Search

Background The value equation of value-based healthcare (VBHC) as a single figure remains ambiguous, closer to a theoretical framework than a useful tool for decision making. The challenge lies in the way patient-centred outcomes (PCOs) might be combined to produce a single value of the numerator. This paper aims to estimate the weights of PCOs to provide a single figure in the numerator, which ultimately will allow a VBHC figure to be reached. Methods A cohort of patients diagnosed with breast cancer (n  = 690) with a 6-month follow-up recruited in 2019–20 across six European hospitals was used. Patient-reported outcomes (PROs), clinical-related outcomes (CROs), and clinical and socio-demographic variables were collected. The numerator was defined as a composite indicator of the PCOs (CI-PCO), and regression analysis was applied to estimate their weights and consequently arrive at a single figure. Results Pain showed as the highest weight followed by physical functioning , emotional functioning , and ability to work , and then by a symptom, either arm or breast. PCOs weights were robust to sensitivity analysis. The CI-PCO value was found to be more informative than the health-related quality of life (HRQoL) value. Conclusions To the best of our knowledge, this is the first research to combine the PCOs proposed by ICHOM to provide a single figure in the numerator of the value equation. This figure shows a step forward in VBHC to reach a holistic benchmarking across healthcare centres and a value-based payment. This research might also be applied in other medical conditions as a methodological pathway. [ABSTRACT FROM AUTHOR]

Research background: Internal business factors are vital to how a company achieves its goals. The present study of internal drivers of pharmaceutical company performance is very insightful, as it has the potential to boost further competitiveness, it may allow health authority personnel to have guidelines to make strategic decisions, as well as inspire investor confidence, ensure regulatory compliance and performance benchmarking, and support talent acquisition and retention. In addition, it can identify the important internal factors that need to receive more priority. Purpose of the article: The European pharmaceutical industry is currently facing multiple challenges. This paper aims to map the relative relationships among the internal factors that influence the business performance of pharmaceutical companies in Europe by using the DEMATEL approach. Method: There are two phases of the present study, an extensive literature review and the use of the decision-making trial and evaluation laboratory (DEMATEL) technique. To identify the key internal drivers and their cause-and-effect relationship with pharmaceutical company performance in Europe, data from experts were obtained using the predesigned DEMATEL questionnaire. Findings & value added: The extensive literature review from the Web of Science and Scopus databases found that seven internal factors are very demanding in the case of European pharmaceutical business performance. The main elements that have the highest impact on pharmaceutical business performance in Europe are human resources competencies, the information system, technological competitiveness, and the patent system. However, financial profitability, research and development competencies, alliances with other companies, and supply chain management are the factors that are affected more by other factors. The study is the first attempt to identify the internal business performance of the pharmaceutical sector in Europe by working with pragmatic and perceptive decisions from pharmaceutical stakeholders in Europe. [ABSTRACT FROM AUTHOR]

Background Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems. Methods In the VOICE community—a European healthcare centre cluster intending to address VBHC from theory to practice—information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics. Results Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers. Conclusions To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions. [ABSTRACT FROM AUTHOR]

This paper examines the principles of benchmarking in healthcare and how benchmarking can contribute to practice improvement and improved health outcomes for patients. It uses the Deepening our Understanding of Quality in Australia (DUQuA) study published in this Supplement and DUQuA's predecessor in Europe, the Deepening our Understanding of Quality improvement in Europe (DUQuE) study, as models. Benchmarking is where the performances of institutions or individuals are compared using agreed indicators or standards. The rationale for benchmarking is that institutions will respond positively to being identified as a low outlier or desire to be or stay as a high performer, or both, and patients will be empowered to make choices to seek care at institutions that are high performers. Benchmarking often begins with a conceptual framework that is based on a logic model. Such a framework can drive the selection of indicators to measure performance, rather than their selection being based on what is easy to measure. A Donabedian range of indicators can be chosen, including structure, process and outcomes, created around multiple domains or specialties. Indicators based on continuous variables allow organizations to understand where their performance is within a population, and their interdependencies and associations can be understood. Benchmarking should optimally target providers, in order to drive them towards improvement. The DUQuA and DUQuE studies both incorporated some of these principles into their design, thereby creating a model of how to incorporate robust benchmarking into large-scale health services research. [ABSTRACT FROM AUTHOR]

The Integrated Pollution Prevention and Control Directive is one of the most relevant environmental regulations in Europe. It affects approximately 50,000 installations belonging to the most polluting industrial sectors. Several scholars have studied the effects of the Directive at the firm level, investigating its effects on environmental performance and competitiveness. Despite this, few studies have focused on experiences related to the transference of the Directive's principles to countries beyond the borders of the European Union. This paper describes a case study that assessed the transposition of the European Union Integrated Pollution Prevention and Control scheme to Egypt, Morocco and Tunisia by means of a method designed for this purpose, which provides the guidelines for analysing and benchmarking policy and legislative frameworks in these Mediterranean Partner Countries by supplying information on the European integrated system for Pollution Prevention and Control. The paper outlines the methodological approach adopted in the two-year international 7th Framework Programme project, Boosting Best Available Techniques in the Mediterranean Partner Countries , pointing out various policy scenarios suitable for implementing the key principles of this scheme in Southern Mediterranean countries. The evaluation of these scenarios establishes the steps to take in order to gradually approach the adoption of the most relevant aspects of the European Union's Integrated Pollution Prevention and Control system and the adoption of the Best Available Techniques in the Mediterranean Partner Countries. [ABSTRACT FROM AUTHOR]

Purpose – Benchmarking, a method for quality assurance has not been very commonly used in higher education with regard to e-learning. Today, e-learning is an integral part of higher education, and so should also be an integral part of quality assurance systems. However, quality indicators, benchmarks and critical success factors on e-learning have not been taken seriously into consideration, nor incorporated in ordinary national or international quality assurance systems. The purpose of this paper is to describe how The European Association of Distance Teaching Universities (EADTU) initiated and developed E-xcellence+, a quality benchmarking assessment method and tool. Design/methodology/approach – This paper, which is part of a larger research project on European benchmarking, focuses on experiences from universities taking part in the E-xcellence+ valorization process. Findings – The results showed that benchmarking is a powerful tool to support improved governance and management in higher education, in alignment with national and international quality agencies. The tool can serve for quality improvements in teaching and learning. Additionally, the results showed critical success issues for e-learning. Originality/value – This original paper reports on a Europe-wide study examining benchmarking of e-learning and presents suggestions for tackling quality issues. [ABSTRACT FROM AUTHOR]

There are several measures that summarize the mortality experience of a population. Of these measures, life expectancies are generally preferred based on their simpler interpretation and direct age standardization, which makes them directly comparable between different populations. However, traditional life expectancy estimations are highly inaccurate for smaller populations and consequently are seldom used in small-area applications. In this paper, the authors compare the relative performance of traditional life expectancy estimation with a Bayesian random-effects approach that uses correlations (i.e., borrows strength) between different age groups, geographic areas, and sexes to improve the small-area life expectancy estimations. In the presented Monte Carlo simulations, the Bayesian random-effects approach outperforms the traditional approach in terms of bias, root mean square error, and coverage of the 95% confidence intervals. Moreover, the Bayesian random-effects approach is found to be usable for populations as small as 2,000 person-years at risk, which is considerably smaller than the minimum of 5,000 person-years at risk recommended for the traditional approach. As such, the proposed Bayesian random-effects approach is well-suited for estimation of life expectancies in small areas. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this paper is to provide estimated Armington elasticities for selected European countries and for three forest biomass commodities of main interest in many energy models: roundwood, chips & particles and wood residues. The Armington elasticity is based on the assumption that a specific forest biomass commodity is differentiated by its origin. The statistically significant estimated Armington elasticities range from 0.52 for roundwood in Hungary to approximately 4.53 for roundwood in Estonia. On average, the statistically significant Armington elasticity for chips & particles over all countries is 1.7 and for wood residues and roundwood 1.3 and 1.5, respectively. These elasticities can provide benchmark values for simulation models trying to assess trade patterns of forest biomass commodities and energy policy effects for European countries or for the EU as a whole. [ABSTRACT FROM AUTHOR]

This paper analyzes the effects of allocating CO2 permits to new power plants free of charge within a tradable permit system. We demonstrate that these free allocations distort investments. Furthermore, we distinguish the effects of a uniform benchmark from a fuel specific benchmark, as both are common elements in EU member states’ national allocation plans. An empirical model for the European market is used to quantify the effects in a realistic framework. [ABSTRACT FROM AUTHOR]

Objective: To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions. Design: Systematic review. Data Sources: Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases. Review Methods: We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria. Results: Of 3,190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post-exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re-infection of treated patients. Conclusion: One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area. [ABSTRACT FROM AUTHOR]

This paper presents reference frameworks which order effective and feasible policies and interventions for the health management of measles, breast cancer and diabetes (type II). These reference frameworks can be used to rapidly appraise regional health policy documents and existing health management systems. Furthermore, the reference frameworks can serve health policy makers for the planning of health management measures. [ABSTRACT FROM AUTHOR]