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117 records – page 1 of 12.

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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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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Accurate diagnosis and effective treatment of leg ulcers reduce prevalence, care time and costs.

https://arctichealth.org/en/permalink/ahliterature81702
Source
J Wound Care. 2006 Jun;15(6):259-62
Publication Type
Article
Date
Jun-2006
Author
Oien R F
Ragnarson Tennvall G.
Author Affiliation
Blekinge Wound Healing Centre, Lyckeby, Sweden. rut.oien@ltblekinge.se
Source
J Wound Care. 2006 Jun;15(6):259-62
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bandages
Community Health Nursing - economics - education
Cost Control
Cost of Illness
Education, Nursing, Continuing
Female
Humans
Leg Ulcer - diagnosis - economics - epidemiology - nursing
Male
Nursing Administration Research
Nursing Assessment
Nursing Staff - economics - education - psychology
Population Surveillance
Practice Guidelines
Prevalence
Questionnaires
Risk factors
Skin Care - economics - nursing
Sweden - epidemiology
Time and Motion Studies
Workload - economics
Wound Healing
Abstract
OBJECTIVE: This long-term follow-up recorded the prevalence, aetiology and treatment of hard-to-heal leg and foot ulcers, and an estimated nurses' time spent providing care, for the years 1994-2005. METHOD: A questionnaire was sent to all district and community nurses in the county of Blekinge, Sweden, during one week in 1994, 1998, 2004 and 2005. Calculating the costs of hard-to-heal leg and foot ulcer care was not a primary aim, but the reduction in prevalence and time spent on wound management suggested it was important to illustrate the economic consequences of these changes over time. RESULTS: Estimated prevalence of hard-to-heal leg and foot ulcers reduced from 0.22% in 1994 to 0.15% in 2005. Treatment time decreased from 1.7 hours per patient per week in 1994 to 1.3 hours in 2005. Annual costs of leg and foot ulcer care reduced by SEK 6.96 million in the study area from 1994 to 2005. CONCLUSION: Improved wound management was demonstrated; leg and foot ulcer prevalence and treatment time were reduced. The results could be attributed to an increased interest in leg and foot ulcer care among staff, which was maintained by repeated questionnaires, continuous education, establishment of a wound healing centre in primary care and wound management recommendations from a multidisciplinary group. The improved ulcer care reduced considerably the annual costs of wound management in the area.
PubMed ID
16802562 View in PubMed
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Administrative claims data analysis of nurse practitioner prescribing for older adults.

https://arctichealth.org/en/permalink/ahliterature149161
Source
J Adv Nurs. 2009 Oct;65(10):2077-87
Publication Type
Article
Date
Oct-2009
Author
Andrea L Murphy
Ruth Martin-Misener
Charmaine Cooke
Ingrid Sketris
Author Affiliation
School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada. andrea.murphy@dal.ca
Source
J Adv Nurs. 2009 Oct;65(10):2077-87
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Aged
Anti-Infective Agents - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Drug Prescriptions - economics - nursing - statistics & numerical data
Female
Health Services Research
Health Services for the Aged
Humans
Insurance, Pharmaceutical Services - statistics & numerical data
Male
Nova Scotia - epidemiology
Nurse Practitioners - statistics & numerical data
Nurse's Practice Patterns - statistics & numerical data - trends
Pharmacoepidemiology
Retrospective Studies
Rural Population
Abstract
This paper is a report of a study to identify the patterns of prescribing by primary health care nurse practitioners for a cohort of older adults.
The older adult population is known to receive complex pharmacotherapy. Monitoring prescribing to older adults can inform quality improvement initiatives. In comparison to other countries, research examining nurse practitioner prescribing in Canada is limited. Nurse practitioner prescribing for older adults is relatively unexplored in the international literature. Although commonly used to study physician prescribing, few studies have used claims data from drug insurance programmes to investigate nurse practitioner prescribing.
Drug claims for prescriptions written by nurse practitioners from fiscal years 2004/05 to 2006/07 for beneficiaries of the Nova Scotia Seniors' Pharmacare programme were analysed. Data were retrieved and analysed in May 2008. Prescribing was described for each drug using the World Health Organization Anatomical Therapeutic Chemical code classification system by usage and costs for each fiscal year.
Antimicrobials and non-steroidal anti-inflammatory drugs consistently represented the top ranked groups for prescription volume and cost. Over the three fiscal years, antimicrobial prescription rates declined relative to rates of other groups of medications. Prescription volume per nurse doubled and cost per prescription increased by approximately 20%.
Prescription claims data can be used to characterize the prescribing trends of nurse practitioners. Research linking patient characteristics, including diagnoses, to prescriptions is needed to assess prescribing quality. Some potential areas of improvement were identified with antimicrobial and non-steroidal antiinflammatory selection.
PubMed ID
19674174 View in PubMed
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AIDS and the small city: the cost at Kingston General Hospital.

https://arctichealth.org/en/permalink/ahliterature232461
Source
CMAJ. 1988 Sep 15;139(6):557-9, 561-2
Publication Type
Article
Date
Sep-15-1988
Author
P. Ford
D. Robertson
Author Affiliation
Department of Medicine, Queen's University, Ont.
Source
CMAJ. 1988 Sep 15;139(6):557-9, 561-2
Date
Sep-15-1988
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - economics - nursing
Canada
Costs and Cost Analysis
Equipment and Supplies, Hospital - economics - standards
Hospitalization - economics
Hospitals, General - economics
Humans
Laboratories, Hospital - standards
Outpatient Clinics, Hospital - organization & administration
Personnel, Hospital - education
Specimen Handling - standards
Abstract
Although AIDS is often thought of as a "big-city" disease, it is also becoming a serious health care issue for doctors and other health care workers in "small-city" Canada. Kingston, Ont., is one of those small cities, and of the facilities trying to come to grips with a disease about which much remains to be learned. In this article, Drs. Peter Ford and David Robertson outline their hospital's estimate of the cost, in manpower and money, of dealing with the AIDS crisis. The final estimate: roughly $700,000. Although most of the cost will involve one-time capital spending, they point out that there will likely be ongoing labour-related costs because of the special programs and increased manpower needed to deal with AIDS patients. Clearly, AIDS is no longer a big-city disease.
PubMed ID
3409146 View in PubMed
Less detail

AIDS management: five hospitals compared.

https://arctichealth.org/en/permalink/ahliterature230659
Source
Dimens Health Serv. 1989 Jun;66(5):14-7, 28-30
Publication Type
Article
Date
Jun-1989

An economic study of cost savings on a care-by-parent ward.

https://arctichealth.org/en/permalink/ahliterature241669
Source
Med Care. 1983 Aug;21(8):768-82
Publication Type
Article
Date
Aug-1983
Author
R G Evans
G C Robinson
Source
Med Care. 1983 Aug;21(8):768-82
Date
Aug-1983
Language
English
Publication Type
Article
Keywords
British Columbia
Child
Child, Hospitalized
Costs and Cost Analysis
Economics, Nursing
Hospital Bed Capacity, under 100
Hospital Units - economics
Humans
Nursing Service, Hospital - economics
Parents
Self-Care Units - economics
Abstract
Alternatives to inpatient care that improve quality of care and save money are desirable during periods of restraint on hospital budgets. One such alternative is the care-by-parent unit (CBPU) in which a parent's stay on the ward can reduce costs by resuming nursing tasks, limiting unnecessary procedures, and encouraging early discharge. This study measured costs per case treated in the CBPU compared with the costs for similar patients treated in the inpatient nursing unit (NU). Average costs per episode were lower in the CBPU--33 per cent for general pediatrics, 13.5 per cent for tonsils and adenoids and 29 per cent for other surgery. These savings are capable of considerable expansion because more than half of the admissions to NU meet the criteria for admission to CBPU. If CBPU facilities were expanded, however, the savings estimated above would not follow automatically. New CBPU facilities must substitute for NU, not add to total utilization.
PubMed ID
6888029 View in PubMed
Less detail

An innovative enterostomal therapy nurse model of community wound care delivery: a retrospective cost-effectiveness analysis.

https://arctichealth.org/en/permalink/ahliterature158249
Source
J Wound Ostomy Continence Nurs. 2008 Mar-Apr;35(2):169-83; discussion 184-5
Publication Type
Article
Author
Connie Harris
Ronald Shannon
Author Affiliation
Ostomy and Wounds CarePartners ET NOW Division, Kitchener, Ontario, Canada. connie.harris@carepartners.ca
Source
J Wound Ostomy Continence Nurs. 2008 Mar-Apr;35(2):169-83; discussion 184-5
Language
English
Publication Type
Article
Keywords
Aged
Community Health Nursing - organization & administration
Cost-Benefit Analysis
Decision Support Techniques
Female
Humans
Kaplan-Meier Estimate
Male
Models, Nursing
Monte Carlo Method
Nurse's Role
Nursing Administration Research
Nursing Evaluation Research
Ontario
Retrospective Studies
Skin Care - economics - nursing
Specialties, Nursing - organization & administration
Time Factors
Treatment Outcome
Wound Healing
Wounds and Injuries - etiology - nursing
Abstract
A Canadian specialty nursing association identified the necessity to examine the role and impact of enterostomal (ET) nursing in Canada. We completed a retrospective analysis of the cost-effectiveness and benefits of ET nurse-driven resources for the treatment of acute and chronic wounds in the community.
This was a multicenter retrospective pragmatic chart audit of 3 models of nursing care utilizing 4 community nursing agencies and 1 specialty company owned and operated by ET nurses. An analysis was completed using quantitative methods to evaluate healing outcomes, nursing costs, and cost-effectiveness.
Kaplan-Meier estimates were calculated to determine the average time to 100% healing of acute and chronic wounds and total nursing visit costs for treatment in a community setting. Average direct nursing costs related to management of each wound were determined by number of nursing visits and related reimbursement for each visit. A Monte Carlo simulation method was used to help account for costs and benefits in determination of cost-effectiveness between caring groups and the uncertainty from variation between patients and wounds.
Three hundred sixty chronic wounds and 54 acute surgical wound charts were audited. Involvement of a registered nurse (RN) with ET or advanced wound ostomy skills (AWOS) in community-level chronic and acute wound care was associated with lower overall costs mainly due to reduced time to 100% closure of the wound and reduced number of nursing visits. The differences in health benefits and total costs of nursing care between the ET/AWOS and a hybrid group that includes interventions developed by an ET nurse and followed by general visiting nurses that could include both RNs and registered practical nurses is an expected reduction in healing times of 45 days and an expected cost difference of $5927.00 per chronic wound treated. When outcomes were broken into ET/AWOS involvement categories for treatment of chronic wounds, there was a significantly faster time to 100% closure at a lower mean cost as the ET/AWOS involvement increased in the case. For acute wound treatment, the differences in health benefits and total costs between the ET/AWOS and a hybrid nursing care model were an expected reduction in healing times of 95 days and an expected cost difference of $9578.00 per acute wound treated. Again, there was a significant difference in healing times and reduced mean cost as the ET/AWOS became more involved in the treatment. The financial benefit to the Ontario Ministry of Health and Long-Term Care is estimated to increase as the involvement of nurses with ET/AWOS specialty training increases.
The greater the involvement both directly and indirectly of an ET/AWOS nurse in the management of wounds, the greater the savings and the shorter the healing times.
PubMed ID
18344791 View in PubMed
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[Assertive community team--better than what?].

https://arctichealth.org/en/permalink/ahliterature198462
Source
Ugeskr Laeger. 2000 Apr 17;162(16):2349-50
Publication Type
Article
Date
Apr-17-2000
Author
R. Rosenberg
Source
Ugeskr Laeger. 2000 Apr 17;162(16):2349-50
Date
Apr-17-2000
Language
Danish
Publication Type
Article
Keywords
Community Mental Health Services - manpower - organization & administration - standards
Denmark
Humans
Patient care team
Psychotic Disorders - economics - nursing - therapy
Notes
Comment On: Ugeskr Laeger. 2000 Feb 28;162(9):1197-20410741223
PubMed ID
10827569 View in PubMed
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The Bedside Oral Exam and the Barrow Oral Care Protocol: translating evidence-based oral care into practice.

https://arctichealth.org/en/permalink/ahliterature113653
Source
Intensive Crit Care Nurs. 2013 Oct;29(5):282-90
Publication Type
Article
Date
Oct-2013
Author
Virginia Prendergast
Cindy Kleiman
Mary King
Author Affiliation
Division of Advanced Practice Nursing, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. Neuropub@dignityhealth.org
Source
Intensive Crit Care Nurs. 2013 Oct;29(5):282-90
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Clinical Protocols
Cost-Benefit Analysis
Critical Care Nursing - standards
Evidence-Based Nursing
Humans
Nursing Assessment
Oral Health
Oral Hygiene - economics - nursing
Pneumonia, Ventilator-Associated - nursing - prevention & control
Quality Improvement
Abstract
To introduce the Bedside Oral Exam (BOE) and the Barrow Oral Care Protocol (BOCP) to guide oral care for intensive care unit patients. Secondary aim: To explore quality improvement data for incidence of ventilator associated pneumonia (VAP), cost effectiveness of oral hygiene supplies and staff response to change in practice.
Descriptive case design for implementation and evaluation of oral assessments and oral hygiene. Incidence of VAP and the cost of oral care supplies before and after implementation was compared. Staff responses were elicited both pre- and post-implementation.
Incidence of VAP fell significantly from 4.21 to 2.1 per 1000 ventilator days (p =.04). A cost savings of 65% was noted on a monthly basis for oral hygiene supplies. Staff reported increased satisfaction in providing oral hygiene with a combination of oral care products.
A significant reduction in VAP was noted using the BOCP. The BOE guided individualised oral care with contemporary supplies, including a tongue scraper, electric toothbrush, non-foaming toothpaste and oral moisturisers. Cost-effective, comprehensive oral care appears to be effective in reducing VAP. Further studies are needed to assess impact of oral hygiene on oral health and patient comfort.
PubMed ID
23702324 View in PubMed
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117 records – page 1 of 12.