Health Economics articles list

Over the recent years, cloud computing has emerged as a powerful means for providing automated healthcare facilities. Cloud helps in massive sharing of information between doctors and hospitals using Electronic Health Records. This major transformation has changed the way doctors and hospitals deliver quality and effective service to their patients. Using Cloud storage inhealthcare services has revolution- ized health industry, making it more efficient. Apart from the primary driving factors of cloud like flexibil- ity in cost of maintenance, infrastructure and development, on-demand scalability of storage centers and pay on use schemes are proven to be most effective. More and more digitalization of data causes breech of security and privacy.Because healthcare information is a highly sensitive data which cannot be com- promised,the future of healthcare relies in providing secure and trustworthy sharing of data by safe- guarding privacy and trust. This paper gives an extensive review of the existing security mechanisms for Cloud based healthcare systems.

Dr.C.Priya

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Background In 2016, the Tanzanian government shifted the vaccine supply chain responsibilities from the Medical Store Department (MSD) to the Expanded Program on Immunization (EPI) to reduce costs. However, cost estimates that informed the decision were based on invoice value of vaccines and related supplies, rather than a proper economic evaluation study. Therefore, this study aims to compare the actual storage and distribution costs of vaccines and related supplies between MSD to EPI. Method Micro-costing approach was used to estimate resource use at MSD and EPI for the year 2018. Data were collected through a review of documents, warehouse databases, and interviews with key staff at MSD and EPI. We included both capital and recurrent costs. Microsoft Excel® was used for analysis with input data from the UNICEF forecasting tool, WHOs vaccine volume and capacity estimation tool, diesel generator calculator, and supply chain service fee estimator version 1.02. Results The total vaccine storage and distribution costs were estimated to be USD 1,996,286 at MSD and USD 543,648 at EPI. Distribution and program management costs represented 41% (USD 819,288) and 38% (USD 762,968) of the total costs at MSD, while storage and distribution costs represented 43% (USD 234,423) and 34% (USD 184,620) of the total costs at EPI, respectively. The cost drivers at MSD were fuel and transport (21%), receiving and dispatch (19%) and, program management personnel cost (14%), while at EPI were storage space (20%), program management personnel cost (18%) and fuel and transport (15%). Conclusion The storage and distribution of vaccines in Tanzania via the EPI reduced the vaccine supply chain cost to about 27% of the program costs at MSD.

DR. OMARY SWALLEHE

Background Mauritius embraces principles of a welfare state with free health care at point of use in any public facilities. However, the health financing landscape changed in 2007 when Private Health Expenditure (PvtHE) surpassed General Government Health Expenditure. PvtHE is predominately out of pocket (OOP) with only 3.4% related to premiums for private insurance. In 2014, Household OOP Expenditure on health accounted for 52.8% of total health expenditure. OOP is known to be regressive and to impact negatively on households’ living standards. Objectives This paper aims to examine trends in OOP in Mauritius, to assess its impacts through an analysis of key indicators of financial protection, namely catastrophic health expenditure (CHE) and impoverishment due to OOP health expenditure. It also aims to predict core determinants of CHEs. Methods Household Budget Surveys (HBS) of 2001/2002, 2006/2007 and 2012 were the primary source data. CHE and impoverishment were used to assess financial hardships resulting from OOP health payments. The incidence of CHE was estimated at three threshold levels (10,25 and 40%), using the budget share and the capacity to pay approaches. Impoverishment due to OOP was measured by changes in the incidence of poverty and intensity of poverty using the US$ 3.1 international poverty line. Logistic regression analysis was used to identify determinants of CHE. Findings Household CHE increased from 5.78% in 2001/02 to 8.85% in 2012 and 0.61% in 2001/02 to 1.25% in 2012, for 10 and 40% thresholds, respectively. The incidence of CHE was significantly higher in urban areas compared to rural areas. The highest levels of CHEs were among households’ heads, who are retired rising from 1.62% in 2001/02 to 3.71% in 2012, followed by households’ head who are widowed from 2.29% in 2001/02 to 2.63% in 2012 and homemakers from 2.12% in 2001/02 to 2.57% in 2012 at the 40% threshold. The share of households pushed below the poverty line due to OOP dropped from 0.4% in 2001/02 to 0.2% in 2006/07 before rising to 0.34% in 2012. In 2012, poverty gap occurred only among households under poorest quintile 1 (0.24%) and quintile 2 (0.03%). Overall poverty gap dropped from 0.08% in 2001/02 to 0.05% in 2012. Logistic regression analysis revealed that the odds ratio of facing CHE were significant only among households with heads being retired and with a presence of an elderly member in the household. Conclusion Despite the rise in incidence of CHE between 2001 and 2012 the impact of OOP on the level of impoverishment and poverty gap has not been significant.

Ajoy Nundoochan

Background General Government Health Expenditure (GGHE) in Mauritius accounted for only 10% of General Government Expenditure for the fiscal year 2018. This is less than the pledge taken under the Abuja 2001 Declaration to allocate at least 15% of national budget to the health sector. The latest National Health Accounts also urged for an expansion in the fiscal space for health. As public hospitals in Mauritius absorb 70% of GGHE, maximising returns of hospitals is essential to achieve Universal Health Coverage. More so, as Mauritius is bracing for its worst recession in 40 years in the aftermath of the COVID-19 pandemic public health financing will be heavily impacted. A thorough assessment of hospital efficiency and its implications on effective public health financing and fiscal space creation is, therefore, vital to inform ongoing health reform agenda. Objectives This paper aims to examine the trend in hospital technical efficiency over the period 2001–2017, to measure the elasticity of hospital output to changes in inputs variables and to assess the impact of improved hospital technical efficiency in terms of fiscal space creation. Methods Annual health statistics released by the Ministry of Health and Wellness and national budget of the Ministry of Finance, Economic Planning and Development were the principal sources of data. Applying Stochastic Frontier Analysis, technical efficiency of public regional hospitals was estimated under Cobb–Douglas, Translog and Multi-output distance functions, using STATA 11. Hospital beds, doctors, nurses and non-medical staff were used as input variables. Output variable combined inpatients and outpatients seen at Accident Emergency, Sorted and Unsorted departments. Efficiency scores were used to determine potential efficiency savings and fiscal space creation. Findings Mean technical efficiency scores, using the Cobb Douglas, Translog and Multi-output functions, were estimated at 0.83, 0.84 and 0.89, respectively. Nurses and beds are the most important factors in hospital production, as a 1% increase in the number of beds and nurses, result in an increase in hospital outputs by 0.73 and 0.51%, respectively. If hospitals are to increase their inputs by 1%, their outputs will increase by 1.16%. Hospital output process has an increasing return to scale. With technical efficiencies improving to scores of 0.95 and 1.0 in 2021–2022, potential savings and fiscal space creation at hospital level, would amount to MUR 633 million (US$ 16.2 million) and MUR 1161 million (US$ 29.6 million), respectively. Conclusion Fiscal space creation through full technical efficiency, is estimated to represent 8.9 and 9.2% of GGHE in fiscal year 2021–2022 and 2022–2023, respectively. This will allow without any restrictions the funding of the national response for HIV, vaccine preventable diseases as well as building a resilient health system to mitigate impact of emerging infectious diseases as experienced with COVID-19.

Ajoy Nundoochan

Assessment of convergent validity of latent variables is one of the steps in conducting structural equation modeling via partial least squares (PLS-SEM). In this paper, we illustrate such an assessment using a loadings-driven approach. The analysis employs WarpPLS, a leading PLSSEM software tool.

Johnny Amora

This paper found that 35% of Adivasis have health problems, and 73% said that they are getting treatment with RMP. 87% have toilet facility and more than 12% still defecate openly. 18.3% said that they faced different problems at open defecation, and 50% of women not using sanitary napkins. Nearly 90% of respondents wash their hands after toilets and coming from outside of the home. Ten per cent of respondents said that they do not have an awareness of sanitation. Therefore, the study confirmed that the sanitation facilities considerably made the women's dignity and quality of life better in the study area. Moreover, four case studies also focused on open defecation problems in the study area.

B Suresh Lal

Market trends indicate that natural health products are being used to maintain health as well as prevent and treat many medical conditions. A recent Canadian survey showed that 71% of the Canadian population have used a natural health product. Among these, many reports that they take natural health products on a daily basis. This review emphasizes on Canadian post-market surveillance system that apply to natural health products for human use. The public's perception is that the natural health products are all-natural, safe and effective, but there is still a wide variety of harms linked with these products. The post-market surveillance system is the monitoring window to observe and control the adverse effects of using natural health products. There are many activities involved in the post-surveillance to ensure the quality of the approved natural health products. Despite the fact that post-market surveillance plays a very important role in eliminating and/or reduce the risk of using natural health products, there are still some challenges and more work to be done to improve the outcome of the post-market surveillance of the natural health products.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Every year, tax laws are updated to create a more straightforward tax system for every Indian taxpayer. It was determined to provide new voluntary taxation to individual assesses in the union budget under section 115BAC of income tax act 1961. This essay discusses the new optional tax system, a comparison to the previous tax system, and the applicability of optional tax in the current context. Understanding tax payers' attitudes towards optional tax and educating them about the new regime, the drawbacks of optional tax, and its implications for the upcoming fiscal year are among the objectives of this research. Data is generally gathered through questionnaires for this purpose, and various research papers and journals are read to provide better analysis. According to survey results, individuals will continue to use the old tax system because there are no deductions available under the new tax law. However, the majority of respondents concurred that the new plan is superior to the previous one since it is completely dependent on the degree of income and investment of the individual. Overall, it can be said that, if you set aside a few of the new tax scheme's flaws, it is the correct step towards becoming a significant tax reform in recent memory. Keywords: Section 115 BAC Optional tax regime, Old tax structure, Relevance.

Sabir Mujawar

Poor water quality and lack of access to improved sanitation continue to pose a significant threat to human health. The burden of disease analysis suggests that lack of access to safe water supply, sanitation and hygiene is the third most significant risk factor for poor health in developing countries with high mortality rates. Diarrhoea is the leading disease associated with unsafe water supply, sanitation and hygiene and is responsible for the deaths. The study observed that out of the 150 respondents, 37% are 31-40 years, followed by 20-30 years with 32%. 130 (86.7%) respondents have got married, and 61% of the respondents are female. 85% adopted the nuclear family system, and 50% of respondents are illiterates in the study areas. 85% of respondents are daily wage earners, 37%are earnings rupees between 2000-2500 per month. 27% of respondents are landless labours, and 37% of households possess below 2 acres of land. 40% of respondents suffer from health problems, and 44% consume rice as their staple food. 62% of respondents have debts, and 33% got from money lenders. 62% of respondents do not have toilet facilities and go open defecation. 92% of respondents stated that toilet makes dignity, saves time and energy, saves their children school days, makes adolescent girls privacy, save wage loss, and toilet makes quality life.

B Suresh Lal

Background: Ending open defecation has been identified as a top priority for reducing global inequalities in water and sanitation (WASH). It is explicitly referenced in sustainable development goals (SDGs) target 6.2 and closely associated with more comprehensive efforts to end extreme poverty by 2030. Since 2000, the global rate of open defecation has decreased from 21% to 9% (0.7 percentage points per year). However, the 673 million people still practicing open defecation in 2017 were increasingly concentrated in a small number of countries, and these will need to be the primary focus of efforts to end open defecation by 2030. Objectives: To study the socio-economic background of Adivasis, to study the status of sanitation in rural areas, to examine whether economic conditions affect open defecation, to examine whether better sanitation facilities improve health conditions and to examine whether improved sanitation facilities impact the quality of life and thereby dignity of tribal women. Methods: Essentially it is an empirical study and a multi-stage random sample design was adopted. Data were collected from 120 sample households from two villages, i.e., Bandarigudem and Nadikudi of Khammam districts in Telangana State through a structured questionnaire. Statistical tools like frequency distribution, percentages, cross-tabulation with Chi-Square test, and a case study method were used. Results & Discussion: This paper found that 35% of Adivasis have health problems, and 73% said that they are getting treatment with RMP. 87% have toilet facility and more than 12% still defecate openly. 18.3% said that they faced different problems at open defecation, and 50% of women not using sanitary napkins. Nearly 90% of respondents wash their hands after toilets and coming from outside of the home. Ten per cent of respondents said that they do not have an awareness of sanitation. Therefore, the study confirmed that the sanitation facilities considerably made the women's dignity and quality of life better in the study area. Moreover, four case studies also focused on open defecation problems in the study area.

B Suresh Lal

This study aims to investigate the relationship between green marketing elements and customer purchase intention. To conceptualize green marketing, the researcher has researched the literature and identified the green marketing elements which include Green products, Green price, Green place, Green promotion, and Green Distribution. By using the snowball sampling technique, questionnaires from the respondents were collected as part of the study's survey methodology. According to the study's findings, there is a clear, substantial correlation between customer purchase intention and Green marketing.

Santhosh Sandy