Effects of COVID-19 nursing home restrictions on people with dementia involved in a Supportive Care programme.

Background: Supportive Care is a person-centred approach encompassing non-pharmacological interventions targeted towards persons with dementia to contain the effects of their behavioural disorders, improving their quality of life.

Aims: To investigate the effects of lockdown restrictions during the first wave of COVID-19 pandemic on behavioural symptoms of patients involved in a Supportive Care programme in an Italian nursing home.

Methods: Analysis is based on Neuropsychiatric Inventory (NPI) scores and related symptoms data collected before (October/November 2019) and after (July 2020) the introduction of COVID-19 restrictions on a non-random sample of 75 patients living in two units of the facility: 38 involved in a Supportive Care programme and 37 receiving standard care (Control).

The Cost of Atrial Fibrillation: A Systematic Review.

Objectives: Atrial fibrillation (AF) is the most common cardiac arrhythmia, with an increasing incidence and prevalence because of progressively aging populations. Costs related to AF are both direct and indirect. This systematic review aims to identify the main cost drivers of the illness, assess the potential economic impact resulting from changes in care strategies, and propose interventions where they are most needed.

The value of supportive care: A systematic review of cost-effectiveness of non-pharmacological interventions for dementia.

Background: Almost 44 million people are currently living with dementia worldwide. This number is set to increase threefold by 2050, posing a serious threat to the sustainability of healthcare systems. Overuse of antipsychotic drugs for the management of the symptoms of dementia carries negative consequences for patients while also increasing the health expenditures for society.

Consensus among clinicians on referrals' priority and use of digital decision-making support systems.

The growing demand for referrals is a main policy concern in health systems. One approach involves the development of demand management tools in the form of clinical prioritization to regulate patient referrals from primary care to specialist care. For clinical prioritization to be effective, it is critical that general practitioners (GPs) assess patient priority in the same way as specialists.

Potential Cost Savings for the Healthcare System by Physical Activity in Different Chronic Diseases: A Pilot Study in the Veneto Region of Italy.

Background: Sedentary behaviour (SB) and physical inactivity (PI) are associated with an increased risk of chronic diseases and a significant economic burden. This pilot study aims to estimate the possible cost savings for the Veneto Regional Health Service (Italy) due to a population-based physical activity (PA) intervention.

Methods: The PA-related cost-savings were assessed for four chronic diseases in the whole and sedentary populations of the Veneto region.

Health and healthcare variables associated with Italy's excess mortality during the first wave of the COVID-19 pandemic: An ecological study.

Background: Healthcare factors have strongly influenced the propagation of COVID-19. This study aims to examine whether excess mortality during the first phase of the COVID-19 outbreak in Italy was associated with health, healthcare, demographic, and socioeconomic, provincial-level indicators.

Methods: This ecological study concerns the raw number of deaths reported from February 1 to April 30, 2020 and the mean number of deaths occurred during the same months from 2015 to 2019, per province.

Opening Schools and Trends in SARS-CoV-2 Transmission in European Countries.

Benefits of school attendance have been debated against SARS-CoV-2 contagion risks. This study examined the trends of contagion before and after schools reopened across 26 countries in the European Union. We compared the average values of estimated before and after school reopening, identifying any significant increase with a one-sample -test.

Demographic and socio-economic factors, and healthcare resource indicators associated with the rapid spread of COVID-19 in Northern Italy: An ecological study.

Background: COVID-19 rapidly escalated into a pandemic, threatening 213 countries, areas, and territories the world over. We aimed to identify potential province-level socioeconomic determinants of the virus's dissemination, and explain between-province differences in the speed of its spread, based on data from 36 provinces of Northern Italy.

Methods: This is an ecological study.

Estimated direct costs of non-small cell lung cancer by stage at diagnosis and disease management phase: A whole-disease model.

Background: Non-small cell lung cancer (NSCLC) is the first cause of cancer-related death among men and the second among women worldwide. It also poses an economic threat to the sustainability of healthcare services. This study estimated the direct costs of care for patients with NSCLC by stage at diagnosis, and management phase of pathway recommended in local and international guidelines.

Retirement and Healthy Eating.

This paper investigates the effect of retirement on healthy eating using data drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE). We estimate the causal effect of retiring from work on daily fruit or vegetable consumption by exploiting policy changes in eligibility rules for early and statutory retirement. Our results show that changes in eating behaviour upon retirement are gender-specific: retirement induces men to reduce healthy eating; it has no effect on women.

Cost-effectiveness of a melanoma screening programme using whole disease modelling.

Objective: To assess the potential impact of a melanoma screening programme, compared with usual care, on direct costs and life expectancy in the era of targeted drugs and cancer immunotherapy.

Methods: Using a Whole Disease Model approach, a Markov simulation model with a time horizon of 25 years was devised to analyse the cost-effectiveness of a one-time, general practitioner-based melanoma screening strategy in the population aged over 20, compared with no screening. The study considered the most up-to-date drug therapy and was conducted from the perspective of the Veneto regional healthcare system within the Italian National Health Service.

Estimation of direct costs of melanoma in the Veneto Region: a budget assessment and cost-consequence analysis.

Background: While many evidence-based pathways have been introduced to drive quality improvements in cancer care, most of these do not include evidence about their affordability. The main aim of this study was to provide an estimation of the overall budget to cover all the needs of melanoma patients in Veneto Region, managed according to the clinical pathway defined by the Rete Oncologica Veneta. A second objective is to conduct a cost-consequence analysis, comparing two different treatments.

Estimation of Direct Melanoma-related Costs by Disease Stage and by Phase of Diagnosis and Treatment According to Clinical Guidelines.

Cutaneous melanoma is a major concern in terms of healthcare systems and economics. The aim of this study was to estimate the direct costs of melanoma by disease stage, phase of diagnosis, and treatment according to the pre-set clinical guidelines drafted by the AIOM (Italian Medical Oncological Association). Based on the AIOM guidelines for malignant cutaneous melanoma, a highly detailed decision-making model was developed describing the patient's pathway from diagnosis through the subsequent phases of disease staging, surgical and medical treatment, and follow-up.

Healthier lifestyles after retirement in Europe? Evidence from SHARE.

This paper investigates changes in health behaviours upon retirement, using data drawn from the Survey of Health Ageing and Retirement in Europe. By exploiting changes in eligibility rules for early and statutory retirement, we identify the causal effect of retiring from work on smoking, alcohol drinking, engagement in physical activity and visits to the general practitioner or specialist. We provide evidence about individual heterogeneous effects related to gender, education, net wealth, early-life conditions and job characteristics.

Cancer, obesity, and legitimation of suggested lifestyles: a libertarian paternalism approach.

We know that around 30% of all cancers are preventable. We also know that there is clear evidence of the causal relations between obesity and cancer. This means that there could be lifestyles that could prevent obesity and, thus, cancer.

Waiting time prioritisation for specialist services in Italy: the homogeneous waiting time groups approach.

The demand for referrals and diagnostic procedures in Italy has been rising constantly in recent years, making access to diagnostic services increasingly difficult with significant waiting times. A number of Health Authorities (known as Local Health Units) have responded by implementing formalised waiting-time prioritisation tools, giving rise to what are known as Homogeneous Waiting Groups (HWGs). The study describes the implementation of the HWG approach in Italy.

Libertarian paternalism and health care policy: a deliberative proposal.

Cass Sunstein and Richard Thaler have been arguing for what they named libertarian paternalism (henceforth LP). Their proposal generated extensive debate as to how and whether LP might lead down a full-blown paternalistic slippery slope. LP has the indubitable merit of having hardwired the best of the empirical psychological and sociological evidence into public and private policy making.

Voluntary private health insurance among the over 50s in Europe.

Using data from Survey of Health, Ageing and Retirement in Europe (SHARE), we investigate the determinants of voluntary private health insurance (VPHI) among the over 50s in 11 European countries and their effects on healthcare spending. First, we find that the main determinants of VPHI are different in each country, reflecting differences in the underlying healthcare systems, but in most countries, education levels and cognitive abilities have a strong positive effect on holding a VPHI policy. We also analyse the effect of holding a voluntary additional health insurance policy on out-of-pocket (OOP) healthcare spending.

Taking decisions on expenditure for high-cost drugs at the regional level: a model for evaluating the overall impact of Trastuzumab in the Veneto Region of Italy.

Introduction: Cost-effectiveness analysis provides a ratio that indicates the value created per unit of money by a given therapy but says nothing about the total expected costs or net health and social impact of this therapy in a particular population of interest.

Objective: The main objective of this study is to define a methodology to calculate the effects of interventions from a local perspective. This will help determine parameters that provide information about resource planning and management to local decision makers.