Priority-setting processes for medicines: the United Kingdom, Australia and New Zealand

The agencies involved in the assessment and prioritisation of medicines for public subsidy purposes in Australia, England and Wales, and New Zealand are compared in terms of their processes; ultimate decision-maker and political involvement in decisions; price-setting processes; decision criteria and inclusion of economic assessment of cost-effectiveness; provision for the rule of rescue and separate treatment of potentially life-saving medicines and cancer drugs; levels of access; extent of consumer participation in processes and decisions; and provision for appeal from decisions. All countries face the key challenge of expanding access to important new treatments, while maintaining cost-effectiveness as a key criterion for public funding and safeguarding the affordability and sustainability of their programs into the future. New Zealand's model may have led to a greater focus on cost-containment and overall affordability than those of the other two agencies. Despite controversial decisions that have led on occasion to disappointment and challenge, the Australian and New Zealand agencies have survived and appear to have managed to date to maintain public and political support. By contrast, the United Kingdom's National Institute for Healthcare and Clinical Excellence is facing major changes to its role that could see it become more of an advisory organisation.     

Elections and political change in post-war Bosnia and Herzegovina

This article examines attempts to use electoral politics to promote substantive political change in post-war Bosnia and Herzegovina. Since 1990 elections have been a key part of virtually all negotiated agreements to end civil wars. The utility of democracy for building peace is often asserted but rarely backed with long-term commitment and resources on the ground. Bosnia since 1996 is a rare exception. There, international actors sought not only to establish a democratic political system but to use electoral democracy as a tool with which to transform the nature of politics in Bosnia in short order. This article focuses on efforts to shape the development of political parties and the party system, assesses the degree to which it has succeeded and examines the broader implications of Bosnia's experience for other state-building efforts of its kind.     

Comparative study of postmortem barbiturates, methadone, and morphine in vitreous humor, blood, and tissue

With the introduction of radioimmunoassay (RIA) techniques, it has become toxicologically possible to determine drug concentrations in postmortem vitreous humor. This study demonstrates and confirms this toxicological feasibility. In 49 medical examiner's drug related cases, postmortem tissue levels of morphine, barbiturates, and methadone were compared to the vitreous humor.     

Special report on reimbursement. Medicare program abandons 1986 malpractice rule

Hospitals with claims "properly pending" before fiscal intermediaries or in the courts need do nothing in order to obtain corrected reimbursement for fiscal years so pending. However, to speed processing of corrected reimbursements for fiscal years pending in appeals before the PRRB, hospitals should request that the Board determine its jurisdiction and remand to the fiscal intermediary for payment as soon as possible. It will be helpful to include with any such request a copy of the notice of program reimbursement and the original appeal letter for each fiscal year under appeal. Despite the fact that HCFA Ruling 91-1 effectively concedes that HCFA has applied an invalid regulation to all fiscal years since May 1, 1986, HCFA counsel have stated that HCFA will not permit reopening of closed cost reports to correct the inappropriate apportionment of malpractice insurance costs. Nevertheless, hospitals that do not presently have a claim or appeal pending have several options. Under the Provider Reimbursement Manual, HIM-15, sections 2930-2931, fiscal intermediaries are required to reopen cost reports filed within the three-year reopening period to correct errors. Accordingly, should a fiscal intermediary deny a provider's reopening request, the provider should seriously consider taking an appeal to the PRRB. The PRRB's jurisdiction to review fiscal intermediary denials of requests to reopen cost reports was affirmed by the United States Court of Appeals for the Ninth Circuit, see State of Oregon v. Bowen, 854 F.2d 346 (9th Cir. 1988), a decision that is controlling in California, Oregon, Washington, Nevada, Arizona, Montana, Idaho, Hawaii, Alaska, Guam, and the Northern Mariana Islands.(ABSTRACT TRUNCATED AT 250 WORDS)     

The Impact of Field Court Attendance Notices on Property Crime in New South Wales,Australia

Objectives

This paper investigates the impact of Field Court Attendance Notices (FCANs) on rates of property crime in New South Wales (NSW), Australia. FCANs are used for relatively minor offenses, are issued ‘on the spot’, and provide an alternative to the time consuming process of arresting an alleged offender and taking them to the police station for processing. Despite their use in NSW for over 20 years, this study is the first to evaluate their impact on crime.

Methods

We use data provided by the NSW Bureau of Crime Statistics and Research, and the Australian Bureau of Statistics. We specify a general dynamic panel data model estimated via the Arellano and Bond (Rev Econ Stud 58:277–297, 1991) estimator, specifically the first-differenced twostep generalised method of moments (GMM) estimator.

Results

For property crime as a whole, in both the short- and long-run, we find no significant relationship between the use of FCANS and levels of offending. However, when offending rates are disaggregated into 11 sub-categories, we find that in the short-run an increase in the use of FCANs leads to statistically significant decreases in the rate of crime for five of the sub-categories offenses considered (break and enter dwelling; motor vehicle theft; steal from motor vehicle; steal from retail store and; steal from dwelling). The long-run results are largely consistent with the short-run results in terms of their signs and statistical significance, suggesting that the effects persist.

Conclusions

The empirical analysis presented in this paper suggests that the use of FCANs is an effective and potentially efficient policing strategy for a subset of property offenses, in that offenders can be processed at lower cost and long-run rates of certain crimes reduced.