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[A study of IVF treatment: misleading polemics on cost effectiveness]

https://arctichealth.org/en/permalink/ahliterature64943
Source
Lakartidningen. 1992 Jul 22;89(30-31):2496
Publication Type
Article
Date
Jul-22-1992
Author
B. Jönsson
B. Brorsson
P. Carlsson
G. Karlsson
Source
Lakartidningen. 1992 Jul 22;89(30-31):2496
Date
Jul-22-1992
Language
Swedish
Publication Type
Article
Keywords
Cost-Benefit Analysis
Female
Fertilization in Vitro
Humans
Pregnancy
Sweden
PubMed ID
1507973 View in PubMed
Less detail

Cancer treatment in Sweden--costs of drugs, inpatient and outpatient care from 1985 to 1996 and cost effectiveness of new drugs.

https://arctichealth.org/en/permalink/ahliterature21357
Source
Acta Oncol. 1998;37(5):447-53
Publication Type
Article
Date
1998
Author
G. Ragnarson Tennvall
G. Karlsson
Author Affiliation
IHE, The Swedish Institute for Health Economics, Lund. grt@ihe.se
Source
Acta Oncol. 1998;37(5):447-53
Date
1998
Language
English
Publication Type
Article
Keywords
Ambulatory Care - economics
Androgen Antagonists - economics - therapeutic use
Antineoplastic Agents - economics - therapeutic use
Cost-Benefit Analysis
Deoxycytidine - analogs & derivatives - economics - therapeutic use
Drug Costs
Filgrastim - economics - therapeutic use
Gonadorelin - economics - therapeutic use
Humans
Neoplasms - drug therapy - economics
Paclitaxel - economics - therapeutic use
Receptors, Serotonin - drug effects
Receptors, Serotonin, 5-HT3
Research Support, Non-U.S. Gov't
Sweden
Abstract
This study was carried out to investigate the direct costs for treatment of patients with cancer from 1985 to 1996 in Sweden, and to examine health economic effects of changes in treatment pattern. Material for the study was collected from official statistics and from published health economic evaluations of cancer treatment. Costs for inpatient care decreased during the period, while costs for outpatient care and drugs increased. In total, the direct health care costs for cancer treatment decreased from 1985 to 1996. New drugs registered on the market are often more expensive than the drugs they replace. From a health economic perspective it is not clear, however, that higher drug costs necessarily increase total costs. Further health economic research is needed because many treatment alternatives have not yet been evaluated, and furthermore, because a treatment option can be cost effective in one specific indication but not in another.
PubMed ID
9831373 View in PubMed
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Cost-benefit evaluation of dental implants.

https://arctichealth.org/en/permalink/ahliterature62915
Source
Int J Technol Assess Health Care. 1990;6(4):545-57
Publication Type
Article
Date
1990
Author
B. Jönsson
G. Karlsson
Author Affiliation
Linköping University.
Source
Int J Technol Assess Health Care. 1990;6(4):545-57
Date
1990
Language
English
Publication Type
Article
Keywords
Cost-Benefit Analysis
Costs and Cost Analysis
Dental Implantation - economics
Dental Implants - economics
Evaluation Studies
Humans
Research Support, Non-U.S. Gov't
Sweden
Abstract
The growing evidence of the efficacy and effectiveness of dental implants calls for economic evaluations to determine the economic efficiency of this technology for different indications. Such studies must be integrated with the clinical evaluations in order to produce the relevant data. In most cases, dental implants will produce a better outcome than the best alternative technology, but this improvement will only come at greater cost. Cost-benefit evaluations of dental implants must therefore address the difficult task of assessing the value of the improvement in oral health.
PubMed ID
2128081 View in PubMed
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Cost-effectiveness analysis and capital costs.

https://arctichealth.org/en/permalink/ahliterature205783
Source
Soc Sci Med. 1998 May;46(9):1183-91
Publication Type
Article
Date
May-1998
Author
G. Karlsson
M. Johannesson
Author Affiliation
Stockholm School of Economics, Sweden.
Source
Soc Sci Med. 1998 May;46(9):1183-91
Date
May-1998
Language
English
Publication Type
Article
Keywords
Budgets
Capital Expenditures
Cost-Benefit Analysis - methods
Decision Making, Organizational
Decision Support Techniques
Health Care Costs
Humans
Investments - economics
Linear Models
Models, Econometric
Quality-Adjusted Life Years
Sweden
Abstract
Traditionally, economic evaluations in terms of cost-effectiveness analysis are based, explicitly or implicitly, on the assumption of constant returns to scale. This assumption has been criticized in the literature and the role of cost-effectiveness as a tool for decision making has been questioned. In this paper we analyze the case of increasing returns to scale due to fixed capital costs. Cost-effectiveness analysis is regarded as a tool for estimating a cost function. To this cost function two types of decision rules can be applied, the budget approach and the constant price approach. It is shown that in the presence of fixed capital costs the application of these two decision rules to a specific patient group will give different results. The budget approach may lead to suboptimizations, while using the price as a decision rule will give optimal solutions. With fixed capital costs and when an investment can be used for treating several patient groups, these groups are no longer independent. Therefore the cost-effectiveness analysis has to be performed simultaneously for all patient groups that are potential users of the investment.
PubMed ID
9572608 View in PubMed
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Costs and effects of microsurgery versus radiosurgery in treating acoustic neuroma.

https://arctichealth.org/en/permalink/ahliterature22288
Source
Acta Neurochir (Wien). 1997;139(10):942-8
Publication Type
Article
Date
1997
Author
L. van Roijen
H G Nijs
C J Avezaat
G. Karlsson
C. Linquist
K H Pauw
F F Rutten
Author Affiliation
Institute for Medical Technology Assessment, Erasmus University Rotterdam, The Netherlands.
Source
Acta Neurochir (Wien). 1997;139(10):942-8
Date
1997
Language
English
Publication Type
Article
Keywords
Adult
Aged
Comparative Study
Cost-Benefit Analysis
Female
Humans
Male
Microsurgery - economics
Middle Aged
Netherlands
Neuroma, Acoustic - economics - surgery
Radiosurgery - economics
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden
Treatment Outcome
Abstract
This study analyses costs and effects of treating acoustic neuroma patients by using microsurgery compared to radiosurgery. Radiosurgery is the stereotactic application of radiotherapy and an innovative medical technology. Cost and effect estimates of conventional treatment were based on a retrospective study in the Netherlands. Similar data for a comparable group of patients in Sweden were collected for radiosurgery, as this treatment option is currently not available in the Netherlands. Fifty-three acoustic neuroma patients who had been operated on the University Hospital Rotterdam between November 1990 and February 1995 were included. This group was compared with 92 acoustic neuroma patients treated with radiosurgery (Gamma Knife. Stockholm, Sweden) in the same period. Data on health care use were collected from patient files. To obtain data on production losses and quality of life, a questionnaire was sent by mail in February 1995. This booklet consisted of the Health and Labour-questionnaire (HLQ), the Short Form-36 (SF36) and the EuroQol. The response rate was 92%. Direct costs for microsurgery amounted to Dfl. 20.072,- and for radiosurgery to Dfl. 14.272,-. Indirect costs were respectively Dfl. 16.400,- and Dfl. 1.020,-. General health rating was better for radiosurgery than for microsurgery. On the whole, differences in clinical outcomes between the two patient groups were small. Assuming a reasonable occupancy rate of the expensive radiosurgery equipment, we demonstrated that for the short term treating patients with acoustic neuroma with an extra-meatal tumour diameter of less than 3 centimeters, radiosurgery is more cost-effective than microsurgery.
PubMed ID
9401654 View in PubMed
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Cost-utility analysis of group living in dementia care.

https://arctichealth.org/en/permalink/ahliterature73104
Source
Int J Technol Assess Health Care. 1995;11(1):49-65
Publication Type
Article
Date
1995
Author
A. Wimo
B. Mattson
I. Krakau
T. Eriksson
A. Nelvig
G. Karlsson
Author Affiliation
Umeå University.
Source
Int J Technol Assess Health Care. 1995;11(1):49-65
Date
1995
Language
English
Publication Type
Article
Keywords
Aged
Comparative Study
Cost-Benefit Analysis - methods
Dementia - economics
Female
Group Homes - economics
Health Care Costs - statistics & numerical data
Humans
Life expectancy
Long-Term Care - economics
Male
Models, Theoretical
Quality of Life
Sweden
Abstract
A cost-utility analysis (CUA) was applied to group living for dementia patients. A Markov-model of an expected life-length of 8 years was used. Forty-six patients in group living were compared to 39 patients living at home by inclusion and 23 institutionalized patients. When the cost per gained quality-adjusted life-year (QALY) was calculated, the group living alternative was the most favorable for the patients, giving a cost per paired QALY of US dollars
PubMed ID
7706014 View in PubMed
Less detail
Source
Acta Oncol. 2001;40(2-3):412-33
Publication Type
Article
Date
2001
Author
G. Karlsson
P. Nygren
B. Glimelius
Author Affiliation
Stockholm School of Economics, Sweden.
Source
Acta Oncol. 2001;40(2-3):412-33
Date
2001
Language
English
Publication Type
Article
Keywords
Antiemetics - economics - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - economics - therapeutic use
Cost Savings
Cost-Benefit Analysis
Health Care Costs - statistics & numerical data
Humans
Neoplasms - drug therapy - economics
Quality-Adjusted Life Years
Sweden
Abstract
A systematic review of the effect of chemotherapy in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The review also included an assessment of the limited number of studies available on the health economics of chemotherapy for diagnoses included in the SBU report. The conclusions reached from this assessment can be summarized as follows: Several international studies and one Swedish study addressed the cost-effectiveness of different chemotherapeutic regimens. The quality of the studies is generally low and comparability is rather limited. Some of the studies compared cytostatic treatment with no cytostatic treatment. Most studies, however, compared two or more treatments. The costs were then compared with potential differences in treatment outcome. Outcomes are mostly measured as the cost per life-year gained. The results from these studies vary by treatment and indication. In some cases, after all relevant costs are taken into account, chemotherapy shows cost savings. In most studies, chemotherapy is associated both with higher costs and improved treatment results, often measured in terms of survival. Studies of rather high quality show that the cost per life-year gained (quality-adjusted) for most chemotherapeutic regimens with relatively limited effects ranges between 100,000 and 250,000 Swedish kronor (SEK). Estimates of cost-effectiveness for more effective chemotherapy has not been reported in the literature. The estimated costs are in parity with the costs of 'established' treatments for other diseases. There is uncertainty about what treatments can be considered cost-effective; there is no consensus concerning what costs are 'reasonable' per life-year gained in health care. The estimates of cost-effectiveness in most studies are highly uncertain and must be interpreted with caution. Improved assessment would require more studies in Sweden. For various reasons it is difficult to apply the results from the international studies to Sweden.
PubMed ID
11441944 View in PubMed
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Long-term economic effects of team-based clinical case management of patients with chronic minor disease and long-term absence from working life.

https://arctichealth.org/en/permalink/ahliterature72625
Source
Scand J Soc Med. 1997 Dec;25(4):229-37
Publication Type
Article
Date
Dec-1997
Author
T. Timpka
M. Leijon
G. Karlsson
L. Svensson
P. Bjurulf
Author Affiliation
Department of Social Medicine, Linköping University Hospital, Sweden. tooti@ida.liu.se
Source
Scand J Soc Med. 1997 Dec;25(4):229-37
Date
Dec-1997
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Case Management - economics
Chronic Disease - rehabilitation
Cost-Benefit Analysis
Female
Follow-Up Studies
Health Care Costs
Humans
Male
Patient care team
Rehabilitation, Vocational - economics
Sweden
Time Factors
Abstract
OBJECTIVES: To examine the socio-economic effects of team-based clinical case management of patients with chronic minor disease bound for early retirement. DESIGN: Marginal analysis of programme costs and benefits to society compared with no-programme baseline of costs occurring in society due to productivity loss. Prospective patient data collection on admission, discharge, and at one year and five years after discharge to determine programme effectiveness. SETTING: Out-patient clinic at the department of social medicine in tertiary care hospital. SUBJECTS: 239 patients with minor disease and long-term vocational absence consecutively admitted to the study. At the one-year evaluation, 17 patients had been readmitted to the team, 7 could not be found, 6 declined the interview and 2 were deceased. At the five-year evaluation of 49 patients who were active after one year, one was deceased and 10 were unable to be found. MAIN OUTCOME MEASURES: Vocational activity. Programme costs. Benefits to society measured by decrease in indirect costs. RESULTS: The one-year vocational rehabilitation rate from the program was 20.5% and the five-year rehabilitation rate was 11.3%. The total discounted cost for case management of the 239 patients was 7.3 MSEK (600,000 Pounds). The decrease in the indirect costs to society from the 28 patients found active after five years was 35.1 MSEK (2,500,000 Pounds). The net present value of the programme at the 1991 price level was 27.5 MSEK (2,365,000 Pounds). CONCLUSIONS: Tertiary care level team-based clinical case management for vocational rehabilitation of patients with chronic minor disease has a positive cost-benefit ratio. A cross-boundary awareness at a health policy level is needed of the societal costs involved for this group of patients who fall between the traditional services in health care and social work.
PubMed ID
9460135 View in PubMed
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Methods of evaluating dental care costs in the Swedish public dental health care sector.

https://arctichealth.org/en/permalink/ahliterature75774
Source
Community Dent Oral Epidemiol. 1998 Jun;26(3):160-5
Publication Type
Article
Date
Jun-1998
Author
N. Oscarson
C. Källestål
G. Karlsson
Author Affiliation
Department of Epidemiology and Public Health, Umeå, Sweden.
Source
Community Dent Oral Epidemiol. 1998 Jun;26(3):160-5
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Clinical Competence
Cost-Benefit Analysis
Dental Assistants - economics
Dental Care - economics
Dental Caries - economics - prevention & control
Dental Hygienists - economics
Dentists - economics
Direct Service Costs
Evaluation Studies
Fees, Dental
Financial Management - economics
Health Care Costs
Health Care Sector
Humans
Practice Management, Dental - economics
Public Health Dentistry - economics
Research Support, Non-U.S. Gov't
Salaries and Fringe Benefits
Sweden
Time Factors
Abstract
Twenty-six Swedish dental health care clinics participating in the intervention study "Evaluation of caries preventive measures" have been analysed with focus on costs, with the aim of demonstrating techniques suitable for evaluating direct dental care costs and also finding out whether charges are acceptable as a proxy for real costs. Three different approaches to calculating unit costs are discussed: average treatment time cost and two methods of different allocation of overhead cost. Average treatment time cost shows treatment time cost regardless of who (dentist, dental hygienist or nurse) provides the dental care. The other two methods reflect both the differences of treatment costs depending on practitioners' skill level and competence (salary) and the methods of handling overhead cost allocation. Our conclusions are that the proposed methods seem useful for evaluating costs in cost-effectiveness and cost-benefit analysis. The alternative to average treatment time cost or unit time cost depends on what data is available and the perspective of the analysis. This study also concludes that charges are not sufficient as an alternative to a more detailed cost evaluation, at least not in Swedish public dental health care, since charges do not cover costs.
PubMed ID
9669593 View in PubMed
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12 records – page 1 of 2.