American journal of preventive medicine
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The Great East Japan Earthquake occurred on March 11, 2011, with a nuclear accident subsequently occurring at the Fukushima Daiichi Nuclear Power Plant. The government ordered a mandatory evacuation from the high radioactive concentration area in Fukushima, which might have forced many evacuees to change particular aspects of their lifestyles. This study assessed the hypothesis that mean body weight and the proportion of overweight/obese individuals would increase among evacuees after versus before the disaster. ⋯ Body weight and the proportion of overweight/obese people increased among residents, especially evacuees, in the evacuation zone of Fukushima prefecture after the Great East Japan Earthquake.
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Comparative Study
Cost Effectiveness of Influenza Vaccine Choices in Children Aged 2-8 Years in the U.S.
Prior evidence found live attenuated influenza vaccine (LAIV) more effective than inactivated influenza vaccine (IIV) in children aged 2-8 years, leading CDC in 2014 to prefer LAIV use in this group. However, since 2013, LAIV has not proven superior, leading CDC in 2015 to rescind their LAIV preference statement. Here, the cost effectiveness of preferred LAIV use compared with IIV in children aged 2-8 years is estimated. ⋯ Results support CDC's decision to no longer prefer LAIV use and provide guidance on effectiveness differences between influenza vaccines that might lead to preferential LAIV recommendation for children aged 2-8 years.
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In an effort to reduce methicillin-resistant Staphylococcus aureus (MRSA) transmission through universal screening and isolation, the Department of Veterans Affairs (VA) launched the National MRSA Prevention Initiative in October 2007. The objective of this analysis was to quantify the budget impact and cost effectiveness of this initiative. ⋯ Wide-scale implementation of a national MRSA surveillance and prevention strategy in VA inpatient settings may have prevented a substantial number of MRSA HAIs. Although the savings associated with prevented infections helped offset some but not all of the cost of the initiative, this model indicated that the initiative would be considered cost effective.
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Although fortification of food with folic acid has been calculated to be cost saving in the U.S., updated estimates are needed. This analysis calculates new estimates from the societal perspective of net cost savings per year associated with mandatory folic acid fortification of enriched cereal grain products in the U.S. that was implemented during 1997-1998. ⋯ The estimates of cost savings are larger than previously reported, even using conservative assumptions. The analysis can also inform assessments of folic acid fortification in other countries.
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Although pay for performance (P4P) programs are being increasingly used by state Medicaid programs to provide incentives for managed care plans to provide high-quality care, no national study has examined the effects of these plans on commonly targeted outcomes such as childhood immunization rates. ⋯ This study provides some evidence that Medicaid P4P programs may be helpful in improving childhood vaccination rates. Further study of the effects on other targeted outcomes as well as the effects of different P4P program designs may increase understanding of the potential role of these programs in improving the quality of health care.