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An economic evaluation of intermittent cyclosporin A therapy versus UVAB phototherapy in the treatment of patients with severe atopic dermatitis.

https://arctichealth.org/en/permalink/ahliterature179565
Source
Acta Derm Venereol. 2004;84(2):138-41
Publication Type
Article
Date
2004
Author
Heini Salo
Markku Pekurinen
Håkan Granlund
Marja Nuutinen
Pekka Erkko
Sakari Reitamo
Author Affiliation
National Public Health Institute, Department of Vaccines, Helsinki, Finland. heini.salo@ktl.fi
Source
Acta Derm Venereol. 2004;84(2):138-41
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Confidence Intervals
Cost Savings
Cost of Illness
Cost-Benefit Analysis
Cyclosporine - economics - therapeutic use
Delivery of Health Care - economics - utilization
Dermatitis, Atopic - diagnosis - drug therapy - economics - radiotherapy
Female
Finland
Health Care Costs
Humans
Male
Middle Aged
Probability
Risk assessment
Severity of Illness Index
Treatment Outcome
Ultraviolet Therapy - economics - methods
United States
Abstract
We performed a cost-effective evaluation of cyclosporin A versus UVAB phototherapy in the treatment of severe atopic dermatitis. The analysis was based on a one-year open prospective clinical trial conducted in Finland and showed that patients who received intermittent cyclosporin A therapy had on average 191 remission days per year, i.e. where disease activity was reduced by 50% or more. Patients receiving UVAB phototherapy had on average 123 remission days per year. All costs were estimated for the one-year period. Health service utilization of the 2 treatment groups was estimated based on the data gathered during the clinical study. Total costs were USD 5,438 in the cyclosporin A group and USD 5,635 in the UVAB group. Direct health-care costs were USD 4,935 in the cyclosporin A group and USD 3,124 in the UVAB group. The cost of a remission day was USD 28 in the cyclosporin A group and USD 46 in the UVAB group. In terms of direct health-care costs, the cost of a remission day was USD 26 in the cyclosporin A group and USD 25 in the UVAB group. Our results demonstrate that cyclosporin A therapy is similarly cost-effective as UVAB phototherapy in terms of total cost in the treatment of atopic dermatitis unresponsive to topical treatment. In terms of direct health-care costs, i.e. treatment and health services utilization costs, however, UVAB is significantly less costly, but side effects are frequent.
PubMed ID
15206694 View in PubMed
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The burden of illness experienced by young children associated with asthma: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature158914
Source
J Asthma. 2008 Jan-Feb;45(1):45-9
Publication Type
Article
Author
Teresa To
Sharon Dell
Paul Dick
Lisa Cicutto
Author Affiliation
Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. teresa.to@sickkids.ca
Source
J Asthma. 2008 Jan-Feb;45(1):45-9
Language
English
Publication Type
Article
Keywords
Asthma - economics - epidemiology - therapy
Child
Child, Preschool
Cohort Studies
Cost of Illness
Delivery of Health Care - economics - utilization
Health Care Costs
Hospitalization - economics - statistics & numerical data
Humans
Infant
Ontario
Seasons
Abstract
Using Ontario healthcare administrative databases, over 228,000 children aged 0 to 9 years were identified as having asthma between 1994 and 1998 and followed until they turned 10 years old or the end of the study. The prevalence of childhood asthma increased by 35% during the study period. These children had a higher healthcare utilization and cost over $100 more per child per year than the general population, and contributed to over one third of the total Ontario Health Insurance Plan expenditures. Findings of this study revealed an enormous burden of illness to children with asthma and the healthcare system.
PubMed ID
18259995 View in PubMed
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The burden of osteoporotic fractures beyond acute care: the Canadian Multicentre Osteoporosis Study (CaMos).

https://arctichealth.org/en/permalink/ahliterature132810
Source
Age Ageing. 2011 Sep;40(5):602-7
Publication Type
Article
Date
Sep-2011
Author
Sara Kaffashian
Parminder Raina
Mark Oremus
Laura Pickard
Jonathan Adachi
Emmanuel Papadimitropoulos
Alexandra Papaioannou
Author Affiliation
Centre for Research in Epidemiology and Population Health/INSERM U1018, Hôpital Paul Brousse, Bâtiment 15/16, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France. sara.kaffashian@inserm.fr
Source
Age Ageing. 2011 Sep;40(5):602-7
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Aged
Canada
Delivery of Health Care - economics - utilization
Female
Health Care Costs
Hip Fractures - economics - etiology - rehabilitation
Home Care Services - economics - utilization
House Calls - economics - utilization
Humans
Logistic Models
Male
Middle Aged
Occupational Therapy - economics - utilization
Odds Ratio
Osteoporotic Fractures - economics - etiology - rehabilitation
Physical Therapy Modalities - economics - utilization
Prospective Studies
Spinal Fractures - economics - etiology - rehabilitation
Time Factors
Abstract
the burden associated with osteoporotic fractures has commonly been reported in terms of utilisation of acute care. However, individuals with fractures suffer lasting deficits in quality of life and the burden of care extends well beyond the initial acute care period. The burden of fractures related to post-acute heath care utilisation, and informal care giving, has not been sufficiently addressed. We examine the use of formal and informal post-acute care in men and women 50 years and older who sustained fractures.
the study sample consisted of 1,116 men and women from the Canadian Multicentre Osteoporosis Study (CaMos) who sustained a fracture. We assessed utilisation of post-acute care including rehabilitative and home care services, as well as informal care in persons with a hip, vertebral, or non-hip-non-vertebral fractures.
use of rehabilitative and home care services was reported by 37.1% and 18.2% of men and women, respectively. Persons with hip fracture were more likely to report use of these services compared with persons with non-hip-non-vertebral fractures; those with vertebral fracture were less likely to report using these services. Use of informal care was reported by 47.2% of participants. Individuals with multiple fractures made more extensive use of post-acute resources compared with those with single fractures.
use of post-acute care in individuals with fracture is extensive and the contribution of use of these resources to the overall burden of fractures cannot be ignored. Our findings have implications for future economic analyses and policy-making related to care of osteoporotic fractures.
PubMed ID
21775335 View in PubMed
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A comparative study of two various models of organising diabetes follow-up in public primary health care - the model influences the use of services, their quality and costs.

https://arctichealth.org/en/permalink/ahliterature256869
Source
BMC Health Serv Res. 2014;14:26
Publication Type
Article
Date
2014
Author
Mikko T Honkasalo
Miika Linna
Timo Sane
Atte Honkasalo
Outi Elonheimo
Author Affiliation
Nurmijärvi Health Centre, Network of Academic Health Centres, University of Helsinki, University Central Hospital of Helsinki, Unit of General Practice, Helsinki, Finland. mikko.honkasalo@nurmijarvi.fi.
Source
BMC Health Serv Res. 2014;14:26
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Delivery of Health Care - economics - utilization
Diabetes Complications - epidemiology - prevention & control
Diabetes Mellitus - economics - therapy
Diabetes Mellitus, Type 1 - economics - therapy
Diabetes Mellitus, Type 2 - economics - therapy
Finland - epidemiology
Health Care Costs - statistics & numerical data
Hospitalization - statistics & numerical data
Humans
Middle Aged
Models, organizational
Primary Health Care - economics - organization & administration - standards - utilization
Quality of Health Care
Young Adult
Abstract
In Finland diabetologists have long been concerned about the level of diabetes care as the incidence of type 1 diabetes and complicated type 2 diabetes is exceeding the capacity of specialist clinics. We compared the outcome of diabetes care in two middle-sized Finnish municipalities with different models of diabetes care organisation in public primary health care. In Kouvola the primary health care of all diabetic patients is based on general practitioners, whereas in Nurmijärvi the follow-up of type 1 and most complicated type 2 diabetic patients is assigned to a general practitioner specialised in diabetes care.
Our study population consisted of all adult diabetic patients living in the municipalities under review.We compared the use and costs of public diabetes care, glycemic control, blood pressure, LDL-cholesterol level, the application of the national guidelines and patient satisfaction. The main outcome measures were the costs and use of health care services due to diabetes and its complications.
In Nurmijärvi, where diabetes care was centralised, more type 1 diabetic patients were followed up in primary health care than in Kouvola, where general practitioners need more specialist consultations. The centralisation resulted in cost savings in the diabetes care of type 1 diabetic patients. Although the quality of care was similar, type 1 diabetic patients were more satisfied with their follow-up in the centralised system. In the care of type 2 diabetic patients the centralised system required fewer specialist consultations, but the quality and costs were similar in both models.
The follow-up of most diabetic patients - including type 1 diabetes - can be organised in primary health care with the same quality as in secondary care units. The centralised primary care of type 1 diabetes is less costly and requires fewer specialist consultations.
Notes
Cites: Value Health. 2009 Jul-Aug;12(5):674-8619171006
Cites: Am J Med Qual. 2004 Jul-Aug;19(4):172-915368782
Cites: Scand J Prim Health Care. 2011 Sep;29(3):165-7021675825
Cites: Diabetes Care. 2000 Oct;23(10):1516-2611023146
Cites: Ugeskr Laeger. 2010 Jul 5;172(27):2020-520594535
Cites: Inform Prim Care. 2010;18(3):157-6821396238
Cites: Diabetes Care. 1996 May;19(5):494-78732715
Cites: Diabetes Care. 1997 Apr;20(4):472-59096962
Cites: Diabetes Care. 1999 Apr;22(4):575-910189534
Cites: Clin Ther. 2009 Mar;31(3):657-6719393856
Cites: Scand J Prim Health Care. 2009;27(4):223-3119929182
Cites: Scand J Prim Health Care. 2009;27(4):202-719929184
PubMed ID
24444378 View in PubMed
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Comparing resource utilization and gastrointestinal outcomes in patients treated with either standard-dose or high-dose proton pump inhibitors: a matched cohort study.

https://arctichealth.org/en/permalink/ahliterature160861
Source
Dig Dis Sci. 2008 Jun;53(6):1519-26
Publication Type
Article
Date
Jun-2008
Author
Laura E Targownik
Colleen Metge
Stella Leung
Author Affiliation
Section of Gastroenterology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada. targowni@cc.umanitoba.ca
Source
Dig Dis Sci. 2008 Jun;53(6):1519-26
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Case-Control Studies
Chi-Square Distribution
Delivery of Health Care - economics - utilization
Drug Utilization
Female
Gastrointestinal Diseases - drug therapy - epidemiology
Humans
Male
Manitoba - epidemiology
Proton Pump Inhibitors - administration & dosage - economics
Statistics, nonparametric
Treatment Outcome
Abstract
The use of double-dose proton pump inhibitors (PPIs) for initial management of upper gastrointestinal (UGI) symptoms is common, though little evidence supports this practice. The aim of this study was to determine whether initial prescription of double-dose PPIs in outpatients with UGI complaints is superior to standard-dose PPIs prescription in reducing resource utilization. Patients in the Manitoba Health database prescribed double-dose PPIs were matched to individuals prescribed PPIs at standard doses. UGI-related inpatient and outpatient resource utilization and prescription drug usage were compared for both groups over the following year. Cases and controls had a similar duration of PPI use, and no difference in either UGI-related outpatient visits or UGI-related hospital admissions. Twelve-month UGI related costs were higher for double-dose PPI users. Initial therapy with double-dose PPIs does not reduce GI-related resource utilization. Prescription of double-dose PPIs as initial therapy for upper gastrointestinal symptoms should be discouraged.
PubMed ID
17932757 View in PubMed
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Do older patients utilize excess health care resources after liver transplantation?

https://arctichealth.org/en/permalink/ahliterature131376
Source
Ann Hepatol. 2011 Oct-Dec;10(4):477-81
Publication Type
Article
Author
Neil Shankar
Mamoun AlBasheer
Paul Marotta
William Wall
Vivian McAlister
Natasha Chandok
Author Affiliation
Division of Gastroenterology, University of Western Ontario, London, Ontario, Canada.
Source
Ann Hepatol. 2011 Oct-Dec;10(4):477-81
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Chi-Square Distribution
Delivery of Health Care - economics - utilization
Female
Health Resources - economics - utilization
Humans
Intensive Care - utilization
Length of Stay
Liver Transplantation - adverse effects - economics
Male
Middle Aged
Odds Ratio
Ontario
Patient Readmission
Referral and Consultation - utilization
Regression Analysis
Reoperation
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Liver transplantation is a highly effective treatment for end-stage liver disease. However, there is debate over the practice of liver transplantation in older recipients (age = 60 years) given the relative shortage of donor grafts, worse post-transplantation survival, and concern that that older patients may utilize excess resources postoperatively, thus threatening the economic feasibility of the procedure.
To determine if patients = 60 years of age utilize more health resources following liver transplantation compared with younger patients.
Consecutive adult patients who underwent primary liver transplantation (n = 208) at a single center were studied over a 2.5-year period. Data were collected on clinico-demographic characteristics and resource utilization. Descriptive statistics, including means, standard deviations, or frequencies were obtained for baseline variables. Patients were stratified into 2 groups: age = 60 years (n = 51) and
PubMed ID
21911888 View in PubMed
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Economic evaluation of Manitoba Health Lines in the management of congestive heart failure.

https://arctichealth.org/en/permalink/ahliterature256895
Source
Healthc Policy. 2013 Nov;9(2):36-50
Publication Type
Article
Date
Nov-2013
Author
Yang Cui
Malcolm Doupe
Alan Katz
Paul Nyhof
Evelyn L Forget
Author Affiliation
PhD Student, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB.
Source
Healthc Policy. 2013 Nov;9(2):36-50
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cost-Benefit Analysis
Delivery of Health Care - economics - utilization
Female
Health Care Costs - statistics & numerical data
Heart Failure - economics - therapy
Humans
Male
Manitoba
Middle Aged
Models, Economic
Quality-Adjusted Life Years
Telemedicine - economics - methods
Abstract
This one-year study investigated whether the Manitoba Provincial Health Contact program for congestive heart failure (CHF) is a cost-effective intervention relative to the standard treatment.
Individual patient-level, randomized clinical trial of cost-effective model using data from the Health Research Data Repository at the Manitoba Centre for Health Policy, University of Manitoba.
A total of 179 patients aged 40 and over with a diagnosis of CHF levels II to IV were recruited from Winnipeg and Central Manitoba and randomized into three treatment groups: one receiving standard care, a second receiving Health Lines (HL) intervention and a third receiving Health Lines intervention plus in-house monitoring (HLM). A cost-effectiveness study was conducted in which outcomes were measured in terms of QALYs derived from the SF-36 and costs using 2005 Canadian dollars. Costs included intervention and healthcare utilization. Bootstrap-resampled incremental cost-effectiveness ratios were computed to take into account the uncertainty related to small sample size.
The total per-patient mean costs (including intervention cost) were not significantly different between study groups. Both interventions (HL and HLM) cost less and are more effective than standard care, with HL able to produce an additional QALY relative to HLM for $2,975. The sensitivity analysis revealed that there is an 85.8% probability that HL is cost-effective if decision-makers are willing to pay $50,000.
Findings demonstrate that the HL intervention from the Manitoba Provincial Health Contact program for CHF is an optimal intervention strategy for CHF management compared to standard care and HLM.
PubMed ID
24359716 View in PubMed
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Gout in the elderly--a population health study.

https://arctichealth.org/en/permalink/ahliterature152067
Source
J Rheumatol. 2009 Apr;36(4):822-30
Publication Type
Article
Date
Apr-2009
Author
John G Hanly
Chris Skedgel
Ingrid Sketris
Charmaine Cooke
Tina Linehan
Kara Thompson
Sander Veldhuyzen van Zanten
Author Affiliation
Division of Rheumatology, Department of Medicine, Queen Elizabeth II Health Sciences Centre, College of Pharmacy, Dalhousie University, Halifax, Nova Scotia B3H 4K4, Canada. john.hanly@cdha.nshealth.ca
Source
J Rheumatol. 2009 Apr;36(4):822-30
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Case-Control Studies
Delivery of Health Care - economics - utilization
Female
Gout - diagnosis - economics - epidemiology - therapy
Hospitalization - economics
Humans
Insurance Coverage - economics
Male
Nova Scotia - epidemiology
Office Visits
Retrospective Studies
Abstract
To determine the incidence, healthcare utilization, and costs in older adults with gout.
A 5-year retrospective case-control study of patients with incident gout and matched controls was performed. Study variables were derived from health administrative data and included patient demographics, International Classification of Diseases diagnostic codes, and healthcare cost information.
There were 4,071 cases and 16,281 controls, providing a 5-year incidence of gout of 4.4%. The mean (+/-SD) age (77+/-7.3 and 76+/-7.1 yrs) and the male:female ratio (1.0:1.04) were similar in both groups. Gout was diagnosed by family physicians (77%), nonrheumatology subspecialists (18%), general internists (4%), and rheumatologists (0.02%). Hospitalizations were significantly higher in cases (p
PubMed ID
19286852 View in PubMed
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High health care utilization and costs associated with lower socio-economic status: results from a linked dataset.

https://arctichealth.org/en/permalink/ahliterature150467
Source
Can J Public Health. 2009 May-Jun;100(3):180-3
Publication Type
Article
Author
Mark Lemstra
Johan Mackenbach
Cory Neudorf
Ushasri Nannapaneni
Author Affiliation
Saskatoon Health Region, 101-310 Idylwyld Drive North, Saskatoon, SK 57L 0Z2. marklemstra@shaw.ca
Source
Can J Public Health. 2009 May-Jun;100(3):180-3
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Cross-Sectional Studies
Delivery of Health Care - economics - utilization
Drug Therapy - economics - utilization
Female
Health Care Surveys
Health status
Hospitalization - economics
Hospitals - utilization
Humans
Income
Logistic Models
Male
Middle Aged
Physicians - economics - utilization
Saskatchewan
Socioeconomic Factors
Abstract
The purpose of this paper was to use a linked dataset to compare health care utilization rates and costs between income groups in Saskatoon, Canada.
The Canadian Community Health Survey was linked to hospital, physician and medication data in Saskatoon.
Of 3,688 eligible participants, 3,433 agreed to the health survey and data linkage with health records (83.7% overall response). Low-income residents were 27-33% more likely to be hospitalized and 36-45% more likely to receive a medication than middle- and higher-income residents, but were 5-7% less likely to visit a physician over a one-year period. In comparison to middle-income residents, low-income residents had 56% more high users of hospitals, 166% more high users of physicians and 90% more high users of medications. Low-income residents had 34-35% higher health care costs overall than middle- and high-income residents. After multivariate adjustment for increased disease prevalence, low income had a reduced association with high health care utilization.
The results demonstrate that residents with lower income are responsible for disproportionate usage of hospitals, physicians and medications; due mainly (but not entirely) to higher disease prevalence.
PubMed ID
19507718 View in PubMed
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Impact of functional dyspepsia on quality of life and health care consumption after cessation of antisecretory treatment. A multicentre 3-month follow-up study.

https://arctichealth.org/en/permalink/ahliterature75015
Source
Scand J Gastroenterol. 1999 Jun;34(6):566-74
Publication Type
Article
Date
Jun-1999
Author
V. Meineche-Schmidt
N J Talley
A. Pap
H. Kordecki
V. Schmid
L. Ohlsson
P. Wahlqvist
I. Wiklund
E. Bolling-Sternevald
Author Affiliation
General Practice, Kokkedal, Denmark.
Source
Scand J Gastroenterol. 1999 Jun;34(6):566-74
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Absenteeism
Adolescent
Adult
Aged
Aged, 80 and over
Ambulatory Care - economics
Animals
Anti-Ulcer Agents - therapeutic use
Delivery of Health Care - economics - utilization
Dyspepsia - drug therapy - economics
Europe
Follow-Up Studies
Humans
Male
Middle Aged
Omeprazole - therapeutic use
Prospective Studies
Quality of Life
Recurrence
Research Support, Non-U.S. Gov't
Treatment Outcome
Abstract
BACKGROUND: The impact of response to treatment on subsequent symptoms, quality of life, health care consumption, and absence from work in functional dyspepsia is unknown. METHODS: Patients with functional dyspepsia from Denmark, France, Germany, The Netherlands, Hungary, and Poland (n = 567 (215 men), 18-80 years old) were followed up for 3 months after a 4-week treatment trial with omeprazole (20 mg or 10 mg) or placebo. The patients were blinded to the initial treatment. Dyspeptic symptoms and quality of life were assessed, and dyspepsia-related costs were calculated in terms of number of clinic visits, days on medication, and absence from work. RESULTS: Responders had fewer clinic visits than non-responders (1.5 versus 2.0 mean visits) and fewer days on medication (mean, 9 days versus 23 days) over the 3-month period (both, P
PubMed ID
10440605 View in PubMed
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15 records – page 1 of 2.