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The 2015 hospital treatment choice reform in Norway: Continuity or change?

https://arctichealth.org/en/permalink/ahliterature285277
Source
Health Policy. 2016 Apr;120(4):350-5
Publication Type
Article
Date
Apr-2016
Author
Ånen Ringard
Ingrid Sperre Saunes
Anna Sagan
Source
Health Policy. 2016 Apr;120(4):350-5
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Choice Behavior
Health Care Reform - organization & administration
Health Expenditures
Health Policy
Health Services Accessibility - economics - organization & administration
Hospitals, Private - economics
Humans
Norway
Patient Preference
Politics
Waiting Lists
Abstract
In several European countries, including Norway, polices to increase patient choice of hospital provider have remained high on the political agenda. The main reason behind the interest in hospital choice reforms in Norway has been the belief that increasing choice can remedy the persistent problem of long waiting times for elective hospital care. Prior to the 2013 General Election, the Conservative Party campaigned in favour of a new choice reform: "the treatment choice reform". This article describes the background and process leading up to introduction of the reform in the autumn of 2015. It also provides a description of the content and discusses possible implications of the reform for patients, providers and government bodies. In sum, the reform contains elements of both continuity and change. The main novelty of the reform lies in the increased role of private for-profit healthcare providers.
PubMed ID
27005300 View in PubMed
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The acceptability and feasibility of an intercultural birth center in the highlands of Chiapas, Mexico.

https://arctichealth.org/en/permalink/ahliterature114720
Source
BMC Pregnancy Childbirth. 2013;13:94
Publication Type
Article
Date
2013
Author
Kathryn Tucker
Hector Ochoa
Rosario Garcia
Kirsty Sievwright
Amy Chambliss
Margaret C Baker
Author Affiliation
Department of International Health, NHS, Georgetown University, Washington, DC 20057, USA.
Source
BMC Pregnancy Childbirth. 2013;13:94
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Birthing Centers - utilization
Female
Focus Groups
Health Knowledge, Attitudes, Practice - ethnology
Health Services Accessibility
Home Childbirth
Humans
Interprofessional Relations
Interviews as Topic
Mexico
Midwifery - education - standards
Patient Preference - ethnology
Pregnancy
Abstract
An intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women. This birth center, known locally as the Casa Materna, is a place where women can come to give birth with their traditional birth attendant. However, three months after opening, no woman had used the birthing house.
This study reports on the knowledge, attitudes and practices related to childbirth and use of the Casa Materna from the perspective of the health workers, traditional birth attendants and the program's target population. Structured interviews, in-depth interviews and focus group discussions were conducted with participants from each of these groups. Data was searched for emerging themes and coded.
Findings show that the potential success of this program is jeopardized by lack of transport and a strong cultural preference for home births. The paper highlights the importance of community participation in planning and implementing such an intervention and of establishing trust and mutual respect among key actors. Recommendations are provided for moving forward the maternal health agenda of indigenous women in Chiapas.
Notes
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PubMed ID
23587122 View in PubMed
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Adherence, preference, and satisfaction of postmenopausal women taking denosumab or alendronate.

https://arctichealth.org/en/permalink/ahliterature140933
Source
Osteoporos Int. 2011 Jun;22(6):1725-35
Publication Type
Article
Date
Jun-2011
Author
D L Kendler
M R McClung
N. Freemantle
M. Lillestol
A H Moffett
J. Borenstein
S. Satram-Hoang
Y-C Yang
P. Kaur
D. Macarios
S. Siddhanti
Author Affiliation
University of British Columbia, 600-1285 West Broadway, V6H 3X8 Vancouver, BC, Canada. kendler@ca.inter.net
Source
Osteoporos Int. 2011 Jun;22(6):1725-35
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Alendronate - administration & dosage - adverse effects - therapeutic use
Antibodies, Monoclonal - administration & dosage - adverse effects - therapeutic use
Antibodies, Monoclonal, Humanized
Bone Density - drug effects
Bone Density Conservation Agents - administration & dosage - adverse effects - therapeutic use
British Columbia
Epidemiologic Methods
Female
Humans
Injections, Subcutaneous
Medication Adherence - statistics & numerical data
Middle Aged
Osteoporosis, Postmenopausal - drug therapy - physiopathology - psychology
Patient Preference - statistics & numerical data
Patient Satisfaction - statistics & numerical data
Treatment Outcome
Abstract
In this study, 250 women with osteoporosis were randomized to 12 months with subcutaneous denosumab 60 mg every 6 months or oral alendronate 70 mg once weekly, then crossed over to the other treatment. The primary endpoint, treatment adherence at 12 months, was 76.6% for alendronate and 87.3% for denosumab.
The purpose of this study is to evaluate treatment adherence with subcutaneous denosumab 60 mg every 6 months or oral alendronate 70 mg once weekly.
In this multicenter, randomized, open-label, 2-year, crossover study, 250 postmenopausal women with low bone mineral density received denosumab or alendronate for 12 months, then the other treatment for 12 months. The alendronate bottle had a medication event monitoring system cap to monitor administration dates. Definitions were as follows: compliance, receiving both denosumab doses 6 (± 1) months apart or 80-100% of alendronate doses; persistence, receiving both denosumab doses and completing the month 12 visit within the visit window or = 2 alendronate doses in the final month; adherence, achieving both compliance and persistence. This report includes data from the first 12 months.
The primary study endpoint, adherence in the first 12 months, was 76.6% (95/124) for alendronate and 87.3% (110/126) for denosumab. Risk ratios for denosumab compared with alendronate at 12 months were 0.58 (p = 0.043) for non-adherence, 0.48 (p = 0.014) for non-compliance, and 0.54 (p = 0.049) for non-persistence. Subject ratings for treatment necessity, preference, and satisfaction were significantly greater for denosumab and ratings for treatment bother were significantly greater for alendronate. Adverse events were reported by 64.1% of alendronate-treated subjects and 72.0% of denosumab-treated subjects (p = 0.403). The most common adverse events were arthralgia, back pain, pain in extremity, cough, and headache (each in
PubMed ID
20827547 View in PubMed
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[Analysis of the results of a questionnaire survey among the patients presenting with nasal cavity and paranasal sinuses diseases concerning organization and quality of specialized medical assistance].

https://arctichealth.org/en/permalink/ahliterature275898
Source
Vestn Otorinolaringol. 2016;81(3):23-5
Publication Type
Article
Date
2016
Author
V I Popadyuk
A V Fomina
I A Korshunova
A V Bitsaeva
Source
Vestn Otorinolaringol. 2016;81(3):23-5
Date
2016
Language
Russian
Publication Type
Article
Keywords
Continuity of Patient Care
Health Services - standards
Humans
Medical Records, Problem-Oriented - statistics & numerical data
Moscow - epidemiology
Nose Diseases - epidemiology - therapy
Otolaryngology - methods - organization & administration - statistics & numerical data
Paranasal Sinus Diseases - epidemiology - therapy
Patient Preference - statistics & numerical data
Quality Assurance, Health Care - methods
Quality Improvement
Surveys and Questionnaires
Abstract
The objective of the present study was to evaluate the influence of the medico-social factors on the development of nasal cavity and paranasal sinuses diseases and satisfaction of the patients with the quality of the provided specialized medical assistance. The approaches to the treatment of such patient at the pre-hospital and hospital levels are discussed.
PubMed ID
27367343 View in PubMed
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An empirical comparison of methods for analyzing correlated data from a discrete choice survey to elicit patient preference for colorectal cancer screening.

https://arctichealth.org/en/permalink/ahliterature126860
Source
BMC Med Res Methodol. 2012;12:15
Publication Type
Article
Date
2012
Author
Ji Cheng
Eleanor Pullenayegum
Deborah A Marshall
John K Marshall
Lehana Thabane
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Source
BMC Med Res Methodol. 2012;12:15
Date
2012
Language
English
Publication Type
Article
Keywords
Canada
Choice Behavior
Cluster analysis
Colorectal Neoplasms - diagnosis - psychology
Decision Support Techniques
Empirical Research
Female
Health Care Surveys
Humans
Logistic Models
Male
Mass Screening - methods
Middle Aged
Patient Preference - statistics & numerical data
Questionnaires
Research Design
Sensitivity and specificity
Abstract
A discrete choice experiment (DCE) is a preference survey which asks participants to make a choice among product portfolios comparing the key product characteristics by performing several choice tasks. Analyzing DCE data needs to account for within-participant correlation because choices from the same participant are likely to be similar. In this study, we empirically compared some commonly-used statistical methods for analyzing DCE data while accounting for within-participant correlation based on a survey of patient preference for colorectal cancer (CRC) screening tests conducted in Hamilton, Ontario, Canada in 2002.
A two-stage DCE design was used to investigate the impact of six attributes on participants' preferences for CRC screening test and willingness to undertake the test. We compared six models for clustered binary outcomes (logistic and probit regressions using cluster-robust standard error (SE), random-effects and generalized estimating equation approaches) and three models for clustered nominal outcomes (multinomial logistic and probit regressions with cluster-robust SE and random-effects multinomial logistic model). We also fitted a bivariate probit model with cluster-robust SE treating the choices from two stages as two correlated binary outcomes. The rank of relative importance between attributes and the estimates of ß coefficient within attributes were used to assess the model robustness.
In total 468 participants with each completing 10 choices were analyzed. Similar results were reported for the rank of relative importance and ß coefficients across models for stage-one data on evaluating participants' preferences for the test. The six attributes ranked from high to low as follows: cost, specificity, process, sensitivity, preparation and pain. However, the results differed across models for stage-two data on evaluating participants' willingness to undertake the tests. Little within-patient correlation (ICC ˜ 0) was found in stage-one data, but substantial within-patient correlation existed (ICC = 0.659) in stage-two data.
When small clustering effect presented in DCE data, results remained robust across statistical models. However, results varied when larger clustering effect presented. Therefore, it is important to assess the robustness of the estimates via sensitivity analysis using different models for analyzing clustered data from DCE studies.
Notes
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PubMed ID
22348526 View in PubMed
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Are patients satisfied with a web-based followup after total joint arthroplasty?

https://arctichealth.org/en/permalink/ahliterature104918
Source
Clin Orthop Relat Res. 2014 Jun;472(6):1972-81
Publication Type
Article
Date
Jun-2014
Author
Jacquelyn Marsh
Dianne Bryant
Steven J MacDonald
Douglas Naudie
Alliya Remtulla
Richard McCalden
James Howard
Robert Bourne
James McAuley
Author Affiliation
Faculty of Health Sciences, The University of Western Ontario, 1201 Western Road, London, ON, N6G 1H1, Canada, marsh.jacquelyn@gmail.com.
Source
Clin Orthop Relat Res. 2014 Jun;472(6):1972-81
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Knee - adverse effects
Chi-Square Distribution
Female
Humans
Internet
Male
Middle Aged
Odds Ratio
Office Visits
Ontario
Patient Preference
Patient satisfaction
Questionnaires
Teleradiology
Time Factors
Treatment Outcome
Abstract
A web-based followup assessment may be a feasible, cost-saving alternative of tracking patient outcomes after total joint arthroplasty. However, before implementing a web-based program, it is important to determine patient satisfaction levels with the new followup method. Satisfaction with the care received is becoming an increasingly important metric, and we do not know to what degree patients are satisfied with an approach to followup that does not involve an in-person visit with their surgeons.
We determined (1) patient satisfaction and (2) patients' preferences for followup method (web-based or in-person) after total joint arthroplasty.
We randomized patients who were at least 12 months after primary THA or TKA to complete a web-based followup or to have their appointment at the clinic. There were 410 eligible patients contacted for the study during the recruitment period. Of these, 256 agreed to participate, and a total of 229 patients completed the study (89% of those enrolled, 56% of those potentially eligible; 111 in the usual-care group, 118 in the web-based group). Their mean age was 69 years (range, 38-86 years). There was no crossover between groups. All 229 patients completed a satisfaction questionnaire at the time of their followup appointments. Patients in the web-based group also completed a satisfaction and preference questionnaire 1 year later. Only patients from the web-based group were asked to indicate preference as they had experienced the web-based and in-person followup methods. We used descriptive statistics to summarize the satisfaction questionnaires and compared results using Pearson's chi-square test.
Ninety-one patients (82.0%) in the usual-care group indicated that they were either extremely or very satisfied with the followup process compared with 90 patients (75.6%) who were in the web-based group (p
PubMed ID
24562873 View in PubMed
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Avoidance of weight gain is important for oral type 2 diabetes treatments in Sweden and Germany: patient preferences.

https://arctichealth.org/en/permalink/ahliterature108502
Source
Diabetes Metab. 2013 Oct;39(5):397-403
Publication Type
Article
Date
Oct-2013
Author
A F Mohamed
J. Zhang
F R Johnson
I Duprat Lomon
E. Malvolti
R. Townsend
C J Ostgren
K G Parhofer
Author Affiliation
RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC, USA.
Source
Diabetes Metab. 2013 Oct;39(5):397-403
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Administration, Oral
Blood Glucose - metabolism
Choice Behavior
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - drug therapy - epidemiology
Diabetic Angiopathies - epidemiology - etiology - prevention & control
Female
Germany - epidemiology
Humans
Hypoglycemia - chemically induced
Hypoglycemic Agents - administration & dosage - adverse effects
Male
Medication Adherence
Middle Aged
Patient Preference
Questionnaires
Self Care
Sweden - epidemiology
Treatment Outcome
Weight Gain - drug effects
Abstract
The aim of the study was to quantify patient preferences for outcomes associated with oral antidiabetic medications (OAMs) in Sweden and Germany through a discrete-choice experiment.
Adults taking OAMs who had a self-reported physician's diagnosis of type 2 diabetes mellitus (T2DM) made a series of nine choices between pairs of hypothetical profiles. Each profile had a predefined range of attributes: blood glucose control, frequency of mild-to-moderate hypoglycaemia, annual severe hypoglycaemic events, annual weight gain, pill burden and frequency of administration, and cost. Choice questions were based on an experimental design with known statistical properties. Bivariate probit analysis estimated the probabilities of choice of medication administration from patient characteristics and, conditional on that choice, preferences for treatment outcomes.
The final sample consisted of 188 Swedish and 195 German patients. For both countries, weight gain was the most important attribute, followed by blood glucose control. Avoiding a 5-kg weight gain was 1.5 times more important in Sweden and 2.3 times more important in Germany than achieving moderate blood glucose control, thereby, suggesting that blood glucose control is relatively more important to Swedish than to German patients. Least important outcomes were the number of daily pills (Sweden) and frequency of mild-to-moderate hypoglycaemia (Germany).
Patients in both Sweden and Germany preferred OAMs not associated with weight gain.
PubMed ID
23880594 View in PubMed
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[Barriers to treatment access reported by people with anxiety disorders].

https://arctichealth.org/en/permalink/ahliterature113187
Source
Can J Psychiatry. 2013 May;58(5):300-5
Publication Type
Article
Date
May-2013
Author
Michel Perreault
David Lafortune
Anick Laverdure
Mariko Chartier-Otis
Claude Bélanger
André Marchand
Stéphane Bouchard
Diana Milton
Author Affiliation
Université McGill, Montréal, Québec. michel.perreault@douglas.mcgill.ca
Source
Can J Psychiatry. 2013 May;58(5):300-5
Date
May-2013
Language
French
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anxiety Disorders - diagnosis - epidemiology - psychology - therapy
Chi-Square Distribution
Communication Barriers
Community Mental Health Services - standards
Female
Health Services Accessibility - standards - statistics & numerical data
Humans
Male
Needs Assessment
Patient Acceptance of Health Care - psychology - statistics & numerical data
Patient Preference - statistics & numerical data
Quebec - epidemiology
Questionnaires
Abstract
Our study examined the barriers to treatment experienced by people with anxiety disorders (ADs) who had not received services for their problems. Recommendations to improve treatment access made by participants are reported.
A web-based questionnaire on treatment accessibility for anxiety disorders was completed by 610 people living in Quebec reporting an anxiety problem. Chi-square tests were used to compare answers from people who received services (n = 151) with answers from people who had not (n = 434 ).
Treatment wait times that were too long (X2 = 29.66, df = 1, P
PubMed ID
23756290 View in PubMed
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Be Careful What You Ask For: Effects of Benefit Descriptions on Diabetes Patients' Benefit-Risk Tradeoff Preferences.

https://arctichealth.org/en/permalink/ahliterature282029
Source
Value Health. 2017 Apr;20(4):670-678
Publication Type
Article
Date
Apr-2017
Author
Lill-Brith von Arx
F Reed Johnson
Morten Raun Mørkbak
Trine Kjær
Source
Value Health. 2017 Apr;20(4):670-678
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Aged
Biomarkers - blood
Blood Glucose - drug effects - metabolism
Choice Behavior
Denmark
Diabetes Mellitus, Type 2 - blood - diagnosis - drug therapy - psychology
Female
Health Knowledge, Attitudes, Practice
Hemoglobin A, Glycosylated - metabolism
Humans
Hypoglycemia - chemically induced
Hypoglycemic Agents - adverse effects - therapeutic use
Insulin - adverse effects - therapeutic use
Likelihood Functions
Logistic Models
Male
Middle Aged
Patient Preference
Risk assessment
Risk factors
Surveys and Questionnaires
Time Factors
Treatment Outcome
Abstract
As more studies report on patient preferences for diabetes treatment, identifying diabetes outcomes other than glycated hemoglobin (HbA1c) to describe effectiveness is warranted to understand patient-relevant, benefit-risk tradeoffs.
The aim of the study was to evaluate how preferences differ when effectiveness (glycemic control) is presented as long-term sequela (LTS) risk mitigation rather than an asymptomatic technical marker (HbA1c).
People with type 2 diabetes and using insulin (n = 3160) were randomly assigned to four self-administered, discrete-choice experiments that differed by their presentation of effectiveness. Epidemiologic reviews were conducted to ensure a close approximation of LTS risk relative to HbA1c levels. The relative importance of treatment benefit-risk characteristics and maximum acceptable risk tradeoffs was estimated using an error-component logit model. Log-likelihood ratio tests were used to compare parameter vectors.
In total, 1031 people responded to the survey. Significantly more severe hypoglycemic events were accepted for a health improvement in terms of LTS mitigation versus HbA1c improvement (0.7 events per year; 95% confidence interval [CI]: 0.4-1.0 vs. 0.2 events per year 95% CI: -0.02 to 0.5) and avoidance of treatment-related heart attack risk (1.4 severe hypoglycemic events per year; 95% CI: 0.8-1.9 vs. 1 event per year; 95% CI: 0.6-1.3). This finding is supported by a log-likelihood test that rejected at the 0.05 level that respondent preference structures are similar across the different experimental arms of the discrete-choice experiment.
We found evidence that benefit descriptions influence elicited preferences for the benefit-risk characteristics of injectable diabetes treatment. These findings argue for using carefully defined effectiveness measures to accurately take account of the patient perspective in benefit-risk assessments.
PubMed ID
28408010 View in PubMed
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Becoming a mother - Mothers' experience of Kangaroo Mother Care.

https://arctichealth.org/en/permalink/ahliterature295485
Source
Sex Reprod Healthc. 2018 Jun; 16:181-185
Publication Type
Journal Article
Date
Jun-2018
Author
Josefine Norén
Kerstin Hedberg Nyqvist
Christine Rubertsson
Ylva Thernström Blomqvist
Author Affiliation
University Hospital, Neonatal Intensive Care Unit, Uppsala, Sweden.
Source
Sex Reprod Healthc. 2018 Jun; 16:181-185
Date
Jun-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Breast Feeding
Female
Humans
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Kangaroo-Mother Care Method
Mothers
Patient Preference
Skin
Sweden
Abstract
To describe mothers' experiences of providing their preterm infants with Kangaroo Mother Care (KMC).
A qualitative descriptive design.
Two level III neonatal intensive care units (NICUs) in Sweden.
Thirteen mothers of preterm infants.
The mothers were interviewed when their infant had reached a corrected age of 4?months?±?2?weeks. The interviews were recorded and transcribed and data were analyzed using qualitative content analysis.
The mothers described the skin-to-skin contact with, and closeness to, the preterm infant as something they valued, and involuntary physical separation as something they had to accept and adapt to. Providing the infant with breast milk by expressing and tube feeding was experienced as time-consuming and as impinging on the skin-to-skin contact.
Mothers want to stay close to their preterm infant. The NICU environment and staff can facilitate KMC by providing a private space for parents and infants, and enable mothers to breastfeed and express breast milk by giving them support based on science and proven experience.
PubMed ID
29804764 View in PubMed
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203 records – page 1 of 21.