Suchergebnisse

Soft budget constraints (SBCs) undermine reforms to increase hospital service efficiency when hospital management can count on being bailed out by (subnational) governments in case of deficits. Using cost accounting data on publicly financed, non-profit hospitals in Austria from 2002 to 2015, we analyse the association between SBCs and hospital efficiency change in a setting with negligible risk of hospital closure in a two-stage study design based on bias-corrected non-radial input-oriented data envelopment analysis and ordinary least squares regression. We find that the European debt crisis altered the pattern of hospital efficiency development: after the economic crisis, hospitals in low-debt states had a 1.1 percentage point lower annual efficiency change compared to hospitals in high-debt states. No such systematic difference is found before the economic crisis. The results suggest that sudden exogenous shocks to public finances can increase the budgetary pressure on publicly financed institutions, thereby counteracting a pre-existing SBC.

Zu den wirtschaftlichen Auswirkungen des Ausbruchs von SARS-CoV-2 können zum jetzigen Zeitpunkt lediglich Schätzungen vorgenommen werden. Wir präsentieren im vorliegenden Policy Brief eine solche aktualisierte Schätzung für die österreichische Volkswirtschaft. War zunächst primär die Wirtschaft in China, so sind mittlerweile auch andere Länder, insbesondere Italien, direkt betroffen. In unseren Berechnungen nehmen wir einen Einbruch des chinesischen Wirtschaftswachstums auf Basis der verfügbaren Quellen für das Jahr 2020 um einen Prozentpunkt an. Auch für Italien wird eine Verminderung um einen Prozentpunkt angenommen, für Deutschland und Frankreich um 0,4 bzw. 0,3 Prozentpunkte, für den Rest der Welt um 0,2 Prozentpunkte. Weiters beziehen wir auch Rückgänge im Konsum betroffener Länder sowie die voraussichtlichen Rückgänge im Tourismus in Österreich in unsere Berechnungen mit ein. Wir kommen zu dem Ergebnis, dass der Wertschöpfungsverlust für Österreich im Jahr 2020 nach aktuellem Informationsstand in Summe etwa EUR 1,3 Mrd. betragen wird, vorwiegend verursacht durch Einbußen bei den Exporten. Der Verlust von Steuer- und Abgabeneinnahmen lässt sich mit rund EUR 480 Mio. beziffern. Aufgrund der Unsicherheit bzgl. der weiteren Verbreitung des Virus müssen solche Schätzungen jedoch immer wieder an neue Gegebenheiten angepasst werden. Noch nicht einbezogen werden konnten auch die Maßnahmen der österreichischen Bundesregierung, die heute, 10.03.2020, getroffen wurden. Daher sind die ausgewiesenen Effekte mit großer Wahrscheinlichkeit an der Untergrenze der möglichen Effekte angesiedelt.

In Europa leiden mittlerweile 50 Millionen Personen an mehr als einer chronischen Erkrankung. Gerade Personen mit drei oder mehr Erkrankungen können besonders von integrierter Versorgung profitieren. Entsprechende Programme wurden in einigen europäischen Ländern bereits entwickelt, oft als lokale Initiativen, die früher oder später auch bei der Politik Unterstützung fanden. Wir stellen Beispiele aus Österreich, Deutschland, den Niederlanden, Spanien und England vor.

Bedeutung und grundlegende Erfassung der Gesundheitswirtschaft Österreich -- Input-Output-Analyse -- Abgrenzung und Klassifizierung der Gesundheitswirtschaft -- Gesundheitsrelevante Güter und Dienstleistungen -- Wertschöpfungskomponenten der Gesundheitswirtschaft.

Wir präsentieren im vorliegenden Policy Brief zwei unterschiedliche Abschätzungen für die österreichische Volkswirtschaft in Abhängigkeit von der angenommenen Dauer der getroffenen politischen Maßnahmen. Im ersten Szenario werden die getroffenen gesundheitspolitischen Maßnahmen nach Ostern 2020 vollumfänglich aufgehoben, im zweiten Szenario gelten diese bis Ende April 2020. Gegenüber dem letzten Policy Brief vom 24.03. wurden in zahlreichen Staaten die Pandemiemaßnahmen teilweise erheblich verschärft, sodass nun die Auswirkungen auf den österreichischen Außenhandel deutlich ansteigt.

The purpose of the document is to provide recommendations on the formatting, organization, and content of reports describing in-silico modelling and results in the field of computational fluid dynamics (CFD) and finite element analysis (FEA) for medical device regulatory submissions. Besides that, those recommendations also aim at helping clear and transparent communication about computational studies in interdisciplinary teams and at improving reproducibility of studies. This document has been built on published recommendations of various organizations concerned with modelling and simulations and V&V activities for health products, such as the Committee on Credible Practice of Modelling & Simulation in Healthcare, V&V sub-Committees of the American Society of Mechanical Engineers (ASME), the Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH). In addition, even though they are not specific to human health and health products, recommendations from NASA have also been accounted for as they provide a high-quality framework for CM&S in potentially high-risk applications1,2. The structure of the document has been built on the FDA guidance for reporting computational modeling studies in medical device submissions3, mainly. ; SIMCor (In-Silico testing and validation of Cardiovascular IMplantable devices) has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 101017578.

Background: The Palliative Care Consult Service (PCCS) programme was among the first initiations in Hungary to provide palliative care for patients admitted to hospital. The PCCS team provides palliative care for mainly cancer patients and their family members and manages the patient pathway after being discharged from the hospital. The service started in 2014 with 300-400 patient visits per year. The aim of this study is to give a comprehensive overview of the PCCS programme guided by a conceptual framework designed by SELFIE ('Sustainable intEgrated chronic care modeLs for multi-morbidity: delivery, FInancing, and performancE'), a Horizon2020 funded EU project and to identify the facilitators and barriers to its wider implementation. Methods: PCCS has been selected by the SELFIE consortium for in-depth evaluation as one of the Hungarian integrated care models for persons with multi-morbidity. The qualitative analysis of the PCCS programme was based on available documents of the care provider and interviews with different stakeholders related to the programme. Results: The integrated, multidisciplinary and patient-centred approach was well-received among the patients, family members and clinical departments, as verified by the increasing number of requests for consultations. As a result of the patient pathway management across providers (e.g. from inpatient care to homecare) a higher level of coordination could be achieved in the continuity of care for seriously-ill patients. The regulatory framework has only partially been established, policies to integrate care across organizations and sectors and adequate financial mechanism to support the enhancement and sustainability of the PCCS are still missing. Conclusions: The service integration of palliative care could be implemented successfully in an academic hospital in Hungary. However, the continuation and enhancement of the programme will require further evidence on the performance of the integrated model of palliative care and a more systematic approach particularly regarding the evaluation, financing and implementation process.

The introduction of COVID-19 vaccination passes (VPs) by many countries coincided with the Delta variant fast becoming dominant across Europe. A thorough assessment of their impact on epidemic dynamics is still lacking. Here, we propose the VAPSIRS model that considers possibly lower restrictions for the VP holders than for the rest of the population, imperfect vaccination effectiveness against infection, rates of (re-)vaccination and waning immunity, fraction of never-vaccinated, and the increased transmissibility of the Delta variant. Some predicted epidemic scenarios for realistic parameter values yield new COVID-19 infection waves within two years, and high daily case numbers in the endemic state, even without introducing VPs and granting more freedom to their holders. Still, suitable adaptive policies can avoid unfavorable outcomes. While VP holders could initially be allowed more freedom, the lack of full vaccine effectiveness and increased transmissibility will require accelerated (re-)vaccination, wide-spread immunity surveillance, and/or minimal long-term common restrictions. ; peer-reviewed

BACKGROUND: The Palliative Care Consult Service (PCCS) programme was among the first initiations in Hungary to provide palliative care for patients admitted to hospital. The PCCS team provides palliative care for mainly cancer patients and their family members and manages the patient pathway after being discharged from the hospital. The service started in 2014 with 300–400 patient visits per year. The aim of this study is to give a comprehensive overview of the PCCS programme guided by a conceptual framework designed by SELFIE ("Sustainable intEgrated chronic care modeLs for multi-morbidity: delivery, FInancing, and performancE"), a Horizon2020 funded EU project and to identify the facilitators and barriers to its wider implementation. METHODS: PCCS has been selected by the SELFIE consortium for in-depth evaluation as one of the Hungarian integrated care models for persons with multi-morbidity. The qualitative analysis of the PCCS programme was based on available documents of the care provider and interviews with different stakeholders related to the programme. RESULTS: The integrated, multidisciplinary and patient-centred approach was well-received among the patients, family members and clinical departments, as verified by the increasing number of requests for consultations. As a result of the patient pathway management across providers (e.g. from inpatient care to homecare) a higher level of coordination could be achieved in the continuity of care for seriously-ill patients. The regulatory framework has only partially been established, policies to integrate care across organizations and sectors and adequate financial mechanism to support the enhancement and sustainability of the PCCS are still missing. CONCLUSIONS: The service integration of palliative care could be implemented successfully in an academic hospital in Hungary. However, the continuation and enhancement of the programme will require further evidence on the performance of the integrated model of palliative care and a more systematic approach ...

Background The rise of multi-morbidity constitutes a serious challenge in health and social care organisation that requires a shift from disease- towards person-centred integrated care. The aim of the current study was to develop a conceptual framework that can aid the development, implementation, description, and evaluation of integrated care programmes for multi-morbidity. Methods A scoping review and expert discussions were used to identify and structure concepts for integrated care for multi-morbidity. A search of scientific and grey literature was conducted. Discussion meetings were organised within the SELFIE research project with representatives of five stakeholder groups (5Ps): patients, partners, professionals, payers, and policy makers. Results In the scientific literature 11,641 publications were identified, 92 were included for data extraction. A draft framework was constructed that was adapted after discussion with SELFIE partners from 8 EU countries and 5P representatives. The core of the framework is the holistic understanding of the person with multi-morbidity in his or her environment. Around the core, concepts were grouped into adapted WHO components of health systems: service delivery, leadership & governance, workforce, financing, technologies & medical products, and information & research. Within each component micro, meso, and macro levels are distinguished. Conclusion The framework structures relevant concepts in integrated care for multi-morbidity and can be applied by different stakeholders to guide development, implementation, description, and evaluation. ; EC/H2020/634288/EU/Sustainable intEgrated care modeLs for multi-morbidity: delivery, FInancing and performancE/SELFIE

This document contains a conceptual framework for the classification and impact assessment of policy measures adopted in Europe since the beginning of the COVID-19 pandemic. We develop a framework that will guide all partners in PERISCOPE in their research endeavours, with the goal of evaluating which measures proved to be most effective since the beginning of the pandemic. PERISCOPE aims at collecting data on impacts, as well as on the policy measures and governance choices adopted by policymakers at all levels of government. We thereby adopt a taxonomy of impacts and a taxonomy of policy measures. In laying the foundations for our assessment, we adopt a theoretical framework that goes beyond the notion of economic growth and GDP, as well as beyond the cost-benefit analysis of policies, to embrace a framework based on three interrelated concepts: subjective well-being, resilience, and sustainability.

In the summer of 2021, European governments removed most NPIs after experiencing prolonged second and third waves of the COVID-19 pandemic. Most countries failed to achieve immunization rates high enough to avoid resurgence of the virus. Public health strategies for autumn and winter 2021 have ranged from countries aiming at low incidence by re-introducing NPIs to accepting high incidence levels. However, such high incidence strategies almost certainly lead to the very consequences that they seek to avoid: restrictions that harm people and economies. At high incidence, the important pandemic containment measure 'test-trace-isolate-support' becomes inefficient. At that point, the spread of SARS-CoV-2 and its numerous harmful consequences can likely only be controlled through restrictions. We argue that all European countries need to pursue a low incidence strategy in a coordinated manner. Such an endeavour can only be successful if it is built on open communication and trust. ; peer-reviewed

In the summer of 2021, European governments removed most NPIs after experiencing prolonged second and third waves of the COVID-19 pandemic. Most countries failed to achieve immunization rates high enough to avoid resurgence of the virus. Public health strategies for autumn and winter 2021 have ranged from countries aiming at low incidence by re-introducing NPIs to accepting high incidence levels. However, such high incidence strategies almost certainly lead to the very consequences that they seek to avoid: restrictions that harm people and economies. At high incidence, the important pandemic containment measure 'test-trace-isolate-support' becomes inefficient. At that point, the spread of SARS-CoV-2 and its numerous harmful consequences can likely only be controlled through restrictions. We argue that all European countries need to pursue a low incidence strategy in a coordinated manner. Such an endeavour can only be successful if it is built on open communication and trust.