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[A comparative clinico-economic study of 2 models of organizational forms of psychiatric care exemplified in schizophrenia].

https://arctichealth.org/en/permalink/ahliterature225077
Source
Zh Nevropatol Psikhiatr Im S S Korsakova. 1992;92(3):85-9
Publication Type
Article
Date
1992
Author
Iu V Ushakov
E D Bogdanova
S V Shipin
M G Mirzoian
Source
Zh Nevropatol Psikhiatr Im S S Korsakova. 1992;92(3):85-9
Date
1992
Language
Russian
Publication Type
Article
Keywords
Costs and Cost Analysis - statistics & numerical data
Female
Health Expenditures - statistics & numerical data
Humans
Male
Mental Health Services - economics - organization & administration - statistics & numerical data
Moscow - epidemiology
Prevalence
Russia - epidemiology
Schizophrenia - economics - epidemiology - therapy
Sex Factors
Socioeconomic Factors
Abstract
The authors describe part of the results of a comparative clinico-economic analysis of the functioning of two models of organizational forms of psychiatric services with special reference to Moscow and Kaluga. The purpose of the given research fragment was to make a comparative analysis of expenditures on schizophrenic patients depending on the system of psychiatric services organization on the whole and between different types of services; to specify approaches to optimization of their functioning with the use of a clinico-economic approach. Based on a comparative investigation of the representative groups of schizophrenic patients (386 patients of a mental health center in Moscow and 531 patients of the Kaluga regional psychiatric hospital No. 1), it has been established that as a result of the proper organization and financing of psychiatric services in Kaluga, the "direct" expenditures on one schizophrenic patient per year could be 20% as reduced and the losses of the national income could be lowered more than 2-fold. It should necessarily be mentioned that the financing of extra hospital services in Kaluga exceeded that in Moscow more than 3-fold, reaching about 20.3% of all the expenditures on schizophrenic patients. Apparently, the organizational and financial experience gained in Kaluga with the design of the common complex and many-staged system of psychiatric services may turn fairly instrumental in elaborating approaches to optimization of the functioning of psychiatric services.
PubMed ID
1332339 View in PubMed
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Adding up provincial expenditures on health care for Manitobans: a POPULIS project. Population Health Information System.

https://arctichealth.org/en/permalink/ahliterature201448
Source
Med Care. 1999 Jun;37(6 Suppl):JS60-82
Publication Type
Article
Date
Jun-1999
Author
M. Shanahan
C. Steinbach
C. Burchill
D. Friesen
C. Black
Author Affiliation
Centre for Health Economics Research and Evaluation, University of Sydney, Camperdown NSW, Australia.
Source
Med Care. 1999 Jun;37(6 Suppl):JS60-82
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Community Health Planning - organization & administration
Female
Health Expenditures - statistics & numerical data
Health services needs and demand - economics - statistics & numerical data
Health Services Research
Health Status Indicators
Home Care Services - economics
Hospitalization - economics
Humans
Infant
Information Systems - organization & administration
Male
Manitoba - epidemiology
Mental Health Services - economics
Middle Aged
Mortality
Needs Assessment
Nursing Homes - economics
Residence Characteristics - statistics & numerical data
Sensitivity and specificity
Abstract
Using the POPULIS framework, this project estimated health care expenditures across the entire population of Manitoba for inpatient and outpatient hospital utilization, physician visits, mental health inpatient, and nursing home utilization.
This estimated expenditure information was then used to compare per capita expenditures relative to premature mortality rates across the various areas of Manitoba.
Considerable variation in health care expenditures was found, with those areas having high premature mortality rates also having higher health care expenditures.
PubMed ID
10409018 View in PubMed
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Alberta's universal dental plan for the elderly: differences in use over 6 years by two cohorts.

https://arctichealth.org/en/permalink/ahliterature214244
Source
Am J Public Health. 1995 Oct;85(10):1408-11
Publication Type
Article
Date
Oct-1995
Author
D W Lewis
G W Thompson
Author Affiliation
Faculty of Dentistry, University of Toronto, Ontario, Canada.
Source
Am J Public Health. 1995 Oct;85(10):1408-11
Date
Oct-1995
Language
English
Publication Type
Article
Keywords
Aged
Alberta
Cohort Studies
Dental Care for Aged - economics - trends - utilization
Denturists - economics - utilization
Health Care Costs
Health Expenditures - statistics & numerical data
Health Services Research
Humans
Insurance, Dental - economics - trends - utilization
Abstract
Dental services use by two cohorts under the universal dental plan for the elderly in Alberta, Canada, was examined.
Two birth cohorts 65 to 69 years old at entry who used the plan from 1978 to 1979 (n = 17,816) or from 1985 to 1986 (n = 27,474) were analyzed over 6 successive years for differences in dental services use and costs.
The 1985/86 cohort received 24% more visits per patient than the 1978/79 cohort. Their inflation-adjusted expenditures increased by 19% mainly as a result of increases in denturists' expenditures (33%) (dentists' expenditures increased just 4% because of lower plan fee increases). The 1985/86 cohort received relatively many more periodontal and fewer denture services. Annual attendance over 6 consecutive years was high, especially for the 1985/86 cohort and dentists' patients; 55% of the 1985/86 cohort who used dentists did so in 5 or all 6 years.
Differences in plan expenditures per patient between the birth cohorts and dentists and denturists, along with the high continuity of care for dentists' patients, have important implications for planning and administering dental plans for the elderly. The large expenditure decreases for removable dentures and the large increases for periodontal services to the 1985/86 cohort are noteworthy.
Notes
Cites: Am J Public Health. 1989 Jan;79(1):47-512783297
Cites: J Am Dent Assoc. 1990 Jun;120(6):665-82112567
Cites: J Can Dent Assoc. 1994 May;60(5):403-68004517
Cites: J Public Health Dent. 1992 Fall;52(5):259-631404070
Cites: Med Care. 1990 Dec;28(12):1165-802250500
PubMed ID
7573626 View in PubMed
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Analysis of primary health care utilisation in south-western Finland--a tool for management.

https://arctichealth.org/en/permalink/ahliterature182681
Source
Health Policy. 2003 Dec;66(3):229-38
Publication Type
Article
Date
Dec-2003
Author
P T Ovaskainen
P T Rautava
A. Ojanlatva
J K Päkkilä
R M Päivärinta
Author Affiliation
Department of Public Health, University of Turku, Lemminkäisenkatu 1, FIN-20014 Turku, Finland. paivi.ovaskainen@utu.fi
Source
Health Policy. 2003 Dec;66(3):229-38
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Catchment Area (Health)
Child
Child, Preschool
Databases as Topic
Decision Support Systems, Management
Finland
Health Expenditures - statistics & numerical data - trends
Humans
Infant
International Classification of Diseases
Middle Aged
National Health Programs - utilization
Needs Assessment
Office visits - statistics & numerical data
Patient Acceptance of Health Care - statistics & numerical data
Primary Health Care - economics - utilization
Social Class
Abstract
Long-term health care planning is presently not based on the needs of the population at the local level in Finland but rather, it is based on retroactive economic values and already realised budget in hospital and primary health care. The existing health care structure and its health care practices continue to guide the supply of services. While we have the most extensive databases on primary health care and hospital services, such tools are not used in the broadest possible sense in the present health care planning at the local level. Simple and informative indicators available to health care planners and decision-makers from databases at the local level were used to appraise the use of health care services. Statistical profiles of health care clients were classified by age groups within the health authority area (population of 13,000) of Paimio-Sauvo in south-western Finland with the intent to explain utilisation of primary health care services, their coverage, and repeat visits as well as groups not using those services. Physicians recorded reasons for each patient visit with the ICD-10 categories. In the case municipalities, primary health care services provided 100% coverage to children of 0-6 years of age and more than 70% coverage to other groups. Most primary health care expenditures were assessed for people 65 years or older in 2000. As an example of a municipality, hospital and primary health care expenditures within Paimio varied from 24 to 30.4% of the total obligations for the last 10 years.
PubMed ID
14637008 View in PubMed
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Are national injury prevention and research efforts matching the distribution of injuries across sectors?

https://arctichealth.org/en/permalink/ahliterature268589
Source
Inj Prev. 2015 Apr;21(e1):e113-5
Publication Type
Article
Date
Apr-2015
Author
Henrik Jaldell
Linda Ryen
Björn Sund
Ragnar Andersson
Source
Inj Prev. 2015 Apr;21(e1):e113-5
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Accident Prevention - economics
Accidents - statistics & numerical data
Accidents, Home - statistics & numerical data
Accidents, Traffic - statistics & numerical data
Emergency Service, Hospital - statistics & numerical data
Financing, Government - statistics & numerical data
Health Expenditures - statistics & numerical data
Humans
Leisure Activities
Risk factors
Sweden - epidemiology
Wounds and Injuries - economics - epidemiology - mortality
Abstract
In 2011, 88% of all unintentional injury fatalities occurred in home and leisure environments in Sweden, while transportation fatalities accounted for 10% and work/school injuries for 2%. The corresponding proportions among non-fatal injuries were 75, 12 and 13%, respectively. However, 83% of the national governmental expenditure on unintentional injury prevention in 2011 was allocated to transportation safety, 7% to home and leisure, and 10% to the work sector including schools. Likewise, around 85% of the governmental research budget aimed for unintentional injury research was allocated to the transportation sector, 9% to home and leisure environments, and 6% to the work and school sector. Our results reveal a striking lack of correspondence between problem profile and governmental countermeasures.
PubMed ID
24599902 View in PubMed
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Assessment of health policy in Costa Rica--some preliminary remarks.

https://arctichealth.org/en/permalink/ahliterature8305
Source
Scand J Soc Med Suppl. 1991;46:82-91
Publication Type
Article
Date
1991
Author
C G Eriksson
E. Mohs
B. Eriksson
Author Affiliation
Nordic School of Public Health, Göteborg.
Source
Scand J Soc Med Suppl. 1991;46:82-91
Date
1991
Language
English
Publication Type
Article
Keywords
Cause of Death
Costa Rica - epidemiology
Health Expenditures - statistics & numerical data
Health Planning - standards
Health Policy
Health Priorities
Health Services Research - methods
Humans
Infant Mortality - trends
Infant, Newborn
Mortality - trends
Policy Making
Politics
Socioeconomic Factors
Abstract
Costa Rica is one of the world's success stories in primary health care. During the past 20 years the country has experienced a demographic and epidemiological transition. However, during the 80's the economic recession severely affected the country. The social, economic, political and geographic contexts are important for the assessment of health policy. The longstanding democracy, investments in public education and health all contribute to the peace and stability. Assessment of health policy needs both a quantitative and qualitative approach. The policy-making process--how policies are made, translated into action and evaluated--is a research challenge. The national health policy 1986-1990 includes commitment to Health for All strategy; development of the National Health Care System; strengthening of the health care infrastructure; consolidation of health achievements and undertaking of new problems and approaches on integral care for the population; community participation in all health care system activities; and health care priorities. Important research issues are the relationship between the needs of the population and health policy development and the impacts of health policy on the health of the population. A comprehensive study of policy-making includes studies of policy content, process, output and evaluation of impacts (including economy of health policy), and analysis for policy, i.e. information for policy making, process and policy advocacy. Recent successful health policy issues are child health and HIV/AIDS, while water pollution and traffic accidents have been more problematic policy issues.
PubMed ID
1805372 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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Association of mental health with health care use and cost: a population study.

https://arctichealth.org/en/permalink/ahliterature131780
Source
Can J Psychiatry. 2011 Aug;56(8):490-4
Publication Type
Article
Date
Aug-2011
Author
David Cawthorpe
Thomas C R Wilkes
Lindsay Guyn
Bing Li
Mingshan Lu
Author Affiliation
Child and Adolescent Mental Health and Addictions Program, Alberta Health Services, Calgary Zone, Calgary, Alberta. cawthord@ucalgary.ca
Source
Can J Psychiatry. 2011 Aug;56(8):490-4
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Alberta
Case-Control Studies
Female
Health Care Costs - statistics & numerical data
Health Expenditures - statistics & numerical data
Humans
Male
Mental Disorders - economics - therapy
Mental Health - economics - statistics & numerical data
Mental Health Services - economics - utilization
Abstract
To compare the health costs of groups with and without psychiatric diagnoses (PDs) using 9 years of physician billing data.
A dataset containing registration data for all patients receiving public mental health service was constructed and subsequently matched, on age and sex, in a final patient to comparison patient ratio of 1:8, with health care users who did not receive treatment in the mental health system. Three groups emerged: a patient PD group-patients with psychiatric disorders treated in public mental health care (n = 76 677); a comparison patient PD group-comparison patients with PDs treated in physicians only (n = 277 627); and a patient- comparison patient non-PD group-patients (treated in specialized publicly funded care or by their physician) without PDs (n = 329 177). Examining over 42 million billing records for all of these patients, we compared the average number of visits and the average health only (nonpsychiatric) billing cost per each patient during the 9-year study period across the groups.
Among all health care users in the data, the health costs (Total Costs - Mental Health Costs) were greater on average for the patients with PD group ($3437) and the comparison patient PD group ($3265), compared with patient-comparison patient non-PD group ($1345). Forty-six percent of the comparison sample had a PD.
Having a mental health problem is related to greater health-related expenditures. This has important policy implications on how mental health resources are constructed and rationed within the health care system.
PubMed ID
21878160 View in PubMed
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Attitudes to and experience of dental care among 50-year-olds in two Swedish counties.

https://arctichealth.org/en/permalink/ahliterature62826
Source
Swed Dent J. 1999;23(2-3):87-96
Publication Type
Article
Date
1999
Author
L. Unell
B. Söderfeldt
A. Halling
D. Birkhed
Author Affiliation
Community Dental Health Unit, Orebro County Council, Sweden.
Source
Swed Dent J. 1999;23(2-3):87-96
Date
1999
Language
English
Publication Type
Article
Keywords
Attitude to Health
Cariostatic Agents - therapeutic use
Cross-Sectional Studies
Dental Care - economics - psychology - statistics & numerical data
Female
Fluorides - therapeutic use
Health Behavior
Health Expenditures - statistics & numerical data
Health status
Humans
Male
Middle Aged
Oral Health
Oral Hygiene
Patient satisfaction
Plants, Toxic
Questionnaires
Sex Factors
Smoking - epidemiology
Sweden - epidemiology
Time Factors
Tobacco, Smokeless
Toothbrushing - statistics & numerical data
Toothpaste - therapeutic use
Abstract
The aim of this study was to investigate attitudes to and experiences of dental care in a population, born 1942. The following items were studied: opinions of general and oral health, attitudes to and experiences of dental care, dental care habits, experiences of latest visit to a dentist, tobacco habits and use of various dental hygiene articles. A cross-sectional mail questionnaire was sent in 1992 to all 50-year-olds in two Swedish counties, Orebro and Ostergotland, totally 8888 persons; the response rate was 71%. Of the population 89%, indicated good health. Satisfaction with dental care was high, 94%. 26% stated attendance to a dentist twice or more per year, and 64% at least once a year. As to expenses, 78% paid less than 1000 SEK the last year. Concerning the latest visit, 38% reported painless treatment, 37% no inconvenience, and 55% good care. The duration of the latest visit included on an average 27 min in travel time, 7 min in waiting time and 27 min in treatment time. Information about oral hygiene was given to 29% and about cost for treatment to 47% of the interviewed. There were 28% daily smokers. Snuff was daily used by 10% of the males. Toothbrushing twice a day with fluoride toothpaste seemed to be the standard oral hygiene procedure and was reported by 80% of the respondents.
PubMed ID
10431344 View in PubMed
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Booming prescription drug expenditure: a population-based analysis of age dynamics.

https://arctichealth.org/en/permalink/ahliterature172853
Source
Med Care. 2005 Oct;43(10):996-1008
Publication Type
Article
Date
Oct-2005
Author
Steven G Morgan
Author Affiliation
Centre for Health Services and Policy Research, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada. morgan@chspr.ubc.ca
Source
Med Care. 2005 Oct;43(10):996-1008
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
British Columbia
Child
Child, Preschool
Databases, Factual
Drug Costs - statistics & numerical data - trends
Drug Utilization - economics - statistics & numerical data - trends
Financing, Personal - statistics & numerical data - trends
Health Expenditures - statistics & numerical data - trends
Humans
Infant
Infant, Newborn
Middle Aged
Population Dynamics
Prescription Fees - statistics & numerical data - trends
Abstract
Prescription drug expenditures in North America have nearly doubled in the past 5 years, creating intense pressure for all public and private benefits managers and policymakers.
The objective of this study was to describe age-specific drug expenditure trends from 1996 to 2002 for the Canadian province of British Columbia.
This study shows changes in expenditures per capita quantified for 5 age categories: residents aged 0 to 19, 20 to 44, 45 to 64, 65 to 84, and 85 and older. The cost impacts of 7 determinants of prescription drug expenditures are quantified.
This study describes population-based, patient-specific pharmaceutical data showing the type, quantity, and cost of every prescription drug purchased by virtually all residents of British Columbia.
Population-wide expenditures per capita grew at a rate of 11.6% per annum. Growth was primarily driven by the selection of more costly drugs per course of treatment and increases in the number concomitant treatments received per patient. Population aging did not have a major impact on expenditures. However, expenditure per capita grew most rapid among residents aged 45 to 64, the cohort that expended most over the period. The aging of this demographic cohort may threaten the financial viability of age-based drug benefit programs.
PubMed ID
16166869 View in PubMed
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197 records – page 1 of 20.