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Biomedical subjects

O O'Donnell

Publications and source records attributed to O O'Donnell.

9 recordsLinked to original sources
PubMed2000

Equity in the delivery of health care in Europe and the US.

This paper presents a comparison of horizontal equity in health care utilization in 10 European countries and the US. It does not only extend previous work by using more recent data from a larger set of countries, but also uses new methods and presents disaggregated results by various types of care. In all countries, the lower-income groups are more intensive users of the health care system. But after indirect standardization for need differences, there is little or no evidence of significant inequity in the delivery of health care overall, though in half of the countries, significant pro-rich inequity emerges for physician contacts. This seems to be due mainly to a higher use of medical specialist services by higher-income groups and a higher use of GP care among lower-income groups. These findings appear to be fairly general and emerge in countries with very diverse characteristics regarding access and provider incentives.

Data Collection↗
PubMed2000

Cost analysis of the treatment of schizophrenia in the UK. A simulation model comparing olanzapine, risperidone and haloperidol.

OBJECTIVE: To compare the costs of 2 atypical drug therapies (olanzapine and risperidone) with one another and with a conventional antipsychotic (haloperidol) in the treatment of schizophrenia. DESIGN AND SETTING: The analysis is based on a simulation model with parameter values taken mainly from clinical trial data in patients with schizophrenia, and was conducted within a UK context. RESULTS: The 3 therapies are approximately cost neutral over a 5-year period (olanzapine 35,701 Pounds, risperidone 36,590 Pounds and haloperidol 36,653 Pounds). There is evidence of greater efficacy with the atypical drugs [average percentage of 5 years with Brief Psychiatric Rating Scale (BPRS) scores < 18: olanzapine 63.6%, risperidone 63.0% and haloperidol 52.2%]. The cost and efficacy differences between the 2 atypical drugs are too small to rank them in terms of cost effectiveness. Extensive sensitivity analysis does not change any of the main conclusions. CONCLUSIONS: Given evidence of efficacy gains to the atypical drugs, these represent cost-effective treatment options. Prospective data from nontrial treatment settings would help substantiate the model findings.

Antipsychotic Agents↗
PubMed1998

Cost analysis of the treatment of schizophrenia in the UK: a comparison of olanzapine and haloperidol.

A decision-tree simulation model is used to examine the costs associated with olanzapine versus haloperidol in the treatment of patients with schizophrenia in the UK. Parameter values and outcome scores were derived mainly from an international clinical trial. Resource consequences were examined on the basis of assumed service delivery and actual unit costs specific to the UK. While olanzapine is more expensive to prescribe than haloperidol, it generates savings by reducing utilisation of medical services. As a result, a comparison of the 2 drugs is approximately cost neutral. Model uncertainties are examined using extensive sensitivity analysis; in most scenarios, cost-neutral results are maintained. Olanzapine is more effective than haloperidol as measured by Brief Psychiatric Rating Scale scores and non-relapse rates. With such gains in effectiveness and near equivalence in terms of costs, olanzapine, in comparison with haloperidol, may represent a cost-effective treatment option.

Benzodiazepines↗
PubMed1997

Income-related inequalities in health: some international comparisons.

This paper presents evidence on income-related inequalities in self-assessed health in nine industrialized countries. Health interview survey data were used to construct concentration curves of self-assessed health, measured as a latent variable. Inequalities in health favoured the higher income groups and were statistically significant in all countries. Inequalities were particularly high in the United States and the United Kingdom. Amongst other European countries, Sweden, Finland and the former East Germany had the lowest inequality. Across countries, a strong association was found between inequalities in health and inequalities in income.

Developed Countries↗
PubMed1993

Income transfers and the labour market participation of disabled individuals in the UK.

Data from the OPCS Disability Survey are used to model the labour force participation of disabled individuals. The model is an endogenous switching regression and estimation is by the two stage probit procedure. The estimates are used to simulate the impact of Disability Working Allowance, introduced in April 1992, on the participation rate of the disabled population.

Adolescent↗
PubMed1991

Equity and the distribution of UK National Health Service resources.

This paper examines the extent to which the British NHS allocates health care according to need. The results, based on 1985 data, show that within morbidity groups the poor receive, on average, more health care than the rich. This does not necessarily indicate pro-poor inequity. There is some evidence of a positive relationship between income and health within any morbidity category. The results contradict those of an earlier study which found bias favouring the middle classes. It is argued that the methodology adopted in the present study is more appropriate for the examination of allocation according to need.

Data Collection↗