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"Quality of Life Europe, Eastern."
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Austerities and Aspirations
This monograph provides an analysis of the economic performance and living standard in Czechoslovakia and its successor states, Hungary, and Poland since 1945. The novelty of the book lies in its broad comparative perspective: it places East Central Europe in a wider European framework that underlines the themes of regional disparities and European commonalities. Going beyond the traditional growth paradigm, the author systematically studies the historical patterns of consumption, leisure, and quality of life-aspects that Tomka argues can best be considered in relation to one other. By adopting this \"triple approach,\" he undertakes a truly interdisciplinary research drawing from history, economics, sociology, and demography.
As a result of Tomka's three-pillar comparative analysis, the book makes a major contribution to the debates on the dynamics of economic growth in communist and postcommunist East Central Europe, on the socialist consumer culture along with its transformation after 1990, and on how the accounts on East Central Europe can be integrated into the emerging field of historical quality of life research.
eBook
Satisfaction with life and service delivery in Eastern Europe and the Former Soviet Union : some insights from the 2006 life in transition survey
The past two decades in Eastern Europe and the former Soviet Union have been times of tremendous change, with countries undergoing rapid transformation from centrally-planned to market-oriented economies. While poverty increased during the initial years of transition, primarily on account of the sharp economic contraction, the resurgence of economic growth in the region since 1998 has resulted in a rebound in household incomes and living standards. Data from the 2006 Life in Transition Survey (LiTS)—a joint initiative of the European Bank for Reconstruction and Development and the World Bank—provides a unique opportunity to investigate the extent to which citizens of ECA countries are satisfied with their lives and with the performances of their governments, and to study key factors influencing their outlook in a systematic way across all countries of the region. The main objective of the LiTS was to assess the impact of transition on people, covering four main themes. First, it collected personal information on aspects of material well-being, including household expenditures, possession of consumer goods such as a car or mobile phone, and access to local public services and utilities. Second, the survey included measures of satisfaction and attitudes towards economic and political reforms as well as public service delivery. Third, the LiTS captured individual 'histories'—key events and episodes that may have influenced their attitudes towards reforms, and information on family background, employment, and coping strategies. Finally, the survey also attempted to capture the extent to which crime and corruption are affecting peoples' lives, and the extent to which individuals' trust in other people and in state institutions has changed over time.
eBook
Population, health and risk factors in a transitional economy
This paper investigates the health status of the population in a transition economy. Against a background of falling living standards compounded by the widening income inequality a deterioration of health status has been outlined. Drawing upon a consumer survey carried out in the capital Bucharest, risk factors are highlighted. Respondents’ age, income, and health motivation are the most significant variables which differentiate between smokers and non-smokers. Respondent’s age and sex are significant factors predicting the physical exercise status. Additionally, respondent’s level of education is a significant predictor of the time spent on physical exercise. The implications of the study for health policy makers are finally discussed. Copyright Springer Science+Business Media, LLC 2006
Journal Article
Getting better
Fifty years ago, health outcomes in the countries of Eastern Europe and Central Asia were not far behind those in Western Europe and well ahead of most other regions of the world. But progress since then has been slow. While life expectancy in the ECA region today is close to the global average, the gap with its western neighbors has doubled, and other middle-income regions have all surpassed ECA. Some countries in the region are doing better, but full convergence with the worlds most advanced health systems is still a long way off. At the same time, survey evidence suggests that the health sector is the top priority for additional investment among populations across the region. The experience of high-income countries also suggests that popular demand for strong and accessible health systems will only grow over time. Yet these aspirations must be reconciled with current fiscal realities. In brief, health sector issues are a challenge here to stay for policy-makers across the ECA region. This report draws on new evidence to explore the development challenge facing health sectors in ECA, and highlights three key agendas to help policy-makers seeking to achieve more rapid convergence with the worlds best performing health systems. The first is the health agenda, where the task is to strengthen public health and primary care interventions to help launch the \"cardiovascular revolution\" that has taken place in the West in recent decades. The second is the financing agenda, in which growing demand for medical care must be satisfied without imposing undue burden on households or government budgets. The third agenda relates to broader institutional arrangements. Here there are some key reform ingredients common to most advanced health systems that are still missing in many ECA countries. A common theme in each of these three agendas is the emphasis on
improving outcomes, or \"Getting Better\".
eBook
Urban Growth, Land-use Efficiency and Local Socioeconomic Context: A Comparative Analysis of 417 Metropolitan Regions in Europe
The present study presents a multidimensional analysis of land-use efficiency in terms of per-capita built-up area over 417 metropolitan regions from 27 European countries. The study period encompasses two urban phases including economic expansion (2000–2007) and crisis (2008–2015). Multiple geographical gradients were identified as relevant predictors of land-use efficiency across Europe. The socioeconomic variables most associated with high land-use efficiency were per-capita disposable income (in Western, Atlantic and Central Europe) and income growth during 2000–2007 (in Eastern Europe), indicating that wealthier cities are characterized by higher land-use efficiency. Land-use efficiency increased in contexts with diversified urban landscapes.
Journal Article
The status of intensive care medicine research and a future agenda for very old patients in the ICU
The “very old intensive care patients” (abbreviated to VOPs; greater than 80 years old) are probably the fastest expanding subgroup of all intensive care unit (ICU) patients. Up until recently most ICU physicians have been reluctant to admit these VOPs. The general consensus was that there was little survival to gain and the incremental life expectancy of ICU admission was considered too small. Several publications have questioned this belief, but others have confirmed the poor long-term mortality rates in VOPs. More appropriate triage (resource limitation enforced decisions), admission decisions based on shared decision-making and improved prediction models are also needed for this particular patient group. Here, an expert panel proposes a research agenda for VOPs for the coming years.
Journal Article
Underreported influenza mortality in Central and Eastern Europe hinders the extension of seasonal influenza vaccination programs in older adults
Several Central and Eastern European (CEE) countries have low seasonal influenza vaccination coverage of older adults coupled with severe underreporting of influenza-related deaths. Our objective was to project influenza mortality estimates for older adults in six CEE countries, building on high-quality mortality data from an EU-15 country with similar climate, population density, and seasonal influenza vaccination coverage. In addition, we aimed to compare the implications of the reported and projected influenza burden estimates on the economic value of extended influenza vaccination for older adults in an exemplary CEE country, Serbia. Multivariate regression modelling was used to adjust for differences in population health status between countries. Economic implication of underreporting influenza burden was investigated by using the VITALO decision analytic model. Locally reported and projected mortality rates were similar in Czech Republic and Slovenia, whereas projected mortality rates far exceeded locally reported influenza mortality rates in Poland, Hungary, Serbia, and Romania. Based on locally reported mortality rates in Serbia, increasing seasonal influenza vaccination coverage in the 65+ population to average coverage in the EU-27 would prevent 2.86 deaths and would generate 16.52 QALYs at the incremental cost of 2,847,994 EUR annually, which translates to 172,378 EUR/QALY incremental cost-effectiveness ratio (ICER). However, adopting Austrian influenza mortality rates adjusted to higher frailty prevalence in Serbia, increased vaccination coverage would prevent 28.96 deaths and generate 132.77 QALYs at the incremental cost of 2,803,675 EUR annually with an 21,116 EUR/QALY ICER, below Serbian willingness to pay threshold. Accordingly, extension of seasonal influenza vaccination in older adults would be a cost-effective public health intervention in Serbia. Underreporting of adult influenza mortality rates prevent policymakers from understanding the true economic value of influenza vaccination. Our approach is applicable in further countries with low reported influenza mortality rates.
•Underreported influenza mortality with low vaccination coverage in CEE.•Projected influenza mortality estimates in the elderly for 6 CEE countries.•Revised economic value of seasonal influenza vaccination in an exemplary country.•Transferable approach to further countries with underreported influenza mortality.
Journal Article
Empirical analysis of the relationship among urbanization, economic growth and ecological footprint: evidence from Eastern Europe
In recent environmental sustainability literature, ecological footprint is largely seen as the most appropriate indicator of environmental destruction. However, due to lack of clarity in its relationship with economic growth, ecosystem services, biodiversity and human well-being, serious academic and political attention on environmental sustainability has not really reflected on ecological footprint. Using CADF unit root test, Westerlund cointegration test, common correlated effects and Dumitrescu Hurlin causality approaches, we conduct empirical analysis of the relationship among urbanization, economic growth and ecological footprint: evidence from Eastern Europe between 1998Q4 and 2017Q4. We address the following protracted questions in the literature: (1) Can we find a relationship between ecological footprint, urbanization and growth? (2) What explains the relationship, if any? The outcomes of the Westerlund cointegration test reveal cointegration among the variables, (ii) the outcome of the Dumitrescu Hurlin causality test indicates that there is a long-run unidirectional causality running from growth to the ecological footprint and (iii) urbanization does not homogeneously cause ecological footprint. The study has implications for regional policy actions that could support the reduction of ecological deficits through growth and urbanization policies towards improving regional environmental quality.
Journal Article
The Costs of Dementia in Europe: An Updated Review and Meta-analysis
Background and Objective
The prevalence of dementia is increasing, while new opportunities for diagnosing, treating and possibly preventing Alzheimer’s disease and other dementia disorders are placing focus on the need for accurate estimates of costs in dementia. Considerable methodological heterogeneity creates challenges for synthesising the existing literature. This study aimed to estimate the costs for persons with dementia in Europe, disaggregated into cost components and informative patient subgroups.
Methods
We conducted an updated literature review searching PubMed, Embase and Web of Science for studies published from 2008 to July 2021 reporting empirically based cost estimates for persons with dementia in European countries. We excluded highly selective or otherwise biased reports, and used a random-effects meta-analysis to produce estimates of mean costs of care across five European regions.
Results
Based on 113 studies from 17 European countries, the estimated mean costs for all patients by region were highest in the British Isles (73,712 EUR), followed by the Nordics (43,767 EUR), Southern (35,866 EUR), Western (38,249 EUR), and Eastern Europe and Baltics (7938 EUR). Costs increased with disease severity, and the distribution of costs over informal and formal care followed a North-South gradient with Southern Europe being most reliant on informal care.
Conclusions
To our knowledge, this study represents the most extensive meta-analysis of the cost for persons with dementia in Europe to date. Though there is considerable heterogeneity across studies, much of this is explained by identifiable factors. Further standardisation of methodology for capturing resource utilisation data may further improve comparability of future studies. The cost estimates presented here may be of value for cost-of-illness studies and economic evaluations of novel diagnostic technologies and therapies for Alzheimer’s disease.
Journal Article