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D M Bishai

Publications and source records attributed to D M Bishai.

6 recordsLinked to original sources
PubMed2001

Modeling the economic benefits of better TB vaccines.

OBJECTIVE: To describe the economic benefits of a better tuberculosis (TB) vaccine by modeling prevented TB medical spending and lost productivity throughout the world. DESIGN: One model is based on benefits obtained from reducing the impact of TB on health spending. An alternative model is based on minimizing the impact of TB on health spending and lost productivity due to death and disability. Both models are applied to various world populations based on secondary data. RESULTS: In terms of avoided medical spending, preventing 100% of the TB risk in a single individual is estimated to be worth from $38 for males in formerly socialist countries to S0.23 for children in Asia. More than 1 billion people would reckon their expected medical savings to exceed $25.00 if they received a 75% effective vaccine of 10 years' duration. Preventing lost productivity is worth substantially more throughout the world. CONCLUSIONS: Improved TB vaccines would be of substantial immediate financial value to most of the populations of the world, including the poorest. The scientific uncertainties surrounding the development of a better vaccine could be a larger obstacle than investor uncertainty over whether a vaccine would be profitable.

Adolescent↗
PubMed2000

The willingness to pay for wait reduction: the disutility of queues for cataract surgery in Canada, Denmark, and Spain.

We estimate demand curves for a one month reduction in waiting time for cataract surgery based on survey data collected in 1992 in Manitoba, Barcelona, and Denmark. Patients answered, "Would you be willing to pay [Bid, B] to reduce your waiting time for cataract surgery to less than one month?" Controlling for SES and visual status, Barcelonan patients have greater WTP for shortened waiting time than the Danes and Manitobans. We estimate the value (in 1992 $) of lost consumer surplus due to the cataract surgery queue at $128 per patient in Manitoba, $160 in Denmark, and $243 in Barcelona.

Aged↗
PubMed1992

Vaccine storage practices in pediatric offices.

Fifty pediatric offices and clinics in the metropolitan Los Angeles area were visited to assess vaccine storage practices. Questionnaires were administered to the personnel responsible for vaccine storage and the vaccine refrigerators were inspected. Only 16% of vaccine storage coordinators could cite appropriate storage temperatures for vaccines and 18% were unaware that heat can harm certain vaccines. Refrigerator thermometers were checked at least weekly in only 20% of offices, and 22% of the refrigerators had inappropriately high temperatures. Vaccines were routinely stored outside of the refrigerator uninsulated during the practice day in 16% of the offices visited. It is concluded that vaccine storage errors occur in pediatric offices at an unacceptably high frequency. Pediatricians should familiarize themselves with the guidelines for optimal vaccine storage in order to minimize the potential for vaccine failure in primary care practice.

Bacterial Vaccines↗
PubMed1986

Current progress toward the prevention of the Wernicke-Korsakoff syndrome.

The Wernicke-Korsakoff syndrome is a rare neurological disorder which strikes primarily alcoholics and is caused, at least in part, by insufficient bioavailability of thiamin. Because of the low cost of preventing this disease by adding thiamin to alcoholic beverages relative to the cost of the long-term care of patients with the chronic phase of the disease, there has been a need to determine the feasibility of this particular preventive strategy. Recent data demonstrating normal levels of erythrocyte transketolase in patients presenting with Wernicke's encephalopathy has led some to question the link between thiamin deficiency, and the development of the syndrome, despite the fact that virtually all patients with Wernicke's encephalopathy will respond favorably to parenteral thiamin, and the evidence that rats deprived of thiamin develop lesions that are characteristic of the disease. Thiamin is nontoxic, is stable in alcoholic beverages, and is undetectable in beer to professional taste-testers at levels theoretically sufficient to guarantee adequate absorption. Although there is much inter-subject variability it appears that thiamin at therapeutic concentrations can be absorbed by the jejunum in the presence of alcohol. Evidence that patients with the Wernicke-Korsakoff syndrome have an altered thiamin-requiring isoenzyme and evidence that six patients with Wernicke's encephalopathy failed to respond to oral thiamin has caused some doubt as to whether the target population would be able to benefit from the measure. Other determinants of thiamin utilization, such as folate and magnesium status, also may figure in the etiology of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Amnestic Disorder↗
PubMedDate not supplied

Infant mortality time series are random walks with drift: are they cointegrated with socioeconomic variables?

Previous time series analyses of infant mortality have failed to provide evidence to support their implicit assumption that infant mortality data used behaved as a stationary time series. The present study applies the augmented Dickey Fuller Test to infant mortality time series for Sweden (1800-1989), United Kingdom (1839-1989) and United States (1915-1989). The null hypothesis that each of these series is non-stationary is accepted at standard levels of significance. A conceptual framework of infant mortality which uses a combination of physical and social overhead capital as factors in a production function is developed to explain the finding of non-stationarity as derivative from the non-stationarity of a stock of health-enhancing capital. Estimation of econometric models of the socioeconomic determinants of infant mortality using differenced data with ARIMA estimation is inconclusive. Estimation of a bivariate cointegration model supports the hypothesis that infant survival and GNP/Capita are cointegrated for 19th century Sweden but not for 19th century UK. Bivariate analysis of 20th century Sweden, UK, and US data demonstrated no cointegration. This may be due to the onset of disequilibrium in the economic determination of infant mortality in the present era as technological advances and demographic shifts began to play a larger role. Supplementing the bivariate analysis with measures of unemployment, and crude birth rate in the 20th century permitted the detection of cointegration in US and UK. The multivariate results may suggest that improvements in 20th century UK GNP/capita have had greater impact on infant survival relative to US GNP/capita.

Birth Rate↗