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The 1982 Hoechst Lecture: "Cost effectiveness--the emerging 'bottom line' for pharmacy?!".

https://arctichealth.org/en/permalink/ahliterature243460
Source
Can J Hosp Pharm. 1982 Mar-Apr;35(2):39-41
Publication Type
Article
Author
J A Marshman
Source
Can J Hosp Pharm. 1982 Mar-Apr;35(2):39-41
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cost-Benefit Analysis
Efficiency
Humans
Ontario
Patient Education as Topic - economics
Pharmacy Service, Hospital - economics
Abstract
In the current climate of budgetary restraint in the health care system, cost effectiveness is a concept which surfaces with increasing frequency, especially in reference to health care services funded by government. Since significant elements of pharmacy services in Canada are thus funded (including in most provinces, hospital pharmacy services, and prescription drug plans for senior citizens), it is important that pharmacy "tune into" the concept, and recognize it as an essential criterion to be met in the maintenance of existing services and in the development of new services. Prerequisite to a consideration of cost effectiveness is, of course, consideration of effectiveness; and a statement about the effectiveness; and a statement about the effectiveness of a service implies a potential for measurement of effect or outcome. In the 1980s, as pharmacy focuses its efforts on patients rather than products, that effect must surely be defined in "people" terms. One of the important dimensions of today's patient-focussed pharmacy services is patient counselling, more broadly, patient education.
PubMed ID
10309676 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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[A simple evaluation of prevention against cardiovascular diseases. Patient education is a beneficial expense].

https://arctichealth.org/en/permalink/ahliterature220831
Source
Lakartidningen. 1993 Jun 30;90(26-27):2460-4
Publication Type
Article
Date
Jun-30-1993

A children's asthma education program: Roaring Adventures of Puff (RAP), improves quality of life.

https://arctichealth.org/en/permalink/ahliterature143980
Source
Can Respir J. 2010 Mar-Apr;17(2):67-73
Publication Type
Article
Author
Shawna L McGhan
Eric Wong
Heather M Sharpe
Patrick A Hessel
Puish Mandhane
Vivki L Boechler
Carina Majaesic
A Dean Befus
Author Affiliation
Alberta Asthma Centre, University of Alberta, 11402 University Avenue, Edmonton, Alberta. smcghan@ualberta.ca
Source
Can Respir J. 2010 Mar-Apr;17(2):67-73
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adolescent
Alberta
Asthma - drug therapy - physiopathology - psychology
Child
Cost-Benefit Analysis
Feasibility Studies
Female
Follow-Up Studies
Humans
Male
Outcome Assessment (Health Care)
Patient Education as Topic - economics
Program Evaluation
Quality of Life - psychology
Steroids - administration & dosage - therapeutic use
Abstract
It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.
To assess the feasibility and impact of 'Roaring Adventures of Puff' (RAP), a six-week childhood asthma education program administered by health professionals in schools.
Thirty-four schools from three health regions in Alberta were randomly assigned to receive either the RAP asthma program (intervention group) or usual care (control group). Baseline measurements from parent and child were taken before the intervention, and at six and 12 months.
The intervention group had more smoke exposure at baseline. Participants lost to follow-up had more asthma symptoms. Improvements were significantly greater in the RAP intervention group from baseline to six months than in the control group in terms of parent's perceived understanding and ability to cope with and control asthma, and overall quality of life (P
Notes
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PubMed ID
20422062 View in PubMed
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Cost analysis of an intensive home follow-up program for first-time post-myocardial infarction patients and their families.

https://arctichealth.org/en/permalink/ahliterature191526
Source
Dynamics. 2001;12(4):25-31
Publication Type
Article
Date
2001
Author
K A Robertson
K. Kayhko
Author Affiliation
School of Nursing, University of Prince Edward Island.
Source
Dynamics. 2001;12(4):25-31
Date
2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aftercare - economics
Canada
Continuity of Patient Care - economics
Cost Savings
Costs and Cost Analysis
Direct Service Costs
Follow-Up Studies
Health Care Costs
Home Care Services - economics
Humans
Myocardial Infarction - economics - rehabilitation
Patient Education as Topic - economics
Patient Readmission - economics
Program Evaluation
Abstract
The general goal of this research was to determine the effectiveness of a home follow-up program in order to acquire guidance in how to plan the future structure and contents of post-myocardial infarction (MI) patients' care and rehabilitation. The specific aim of this study was to evaluate the cost-effectiveness of the program in reducing the rate of rehospitalization of first-time post-MI patients when measured at six weeks and six months post-discharge.
The supportive-educative home follow-up program will prove to be cost-effective by indicating an inverse correlation with the cost of post-MI patients being rehospitalized for unplanned and preventable diagnoses.
Cost analysis, using data from a one year randomized control clinical trial conducted in a small urban hospital in eastern Canada. An experimental post test only control group design, including the process of randomization, was used in this study.
62 people admitted with a diagnosis of a first-time acute MI during a one-year period with no co-morbidity likely to affect rehabilitation.
Health care costs.
Early supportive home follow-up reduced inpatient rehospitalization by more than half (three rehospitalizations vs seven rehospitalizations) and reduced the average length of stay (five days vs seven days). Cost analysis demonstrated that intense home follow-up in the time immediately following patient discharge could still produce cost savings to the health care system.
Intensive home follow-up provided a cost-effective alternative to traditional cardiac rehabilitation programs; however, a larger study is required to assess the generalizability of the results and long-term cost effectiveness.
PubMed ID
11845484 View in PubMed
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Cost-effectiveness of a personal health document in different distribution settings.

https://arctichealth.org/en/permalink/ahliterature92742
Source
Health Promot J Austr. 2008 Aug;19(2):125-31
Publication Type
Article
Date
Aug-2008
Author
Jerdén Lars
Lindholm Lars
Weinehall Lars
Author Affiliation
Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University, S-901 85 Umeå, Sweden. lars.jerden@ltdalarna.se
Source
Health Promot J Austr. 2008 Aug;19(2):125-31
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adult
Cost-Benefit Analysis
Female
Health Behavior
Health Promotion - economics - methods
Humans
Male
Medical Records
Middle Aged
Patient Education as Topic - economics - methods
Primary Health Care
Abstract
ISSUE ADDRESSED: The aim was to compare the cost-effectiveness of different ways to distribute a personal health document that was primarily aimed at supporting behaviour change. Personal health documents have been widely used in health-promoting efforts but their effective use is rather sparsely studied. METHODS: Four types of distribution were tested in Sweden: primary health care centres (n=418); work site meetings (n=164); at an occupational health examination (n=279); by mail (n=445). Participant behaviour changes were measured by a questionnaire. Cost calculations were made based on the results of the study. RESULTS: Between 10% and 26% of participants reported behaviour changes as a result of reading the booklet. A change in health situation was less likely using postal distribution. There were no significant differences between the other types of distribution. Cost-effective distribution at work sites and in occupational health was superior to distribution in primary health care when direct costs were used. Distribution at work sites was the least cost-effective when indirect costs, i.e. productivity losses of participants, were included. CONCLUSIONS: Cost-effectiveness analyses support distribution of personal health documents in occupational health. In primary health care, high training costs in combination with low distribution rates might be problematic. Providing information during distribution at work sites is time-consuming and might therefore be a problem if productivity losses are taken into account.
PubMed ID
18647126 View in PubMed
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Cost-effectiveness of early intervention in first-episode psychosis: economic evaluation of a randomised controlled trial (the OPUS study).

https://arctichealth.org/en/permalink/ahliterature118731
Source
Br J Psychiatry. 2013 Jan;202(1):35-41
Publication Type
Article
Date
Jan-2013
Author
Lene Halling Hastrup
Christian Kronborg
Mette Bertelsen
Pia Jeppesen
Per Jorgensen
Lone Petersen
Anne Thorup
Erik Simonsen
Merete Nordentoft
Author Affiliation
Region Zealand, Psychiatric Research Unit, Roskilde, Denmark. lhhs@regionsjaelland.dk
Source
Br J Psychiatry. 2013 Jan;202(1):35-41
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Community Mental Health Services - economics - organization & administration
Cost-Benefit Analysis
Denmark
Diagnosis-Related Groups - economics
Early Medical Intervention - economics
Family Therapy - economics
Health Care Costs - statistics & numerical data
Health Services - utilization
Humans
Intention to Treat Analysis
Middle Aged
Outcome and Process Assessment (Health Care)
Patient Care Team - economics
Patient Education as Topic - economics
Psychotic Disorders - economics - therapy
Schizophrenia - economics - therapy
Single-Blind Method
Socialization
Young Adult
Abstract
Information about the cost-effectiveness of early intervention programmes for first-episode psychosis is limited.
To evaluate the cost-effectiveness of an intensive early-intervention programme (called OPUS) (trial registration NCT00157313) consisting of enriched assertive community treatment, psychoeducational family treatment and social skills training for individuals with first-episode psychosis compared with standard treatment.
An incremental cost-effectiveness analysis of a randomised controlled trial, adopting a public sector perspective was undertaken.
The mean total costs of OPUS over 5 years (€123,683, s.e. = 8970) were not significantly different from that of standard treatment (€148,751, s.e. = 13073). At 2-year follow-up the mean Global Assessment of Functioning (GAF) score in the OPUS group (55.16, s.d. = 15.15) was significantly higher than in standard treatment group (51.13, s.d. = 15.92). However, the mean GAF did not differ significantly between the groups at 5-year follow-up (55.35 (s.d. = 18.28) and 54.16 (s.d. = 18.41), respectively). Cost-effectiveness planes based on non-parametric bootstrapping showed that OPUS was less costly and more effective in 70% of the replications. For a willingness-to-pay up to €50,000 the probability that OPUS was cost-effective was more than 80%.
The incremental cost-effectiveness analysis showed that there was a high probability of OPUS being cost-effective compared with standard treatment.
PubMed ID
23174515 View in PubMed
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The cost of starting and maintaining a large home hemodialysis program.

https://arctichealth.org/en/permalink/ahliterature144364
Source
Kidney Int. 2010 Jun;77(11):1039-45
Publication Type
Article
Date
Jun-2010
Author
Paul Komenda
Michael Copland
Jay Makwana
Ogdjenka Djurdjev
Manish M Sood
Adeera Levin
Author Affiliation
British Columbia Provincial Renal Agency, Vancouver, Canada. paulkomenda@yahoo.com
Source
Kidney Int. 2010 Jun;77(11):1039-45
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
British Columbia
Cost-Benefit Analysis
Drug Costs
Health Care Costs
Health Personnel - economics
Hemodialysis Units, Hospital - economics
Hemodialysis, Home - adverse effects - economics - mortality
Hospitalization - economics
Humans
Kidney Failure, Chronic - economics - mortality - therapy
Models, Economic
Patient Education as Topic - economics
Personnel Staffing and Scheduling - economics
Program Development
Retrospective Studies
Time Factors
Abstract
Home extended hours hemodialysis improves some measurable biological and quality-of-life parameters over conventional renal replacement therapies in patients with end-stage renal disease. Published small studies evaluating costs have shown savings in terms of ongoing operating costs with this modality. However, all estimates need to include the total costs, including infrastructure, patient training, and maintenance; patient attrition by death, transplantation, technique failure; and the necessity of in-center dialysis. We describe a comprehensive funding model for a large centrally administered but locally delivered home hemodialysis program in British Columbia, Canada that covered 122 patients, of which 113 were still in the program at study end. The majority of patients performed home nocturnal hemodialysis in this 2-year retrospective study. All training periods, both in-center and in-home dialysis, medications, hospitalizations, and deaths were captured using our provincial renal database and vital statistics. Comparative data from the provincial database and pricing models were used for costing purposes. The total comprehensive costs per patient-incorporating startup, home, and in-center dialysis; medications; home remodeling; and consumables-was $59,179 for years 2004-2005 and $48,648 for 2005-2006. The home dialysis patients required multiple in-center dialysis runs, significantly contributing to the overall costs. Our study describes a valid, comprehensive funding model delineating reliable cost estimates of starting and maintaining a large home-based hemodialysis program. Consideration of hidden costs is important for administrators and planners to take into account when designing budgets for home hemodialysis.
Notes
Comment In: Kidney Int. 2010 Oct;78(8):819; author reply 819-2020877379
PubMed ID
20375983 View in PubMed
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Current situation regarding toxoplasmosis in Finland.

https://arctichealth.org/en/permalink/ahliterature184980
Source
Arch Pediatr. 2003 Feb;10 Suppl 1:19
Publication Type
Article
Date
Feb-2003

Direct and indirect costs of asthma in Canada, 1990.

https://arctichealth.org/en/permalink/ahliterature212377
Source
CMAJ. 1996 Mar 15;154(6):821-31
Publication Type
Article
Date
Mar-15-1996
Author
M D Krahn
C. Berka
P. Langlois
A S Detsky
Author Affiliation
Department of Medicine, University of Toronto, Ontario.
Source
CMAJ. 1996 Mar 15;154(6):821-31
Date
Mar-15-1996
Language
English
Publication Type
Article
Keywords
Absenteeism
Activities of Daily Living
Ambulances - economics
Ambulatory Care - economics
Appointments and Schedules
Asthma - diagnosis - drug therapy - economics - mortality
Canada - epidemiology
Child
Child Care - economics
Cost of Illness
Cost-Benefit Analysis
Drug Costs
Emergency Medical Services - economics
Health Care Costs
Health Care Rationing
Hospitalization - economics
Humans
Nursing Services - economics
Patient Education as Topic - economics
Physicians - economics
Research Support as Topic
Travel
Value of Life
Abstract
To calculate the direct and indirect costs of asthma in Canada.
Cost-of-illness study.
Canada.
All Canadians receiving inpatient or outpatient care for asthma in 1990.
Direct costs incurred by inpatient care, emergency services, physician and nursing services, ambulance use, drugs and devices, outpatient diagnostic tests, research and education. Indirect costs from productivity loss due to absence from work, inability to to perform housekeeping activities, need to care for children with asthma who were absent from school, time spent travelling and waiting for medical care, and premature death from asthma. All costs are in 1990 Canadian dollars.
Depending on assumptions, the total cost of asthma was estimated to be between $504 million and $648 million. Direct costs were $306 million. The single largest component of direct costs was the cost of drugs ($124 million). The largest component of indirect costs was illness-related disability ($76 million).
Annual costs of treating asthma are comparable to the individual cost of infectious diseases, hematological diseases, congenital defects, perinatal illnesses, home care and ambulance services. Asthma costs may increase in the future, given current morbidity and mortality trends. Further evaluation of the effectiveness and cost-effectiveness of available asthma interventions in addition to aggregate cost data are required to determine whether resource allocation for the treatment of asthma can be improved.
Notes
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Comment In: CMAJ. 1996 Oct 1;155(7):862-3; author reply 8648837531
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PubMed ID
8634960 View in PubMed
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23 records – page 1 of 3.