Skip header and navigation

Refine By

351 records – page 1 of 36.

A 5-year retrospective analysis of employer-provided dental care for Finnish male industrial workers.

https://arctichealth.org/en/permalink/ahliterature206874
Source
Community Dent Oral Epidemiol. 1997 Dec;25(6):419-22
Publication Type
Article
Date
Dec-1997
Author
J. Ahlberg
R. Tuominen
H. Murtomaa
Author Affiliation
Department of Dental Public Health, University of Helsinki, Finland. jari.ahlberg@helsinki.fi
Source
Community Dent Oral Epidemiol. 1997 Dec;25(6):419-22
Date
Dec-1997
Language
English
Publication Type
Article
Keywords
American Dental Association
DMF Index
Dental Care - statistics & numerical data - utilization
Dental Prophylaxis
Dental Records
Dental Restoration, Permanent
Dentures
Diagnosis-Related Groups
Finland - epidemiology
Health Education, Dental
Humans
Male
Middle Aged
Occupational Health Services - statistics & numerical data - utilization
Oral Health
Oral Hygiene
Patient Education as Topic
Periodontal Diseases - therapy
Radiography, Dental
Retrospective Studies
Root Canal Therapy
Time Factors
United States
Abstract
The treatment-mix, treatment time, and dental status of 268 male industrial workers entitled to employer-provided dental care were studied. The data were collected from treatment records of the covered workers over the 5-year period 1989-93. Treatment time was based on clinical treatment time recorded per patient visit, and the treatment procedure codes were reclassified into a treatment-mix according to American Dental Association categories, with a modification combining endodontics and restorative treatment. The mean number of check-ups followed by prescribed treatment (treatment courses) during the 5 years was 3.7 among those who had entered the in-house dental care program prior to the monitored period (old attenders). Their treatment time was stable, 57-63 min per year, while the first-year mean treatment time (170 min) of those who had entered the program during the study period (new attenders) was significantly higher (P
PubMed ID
9429814 View in PubMed
Less detail

30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

https://arctichealth.org/en/permalink/ahliterature273361
Source
PLoS One. 2015;10(9):e0136547
Publication Type
Article
Date
2015
Author
Sahar Hassani
Anja Schou Lindman
Doris Tove Kristoffersen
Oliver Tomic
Jon Helgeland
Source
PLoS One. 2015;10(9):e0136547
Date
2015
Language
English
Publication Type
Article
Keywords
Comorbidity
Diagnosis-Related Groups
Episode of Care
Hospital Mortality
Hospital records
Hospitals - standards - statistics & numerical data
Humans
Length of Stay
Norway - epidemiology
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Patient transfer
Probability
Quality Improvement
Quality Indicators, Health Care
Survival Analysis
Abstract
The Norwegian Knowledge Centre for the Health Services (NOKC) reports 30-day survival as a quality indicator for Norwegian hospitals. The indicators have been published annually since 2011 on the website of the Norwegian Directorate of Health (www.helsenorge.no), as part of the Norwegian Quality Indicator System authorized by the Ministry of Health. Openness regarding calculation of quality indicators is important, as it provides the opportunity to critically review and discuss the method. The purpose of this article is to describe the data collection, data pre-processing, and data analyses, as carried out by NOKC, for the calculation of 30-day risk-adjusted survival probability as a quality indicator.
Three diagnosis-specific 30-day survival indicators (first time acute myocardial infarction (AMI), stroke and hip fracture) are estimated based on all-cause deaths, occurring in-hospital or out-of-hospital, within 30 days counting from the first day of hospitalization. Furthermore, a hospital-wide (i.e. overall) 30-day survival indicator is calculated. Patient administrative data from all Norwegian hospitals and information from the Norwegian Population Register are retrieved annually, and linked to datasets for previous years. The outcome (alive/death within 30 days) is attributed to every hospital by the fraction of time spent in each hospital. A logistic regression followed by a hierarchical Bayesian analysis is used for the estimation of risk-adjusted survival probabilities. A multiple testing procedure with a false discovery rate of 5% is used to identify hospitals, hospital trusts and regional health authorities with significantly higher/lower survival than the reference. In addition, estimated risk-adjusted survival probabilities are published per hospital, hospital trust and regional health authority. The variation in risk-adjusted survival probabilities across hospitals for AMI shows a decreasing trend over time: estimated survival probabilities for AMI in 2011 varied from 80.6% (in the hospital with lowest estimated survival) to 91.7% (in the hospital with highest estimated survival), whereas it ranged from 83.8% to 91.2% in 2013.
Since 2011, several hospitals and hospital trusts have initiated quality improvement projects, and some of the hospitals have improved the survival over these years. Public reporting of survival/mortality indicators are increasingly being used as quality measures of health care systems. Openness regarding the methods used to calculate the indicators are important, as it provides the opportunity of critically reviewing and discussing the methods in the literature. In this way, the methods employed for establishing the indicators may be improved.
Notes
Cites: PLoS Med. 2010;7(11):e100100421151347
Cites: Med Care. 2010 Dec;48(12):1117-2120978451
Cites: BMC Health Serv Res. 2012;12:36423088745
Cites: Qual Saf Health Care. 2003 Apr;12(2):100-612679505
Cites: Int J Qual Health Care. 2001 Dec;13(6):475-8011769750
Cites: BMJ Open. 2015;5(3):e00674125808167
Cites: BMJ. 2003 Apr 12;326(7393):816-912689983
Cites: Int J Qual Health Care. 2003 Dec;15(6):523-3014660535
Cites: Stat Med. 1994 May 15;13(9):889-9038047743
Cites: Health Care Financ Rev. 1995 Summer;16(4):107-2710151883
Cites: Heart. 1996 Jul;76(1):70-58774332
Cites: Stat Med. 1997 Dec 15;16(23):2645-649421867
Cites: Med Care. 2005 Nov;43(11):1130-916224307
Cites: Circulation. 2006 Jan 24;113(3):456-6216365198
Cites: Am J Epidemiol. 2011 Mar 15;173(6):676-8221330339
PubMed ID
26352600 View in PubMed
Less detail

[A cost-benefit analysis of different therapeutic methods in menorrhagia]

https://arctichealth.org/en/permalink/ahliterature73080
Source
Tidsskr Nor Laegeforen. 1995 Feb 20;115(5):618-21
Publication Type
Article
Date
Feb-20-1995
Author
R. Kirschner
Author Affiliation
Kvinneklinikken Sentralsykehuset i Akershus, Nordbyhagen.
Source
Tidsskr Nor Laegeforen. 1995 Feb 20;115(5):618-21
Date
Feb-20-1995
Language
Norwegian
Publication Type
Article
Keywords
Adult
Comparative Study
Cost-Benefit Analysis
Diagnosis-Related Groups
English Abstract
Female
Humans
Menorrhagia - drug therapy - economics - surgery - therapy
Middle Aged
Models, Economic
Norway
Abstract
When deciding the right forms of treatment for various medical conditions it has been usual to consider medical knowledge, norms and experience. Increasingly, economic factors and principles are being introduced by the management, in the form of health economics and pharmaco-economic analyses, enforced as budgetary cuts and demands for rationalisation and measures to increase efficiency. Economic evaluations require construction of models for analyses. We have used DRG-information, National Health reimbursements and pharmacological retail prices to make a cost-efficiency analysis of treatments of menorrhagia. The analysis showed better cost-efficiency for certain pharmacological treatments than for surgery.
PubMed ID
7900119 View in PubMed
Less detail

Adapting the Charlson Comorbidity Index for use in patients with ESRD.

https://arctichealth.org/en/permalink/ahliterature184742
Source
Am J Kidney Dis. 2003 Jul;42(1):125-32
Publication Type
Article
Date
Jul-2003
Author
Brenda R Hemmelgarn
Braden J Manns
Hude Quan
William A Ghali
Author Affiliation
Department of Medicine, University of Calgary, Calgary, Alberta, Canada. bhemmelg@ucalgary.ca
Source
Am J Kidney Dis. 2003 Jul;42(1):125-32
Date
Jul-2003
Language
English
Publication Type
Article
Keywords
Aged
Alberta - epidemiology
Comorbidity
Diagnosis-Related Groups
Female
Humans
Kidney Failure, Chronic - epidemiology - therapy
Life tables
Likelihood Functions
Male
Middle Aged
Multivariate Analysis
Peritoneal dialysis
Proportional Hazards Models
Renal Dialysis
Risk Adjustment
Severity of Illness Index
Survival Analysis
Abstract
Accurate prediction of survival for patients with end-stage renal disease (ESRD) and multiple comorbid conditions is difficult. In nondialysis patients, the Charlson Comorbidity Index has been used to adjust for comorbidity. The purpose of this study is to assess the validity of the Charlson index in incident dialysis patients and modify the index for use specifically in this patient population.
Subjects included all incident hemodialysis and peritoneal dialysis patients starting dialysis therapy between July 1, 1999, and November 30, 2000. These 237 patients formed a cohort from which new integer weights for Charlson comorbidities were derived using Cox proportional hazards modeling. Performance of the original Charlson index and the new ESRD comorbidity index were compared using Kaplan-Meier survival curves, change in likelihood ratio, and the c statistic.
After multivariate analysis and conversion of hazard ratios to index weights, only 6 of the original 18 Charlson variables were assigned the same weight and 6 variables were assigned a weight higher than in the original Charlson index. Using Kaplan-Meier survival curves, we found that both the original Charlson index and the new ESRD comorbidity index were associated with and able to describe a wide range of survival. However, the new study-specific index had better validated performance, indicated by a greater change in the likelihood ratio test and higher c statistic.
This study indicates that the original Charlson index is a valid tool to assess comorbidity and predict survival in patients with ESRD. However, our modified ESRD comorbidity index had slightly better performance characteristics in this population.
PubMed ID
12830464 View in PubMed
Less detail

Adjusting case mix payment amounts for inaccurately reported comorbidity data.

https://arctichealth.org/en/permalink/ahliterature144128
Source
Health Care Manag Sci. 2010 Mar;13(1):65-73
Publication Type
Article
Date
Mar-2010
Author
Jason M Sutherland
Jeremy Hamm
Jeff Hatcher
Author Affiliation
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, 35 Centerra Parkway, Suite 110, Lebanon, NH 03766, USA. Jason.Sutherland@Dartmouth.edu
Source
Health Care Manag Sci. 2010 Mar;13(1):65-73
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Comorbidity
Diagnosis-Related Groups - classification - economics
Humans
Models, Econometric
Monte Carlo Method
Ontario
Reimbursement Mechanisms - economics
Abstract
Case mix methods such as diagnosis related groups have become a basis of payment for inpatient hospitalizations in many countries. Specifying cost weight values for case mix system payment has important consequences; recent evidence suggests case mix cost weight inaccuracies influence the supply of some hospital-based services. To begin to address the question of case mix cost weight accuracy, this paper is motivated by the objective of improving the accuracy of cost weight values due to inaccurate or incomplete comorbidity data. The methods are suitable to case mix methods that incorporate disease severity or comorbidity adjustments. The methods are based on the availability of detailed clinical and cost information linked at the patient level and leverage recent results from clinical data audits. A Bayesian framework is used to synthesize clinical data audit information regarding misclassification probabilities into cost weight value calculations. The models are implemented through Markov chain Monte Carlo methods. An example used to demonstrate the methods finds that inaccurate comorbidity data affects cost weight values by biasing cost weight values (and payments) downward. The implications for hospital payments are discussed and the generalizability of the approach is explored.
PubMed ID
20402283 View in PubMed
Less detail

Adjusting outcome measurements for case-mix in a vascular surgical register--is it possible and desirable?

https://arctichealth.org/en/permalink/ahliterature48246
Source
Eur J Vasc Endovasc Surg. 1996 Nov;12(4):459-63
Publication Type
Article
Date
Nov-1996
Author
J. Elfström
T. Troëng
A. Stubberöd
Author Affiliation
Department of Vascular Surgery, University Hospital, Linköping, Sweden.
Source
Eur J Vasc Endovasc Surg. 1996 Nov;12(4):459-63
Date
Nov-1996
Language
English
Publication Type
Article
Keywords
Aged
Amputation - statistics & numerical data
Arterial Occlusive Diseases - mortality - surgery
Chi-Square Distribution
Diagnosis-Related Groups - statistics & numerical data
Female
Humans
Leg - blood supply
Male
Odds Ratio
Registries
Regression Analysis
Retrospective Studies
Survival Rate
Sweden - epidemiology
Treatment Outcome
Vascular Patency
Vascular Surgical Procedures - statistics & numerical data
Veins - transplantation
Abstract
OBJECTIVE: We analysed the variation in the outcome of infrainguinal bypass surgery between departments in a register for clinical audit to see if variation in case-mix influenced the results. MATERIALS AND METHODS: The study was a retrospective analysis of 764 infrainguinal bypass operations performed from 1988 to 1990 at six Swedish surgical departments. Results were assessed at 30 days and at 1 year postoperatively. RESULTS: There was a significant variation (p
Notes
Comment In: Eur J Vasc Endovasc Surg. 1998 Jul;16(1):879715725
PubMed ID
8980438 View in PubMed
Less detail

Admissions and transfers from a rural emergency department.

https://arctichealth.org/en/permalink/ahliterature205679
Source
Can Fam Physician. 1998 Apr;44:789-95
Publication Type
Article
Date
Apr-1998
Author
T L De Freitas
G R Spooner
O. Szafran
Author Affiliation
Department of Family Medicine, University of Alberta.
Source
Can Fam Physician. 1998 Apr;44:789-95
Date
Apr-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alberta
Child
Child, Preschool
Diagnosis-Related Groups
Emergency Service, Hospital
Female
Health Services Research
Humans
Infant
Infant, Newborn
Length of Stay
Male
Middle Aged
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Patient Transfer - statistics & numerical data
Retrospective Studies
Rural Health Services
Abstract
To examine the characteristics of patients transferred from a rural hospital emergency department, to compare them with patients admitted on an emergency basis, and to use this information to help plan physician education.
Descriptive study using records for the period January 1, 1991, to June 30, 1992.
The emergency department at Bonnyville Health Centre, an acute care rural hospital located 240 km northeast of Edmonton, serving a catchment population of approximately 10,000.
One thousand fifty-five patients seen in the emergency department who were either transferred to another centre or admitted to the Bonnyville Health Centre on an emergency basis.
For the transferred group, main diagnosis, category of transfer, and reason for transfer. For the admitted group, main diagnosis, length of stay, type of discharge.
Of the 1055 patients ill enough to be either admitted or transferred, 114 (10.8%) were transferred. Those transferred were predominantly men, the elderly, and people with orthopedic injuries or neurologic diseases. Those admitted presented primarily with internal, respiratory, gynecologic, or pediatric disorders. Reason for transfer was mainly lack of specialized services or equipment at the rural hospital.
Patients transferred out of the emergency department differed from those admitted in diagnoses and sex. Most transfers were considered "mandatory." Results of this analysis supported incorporating a formal rotation in orthopedics and adding 4 weeks to the existing emergency medicine rotation in our family medicine residency program.
Notes
Cites: Fam Med. 1991 Jul;23(5):351-31884928
Cites: Fam Pract Res J. 1990 Fall;10(1):19-262382578
PubMed ID
9585852 View in PubMed
Less detail

Adolescent psychiatric in-patients. A high-risk group for premature death.

https://arctichealth.org/en/permalink/ahliterature196074
Source
Br J Psychiatry. 2000 Feb;176:121-5
Publication Type
Article
Date
Feb-2000
Author
E. Kjelsberg
Author Affiliation
Centre for Child and Adolescent Psychiatry, Oslo, Norway.
Source
Br J Psychiatry. 2000 Feb;176:121-5
Date
Feb-2000
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Cause of Death
Cohort Studies
Diagnosis-Related Groups - statistics & numerical data
Female
Humans
Inpatients - statistics & numerical data
Male
Mental Disorders - mortality
Norway - epidemiology
Risk factors
Abstract
Research has demonstrated increased mortality rates in adolescent psychiatric in-patients.
To investigate this excess mortality by calculating standardised mortality ratios (SMRs) relative to cause of death, diagnosis, cohort and age.
A nationwide Norwegian sample of 1095 former adolescent psychiatric in-patients were followed up 15-33 years after first hospitalisation by record linkage to the National Death Cause Registry.
The SMR was significantly increased for almost all causes of death investigated. In males, all psychiatric diagnoses had significantly increased SMRs, whereas in females, organic mental disorder, anxiety disorder and affective disorder had non-significantly increased SMRs. The SMR was significantly elevated for all age-spans and cohorts investigated.
A broad prevention strategy is needed to combat the increased mortality rates found in adolescent psychiatric in-patients.
PubMed ID
10755047 View in PubMed
Less detail

[A DRG model at the Kungälv Hospital: an attempt to overcome the gap between the administration and the medical profession].

https://arctichealth.org/en/permalink/ahliterature225405
Source
Lakartidningen. 1991 Nov 6;88(45):3780-2
Publication Type
Article
Date
Nov-6-1991

All-cause readmission to acute care for cancer patients.

https://arctichealth.org/en/permalink/ahliterature120630
Source
Healthc Q. 2012;15(3):14-6
Publication Type
Article
Date
2012
Author
Hong Ji
Hani Abushomar
Xi-Kuan Chen
Cheng Qian
Darren Gerson
Author Affiliation
Canadian Institute for Health Information (CIHI).
Source
Healthc Q. 2012;15(3):14-6
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Canada
Child
Diagnosis-Related Groups
Female
Follow-Up Studies
Health Facility Size
Humans
Logistic Models
Male
Neoplasms - economics - therapy
Patient Readmission - statistics & numerical data
Quality Improvement
Residence Characteristics
Risk factors
Abstract
A recent Canadian Institute for Health Information report on all-cause readmission identified that cancer patients had higher-than-average readmission rates. This study provides further insight on the experience of cancer patients, exploring the risk factors associated with readmission at patient, hospital and community levels. An analysis showed that patient characteristics, including the reason for initial hospitalization, sex, co-morbidity levels, admission through the emergency department and the number of previous acute care admissions, were associated with readmission for cancer patients. In addition, we found that the readmission rate for these patients varied by hospital size and whether the patients lived in rural or urban locations.
PubMed ID
22986560 View in PubMed
Less detail

351 records – page 1 of 36.