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A Norlund

Publications and source records attributed to A Norlund.

11 recordsLinked to original sources
PubMed2001

[Multilevel analysis of regional disparities in survival after heart failure: differences between county health services affect little patients' prognosis].

The prognosis for patients suffering from heart failure in Sweden differs from county to county, indicating a need for a comparative study in order to uncover the reasons. Conventional single-level analytical methods, however, underestimate the statistical uncertainty in such studies, leading to an inappropriate ranking of regions. Consequently, public opinion and decision-making may be misled. Conventional methods are also unable to disentangle the extent to which differences in prognosis may depend on individual or regional factors. Multilevel analysis, on the other hand, provides a better estimate of statistical uncertainty, and can both identify and quantify the extent to which differences in prognosis depend on either patient-related or regional factors. Using multilevel analysis, we examined the one-year mortality of 38,343 heart failure patients for the period 1992-1995 in every county in Sweden. Regional differences in one-year mortality were found to be very small, the most relevant factors being individual ones. The limited differences distinguishable at the county level may be explained in part by physician density: the more physicians in a county, the better an individual patient's prognosis.

Aged↗
PubMed2001

Cost of illness of adult diabetes mellitus underestimated if comorbidity is not considered.

OBJECTIVE: To determine costs of illness for adult diabetes mellitus (DM), including complications caused by DM. DESIGN: A population-based multicentre cross- sectional study including an interview and a physical examination of patients identified as having DM. The patients' medical records were analysed regarding diagnoses and complications attributable to DM. SETTING: Eight health care centres of six primary care districts in Southern Sweden. SUBJECTS: 1677 adults aged 25+, cared for at the health care centres, entered the study. MAIN OUTCOME MEASURES: Utilization of health care and care from relatives and the municipality, absence of short- and long-term sickness, cost of illness. RESULTS: The average annual direct and indirect costs for an adult with DM were calculated to be 61 700 Swedish Kronor (SEK) or 2.5 times higher than earlier estimates. The incremental cost of DM was 34 100 SEK. The cost distribution was 28% for health care, 31% for the municipality and relatives and 41% lost productivity. CONCLUSIONS: Calculations for the cost of illness of DM are underestimated if comorbidity caused by DM is not considered. When DM-related complications are included to identify the actual burden of disease to society, the cost of illness as a result of DM in Sweden is substantially higher than previously estimated.

Adult↗
PubMed1996

Prevention of osteoporosis--a cost-effectiveness. Analysis regarding fractures.

Osteoporosis increases for postmenopausal women. The risks of complications, i e fractures, from osteoporosis is recognized. The affected women with fractures suffer and the costs of health care are considerable. Screening by bone mineral density (BMD) measurement in combination with estrogen prevention of osteoporosis may reduce fractures in elderly women. The question whether benefits will exceed costs is studied for a cohort of women, aged 50-54 years, in Malmöhus county council.

Adult↗
PubMedDate not supplied

Severe traumatic brain lesions in Sweden. Part 3: Economic aspects of aggressive neurosurgical intensive care.

The present study had two main objectives: Firstly, to document the economic differences between 'ordinary' and 'aggressive' neurosurgical intensive care and secondly, to evaluate the medical benefits in relation to costs for different subgroups of head-injured patients. The study compares patients injured in traffic accidents and treated in the Department of Neurosurgery, University Hospital of Lund, during 1977-1978 (n = 67) with similar patients treated during 1983-1984 (n = 87) after introduction of more vigorous neurosurgical intensive care. The economic analysis was performed by means of the CRISE-method (Cost Related Index Score Evaluation) and all costs were related to the monetary value in 1984. Adoption of a program for 'aggressive' neurosurgical intensive care increased the costs per treated patient by about 46% (from 70.887 Swedish Crowns (SEK) to 103.452 SEK). Mortality decreased significantly after the change in intensive care and the cost per surviving patient remained virtually unaffected (131.928 SEK vs. 132.357 SEK). Further, after introduction of the 'aggressive' programme a larger proportion of the economic expenditures were spent on patients who ultimately recovered well. It is concluded that the increase in costs following introduction of a more vigorous intensive care programme in patients with severe traumatic brain lesions is very reasonable in relation to the documented medical benefits.

Accidents, Traffic↗