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Biomedical subjects

G Hultén

Publications and source records attributed to G Hultén.

11 recordsLinked to original sources
PubMed2000

[Wide variations among hospitals in use of laboratory tests. Information and education to increase cost-effectiveness].

Hospitals in Sweden differ greatly in their use of laboratory tests. These differences seem to be due to traditions and regional differences. The cost of a single laboratory test is often low, but since many tests are used in great numbers, the consequences of false or misleading results can be very costly. Recently, several intervention studies have been carried out in Sweden with the aim of optimizing clinical chemistry testing routines in primary care. These studies show that it is possible to reduce the cost to primary care by SEK 100 million per year while increasing clinical utility. SEK 100 million is approximately 10% of the total cost of clinical chemistry testing in primary care. It should also be possible to reduce this cost in secondary and tertiary care. Hospitals order more tests than primary care, and thus the potential savings are larger. We have studied ordering routines at eleven Swedish hospitals. Comparisons were made in the form of ratios between related laboratory tests, in order to reduce the effects of differences of scale between the laboratories that were studied. The large variation between hospitals indicates that an ongoing discussion between clinicians and laboratories could reduce costs. We have used the figures from this comparison and calculated the potential savings for seven frequently used tests. The potential yearly savings in Sweden for these tests alone is approximately SEK 150 million. We estimate that this is just half of the amount that could be saved if all tests were included.

Chemistry, Clinical↗
PubMed2000

Large differences in laboratory utilisation between hospitals in Sweden.

There are large differences in the use of laboratory tests between hospitals in Sweden. These differences are not only due to differences between the patients treated but also to differences in practice. Use of laboratory test seems to reflect local traditions to a large extent. These large variations in practice are not compatible with the objective of providing care on equal terms and reduce the cost-effectiveness of clinical chemistry. Recently, several intervention studies have been performed in Sweden with the aim to optimise the use of clinical chemistry tests in primary care. The results show that it is possible to reduce the cost in primary care by SEK 100 million per year while increasing the clinical usefulness. This constitutes approximately 10% of the total cost for clinical chemistry tests in primary care. It should also be possible to reduce the cost for clinical chemistry tests in secondary and tertiary care. Hospitals order more tests than primary care and the potential savings are thus greater. We have studied the ordering habits for eleven Swedish hospitals. The comparison was made in the form of ratios between related laboratory tests to reduce the effects of differences in size between the studied laboratories. The large variation between hospitals indicates that a continuous discussion between the clinicians and the laboratories could reduce the cost. We have used the figures from the comparison and calculated the potential savings for seven frequently used tests. The potential yearly saving in Sweden for these tests is approximately SEK 150 million.

Clinical Chemistry Tests↗
PubMed1999

Effects of an education programme to change clinical laboratory testing habits in primary care.

OBJECTIVE: The aim of this study was to investigate the use of clinical laboratory tests in primary care and to evaluate if it is possible to improve the cost-effectiveness of laboratory testing by a short-term education programme. Our main goal has been to lower the total costs of care. DESIGN: An education programme that was monitored by laboratory test ratios. SETTING: Primary health care. SUBJECTS: 63 primary care doctors at 19 primary care centres in the county of Uppsala, Sweden. MAIN OUTCOME MEASURES: The effects of the education programme were monitored by laboratory test ratios (e.g. ASAT/ALAT) of individual doctors before and after the education programme. RESULTS: The education programme resulted in significant changes for the majority of the ratios studied. The savings on direct laboratory costs were approximately SEK 400,000 for assays that were recommended to decrease. The increased cost for assays that were recommended to increase was approximately SEK 140,000 but was considered cost-effective. CONCLUSION: It is possible to achieve significant changes in clinical chemistry test ordering habits of primary care doctors with a 2 day education programme. It resulted in cost savings and a better use of clinical chemistry tests in primary care. The effects were sustained for at least 6 months.

Clinical Chemistry Tests↗
PubMed1980

Future nursing homes in Sweden -- users' opinion.

The purpose of this study was to gather knowledge in order to provide a basis for the future planning of local nursing homes in Sweden. A total of 306 patients, residents and staff of six nursing homes and four old age homes were interviewed. The interview was combined with questions regarding a model for the design of a nursing home. The subjects were found to have opinions on the designs on the design which, in some cases, differed significantly from what is generally assumed to be true today in Sweden.

Adult↗
PubMed1975

Electron depth absorbed dose distribution for a 10 MeV clinical microtron.

Central axis depth absorbed dose distributions of the electron beam from a medical microtron accelerator have been measured. The measured distributions differ from those of existing betatrons and linear accelerators. A larger absorbed dose build-up and a sharper dose fall-off are obtained in close agreement with theoretical calcuations for monoenergetic electron beams. The differences from other accelerators are explained by the narrow energy spectrum, the clean geometry and the small amount of scattering material in the electron beam of the microtron.

Electrons↗
PubMed1975

Electron depth absorbed doses for small phantom depths. Comparison between different accelerators.

Depth dose distributions at small phantom depths in polystyrene were measured with a liquid ionization chamber at six different accelerators. The absorbed dose at 0.5 mm depth relative to the absorbed dose maximum in the central beam varied between 0.77 and 0.92 for 10 MeV electrons. Generally the surface absorbed dose increased with increasing energy or decreasing field size. Results from measurements off axis indicate small differences from the data available for the central beam.

Electrons↗