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Acute stroke care and rehabilitation: an analysis of the direct cost and its clinical and social determinants. The Copenhagen Stroke Study.

https://arctichealth.org/en/permalink/ahliterature11045
Source
Stroke. 1997 Jun;28(6):1138-41
Publication Type
Article
Date
Jun-1997
Author
H S Jørgensen
H. Nakayama
H O Raaschou
T S Olsen
Author Affiliation
Department of Neurology, Bispehjerg Hospital, Copenhagen, Denmark.
Source
Stroke. 1997 Jun;28(6):1138-41
Date
Jun-1997
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Cerebrovascular Disorders - economics - rehabilitation - therapy
Comorbidity
Costs and Cost Analysis
Denmark
Female
Humans
Length of Stay - economics
Male
Regression Analysis
Research Support, Non-U.S. Gov't
Abstract
BACKGROUND AND PURPOSE: Stroke represents a major economic challenge to society. The direct cost of stroke is largely determined by the duration of hospital stay, but internationally applicable estimates of the direct cost of acute stroke care and rehabilitation on cost-efficient stroke units are not available. Information regarding social and medical factors influencing the length of hospital stay (LOHS) and thereby cost is needed to direct cost-reducing efforts. METHODS: We determined the direct cost of stroke in the prospective, consecutive, and community-based stroke population of the Copenhagen Stroke Study by measuring the total LOHS in the 1197 acute stroke patients included in the study. All patients had all their acute care and rehabilitation on a dedicated stroke unit. Neurological impairment was measured by the Scandinavian Stroke Scale. Local nonmedical factors affecting the LOHS, such as waiting time for discharge to a nursing home after completed rehabilitation, were accounted for in the analysis. The influence of social and medical factors on the LOHS was analyzed in a multiple linear regression model. RESULTS: The average LOHS was 27.1 days (SD, 44.1; range, 1 to 193), corresponding to a direct cost of $12.150 per patient including all acute care and rehabilitation. The LOHS increased with increasing stroke severity (6 days per 10-point increase in severity; P
PubMed ID
9183339 View in PubMed
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Adjuvant chemotherapy (5-fluorouracil and levamisole) in Dukes' B and C colorectal carcinoma. A cost-effectiveness analysis.

https://arctichealth.org/en/permalink/ahliterature22339
Source
Ann Oncol. 1997 Jan;8(1):65-70
Publication Type
Article
Date
Jan-1997
Author
J. Norum
B. Vonen
J A Olsen
A. Revhaug
Author Affiliation
Department of Oncology, University of Tromsø, Norway.
Source
Ann Oncol. 1997 Jan;8(1):65-70
Date
Jan-1997
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - economics - therapeutic use
Chemotherapy, Adjuvant - economics
Colorectal Neoplasms - drug therapy - economics - mortality - pathology - surgery
Colostomy
Cost-Benefit Analysis
Female
Fluorouracil - administration & dosage - economics
Follow-Up Studies
Health Care Costs
Humans
Length of Stay - economics
Levamisole - administration & dosage - economics
Male
Middle Aged
Norway - epidemiology
Quality of Life
Research Support, Non-U.S. Gov't
Survival Analysis
Survival Rate
Travel - economics
Abstract
BACKGROUND: Adjuvant chemotherapy (5-fluorouracil, levamisole) is now standard practice in the treatment of Dukes' B and C coloretal carcinoma (CRC), and this has increased the financial burden on health care systems world-wide. PATIENTS AND METHODS: Between 1993 and 1996, 95 patients in northern Norway were included in a national randomised CRC study, and assigned to surgery plus adjuvant chemotherapy or surgery alone. In April 1996, 94 of the patients were evaluable and 82 were still alive. The total treatment costs (hospital stay, surgery, chemotherapy, administrative and travelling costs) were calculated. A questionnaire was mailed to all survivors for assessment of the quality of their lives (QoL) (EuroQol questionnaire, a simple QoL-scale, global QoL-measure of the EORTC QLQ-C30), and 62 of them (76%) responded. RESULTS: Adjuvant chemotherapy in Dukes' B and C CRC raised the total treatment costs by 3,369 pounds. The median QoL was 0.83 (0-1 scale) in both arms. Employing a 5% discount rate and an improved survival of adjuvant therapy ranging from 5% to 15%, we calculated the cost of one gained quality-adjusted life-year (QALY) to be between 4,800 pounds and 16,800 pounds. CONCLUSION: Using a cut-off point level of 20,000 pounds per QALY, adjuvant chemotherapy in CRC appears to be cost-effective only when the improvement in 5-year survival is > or = 5%. Adjuvant chemotherapy does not affect short-term QoL.
PubMed ID
9093709 View in PubMed
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[A DRG model at the Kungälv Hospital: an attempt to overcome the gap between the administration and the medical profession].

https://arctichealth.org/en/permalink/ahliterature225405
Source
Lakartidningen. 1991 Nov 6;88(45):3780-2
Publication Type
Article
Date
Nov-6-1991

The aging Canadian population and hospitalizations for acute myocardial infarction: projection to 2020.

https://arctichealth.org/en/permalink/ahliterature125549
Source
BMC Cardiovasc Disord. 2012;12:25
Publication Type
Article
Date
2012
Author
Nigel S B Rawson
Rong Chu
Afisi S Ismaila
Jorge Alfonso Ross Terres
Author Affiliation
Medical Affairs, GlaxoSmithKline Inc, 7333 Mississauga Road, Mississauga L5N 6L4, ON, Canada.
Source
BMC Cardiovasc Disord. 2012;12:25
Date
2012
Language
English
Publication Type
Article
Keywords
Aged
Canada - epidemiology
Cardiac Catheterization - economics - statistics & numerical data - trends
Coronary Artery Bypass - economics - statistics & numerical data - trends
Female
Forecasting
Hospitalization - economics - statistics & numerical data - trends
Humans
Length of Stay - economics - statistics & numerical data - trends
Male
Middle Aged
Myocardial Infarction - economics - epidemiology - surgery
Myocardial Revascularization - economics - statistics & numerical data - trends
Population Dynamics
Abstract
The risk of experiencing an acute myocardial infarction (AMI) increases with age and Canada's population is aging. The objective of this analysis was to examine trends in the AMI hospitalization rate in Canada between 2002 and 2009 and to estimate the potential increase in the number of AMI hospitalizations over the next decade.
Aggregated data on annual AMI hospitalizations were obtained from the Canadian Institute for Health Information for all provinces and territories, except Quebec, for 2002/03 and 2009/10. Using these data in a Poisson regression model to control for age, gender and year, the rate of AMI hospitalizations was extrapolated between 2010 and 2020. The extrapolated rate and Statistics Canada population projections were used to estimate the number of AMI hospitalizations in 2020.
The rates of AMI hospitalizations by gender and age group showed a decrease between 2002 and 2009 in patients aged = 65 years and relatively stable rates in those aged
Notes
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PubMed ID
22471314 View in PubMed
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[Ambulatory labor--experience from the first 2 years]

https://arctichealth.org/en/permalink/ahliterature36163
Source
Ugeskr Laeger. 1993 Aug 23;155(34):2605-9
Publication Type
Article
Date
Aug-23-1993
Author
O. Kierkegaard
R M Hansen
Author Affiliation
Gynaekologisk/obstetrisk afdeling, Herning Centralsygehus.
Source
Ugeskr Laeger. 1993 Aug 23;155(34):2605-9
Date
Aug-23-1993
Language
Danish
Publication Type
Article
Keywords
Adult
Ambulatory Care - economics - legislation & jurisprudence - statistics & numerical data
Denmark
English Abstract
Female
Humans
Infant, Newborn
Labor, Obstetric
Length of Stay - economics - statistics & numerical data
Parity
Patient Discharge - economics - statistics & numerical data
Pregnancy
Prospective Studies
Abstract
A trial arrangement for mandatory early discharge for all normal multiparae in 1990 and 1991 was evaluated. 63.4 percent of 1661 multiparous women were discharged within 24 hours of giving birth. During the period the mean time to discharge rose from 6 1/2 to 10 1/2 hours. Only 2.6 per cent of the children were readmitted to hospital, as were 1.2 percent of the mothers. The purpose of the trial was to save money, but in the trial period no money was saved from the early discharged women, the savings came from deductions in the perinatal service to the non-early discharged women.
PubMed ID
8212367 View in PubMed
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[Analysis of bed availability in the hospital sector].

https://arctichealth.org/en/permalink/ahliterature244645
Source
Ugeskr Laeger. 1981 Mar 16;143(12):773-6
Publication Type
Article
Date
Mar-16-1981

An economic analysis of management strategies for closed and open grade I tibial shaft fractures.

https://arctichealth.org/en/permalink/ahliterature172175
Source
Acta Orthop. 2005 Oct;76(5):705-12
Publication Type
Article
Date
Oct-2005
Author
Jason W Busse
Mohit Bhandari
Sheila Sprague
Ana P Johnson-Masotti
Amiram Gafni
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. j.busse@utoronto.ca
Source
Acta Orthop. 2005 Oct;76(5):705-12
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Cost of Illness
Costs and Cost Analysis
Fracture Fixation - adverse effects - economics - methods
Fracture Fixation, Internal - adverse effects - economics - methods
Fracture Fixation, Intramedullary - adverse effects - economics - methods
Fractures, Closed - economics - surgery - ultrasonography
Fractures, Open - economics - surgery - ultrasonography
Health Care Costs
Humans
Length of Stay - economics
Ontario
Postoperative Complications - economics
Tibial Fractures - economics - surgery - ultrasonography
Abstract
Closed and open grade I (low-energy) tibial shaft fractures are a common and costly event, and the optimal management for such injuries remains uncertain.
We explored costs associated with treatment of low-energy tibial fractures with either casting, casting with therapeutic ultrasound, or intramedullary nailing (with and without reaming) by use of a decision tree.
From a governmental perspective, the mean associated costs were USD 3,400 for operative management by reamed intramedullary nailing, USD 5,000 for operative management by non-reamed intramedullary nailing, USD 5,000 for casting, and USD 5,300 for casting with therapeutic ultrasound. With respect to the financial burden to society, the mean associated costs were USD 12,500 for reamed intramedullary nailing, USD 13,300 for casting with therapeutic ultrasound, USD 15,600 for operative management by non-reamed intramedullary nailing, and USD 17,300 for casting alone.
Our analysis suggests that, from an economic standpoint, reamed intramedullary nailing is the treatment of choice for closed and open grade I tibial shaft fractures. Considering financial burden to society, there is preliminary evidence that treatment of low-energy tibial fractures with therapeutic ultrasound and casting may also be an economically sound intervention.
PubMed ID
16263619 View in PubMed
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An economic evaluation of early versus delayed operative treatment in patients with closed tibial shaft fractures.

https://arctichealth.org/en/permalink/ahliterature189289
Source
Arch Orthop Trauma Surg. 2002 Jul;122(6):315-23
Publication Type
Article
Date
Jul-2002
Author
Sheila Sprague
Mohit Bhandari
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Health Sciences Centre, Room 2C12, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada.
Source
Arch Orthop Trauma Surg. 2002 Jul;122(6):315-23
Date
Jul-2002
Language
English
Publication Type
Article
Keywords
Ambulatory Care - economics
Canada
Costs and Cost Analysis
Fractures, Closed - economics - surgery
Fractures, Ununited - economics
Hospital Costs
Humans
Length of Stay - economics
Outcome Assessment (Health Care) - economics
Postoperative Complications - economics
Quality-Adjusted Life Years
Retrospective Studies
Statistics as Topic
Tibial Fractures - economics - surgery
Time Factors
Abstract
There are few reports examining the effect of surgical delay on outcomes following operative treatment of lower extremity fractures. Delays in the surgery for closed tibial shaft fractures have been reported to increase the overall complication rate, postoperative hospital stays and crude costs to the health care system. Our purpose was to estimate the cost-effectiveness and cost-utility associated with the adoption of a programme of early operative treatment of all closed tibial shaft fractures. We performed cost analyses based upon data obtained from an observational study. A cohort of patients with closed tibial shaft fractures was identified at a university-affiliated level I trauma centre. Patients were divided into an early surgical group (within 12 h) and delayed surgical group (longer than 12 h). Study outcomes included time to fracture union (weeks), direct inpatient and outpatient costs associated with each intervention, loss of productivity costs, and utilities (patient health perception) as determined from content experts. Sixteen patients were operated on within 12 h of injury and 19 patients were treated later than 12 h after their fracture. These groups were similar for all baseline variables. The average time to fracture union was 28.2 weeks (SD 9.4) and 44.2 weeks (SD 7.4) for the early surgical group and the delayed surgical group, respectively ( p
PubMed ID
12136294 View in PubMed
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238 records – page 1 of 24.