Table Model Research Articles

Estimated health benefits, costs, and cost-effectiveness of implementing WHO's sodium benchmarks for packaged foods in India: a modelling study.

Excess dietary sodium intake has been associated with death and disability. WHO has released global sodium benchmarks for packaged foods to support countries to reduce population sodium intake. This study aimed to assess the potential health effect, costs, and cost effectiveness of implementing these WHO sodium benchmarks in India. We used a multiple cohort, proportional multistate, life table (Markov) model to estimate the health gains and cost effectiveness for adults if sodium content in packaged foods complied with the WHO benchmarks compared to the status quo. We used India-specific dietary surveys, food composition tables, foods sales data, and sodium content data from packaged food labels to estimate sodium intake before and after the intervention. Data on blood pressure, cardiovascular disease, and chronic kidney disease burden were obtained from the Global Burden of Diseases, Injuries, and Risk Factors study, and the effect of sodium reduction on blood pressure and disease risk was modelled on the basis of meta-analyses of randomised trials and cohort studies. Intervention and health-care costs were used to estimate net costs, and calculate the incremental cost per health-adjusted life-year (HALY) gained. Costs and HALYs were discounted at 3%. In the first 10 years, compliance with the WHO sodium benchmarks was estimated to avert a mean of 0·3 (95% uncertainty interval [UI] 0·2-0·5) million deaths from cardiovascular diseases and chronic kidney disease, a mean of 1·7 (95% UI 1·0-2·4) million incident cardiovascular disease events, and 0·7 (0·4-1·0) million new chronic kidney disease cases, compared with current practice. Over 10 years, the intervention was projected to be cost saving (100·0% probability), generating 1·0 (0·6 to 1·4) billion HALYs and US$0·8 (95% UI 0·3 to 1·4) million in cost savings. Over the population lifetime, the intervention could prevent 4·2 (2·4-6·0) million deaths from cardiovascular diseases and chronic kidney disease, 14·0 (8·2-20·1) million incident cardiovascular disease events, and 4·8 (2·8-6·8) new chronic kidney disease cases, with an 84·2% probability of being cost-saving and 100·0% probability of being cost-effective. Our modelling data suggest a high potential for compliance with WHO sodium benchmarks for packaged food being associated with substantial health gains and cost savings, making a strong case for India to mandate the implementation of the WHO sodium benchmarks, particularly as packaged food consumption continues to rise. WHO Country Office India.

Estimated health effect, cost, and cost-effectiveness of mandating sodium benchmarks in Australia's packaged foods: a modelling study

Excess dietary sodium is a leading cause of death and disability globally. Because packaged foods are a major source of sodium in many countries, including Australia, mandatory limits for sodium might improve population health. We aimed to estimate the long-term health and economic effect of mandating such thresholds in Australia. We used a multiple cohort, proportional, multistate, life table model to simulate the effect of mandating either the WHO global sodium benchmarks or the currently non-mandatory Australian Healthy Food Partnership (HFP) sodium targets. We compared maintaining the current sodium intake status quo with intervention scenarios, using nationally representative data on dietary intake, sodium in packaged foods, and food sales volume. Blood pressure and disease burden data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study. The effect of sodium reduction on blood pressure and disease risk was modelled on the basis of meta-analyses of randomised trials and cohort studies. Intervention and health-care costs were used to calculate the incremental cost per health-adjusted life-year (HALY) gained. Costs and HALYs were discounted annually at 3%. Compared with the status quo intervention, mandating the WHO benchmarks could be cost saving over the first 10 years (AUD$223 [95% uncertainty interval 82-433] million saved), with 2743 (1677-3976) cardiovascular disease deaths and 43 971 (26 892-63 748) incident cardiovascular disease events averted, and 11 174 (6800-16 205) HALYs gained. Over the population's lifetime, the intervention was cost effective (100·0% probability). Mandating the HFP sodium targets was also estimated to be cost effective (100·0% probability), but with 29% of the health benefits compared with the WHO benchmarks. Our modelling study supports mandating sodium thresholds for packaged foods as a cost-effective strategy to prevent death and disease in Australia. Although making Australia's voluntary reformulation targets mandatory might save thousands of lives, mandating the WHO global benchmarks could yield substantially greater health gains. None.

Shaking Table Test and Numerical Modeling of Seismic Behavior of Rectangular Tunnel Structures Embedded in Soft Clay

In this paper, a series of 1-g shaking table model tests were carried out to investigate the seismic behavior of a relatively stiff rectangular tunnel structure installed in soft clay bed, accounting for different ground motions with varying peak accelerations. Using a validated numerical analysis procedure, a suite of three-dimensional (3D) finite element (FE) analyses was performed to systematically study the factors of tunnel burial depth, seismic intensity, flexural rigidity of the middle column and tunnel wall thickness on the seismic response of rectangular tunnel structures installed in clayey ground. It was found that, with the increasing burial depth, the seismic response of rectangular tunnel structure became more intense due to the increased inertial force arising from the overlying clay; in terms of improving the seismic performance of tunnel structure, increasing tunnel wall thickness seemed more effective than increasing flexural rigidity of the middle column. Furthermore, it was found that the existing simplified approaches generally tended to overestimate the earthquake-induced racking distortions of rectangular tunnels installed in clayey ground. A new semi-empirical relationship was derived for better correlating the racking ratio with flexibility ratio for rectangular tunnels embedded in soft clays, which could provide a useful reference for the seismic design and risk assessment of similar clay-tunnel systems.

Failure analysis and deformation characteristics of shield tunnel obliquely crossing ground fissure under earthquake

In order to study the deformation law and failure characteristics of shield tunnel obliquely crossing ground fissure under earthquake action, taking the shield tunnel of Xi ’an Metro Line 8 crossing f3 ground fissure as the engineering background, the 1: 20 shaking table model test method was used to analyze the strain of shield tunnel, the contact pressure with surrounding rock soil, the dislocation of segment and the axial force of bolt in detail, and the seismic damage mechanism and failure characteristics of shield tunnel obliquely crossing ground fissure were obtained. The test results show that under the action of earthquake, the shield tunnel has complex three-dimensional deformation characteristics, among which the vertical deformation is the most obvious. The deformation is mainly concentrated in the location of the ground fissure. The tensile strain and contact pressure of the hanging wall of the tunnel segment are greater than the strain value and contact pressure of the footwall. Because the vertical deformation of the tunnel is the largest, the bolts at the vault and the arch bottom are most obviously pulled. Excavation after the test, it can be seen that the tunnel appeared the phenomenon of ring joint opening, lining cracking and other damage. Under the action of the earthquake, the shield tunnel across the ground fissure is mainly subjected to tensile failure. The failure area is within 10 m from the ground fissure in the hanging wall and footwall, and the total length is 20 m. The closer to the ground fissure, the more serious the damage. The research results provide a scientific and reasonable reference for the subsequent construction and disaster prevention and mitigation design of Xi ’an Metro.

Economic impact of screening on postdiagnosis work productivity in Japanese women with breast cancer: a life-table modeling approach.

In Japan, biennial mammography screening has been recommended for the early detection of breast cancer (BC) in women aged 40years or above since 2004 by the Ministry of Health, Labor and Welfare. The purpose of this study is to estimate the economic impact of BC screening on work productivity, using a new measure called the productivity-adjusted life-year (PALY). We used a dynamic life table modeling approach to estimate the work productivity of female patients aged 40-64years diagnosed with BC in 2019 over the year of diagnosis and the subsequent 5years. Changes in life-years, PALYs, and gross domestic product (GDP) were assessed by changing the screening detection rate from the current (34.2%) to an ideal (100%) percentage. Each input for modeling was obtained from the most recent public database available. BC patients were estimated to lose 1903 in life-years, 3596 in PALYs, and US$281 million in GDP at the current screening detection rate compared with the ideal detection rate. On the other hand, the following gains are expected when the current screening detection rate was increased to 40-80%; life-years gain; 168-1325, PALYs gain; 317-2503, GDP gain: US$25-196 million. This study has used modeling to show that detecting BC without screening is associated with a lower work productivity and an economic and life-years loss. Encouraging BC screening may be beneficial to maintaining work productivity after diagnosis.

A novel deep learning-based method for generating floor response spectra of building structures

Accurately and efficiently generating floor response spectra is crucial for the seismic design and analysis of nonstructural components, and seismic analysis of equipment placed on floors. In this article, a direct spectra-to-spectra method for generating floor response spectra is designed based on deep learning algorithms. The dataset was developed using the records of 102 building observation arrays in the Center for Engineering Strong Motion Data, which included 48 concrete structures, 44 steel structures and 10 masonry structures. The procedure involves training a deep learning model (FRSNet) with the ground response spectra and easily obtained structural parameters as inputs and the floor response spectra as outputs. Analysis results show that the prediction performance of the model is good on concrete structures, steel structures and masonry structures. The proposed model has sufficient accuracy, and the prediction performance is better than that of other models compared in this article. Finally, the proposed model is validated through two numerical models, a shaking table model structure and an actual structure. Convincing results confirm the accurate prediction capabilities of the proposed method.

Lifetime Cost-Effectiveness of Structured Education and Exercise Therapy for Knee Osteoarthritis in Australia.

Structured education and exercise therapy programs have been proposed to reduce reliance on total knee replacement (TKR) surgery and improve health care sustainability. The long-term cost-effectiveness of these programs is unclear. To estimate the lifetime cost-effectiveness of implementing a national structured education and exercise therapy program for individuals with knee osteoarthritis with the option for future TKR compared with usual care (TKR for all). This economic evaluation used a life table model in combination with a Markov model to compare costs and health outcomes of a national education and exercise therapy program vs usual care in the Australian health care system. Subgroup, deterministic, and probabilistic sensitivity analyses were completed. A hypothetical cohort of adults aged 45 to 84 years who would undergo TKR was created. Structured education and exercise therapy intervention provided by physiotherapists. The comparator was usual care where all people undergo TKR without accessing the program in the first year. Incremental net monetary benefit (INMB), with an incremental cost-effectiveness ratio threshold of 28 033 Australian dollars (A$) per quality-adjusted life-year (QALY) gained, was calculated from a health care perspective. Transition probabilities, costs, and utilities were estimated from national registries and a randomized clinical trial. The hypothetical cohort included 61 394 individuals (53.9% female; 93.6% aged ≥55 years). Implementation of an education and exercise therapy program resulted in a lifetime cost savings of A$498 307 942 (US $339 922 227), or A$7970 (US $5537) per individual, and resulted in fewer QALYs (0.43 per individual) compared with usual care. At a population level, education and exercise therapy was not cost-effective at the lifetime horizon (INMB, -A$4090 [-US $2841]). Subgroup analysis revealed that the intervention was cost-effective only for the first 9 years and over a lifetime only in individuals with no or mild pain at baseline (INMB, A$11 [US $8]). Results were robust to uncertainty around model inputs. In this economic evaluation of structured education and exercise therapy compared with usual care, the intervention was not cost-effective over the lifetime for all patients but was for the first 9 years and for those with minimal pain. These findings point to opportunities to invest early cost savings in additional care or prevention, including targeted implementation to specific subgroups.

Everyone's been wondering what are the mechanisms for interpreting embedded root clauses in German and English…

This paper compares three types of embedded root clause (verb second in complement clauses, embedded imperatives and embedded inverted interrogatives) in German and English. It will describe in detail how these constructions differ from their non-root counterparts syntactically and pragmatically, and how equivalent constructions in German and English differ from each other. I will then use Farkas's (2022) version of the Table model to formalise how the pragmatic characteristics of these constructions falls out from a mixture of the generations of a conventional implicature and language-specific rules on how perspectives may shift under attitude predicates.

The impact of strategic infrastructure development of Bali on the economic growth

Bali is the most famous tourist destination in the world, and this popularity has led to a significant rise in the island’s economy. The rise in income has also driven an increase in demand for infrastructure. Moreover, the Bali regional competitiveness index, in the infrastructure pillar, shows a lower figure compared to the national level. So that the Bali Provincial Government focuses on building an infrastructure strategy. This research uses the Input-Output Table (IOT) model, namely the 2016 Bali Province IOT which will be released in 2021. This analysis was chosen because IOT assumes that one sector can be an input for other sectors, in terms of this this is the construction sector. With investment in strategic and monumental infrastructure marking the New Era of Bali, it will result in additional Gross Regional Domestic Product (GRDP) of IDR 18.7 trillion, or in other words Bali’s GRDP will increase by 9.71% from the condition of no investment. This shows that infrastructure development is able to boost Bali’s economy. Further research is needed to be able to qualitatively analyze development infrastructure strategies in Bali. Remembering that a qualitative approach is also important to be able to analyze in depth.

Seismic response investigation of prestressed anchor cable supporting rock slope with weak interlayer in Qinghai-Tibet Plateau, China

Earthquake-induced rock landslides in the eastern mountains of the Tibetan Plateau, especially landslides with weak interlayers pose a significant threat to major construction projects. Prestressed anchor cable is one of the main reinforcement methods of rock slopes. This paper combines shaking table model tests and numerical simulation to study the reinforcement effect and dynamic response characteristics of prestressed anchor cables applied to rock slopes with weak interlayers under strong earthquakes. The research results show that prestressed anchor cables can effectively reinforce slopes with weak interlayers. A small cable inclination, a small spacing and a high prestress are recommended in the seismic reinforcement design of prestressed anchor cable. In addition, the characteristics of slope progressive damage and prestress loss under the earthquake are found by the shaking table test. The results have been applied in hazard prevention and control of rock slopes on the Chengdu-Lanzhou Railway at the eastern Qinghai-Tibet Plateau.

Shaking Table Model Tests and Stability Analysis of Slopes Reinforced with New Anti-Seismic Anchor Cables

Shaking Table Model Tests and Stability Analysis of Slopes Reinforced with New Anti-Seismic Anchor Cables

Seismically induced deformations of layered slopes with non-unique and non-planar slip surfaces

Earthquake-induced deformation is prevalently used to evaluate the seismic performance of slopes, often assumed to occur along a predefined single slip surface. This paper presents a new limit equilibrium method combining with Newmark sliding block analysis for calculating the seismic displacement of layered slopes with non-unique and non-planar slip surfaces. The determination of the most and subsequent critical slip surfaces during the earthquake shaking is discussed with an emphasis on the coupling effects between the shallow and deep failures. The approach is validated by the results from numerical simulation and the shaking table model test of layered slopes. Comparison analyses are also performed for the predictions of seismic displacement from the developed and previous sliding-block models. It is found that the seismic sliding deformation at the first slip surface significantly affects the evolution and sliding deformation of the subsequent slip surface. For the considered example of layered slope, a second slip surface at deeper location passing through the slope toe is identified, and a coupled variation is observed for the sliding displacement along the two slip surfaces. These features are not well predicted from the available sliding-block models. The developed model can capture the interaction between the non-unique slip surfaces and the geometry effect of the non-planar slip surfaces.

Pemanfaatan Internet Of Things (IOT) Oleh Pemustaka Dalam Pencarian Informasi Di Dinas Kearsipan dan Perpustakaan Provinsi Sumatera Barat

The purpose of this research is (1) to determine the use of the Internet of Tings (IoT) to help simplify the process of searching for information at the Archives and Library Service of West Sumatra Province, (2) to determine the implementation of the Internet of Tings (IoT) in searching for information in libraries can increase the effectiveness and efficiency of services at the West Sumatra Province Archives and Library Service, (3) to find out what Internet of Things (IoT) devices can be used to assist the information search process at the West Sumatra Province Archives and Library Service. Measurement of the Internet of Things (IoT) is seen through four indicators, namely OPAC, RFID, information literacy and recommendation services. Measuring search information is seen through five indicators, namely, cognitive needs, affective needs, personal integration needs, social integration needs and fantasy needs. This research is quantitative research with descriptive methods. The population in this study was all users at the West Sumatra Province Archives and Library Service, using a random sampling technique. The main instrument used is a research questionnaire whose validity and reliability have been tested with a sample size of 100 respondents. The research results are: (1) The Internet of Things (IoT) variable has a total average score of 3.46. This indicates that the score is on an interval scale of 3.26-4.00, which means it is classified as very good. (2) The information search variable has a total average score of 3.23. This indicates that the score is on an interval scale of 2.51-3.25, which means it is in the good category. (3) The influence of the Internet of Things (IoT) on information searches at the West Sumatra Province Archives and Library Service. In the hypothesis test, the result was 0.398, which means that information needs have a significant relationship with the use of collections at the Sawahlunto City Library and Archives Service, as well as in the table model summary obtained R = 0.288. Then R2 = 0.083. If converted into a percentage, it is 28.8%, this shows that the influence of the Internet of Things (IoT) on information search is 28.8% and the remaining 71.2% is influenced by other factors. Overall, the results of the research analysis can be concluded by researchers that there is a significant influence on the Internet of Things (IoT) on information searches at the West Sumatra Province Archives and Library Service.

Analyses of Pile-Supported Structures with Base Isolation Systems by Shaking Table Tests

The dynamic behavior of a pile-supported structure with a base isolator was investigated by using 1 g shaking table model tests considering soil–structure interaction (SSI). The emphasis was placed on evaluating the effect of the with/without developed base isolator on the dynamic behavior of end-bearing piles and structures. The experiment was performed through sweep tests and sinusoidal wave tests. As a result of the tests, the developed base isolator was found to effectively reduce the structure’s resonant frequencies and damped the response acceleration under resonance frequencies. According to sweep tests, the base shear force of the pile-supported structure system tends to decrease as the relative density of the soil increases during resonance. It showed that the base isolator tends to reduce significantly the response acceleration of not only the rigid-based structure but also the pile-supported structure. It was shown that although the isolated superstructure recorded large horizontal displacements, piles experienced reduced horizontal displacement and bending moments, regardless of soil conditions.

Moving toward the “Other” on the Margins

AbstractAs the world grows into a global village through modernity and migration, one would think that boundaries and differences would be less; however, the closer we get to each other in the world, the more social, ethnic, economic, religious, and political boundaries we encounter. This phenomenon has led to the concepts of the “other” and those on the margins. Trying to define the term “margins” can be problematic. This article begins by reviewing the “incarnational model,” where the mighty and powerful are supposed to move toward the less powerful and bridge the gap between those in the centre and those on the margins. It goes on to propose the “eucharist model” and the “table model” for encounters, in this way removing barriers between people in a quest for a classless world.

Life tables of annual life expectancy and risk factors for mortality in cats in the UK.

The aims of the present study were to generate the first life tables for the UK companion cat population overall as well as broken down by sex and breed status, and to quantify associations between mortality and traits such as sex, neuter status, breed status and body weight in relation to mortality. Life table construction and modelling included data on 7936 confirmed deaths in cats under primary veterinary care at clinics participating in the VetCompass Programme in 2019. The life tables were built for cats overall, female and male cats, and crossbred and purebred cats. Multivariable generalised linear regression models were generated to explore the risk factors for a shortened lifespan. Life expectancy at age 0 for UK companion cats overall was 11.74 years (95% confidence interval [CI] 11.61-11.87). The probability of death at each year interval increased with age from year interval 3-4, with the probability value not exceeding 0.05 before year 9. Female cats (12.51 years; 95% CI 12.32-12.69) had a 1.33-year longer life expectancy than male cats (11.18 years; 95% CI 11.01-11.38) at age 0. Among the 12 breeds (including crossbred) analysed, Burmese and Birman had the longest life expectancy at year 0, showing 14.42 years (95% CI 12.91-15.93) and 14.39 years (95% CI 12.87-15.91), respectively. Sphynx had the shortest life expectancy at year 0 among the analysed breeds at 6.68 years (95% CI 4.53-8.83). Being entire, purebred and with a non-ideal body weight were significantly linked to a decreased lifespan. The life tables presented here for companion cats in the UK overall, by sex, and by crossbred and purebred cats can contribute to a better understanding of the life trajectory of cats, helping with evidence-based decision-making for cat owners and the veterinary profession. We have also provided an updated life expectancy at age 0 for various cat breeds for 2019 and showed evidence of the association between non-ideal weight and a decreased lifespan.

The association between disability and mortality: a mixed-methods study

Globally, 1·3 billion people have a disability and are more likely to experience poor health than the general population. However, little is known about the mortality or life expectancy gaps experienced by people with disabilities. We aimed to undertake a systematic review and meta-analysis of the association between disability and mortality, compare these findings to the evidence on the association of impairment types and mortality, and model the estimated life expectancy gap experienced by people with disabilities. We did a mixed-methods study, which included a systematic review and meta-analysis, umbrella review, and life expectancy modelling. For the systematic review and meta-analysis, we searched MEDLINE, Global Health, PsycINFO, and Embase for studies published in English between Jan 1, 2007, and June 7, 2023, investigating the association of mortality and disability. We included prospective and retrospective cohort studies and randomised controlled trials with a baseline assessment of disability and a longitudinal assessment of all-cause mortality or cause-specific mortality. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We did a random-effects meta-analysis to calculate a pooled estimate of the mortality rate ratio for people with disabilities compared with those without disabilities. We did an umbrella review of meta-analyses examining the association between different impairment types and mortality. We used life table modelling to translate the mortality rate ratio into an estimate of the life expectancy gap between people with disabilities and the general population. The systematic review and meta-analysis is registered with PROSPERO, CRD42023433374. Our search identified 3731 articles, of which 42 studies were included in the systematic review. The meta-analysis included 31 studies. Pooled estimates showed that all-cause mortality was 2·24 times (95% CI 1·84-2·72) higher in people with disabilities than among people without disabilities, although heterogeneity between the studies was high (τ2=0·28, I2=100%). Modelling indicated a median gap in life expectancy of 13·8 years (95% CI 13·1-14·5) by disability status. Cause-specific mortality was also higher for people with disabilities, including for cancer, COVID-19, cardiovascular disease, and suicide. The umbrella review identified nine meta-analyses, which showed consistently elevated mortality rates among people with different impairment types. Mortality inequities experienced by people with disabilities necessitate health system changes and efforts to address inclusion and the social determinants of health. National Institute for Health and Care Research, Rhodes Scholarship, Indonesia Endowment Funds for Education, Foreign, Commonwealth and Development Office (Programme for Evidence to Inform Disability Action), and the Arts and Humanities Research Council.

Shaking table model test for seismic response of soft soil site

Soil sites play a crucial role during earthquakes and serve as conduits for the transmission of seismic effects from the bedrock to urban structures. Analyzing the dynamic response of soil sites to seismic waves is crucial as it presents deeper insights into earthquake damage mechanisms. In this study, we prepared a mixture of sawdust and medium sand with a 1:2.5 mass ratio to model soil samples from a soft soil site in Shanghai. The applicability of the scale-factor equation was verified using resonance column tests. A series of shaking table tests were conducted to simulate free-field site responses based on the dimensions, operating frequencies, and vibration modes of the shaking table at the State Key Laboratory of Disaster Reduction in Civil Engineering at Tongji University. Three different types of earthquake waves were selected as the input motions: TCU003 for far-field long-period seismic waves, TCU068 for near-field pulse-type seismic waves, and the El Centro earthquake wave. The Kramer frequency domain method was used to verify the transfer functions of the site seismic responses. Furthermore, discrepancies in the time–frequency distribution of the soft site responses influenced by various types of earthquake waves were assessed and analyzed. The seismic response characteristics of the soft soil sites under varying input intensities were also analyzed. The findings of this study present valuable reference data for the seismic zoning of soft-soil sites and facilitate the determination of seismic input parameters for engineering structures.

Future Burden of Ischemic Stroke in Australia: Impact on Health Outcomes between 2019 and 2038

Background: Projections of the future burden of ischemic stroke (IS) has not been extensively reported for the Australian population; the availability of such data would assist in health policy planning, clinical guideline updates, and public health. Methods: First, we estimated the lifetime risk of IS (from age 40 to 100 years) using a multistate life table model. Second, a dynamic multistate model was constructed to project the burden of IS for the whole Australian population aged between 40 and 100 years over a 20-year period (2019–2038). Data for the study were primarily sourced from a large, representative Victorian linked dataset based on the Victorian Admitted Episode Dataset and National Death Index. The model projected prevalent and incident cases of nonfatal IS, fatal IS, and years of life lived (YLL) with and without IS. The YLL outcome was discounted by 5% annually; we varied the discounting rate in scenario analyses. Results: The lifetime risk of IS from age 40 years was estimated as 15.5% for males and 14.0% for females in 2018. From 2019 to 2038, 644,208 Australians were projected to develop incident IS (564,922 nonfatal and 79,287 fatal). By 2038, the model projected there would be 358,534 people with prevalent IS, 35,554 people with incident nonfatal IS and 5,338 people with fatal IS, a 14.2% (44,535), 72.9% (14,988), and 106.3% (2,751) increase compared to 2019 estimations, respectively. Projected YLL (with a 5% discount rate) accrued by the Australian population were 174,782,672 (84,251,360 in males and 90,531,312 in females), with 4,053,794 YLL among people with IS (2,320,513 in males, 1,733,281 in females). Conclusion: The burden of IS was projected to increase between 2019 and 2038 in Australia. The outcomes of the model provide important information for decision-makers to design strategies to reduce stroke burden.

Current and Future Cost Burden of Ischemic Stroke in Australia: Dynamic Model

Background: Stroke remains one of the leading causes of morbidity and mortality in Australia. The objective of this study was to estimate the current and future cost burden of ischemic stroke (IS) in Australia. Method: First, the annual chronic management cost per person following IS were derived for all people aged ≥30 years discharged from a public or private hospital in Victoria, Australia between July 2012 and June 2017 (with follow-up data until June 2018 [n = 34,471]). Then extrapolated the data from from Victoria to the whole Australian population aged between 30 years and 99 years to project the total healthcare costs following IS (combination of acute event and chronic management cost) over a 20-year period (2019–2038) using a dynamic multistate life table model. Data for the dynamic model were sourced from the Victorian Admitted Episodes Dataset (VAED) and supplemented with other published data. Result: The estimated annual total chronic management cost following IS was 13,525 Australian dollars (AUD) per person (95% CI: AUD 13,380, AUD 13,670) for cohorts in the VAED between July 2012 and June 2017. The annual chronic management cost was estimated to decline following IS. The highest cost was incurred in the first year of follow-up post-IS (AUD 14,309 per person) and declined to AUD 9,776 in the sixth year of follow-up post-IS. The total healthcare cost for people aged 30–99 years was projected to be AUD 47.7 billion (95% UI: AUD 44.6 billion, AUD 51.0 billion) over the 20-year period (2019–2038) Australia-wide, of which 91.3% (AUD 43.6 billion) was attributed to chronic management costs and the remaining 8.7% (AUD 4.2 billion) were due to acute IS events. Conclusion: IS has and will continue to have a considerable financial impact in the next 2 decades on the Australian healthcare system. Our estimated and projected cost burden following IS provides important information for decision making in relation to IS.