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2709 records – page 1 of 271.

A 1-year community-based health economic study of ciprofloxacin vs usual antibiotic treatment in acute exacerbations of chronic bronchitis: the Canadian Ciprofloxacin Health Economic Study Group.

https://arctichealth.org/en/permalink/ahliterature206818
Source
Chest. 1998 Jan;113(1):131-41
Publication Type
Article
Date
Jan-1998
Author
R. Grossman
J. Mukherjee
D. Vaughan
C. Eastwood
R. Cook
J. LaForge
N. Lampron
Author Affiliation
Department of Respiratory Medicine, Mount Sinai Hospital, Toronto, ON.
Source
Chest. 1998 Jan;113(1):131-41
Date
Jan-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anti-Infective Agents - adverse effects - economics - therapeutic use
Bronchitis - drug therapy - economics
Canada
Chronic Disease
Ciprofloxacin - adverse effects - economics - therapeutic use
Cost-Benefit Analysis
Female
Follow-Up Studies
Health Care Costs
Hospitalization - economics
Humans
Male
Middle Aged
Predictive value of tests
Quality-Adjusted Life Years
Recurrence
Treatment Outcome
Abstract
To evaluate the costs, consequences, effectiveness, and safety of ciprofloxacin vs standard antibiotic care in patients with an initial acute exacerbation of chronic bronchitis (AECB) as well as recurrent AECBs over a 1-year period.
Randomized, multicenter, parallel-group, open-label study.
Outpatient general practice.
A total of 240 patients, 18 years or older with chronic bronchitis, with a history of frequent exacerbations (three or more in the past year) presenting with a type 1 or 2 AECB (two or more of increased dyspnea, increased sputum volume, or sputum purulence).
The assessment included AECB symptoms, antibiotics prescribed, concomitant medications, adverse events, hospitalizations, emergency department visits, outpatient resources such as diagnostic tests, procedures, and patient and caregiver out-of-pocket expenses. Patients completed the Nottingham Health Profile, St. George's Respiratory Questionnaire, and the Health Utilities Index. The parameters were recorded with each AECB and at regular quarterly intervals for 1 year. These variables were compared between the ciprofloxacin-treated group and the usual-care-treated group.
Patients receiving ciprofloxacin experienced a median of two AECBs per patient compared to a median of three AECBs per patient receiving usual care. The mean annualized total number of AECB-symptom days was 42.9+/-2.8 in the ciprofloxacin arm compared to 45.6+/-3.0 days in the usual-care arm (p=0.50). The overall duration of the average AECB was 15.2+/-0.6 days for the ciprofloxacin arm compared to 16.3+/-0.6 days for the usual-care arm. Treatment with ciprofloxacin tended to accelerate the resolution of all AECBs compared to usual care (relative risk=1.20; 95% confidence interval [CI], 0.91 to 1.58; p=0.19). Treatment assignment did not affect the interexacerbation period but a history of severe bronchitis, prolonged chronic bronchitis, and an increased number of AECBs in the past year were associated with shorter exacerbations-free periods. There was a slight, but not statistically significant, improvement in all quality of life measures with ciprofloxacin over usual care. The only factors predictive of hospitalization were duration of chronic bronchitis (odds ratio=4.6; 95% CI, 1.6, 13.0) and severity of chronic bronchitis (odds ratio=4.3; 95% CI, 0.8, 24.6). The incremental cost difference of $578 Canadian in favor of usual care was not significant (95% CI, -$778, $1,932). The cost for the ciprofloxacin arm over the usual care arm was $18,588 Canadian per quality-adjusted life year gained. When the simple base case analysis was expanded to examine the effect of risk stratification, the presence of moderate or severe bronchitis and at least four AECBs in the previous year changed the economic and clinical analysis to one favorable to ciprofloxacin with the ciprofloxacin-treated group having a better clinical outcome at lower cost ("win-win" scenario).
Treatment with ciprofloxacin tended to accelerate the resolution of all AECBs compared to usual care; however, the difference was not statistically significant. Further, usual care was found to be more reflective of best available care rather than usual first-line agents such as amoxicillin, tetracycline, or trimethoprim-sulfamethoxazole as originally expected. Despite the similar antimicrobial activities and broad-spectrum coverage of both ciprofloxacin and usual care, the trends in clinical outcomes and all quality of life measurements favor ciprofloxacin. In patients suffering from an AECB with a history of moderate to severe chronic bronchitis and at least four AECBs in the previous year, ciprofloxacin treatment offered substantial clinical and economic benefits. In these patients, ciprofloxacin may be the preferred first antimicrobial choice.
PubMed ID
9440580 View in PubMed
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2nd-generation HIV surveillance and injecting drug use: uncovering the epidemiological ice-berg.

https://arctichealth.org/en/permalink/ahliterature84543
Source
Int J Public Health. 2007;52(3):166-72
Publication Type
Article
Date
2007
Author
Reintjes Ralf
Wiessing Lucas
Author Affiliation
Department of Public Health, Faculty Life Sciences, Hamburg University of Applied Sciences, Hamburg, Germany. Ralf.Reintjes@rzbd.haw-hamburg.de
Source
Int J Public Health. 2007;52(3):166-72
Date
2007
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - epidemiology - prevention & control - therapy
Cost-Benefit Analysis
Europe - epidemiology
HIV Infections - epidemiology - prevention & control - therapy
Hepatitis C - epidemiology
Humans
Norway - epidemiology
Population Surveillance
Prevalence
Risk factors
Risk-Taking
Substance Abuse, Intravenous - epidemiology
Turkey - epidemiology
Abstract
OBJECTIVES: HIV/AIDS surveillance methods are under revision as the diversity of HIV epidemics is becoming more apparent. The so called "2nd generation surveillance (SGS) systems" aim to enhance surveillance by broadening the range of indicators to prevalence, behaviors and correlates, for a better understanding and a more complete and timely awareness of evolving epidemics. METHODS: Concepts of HIV SGS are reviewed with a special focus on injecting drug users, a major at-risk and hard to reach group in Europe, a region with mainly low or concentrated epidemics. RESULTS: The scope of HIV/AIDS surveillance needs to be broadened following principles of SGS. Specifically for IDUs we propose including hepatitis C data as indicator for injecting risk in routine systems like those monitoring sexually transmitted infections and information on knowledge and attitudes as potential major determinants of risk behavior. CONCLUSIONS: The suggested approach should lead to more complete and timely information for public health interventions, however there is a clear need for comparative validation studies to assess the validity, reliability and cost-effectiveness of traditional and enhanced HIV/AIDS surveillance systems.
PubMed ID
17958283 View in PubMed
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The 2-year costs and effects of a public health nursing case management intervention on mood-disordered single parents on social assistance.

https://arctichealth.org/en/permalink/ahliterature191135
Source
J Eval Clin Pract. 2002 Feb;8(1):45-59
Publication Type
Article
Date
Feb-2002
Author
Maureen Markle-Reid
Gina Browne
Jacqueline Roberts
Amiram Gafni
Carolyn Byrne
Author Affiliation
System-Linked Research Unit on Health and Social Service Utilization, School of Nursing, McMaster University, Room 3N46, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada. mreid@mcmaster.ca
Source
J Eval Clin Pract. 2002 Feb;8(1):45-59
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Case Management - economics
Child
Cost-Benefit Analysis
Depressive Disorder - economics - nursing - rehabilitation
Employment
Female
Health Care Costs
Health Services - utilization
Health Services Accessibility
Humans
Male
Ontario
Public Assistance
Public Health Nursing - economics
Single Parent - psychology
Social Adjustment
Abstract
This randomized controlled trial was designed to evaluate the 2-year costs and effects of a proactive, public health nursing case management approach compared with a self-directed approach for 129 single parents (98% were mothers) on social assistance in a Canadian setting. A total of 43% of these parents had a major depressive disorder and 38% had two or three other health conditions at baseline.
Study participants were recruited over a 12 month period and randomized into two groups: one receiving proactive public health nursing and one which did not.
At 2 years, 69 single parents with 123 children receiving proactive public health nursing (compared with 60 parents with 91 children who did not receive public health nursing services) showed a slightly greater reduction in dysthymia and slightly higher social adjustment. There was no difference between the public health and control groups in total per parent annual cost of health and support services. However, costs were averted due to a 12% difference in non-use of social assistance in the previous 12 months for parents in the public health nursing group. This translates into an annual cost saving of 240,000 dollars (Canadian) of costs averted within 1 year for every 100 parents.
In the context of a system of national health and social insurance, this study supports the fact that it is no more costly to proactively service this population of parents on social assistance.
PubMed ID
11882101 View in PubMed
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A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain.

https://arctichealth.org/en/permalink/ahliterature61395
Source
Pain. 2005 Jun;115(3):273-83
Publication Type
Article
Date
Jun-2005
Author
Jensen IB
Bergström G
Ljungquist T
Bodin L
Author Affiliation
Section for Personal Injury Prevention, Karolinska Institutet, Box 127 18, 112 94 Stockholm, Sweden. irene.jensen@cns.ki.se
Source
Pain. 2005 Jun;115(3):273-83
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Adult
Back Pain - economics - rehabilitation
Cognitive Therapy
Comparative Study
Cost-Benefit Analysis
Delivery of Health Care - utilization
Employment
Female
Follow-Up Studies
Health Care Costs
Humans
Male
Middle Aged
Neck Pain - economics - rehabilitation
Pensions
Physical Therapy (Specialty) - economics - organization & administration
Program Evaluation
Quality of Life
Rehabilitation - economics - organization & administration
Research Support, Non-U.S. Gov't
Sick Leave
Abstract
The aim of the present study was to evaluate the long-term outcome of a behavioural medicine rehabilitation programme and the outcome of its two main components, compared to a 'treatment-as-usual' control group. The study employed a 4 x 5 repeated-measures design with four groups and five assessment periods during a 3-year follow-up. The group studied consisted of blue-collar and service/care workers on sick leave, identified in a nationwide health insurance scheme in Sweden. After inclusion, the subjects were randomised to one of the four conditions: behaviour-oriented physiotherapy (PT), cognitive behavioural therapy (CBT), behavioural medicine rehabilitation consisting of PT+CBT (BM) and a 'treatment-as-usual' control group (CG). Outcome variables were sick leave, early retirement and health-related quality of life. A cost-effectiveness analysis, comparing the programmes, was made. The results showed, consistently, the full-time behavioural medicine programme being superior to the three other conditions. The strongest effect was found on females. Regarding sick leave, the mean difference in the per-protocol analysis between the BM programme and the control group was 201 days, thus reducing sick leave by about two-thirds of a working year. Rehabilitating women has a substantial impact on costs for production losses, whereas rehabilitating men seem to be effortless with no significant effect on either health or costs. In conclusion, a full-time behavioural medicine programme is a cost-effective method for improving health and increasing return to work in women working in blue-collar or service/care occupations and suffering from back/neck pain.
PubMed ID
15911154 View in PubMed
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A 7-year follow-up of multidisciplinary rehabilitation among chronic neck and back pain patients. Is sick leave outcome dependent on psychologically derived patient groups?

https://arctichealth.org/en/permalink/ahliterature149098
Source
Eur J Pain. 2010 Apr;14(4):426-33
Publication Type
Article
Date
Apr-2010
Author
Gunnar Bergström
Cecilia Bergström
Jan Hagberg
Lennart Bodin
Irene Jensen
Author Affiliation
Karolinska Institutet, Division of Intervention and Implementation Research, Department of Public Health Sciences, Stockholm, Sweden.
Source
Eur J Pain. 2010 Apr;14(4):426-33
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Back Pain - classification - psychology - rehabilitation
Cost-Benefit Analysis
Costs and Cost Analysis
Disability Evaluation
Female
Follow-Up Studies
Humans
Income
Male
Middle Aged
Neck Pain - classification - psychology - rehabilitation
Pain Measurement
Patient care team
Pensions
Prognosis
Risk
Sick Leave - economics - statistics & numerical data
Sweden - epidemiology
Treatment Outcome
Abstract
A valid method for classifying chronic pain patients into more homogenous groups could be useful for treatment planning, that is, which treatment is effective for which patient, and as a marker when evaluating treatment outcome. One instrument that has been used to derive subgroups of patients is the Multidimensional Pain Inventory (MPI). The primary aim of this study was to evaluate a classification method based on the Swedish version of the MPI, the MPI-S, to predict sick leave among chronic neck and back pain patients for a period of 7 years after vocational rehabilitation. As hypothesized, dysfunctional patients (DYS), according to the MPI-S, showed a higher amount of sickness absence and disability pension expressed in days than adaptive copers (AC) during the 7-years follow-up period, even when adjusting for sickness absence prior to rehabilitation (355.8days, 95% confidence interval, 71.7; 639.9). Forty percent of DYS patients and 26.7% of AC patients received disability pension during the follow-up period. However, this difference was not statistically significant. Further analyses showed that the difference between patient groups was most pronounced among patients with more than 60days of sickness absence prior to rehabilitation. Cost-effectiveness calculations indicated that the DYS patients showed an increase in production loss compared to AC patients. The present study yields support for the prognostic value of this subgroup classification method concerning long-term outcome on sick leave following this type of vocational rehabilitation.
PubMed ID
19683950 View in PubMed
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The 1982 Hoechst Lecture: "Cost effectiveness--the emerging 'bottom line' for pharmacy?!".

https://arctichealth.org/en/permalink/ahliterature243460
Source
Can J Hosp Pharm. 1982 Mar-Apr;35(2):39-41
Publication Type
Article
Author
J A Marshman
Source
Can J Hosp Pharm. 1982 Mar-Apr;35(2):39-41
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cost-Benefit Analysis
Efficiency
Humans
Ontario
Patient Education as Topic - economics
Pharmacy Service, Hospital - economics
Abstract
In the current climate of budgetary restraint in the health care system, cost effectiveness is a concept which surfaces with increasing frequency, especially in reference to health care services funded by government. Since significant elements of pharmacy services in Canada are thus funded (including in most provinces, hospital pharmacy services, and prescription drug plans for senior citizens), it is important that pharmacy "tune into" the concept, and recognize it as an essential criterion to be met in the maintenance of existing services and in the development of new services. Prerequisite to a consideration of cost effectiveness is, of course, consideration of effectiveness; and a statement about the effectiveness; and a statement about the effectiveness of a service implies a potential for measurement of effect or outcome. In the 1980s, as pharmacy focuses its efforts on patients rather than products, that effect must surely be defined in "people" terms. One of the important dimensions of today's patient-focussed pharmacy services is patient counselling, more broadly, patient education.
PubMed ID
10309676 View in PubMed
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The 2003 Canadian recommendations for dyslipidemia management: revisions are needed.

https://arctichealth.org/en/permalink/ahliterature175311
Source
CMAJ. 2005 Apr 12;172(8):1027-31
Publication Type
Article
Date
Apr-12-2005
Author
Douglas G Manuel
Peter Tanuseputro
Cameron A Mustard
Susan E Schultz
Geoffrey M Anderson
Sten Ardal
David A Alter
Andreas Laupacis
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Ont. doug.manuel@ices.on.ca
Source
CMAJ. 2005 Apr 12;172(8):1027-31
Date
Apr-12-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Cholesterol, LDL - blood
Coronary Disease - mortality - prevention & control
Cost-Benefit Analysis
Health Expenditures
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hyperlipidemias - drug therapy
Hypolipidemic Agents - therapeutic use
Middle Aged
Practice Guidelines as Topic
Risk factors
Notes
Cites: Eur Heart J. 2003 Sep;24(17):1601-1012964575
Cites: CMAJ. 2003 Jun 24;168(13):1644-5; author reply 1645-612821610
Cites: Can J Cardiol. 2003 Nov;19(12):1359-6614631469
Cites: Can J Cardiol. 2003 Dec;19(13):1499-50214760440
Cites: Am J Med. 2004 Apr 15;116(8):540-515063816
Cites: JAMA. 2004 Apr 21;291(15):1864-7015100205
Cites: Am Heart J. 1991 Jan;121(1 Pt 2):293-81985385
Cites: N Engl J Med. 1998 Nov 5;339(19):1349-579841303
Cites: Can J Cardiol. 1999 Apr;15(4):445-5110322254
Cites: CMAJ. 2003 Oct 28;169(9):921-414581310
Cites: Fam Pract. 2003 Feb;20(1):16-2112509365
Cites: JAMA. 2002 Jul 24-31;288(4):462-712132976
Cites: JAMA. 2002 Jul 24-31;288(4):455-6112132975
Cites: JAMA. 1999 Dec 22-29;282(24):2340-610612322
Cites: CMAJ. 2000 May 16;162(10):1441-710834048
Cites: CMAJ. 2000 Aug 22;163(4):403-810976255
Cites: Lancet. 2002 Jul 6;360(9326):7-2212114036
Comment In: CMAJ. 2005 Nov 8;173(10):1210; author reply 121016275979
Comment In: CMAJ. 2005 Nov 8;173(10):1207; author reply 121016275976
Comment In: CMAJ. 2005 Apr 12;172(8):1033-4; discussion 103715824410
Erratum In: CMAJ. 2005 Jul 19;173(2):133
PubMed ID
15824409 View in PubMed
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Abdominal massage for people with constipation: a cost utility analysis.

https://arctichealth.org/en/permalink/ahliterature142788
Source
J Adv Nurs. 2010 Aug;66(8):1719-29
Publication Type
Article
Date
Aug-2010
Author
Kristina Lämås
Lars Lindholm
Birgitta Engström
Catrine Jacobsson
Author Affiliation
Department of Nursing, Umeå University, Sweden. kristina.lamas@nurs.umu.se
Source
J Adv Nurs. 2010 Aug;66(8):1719-29
Date
Aug-2010
Language
English
Publication Type
Article
Keywords
Abdomen
Adult
Aged
Aged, 80 and over
Constipation - economics - physiopathology - therapy
Cost-Benefit Analysis
Female
Humans
Laxatives - economics - therapeutic use
Male
Massage - economics - nursing
Middle Aged
Patient Dropouts
Patient Education as Topic
Prospective Studies
Quality of Life
Regression Analysis
Self Care - economics
Sweden
Abstract
This paper is a report of a study conducted to evaluate change in health-related quality of life for people with constipation receiving abdominal massage and to estimate the cost-effectiveness of two alternative scenarios developed from the original trial.
Constipation is a common problem and is associated with decrease in quality of life. Abdominal massage appears to decrease the severity of gastrointestinal symptoms, but its impact on health-related quality of life has not been assessed.
A randomized controlled trial including 60 participants was conducted in Sweden between 2005 and 2007. The control group continued using laxatives as before and the intervention group received additional abdominal massage. Health-related quality of life was assessed using the EQ-5D and analyzed with linear regression. Two scenarios were outlined to conduct a cost utility analysis. In the self-massage scenario patients learned to give self-massage, and in the professional massage scenario patients in hospital received abdominal massage from an Enrolled Nurse.
Linear regression analysis showed that health-related quality of life was statistically significantly increased after 8 weeks of abdominal massage. About 40% were estimated to receive good effect. For 'self-massage', the cost per quality adjusted life year was euro75,000 for the first 16 weeks. For every additional week of abdominal massage, the average dropped and eventually approached euro8300. For 'professional massage', the cost per quality adjusted life year was euro60,000 and eventually dropped to euro28,000.
Abdominal massage may be cost-effective in the long-term and it is relevant to consider it when managing constipation. A crucial aspect will be to identify those who will benefit.
PubMed ID
20557387 View in PubMed
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[A blood transfusion in Sweden--the societal cost].

https://arctichealth.org/en/permalink/ahliterature166918
Source
Lakartidningen. 2006 Sep 20-26;103(38):2752-6
Publication Type
Article

[A care program for primary health care: improved care of patients with dyspepsia].

https://arctichealth.org/en/permalink/ahliterature210802
Source
Lakartidningen. 1996 Oct 30;93(44):3892-6
Publication Type
Article
Date
Oct-30-1996
Author
B. Lennholm
Source
Lakartidningen. 1996 Oct 30;93(44):3892-6
Date
Oct-30-1996
Language
Swedish
Publication Type
Article
Keywords
Cost-Benefit Analysis
Dyspepsia - diagnosis - economics - therapy
Humans
Patient Care Planning
Primary Health Care - economics
Sweden
PubMed ID
8965575 View in PubMed
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2709 records – page 1 of 271.