Objectives:The aim of the Consensus on Health Economic Criteria (CHEC) project is to develop a criteria list for assessment of the methodological quality of economic evaluations in systematic reviews. The criteria list resulting from this CHEC project should be regarded as a minimum standard.Methods:The criteria list has been developed using a Delphi method. Three Delphi rounds were needed to reach consensus. Twenty-three international experts participated in the Delphi panel.Results:The Delphi panel achieved consensus over a generic core set of items for the quality assessment of economic evaluations. Each item of the CHEC-list was formulated as a question that can be answered by yes or no. To standardize the interpretation of the list and facilitate its use, the project team also provided an operationalization of the criteria list items.Conclusions:There was consensus among a group of international experts regarding a core set of items that can be used to assess the quality of economic evaluations in systematic reviews. Using this checklist will make future systematic reviews of economic evaluations more transparent, informative, and comparable. Consequently, researchers and policy-makers might use these systematic reviews more easily. The CHEC-list can be downloaded freely fromhttp://www.beoz.unimaas.nl/chec/.
Purpose-With the rapid international spread of interventions, there is a need to understand the economic implications of these changes and to interpret these economic implications on the international level. The purpose of this study is to systematically compare total health care expenditures on stroke, the costs of stroke per capita, and the distribution of stroke costs within different countries, with special attention to the allocation of resources among different health care facilities. Methods-Studies for this literature review were selected by conducting a literature search from January 1966 to July 2003. Key methodological, country-related, and monetary issues of the selected stroke cost studies were evaluated using a checklist. Results-After selection, 25 stroke cost studies were reviewed. Although the selected cost of illness studies used different methodologies, the estimated expenditures for stroke are approximately similar. The proportion of national health care in the 8 countries studied is unequivocal for the more recent studies, ie, Ϸ3% of total health care expenditures. A shift is observed from the inpatient treatment costs (in the first year) toward outpatient treatment and long-term care costs (in the latter years). Furthermore, it is remarkable that in the studies, little attention is paid to costs borne by the patient and family or to the costs of comorbidity. Key Words: cost and cost analysis Ⅲ internationality Ⅲ health resources S troke is a major disease in both medical and economic terms. The prevailing emphasis on cost containment and managed care has led to increased interest in the economic aspects of stroke. A total overview of the economic aspects of stroke is given in cost of illness (COI) studies. Results of these COI studies can be used for resource allocation purposes. Over the years, there has been a marked increase in the number of these publications on the economic aspects of stroke. [1][2][3] With the rapid international spread of new diagnostic interventions and care arrangements for stroke, there is a need to understand the economic implications of these changes and to interpret these economic implications on the international level. This article aims to systematically compare how the costs of stroke in different countries are affected by cross-national differences by using a quality checklist. No complete systematic international review of the quality of COI studies in stroke has been undertaken in the literature, although efforts 2-4 have been made to illustrate the economic implication of stroke. The following study is a further elaboration of these earlier reviews. The purpose of this study is to present an international comparison of the total health care expenditures on stroke, the costs of stroke per capita, and the distribution of stroke costs within different countries, with special attention to the allocation of resources among different health care facilities.
Conclusions-This
Cognitive therapy had enduring effects that lasted beyond the end of treatment. This potential prophylactic effect of cognitive therapy is promising; it might be a new strategy to combat the global epidemic of obesity.
The two strategies, both singly and combined, are cost-effective interventions to reduce antibiotic prescribing for LRTI, at no, or low willingness-to-pay. Taking GP preferences into account will optimize investment in strategies to reduce antibiotic prescribing for LRTI.
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