No abstract

Background: Excessive alcohol consumption causes premature death (average of 79,000 deaths annually); increased disease and injury; property damage from fıre and motor vehicle crashes; alcohol-related crime; and lost productivity. However, its economic cost has not been assessed for the U.S. since 1998.Purpose: To update prior national estimates of the economic costs of excessive drinking.Methods: This study (conducted 2009 -2010) followed U.S. Public Health Service Guidelines to assess the economic cost of excessive alcohol consumption in 2006. Costs for health care, productivity losses, and other effects (e.g., property damage) in 2006 were obtained from national databases. Alcohol-attributable fractions were obtained from multiple sources and used to assess the proportion of costs that could be attributed to excessive alcohol consumption. Results:The estimated economic cost of excessive drinking was $223.5 billion in 2006 (72.2% from lost productivity, 11.0% from healthcare costs, 9.4% from criminal justice costs, and 7.5% from other effects) or approximately $1.90 per alcoholic drink. Binge drinking resulted in costs of $170.7 billion (76.4% of the total); underage drinking $27.0 billion; and drinking during pregnancy $5.2 billion. The cost of alcohol-attributable crime was $73.3 billion. The cost to government was $94.2 billion (42.1% of the total cost), which corresponds to about $0.80 per alcoholic drink consumed in 2006 (categories are not mutually exclusive and may overlap).Conclusions: On a per capita basis, the economic impact of excessive alcohol consumption in the U.S. is approximately $746 per person, most of which is attributable to binge drinking. Evidencebased strategies for reducing excessive drinking should be widely implemented. (Am J Prev Med 2011;41(5):516 -524)

Objective. To develop and apply a model that allows prediction of current and future supply and demand for rheumatology services in the US.Methods. A supply model was developed using the age and sex distribution of current physicians, retirement and mortality rates, the number of fellowship slots and fill rates, and practice patterns of rheumatologists. increase the number of people with rheumatic disorders, growth in the Gross Domestic Product, and flat rheumatology supply due to fixed numbers entering the workforce and to retirements. The productivity of younger rheumatologists and women, who will make up a greater percentage of the future workforce, may also have important effects on supply. Unknown effects that could influence these projections include technology advances, more efficient practice methods, changes in insurance reimbursements, and shifting lifestyles. Current data suggest that the pediatric rheumatology workforce is experiencing a substantial excess of demand versus supply.Conclusion. Based on assessment of supply and demand under current scenarios, the demand for rheumatologists is expected to exceed supply in the coming decades. Strategies for the profession to adapt to this changing health care landscape include increasing the number of fellows each year, utilizing physician assistants and nurse practitioners in greater numbers, and improving practice efficiency.The American College of Rheumatology (ACR) created the Workforce Study Advisory Group and retained The Lewin Group to conduct a new workforce study of US rheumatologists in 2005, to project demand for rheumatology services, in order to guide policy regarding rheumatology manpower for the next 2 decades. The Lewin Group is an applied research and consulting group specializing in health policy issues. While workforce projections are not an exact science, they attempt to model future needs using information and assumptions from the present.

Background: Chronic fatigue syndrome (CFS) is a chronic incapacitating illness that affects between 400,000 and 800,000 Americans. Despite the disabling nature of this illness, scant research has addressed the economic impact of CFS either on those affected or on the national economy.

Excessive drinking cost states a median of $2.9 billion in 2006. Most of the costs were due to binge drinking and about $2 of every $5 were paid by government. The Guide to Community Preventive Services has recommended several evidence-based strategies-including increasing alcohol excise taxes, limiting alcohol outlet density, and commercial host liability-that can help reduce excessive alcohol use and the associated economic costs.