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[2 cities or: Contrasts within mental deficiency care]

https://arctichealth.org/en/permalink/ahliterature43050
Source
Ugeskr Laeger. 1974 Mar 11;136(11):611-4
Publication Type
Article
Date
Mar-11-1974

[A false image of health care activities in Lotz reports].

https://arctichealth.org/en/permalink/ahliterature232155
Source
Sygeplejersken. 1988 Nov 16;88(46):38-40
Publication Type
Article
Date
Nov-16-1988

An administrative perspective on implementing the MIS Guidelines.

https://arctichealth.org/en/permalink/ahliterature234766
Source
Dimens Health Serv. 1987 Sep;64(6):25-7
Publication Type
Article
Date
Sep-1987
Author
P. Langelle
Author Affiliation
Wetaskiwin General Hospital, Alta.
Source
Dimens Health Serv. 1987 Sep;64(6):25-7
Date
Sep-1987
Language
English
Publication Type
Article
Keywords
Accounting - methods
Canada
Economics, Hospital - trends
Hospital records
Humans
Microcomputers
Software
PubMed ID
3653553 View in PubMed
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[An intensive therapeutic effort in spite of reduced economic resources. Background, course and consequences of a structural reorganization at a large regional diabetic clinic]

https://arctichealth.org/en/permalink/ahliterature48705
Source
Ugeskr Laeger. 1990 Aug 20;152(34):2442-4
Publication Type
Article
Date
Aug-20-1990

Are labour-intensive efforts to prevent pressure ulcers cost-effective?

https://arctichealth.org/en/permalink/ahliterature108167
Source
J Med Econ. 2013 Oct;16(10):1238-45
Publication Type
Article
Date
Oct-2013
Author
Anne Sofie Mølbak Mathiesen
Kamilla Nørgaard
Marie Frederikke Bruun Andersen
Klaus Meyer Møller
Lars Holger Ehlers
Author Affiliation
Danish Center for Health Care Improvement, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University , Aalborg , Denmark.
Source
J Med Econ. 2013 Oct;16(10):1238-45
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Community Health Nursing - economics
Cost-Benefit Analysis
Cross Infection - economics - epidemiology - prevention & control
Decision Support Techniques
Decision Trees
Denmark - epidemiology
Economics, Hospital
Health Care Costs - statistics & numerical data
Home Care Services - economics
Humans
Incidence
Inpatients - statistics & numerical data
Long-Term Care - economics
Patient Discharge - economics - statistics & numerical data
Pressure Ulcer - economics - epidemiology - prevention & control
Prevalence
Probability
Standard of Care - economics
Time Factors
Abstract
Pressure ulcers are a major problem in Danish healthcare with a prevalence of 13-43% among hospitalized patients. The associated costs to the Danish Health Care Sector are estimated to be €174.5 million annually. In 2010, The Danish Society for Patient Safety introduced the Pressure Ulcer Bundle (PUB) in order to reduce hospital-acquired pressure ulcers by a minimum of 50% in five hospitals. The PUB consists of evidence-based preventive initiatives implemented by ward staff using the Model for Improvement.
To investigate the cost-effectiveness of labour-intensive efforts to reduce pressure ulcers in the Danish Health Care Sector, comparing the PUB with standard care.
A decision analytic model was constructed to assess the costs and consequences of hospital-acquired pressure ulcers during an average hospital admission in Denmark. The model inputs were based on a systematic review of clinical efficacy data combined with local cost and effectiveness data from the Thy-Mors Hospital, Denmark. A probabilistic sensitivity analysis (PSA) was conducted to assess the uncertainty.
Prevention of hospital-acquired pressure ulcers by implementing labour-intensive effects according to the PUB was cost-saving and resulted in an improved effect compared to standard care. The incremental cost of the PUB was -€38.62. The incremental effects were a reduction of 9.3% prevented pressure ulcers and 0.47% prevented deaths. The PSAs confirmed the incremental cost-effectiveness ratio (ICER)'s dominance for both prevented pressure ulcers and saved lives with the PUB.
This study shows that labour-intensive efforts to reduce pressure ulcers on hospital wards can be cost-effective and lead to savings in total costs of hospital and social care.
The data included in the study regarding costs and effects of the PUB in Denmark were based on preliminary findings from a pilot study at Thy-Mors Hospital and literature.
PubMed ID
23926909 View in PubMed
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Association of hospital spending intensity with mortality and readmission rates in Ontario hospitals.

https://arctichealth.org/en/permalink/ahliterature126185
Source
JAMA. 2012 Mar 14;307(10):1037-45
Publication Type
Article
Date
Mar-14-2012
Author
Therese A Stukel
Elliott S Fisher
David A Alter
Astrid Guttmann
Dennis T Ko
Kinwah Fung
Walter P Wodchis
Nancy N Baxter
Craig C Earle
Douglas S Lee
Author Affiliation
Institute for Clinical Evaluative Sciences, G106-2075 Bayview Ave, Toronto, ON M4N 3M5, Canada. stukel@ices.on.ca
Source
JAMA. 2012 Mar 14;307(10):1037-45
Date
Mar-14-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Colonic Neoplasms - mortality - therapy
Economics, Hospital
Female
Health Expenditures - statistics & numerical data
Heart Failure - mortality - therapy
Hip Fractures - mortality - therapy
Hospital Costs - statistics & numerical data
Humans
Longitudinal Studies
Male
Middle Aged
Myocardial Infarction - mortality - therapy
Ontario - epidemiology
Patient Readmission - statistics & numerical data
Quality of Health Care
Treatment Outcome
Young Adult
Abstract
The extent to which better spending produces higher-quality care and better patient outcomes in a universal health care system with selective access to medical technology is unknown.
To assess whether acute care patients admitted to higher-spending hospitals have lower mortality and readmissions.
The study population comprised adults (>18 years) in Ontario, Canada, with a first admission for acute myocardial infarction (AMI) (n = 179,139), congestive heart failure (CHF) (n = 92,377), hip fracture (n = 90,046), or colon cancer (n = 26,195) during 1998-2008, with follow-up to 1 year. The exposure measure was the index hospital's end-of-life expenditure index for hospital, physician, and emergency department services.
The primary outcomes were 30-day and 1-year mortality and readmissions and major cardiac events (readmissions for AMI, angina, CHF, or death) for AMI and CHF.
Patients' baseline health status was similar across hospital expenditure groups. Patients admitted to hospitals in the highest- vs lowest-spending intensity terciles had lower rates of all adverse outcomes. In the highest- vs lowest-spending hospitals, respectively, the age- and sex-adjusted 30-day mortality rate was 12.7% vs 12.8% for AMI, 10.2% vs 12.4% for CHF, 7.7% vs 9.7% for hip fracture, and 3.3% vs 3.9% for CHF; fully adjusted relative 30-day mortality rates were 0.93 (95% CI, 0.89-0.98) for AMI, 0.81 (95% CI, 0.76-0.86) for CHF, 0.74 (95% CI, 0.68-0.80) for hip fracture, and 0.78 (95% CI, 0.66-0.91) for colon cancer. Results for 1-year mortality, readmissions, and major cardiac events were similar. Higher-spending hospitals had higher nursing staff ratios, and their patients received more inpatient medical specialist visits, interventional (AMI cohort) and medical (AMI and CHF cohorts) cardiac therapies, preoperative specialty care (colon cancer cohort), and postdischarge collaborative care with a cardiologist and primary care physician (AMI and CHF cohorts).
Among Ontario hospitals, higher spending intensity was associated with lower mortality, readmissions, and cardiac event rates.
Notes
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Comment In: JAMA. 2012 Mar 14;307(10):1082-322416105
PubMed ID
22416099 View in PubMed
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Source
CMAJ. 1989 Mar 1;140(5):494
Publication Type
Article
Date
Mar-1-1989
Author
M D Silver
Source
CMAJ. 1989 Mar 1;140(5):494
Date
Mar-1-1989
Language
English
Publication Type
Article
Keywords
Economics, Hospital
Hospitals, Teaching
Hospitals, University
Humans
Ontario
Patient Admission - economics
PubMed ID
2917286 View in PubMed
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104 records – page 1 of 11.