Canada began to fortify its flour and bread with vitamin B when it entered the Second World War. The decision was informed by the biology of vitamin B and therefore I suggest that the complexity of this political maneuver can best be understood by considering the specificity of the biochemistry of vitamin B. In this paper I will show that the specific biology of vitamin B allowed the Canadian government the possibility of a healthier population under wartime conditions but also allowed the government a variety of means by which to develop and organize food processing practices to this end.
The Gorky N. A. Semashko Regional Clinical Hospital has the long-term experience in drawing additional means into patients' treatment at the expense of enterprises and collective farms on the strength of the agreement on cooperation. In order to expand cost accounting in public health it is necessary to determine cost indices in the work of curative and preventive facilities. Total cost of the provision of various types of medical services and that per patient have been calculated in the Gorky Regional Hospital. Besides current expenditure they involve the main funds, estimated by annual indices. Complete cost of 306 diagnostic and treatment procedures have been determined. Proceeding from the data obtained complete actual costs of diagnostic and treatment procedures per patient on 105 nosologic forms have been identified along with the expenditure on these nosologic forms that is necessary for modern diagnostic and treatment care.
Chronic obstructive pulmonary disease (COPD) is a major burden for the health care system, but the exact costs are difficult to estimate and there are insufficient data available on past and future time trends of COPD-related costs.
The aim of the study was to calculate COPD-related costs in Finland during the years 1996-2006 and estimate future costs for the years 2007-2030.
COPD-related direct and indirect costs in the public health care sector of the whole of Finland during the years 1996-2006 were retrieved from national registers. In addition, we made a mathematical prediction model on COPD costs for the years 2007-2030 on the basis of population projection and changes in smoking habits.
The total annual COPD-related costs amounted to about 100-110 million Euros in 1996-2006, with no obvious change, but there was a slight decrease in direct costs and an increase in indirect costs during these years. The estimation model predicted a 60% increase up to 166 million Euros in COPD-related annual costs by the year 2030. This is caused almost entirely by an increase in direct health care costs that reflect the predicted ageing of the Finnish population, as older age is a significant factor that increases the need for hospitalisation.
The total annual COPD-related costs in Finland have been stable during the years 1996-2006, but if management strategies are not changed a significant increase in direct costs is expected by the year 2030 due to ageing of the population.
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Funded immunization programs are best able to achieve high participation rates, optimal protection of the target population, and indirect protection of others. However, in many countries public funding of approved vaccines can be substantially delayed, limited to a portion of the at-risk population or denied altogether. In these situations, unfunded vaccines are often inaccessible to individuals at risk, allowing potentially avoidable morbidity and mortality to continue to occur. We contend that private access to approved but unfunded vaccines should be reconsidered and encouraged, with recognition that individuals have a prerogative to take advantage of a vaccine of potential benefit to them whether it is publicly funded or not. Moreover, numbers of "approved but unfunded" vaccines are likely to grow because governments will not be able to fund all future vaccines of potential benefit to some citizens. New strategies are needed to better use unfunded vaccines even though the net benefits will fall short of those of funded programs. Canada, after recent delays funding several new vaccine programs, has developed means to encourage private vaccine use. Physicians are required to inform relevant patients about risks and benefits of all recommended vaccines, publicly funded or not. Likewise, some provincial public health departments now recommend and promote both funded and unfunded vaccines. Pharmacists are key players in making unfunded vaccines locally available. Professional organizations are contributing to public and provider education about unfunded vaccines (e.g. herpes zoster, not funded in any province). Vaccine companies are gaining expertise with direct-to-consumer advertising. However, major challenges remain, such as making unfunded vaccines more available to low-income families and overcoming public expectations that all vaccines will be provided cost-free, when many other recommended personal preventive measures are user-pay. The greatest need is to change the widespread perception that approved vaccines should be publicly funded or ignored.