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Etre malade... est aussi parfois un danger pour la santé financière du patient.Les soins de santé sont bien développés en Belgique et sont en principe accessibles à tout le monde. Mais dans certains cas, cette accessibilité peut être problématique. Les frais médicaux peuvent quelquefois être très élevés. Une situation d'autant plus poignante pour quiconque doit vivre avec un faible revenu ou avec une indemnité d'incapacité de travail ou d'invalidité. Dans un premier chapitre, quatre exemples illustrent la façon dont certaines dépenses de santé peuvent grimper, et comment elles peuvent briser l'équilibre financier d'un ménage.La suite de ce dossier est consacrée à un examen des principales mesures qui ont exercé un impact sur les frais à charge du patient au cours des quinze dernières années et à l'analyse des parts publique et privée dans les dépenses et le financement des soins.
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1. This study presents the results of a joint analysis of patterns of consumption, expenditure, and unit expenditure for a core set of drugs aimed at preventing and treating cardiovascular disease. The current study examines the relationships among three pharmaceutical variables (expenditure, volume of drug use, and unit expenditure) classified according to eight therapeutic categories which are specific for the prevention and treatment of cardiovascular disease and stroke. It covers an 11-year time period, and specifies relevant country-specific structural features in a sample of 12 OECD countries.2. The data presented in this report show how the three descriptive pharmaceutical variables vary across these countries. The study also contains a preliminary exploration of factors associated with variation in these variables across countries and through time. Findings for each of the eight cardiovascular disease and stroke drug therapeutic categories investigated in this study are discussed in relationship to volume of use, expenditure, and unit expenditure to provide a basis for discussing the value ofpharmaceuticals. In addition, findings are presented for subcategories of cardiovascular drugs to better understand how more specific drug classifications affect the results.3. The main finding is that cross-country variations in the use of less expensive effective drugs such as diuretics and betablockers seem to be related to "needs", as measured by the Ischaemic Heart Disease burden of disease. The pattern for newer, more expensive agents is more difficult to interpret. While expenditure is higher, it is not clear whether this is due to changing patterns of use, a perception of increased need, or a willingness to pay. Much of the increase appears to be in the serum lipid group whichhas experienced rapid growth in utilisation recently. This may be due, at least in part, to increasing evidence that lowering serum lipid levels has benefits for segments of the population not previously treated.4. Overall, the results show that use of newer pharmaceutical agents (calcium channel blockers, ACE inhibitors, and serum lipid reducers) is higher among those countries that spend a greater percentage of GDP on health. A range of factors could have contributed to these trends, including clinical judgement that the new compounds are more effective and marketing efforts which concentrate more on new in-patent products.5. Beyond their descriptive value, the results invite a retrospective examination of the effect of different policies on pharmaceutical expenditure. Although policy and expenditure decisions on pharmaceuticals are ultimately qualitative judgements, they can, and should, be informed by better data. In particular, this study contributes to a better understanding of the underlying trends driving the increase in pharmaceutical expenditure.
W 74 Medical economics. Health care costs (General) --- Health Expenditures --- Cardiovascular diseases --- Stroke --- Comparative Study --- Drug Utilization
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Technological innovation is deeply woven into the fabric of American culture, and is no less a basic feature of American health care. Medical technology saves lives and relieves suffering, and is enormously popular with the public, profitable for doctors, and a source of great wealth for industry. Yet its costs are rising at a dangerously unsustainable rate. The control of technology costs poses a terrible ethical and policy dilemma. How can we deny people what they may need to live and flourish? Yet is it not also harmful to let rising costs strangle our health care system, eventually harming everyone?In Taming the Beloved Beast, esteemed medical ethicist Daniel Callahan confronts this dilemma head-on. He argues that we can't escape it by organizational changes alone. Nothing less than a fundamental transformation of our thinking about health care is needed to achieve lasting and economically sustainable reform. The technology bubble, he contends, is beginning to burst.Callahan weighs the ethical arguments for and against limiting the use of medical technologies, and he argues that reining in health care costs requires us to change entrenched values about progress and technological innovation. Taming the Beloved Beast shows that the cost crisis is as great as that of the uninsured. Only a government-regulated universal health care system can offer the hope of managing technology and making it affordable for all.
Medical care, Cost of --United States. --- Medical technology --Economic aspects --United States. --- Medical care, Cost of --- Medical technology --- Health Care Costs --- Biomedical Technology --- United States --- Economics --- Insurance --- Delivery of Health Care --- Technology --- North America --- Costs and Cost Analysis --- Financing, Organized --- Social Sciences --- Americas --- Health Care Quality, Access, and Evaluation --- Anthropology, Education, Sociology and Social Phenomena --- Technology, Industry, and Agriculture --- Geographic Locations --- Health Care Economics and Organizations --- Technology, Industry, Agriculture --- Health Care --- Geographicals --- Medical Economics --- Public Health --- Health & Biological Sciences --- Economic aspects --- Health care technology --- Health technology --- Biomedical Technologies --- Technology, Biomedical --- Technology, Health --- Technology, Health Care --- Health Care Technology --- Health Technology --- Biomedical Engineering --- Medical Informatics --- Costs, Medical Care --- Health Costs --- Healthcare Costs --- Medical Care Costs --- Treatment Costs --- Cost, Health --- Cost, Health Care --- Cost, Healthcare --- Cost, Medical Care --- Cost, Treatment --- Costs, Health --- Costs, Health Care --- Costs, Healthcare --- Costs, Treatment --- Health Care Cost --- Health Cost --- Healthcare Cost --- Medical Care Cost --- Treatment Cost --- Health Expenditures --- Indemnity --- Insurance Premiums --- Insurance Premium --- Premium, Insurance --- Premiums, Insurance --- economics --- E-books --- Cost of medical care --- Health care costs --- Health care expenditures --- Medical care --- Medical costs --- Medical expenses --- Medical service, Cost of --- Medicine --- Medical economics --- Medical savings accounts --- Assurance (Insurance) --- Coverage, Insurance --- Indemnity insurance --- Insurance coverage --- Insurance industry --- Insurance protection --- Mutual insurance --- Underwriting --- Finance --- Costs --- Ethics --- Technology Assessment, Biomedical --- W 82 Biomedical technology (General)
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