http://repub.eur.nl/res/aut/3617/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/21370/ 2010-11-01T00:00:00Z This paper estimates medical resource use, direct costs, and productivity losses and costs (indirect costs) during episodes of acute otitis media (AOM) in young children. A 24-item Internet questionnaire was developed for parents in Belgium (Flanders), France, Germany, Italy, The Netherlands, Spain, and the United Kingdom (UK) to report health care resource use and productivity losses during the most recent episode of AOM in their child, younger than 5 years. The percentage who did not seek medical help for AOM was considerable in The Netherlands (28.3%) and the UK (19.7%). Antibiotic use was high, ranging from 60.8% (Germany) to 87.1% (Italy). Total costs per AOM episode ranged from D 332.00 (The Netherlands) to D 752.49 (UK). Losses in productivity accounted for 61% (France) to 83% (Germany) of the total costs. AOM poses a significant medical and economic burden to society. http://repub.eur.nl/res/pub/21371/ 2010-11-01T00:00:00Z This paper estimates medical resource use, direct costs, and productivity losses and costs (indirect costs) during episodes of acute otitis media (AOM) in young children. A 24-item Internet questionnaire was developed for parents in Belgium (Flanders), France, Germany, Italy, The Netherlands, Spain, and the United Kingdom (UK) to report health care resource use and productivity losses during the most recent episode of AOM in their child, younger than 5 years. The percentage who did not seek medical help for AOM was considerable in The Netherlands (28.3%) and the UK (19.7%). Antibiotic use was high, ranging from 60.8% (Germany) to 87.1% (Italy). Total costs per AOM episode ranged from D 332.00 (The Netherlands) to D 752.49 (UK). Losses in productivity accounted for 61% (France) to 83% (Germany) of the total costs. AOM poses a significant medical and economic burden to society. http://repub.eur.nl/res/pub/21828/ 2010-11-01T00:00:00Z This paper estimates medical resource use, direct costs, and productivity losses and costs (indirect costs) during episodes of acute otitis media (AOM) in young children. A 24-item Internet questionnaire was developed for parents in Belgium (Flanders), France, Germany, Italy, The Netherlands, Spain, and the United Kingdom (UK) to report health care resource use and productivity losses during the most recent episode of AOM in their child, younger than 5 years. The percentage who did not seek medical help for AOM was considerable in The Netherlands (28.3%) and the UK (19.7%). Antibiotic use was high, ranging from 60.8% (Germany) to 87.1% (Italy). Total costs per AOM episode ranged from €332.00 (The Netherlands) to €752.49 (UK). Losses in productivity accounted for 61% (France) to 83% (Germany) of the total costs. AOM poses a significant medical and economic burden to society. http://repub.eur.nl/res/pub/9547/ 2000-01-01T00:00:00Z OBJECTIVE: To study the relative importance of various determinants of total and cause-specific infant and early childhood mortality rates and their decline in The Netherlands in the period 1875-1879 to 1895-1899. DATA AND METHODS: Mortality and population data were derived from Statistics Netherlands for 16 towns and 11 rural areas. Mortality levels and their decline were estimated with a Poisson regression model. The associations of the estimated levels and declines, and determinants of infant and early childhood mortality were analysed using multivariate linear regression analysis. The causes of death studied were major contributors to infant mortality (convulsions, acute digestive disease, acute respiratory disease) and early childhood mortality (encephalitis/meningitis, acute respiratory disease, measles). RESULTS: Infant mortality rates were high in the south-western part of The Netherlands in 1875-1879. Due to a rapid decline in the western regions, this pattern changed to a north-south gradient in 1895-1899. Early childhood mortality showed an urban-rural gradient in 1875-1879 with mortality high in towns. This gradient had largely disappeared by 1895-1899, due to a rapid decline in mortality in towns. Roman Catholicism was significantly associated with infant mortality (particularly from diarrhoeal disease) in 1875-1879 and 1895-1899. The association with Roman Catholicism was stronger in 1895-1899 because mortality declines were less rapid in Roman Catholic areas in 1875-1879 to 1895-1899. Urbanization was significantly associated with early childhood mortality (particularly from respiratory disease) in 1875-1879 and 1895-1899. This association weakened over time, due to the rapid decline in mortality in towns. CONCLUSIONS: Different determinants of mortality (decline) were important in infant and early childhood mortality and they acted on different causes of death. Therefore, infant and childhood mortality should be studied separately. International comparison of the results showed that findings with respect to determinants of mortality (decline) for one country do not necessarily apply to other countries. The results for The Netherlands with respect to infant mortality differed from England and Wales. http://repub.eur.nl/res/pub/17663/ 1998-11-25T00:00:00Z Mortality has declined drastically in many countries throughout the world over the past centuries. Life expectancies doubled, infant and child mortality declined strongly and mortality shifted to older ages. This phenomenon started in the 18th or 19th centuries in western industrialised countries and it was observed in other countries as well, although in a later period of titne and at a different pace of decline. This common pattern of mortality decline observed in western countries has led to the fonllulation of the demographic transition theory and, later, to the formulation of the epidctniological transition theory, which is the subject of this study. http://repub.eur.nl/res/pub/8679/ 1997-01-01T00:00:00Z BACKGROUND: Although mortality from conditions amenable to medical intervention has frequently been shown to be higher in the countries of Central and Eastern Europe (CCEE) than in the countries of Western Europe (CWE), the contribution of these mortality differences to the East-West gap in life expectancy is unknown. We have determined the contribution of mortality from nine amenable causes to differences in temporary life expectancy from birth to age 75 (TLE0-75) between 12 CCEE and the average TLE0-75 for CWE in ca. 1988. DATA AND METHODS: Population and mortality data were extracted from publications of the World Health Organization. Chiang's method was used for constructing abridged life tables, and Arriaga's method was used for decomposition by cause of death of the differences in TLE0-75 between each of the CCEE and the average for CWE. RESULTS: Differences in TLE0-75 between CCEE and the average for CWE ranged between 1.25 and 6.29 years in men, and between 1.09 and 3.44 years in women. After exclusion of early neonatal deaths, for which data were not available in all CCEE, amenable causes accounted for between 11% and 50% of the difference in TLE0-75 in men, and between 24% and 59% in women. The results for countries where data on early neonatal deaths were available show that inclusion of this category generally raises these estimates substantially. The contribution of conditions amenable to medical intervention to the East-West life expectancy gap is of the same order of magnitude as that of cardiovascular diseases, and much larger than that of neoplasms, respiratory diseases or external causes. CONCLUSION: Although the contribution of conditions amenable to medical intervention should not be taken as a direct estimate of the contribution of medical care to the East-West life expectancy gap, these results suggest that reducing differences in the effectiveness of medical care may be more important for narrowing the life expectancy gap than has hitherto been assumed. http://repub.eur.nl/res/pub/8714/ 1997-01-01T00:00:00Z BACKGROUND: The objective of this study is to produce a detailed yet robust description of the epidemiologic transition in The Netherlands. METHODS: National mortality data on sex, age, cause of death and calendar year (1875-1992) were extracted from official publications. For the entire period, 27 causes of death could be distinguished, while 65 causes (nested within the 27) could be studied from 1901 onwards. Cluster analysis was used to determine groups of causes of death with similar trend curves over a period of time with respect to age- and sex-standardized mortality rates. RESULTS: With respect to the 27 causes, three important clusters were found: (1) infectious diseases which declined rapidly in the late 19th century (e.g. typhoid fever), (2) infectious diseases which showed a less precipitous decline (e.g. respiratory tuberculosis), and (3) non-infectious diseases which showed an increasing trend during most of the period 1875-1992 (e.g. cancer). The 65 causes provided more detail. Seven important clusters were found: four consisted mainly of infectious diseases, including a new cluster that declined rapidly after the Second World War (WW2) (e.g. acute bronchitis/influenza) and a new cluster showing an increasing trend in the 1920s and 1930s before declining in the years thereafter (e.g. appendicitis). Three clusters mainly contained non-infectious diseases, including a new one that declined from 1900 onwards (e.g. cancer of the stomach) and a new one that increased until WW2 but declined thereafter (e.g. chronic rheumatic heart disease). CONCLUSIONS: The results suggest that the conventional interpretation of the epidemiologic transition, which assumes a uniform decline of infectious diseases and a uniform increase of non-infectious diseases, needs to be modified.