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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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Adding value while saving dollars: unleashing the potential of a national, integrated approach to home and community care.

https://arctichealth.org/en/permalink/ahliterature146214
Source
Healthc Pap. 2009;9(4):41-6; discussion 52-5
Publication Type
Article
Date
2009
Author
Teresa Petch
Judith Shamian
Author Affiliation
Victorian Order of Nurses (VON) Canada.
Source
Healthc Pap. 2009;9(4):41-6; discussion 52-5
Date
2009
Language
English
Publication Type
Article
Keywords
Canada
Community Health Services - economics - organization & administration
Delivery of Health Care - economics - organization & administration
Delivery of Health Care, Integrated - economics - organization & administration
Efficiency, Organizational - economics
Health Services Accessibility
Health services needs and demand
Home Care Services - economics - organization & administration
Humans
Abstract
This commentary by Victorian Order of Nurses Canada, written in response to "Getting What We Pay For? The Value-for-Money Challenge," by McGrail, Zierler and Ip, answers four key questions about Canada's home and community care sector: (1) What are our objectives? (2) Where do we achieve good value now? (3) Where and why are we failing? and (4) What will help us do better? We conclude that although the home and community care sector offers great promise in meeting the evolving health and social needs of Canadians, it is not living up to its potential. We propose the development of a national, integrated approach to home and community care to help Canadians remain healthy and independent in their homes. This would represent a wise financial investment for governments and would contribute to the long-term health of Canadians.
Notes
Comment On: Healthc Pap. 2009;9(4):8-2220057203
PubMed ID
20057208 View in PubMed
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[Advanced medical therapy at home. Home at any cost?].

https://arctichealth.org/en/permalink/ahliterature215782
Source
Tidsskr Nor Laegeforen. 1995 Feb 28;115(6):695-6
Publication Type
Article
Date
Feb-28-1995
Author
H. Flaatten
Author Affiliation
Anestesi- og intensivavdeling, Haukeland Sykehus, Bergen.
Source
Tidsskr Nor Laegeforen. 1995 Feb 28;115(6):695-6
Date
Feb-28-1995
Language
Norwegian
Publication Type
Article
Keywords
Home Care Services - economics
Home Care Services, Hospital-Based - economics
Humans
Intensive Care - economics
Norway
United States
PubMed ID
7900126 View in PubMed
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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
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[A physician in Gothenburg wanted to test something new. A private emergency call car improved quality of life].

https://arctichealth.org/en/permalink/ahliterature213851
Source
Lakartidningen. 1995 Nov 15;92(46):4292-3
Publication Type
Article
Date
Nov-15-1995

Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark.

https://arctichealth.org/en/permalink/ahliterature123849
Source
BMC Public Health. 2012;12:396
Publication Type
Article
Date
2012
Author
Yukari Yamada
Anette Ekmann
Charlotte Juul Nilsson
Mikkel Vass
Kirsten Avlund
Author Affiliation
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. yukari.yamada@upol.cz
Source
BMC Public Health. 2012;12:396
Date
2012
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Cross-Sectional Studies
Denmark
Female
Financing, Personal - economics - statistics & numerical data
Geriatric Assessment
Health Services for the Aged - economics
Healthcare Disparities - economics
Home Care Services - economics - utilization
House Calls - utilization
Humans
Logistic Models
Male
Patient Acceptance of Health Care - psychology - statistics & numerical data
Physicians, Family - education - standards
Prevalence
Preventive Health Services - economics - methods
Program Evaluation
Questionnaires
Residence Characteristics
Sex Distribution
Social Class
Abstract
Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1) whether socioeconomic status was associated with acceptance of preventive home visits among older people and 2) whether municipality invitational procedures for the preventive home visits modified the association.
The study population included 1,023 community dwelling 80-year-old individuals from the Danish intervention study on preventive home visits. Information on preventive home visit acceptance rates was obtained from questionnaires. Socioeconomic status was measured by financial assets obtained from national registry data, and invitational procedures were identified through the municipalities. Logistic regression analyses were used, adjusted by gender.
Older persons with high financial assets accepted preventive home visits more frequently than persons with low assets (adjusted OR = 1.5 (CI95%: 1.1-2.0)). However, the association was attenuated when adjusted by the invitational procedures. The odds ratio for accepting preventive home visits was larger among persons with low financial assets invited by a letter with a proposed date than among persons with high financial assets invited by other procedures, though these estimates had wide confidence intervals.
High socioeconomic status was associated with a higher acceptance rate of preventive home visits, but the association was attenuated by invitational procedures. The results indicate that the social inequality in acceptance of publicly offered preventive services might decrease if municipalities adopt more proactive invitational procedures.
Notes
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Cites: J Community Health. 2000 Dec;25(6):439-5311071226
PubMed ID
22656647 View in PubMed
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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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[Artificial ventilation in the home. Experiences from a department of pulmonary medicine, Ullevål hospital]

https://arctichealth.org/en/permalink/ahliterature73079
Source
Tidsskr Nor Laegeforen. 1995 Feb 28;115(6):699-702
Publication Type
Article
Date
Feb-28-1995
Author
H. Mellem
B. Bendz
Author Affiliation
Lungemedisinsk avdeling, Ullevål sykehus, Oslo.
Source
Tidsskr Nor Laegeforen. 1995 Feb 28;115(6):699-702
Date
Feb-28-1995
Language
Norwegian
Publication Type
Article
Keywords
Adult
Costs and Cost Analysis
English Abstract
Female
Home Care Services - economics - organization & administration
Home Care Services, Hospital-Based - economics - organization & administration
Humans
Male
Middle Aged
Norway
Respiration, Artificial - methods
Ventilators, Mechanical
Abstract
31 adult patients have been treated with home mechanical ventilation. 17 were poliomyelitis patients, eight myopathies, the rest had miscellaneous diagnoses. Median duration of treatment is five years (range one month--38 years). Of the 26 patients who are still alive, ten have a tracheostomy and 16 are ventilated non-invasively. In the group with the most severe functional disability (n = 12) the median cost of home care was NOK 656,460 per year. The median cost was NOK 140,000 for the group with moderate need of home care (n = 4) and NOK 0 in the self-sufficient group (n = 10). Both the total number of patients treated with home mechanical ventilation and the fraction of patients requiring both high-cost home care and hospitalisation will increase. A new national plan is needed for organising and financing both the hospital services and health care in the community.
PubMed ID
7900129 View in PubMed
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Atraumatic dental treatment among Finnish elderly persons.

https://arctichealth.org/en/permalink/ahliterature190062
Source
J Oral Rehabil. 2002 May;29(5):435-40
Publication Type
Article
Date
May-2002
Author
S. Honkala
E. Honkala
Author Affiliation
Faculty of Dentistry, Health Science Centre, Kuwait University, Kuwait, Finland. sisko.honkala@hs.kuniv.edu.kw
Source
J Oral Rehabil. 2002 May;29(5):435-40
Date
May-2002
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Chi-Square Distribution
Community Health Services
Cost-Benefit Analysis
DMF Index
Dental Care for Aged - economics
Dental Marginal Adaptation
Dental Restoration Failure
Dental Restoration, Permanent - methods
Dental Scaling
Feasibility Studies
Finland
Follow-Up Studies
Health Education, Dental
Home Care Services - economics
Humans
Oral Hygiene
Patient satisfaction
Statistics as Topic
Surface Properties
Abstract
There is an increase in elderly dentate adults who will retain more of their natural teeth, and thus the demand for restorative dental services among them will be high. In Finland, systematic dental care for old people has not been organized. Health centres have mainly targeted the development of dental care for children, adolescents and young adults. With this background, atraumatic restorative treatment (ART) was seen as a complementary procedure in oral health services for the elderly. It was tested in 1997-1999 in Helsinki among 119 old people (mean age 72.5 years) living in their homes and receiving community-based support services. Patients were satisfied with having dental examination and oral health education at home. The ART fillings (n=33) were provided for 21 persons and depuration for 56. After 1 year, 25 fillings (58%) could be evaluated: 68% of the fillings were assessed as being good, 11% as having a slight marginal detect and 16% as having unacceptable marginal defect, and one filling was totally lost. In conclusion, ART is an appropriate approach in dental care for the elderly. However, more testing should be completed to find out how the screening could be organized to make the dental home visits more cost-effective and less time consuming.
PubMed ID
12028490 View in PubMed
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[Autonomy insurance: An essential innovation in response to the challenges of aging].

https://arctichealth.org/en/permalink/ahliterature126785
Source
Can J Aging. 2012 Mar;31(1):1-11
Publication Type
Article
Date
Mar-2012
Author
Réjean Hébert
Author Affiliation
Université de Sherbrooke Centre de recherche sur le vieillissement, Sherbrooke. Rejean.Hebert@USherbrooke.ca
Source
Can J Aging. 2012 Mar;31(1):1-11
Date
Mar-2012
Language
French
Publication Type
Article
Keywords
Canada
Health Care Reform
Home Care Services - economics
Humans
Insurance Benefits
Long-Term Care - economics
National Health Programs - economics
Quebec
Abstract
The aging population and the epidemic of chronic diseases requires an accompanying finance reform of long-term care that will become increasingly dominant. Many countries have faced this situation and have set up a separate public funding for such care on the basis of a universal insurance covering both home care and institutions. Canada and Quebec must adopt such autonomy insurance and create a separate fund financed partly by a more judicious use of current budgets and tax credits, and also by a significant investment in home care. An autonomy support benefit could be allocated in kind to fund public services and by contract to pay for services delivered by private, voluntary, and social economy agencies. This benefit would be established following a standardized assessment of functional autonomy achieved by the case manager who will manage the services and control their quality.
PubMed ID
22355000 View in PubMed
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190 records – page 1 of 19.