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291 records – page 1 of 30.

Source
J Health Econ. 1999 Aug;18(4):393-407
Publication Type
Article
Date
Aug-1999
Author
A L Bretteville-Jensen
Author Affiliation
National Institute for Alcohol and Drug Research, Oslo, Norway. alb@sifa.no
Source
J Health Econ. 1999 Aug;18(4):393-407
Date
Aug-1999
Language
English
Publication Type
Article
Keywords
Budgets
Choice Behavior
Health Behavior
Humans
Income
Interviews as Topic
Mental Disorders - complications
Models, Econometric
Norway
Questionnaires
Research Design
Substance-Related Disorders - complications - economics - psychology
Time Factors
Abstract
In 1988, Becker and Murphy [Becker, G.S., Murphy, K.M., 1988. A theory of rational addiction. Journal of Political Economy, 96, 675-700.] launched a theory in which they proposed that the perspective of rational decision-making could be applied also to cases of addictive behaviour. This paper discusses the theory's assumptions of interpersonal variation and stability in time preferences on the basis of estimates derived from three groups of people with different consumption levels of illegal intoxicants. We find that active injectors of heroin and amphetamine have a higher discount rate than a group reporting that they have never used the substances. Of greater interest, though not in accordance with Becker and Murphy's assumption of stability, we also find that the discount rate among active and former users differs significantly. These findings raise the question of whether a high time-preference rate leads to addiction or whether the onset of an addiction itself alters people's inter-temporal equilibrium.
PubMed ID
10539613 View in PubMed
Less detail

Adjusting case mix payment amounts for inaccurately reported comorbidity data.

https://arctichealth.org/en/permalink/ahliterature144128
Source
Health Care Manag Sci. 2010 Mar;13(1):65-73
Publication Type
Article
Date
Mar-2010
Author
Jason M Sutherland
Jeremy Hamm
Jeff Hatcher
Author Affiliation
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, 35 Centerra Parkway, Suite 110, Lebanon, NH 03766, USA. Jason.Sutherland@Dartmouth.edu
Source
Health Care Manag Sci. 2010 Mar;13(1):65-73
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Comorbidity
Diagnosis-Related Groups - classification - economics
Humans
Models, Econometric
Monte Carlo Method
Ontario
Reimbursement Mechanisms - economics
Abstract
Case mix methods such as diagnosis related groups have become a basis of payment for inpatient hospitalizations in many countries. Specifying cost weight values for case mix system payment has important consequences; recent evidence suggests case mix cost weight inaccuracies influence the supply of some hospital-based services. To begin to address the question of case mix cost weight accuracy, this paper is motivated by the objective of improving the accuracy of cost weight values due to inaccurate or incomplete comorbidity data. The methods are suitable to case mix methods that incorporate disease severity or comorbidity adjustments. The methods are based on the availability of detailed clinical and cost information linked at the patient level and leverage recent results from clinical data audits. A Bayesian framework is used to synthesize clinical data audit information regarding misclassification probabilities into cost weight value calculations. The models are implemented through Markov chain Monte Carlo methods. An example used to demonstrate the methods finds that inaccurate comorbidity data affects cost weight values by biasing cost weight values (and payments) downward. The implications for hospital payments are discussed and the generalizability of the approach is explored.
PubMed ID
20402283 View in PubMed
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Administrative costs: answering the critics.

https://arctichealth.org/en/permalink/ahliterature224801
Source
Health Aff (Millwood). 1992;11(2):231-3
Publication Type
Article
Date
1992
Author
P M Danzon
Source
Health Aff (Millwood). 1992;11(2):231-3
Date
1992
Language
English
Publication Type
Article
Keywords
Canada
Economic Competition
Humans
Insurance Carriers - economics
Insurance, Health - economics
Models, Econometric
United States
Notes
Comment On: Health Aff (Millwood). 1992 Spring;11(1):44-611445524
PubMed ID
1500054 View in PubMed
Less detail

Agency in health care with an endogenous budget constraint.

https://arctichealth.org/en/permalink/ahliterature217989
Source
J Health Econ. 1994 Jul;13(2):231-51
Publication Type
Article
Date
Jul-1994
Author
D. Clark
J A Olsen
Author Affiliation
Department of Economics, University of Tromsø, Norway.
Source
J Health Econ. 1994 Jul;13(2):231-51
Date
Jul-1994
Language
English
Publication Type
Article
Keywords
Budgets
Consumer Satisfaction - economics
Ethics, Medical
Health Maintenance Organizations - economics
Humans
Insurance, Health - economics
Models, Econometric
Norway
Patient Participation - economics
Physician's Role
Abstract
In this paper a doctor acts as a perfect agent for a group of patients in an environment where the health service is funded by a group of contributors. The contributor group donates resources to the health sector in accordance with its split preferences about the health care services which they would like for themselves and those which they would like for others. We show that the size of the health budget is endogenous and depends on the choices made by the doctor. The focus is on the division of the budget between health enhancing and non-health enhancing health care.
PubMed ID
10138027 View in PubMed
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An economic evaluation of asthma action plans for children with asthma.

https://arctichealth.org/en/permalink/ahliterature161178
Source
J Asthma. 2007 Sep;44(7):501-8
Publication Type
Article
Date
Sep-2007
Author
Julie Polisena
Susanna Tam
Abhay Lodha
Audrey Laporte
Peter C Coyte
Wendy J Ungar
Author Affiliation
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Source
J Asthma. 2007 Sep;44(7):501-8
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Asthma - economics - therapy
Child
Child Health Services - utilization
Child, Preschool
Cost-Benefit Analysis
Cross-Sectional Studies
Female
Health Expenditures
Health Knowledge, Attitudes, Practice
Humans
Male
Models, Econometric
Ontario
Patient Education as Topic - economics
Abstract
The costs and effectiveness of asthma action plans for children were evaluated in a cross-sectional economic analysis. Direct health care and indirect costs, nights with symptoms, and asthma attacks were measured in 879 Ontario children with asthma. From a societal perspective, the total annual costs of the asthma action plan and the control groups were CDN$6,948 and CDN$6,140 per patient, respectively. Health outcomes were similar. The difference in cost was attributable to greater medication and health services use in the intervention group. Prospective randomized trials are necessary to measure potential improvements in control of asthma using asthma action plans.
PubMed ID
17885851 View in PubMed
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An economic evaluation of surgery versus collagen injection for the treatment of female stress urinary incontinence.

https://arctichealth.org/en/permalink/ahliterature144170
Source
Can J Urol. 2010 Apr;17(2):5087-93
Publication Type
Article
Date
Apr-2010
Author
Mark Oremus
Jean-Eric Tarride
Author Affiliation
McMaster Evidence-based Practice Centre, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Source
Can J Urol. 2010 Apr;17(2):5087-93
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Collagen - administration & dosage - economics
Cost-Benefit Analysis
Decision Support Techniques
Decision Trees
Female
Humans
Injections
Male
Models, Econometric
Ontario
Outcome Assessment (Health Care)
Probability
Randomized Controlled Trials as Topic
Urinary Incontinence, Stress - economics - therapy
Urologic Surgical Procedures - economics - methods
Abstract
To use data from a randomized controlled trial and update an earlier economic evaluation of surgery versus collagen injection for the treatment of female stress urinary incontinence (SUI).
A decision tree model was developed using probabilities of success and complications from a randomized controlled trial. Resource use and cost data were taken from the earlier economic evaluation. The primary outcome was treatment success, which was defined as a negative 24 hour PAD test given 1 year post-treatment. The evaluation was conducted from the 'healthcare system' perspective and separate analyses were undertaken for Ontario and Québec. Sensitivity analyses were used to examine uncertainty in probabilities and costs.
Surgery was generally more costly and more successful than collagen injection. Incremental cost effectiveness ratios indicated that the healthcare system would incur an additional cost of $121.08 to $341.35 per additional patient that was successfully treated with surgery. Sensitivity analyses showed that surgery would be less costly and more successful than collagen injection if the postoperative length of hospital stay was reduced to 1 day. Surgery might also be more cost effective than collagen injection if the number of injections used to treat patients were to increase beyond two for treatment successes and four for treatment failures.
Collagen injection is an outpatient procedure without risk of significant morbidity or complications. However, this does not readily translate into a clear cost effective advantage relative to surgery. In some cases, surgery may be more cost effective than collagen injection in the treatment of female SUI.
PubMed ID
20398447 View in PubMed
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An economic evaluation of trauma care in a Canadian lead trauma hospital.

https://arctichealth.org/en/permalink/ahliterature200769
Source
J Trauma. 1999 Sep;47(3 Suppl):S99-103
Publication Type
Article
Date
Sep-1999
Author
J. Séguin
B G Garber
D. Coyle
P C Hébert
Author Affiliation
Department of Surgery, University of Ottawa, Ontario, Canada.
Source
J Trauma. 1999 Sep;47(3 Suppl):S99-103
Date
Sep-1999
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cost-Benefit Analysis
Cross-Sectional Studies
Female
Health Services Research
Hospital Costs - statistics & numerical data
Humans
Male
Middle Aged
Models, Econometric
Ontario
Quality-Adjusted Life Years
Retrospective Studies
Trauma Centers - economics
Abstract
The objective was to determine the average cost per quality-adjusted life year (QALY) gained of treating trauma victims at a tertiary trauma hospital and to determine the cost-effectiveness of trauma care at this center. The setting was a tertiary trauma center in the province of Ontario, Canada. The study population consisted of consecutive trauma admissions with ISS > 12 from April, 1994 to April, 1996. The study was of a retrospective cohort design with a cross-sectional survey.
The hospital perspective was taken. Costs were determined from a retrospective cohort using a hospital-based case-costing system. Utility estimates for calculation of QALYs gained were obtained using a cross-sectional survey design. Cost-effectiveness was determined by estimating the incremental cost/QALY attributable to treatment at the trauma center. Sensitivity analysis was employed to vary assumptions about the proportion of costs and increased survival.
484 patients with a median age of 39 years and a median ISS of 22 were studied. The average cost per QALY was $1,721, with a maximum value of $3,861. The increase in cost per QALY gained for treatment in a tertiary care center as opposed to a nontrauma center was $4,303, assuming a 20% increase in survival and assuming that the existence of the center increased the cost of care by 50%. The incremental cost/QALY ranged from $191 to $15,492 in the sensitivity analysis varying assumptions about the increased proportion of costs and survival attributable to care at the tertiary trauma center.
This is the first economic evaluation of tertiary trauma care which includes both costs as opposed to charges as well as estimates of the QALYs gained. The results suggest that tertiary trauma care is cost-effective and less costly than treatment programs for other disease conditions when the quality-adjusted life years gained are included in the evaluation.
Notes
Comment In: J Trauma. 1999 Sep;47(3 Suppl):S104-510496623
PubMed ID
10496622 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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Area-aggregated assessments of perceived environmental attributes may overcome single-source bias in studies of green environments and health: results from a cross-sectional survey in southern Sweden.

https://arctichealth.org/en/permalink/ahliterature137891
Source
Environ Health. 2011;10(1):4
Publication Type
Article
Date
2011
Author
Kim de Jong
Maria Albin
Erik Skärbäck
Patrik Grahn
John Wadbro
Juan Merlo
Jonas Björk
Author Affiliation
Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Source
Environ Health. 2011;10(1):4
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Bias (epidemiology)
Cross-Sectional Studies
Environment
Female
Geographic Information Systems
Health Surveys
Humans
Male
Middle Aged
Models, Econometric
Public Health
Public Opinion
Residence Characteristics
Sweden
Young Adult
Abstract
Most studies assessing health effects of neighborhood characteristics either use self-reports or objective assessments of the environment, the latter often based on Geographical Information Systems (GIS). While objective measures require detailed landscape data, self-assessments may yield confounded results. In this study we demonstrate how self-assessments of green neighborhood environments aggregated to narrow area units may serve as an appealing compromise between objective measures and individual self-assessments.
The study uses cross-sectional data (N = 24,847) from a public health survey conducted in the county of Scania, southern Sweden, in 2008 and validates the Scania Green Score (SGS), a new index comprising five self-reported green neighborhood qualities (Culture, Lush, Serene, Spacious and Wild). The same qualities were also assessed objectively using landscape data and GIS. A multilevel (ecometric) model was used to aggregate individual self-reports to assessments of perceived green environmental attributes for areas of 1,000 square meters. We assessed convergent and concurrent validity for self-assessments of the five items separately and for the sum score, individually and area-aggregated.
Correlations between the index scores based on self-assessments and the corresponding objective assessments were clearly present, indicating convergent validity, but the agreement was low. The correlation was even more evident for the area-aggregated SGS. All three scores (individual SGS, area-aggregated SGS and GIS index score) were associated with neighborhood satisfaction, indicating concurrent validity. However, while individual SGS was associated with vitality, this association was not present for aggregated SGS and the GIS-index score, suggesting confounding (single-source bias) when individual SGS was used.
Perceived and objectively assessed qualities of the green neighborhood environment correlate but do not agree. An index score based on self-reports but aggregated to narrow area units can be a valid approach to assess perceived green neighborhood qualities in settings where objective assessments are not possible or feasible.
Notes
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PubMed ID
21235826 View in PubMed
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Assessing automated external defibrillators in preventing deaths from sudden cardiac arrest: an economic evaluation.

https://arctichealth.org/en/permalink/ahliterature162903
Source
Int J Technol Assess Health Care. 2007;23(3):362-7
Publication Type
Article
Date
2007
Author
Waseem Sharieff
Kellee Kaulback
Author Affiliation
Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada. doc.sharieff@utoronto.ca
Source
Int J Technol Assess Health Care. 2007;23(3):362-7
Date
2007
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Arrhythmias, Cardiac - therapy
Computer simulation
Cost-Benefit Analysis
Death, Sudden, Cardiac - prevention & control
Defibrillators - economics
Female
Humans
Male
Models, Econometric
Ontario
Quality-Adjusted Life Years
Reproducibility of Results
Abstract
The aim of this study was to evaluate the cost-effectiveness of on-site automated external defibrillators (AEDs) in the initial management of cardiac arrest in Ontario.
This was a cost-effectiveness analysis based on published literature and data from the Canadian Institute of Health Information. The participants were fictitious male and female cardiac arrest patients who were initially managed with on-site AEDs, compared with similar patients managed without on-site AEDs. This group included a subgroup of high-risk patients (i.e., heart failure and left ventricular ejection fraction
PubMed ID
17579940 View in PubMed
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291 records – page 1 of 30.