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A 10 year asthma programme in Finland: major change for the better.

https://arctichealth.org/en/permalink/ahliterature168103
Source
Thorax. 2006 Aug;61(8):663-70
Publication Type
Article
Date
Aug-2006
Author
T. Haahtela
L E Tuomisto
A. Pietinalho
T. Klaukka
M. Erhola
M. Kaila
M M Nieminen
E. Kontula
L A Laitinen
Author Affiliation
Skin and Allergy Hospital, Helsinki University Central Hospital, P O Box 160, FIN-00029 HUS, Finland. tari.haahtela@hus.fi
Source
Thorax. 2006 Aug;61(8):663-70
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adult
Anti-Asthmatic Agents - therapeutic use
Asthma - economics - epidemiology - therapy
Child
Communication
Cost of Illness
Disabled Persons
Emergency Treatment - statistics & numerical data
Finland - epidemiology
Health Promotion - economics - organization & administration - trends
Hospitalization - statistics & numerical data
Humans
Incidence
Insurance, Disability - economics
Interprofessional Relations
National Health Programs - economics - trends
Pharmaceutical Services - standards
Primary Health Care
Program Evaluation
Smoking - epidemiology
Abstract
A National Asthma Programme was undertaken in Finland from 1994 to 2004 to improve asthma care and prevent an increase in costs. The main goal was to lessen the burden of asthma to individuals and society.
The action programme focused on implementation of new knowledge, especially for primary care. The main premise underpinning the campaign was that asthma is an inflammatory disease and requires anti-inflammatory treatment from the outset. The key for implementation was an effective network of asthma-responsible professionals and development of a post hoc evaluation strategy. In 1997 Finnish pharmacies were included in the Pharmacy Programme and in 2002 a Childhood Asthma mini-Programme was launched.
The incidence of asthma is still increasing, but the burden of asthma has decreased considerably. The number of hospital days has fallen by 54% from 110 000 in 1993 to 51 000 in 2003, 69% in relation to the number of asthmatics (n = 135 363 and 207 757, respectively), with the trend still downwards. In 1993, 7212 patients of working age (9% of 80 133 asthmatics) received a disability pension from the Social Insurance Institution compared with 1741 in 2003 (1.5% of 116 067 asthmatics). The absolute decrease was 76%, and 83% in relation to the number of asthmatics. The increase in the cost of asthma (compensation for disability, drugs, hospital care, and outpatient doctor visits) ended: in 1993 the costs were 218 million euro which had fallen to 213.5 million euro in 2003. Costs per patient per year have decreased 36% (from 1611 euro to 1031 euro).
It is possible to reduce the morbidity of asthma and its impact on individuals as well as on society. Improvements would have taken place without the programme, but not of this magnitude.
Notes
Cites: Eur Respir J. 1999 Aug;14(2):288-9410515403
Cites: BMJ. 1996 Mar 23;312(7033):762-68605467
Cites: Allergy. 2005 Mar;60(3):283-9215679712
Cites: N Engl J Med. 2005 Apr 14;352(15):1519-2815829533
Cites: BMJ. 2005 May 21;330(7501):1186-715849204
Cites: Thorax. 2005 Jul;60(7):545-815994260
Cites: Eur Respir J. 2000 Feb;15(2):235-710706483
Cites: Respir Med. 2000 Apr;94(4):299-32710845429
Cites: CMAJ. 1999 Nov 30;161(11 Suppl):S1-6110906907
Cites: Pediatr Allergy Immunol. 2000 Nov;11(4):236-4011110578
Cites: Eur Respir J. 2000 Nov;16(5):802-711153575
Cites: Am J Respir Crit Care Med. 2001 Aug 15;164(4):565-811520716
Cites: Thorax. 2001 Oct;56(10):806-1411562522
Cites: J Allergy Clin Immunol. 2001 Nov;108(5 Suppl):S147-33411707753
Cites: Eur Respir J. 2002 Aug;20(2):397-40212212973
Cites: Thorax. 2003 Feb;58 Suppl 1:i1-9412653493
Cites: Int J Tuberc Lung Dis. 2003 Jun;7(6):592-812797704
Cites: J Allergy Clin Immunol. 2004 Jul;114(1):40-715241342
Cites: Scand J Public Health. 2004;32(4):310-615370772
Cites: Am Rev Respir Dis. 1985 Apr;131(4):599-6063994155
Cites: N Engl J Med. 1991 Aug 8;325(6):388-922062329
Cites: N Engl J Med. 1994 Sep 15;331(11):700-58058076
Cites: Qual Health Care. 1994 Mar;3(1):45-5210136260
Cites: BMJ. 1996 Mar 23;312(7033):748-528605463
Cites: Eur Respir J. 2004 Nov;24(5):734-915516665
PubMed ID
16877690 View in PubMed
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An economic evaluation of a participatory ergonomics process in an auto parts manufacturer.

https://arctichealth.org/en/permalink/ahliterature152071
Source
J Safety Res. 2009;40(1):41-7
Publication Type
Article
Date
2009
Author
Emile Tompa
Roman Dolinschi
Andrew Laing
Author Affiliation
Institute for Work & Health, 481 University Avenue, Toronto, Ontario, Canada. etompa@iwh.on.ca
Source
J Safety Res. 2009;40(1):41-7
Date
2009
Language
English
Publication Type
Article
Keywords
Accidents, Occupational - economics - prevention & control
Automobiles
Cost-Benefit Analysis
Human Engineering - economics - methods
Humans
Industry - economics
Insurance, Disability - economics
Ontario
Abstract
We assess the costs and consequences of a participatory ergonomics process at a Canadian car parts manufacturer from the perspective of the firm.
Regression modeling was used with interrupted time series data to assess the impact of the process on several health measures. Consequences were kept in natural units for cost-effectiveness analysis, and translated into monetary units for cost-benefit analysis.
The duration of disability insurance claims and the number of denied workers' compensation claims was significantly reduced. The cost-effectiveness ratio is $12.06 per disability day averted. The net present value is $244,416 for a 23-month period with a benefit-to-cost ratio of 10.6, suggesting that the process was worth undertaking (monetary units in 2001 Canadian dollars).
Our findings emphasize the importance of considering a range of outcomes when evaluating an occupational health and safety intervention.
Participatory ergonomics process can be cost-effective for a firm.
PubMed ID
19285585 View in PubMed
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Anorexia nervosa: the cost of long-term disability.

https://arctichealth.org/en/permalink/ahliterature185246
Source
Eat Weight Disord. 2003 Mar;8(1):76-9
Publication Type
Article
Date
Mar-2003
Author
J C Su
C L Birmingham
Author Affiliation
University of British Columbia, Canada.
Source
Eat Weight Disord. 2003 Mar;8(1):76-9
Date
Mar-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anorexia Nervosa - economics - epidemiology
British Columbia - epidemiology
Direct Service Costs
Female
Financing, Government
Humans
Insurance, Disability - economics
Long-Term Care - economics
Male
Middle Aged
Models, Econometric
Abstract
This study was performed to estimate the cost of long-term disability in people who have anorexia nervosa (AN) that live in the province of British Columbia (BC), Canada. Canada provides universal socialized health and welfare services, and each of the 10 provinces is responsible for its own funding. As the provincial government of BC does not categorize its disability payments by the cause of the disability, a survey was used to determine the rate of disability from AN. A sensitivity analysis was performed to assess the influence of variations on the yearly cost of disability in BC: the number of patients with AN was varied between 1.0 and 2.0% of the female and 0.05 and 0.1% of the male population; the percentage of patients with AN receiving disability payments was determined by the survey to be 35%; the cost of these payments was varied between the lowest and highest benefits a single person can receive from the BC provincial government; and finally, to allow for possible sampling bias and a possible lower prevalence of AN, the lower limit of the sensitivity analysis was derived by dividing the lowest estimate above by seven. The sensitivity analysis revealed that the total estimated cost of long-term disability in BC could be as low as $2.5 million (Canadian) or as high as $101.7 million per year, which is a cost of up to 30 times the total yearly cost of all tertiary care services for the treatment of eating disorders in BC. In view of this finding, an increase in funding is warranted for primary, secondary and tertiary prevention programs for AN in BC.
PubMed ID
12762629 View in PubMed
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Back to work: vocational issues and strategies for Canadians living with HIV/AIDS.

https://arctichealth.org/en/permalink/ahliterature173113
Source
Work. 2005;25(2):163-71
Publication Type
Article
Date
2005
Author
Fred McGinn
Jacqueline Gahagan
Elaine Gibson
Author Affiliation
Diploma in Disability Management, Dalhousie University, 6226 University Avenue, Halifax, Nova Scotia, Canada B3H 3J5. Fred.mcginn@dal.ca
Source
Work. 2005;25(2):163-71
Date
2005
Language
English
Publication Type
Article
Keywords
Adult
Canada
Employment - legislation & jurisprudence - psychology
Female
HIV Infections - psychology
Humans
Insurance, Disability - economics
Male
Middle Aged
Rehabilitation, Vocational
Vocational Guidance
Workplace
Abstract
Much has been written since the first appearance of HIV/AIDS in 1981 about its effects on the Canadian health care and social services systems. However, researchers have given limited attention to issues of entry or re-entry to the competitive job market for HIV positive individuals. The emergence of highly active antiretroviral therapies (HAART) has allowed a significant number of persons who are HIV positive to experience a major recovery in health and energy. This increase in physical health has in turn led to a re-examination of the possibility of returning to former types and levels of activity, including the prospect of going back to work or entering the competitive workforce for the first time. The purpose of this paper is to outline some of the issues and concerns that impact HIV positive individuals' attempts to return to or enter the competitive workforce, particularly those relating to disability policies and public insurance. Data from in-depth interviews with a sample of people living with HIV/AIDS (PHAs) are used to help illustrate the disconnect between these policies and the lived experiences of PHAs. Also discussed are the opportunities for Canadian policies and practices to employ a functional definition of disability and a philosophy of early intervention in vocational rehabilitation.
PubMed ID
16131746 View in PubMed
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Cost, effectiveness, and cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders.

https://arctichealth.org/en/permalink/ahliterature150294
Source
Can J Psychiatry. 2009 Jun;54(6):379-88
Publication Type
Article
Date
Jun-2009
Author
Carolyn S Dewa
Jeffrey S Hoch
Glenn Carmen
Richard Guscott
Richard Gusscott
Chris Anderson
Author Affiliation
Centre for Addiction and Mental Health, Health Systems Research and Consulting Unit, Toronto, Ontario. carolyn_dewa@camh.net
Source
Can J Psychiatry. 2009 Jun;54(6):379-88
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Adult
Canada
Case Management - economics
Community Mental Health Centers - economics
Cooperative Behavior
Cost-Benefit Analysis
Female
Humans
Insurance Benefits - economics
Insurance, Disability - economics
Interdisciplinary Communication
Male
Mental Disorders - economics - rehabilitation
Middle Aged
Patient Care Team - economics
Referral and Consultation - economics
Rehabilitation, Vocational - economics
Abstract
To examine the cost, effectiveness, and cost-effectiveness of a collaborative mental health care (CMHC) pilot program for people on short-term disability leave for psychiatric disorders.
Using a quasi-experimental design, the analyses were conducted using 2 groups of subjects who received short-term disability benefits for psychiatric disorders. One group (n = 75) was treated in a CMHC program during their disability episode. The comparison group (n = 51) received short-term disability benefits related to psychiatric disorders in the prior year but did not receive CMHC during their disability episode. People in both groups met screening criteria for the CMHC program. Differences in cost and days absent from work were tested using Student t tests and confirmed using nonparametric Wilcoxon rank sum tests. Differences in return to work and transition to long-term disability leave were tested using chi-square tests. The cost-effectiveness analysis used the net benefit regression framework.
The results suggest that with CMHC, for every 100 people on short-term disability leave for psychiatric disorders, there could be $50 000 in savings related to disability benefits along with more people returning to work (n = 23), less people transitioning to long-term disability leave (n = 24), and 1600 more workdays.
CMHC models of disability management based on our Canadian data may be a worthwhile investment in helping people who are receiving short-term disability benefits for psychiatric disorders to receive adequate treatment.
Notes
Erratum In: Can J Psychiatry. 2009 Jul;54(7):428Gusscott, Richard [corrected to Guscott, Richard]
PubMed ID
19527558 View in PubMed
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[Could sick leaves be reduced by augmenting the knowledge of the general practitioner?]

https://arctichealth.org/en/permalink/ahliterature71264
Source
Tidsskr Nor Laegeforen. 2003 Aug 14;123(15):2068-71
Publication Type
Article
Date
Aug-14-2003
Author
Håkon Lie
Author Affiliation
Arnegårdsveien 7A, og, Ringerike sykehus, 3500 Hønefoss.
Source
Tidsskr Nor Laegeforen. 2003 Aug 14;123(15):2068-71
Date
Aug-14-2003
Language
Norwegian
Publication Type
Article
Keywords
Adult
Clinical Competence
Comparative Study
Disability Evaluation
Education, Medical, Continuing
English Abstract
Female
Follow-Up Studies
Health Knowledge, Attitudes, Practice
Humans
Insurance, Disability - economics - statistics & numerical data
Male
Middle Aged
Musculoskeletal Diseases - economics - epidemiology - rehabilitation
Norway - epidemiology
Occupational Diseases - economics - epidemiology - rehabilitation
Occupations
Physicians, Family - education - psychology - standards
Sick Leave - economics - statistics & numerical data
Abstract
BACKGROUND: Musculoskeletal disorders account for about 50 % of the cost of sick leaves in Norway. The aim of the study was to evaluate whether it is possible cut down the length of such sick leaves by augmenting the knowledge of these disorders among general practitioners (GPs). MATERIAL AND METHODS: Among GPs in a region of 50 000 inhabitants in Buskerud county, 24 joined a continuous medical education programme on musculoskeletal disorders and received financial compensation for the extra time spent on an extended clinical examination of patients whose sick leave had exceeded 16 days. 41 GPs that did not wish to attend the programme joined the study as a control group. Patients were included over one year and there was a one-year follow-up period. RESULTS: The GPs in the programme had a total of 753 patients who were included in the study; the GPs in the control group had 964. There were no differences between these patient groups with regard to sex, age, occupation and diagnosis, in length of sick leaves, or more permanent disability benefits. Among patients on sick leave of more than one year, 55% had not been referred to a specialist. INTERPRETATION: Augmenting the skills of GPs and giving them incentives to conduct more thorough clinical examinations does not reduce length of sick leaves caused by musculoskeletal disorders.
PubMed ID
12934135 View in PubMed
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Disability and prognosis in multiple sclerosis: demographic and clinical variables important for the ability to walk and awarding of disability pension.

https://arctichealth.org/en/permalink/ahliterature194912
Source
Mult Scler. 2001 Feb;7(1):59-65
Publication Type
Article
Date
Feb-2001
Author
K M Myhr
T. Riise
C. Vedeler
M W Nortvedt
R. Grønning
R. Midgard
H I Nyland
Author Affiliation
Department of Neurology, Haukeland University Hospital, University of Bergen, Norway.
Source
Mult Scler. 2001 Feb;7(1):59-65
Date
Feb-2001
Language
English
Publication Type
Article
Keywords
Adult
Age of Onset
Autoimmune Diseases - economics - epidemiology
Canes - utilization
Cohort Studies
Cross-Sectional Studies
Disability Evaluation
Disease Progression
Female
Follow-Up Studies
Humans
Incidence
Insurance, Disability - economics - statistics & numerical data
Life tables
Male
Multiple Sclerosis - economics - epidemiology
Norway - epidemiology
Prognosis
Proportional Hazards Models
Severity of Illness Index
Survival Analysis
Treatment Outcome
Walking
Wheelchairs - utilization
Abstract
To evaluate disability and prognosis in an untreated population-based incidence cohort of multiple sclerosis (MS) patients.
The Expanded Disability Status Scale (EDSS) score was recorded in 220 MS patients. Disease progression was assessed by life table analysis with different endpoints and multivariate Cox regression analysis was performed for evaluation of prognostic factors.
The probability of being alive after 15 years was 94.8 +/- 1.8% (s.e.), of managing without a wheelchair (EDSS 3 years) predicted favorable outcome. There was also a trend towards favorable outcome in patients with optic neuritis, sensory symptoms and low age at onset but these factors were associated with the RR course. Motor symptoms and high age at onset indicated unfavorable outcome, but these factors were associated with the primary progressive course.
A RR course and long inter-episode intervals in the early phase of the disease were associated with a better outcome. Other onset characteristics indicating a favorable outcome were associated with the RR course while characteristics indicating an unfavorable outcome were associated with the PP course.
PubMed ID
11321195 View in PubMed
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Disability forms and third-party reports.

https://arctichealth.org/en/permalink/ahliterature209014
Source
CMAJ. 1997 Mar 15;156(6):764
Publication Type
Article
Date
Mar-15-1997
Author
P M Peloso
Source
CMAJ. 1997 Mar 15;156(6):764
Date
Mar-15-1997
Language
English
Publication Type
Article
Keywords
Canada
Confidentiality
Disability Evaluation
Humans
Insurance, Disability - economics
Medical History Taking
Physician-Patient Relations
Reproducibility of Results
Notes
Comment On: CMAJ. 1997 Jan 1;156(1):61-49006568
PubMed ID
9084376 View in PubMed
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[Does systematic evaluation of sickness certification II lead to less use of health insurance?]

https://arctichealth.org/en/permalink/ahliterature71734
Source
Tidsskr Nor Laegeforen. 2002 Jan 20;122(2):157-60
Publication Type
Article
Date
Jan-20-2002
Author
Peder Rolfssøn Ringdal
Kjell Haug
John Gunnar Maeland
Author Affiliation
Seksjon for sosialmedisin Institutt for samfunnsmedisinske fag Universitetet i Bergen Ulriksdal 8C 5009 Bergen. peder.ringdal@isf.uib.no
Source
Tidsskr Nor Laegeforen. 2002 Jan 20;122(2):157-60
Date
Jan-20-2002
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Certification
Clinical Competence
Consultants
Disability Evaluation
English Abstract
Female
Humans
Insurance, Disability - economics - statistics & numerical data - trends
Male
Middle Aged
Norway
Physician's Role
Professional Competence
Sick Leave - economics - statistics & numerical data - trends
Socioeconomic Factors
Abstract
BACKGROUND: The increasing prevalence of disability pensioning in Norway has led to several attempts at strengthening the proactive role of the National Insurance System (NIS) in cases of long-term sick-listing. Since 1988, a special medical certificate is required after eight weeks of sick-leave. The aim of this study was to examine whether systematic evaluation of this medical certificate by NIS officers and NIS medical consultants could reduce future health insurance expenditure. MATERIAL AND METHODS: In 1994 a randomised study using a paired design of the NIS local offices in the county of Hordaland was undertaken. All eight-week medical certificates in the intervention group (N = 2,237) were systematically reviewed, whereas standard routines were used for the control group (N = 1,764). RESULTS: After three years, no significant differences were observed between the two groups in health insurance utilisation. INTERPRETATION: We conclude that local NIS offices are unable to use the information in the eight-week sick notes to effectively influence future utilisation of health insurance. The reason may be that NIS offices lack the skills necessary for early intervention in long-term sick-listing.
PubMed ID
11873569 View in PubMed
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Early intervention services for psychosis and time until application for disability income support: a survival analysis.

https://arctichealth.org/en/permalink/ahliterature127368
Source
Community Ment Health J. 2012 Oct;48(5):535-46
Publication Type
Article
Date
Oct-2012
Author
Terry Krupa
Kola Oyewumi
Suzanne Archie
J Stuart Lawson
Joan Nandlal
Gretchen Conrad
Author Affiliation
School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada. krupat@queensu.ca
Source
Community Ment Health J. 2012 Oct;48(5):535-46
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Disability Evaluation
Disabled Persons
Female
Humans
Income
Insurance Benefits - economics - statistics & numerical data
Insurance, Disability - economics - statistics & numerical data
Male
Ontario
Proportional Hazards Models
Psychotic Disorders - economics - therapy
Regression Analysis
Retrospective Studies
Socioeconomic Factors
Survival Analysis
Time Factors
Young Adult
Abstract
Ensuring the financial security of individuals recovering from first episode psychosis is imperative, but disability income programs can be powerful disincentives to employment, compromising the social and occupational aspects of recovery. Survival analysis and Cox regression analysis were used to examine the rate at which individuals served by early intervention for psychosis (EIP) services apply for government disability income benefits and factors that predict rate of application. Health records for 558 individuals served by EIP programs were reviewed. Within the first year of receiving services 30% will make application for disability income; 60% will do so by 5 years. Rate of application is predicted by rate of hospital admission, financial status and engagement in productivity roles at the time of entry to EIP service. The findings suggest the need to examine the extent to which the recovery goals of EI services are undermined by early application for government income support. They also suggest the need to develop best practice guidelines related to ensuring the economic security of individuals served.
PubMed ID
22302213 View in PubMed
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25 records – page 1 of 3.