Day 2 :
Keynote Forum
Govinda R Timilsina
World Bank, USA
Keynote: The Nexus Of Energy Supply And Human Health
Time : 09:00-09:35
Biography:
Govinda R Timilsina is a Senior Research Economist at the Development Research Department of the World Bank. He works in the field of energy and economic development covering a wide range of topics including energy & environment, climate change, energy and poverty, clean and renewable energy. He has been widely published more than 50 journal articles, more two dozens of books, book chapters and technical reports.
Abstract:
The main sources of energy (coal, oil, and solid biomass) are directly linked to human health. Global health observatory data produced by the World Health Organization shows that ambient air pollution was responsible for 3.7 million deaths in 2012, of which 88% in low and middle-income countries. It was responsible for 16% of the lung cancer deaths, 11% of chronic obstructive pulmonary disease (COPD) deaths, more than 20% of ischaemic heart disease and stroke, and about 13% of respiratory infection deaths. Energy production activities, such as coal-fired power plants and fuel consumption activities, such as urban road transportation, are the primary sources of emissions responsible for ambient air pollution. Similarly, it is estimated that acute respiratory infections, mainly caused by indoor air pollution resulted from biomass and fossil fuel burning is the largest single category of deaths (64%) in children under 5 years of age in developing countries. Indoor air pollution ranks 4th on the global burden of disease risk factors at almost 5%, coming after high blood pressure (8%), tobacco smoking and second-hand smoke (7%), and alcohol use (6%). More than 40% of the global population today still rely on solid biomass fuels (e.g., fuel, wood, charcoal, coal, animal and crop wastes), the main precursors of the indoor air pollution, for cooking and home heating. These statistics indicate the deep nexus between energy supply and human health. Yet, the negative implications for human health are mostly ignored while developing energy supply plans and strategies in developing countries. If the costs to human health caused by an energy supply chain are reflected in the energy pricing system, it could significantly change the energy supply mix world-wide.
Keynote Forum
Johannes Bircher
University of Bern, Switzerland
Keynote: Impact On Health Economy Of A New Theoretical Framework Of Health: The Meikirch Model
Time : 09:35-10:10
Biography:
Johannes Bircher has completed his professional formation at the University of Zürich, and his postgraduate education at the Mayo Clinic and the University of Zürich. Then he worked at the Department of Clinical Pharmacology of the University of Bern, at the Black Lion Hos-pital in Addis Ababa and at the University of Gottingen before he became dean of the Faculty of Medicine at the University of Witten/Herdecke. Now he is retired. He published 253 papers partly in high ranking scientific journals, and seven books.
Abstract:
Costs of health care have become a growing and potentially dangerous burden to the society. Yet, so far health economy (HE) has not been able to relieve the situation. We invite health economists to give considerations to a new look at the nature of health described by the Mei-kirch model (MM) and to explore its possible benefits for HE. The Mm states: “Health is a dynamic state of wellbeing emergent from conductive interactions between individuals’ po-tentials, life’s demands, and social and environmental determinants. Throughout the life course health results when an individuals’ biologically given potential (BGP) and his or her personally acquired potential (PAP), interacting with social and environmental determinants, satisfactorily respond to the demands of life.” The PAP of each individual is the most modifi-able component of the model. It responds positively to constructive social interactions and to personal growth. It is the site of personal responsibility. The rising costs of health care pre-sumably are due in part to the tragedy of the commons, to Moral Hazard of patients and of physicians, to managers and to other factors. Only a new culture of health will bring costs down to a satisfactory level. This encompasses innovations in personal health leadership and renegotiations of relationships at all social levels. Thereby equal weight is to be given to the MM, to HE, and to normative considerations. Refocusing of the health care system on the Mm may relieve the society from damages related to a destructive financial burden.
- Health Economics
Health Policy
Healthcare Markets
Health Economics Modelling
Health Statistics
Private Healthcare Insurance
Chair
Jan Baekelandt
Imelda Hospital, Belgium
Session Introduction
Govinda R Timilsina
World Bank, USA
Title: The nexus of energy supply and human health
Biography:
Govinda R Timilsina is a Senior Research Economist at the Development Research Department of the World Bank. He works in the field of energy and economic development covering a wide range of topics including energy & environment, climate change, energy and poverty, clean and renewable energy. He has been widely published more than 50 journal articles, more two dozens of books, book chapters and technical reports.
Abstract:
The main sources of energy (coal, oil, and solid biomass) are directly linked to human health. Global health observatory data produced by the World Health Organization shows that ambient air pollution was responsible for 3.7 million deaths in 2012, of which 88% in low and middle-income countries. It was responsible for 16% of the lung cancer deaths, 11% of chronic obstructive pulmonary disease (COPD) deaths, more than 20% of ischaemic heart disease and stroke, and about 13% of respiratory infection deaths. Energy production activities, such as coal-fired power plants and fuel consumption activities, such as urban road transportation, are the primary sources of emissions responsible for ambient air pollution. Similarly, it is estimated that acute respiratory infections, mainly caused by indoor air pollution resulted from biomass and fossil fuel burning is the largest single category of deaths (64%) in children under 5 years of age in developing countries. Indoor air pollution ranks 4th on the global burden of disease risk factors at almost 5%, coming after high blood pressure (8%), tobacco smoking and second-hand smoke (7%), and alcohol use (6%). More than 40% of the global population today still rely on solid biomass fuels (e.g., fuel, wood, charcoal, coal, animal and crop wastes), the main precursors of the indoor air pollution, for cooking and home heating. These statistics indicate the deep nexus between energy supply and human health. Yet, the negative implications for human health are mostly ignored while developing energy supply plans and strategies in developing countries. If the costs to human health caused by an energy supply chain are reflected in the energy pricing system, it could significantly change the energy supply mix world-wide.
Johannes Bircher
University of Bern, Switzerland
Title: Impact on health economy of a new theoretical framework of health: The meikirch model
Biography:
Johannes Bircher has completed his professional formation at the University of Zürich, and his postgraduate education at the Mayo Clinic and the University of Zürich. Then he worked at the Department of Clinical Pharmacology of the University of Bern, at the Black Lion Hos-pital in Addis Ababa and at the University of Gottingen before he became dean of the Faculty of Medicine at the University of Witten/Herdecke. Now he is retired. He published 253 papers partly in high ranking scientific journals, and seven books.
Abstract:
Costs of health care have become a growing and potentially dangerous burden to the society. Yet, so far health economy (HE) has not been able to relieve the situation. We invite health economists to give considerations to a new look at the nature of health described by the Mei-kirch model (MM) and to explore its possible benefits for HE. The Mm states: “Health is a dynamic state of wellbeing emergent from conductive interactions between individuals’ po-tentials, life’s demands, and social and environmental determinants. Throughout the life course health results when an individuals’ biologically given potential (BGP) and his or her personally acquired potential (PAP), interacting with social and environmental determinants, satisfactorily respond to the demands of life.†The PAP of each individual is the most modifi-able component of the model. It responds positively to constructive social interactions and to personal growth. It is the site of personal responsibility. The rising costs of health care pre-sumably are due in part to the tragedy of the commons, to Moral Hazard of patients and of physicians, to managers and to other factors. Only a new culture of health will bring costs down to a satisfactory level. This encompasses innovations in personal health leadership and renegotiations of relationships at all social levels. Thereby equal weight is to be given to the MM, to HE, and to normative considerations. Refocusing of the health care system on the Mm may relieve the society from damages related to a destructive financial burden.
Georgi Boichev
University of Regina, Canada
Title: Lump-Sum Finanancial Incentives Work In Attracting Primary Care Physicians To Rural Areas: Evidence From Bulgaria
Time : 10:10-10:35
Biography:
Jan Baekelandt qualified as a Medical Doctor (1999) and specialist in Gynaecology and Obstetrics (2004) at the Catholic University of Leuven, Belgium. He subspecialized as gynaecological oncologist (2004-2006) in Pretoria (South Africa) and Köln (Germany). He currently consults at Imelda Hospital (Bonheiden, Belgium), specializing in gynaecological oncology, and robotic and endoscopic surgery. He is a pioneer in the emerging field of Natural Orifice Surgery and has published multiple papers on transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES) and on frugal innovations in endoscopic surgery. He was first to introduce transvaginal robotic surgery.
Abstract:
Minimally invasive surgery not only improves cosmetic outcome, it has the potential to restrict the magnitude of the surgical injury, which in turn can attenuate the inflammatory and neuroendocrine response resulting in less postoperative pain and quicker recovery. In recent years, innovations in minimally invasive surgery go hand in hand with technological innovations. As these technological innovations are often industry driven, they are geared for a first world market. Frugal innovation involves designing solutions specifically for low-income settings. We will present frugally innovative measures that can make new surgical techniques also available in a low resource setting, so that more patients can benefit from the advantages of these new techniques. Natural Orifice Transluminal Endoscopic Surgery (NOTES) enables surgeons to operate in the abdominal cavity by scar free means. The Poor Man’s NOTES technique for the treatment of ectopic pregnancy, ovarian pathology, adhaesiolysis and hysterectomy, will be presented. We will present the Poor Man’s SILS technique that enables a surgeon to perform a hysterectomy through one small umbilical incision. We will demonstrate how innovations in smartphone development can replace expensive laparascopic cameras, light sources, screens and recording devices, and can reduce the investment needed to start performing minimally invasive surgery by more than 90%. We will also present a frugal morcellation technique to reduce the risk of tumor spread when retrieving a specimen from the abdominal cavity during laparoscopic surgery.
Wael Eweida
Children’s Cancer Hospital - 57357 Group, Egypt
Title: New Theory Linking Disease Prognosis With Healthcare Operations And Economics; “Scenario- Based Prediction-Of-Eventsâ€: The Future Magic Stick
Time : 11:50-12:15
Biography:
Wael Eweida is a pioneer in strategic sciences, healthcare operations and supply of healthcare. He is the Chief Operating Officer (COO) for the Children’s Cancer Hospital Egypt (57357 hospital) and he is the strategic consultant for Board of Trustees for 57357 Group. He has over 30 years of experience in strategic management, and healthcare business development. His research is now focused on health economics and healthcare operations management.
Abstract:
The “Scenario-based Prediction-of-Events” theory and conceptual model predicts the occurrence of future events according to different potential scenarios based on fixed certainities that include business, humanistic, and system-related factors, as well as other unexpected uncertainties. The new theory and model can be applied in any sector at the different industries. Upon applying the theory in the healthcare industry, it was found that the new model has the ability to link different scenarios of disease prognosis to healthcare operations management and economics, and strategic planning of rescource utilization in the future. The theory does not consider the incidence of an event as the deviation from the usual scenario, but rather deals with the occurrence of the different events in disease prognosis as predicted scenarios with varying likelihoods of occurrence, that all deviate from the best-case scenario called the “Zero-base scenario”. Prediction of how a certain disease will behave and creating scenarios based on the certainties (historical data) and the uncertainties (future expectations) using scenario-based analysis and planning is an innovative economic model to predict all the possible consequences of disease prognosis on the consumption of the resources of a healthcare organization. Developing SOPs for each written scenario with expected cost and capacity requirements will help the organization better strategically predict future needs for capacity-building and lead to better management of healthcare economics and resources based on strategic planning and readiness. By building alternative scenarios, you can foresee more unknowns that may happen and strategically plan measures to control the health economics.
Jan Baekelandt
Imelda Hospital, Belgium
Title: Frugal Innovations In Minimally Invasive Surgery
Time : 10:35-11:00
Biography:
Jan Baekelandt qualified as a Medical Doctor (1999) and specialist in Gynaecology and Obstetrics (2004) at the Catholic University of Leuven, Belgium. He subspecialized as gynaecological oncologist (2004-2006) in Pretoria (South Africa) and Köln (Germany). He currently consults at Imelda Hospital (Bonheiden, Belgium), specializing in gynaecological oncology, and robotic and endoscopic surgery. He is a pioneer in the emerging field of Natural Orifice Surgery and has published multiple papers on transvaginal Natural Orifice Transluminal Endoscopic Surgery (NOTES) and on frugal innovations in endoscopic surgery. He was first to introduce transvaginal robotic surgery.
Abstract:
Minimally invasive surgery not only improves cosmetic outcome, it has the potential to restrict the magnitude of the surgical injury, which in turn can attenuate the inflammatory and neuroendocrine response resulting in less postoperative pain and quicker recovery. In recent years, innovations in minimally invasive surgery go hand in hand with technological innovations. As these technological innovations are often industry driven, they are geared for a first world market. Frugal innovation involves designing solutions specifically for low-income settings. We will present frugally innovative measures that can make new surgical techniques also available in a low resource setting, so that more patients can benefit from the advantages of these new techniques. Natural Orifice Transluminal Endoscopic Surgery (NOTES) enables surgeons to operate in the abdominal cavity by scar free means. The Poor Man’s NOTES technique for the treatment of ectopic pregnancy, ovarian pathology, adhaesiolysis and hysterectomy, will be presented. We will present the Poor Man’s SILS technique that enables a surgeon to perform a hysterectomy through one small umbilical incision. We will demonstrate how innovations in smartphone development can replace expensive laparascopic cameras, light sources, screens and recording devices, and can reduce the investment needed to start performing minimally invasive surgery by more than 90%. We will also present a frugal morcellation technique to reduce the risk of tumor spread when retrieving a specimen from the abdominal cavity during laparoscopic surgery.
Sherif Aboulnaga
Children’s Cancer Hospital - 57357 Group, Egypt
Title: Delivering Healthcare And Education As Righteous Services Not Commodities: A Noble Concept With Great Practical Implications
Time : 12:15-12:40
Biography:
Sherif Aboulnaga is a pioneer in healthcare reform and health economics. He is the Chief Executive Officer (CEO) of 57357 Group, and the Managing Director of the Children’s Cancer Hospital Egypt (57357 hospital). He has extensive experience and research activities in the areas of health economics and health policy, healthcare management, healthcare strategic sciences and peditaric oncology. He is a leader in transforming the healthcare system in Egypt for children with cancer, and transforming the educational system in Egypt.
Abstract:
Health care and education should be delivered to everyone as righteous services with a moral motive evolving form the fact that they are basic human rights and not commodities. Services are attainable rights, while commodities are only delivered or become of better quality when someone pays for them. Being labelled as righteous services, healthcare and education cannot be owned. And that is the right policy for health and education reform, because if they were owned as commodities, it would be easy to control them and limit their delivery based on affordability to pay. The delivery of healthcare and educational services as righteous services has humanistic, economic, and developmental implications. From a humanistic standpoint, healthcare and education should be delivered as basic human rights, and not as gifts or privileges that are granted to people with terms and conditions. Also, the concept of delivering healthcare and education from an economical –versus commercial- point of view will lead to the delivery of more services with lower costs, thus increasing access to these services, and leading to more productivity and overall economic positive output. Consequently, this would have a developmental implication, where the performance of individuals who receive their basic human rights would tremendously improve as a result of being healthy and well-educated. These concepts have actually been practically applied at the Children’s Cancer Hospital Egypt (57357 hospital) which treats children with cancer free of charge and implements continous learning and education for its patients and employees as righeous services.
Tuvia Horev
Ben-Gurion University of the Negev, Israel
Title: How To Strengthen The Capacities Of A National Health Authority In The Effort To Mitigate Health Inequity: A Generic Framework Based On An Israeli Model
Time : 12:40-13:05
Biography:
Tuvia Horev is an associate professor in the Department of Health Systems Management, Ben-Gurion University of the Negev (BGU). He holds a PhD in Health Policy and Management (BGU), a Master of Public Health degree from the Hebrew University Jerusalem (HUJI), and he is Dental Surgeon (HUHI). Horev served in various senior executive positions in the Israeli Healthcare system. His latest position, until December 2014, was Senior Deputy Director General for Strategic and Economic Planning, in the Ministry of Health (MoH), Israel.
Abstract:
The need for a national policy to mitigate health inequity has been recognized in scientific research and policy papers around the world. Despite the moral duty and the social, medical, and economic logic behind this goal, much difficulty surfaces in implementing national policies that propose to attain it. This is mainly due to an implementation gap that originates in the complex interventions that are needed and the lack of practical ability to translate knowledge into practices and policy tools. The article describes the Israeli attempt to design and implement a national strategic plan to mitigate health inequity. It describes the basic assumptions and objectives of the plan, its main components, and various examples of interventions implemented. Limitations of the Israeli policy and future challenges are discussed as well. Based on the Israeli experience, the article then sketches a generic framework for national-level action to mitigate inequalities in health and in the healthcare system. The framework suggests four main focal points as well as an outline of the main stakeholders that a national policy should take into consideration as agents of change. The Israeli policy and the generic framework presented in the article may serve researchers, decision-makers, and health officials as a case study on ways in which prevalent approaches toward the issue of health inequality may be translated into policy practice.
Sophie Ces,
Catholic University of Louvain, Belgium
Title: Estimation Of The Cost Of The Home-Based Support Of The Frail Older People Living At Home In Belgium
Time : 14:10-14:25
Biography:
Sophie Ces has a Master’s degree in health economics (2005, Conservatoire des Arts et Métiers Paris,). Since 2012, she is a Phd candidate in public health at Universite Catholique de Louvain.
Abstract:
The article focuses on the estimation of the costs of long term care, both formal and informal care, provided to the frail older people living at home in Belgium. A typology of situations is built by combining the level of impairment and the presence of informal caregivers is used to describe the costs of long term care. The cost estimation is performed for the patients, the informal caregivers, the National Institute for Health and Disability Insurance.Individual data are collected through patient questionnaires: the inter RAI Home Care instrument and an ad-hoc questionnaire for assessing the utilisation of non-health care services at home and the time spent on informal caregiving. In complement, the data of the reimbursed health care consumption (routinely recorded by the health care insurance) is also available for the sample. The “normal” consumption part for the household aid, pedicure or meals-on-wheels has to be retrieved since they are not specific to frailty. Therefore, to obtain a sample of individuals with similar characteristics (e.g. the age, the socio-economic status, gender,) but without any disability, a propensity score is used. The time spent on informal caregiving is valued by using the proxy-good method. The costs of the health care reimbursed services are directly available in the official database. The estimation of the different cost components of long care for the frail older people living at home will allow an accurate description of the contributions of the main stakeholders in Belgium according to the different types of situations (impairment level/informal caregiver presence).
Jessica Ho
Central Queensland University, Australia
Title: The Consumerisation Of Healthcare Data In Australiaa
Time : 14:25-14:40
Biography:
Jessica Ho is currently finishing her PhD thesis - 'Building an Australian Health Interoperability Framework' with Central Queensland University. She is currently working in the Australian Government, as the CIO for Australian Financial Security Authority. She is an experienced IT executive with extensive background delivering large and complex programs in change and digital transformation agenda. She has published a number of papers and co-authored books in the field of health informatics.
Abstract:
Consumerisation of healthcare data is an inescapable growing trend worldwide. With the evolution of technology, the availability and increased affordability of new health gadgets, health care consumers are consuming these devices and applications in drove. Data, in particular health data are swapped, exchanged, saved in memory, saved in cloud, within a number of different platforms, standards, ready to be manipulated, shared, uploaded in other social media spaces. Health care consumers are increasingly taking an active role in their care experience and are evermore empowered to choose their own care alternatives, consulting with "Dr. Google", easily available health information and their social circles. Today's patients are used to having mobile tools at their fingertips to access and manage information anywhere, anytime. There is a greater expectation for personalised experience in healthcare. The implementation of Australia current e-Health agenda may not be sufficient in keeping up with the demand from health care consumer. This paper aims to examine the economic impact of the consumer health care technology evolution and the opportunities it will bring in lowering the cost of care and improving current state of health funding, most importantly, the improvements to the overall health outcomes and wellbeing of health consumers.
Selden Coskun
Isık University, Istanbul
Title: A Theoretical Assessment On The Relationship Of Hospital’s Quality And Accreditation Applications With Asymmetric Informationa
Time : 14:40-14:55
Biography:
Selden COSKUN has been Graduated from Chemical Engineering and made a master degree on chemical engineering and on business administration. Later on she worked as professional on medical device sector as a quality profession. Now she is giving lectures at Isık University on quality at health sector and on occupational health & Safety. Meanwhile she is also on her last quarter to finish her PhD on health management at Okan University , Istanbul.
Abstract:
Many country governments try to control the hospital costs and make re-arrangements in health systems. In other respect, the quality phenomenon which is been adding to all products, is also effective in hospital sector. The basic reasons of increased health expenditures are an increase in the life time, development of health acknowledgement among people, use of advanced technology and except these factors problems due to asymmetric information also exist. At the same time in Turkey and in all over the world, both in public hospitals and private hospitals quality management systems are spreading wide. By the quality management systems the loaded cost also increases more. Information asymmetry and the demand that has been made by supply problem is getting layered by the rapidly developing quality phenomenon. In this work the effect of hospital quality costs to asymmetric information has been evaluated by analyzing publishes from foreign and internal releases. Under a theoretical perspective in a short period analyses, limiting the supply by quality management systems and because of the cost increase, the equilibrium service production level would decrease; in long term according to the increase of the information asymmetry the decrease will show up in a equilibrium according to the demand that has been occurred by supply and only the price increase will be a result.
Manhal Mohammad Ali
University of Manchester, UK
Title: Hospital Heterogeneity: What Determines The Quality Of Care?
Time : 15:10-15:25
Biography:
Manhal Mohammad Ali is a 3rd year Ph.D. student at Alliance Manchester Business School and researching in the area of health economics. His research specifically focuses on healthcare performances measured by quality, productivity, organizational and managerial performances and, trying to understand what causes their variations. He completed his MSc and BSc in Economics from the University of Bristol and the University of Greenwich respectively and worked as senior Lecturer at East West University, Bangladesh. His other research interests include econometrics, causal inference, digital economy and big data.
Abstract:
A feature of health care systems, for instance, the NHS is the presence of heterogeneity in health care quality across hospitals. This study seeks to understand what internal and external hospital based factors are responsible for explaining variations in quality of care measured using the processes of care in the case of stroke. We used NHS trust data from National Sentinel Stroke Audit from 2004 to 2010. The data were merged with other administrative data sets to capture hospital’s characteristics. We employed a new class of panel regression tree estimators from the machine learning literature to study the data. A reason behind the choice of the method is the intuitive interpretability of the results. The non-parametric method has the capability to reveal potential interactions among the variables, which could offer valuable information about the processes driving variations in quality across NHS hospitals. The study found complex interactions or complementarities amongst the hospitals organizational, structural and regional level factors in determining quality with organizational factors for stroke care to be the most important predictors. The main results from the tree method are robust to alternative specifications and methods for instance, linear and fixed effect models which control for fixed effects. Cross validations and in sample statistics were carried out to assess the sample predictive performances and fit the data. The findings shed new light on previous research determinants of healthcare quality by identifying critical interactions. The findings helped us to improve and inform policy decisions for quality improvement by identifying the factors that drive quality.