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34 records – page 1 of 4.

[A substantial part of health resources is reserved for the dying. Cost analysis of terminal care].

https://arctichealth.org/en/permalink/ahliterature216874
Source
Lakartidningen. 1994 Nov 23;91(47):4390-2
Publication Type
Article
Date
Nov-23-1994
Author
T. Lithman
D. Noreen
A. Norlund
B. Sundström
Author Affiliation
Miljö- och samhällsmedicinska sektionen, Malmöhus läns landsting, Lund.
Source
Lakartidningen. 1994 Nov 23;91(47):4390-2
Date
Nov-23-1994
Language
Swedish
Publication Type
Article
Keywords
Cost Allocation
Health Resources
Humans
Norway
Sweden
Terminal Care - economics
United States
PubMed ID
7808148 View in PubMed
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Case costing's contribution to utilization review activities: a review of a laparoscopic cholecystectomy patient population.

https://arctichealth.org/en/permalink/ahliterature214568
Source
Leadersh Health Serv. 1995 Sep-Oct;4(5):26-31
Publication Type
Article
Author
K A Potvin
Author Affiliation
Ottawa General Hospital, Ontario.
Source
Leadersh Health Serv. 1995 Sep-Oct;4(5):26-31
Language
English
Publication Type
Article
Keywords
Case Management - economics - organization & administration - statistics & numerical data
Cholecystectomy, Laparoscopic - economics - utilization
Comorbidity
Cost Allocation - methods
Data Display
Hospital Costs - statistics & numerical data
Hospitals, General - economics - statistics & numerical data
Humans
Medical Staff, Hospital - economics - statistics & numerical data
Ontario
Physician's Practice Patterns - economics - statistics & numerical data
Surgical Procedures, Elective - economics
Time and Motion Studies
Utilization Review - economics - statistics & numerical data
Abstract
The Ottawa General Hospital is one of 13 Ontario hospitals participating in the Ontario Case Cost Project. The hospital has been collecting clinical and financial information based on the patient-specific use of products and services since April 1, 1993. The resulting decision-support database that is evolving enhances the traditional utilization review process. The author presents the analysis and conclusions regarding laparoscopic cholecystectomy patients as an example of the hospital's use of the data in utilization review activities.
PubMed ID
10172432 View in PubMed
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[Cessation of smoking decreases the number of cases with spontaneous pneumothorax and resources can be redistributed]

https://arctichealth.org/en/permalink/ahliterature67942
Source
Lakartidningen. 1989 Nov 15;86(46):4023-6
Publication Type
Article
Date
Nov-15-1989
Author
L. Bense
L C Wiman
S. Jendteg
B. Lindgren
Source
Lakartidningen. 1989 Nov 15;86(46):4023-6
Date
Nov-15-1989
Language
Swedish
Publication Type
Article
Keywords
Cost Allocation
English Abstract
Humans
Pneumothorax - economics - epidemiology
Smoking
Sweden - epidemiology
Abstract
The incidence of spontaneous pneumothorax has increased during the last fifty years, and recent studies indicate that tobacco smoking increases the incidence approximately tenfold among women and twentyfold among men. Total direct and indirect costs for the community due to smoking-induced spontaneous pneumothorax in Sweden amount to roughly 70 million SEK annually. Were smokers to give up smoking, 70 to 90 per cent of the cases could be avoided. These figures, and the fact that other smoking-induced diseases annually cause at least 10,000 deaths, 1,000 permanent disabilities, and 450,000 days of hospital care in Sweden, constitute formidable arguments in favour of efforts to prevent smoking.
PubMed ID
2586216 View in PubMed
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Source
Am J Health Syst Pharm. 1995 Apr 1;52(7):757-8
Publication Type
Article
Date
Apr-1-1995
Author
K. Maclean
Source
Am J Health Syst Pharm. 1995 Apr 1;52(7):757-8
Date
Apr-1-1995
Language
English
Publication Type
Article
Keywords
Canada
Cost Allocation - methods
Drug Costs
Drug Prescriptions - economics
Humans
Pharmacy Service, Hospital - economics
Notes
Comment On: Am J Hosp Pharm. 1994 May 15;51(10):1331-48085571
PubMed ID
7627745 View in PubMed
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Coding response to a case-mix measurement system based on multiple diagnoses.

https://arctichealth.org/en/permalink/ahliterature179367
Source
Health Serv Res. 2004 Aug;39(4 Pt 1):1027-45
Publication Type
Article
Date
Aug-2004
Author
Colin Preyra
Author Affiliation
Department of Health Policy, Management and Evaluation, University of Toronto, Canada. Colin@preyra.com
Source
Health Serv Res. 2004 Aug;39(4 Pt 1):1027-45
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Comorbidity
Cost Allocation
Diagnosis-Related Groups - classification - economics
Efficiency, Organizational
Forms and Records Control - methods
Health Services Research
Hospital Costs
Hospital Information Systems - organization & administration
Humans
Inpatients - classification
Medical Records - classification
Models, Econometric
Ontario
Regression Analysis
Reimbursement Mechanisms
Abstract
To examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model.
Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002.
Disaggregated trends in hospital case-mix growth are examined for five years following the adoption of an inpatient classification system making extensive use of combinations of secondary diagnoses. Hospital case mix is decomposed into base and complexity components. The longitudinal effects of coding variation on a standard hospital payment model are examined in terms of payment accuracy and impact on adjustment factors.
Introduction of the refined case-mix system provided incentives for hospitals to increase reporting of secondary diagnoses and resulted in growth in highest complexity cases that were not matched by increased resource use over time. Despite a pronounced coding response on the part of hospitals, the increase in measured complexity and case mix did not reduce the unexplained variation in hospital unit cost nor did it reduce the reliance on the teaching adjustment factor, a potential proxy for case mix. The main implication was changes in the size and distribution of predicted hospital operating costs.
Jurisdictions introducing extensive refinements to standard diagnostic related group (DRG)-type payment systems should consider the effects of induced changes to hospital coding practices. Assessing model performance should include analysis of the robustness of classification systems to hospital-level variation in coding practices. Unanticipated coding effects imply that case-mix models hypothesized to perform well ex ante may not meet expectations ex post.
Notes
Cites: Health Serv Res. 2001 Feb;35(6):1267-9111221819
Cites: J Health Care Finance. 2002 Spring;28(3):1-1312079147
Cites: Med Care. 2002 Oct;40(10):847-5012395017
Cites: Med Care. 2002 Oct;40(10):856-6712395020
Cites: N Engl J Med. 1985 Jul 4;313(1):20-43923354
Cites: Ann Intern Med. 1997 Oct 15;127(8 Pt 2):666-749382378
Cites: N Engl J Med. 1988 Feb 11;318(6):352-53123929
Cites: Health Aff (Millwood). 1989 Summer;8(2):35-472501203
Cites: JAMA. 1992 Aug 19;268(7):896-91640619
Cites: Health Serv Res. 1992 Dec;27(5):587-606; discussion 607-121464535
Cites: Med Care. 1996 Aug;34(8):767-828709659
Cites: Health Care Financ Rev. 1986 Summer;7(4):51-6510311672
PubMed ID
15230940 View in PubMed
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Comparing the financial risk of bed-day and DRG based pricing types using parametric and simulation methods.

https://arctichealth.org/en/permalink/ahliterature185506
Source
Health Care Manag Sci. 2003 May;6(2):67-74
Publication Type
Article
Date
May-2003
Author
Hennamari Mikkola
Reijo Sund
Miika Linna
Unto Häkkinen
Author Affiliation
National R&D Centre for Welfare and Health, Helsinki, Finland. Hennamari.Mikkola@stakes.fi
Source
Health Care Manag Sci. 2003 May;6(2):67-74
Date
May-2003
Language
English
Publication Type
Article
Keywords
Benchmarking
Cost Allocation
Data Interpretation, Statistical
Diagnosis-Related Groups - economics
Financing, Government
Finland
Health Services Research
Hospital Costs - classification - statistics & numerical data
Hospitals, District - economics
Humans
Local Government
Models, Econometric
Rate Setting and Review - classification - statistics & numerical data
Reimbursement Mechanisms
Risk Sharing, Financial
Abstract
The extent of random financial risk involved in the Finnish bed-day and Diagnosis Related Groups (DRG) based hospital pricing systems were estimated and compared using parametric and simulation methods. DRG based payment schemes were found to provide significantly better protection against financial risk for municipalities, but municipality's size was the main determinant of financial risk. Small municipalities should use longer contracts between hospitals or form bigger purchaser-organisations for risk pooling. In addition, the current risk management system proved to be ineffective in decreasing the random variation in total costs.
PubMed ID
12733610 View in PubMed
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Continuity of care and health care costs among persons with severe mental illness.

https://arctichealth.org/en/permalink/ahliterature172995
Source
Psychiatr Serv. 2005 Sep;56(9):1070-6
Publication Type
Article
Date
Sep-2005
Author
Craig R Mitton
Carol E Adair
Gerry M McDougall
Gisele Marcoux
Author Affiliation
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada. cmitton@exchange.ubc.ca
Source
Psychiatr Serv. 2005 Sep;56(9):1070-6
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - classification - psychology
Adult
Alberta
Analysis of Variance
Community Mental Health Services - economics
Continuity of Patient Care - economics
Cost Allocation
Cost-Benefit Analysis
Economics
Female
Health Care Costs - statistics & numerical data
Health services needs and demand
Hospitalization - economics
Humans
Male
Middle Aged
Outcome Assessment (Health Care) - statistics & numerical data
Psychotic Disorders - economics - rehabilitation
Quality of Life - psychology
Regression Analysis
Abstract
Although the association between continuity of care and health outcomes among persons with severe mental illness is beginning to be elucidated, the association between continuity and costs has remained virtually unexplored. The purpose of this study was to examine the relationship of continuity of care and health care costs in a sample of 437 adults with severe mental illness in three health regions of Alberta, Canada.
Service use events and costs were tracked through self-reported and administrative data. Associations between continuity and costs were examined by using analysis of variance and regression analysis.
Mean+/-SD total, hospital, and community cost over the 17-month study period were $24,070+/-$25,643, $12,505+/-$20,991, and $2,848+/-$4,420, respectively. The difference in means across levels of observer-rated continuity was not statistically significant for total cost, but improved continuity was associated with both lower hospital cost and higher community cost. Total cost was significantly lower for patients with a higher self-rated quality of life as indicated on the EQ-5D visual analogue scale, although associations did not hold up in the regression analysis. Patients with higher functioning as rated by the Multnomah Community Abilities Scale had significantly lower total and community costs.
The study showed a relationship between continuity of care and both hospital and community costs. The data also indicate that a relationship exists between cost and level of patient functioning. It will be necessary to conduct further studies using experimental designs to examine the impact of shifting resources from hospitals to the community, particularly for high-need patients, on continuity of care and subsequent outcomes.
Notes
Comment On: Psychiatr Serv. 2005 Sep;56(9):1061-916148318
PubMed ID
16148319 View in PubMed
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Cost implications of routine mammography screening of women 50-69 years in the county of Funen, Denmark.

https://arctichealth.org/en/permalink/ahliterature20116
Source
Health Policy. 2000 Nov 17;54(2):125-41
Publication Type
Article
Date
Nov-17-2000
Author
M. Bech
D. Gyrd-Hansen
Author Affiliation
Institute of Public Health, Health Economics, SDU-Odense University, Winslowparken 19, 3., DK-5000 Odense C, Denmark. mbe@sam.sdu.dk
Source
Health Policy. 2000 Nov 17;54(2):125-41
Date
Nov-17-2000
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - diagnosis - economics
Cost Allocation
Denmark - epidemiology
Diagnostic Tests, Routine
Female
Health Care Costs
Humans
Mammography - economics - utilization
Mass Screening - economics
Middle Aged
Abstract
In order to estimate the net costs of introducing mammography screening to women 50-69 years of age, unit costs of all relevant activities related to detection and treatment of breast cancer were estimated using activity based costing methods. In order to determine the overall impact of mammography screening, activity data collected from the second screening round (1996-1997) were compared with expected activity levels in the case no screening had taken place in this time period. The direct health care costs associated with the screening activity, excluding effects on treatment and diagnostics but including women's transport and time costs, were estimated at DKK 305 per attendee. The cost of clinical mammography decreases with the introduction of screening due to a decrease in the total number of women undergoing this introductory diagnostic activity, while surgery costs increases, whereas cost incurred by adjuvant treatment and treatment of recurrences will be significantly reduced. Overall, inclusion of effects on course of treatment decreases the net cost of screening by 30-40% to DKK 208 and DKK 128 including and excluding the women's time and transport costs, respectively.
PubMed ID
11094266 View in PubMed
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The cost of radiotherapy at an Ontario regional cancer centre: a re-evaluation.

https://arctichealth.org/en/permalink/ahliterature199922
Source
Crit Rev Oncol Hematol. 1999 Nov;32(2):87-93
Publication Type
Article
Date
Nov-1999
Author
C. Earle
D. Coyle
A. Smith
O. Agboola
W K Evans
Author Affiliation
Ottawa Regional Cancer Centre, University of Ottawa, Ontario, Canada. craig_earle@cancercare.on.ca
Source
Crit Rev Oncol Hematol. 1999 Nov;32(2):87-93
Date
Nov-1999
Language
English
Publication Type
Article
Keywords
Cancer Care Facilities - economics
Cost Allocation
Costs and Cost Analysis
Humans
Neoplasms - economics - radiotherapy
Ontario
Radiotherapy - economics
PubMed ID
10612008 View in PubMed
Less detail

Costs and effects in lumbar spinal fusion. A follow-up study in 136 consecutive patients with chronic low back pain.

https://arctichealth.org/en/permalink/ahliterature81297
Source
Eur Spine J. 2007 May;16(5):657-68
Publication Type
Article
Date
May-2007
Author
Soegaard Rikke
Christensen Finn Bjarke
Christiansen Terkel
Bünger Cody
Author Affiliation
Spine Unit, Orthopaedic Research Lab., University Hospital of Aarhus, Aarhus, Denmark. rikke.sogaard@ki.au.dk
Source
Eur Spine J. 2007 May;16(5):657-68
Date
May-2007
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Chronic Disease
Cost Allocation
Cost-Benefit Analysis
Denmark
Female
Follow-Up Studies
Hospital Costs
Hospitals, University - economics
Humans
Low Back Pain - economics - surgery
Lumbar Vertebrae - surgery
Male
Middle Aged
Outcome Assessment (Health Care) - economics
Regression Analysis
Spinal Fusion - economics - instrumentation
Abstract
Although cost-effectiveness is becoming the foremost evaluative criterion within health service management of spine surgery, scientific knowledge about cost-patterns and cost-effectiveness is limited. The aims of this study were (1) to establish an activity-based method for costing at the patient-level, (2) to investigate the correlation between costs and effects, (3) to investigate the influence of selected patient characteristics on cost-effectiveness and, (4) to investigate the incremental cost-effectiveness ratio of (a) posterior instrumentation and (b) intervertebral anterior support in lumbar spinal fusion. We hypothesized a positive correlation between costs and effects, that determinants of effects would also determine cost-effectiveness, and that posterolateral instrumentation and anterior intervertebral support are cost-effective adjuncts in posterolateral lumbar fusion. A cohort of 136 consecutive patients with chronic low back pain, who were surgically treated from January 2001 through January 2003, was followed until 2 years postoperatively. Operations took place at University Hospital of Aarhus and all patients had either (1) non-instrumented posterolateral lumbar spinal fusion, (2) instrumented posterolateral lumbar spinal fusion, or (3) instrumented posterolateral lumbar spinal fusion + anterior intervertebral support. Analysis of costs was performed at the patient-level, from an administrator's perspective, by means of Activity-Based-Costing. Clinical effects were measured by means of the Dallas Pain Questionnaire and the Low Back Pain Rating Scale at baseline and 2 years postoperatively. Regression models were used to reveal determinants for costs and effects. Costs and effects were analyzed as a net-benefit measure to reveal determinants for cost-effectiveness, and finally, adjusted analysis (for non-random allocation of patients) was performed in order to reveal the incremental cost-effectiveness ratios of (a) posterior instrumentation and (b) anterior support. The costs of non-instrumented posterolateral spinal fusion were estimated at DKK 88,285(95% CI 81,369;95,546), instrumented posterolateral spinal fusion at DKK 94,396(95% CI 89,865;99,574) and instrumented posterolateral lumbar spinal fusion + anterior intervertebral support at DKK 120,759(95% CI 111,981;133,738). The net-benefit of the regimens was significantly affected by smoking and functional disability in psychosocial life areas. Multi-level fusion and surgical technique significantly affected the net-benefit as well. Surprisingly, no correlation was found between treatment costs and treatment effects. Incremental analysis suggested that the probability of posterior instrumentation being cost-effective was limited, whereas the probability of anterior intervertebral support being cost-effective escalates as willingness-to-pay per effect unit increases. This study reveals useful and hitherto unknown information both about cost-patterns at the patient-level and determinants of cost-effectiveness. The overall conclusion of the present investigation is a recommendation to focus further on determinants of cost-effectiveness. For example, patient characteristics that are modifiable at a relatively low expense may have greater influence on cost-effectiveness than the surgical technique itself--at least from an administrator's perspective.
PubMed ID
16871387 View in PubMed
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34 records – page 1 of 4.