Skip header and navigation

Refine By

417 records – page 1 of 42.

[Actual cost of complex surgical treatment of patients with neuroischemic form of diabetic foot syndrome].

https://arctichealth.org/en/permalink/ahliterature266227
Source
Khirurgiia (Mosk). 2015;(4):48-53
Publication Type
Article
Date
2015
Author
V A Mitish
F T Mahkamova
Iu S Paskhalova
V A Gruzman
I I Margolina
S L Sokov
Source
Khirurgiia (Mosk). 2015;(4):48-53
Date
2015
Language
Russian
Publication Type
Article
Keywords
Adult
Aged
Diabetic Angiopathies - complications
Diabetic Foot - economics - etiology - surgery
Diabetic Nephropathies - complications
Female
Follow-Up Studies
Health Care Costs - statistics & numerical data
Humans
Male
Middle Aged
Prospective Studies
Russia
Syndrome
Vascular Surgical Procedures - economics
Abstract
The results of calculation the average cost of complex surgical treatment of 52 patients with neuroischemic form of diabetic foot syndrome (Wagner 3, 4) are presented in the article. Calculation was performed in the program "Computer-aided system for calculation of patient's treatment cost" developed in A.V. Vishnevsky Institute of Surgery. This program permits you to analyze such components as hospital-stay duration, cost of surgery, pre- and postoperative management, pharmacotherapy, laboratory and instrumental research methods. Actual cost necessary to prevent high lower extremity amputations in patients with neuroischemic form of diabetic foot syndrome is 458 387.8 rubles per person that 10.02 times higher than amount allocated from the state budget.
PubMed ID
26081187 View in PubMed
Less detail

Ambulatory care or home-based treatment? An economic evaluation of two physiotherapy delivery options for people with rheumatoid arthritis.

https://arctichealth.org/en/permalink/ahliterature182690
Source
Arthritis Care Res. 2000 Aug;13(4):183-90
Publication Type
Article
Date
Aug-2000
Author
L C Li
P C Coyte
S C Lineker
H. Wood
M. Renahan
Author Affiliation
Arthritis & Autoimmunity Research Centre, University Health Network, Consultation and Rehabilitation Service, Arthritis Society, Ontario Division, Toronto, Ontario, Canada.
Source
Arthritis Care Res. 2000 Aug;13(4):183-90
Date
Aug-2000
Language
English
Publication Type
Article
Keywords
Aged
Ambulatory Care - economics
Arthritis, Rheumatoid - rehabilitation
Cost-Benefit Analysis
Employment - economics
Female
Health Care Costs - statistics & numerical data
Health Services Research
Home Care Services - economics
Humans
Male
Middle Aged
Models, Economic
Ontario
Physical Therapy Modalities - economics
Sensitivity and specificity
Time Factors
Travel - economics
Abstract
To assess the difference in costs of home-based versus clinic-based physiotherapy (PT) for patients with rheumatoid arthritis (RA) from a societal perspective.
A cost analysis was performed using statistical and financial information provided by The Arthritis Society, Ontario Division, from April 1, 1997 to March 30, 1998. Cost estimates included treatment costs and costs borne by patients. A sensitivity analysis was conducted to examine the effect of altering the valuation of treatment time and patient employment status.
Total costs per case were $210.87 for the home setting, and $183.87 for the clinic setting when patients were employed. Sensitivity analysis did not change the trend of the results. The estimated start-up costs for an arthritis clinic were between $302.90 and $652.40. From the perspective of the health care system, these costs would be recovered after serving 4 to 8 RA patients at a clinic.
The findings suggest that ambulatory PT care is less costly than home-based services for people with RA based on The Arthritis Society model. Further studies should be conducted to examine the effectiveness and the possible adverse consequences of alternative settings for service delivery.
PubMed ID
14635272 View in PubMed
Less detail

Analyzing differences in the costs of treatment across centers within economic evaluations.

https://arctichealth.org/en/permalink/ahliterature194089
Source
Int J Technol Assess Health Care. 2001;17(2):155-63
Publication Type
Article
Date
2001
Author
D. Coyle
M F Drummond
Author Affiliation
Ottawa Hospital Research Institute, University of Ottawa.
Source
Int J Technol Assess Health Care. 2001;17(2):155-63
Date
2001
Language
English
Publication Type
Article
Keywords
Bronchial Neoplasms - radiotherapy
Canada
Clinical Trials as Topic - economics
Head and Neck Neoplasms - radiotherapy
Health Care Costs - statistics & numerical data
Humans
Multicenter Studies as Topic
Technology Assessment, Biomedical - economics
Abstract
Assessments of health technologies increasingly include economic evaluations conducted alongside clinical trials. One particular concern with economic evaluations conducted alongside clinical trials is the generalizability of results from one setting to another. Much of the focus relating to this topic has been on the generalizability of results between countries. However, the characteristics of clinical trial design require further consideration of the generalizability of cost data between centers within a single country, which could be important in decisions about adoption of the new technology.
We used data from a multicenter clinical trial conducted in the United Kingdom to assess the degree of variation in costs between patients and between treatment centers and the determinants of the degree of such variation.
The variation between patients was statistically significant for both the experimental and conventional treatments. However, the degree of variation between centers was only statistically significant for the experimental treatment. Such variation appeared to be a result of hospital practice, such as payment mechanisms for staff and provision of hostel accommodation, rather than variations in physical resource use or substantive differences in cost structure.
Multicenter economic evaluations are necessary for determining the variations in hospital practice and characteristics that can in turn determine the generalizability of study results to other settings. Such analyses can identify issues that may be important in adopting a new health technology. Analysis is required of similar large multicenter trials to confirm these conclusions.
PubMed ID
11446127 View in PubMed
Less detail

An American physician's foray into Scandinavian healthcare.

https://arctichealth.org/en/permalink/ahliterature275731
Source
Scand J Public Health. 2016 May;44(3):225-7
Publication Type
Article
Date
May-2016
Author
Robert Gendler
Source
Scand J Public Health. 2016 May;44(3):225-7
Date
May-2016
Language
English
Publication Type
Article
Keywords
Finland
Health Care Costs - statistics & numerical data
Humans
Medical Tourism
Patient Acceptance of Health Care
Physicians - psychology
Tendinopathy - surgery
United States
Abstract
The article describes the experience of the author, an American Physician, seeking care for an uncommon orthopedic condition. Unable to find adequate treatment in the United States, the author traveled to Finland for surgical treatment.
PubMed ID
26879080 View in PubMed
Less detail

An economic evaluation of home care for children with newly diagnosed diabetes: results from a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature205981
Source
Med Care. 1998 Apr;36(4):586-98
Publication Type
Article
Date
Apr-1998
Author
G E Dougherty
L. Soderstrom
A. Schiffrin
Author Affiliation
Intensive Ambulatory Care Service, Montreal Children's Hospital, and Department of Pediatrics, McGill University, Québec, Canada.
Source
Med Care. 1998 Apr;36(4):586-98
Date
Apr-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Child Health Services - economics
Child, Preschool
Cost of Illness
Diabetes Mellitus, Type 1 - diagnosis - economics - therapy
Female
Health Care Costs - statistics & numerical data
Home Care Services, Hospital-Based - economics
Hospitalization - economics
Hospitals, Pediatric - economics
Humans
Male
Program Evaluation
Quebec
Treatment Outcome
Abstract
This study was undertaken to determine the health and cost effects of using home care to treat newly diagnosed Type I diabetic children rather than traditional inpatient hospital care. There had been no well-designed evaluations of home care for such children, and very few for children with other health conditions.
Sixty-three children seen at the Montreal Children's Hospital were randomly assigned at diagnosis to home care or traditional inpatient care. The children in the former group were discharged once their metabolic condition stabilized; insulin adjustments and teaching were done in their homes by a trained nurse. The children in the latter group remained hospitalized for insulin adjustments and teaching. All were followed for 24 months. The cost effects were estimated using hospital and parental data.
Social costs were only $48 higher with home care. It had little effect on social costs, because the increased costs of health care services with home care ($768) were largely offset by parental cost savings ($720). Home care improved the children's metabolic outcomes without adversely affecting their psychosocial outcomes.
Using home care to reduce hospital stays for children with newly diagnosed Type I diabetes improved the children's health outcomes without significantly increasing social costs.
PubMed ID
9544598 View in PubMed
Less detail

An introduction to economic evaluation: what's in a name?

https://arctichealth.org/en/permalink/ahliterature175250
Source
Can J Psychiatry. 2005 Mar;50(3):159-66
Publication Type
Article
Date
Mar-2005
Author
Jeffrey S Hoch
Carolyn S Dewa
Author Affiliation
Department of Health Policy Management and Evaluation, University of Toronto, Ontario. hochj@smh.toronto.on.ca
Source
Can J Psychiatry. 2005 Mar;50(3):159-66
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Canada
Cost-Benefit Analysis
Costs and Cost Analysis - economics
Delivery of Health Care - economics
Health Care Costs - statistics & numerical data
Humans
Models, Economic
National Health Programs - economics
Treatment Outcome
Abstract
This paper describes the main types of economic evaluation techniques.
To examine the strengths and limitations of different types of economic evaluations, we used a hypothetical example to review the reasoning underlying each method and to illustrate when it is appropriate to use each method.
The choice of economic evaluation method reflects a decision about what should represent "success" and how success should be valued. Measures of benefit and cost must be considered systematically and simultaneously. Claiming that a new treatment is cost-effective requires making a value judgment based on the personal beliefs of the claimant. Even when cost and effect data are objective, a verdict of cost-effective is subjective. The conclusions of an economic study can change significantly, depending on which patient outcome is used to measure success.
Clinicians must be sure that important patient outcomes are not excluded from economic evaluations. Economic evaluation is a process designed to produce an estimate rather than a decision. New treatment can be more costly and still be cost-effective (if the extra benefit is valued more than the extra cost to produce it). However, since economic evaluation does not explicitly consider a decision maker's available budget, a new treatment can be deemed cost-effective but too expensive to approve.
PubMed ID
15830826 View in PubMed
Less detail

An occupational health intervention programme for workers at high risk for sickness absence. Cost effectiveness analysis based on a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature160853
Source
Occup Environ Med. 2008 Apr;65(4):242-8
Publication Type
Article
Date
Apr-2008
Author
S. Taimela
S. Justén
P. Aronen
H. Sintonen
E. Läärä
A. Malmivaara
J. Tiekso
T. Aro
Author Affiliation
Evalua International, PO Box 35, FIN-01531 Vantaa, Finland. simo.taimela@evalua.fi
Source
Occup Environ Med. 2008 Apr;65(4):242-8
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Absenteeism
Adolescent
Adult
Cost-Benefit Analysis
Female
Finland
Health Care Costs - statistics & numerical data
Health Resources - utilization
Humans
Male
Middle Aged
Occupational Health - statistics & numerical data
Occupational Health Services - economics - methods
Outcome and Process Assessment (Health Care) - methods
Risk assessment
Sick Leave - economics - statistics & numerical data
Abstract
To determine whether, from a healthcare perspective, a specific occupational health intervention is cost effective in reducing sickness absence when compared with usual care in occupational health in workers with high risk of sickness absence.
Economic evaluation alongside a randomised controlled trial. 418 workers with high risk of sickness absence from one corporation were randomised to intervention (n = 209) or to usual care (n = 209). The subjects in the intervention group were invited to occupational health service for a consultation. The intervention included, if appropriate, a referral to specialist treatment. Register data of sickness absence were available for 384 subjects and questionnaire data on healthcare costs from 272 subjects. Missing direct total cost data were imputed using a two-part regression model. Primary outcome measures were sickness absence days and direct healthcare costs up to 12 months after randomisation. Cost effectiveness (CE) was expressed as an incremental CE ratio, CE plane and CE acceptability curve with both available direct total cost data and missing total cost data imputed.
After one year, the mean of sickness absence was 30 days in the usual care group (n = 192) and 11 days less (95% CI 1 to 20 days) in the intervention group (n = 192). Among the employees with available cost data, the mean days of sickness absence were 22 and 24, and the mean total cost euro974 and euro1049 in the intervention group (n = 134) and in the usual care group (n = 138), respectively. The intervention turned out to be dominant-both cost saving and more effective than usual occupational health care. The saving was euro43 per sickness absence day avoided with available direct total cost data, and euro17 with missing total cost data imputed.
One year follow-up data show that occupational health intervention for workers with high risk of sickness absence is a cost effective use of healthcare resources.
Notes
Cites: Stat Med. 2003 Sep 15;22(17):2799-81512939787
Cites: J Occup Environ Med. 2003 May;45(5):499-50612762074
Cites: Annu Rev Public Health. 2002;23:151-6911910059
Cites: Occup Environ Med. 2004 Nov;61(11):924-915477286
Cites: Occup Environ Med. 2007 Nov;64(11):739-4617303674
Cites: Eur Spine J. 2007 Jul;16(7):919-2417186282
Cites: J Occup Rehabil. 2006 Dec;16(4):557-7817086503
Cites: Occup Environ Med. 2006 Oct;63(10):676-8216644897
Cites: Spine (Phila Pa 1976). 2006 May 1;31(10):1075-8216648740
Cites: Med Care. 2006 Apr;44(4):352-816565636
Cites: J Occup Rehabil. 2005 Dec;15(4):569-8016254756
Cites: Occup Environ Med. 2005 Feb;62(2):74-915657187
Comment In: Occup Environ Med. 2008 Apr;65(4):219-2018349154
PubMed ID
17933885 View in PubMed
Less detail

Are fish eaters healthier and do they consume less health-care resources?

https://arctichealth.org/en/permalink/ahliterature98917
Source
Public Health Nutr. 2010 Apr;13(4):453-60
Publication Type
Article
Date
Apr-2010
Author
Gisela Hostenkamp
Jan Sørensen
Author Affiliation
Institute of Public Health, University of Southern Denmark, Odense C, Denmark. gih@sam.sdu.dk
Source
Public Health Nutr. 2010 Apr;13(4):453-60
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Denmark
Diet Surveys
Female
Food Habits
Health Care Costs - statistics & numerical data
Health Services - utilization
Health status
Humans
Male
Middle Aged
Questionnaires
Seafood
Self Disclosure
Socioeconomic Factors
Young Adult
Abstract
OBJECTIVE: Regular dietary intake of fish is associated with reduced risk of developing cardiovascular and other chronic diseases, and may improve general well-being. If fish eaters are healthier, they may use fewer health-care resources. The present study aimed to describe the reported intake of fish and fish products in a Danish general population, and to investigate whether fish consumption is associated with generic measures of self-reported health and consumption of health-care resources. DESIGN: Data on eating patterns and health status for 3422 Danish adults were obtained by telephone interview in the Funen County Health Survey. These data were merged with individual-level register data on health-care utilisation. Survey respondents were categorised into those consuming fish at least once weekly (fish eaters) and those consuming fish less frequently (non-fish eaters). RESULTS: People who reported eating fish twice monthly or once weekly had significantly better overall self-reported health than those who rarely eat fish, even after adjustment for age, gender, social characteristics and lifestyle factors. Fish eaters did not have significantly lower aggregated health-care costs, although their hospital utilisation was significantly lower than that for non-fish eaters. CONCLUSIONS: Moderate fish consumption was associated with better self-reported general health even after controlling for possible confounding variables. Overall, fish eaters appeared to use the same amount of health-care resources as non-eaters, although fish eaters used more medicine but were less likely to be admitted to a hospital.
PubMed ID
19719888 View in PubMed
Less detail

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
Less detail

417 records – page 1 of 42.