المؤلفون: Niskanen, Leo, Toresson-Grip, Emilie, Gunnarsson, Joel, Casajust, Paula, Tuovinen, Mikko, Stenman, Lotta K., Ustyugova, Anastasia

المساهمون: HUS Abdominal Center, Päijät-Häme Welfare Consortium

مصطلحات موضوعية: Diabetes Mellitus, Type 2, +drug therapy, Benzhydryl Compounds, Glucosides, Sodium-Glucose Transporter 2 Inhibitors, Dipeptidyl-Peptidase IV Inhibitors, Treatment Outcome, Heart Failure, Myocardial Infarction, Stroke, Mortality, Facilities and Services Utilization, 3121 General medicine, internal medicine and other clinical medicine

الوصف: Lähtökohdat : Vertailimme empagliflotsiinin ja dipeptidyylipeptidaasi-4:n (DPP-4) estäjien vaikuttavuutta ja terveydenhuollon resurssien käyttöä Suomessa. Työ tehtiin osana EU:n ja Aasian Emprise-tutkimusta (EUPAS27606, NCT03817463). Menetelmät : Ei-interventionaalinen, retrospektiivinen kohorttitutkimus käytti suomalaisia rekisteriaineistoja. Aikuiset, jotka aloittivat tyypin 2 diabetekseensa lääkehoidon empagliflotsiinilla tai DPP-4:n estäjillä 5/2014–12/2018, kaltaistettiin pareiksi ≥ 170 muuttujaan perustuvilla propensiteettipisteillä. Päätetapahtumia ja terveydenhuollon resurssien käyttöä vertailtiin Coxin mallilla ja Poissonin regressiomallilla. Tulokset : 11 801 potilasparia kaltaistettiin. Empagliflotsiinia käyttävillä oli DPP-4:n estäjiin verrattuna pienempi sydämen vajaatoiminnan (HR = 0,54; 95 %:n LV 0,39–0,74), kuoleman (HR = 0,36; 0,27–0,48), sydäninfarktin, aivohalvauksen tai kokonaiskuolleisuuden yhteismuuttujan (HR = 0,53; 0,43–0,66) ja loppuvaiheen munuaistaudin (ESRD) (HR = 0,43; 0,19–0,95) riski. Lisäksi empagliflotsiinipotilailla terveydenhuollon resurssien käyttö oli merkitsevästi vähäisempää. Tulokset olivat samansuuntaisia sydän- ja verisuonitautia sairastavilla ja muilla diabetespotilailla. Päätelmät : Empagliflotsiinia käyttäneillä oli pienempi vakavien päätetapahtumien riski sekä vähemmän terveydenhuollon resurssien käyttöä DPP-4:n estäjiin verrattuna. ; Peer reviewed

وصف الملف: application/pdf

العلاقة: Niskanen , L , Toresson-Grip , E , Gunnarsson , J , Casajust , P , Tuovinen , M , Stenman , L K & Ustyugova , A 2023 , ' Lääkevalinnalla on merkitystä tyypin 2 diabeteksessa ' , Suomen lääkärilehti , vol. 78 , no. 32 , e36144 . < https://www.laakarilehti.fi/pdf/2023/SLL32-2023-1197.pdfTest >; RIS: urn:F3AEDF83E14DC3DAF4FC463F9E3732BC; 3709cb2d-2d7e-4496-884d-cd709d724886; http://hdl.handle.net/10138/572273Test

الإتاحة: http://hdl.handle.net/10138/572273Test

المؤلفون: Wester, Axel, Shang, Ying, Toresson Grip, Emilie, Matthews, Anthony A, Hagström, Hannes

مصطلحات موضوعية: Hepatology

الوصف: Objective Phase II trials suggest glucagon-like peptide-1 receptor (GLP1) agonists resolve metabolic dysfunction-associated steatohepatitis but do not affect fibrosis regression. We aimed to determine the long-term causal effect of GLP1 agonists on the risk of major adverse liver outcomes (MALO) in patients with any chronic liver disease and type 2 diabetes. Design We used observational data from Swedish healthcare registers 2010–2020 to emulate a target trial of GLP1 agonists in eligible patients with chronic liver disease and type 2 diabetes. We used an inverse-probability weighted marginal structural model to compare parametric estimates of 10-year MALO risk (decompensated cirrhosis, hepatocellular carcinoma, liver transplantation or MALO-related death) in initiators of GLP1 agonists with non-initiators. We randomly sampled 5% of the non-initiators to increase computational efficiency. Results GLP1 agonist initiators had a 10-year risk of MALO at 13.3% (42/1026) vs 14.6% in non-initiators (1079/15 633) in intention-to-treat analysis (risk ratio (RR)=0.91, 95% CI=0.50 to 1.32). The corresponding 10-year per-protocol risk estimates were 7.4% (22/1026) and 14.4% (1079/15 633), respectively (RR=0.51, 95% CI=0.14 to 0.88). The per-protocol risk estimates at 6 years were 5.4% (21/1026) vs 9.0% (933/15 633) (RR=0.60, 95% CI=0.29 to 0.90) and at 8 years 7.2% (22/1026) vs 11.7% (1036/15 633) (RR=0.61, 95% CI=0.21 to 1.01). Conclusion In patients with chronic liver disease and type 2 diabetes who adhered to therapy over time, GLP1 agonists may result in lower risk of MALO. This suggests that GLP1 agonists are promising agents to reduce risk of chronic liver disease progression in patients with concurrent type 2 diabetes, although this needs to be corroborated in randomised trials.

وصف الملف: text/html

العلاقة: http://gut.bmj.com/cgi/content/short/73/5/835Test; http://dx.doi.org/10.1136/gutjnl-2023-330962Test

الإتاحة: https://doi.org/10.1136/gutjnl-2023-330962Test
http://gut.bmj.com/cgi/content/short/73/5/835Test

المؤلفون: Hallberg, Sara, Rolfson, Ola, Karppinen, Jaro, Schiøttz-Christensen, Berit, Stubhaug, Audun, Rivano Fischer, Marcelo, Gerdle, Björn, Toresson Grip, Emilie, Gustavsson, Anders, Robinson, Rebecca L., Varenhorst, Christoph, Schepman, Patricia

المصدر: Hallberg , S , Rolfson , O , Karppinen , J , Schiøttz-Christensen , B , Stubhaug , A , Rivano Fischer , M , Gerdle , B , Toresson Grip , E , Gustavsson , A , Robinson , R L , Varenhorst , C & Schepman , P 2023 , ' Burden of disease and management of osteoarthritis and chronic low back pain : Healthcare utilization and sick leave in Sweden, Norway, Finland and Denmark (BISCUITS): Study design and patient characteristics of a real world data study ' , Scandinavian Journal of Pain , vol. 23 , ....

مصطلحات موضوعية: burden of illness, cohort studies, musculoskeletal disorders, observational study, prevalence, quality of life, Low Back Pain/therapy, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Humans, Cost of Illness, Finland/epidemiology, Denmark/epidemiology, Patient Acceptance of Health Care, Norway, Sick Leave, Sweden/epidemiology, Osteoarthritis/therapy

الوصف: Objectives: Osteoarthritis (OA) and chronic low back pain (CLBP) are common musculoskeletal disorders with substantial patient and societal burden. Nordic administrative registers offer a unique opportunity to study the impact of these conditions in the real-world setting. The Burden of Disease and Management of Osteoarthritis and Chronic Low Back Pain: Health Care Utilization and Sick Leave in Sweden, Norway, Finland and Denmark (BISCUITS) study was designed to study disease prevalence and the societal and economic burden in broad OA and CLBP populations. Methods: Patients in Sweden, Norway, Finland and Denmark with diagnoses of OA or CLBP (low back pain record plus ≥2 pain relief prescriptions to indicate chronicity) were identified in specialty care, in primary care (Sweden and Finland) and in a quality-of-care register (Sweden). Matched controls were identified for the specialty care cohort. Longitudinal data were extracted on prevalence, treatment patterns, patient-reported outcomes, social and economic burden. Results: Almost 1.4 million patients with OA and 0.4 million with CLBP were identified in specialty care, corresponding to a prevalence in the Nordic countries of 6.3 and 1.9%, respectively. The prevalence increased to 11-14% for OA and almost 6% for CLBP when adding patients identified in primary care. OA patients had a higher Elixhauser comorbidity index (0.66 vs. 0.46) and were using opioids (44.7 vs. 10.2%) or long-term nonsteroidal anti-inflammatory drug (NSAIDs) (20.9 vs. 4.5%) more than four times as often as compared to controls. The differences were even larger for CLBP patients compared to their controls (comorbidity index 0.89 vs. 0.39, opioid use 77.7 vs. 9.4%, and long-term NSAID use 37.2 vs. 4.8%). Conclusions: The BISCUITS study offers an unprecedented, longitudinal healthcare data source to quantify the real-world burden of more than 1.8 million patients with OA or CLBP across four countries. In subsequent papers we aim to explore among others additional outcomes and subgroups of ...

وصف الملف: application/pdf

العلاقة: https://portal.findresearcher.sdu.dk/da/publications/1ca120fa-7d90-4b45-8186-b84406839d0cTest

الإتاحة: https://doi.org/10.1515/sjpain-2021-0212Test
https://portal.findresearcher.sdu.dk/da/publications/1ca120fa-7d90-4b45-8186-b84406839d0cTest

المؤلفون: Nyström, Thomas, Toresson Grip, Emilie, Gunnarsson, Joel, Casajust, Paula, Karlsdotter, Kristina, Skogsberg, Josefin, Ustyugova, Anastasia

المساهمون: Eli Lilly and Company, Boehringer Ingelheim

المصدر: Diabetes, Obesity and Metabolism ; volume 25, issue 1, page 261-271 ; ISSN 1462-8902 1463-1326

الوصف: Aims To evaluate effectiveness and healthcare resource utilization (HCRU) of empagliflozin versus dipeptidyl peptidase‐4 inhibitors (DPP‐4i) in Swedish clinical practice, as part of the EMPRISE EU study (EUPAS27606, NCT03817463). Materials and Methods A non‐interventional, cohort study using retrospectively collected data from Swedish national registries. Adults with type 2 diabetes newly initiated on empagliflozin or DPP‐4i from May 2014 to December 2018 were matched 1:1 using propensity scores based on >180 covariates. Cardiovascular outcomes included hospitalization for heart failure (HHF), all‐cause mortality (ACM), myocardial infarction (MI), stroke and cardiovascular mortality (CVM), as well as their composite outcomes. Renal outcomes included end‐stage renal disease (ESRD), estimated glomerular filtration rate (eGFR) decline to <60 ml/min/1.73 m 2 and progression to micro/macroalbuminuria. HCRU outcomes were also assessed. Comparisons were done using Cox proportional hazards and Poisson regression models. Results Overall, 15,785 matched‐pairs were identified, with a mean follow‐up of 6.4 and 9.7 months for patients initiating empagliflozin versus DPP‐4i, respectively. Empagliflozin was associated with significant reduction in rates of HHF (hazard ratio [HR] = 0.67; 95% confidence interval: 0.49‐0.91), ACM (HR = 0.53; 0.41‐0.68), HHF + ACM (HR = 0.59; 0.48‐0.73), MI + stroke + ACM (HR = 0.68; 0.57‐0.81), CVM (HR = 0.46; 0.29‐0.73), HHF + CVM (HR = 0.61; 0.47‐0.79) and MI + stroke + CVM (HR = 0.79; 0.63‐0.98) versus DPP‐4i. Empagliflozin also reduced the rates of ESRD (HR = 0.13; 0.03‐0.57) and eGFR decline (HR = 0.83; 0.70‐0.99). Regarding HCRU, empagliflozin was associated with lower risk of first inpatient stay (HR = 0.87; 0.81‐0.93), and lower rate of inpatient and outpatient visits (rate ratio [RR] = 0.85; 0.80‐0.89 and RR = 0.96; 0.94‐0.98) than DPP‐4i. Conclusions Empagliflozin treatment compared to DPP‐4i reduced cardiorenal events and overall mortality, which may explain lower HCRU ...

الإتاحة: https://doi.org/10.1111/dom.14870Test

المؤلفون: Hallberg, Sara, Rolfson, Ola, Karppinen, Jaro, Schiøttz-Christensen, Berit, Stubhaug, Audun, Toresson Grip, Emilie, Robinson, Rebecca L., De Geer, Anna, Schepman, Patricia

المصدر: Scandinavian Journal of Pain; Oct2023, Vol. 23 Issue 4, p694-704, 11p

مستخلص: Data from 'BISCUITS', a large Nordic cohort study linking several registries, were used to estimate differences in average direct and indirect costs between patients with osteoarthritis and controls (matched 1:1 based on birth year and sex) from the general population in Sweden, Norway, Finland and Denmark for 2017. Patients ≥18 years with ≥1 diagnosis of osteoarthritis (ICD-10: M15–M19) recorded in specialty or primary care (the latter available for a subset of patients in Sweden and for all patients in Finland) during 2011–2017 were included. Patients with a cancer diagnosis (ICD-10: C00–C43/C45–C97) were excluded. Productivity loss (sick leave and disability pension) and associated indirect costs were estimated among working-age adults (18–66 years). In 2017, average annual incremental direct costs among adults with osteoarthritis (n=1,157,236) in specialty care relative to controls ranged between €1,259 and €1,693 (p<0.001) per patient across all countries. Total average annual incremental costs were €3,224–€4,969 (p<0.001) per patient. Healthcare cost differences were mainly explained by osteoarthritis patients having more surgeries. However, among patients with both primary and secondary care data, primary care costs exceeded the costs of surgery. Primary care constituted 41 and 29 % of the difference in direct costs in Sweden and Finland, respectively. From a societal perspective, the total economic burden of osteoarthritis is substantial, and the incremental cost was estimated to €1.1–€1.3 billion yearly for patients in specialty care across the Nordic countries. When including patients in primary care, incremental costs rose to €3 billion in Sweden and €1.8 billion in Finland. Given the large economic impact, finding cost-effective and safe therapeutic strategies for these patients will be important. [ABSTRACT FROM AUTHOR]

: Copyright of Scandinavian Journal of Pain is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Hallberg, Sara, Rolfson, Ola, Karppinen, Jaro, Schiøttz-Christensen, Berit, Stubhaug, Audun, Rivano Fischer, Marcelo, Gerdle, Björn, Toresson Grip, Emilie, Gustavsson, Anders, Robinson, Rebecca L, Varenhorst, Christoph, Schepman, Patricia

المصدر: Hallberg, Sara Rolfson, Ola Karppinen, Jaro Schiøttz-Christensen, Berit Stubhaug, Audun Rivano Fischer, Marcelo Gerdle, Björn Toresson Grip, Emilie Gustavsson, Anders Robinson, Rebecca L Varenhorst, Christoph Schepman, Patricia . Burden of disease and management of osteoarthritis and chronic low back pain: Healthcare utilization and sick leave in Sweden, Norway, Finland and Denmark (BISCUITS): Study design and patient characteristics of a real world data study. Scandinavian Jo
Scandinavian Jo

الإتاحة: http://hdl.handle.net/10852/101469Test

المؤلفون: Hallberg, Sara, Rolfson, Ola, Karppinen, Jaro, Schiøttz-Christensen, Berit, Stubhaug, Audun, Rivano Fischer, Marcelo, Gerdle, Björn, Toresson Grip, Emilie, Gustavsson, Anders, Robinson, Rebecca L, Varenhorst, Christoph, Schepman, Patricia

المصدر: 1877-8860.

الوصف: Objectives Osteoarthritis (OA) and chronic low back pain (CLBP) are common musculoskeletal disorders with substantial patient and societal burden. Nordic administrative registers offer a unique opportunity to study the impact of these conditions in the real-world setting. The Burden of Disease and Management of Osteoarthritis and Chronic Low Back Pain: Health Care Utilization and Sick Leave in Sweden, Norway, Finland and Denmark (BISCUITS) study was designed to study disease prevalence and the societal and economic burden in broad OA and CLBP populations. Methods Patients in Sweden, Norway, Finland and Denmark with diagnoses of OA or CLBP (low back pain record plus ≥2 pain relief prescriptions to indicate chronicity) were identified in specialty care, in primary care (Sweden and Finland) and in a quality-of-care register (Sweden). Matched controls were identified for the specialty care cohort. Longitudinal data were extracted on prevalence, treatment patterns, patient-reported outcomes, social and economic burden. Results Almost 1.4 million patients with OA and 0.4 million with CLBP were identified in specialty care, corresponding to a prevalence in the Nordic countries of 6.3 and 1.9%, respectively. The prevalence increased to 11–14% for OA and almost 6% for CLBP when adding patients identified in primary care. OA patients had a higher Elixhauser comorbidity index (0.66 vs. 0.46) and were using opioids (44.7 vs. 10.2%) or long-term nonsteroidal anti-inflammatory drug (NSAIDs) (20.9 vs. 4.5%) more than four times as often as compared to controls. The differences were even larger for CLBP patients compared to their controls (comorbidity index 0.89 vs. 0.39, opioid use 77.7 vs. 9.4%, and long-term NSAID use 37.2 vs. 4.8%). Conclusions The BISCUITS study offers an unprecedented, longitudinal healthcare data source to quantify the real-world burden of more than 1.8 million patients with OA or CLBP across four countries. In subsequent papers we aim to explore among others additional outcomes and subgroups of ...

العلاقة: Hallberg, Sara Rolfson, Ola Karppinen, Jaro Schiøttz-Christensen, Berit Stubhaug, Audun Rivano Fischer, Marcelo Gerdle, Björn Toresson Grip, Emilie Gustavsson, Anders Robinson, Rebecca L Varenhorst, Christoph Schepman, Patricia . Burden of disease and management of osteoarthritis and chronic low back pain: Healthcare utilization and sick leave in Sweden, Norway, Finland and Denmark (BISCUITS): Study design and patient characteristics of a real world data study. Scandinavian Journal of Pain. 2022; http://hdl.handle.net/10852/101469Test; 2063563; info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Scandinavian Journal of Pain&rft.volume=&rft.spage=&rft.date=2022; Scandinavian Journal of Pain; 23; 126; 138; https://doi.org/10.1515/sjpain-2021-0212Test

الإتاحة: https://doi.org/10.1515/sjpain-2021-0212Test
http://hdl.handle.net/10852/101469Test

المؤلفون: Nyström, Thomas¹ (AUTHOR) thomas.nystrom@ki.se, Toresson Grip, Emilie^2,3 (AUTHOR), Gunnarsson, Joel² (AUTHOR), Casajust, Paula⁴ (AUTHOR), Karlsdotter, Kristina⁵ (AUTHOR), Skogsberg, Josefin⁵ (AUTHOR), Ustyugova, Anastasia⁶ (AUTHOR)

المصدر: Diabetes, Obesity & Metabolism. Jan2023, Vol. 25 Issue 1, p261-271. 11p.

مصطلحات موضوعية: *CD26 antigen, *EMPAGLIFLOZIN, *CHRONIC kidney failure, *GLOMERULAR filtration rate, *POISSON regression

مصطلحات جغرافية: SWEDEN

مستخلص: Aims: To evaluate effectiveness and healthcare resource utilization (HCRU) of empagliflozin versus dipeptidyl peptidase‐4 inhibitors (DPP‐4i) in Swedish clinical practice, as part of the EMPRISE EU study (EUPAS27606, NCT03817463). Materials and Methods: A non‐interventional, cohort study using retrospectively collected data from Swedish national registries. Adults with type 2 diabetes newly initiated on empagliflozin or DPP‐4i from May 2014 to December 2018 were matched 1:1 using propensity scores based on >180 covariates. Cardiovascular outcomes included hospitalization for heart failure (HHF), all‐cause mortality (ACM), myocardial infarction (MI), stroke and cardiovascular mortality (CVM), as well as their composite outcomes. Renal outcomes included end‐stage renal disease (ESRD), estimated glomerular filtration rate (eGFR) decline to <60 ml/min/1.73 m2 and progression to micro/macroalbuminuria. HCRU outcomes were also assessed. Comparisons were done using Cox proportional hazards and Poisson regression models. Results: Overall, 15,785 matched‐pairs were identified, with a mean follow‐up of 6.4 and 9.7 months for patients initiating empagliflozin versus DPP‐4i, respectively. Empagliflozin was associated with significant reduction in rates of HHF (hazard ratio [HR] = 0.67; 95% confidence interval: 0.49‐0.91), ACM (HR = 0.53; 0.41‐0.68), HHF + ACM (HR = 0.59; 0.48‐0.73), MI + stroke + ACM (HR = 0.68; 0.57‐0.81), CVM (HR = 0.46; 0.29‐0.73), HHF + CVM (HR = 0.61; 0.47‐0.79) and MI + stroke + CVM (HR = 0.79; 0.63‐0.98) versus DPP‐4i. Empagliflozin also reduced the rates of ESRD (HR = 0.13; 0.03‐0.57) and eGFR decline (HR = 0.83; 0.70‐0.99). Regarding HCRU, empagliflozin was associated with lower risk of first inpatient stay (HR = 0.87; 0.81‐0.93), and lower rate of inpatient and outpatient visits (rate ratio [RR] = 0.85; 0.80‐0.89 and RR = 0.96; 0.94‐0.98) than DPP‐4i. Conclusions: Empagliflozin treatment compared to DPP‐4i reduced cardiorenal events and overall mortality, which may explain lower HCRU among empagliflozin users in Sweden. [ABSTRACT FROM AUTHOR]

المؤلفون: Toresson Grip, Emilie¹, Svensson, Ann-Marie², Miftaraj, Mervete², Eliasson, Björn^2,3, Franzén, Stefan², Gudbjörnsdottir, Soffia^2,3, Carlsson, Katarina Steen^1,4 katarina.steen_carlsson@ihe.se, Steen Carlsson, Katarina^1,4 (AUTHOR)

المصدر: Diabetes Care. Apr2019, Vol. 42 Issue 4, p545-552. 8p.

مصطلحات موضوعية: *TYPE 1 diabetes, *INSULIN pumps, *MEDICAL care costs, *HIGHER education costs, *MEDICAL care use

مستخلص: Objective: To investigate real-world costs of continuous insulin pump therapy compared with multiple daily injection (MDI) therapy for type 1 diabetes.Research Design and Methods: Individuals with type 1 diabetes and pump therapy in the Swedish National Diabetes Register (NDR) since 2002 were eligible. Control subjects on MDI were matched 2:1 using time-varying propensity scores. Longitudinal data on health care resource use, antidiabetes treatment, sickness absence, and early retirement were taken from national registers for 2005-2013. Mean annual costs were analyzed using univariate analysis. Regression analyses explored the role of sociodemographic factors. Subgroup and sensitivity analyses were performed.Results: A total of 14,238 individuals with type 1 diabetes entered in the NDR between 2005 and 2013 (insulin pump n = 4,991, MDI n = 9,247, with switches allowed during the study) were included. Mean age at baseline was 34 years, with 21 years of diabetes duration and a mean HbA1c of 8.1% (65 mmol/mol). We had 73,920 person-years of observation with a mean follow-up of 5 years per participant. Mean annual costs were higher for pump therapy than for MDI therapy ($12,928 vs. $9,005, respectively; P < 0.001; mean difference $3,923 [95% CI $3,703-$4,143]). Health care costs, including medications and disposables, accounted for 73% of the costs for pump therapy and 63% of the costs for MDI therapy. Regression analyses showed higher costs for low education, low disposable income, women, and older age.Conclusions: Nine years of real-world data on all measurable diabetes-related resource use show robust results for additional costs of insulin pump therapy in adults by subgroup and alternative propensity score specifications. Identification of tangible and intangible benefits of pump therapy over time remain important to support resource allocation decisions. [ABSTRACT FROM AUTHOR]

المؤلفون: Toresson Grip, Emilie, Järvinen, Mieke

مصطلحات موضوعية: Europe, bounded variables, concentration index, inequality measurements, income-related health inequality, Business and Economics

الوصف: This essay estimates the trends in Income-Related Health Inequalities (IRHI) in 11 European countries between 2006 to 2013 and investigates the sensitivity of these trends with respect to different inequality measures. The motivation for this study is both empirically and theoretically driven. Empirically, there have been many studies aiming to quantify and explain IRHI but relatively few have investigated the trends in IRHI. Of those who have, an increasing, to the least, stable trend in IRHI seem to be suggested. However, recent theoretical developments and debates have highlighted technical complications and lately, normative challenges that arises when researchers aim to estimate IRHI using bounded health variables, variables that are commonly used in the literature. Thus, by summarising the most recent theoretical developments in the field of IRHI measurements and applying these different inequality indices in an empirical analysis, this essay contributes to the current literature by, firstly, the trend analysis over time and secondly, and most importantly, by the thorough and transparent empirical design which allow us to perform an extensive sensitivity analysis not previously performed. The results yield IRHI trends that are both increasing (Germany, the Netherlands and Spain) and decreasing (Austria, Sweden, Switzerland, Belgium and Czech Republic) between 2006 to 2013. The sensitivity analysis indicate that most of these findings are robust across different measurements but contain a few examples of different and even opposing changes over time when using different indices. Thus, the results confirm the recent theoretical debate and underline the need for using several measurements when estimating IRHI. The analysis of the consistent trends across measures are explained by the characteristics of the health variable and points to the close link between the results of different measurements and the prevalence of health.

وصف الملف: application/pdf

العلاقة: http://lup.lub.lu.se/student-papers/record/7867149Test

الإتاحة: http://lup.lub.lu.se/student-papers/record/7867149Test