Public health has, for many years, been concerned with efforts to increase the efficiency of health care delivery, to measure changes in health care resource utilization and associated costs, and to link these changes to different types of interventions. These efforts, as well as collaboration between biopharmaceutical organizations, producers of medical devices, and managed care and public health organizations, have been enhanced by the opportunities created within the fast growing field of outcomes research. This volume presents studies contributing to the enhancement of the outcomes research paradigm by incorporating economic and social interactions within the health care delivery, clinical decision-making and outcomes systems. A multidisciplinary team of scientists in the fields of outcomes research, pharmacoeconomics, public health, health services research, and health economics address such complex problems as: benefits and cost of advancements in genetic technologies; methodologies for constructing health care utilization and cost estimates; and the effect of insurance type on resource utilization and health outcomes. Other studies consider both the types of drugs purchased and the prices paid, pharmaceutical spending and health outcomes, incremental advantages of newer treatments, willingness to pay measurements, disease-specific impacts on human capital and quality of life, and modelling clinical trial results. One of the most important findings in this book is the description of the role of low energy in the symptomatology of depression and its strong relationship with absenteeism, work productivity and social functioning. Another paper documents the disease-specific mortality, case-fatality and annual health care utilization in diabetics and establishes the association of respiratory conditions with elevated mortality among diabetics. The work contains other papers which provide significant results in cardiovascular, infectious, central nervous system disease areas as well as in quality of life and health outcomes measurements.

Three important issues have recently attracted researchers to study the economics of disability. First with the availability of sophisticated "data sets," it has become possible to conduct highly quantative investigations of the relative economic impacts of various types of disabling health problems. Second, the passage of the Americans with Disabilities Act in 1991, and the subsequent implementation of its employment provisions, focused national attention on the continuing scarcity of employment opportunities for disabled persons. The tools of analysis that have been developed over the past several decades to study racial and gender discrimination in labor markets are applied in this book to study the experiences of persons with disabilities. Third, the past several decades have witnessed a rapid growth in the public and private costs of disability support programs. Many economists recognize the need to design such programs that would provide continued economic security, without the work disincentives, high budgetary costs, and efficiency losses of existing programs.

A major purpose of this volume is to bring together empirical studies dealing with all three of the above issues in a single volume. By doing this we can illustrate the breadth of current research in the field and allow the reader to see the connections and common threads that underlie this scope of concerns and research objectives.

This book will present contributions by economists, systems developers, safety, health services, occupational and environmental health, and biomedical researchers in the fields of regulatory development, safety, quality assurance, health outcomes, occupational health, and biomedicine. The contributing research will explore the synergy of new science-based risk regulatory approaches, industry focus on manufacturing efficiencies and information technology and biogenetic innovations, and consumers demand for improved safety and quality of products, services, quality assurance, and transparency of information.The book investigates the impact of information technology, biogenetic, and pharmacological innovation on individuals quality of life, safety, individual and system health care utilization, occupational and environmental health and formulary decision making, and costs. It contains analyses of clinical and health outcomes resulting from innovative biopharmaceutical entities and delivery systems in the treatment of chronic conditions. It emphasises effective quality, regulatory system, and consistent science-based decision-making practices from private and public organizations and demonstrates regulatory issues affecting innovation and efficiency.

This is the 12th volume in a series which considers research in human capital and development.