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Biomedical subjects

D Hailey

Publications and source records attributed to D Hailey.

50 records · Page 3Linked to original sources
PubMed1996

The assessment of diagnostic imaging technologies: a policy perspective.

Diagnostic imaging technologies are essential in health care but have high costs and poorly defined benefits. Formulation and implementation of policy on their procurement and use is made difficult by the complexity of the diagnostic process, and the limitations of available data and assessment methodology. Informed policy decisions will need to be based on a synthesis of imperfect data from a variety of perspectives, and supplemented by effective dissemination and feedback of information. A list of attributes for consideration in the policy formulation process is presented.

Australia↗
PubMed1996

Underutilization of laparoscopic oophorectomy.

The objective of this study was to compare the use and effectiveness of laparoscopic and laparotomy oophorectomy in 3 hospitals in Melbourne. A retrospective analysis was made of medical records of 140 patients having laparoscopic or laparotomy oophorectomy in the Mercy Hospital for Women (41), Monash Medical Centre (37), and Cliveden Hill Private Hospital (62). Both public hospitals used the laparoscopic procedure, 12% and 22% respectively, less often than the private hospital, 94%. The average number of hospital days for procedures completed by laparoscopy was 1.3 and for laparotomy 6.9. Fourteen percent of laparoscopic procedures were converted to laparotomy. Adjusting for this the average hospital stay was 1.6 days of procedures started laparoscopically. Assuming 1,000 oophorectomies are performed each year in Australia of which 80% could be performed laparoscopically, there may be cost savings to health care providers of over $1.5 million. Laparoscopic oophorectomy is a safe, effective and cost-efficient method of removing the ovary and gynaecologists should be encouraged to learn and perform this procedure.

Adult↗
PubMed1995

The place of magnetic resonance imaging in health care.

Magnetic resonance imaging has been an important advance in diagnostic imaging technology and is now widely established in many countries. However, evidence of proven benefit in patient management and outcome remains limited. Health policy makers, professional groups and administrators are faced with a range of questions on the technical capabilities, costs and comparative advantage over other diagnostic methods. The challenge remains to use this expensive technology in an effective manner, with critical review of its cost effectiveness and its suitability for individual health care programs.

Australia↗
PubMed1995

The evolution of heart, lung and liver transplantation services in Australia.

The introduction and operation of heart, lung and liver transplantation services in Australia have been assisted by a Nationally Funded Centres policy adopted by health ministers. Assessment for eligibility for support under the program has been undertaken by the Australian Health Technology Advisory Committee. Outcomes/survival rates at transplantation centres have compared favourably with results from other countries. As in other countries, shortage of donor organs has limited the number of procedures undertaken. Some concern remains regarding the viability of newer transplantation programs which are now being established in smaller centres of population.

Australia↗
PubMed1995

The evolution of laparoscopic surgery in routine health care.

While laparoscopic cholecystectomy is now widely used, diffusion of other laparoscopic surgical methods has been more modest. Uptake of most laparoscopic methods has been influenced by considerations of effectiveness compared with open surgery, competing minimally invasive therapies, and the inconvenience and cost of technical change.

Australia↗
PubMed1995

The status of laparoscopic surgery in Australia.

Laparoscopic surgery continues to evolve and to offer major potential for achieving benefits to patients and to health care providers because of decreased morbidity. Laparoscopic cholecystectomy has diffused rapidly and widely. However, the spread of other minimal access surgery methods has been more gradual, reflecting uncertainties as to the degree of benefit and rate of change of technology. Firm evidence of efficacy and costs of the new methods is still limited, and a number of organisational issues continue to demand attention.

Australia↗
PubMed1994

The impact of laparoscopic cholecystectomy in Canada and Australia.

The introduction of laparoscopic cholecystectomy in Canada and Australia has been associated in each country with an increase in the rates of all cholecystectomies following a period where these had remained constant. Estimated costs of cholecystectomies to health programs declined by about 13% in Canada after the laparoscopic procedure became widely available, and about 2% in Australia. Days lost to patients because of surgery, and associated costs to them, decreased in each country. Neither country is realising the potential savings through use of laparoscopic cholecystectomy because of the increase in the number of procedures. The utility of these additional operations remains unclear. These trends associated with the advent of laparoscopic cholecystectomy suggest the need for caution in the introduction and application of other minimal-access surgery techniques.

Australia↗
PubMed1994

The role of economic appraisal in health technology assessment: the Australian case.

This paper examines the role and importance of economic appraisal of health technology in Australia, particularly those appraisals conducted under the auspices of a Federal Committee. Eight specific examples are considered: extracorporeal shock wave lithotripsy, office pathology testing, magnetic resonance imaging, cervical cancer screening, bone mineral assessment, automated implantable cardiac defibrillators, liver transplantation and extracorporeal membrane oxygenation. It was found that in most cases the appraisal influenced policy, but that it was harder to assess whether there had been changes in practice or final health outcomes. It is concluded that the roles and relationships of the various players in technology assessment need to be clear, that appropriate incentives are required if socially desirable priorities are to be achieved and that the application of economic appraisal techniques needs to be timely and relevant.

Absorptiometry, Photon↗
PubMed1994

Magnetic field strength issues in magnetic resonance imaging.

The authors review the current status of magnetic resonance imaging (MRI) with respect to magnetic field strength. The discussion covers the practical aspects of MRI--safety, throughput and costs--as well as the clinical aspects as they are influenced by field strength. Data on the world distribution of MRI units of various field strengths are presented. Canada had the highest proportion of high-field units among the 11 countries or regions included in this comparison, probably because most Canadian MRI units are located in teaching hospitals, where they are used for both research and clinical work.

Costs and Cost Analysis↗
PubMed1990

Costs of magnetic resonance imaging services in public hospitals.

Audited cost data from two public hospital installations participating in a trial of the utilisation and efficacy of magnetic resonance imaging are presented. The data cover the period July 1987 to June 1988 when both installations had attained stable patterns of operation. One hospital operated a superconductive system and the other a resistive magnetic resonance imaging unit. Depreciation and salaries represented the major components of cost.

Australia↗
PubMedDate not supplied

Health care technology in Australia.

The health care system in Australia is pluralistic, complex, and only loosely organized. The Commonwealth government is primarily concerned with funding programs and the development of broad policies. The introduction and diffusion of health care technologies in Australia is determined by a complex interaction of market forces, public funding, and regulation. Australia became involved in health care technology assessment in 1982. In 1990, activities were reorganized and the Australian Health Technology Advisory Committee (AHTAC) was formed at the national level. Despite limited funding, Australia has had some significant successes in informing policy through appropriately targeted, well-timed assessment.

Australia↗
PubMedDate not supplied

Technology and managed care: is telemedicine the right tool for rural communities?

Telemedicine offers a unique opportunity for the delivery of healthcare to rural communities. For this opportunity to be realized, telemedicine services need to be planned carefully with attention to acceptance by clients and providers, economic viability and effective administration. To be sustainable, services for rural populations must be supported by a well-defined and resourced infrastructure. Managed care, considered as an approach to the effective delivery of appropriate services, is indeed the right tool for rural communities. Cost savings will be an important issue for health care managers, but rural telemedicine services should be considered in a broader economic perspective, taking account of both costs and benefits from various perspectives, and considering long term outcomes.

Humans↗