess the cost-effectiveness of rotavirus immunization in Indonesia, taking breastfeeding patterns explicitly into account.

Method: An age-structured cohort model was developed for the 2011 Indonesia birth cohort. Next, we compared two strategies, the current situation without rotavirus immunization versus the alternative of a national immunization program.

An update of "Cost-effectiveness of rotavirus vaccination in the Netherlands: the results of a Consensus Rotavirus Vaccine model".

Background: To update a cost-effectiveness analysis of rotavirus vaccination in the Netherlands previously published in 2011.

Methods: The rotavirus burden of disease and the indirect protection of older children and young adults (herd protection) were updated.

Results: When updated data was used, routine infant rotavirus vaccination in the Netherlands would potentially become an even more cost-effective strategy than previously estimated with the incremental cost per QALY at only €3,000-4,000.

Limited options to manage specialty drug spending.

Spending on specialty drugs--typically high-cost biologic medications to treat complex medical conditions--is growing at a high rate and represents an increasing share of U.S. pharmaceutical spending and overall health spending.

Cost-Effectiveness Analysis of Hepatitis B Immunization in Vietnam: Application of Cost-Effectiveness Affordability Curves in Health Care Decision Making.

Objectives: To perform a cost-effectiveness analysis and to identify the cost-effectiveness affordability levels for a newborn universal vaccination program against hepatitis B virus (HBV) in Vietnam.

Methods: By using a Markov model, we simulated a Vietnamese birth cohort using 1,639,000 newborns in 2002 and estimated the incremental cost-effectiveness ratios for quality-adjusted life-year gained following universal newborn HBV vaccination. Two types of analyses were performed, including and excluding expenditures on the treatment of chronic hepatitis B and its complications.

Cost of Illness of Chronic Hepatitis B Infection in Vietnam.

Objectives: To estimate the total financial burden of chronic hepatitis B virus (HBV) infection for Vietnam by quantifying the direct medical, the direct nonmedical, and indirect costs among patients with various stages of chronic HBV infection.

Methods: Direct medical cost data were retrieved retrospectively from medical histories of inpatients and outpatients in 2008 from a large referral hospital in Hanoi, Vietnam. Direct nonmedical and indirect costs data were obtained from face-to-face interviews of outpatients from the same hospital.

A review of the literature on the economics of vaccination against TB.

The BCG vaccine was introduced in 1921 and remains the only licensed vaccine for the prevention of TB worldwide. Despite its extensive use, the BCG vaccine lacks the ability to fully control the TB-endemic and -pandemic situations. The BCG vaccine is most effective in preventing pediatric TB, in particular, miliary TB and tuberculous meningitis.

Surprising decline in consumers seeking health information.

In 2010, 50 percent of American adults sought information about a personal health concern, down from 56 percent in 2007, according to a new national study from the Center for Studying Health System Change (HSC). The likelihood of people seeking information from the Internet and from friends and relatives changed little between 2007 and 2010, but their use of hardcopy books, magazines and newspapers dropped by nearly half to 18 percent. While the reduced tendency to seek health information applied to consumers across nearly all demographic categories, it was most pronounced for older Americans, people with chronic conditions and people with lower-education levels.

Health economics of rotavirus immunization in Vietnam: potentials for favorable cost-effectiveness in developing countries.

Introduction: Rotavirus is the most common cause of severe diarrhoea worldwide. Vietnam is situated in the region of high rotavirus infection incidence and eligible for financial support to introduce rotavirus vaccines into the Expanded Program of Immunization (EPI) from the GAVI. This study was designed to assess the cost-effectiveness of rotavirus immunization in Vietnam, explicitly the use of Rotateq(®) and to assess the affordability of implementing universal rotavirus immunization based on GAVI-subsidized vaccine price in the context of Vietnamese healthcare system for the next 5 years.

Employer-sponsored health insurance: down but not out.

Rising costs and the lingering fallout from the great recession are altering the calculus of employer approaches to offering health benefits, according to findings from the Center for Studying Health System Change's (HSC) 2010 site visits to 12 nationally representative metropolitan communities. Employers responded to the economic downturn by continuing to shift health care costs to employees, with the trend more pronounced in small, mid-sized and low-wage firms. At the same time, employers and health plans are dissatisfied and frustrated with their inability to influence medical cost trends by controlling utilization or negotiating more-favorable provider contracts.

Economic evaluations of rotavirus immunization for developing countries: a review of the literature.

Diarrhea is a leading cause of mortality for children under 5 years of age, and rotavirus is identified as the main cause of severe diarrhea worldwide. Since 2006, two rotavirus vaccines, Rotarix and Rotateq, have been available in the market. These vaccines have proved to have high efficacy in developed countries.

Key findings from HSC's 2010 site visits: health care markets weather economic downturn, brace for health reform.

Lingering fallout--loss of jobs and employer coverage--from the great recession slowed demand for health care services but did little to slow aggressive competition by dominant hospital systems for well-insured patients, according to key findings from the Center for Studying Health System Change's (HSC) 2010 site visits to 12 nationally representative metropolitan communities. Hospitals with significant market clout continued to command high payment rate increases from private insurers, and tighter hospital-physician alignment heightened concerns about growing provider market power. High and rising premiums led to increasing employer adoption of consumer-driven health plans and continued increases in patient cost sharing, but the broader movement to educate and engage consumers in care decisions did not keep pace.

Workplace clinics: a sign of growing employer interest in wellness.

Interest in workplace clinics has intensified in recent years, with employers moving well beyond traditional niches of occupational health and minor acute care to offering clinics that provide a full range of wellness and primary care services. Employers view workplace clinics as a tool to contain medical costs, boost productivity and enhance companies' reputations as employers of choice. The potential for clinics to transform primary care delivery through the trusted clinician model holds promise, according to experts interviewed for a new qualitative research study from the Center for Studying Health System Change (HSC).

Results of a retrospective database analysis of drug utilization and costs for treatment of chronic hepatitis B virus infection in the northern Netherlands between 2000 and 2006.

Objectives: The main aims of this work were to describe patterns of medication use in the treatment of chronic hepatitis B virus (HBV) infection in patients in the northern part of the Netherlands and to compare these practices with established guidelines. In addition, the duration of use and the costs of these treatments were investigated.

Methods: We selected subjects from the University of Groningen's IADB.

Impact of health care price transparency on price variation: the New Hampshire experience.

Price variation for medical procedures performed in both hospital outpatient departments and freestanding facilities has not decreased in New Hampshire since the state launched the HealthCost price transparency program in early 2007, according to new research jointly conducted by the New Hampshire Insurance Department and the Center for Studying Health System Change (HSC). New Hampshire stakeholders cited weak provider competition as the key reason for lack of impact. The state's hospital market is geographically segmented in rural areas and has few competitors even in urban areas.

Designing effective health care quality transparency initiatives.

Among the many health care quality transparency initiatives introduced in recent years, two state-based programs stand out for thoughtful design, implementation and usable, useful data: CalHospitalCompare, a report card for California hospitals, and Massachusetts Health Quality Partners, a report card for Massachusetts primary care physician groups. According to a new Center for Studying Health System Change (HSC) analysis, both programs share key elements that contribute to their effectiveness: engaging and collaborating with the provider community from the outset; paying particular attention to the caliber of the quality data reported; presenting the quality data to consumers in formats that are easy to understand and remember; and providing hospitals and physicians with detailed information on their own performance. Quality transparency initiatives that do not focus sufficiently on these key design and implementation elements are unlikely to influence quality improvement in a meaningful way.

Economic evaluations of hepatitis B vaccination for developing countries.

Economic evaluations, in particular cost-effectiveness, are important determinants for policy makers and stakeholders involved in decision-making for health interventions. Up until now, most evaluations of cost-effectiveness of hepatitis B vaccination have been performed in developed countries. Appropriate health-economic studies on this topic specifically targeted at the developing world are essential in order to justify adding another vaccine into the existing Expanded Program on Immunization in these countries.

Financial and health burdens of chronic conditions grow.

Almost 72 million working-age Americans--18-64 years old--live with chronic conditions, such as diabetes, asthma or depression. In 2007, almost three in 10, or more than 20 million people with chronic conditions, lived in families with problems paying medical bills--a significant increase from 21 percent in 2003, according to a new national study by the Center for Studying Health System Change (HSC). While problems paying medical bills are especially acute and still rising for uninsured people with chronic conditions (62%), medical-bill problems also are significant and growing among people with private insurance and higher incomes.

Word of mouth and physician referrals still drive health care provider choice.

Sponsors of health care price and quality transparency initiatives often identify all consumers as their target audiences, but the true audiences for these programs are much more limited. In 2007, only 11 percent of American adults looked for a new primary care physician, 28 percent needed a new specialist physician and 16 percent underwent a medical procedure at a new facility, according to a new national study by the Center for Studying Health System Change (HSC). Among consumers who found a new provider, few engaged in active shopping or considered price or quality information--especially when choosing specialists or facilities for medical procedures.

Striking jump in consumers seeking health care information.

In 2007, 56 percent of American adults--more than 122 million people--sought information about a personal health concern, up from 38 percent in 2001, according to a new national study by the Center for Studying Health System Change (HSC). Use of all information sources rose substantially, with the Internet leading the way: Internet information seeking doubled to 32 percent during the six-year period. Consumers across all categories of age, education, income, race/ethnicity and health status increased their information seeking significantly, but education level remained the key factor in explaining how likely people are to seek health information.