UNASSIGNED: Intensive care unit (ICU) cost estimates are critical to achieving healthcare system efficiency and sustainability. We aimed to review the published literature describing ICU costs in Australia.
UNASSIGNED: A systematic review was conducted to identify studies that estimated the cost of ICU care in Australia. Studies conducted in specific patient cohorts or on specific treatments were excluded.
UNASSIGNED: Relevant studies were sourced from a previously published review (1970-2016), a systematic search of MEDLINE and EMBASE (2016-5 May 2023), and reference checking.
UNASSIGNED: A tool was developed to assess study quality and risk of bias (maximum score 57/57). Total and component costs were tabulated and indexed to 2022 Australian Dollars. Costing methodologies and study quality assessments were summarised.
UNASSIGNED: Six costing studies met the inclusion criteria. Study quality scores were low (15/41 to 35/47). Most studies were conducted only in tertiary metropolitan public ICUs; sample sizes ranged from 100 to 10,204 patients. One study used data collected within the past 10 years. Mean daily ICU costs ranged from $966 to $5381 and mean total ICU admission costs $4888 to $14,606. Three studies used a top-down costing approach, deriving cost estimates from budget reports. The other three studies used both bottom-up and top-down costing approaches. Bottom-up approaches collected individual patient resource use.
UNASSIGNED: Available ICU cost estimates are largely outdated and lack granular data. Future research is needed to estimate ICU costs that better reflect current practice and patient complexity and to determine the best methods for generating these estimates.

This EBCOG guidance reviews the current and future status of genomics within fetal and maternal medicine. This document addresses the clinical uses of genetic testing in both screening and diagnostic testing prenatally. The role of genomics within fetal and maternal medicine is described. The research and future implications of genetic testing as well as the educational, ethical and economic implications of genomics are discussed.

UNASSIGNED: People living with terminal illness are at higher risk of experiencing financial insecurity. The variance in definitions of financial insecurity, in addition to its impact on the well-being of this population has not yet been systematically analysed.
UNASSIGNED: To understand the definition, prevalence and impact of financial insecurity on the physical and psychological well-being of people living with terminal illness.
UNASSIGNED: A systematic review with a narrative synthesis (prospectively registered; CRD42023404516).
UNASSIGNED: Medline, Embase, CINAHL, AMED, PsycINFO, ProQuest Central and Cochrane Central Register of Controlled Trials, from inception to May 2023. Included studies had to measure or describe the impact of financial insecurity on an aspect of participants\' physical or mental well-being. Study quality was assessed using the Hawker tool.
UNASSIGNED: A total of 26 studies were included in the review. Financial insecurity was defined using many different definitions and terminology. Out of 4824 participants, 1126 (23%) reported experiencing high levels of financial insecurity. Nine studies reported 21 unique analyses across three domains of physical well-being. Out of those 21 analyses, 10 (48%) reported a negative result (an increase in financial insecurity was reported with a decrease in physical well-being). Twenty-one studies reported 51 unique analyses across nine domains of psychological well-being. Out of these analyses, 35 (69%) reported a negative result (an increase in financial insecurity was reported with a decrease in psychological well-being).
UNASSIGNED: People living with terminal illness require support with their financial situation to ensure their well-being is not negatively impacted by financial insecurity.

High levels of economic inflation can adversely affect societies and individuals in many ways. Although numerous studies explore the health implications of macroeconomic factors, systematic investigation of the inflation-health nexus has been scarce. We conducted a comprehensive scoping review mapping the literature on inflation and health. From 8923 screened records, 69 empirical studies were analysed. These studies explored a wide range of health-related risk factors (eg, diet, substance use, stress, and violence) and outcomes (eg, life expectancy, mortality, suicidal behaviour, and mental health) linked to inflation, across diverse contexts and timeframes. The findings suggest a predominantly negative effect of inflation on health, with specific socioeconomic groups facing greater risks. Our Review uncovers notable gaps in the literature, particularly in geographical coverage, methodological approaches, and specific health outcomes. Among global socioeconomic and geopolitical shifts, understanding and mitigating the health effects of inflation is of contemporary relevance and merits thorough academic attention.

BACKGROUND: Economic evaluations of public health interventions like sugar-sweetened beverage (SSB) taxes face difficulties similar to those previously identified in other public health areas. This stems from challenges in accurately attributing effects, capturing outcomes and costs beyond health, and integrating equity effects. This review examines how these challenges were addressed in economic evaluations of SSB taxes.
METHODS: A systematic review was conducted to identify economic evaluations of SSB taxes focused on addressing obesity in adults, published up to February 2021. The methodological challenges examined include measuring effects, valuing outcomes, assessing costs, and incorporating equity.
RESULTS: Fourteen economic evaluations of SSB taxes were identified. Across these evaluations, estimating SSB tax effects was uncertain due to a reliance on indirect evidence that was less robust than evidence from randomised controlled trials. Health outcomes, like quality-adjusted life years, along with a healthcare system perspective for costs, dominated the evaluations of SSB taxes, with a limited focus on broader non-health consequences. Equity analyses were common but employed significantly different approaches and exhibited varying degrees of quality.
CONCLUSIONS: Addressing the methodological challenges remains an issue for economic evaluations of public health interventions like SSB taxes, suggesting the need for increased attention on those issues in future studies. Dedicated methodological guidelines, in particular addressing the measurement of effect and incorporation of equity impacts, are warranted.

Independently run single microgrids (MGs) encounter difficulties with inadequate self-consumption of local renewable energy and frequent power exchange with the grid. Combining numerous MGs to form a multi-microgrid (MMG) is a viable approach to enhance smart distribution networks\' operational and financial performance. However, the correlation and coordination of intermittent power generation within each MG network pose many techno-economic challenges for energy sharing and trading. This review offers a comprehensive analysis of these challenges within the framework of MMG operations. It examines state-of-the-art methodologies for optimizing multi-energy dispatch and scrutinizes contemporary strategies within energy markets that contribute to the resilience of power systems. The discourse extends to the burgeoning role of blockchain technology in revolutionizing decentralized market frameworks and the intricacies of MMG coordination for reliable and cost-effective energy distribution. Overall, this study provides ample inspiration for theoretical and practical research to the new entrants and experts alike to develop new concepts for energy markets, scheduling and novel operating models for future resilient multi-energy networked systems/MMGs.

OBJECTIVE: Provide an overview of the methods used to estimate the cost of sports-related injury published to date, and to highlight considerations and opportunities for future research.
METHODS: Scoping review.
METHODS: Scopus, MEDLINE and CINHAL were searched from 1st January 2000 to 1st January 2023. Studies were screened by two independent reviewers and were eligible if they reported on a cost analysis or cost estimation of sports related injury.
RESULTS: Thirty-one studies fulfilled the inclusion criteria. Twenty-seven studies (87 %) were published since 2014. The type of costs included direct healthcare costs (12 studies), indirect costs (10 studies) and a combination of both (9 studies). Twenty-one studies (68 %) used a bottom-up costing approach to measure costs of sports injury and estimated direct costs from the service rates or fee schedules of health systems, hospital, insurance companies or national insurance boards. A top-down approach was used in seven studies (23 %) to estimate the indirect salary cost of time-loss injuries using data from publicly available resources. Ten studies were from the cost perspective of a sporting organisation (32 %). There was a lack of explicit reporting of the costing method used and the perspective of those bearing the costs.
CONCLUSIONS: Estimating the cost of sports injuries is an emerging area of research, with publications increasing in recent years. However, there remains a lack of methodological guidance to inform or appraise these studies. The expansion of established cost of illness checklists with sport injury explanations to guide future cost of sports injury studies is recommended.

While biosimilar medicines can contribute to the sustainability of healthcare systems, their utilization rate varies across European countries. This study aims to identify and systematize policy measures and instruments used in European countries to increase biosimilar market share.
A systematic review was conducted according to PRISMA 2020 recommendations. Medline-PubMed, Web of Science and ScienceDirect databases were searched using inclusion criteria that required full articles published in English between January 2006 and November 2023. Reviews, letters, reports, editorials and comments or opinion articles were excluded from this study.
Of the 1,137 articles, only 13 met the eligibility criteria for analysis, which covered a total of 28 European countries. Pricing regulation measures were found in 27 of these countries with tendering, price-linkage and internal reference price being the most used. Tendering was used by 27 countries to procure biosimilars in inpatient setting. Prescribing guidelines and recommendations were the widely used instrument. Some European countries adopted physician incentives, quotas, and prescription by international non-proprietary name.
Automatic substitution was not commonly recommended or applied. Interchangeability and switching will become increasingly relevant issues. It is important that the positive results from some countries serve as an example for the future of these medicines in the European market.
https://inplasy.com/, Identifier INPLASY2023120032.

This umbrella review amalgamates the outcomes of economic evaluations pertaining to bariatric surgeries, pharmacotherapy, and gastric balloon for adult obesity treatment. Six databases were systematically searched. The inclusion criteria were established following the Patient/population Intervention Comparison and Outcomes (PICO) statement. Fifteen reviews met all the inclusion criteria. Eight studies focused on surgical interventions, four on pharmacotherapy, and three on both interventions. No systematic review of the economic evaluation of gastric balloons was identified. The majority of reviews advocated bariatric surgery as a cost-effective approach; however, there was discordance in the interpretation of pharmacological cost-effectiveness. Most of the economic evaluations were conducted from the payer and the healthcare system perspectives. We propose that future economic evaluations assessing weight loss interventions in adults adopt a societal perspective and longer-term time horizons.

BACKGROUND: In the UK, unique and unforeseen factors, including COVID-19, Brexit, and Ukraine-Russia war, have resulted in an unprecedented cost of living crisis, creating a second health emergency. We present, one of the first rapid reviews with the aim of examining the impact of this current crisis, at a population level. We reviewed published literature, as well as grey literature, examining a broad range of physical and mental impacts on health in the short, mid, and long term, identifying those most at risk, impacts on system partners, including emergency services and the third sector, as well as mitigation strategies.
METHODS: We conducted a rapid review by searching PubMed, Embase, MEDLINE, and HMIC (2020 to 2023). We searched for grey literature on Google and hand-searched the reports of relevant public health organisations. We included interventional and observational studies that reported outcomes of interventions aimed at mitigating against the impacts of cost of living at a population level.
RESULTS: We found that the strongest evidence was for the impact of cold and mouldy homes on respiratory-related infections and respiratory conditions. Those at an increased risk were young children (0-4 years), the elderly (aged 75 and over), as well as those already vulnerable, including those with long-term multimorbidity. Further short-term impacts include an increased risk of physical pain including musculoskeletal and chest pain, and increased risk of enteric infections and malnutrition. In the mid-term, we could see increases in hypertension, transient ischaemic attacks, and myocardial infarctions, and respiratory illnesses. In the long term we could see an increase in mortality and morbidity rates from respiratory and cardiovascular disease, as well as increase rates of suicide and self-harm and infectious disease outcomes. Changes in behaviour are likely particularly around changes in food buying patterns and the ability to heat a home. System partners are also impacted, with voluntary sectors seeing fewer volunteers, an increase in petty crime and theft, alternative heating appliances causing fires, and an increase in burns and burn-related admissions. To mitigate against these impacts, support should be provided, to the most vulnerable, to help increase disposable income, reduce energy bills, and encourage home improvements linked with energy efficiency. Stronger links to bridge voluntary, community, charity and faith groups are needed to help provide additional aid and support.
CONCLUSIONS: Although the CoL crisis affects the entire population, the impacts are exacerbated in those that are most vulnerable, particularly young children, single parents, multigenerational families. More can be done at a community and societal level to support the most vulnerable, and those living with long-term multimorbidity. This review consolidates the current evidence on the impacts of the cost of living crisis and may enable decision makers to target limited resources more effectively.