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Biomedical subjects

H Brodin

Publications and source records attributed to H Brodin.

At least 19 recordsLinked to original sources
PubMed1998

Domiciliary liquid oxygen versus concentrator treatment in chronic hypoxaemia: a cost-utility analysis.

Whether long-term oxygen therapy (LTOT) improves quality of life in chronic hypoxaemia has been questioned. LTOT with an oxygen concentrator (C/C) and gas cylinders for ambulation is considered cumbersome compared to mobile liquid oxygen equipment (L). The hypothesis for this study was that LTOT with liquid oxygen treatment (L) improves patients' health-related quality of life, but that it is also more expensive compared to concentrator (C/C) treatment. A prospective, randomized multicentre trial comparing C/C with L for LTOT was conducted during a six-month period. Fifty-one patients (29 on L and 22 on C/C) with chronic hypoxaemia, regularly active outside the home, participated in the study initially. Costs for oxygen were obtained from the pharmacies. Patient diaries and telephone contacts with members of the healthcare sector were used to estimate costs. Health-related quality of life was measured by the Sickness Impact Profile (SIP) and the EuroQol, instruments at the start and after 6 months. The average total cost per patient for group C/C for the six-month period was US$1,310, and for group L it was US$4,950. Health-related quality of life measured by the SIP instrument showed significant differences in favour of group L in the categories/dimensions of physical function, body care, ambulation, social interaction and total SIP score. In conclusion, liquid-oxygen treatment was more expensive compared to concentrator treatment. However, treatment effects showed that liquid oxygen had a better impact on quality of life.

Chronic Disease↗
PubMed1997

Assistive technology selection: a study of participation of users with rheumatoid arthritis.

A new program based on improved user participation for the selection of assistive devices was implemented and its effectiveness and efficiency assessed. The intervention was compared with traditional routines. The study population comprised persons with rheumatoid arthritis who lived in two communities in Sweden. The selection process yielded increased user participation, user satisfaction, an increased number of prescriptions, and consequently also higher costs. The outcome measures showed more vague improvements. No improvement in functional ability was found regarding pain and difficulty with daily activities in the two study groups, but an increased use of assistive devices was found among women below 64 years in the intervention group (p = 0.001). Women below 64 years in the intervention group rated an improved health-related quality of life regarding both the total score (p = 0.017) and the underlying dimensions of physical function (p = 0.012). Even though the intervention yielded positive results on process-variables as increased user participation and an increased number of prescribed assistive devices, only women below 64 years showed an increased use of assistive devices in daily activities and an improved health related quality of life.

Activities of Daily Living↗
PubMed1996

One-year economic consequences of accidents in a Swedish municipality.

The objectives of this study were to develop a system to calculate the economic consequences of accidents and to account for the economic consequences of all accidents during 1 year in a district. A total population injury survey was done in an area with a population of over 41,000. All accidents (N = 4926) occurring within a 12-month period and requiring medical care were noted. The costs (calculated at 1991 prices) to the health care service (outpatient care, including primary health care and hospital care) were SEK 23.7 million (US $3.59 million), to trade and industry SEK 79.7 million (US $12.08 million), and for health insurance SEK 9.1 million (US $1.38 million). The cost for society of uninsured people is not possible to estimate using loss of production. However, the time lost from "normal activities" was registered. If this time is valued at the same price as working hours, a welfare cost of SEK 43.1 million (US $6.53 million) should be added. In a forthcoming paper, an assessment of the cost-effectiveness of interventions against accidents will be published.

Absenteeism↗
PubMed1995

Assessment of rehabilitation technologies in stroke. Outcomes and costs.

Initial functional ability (Barthel Index, mean 57) was found to be an important predictor of functional ability 1 year after stroke (mean 80) and for costs during the period. On average the total cost for a stroke patient was about SEK 200,000; the main expense, accommodation, averaged about SEK 140,000, while assistive devices amounted to SEK 2,600. Those who use assistive devices, although having achieved a high functional ability, perceive and rate their life situation (Nottingham Health Profile) considerably more impaired than those without assistive devices.

Aged↗
PubMed1995

Cost-utility analysis of assistive technologies in the European Commission's TIDE Program. Technology Initiative for Disabled and Elderly People.

Socioeconomic evaluation is an issue dealt with in the European Commission's research program TIDE. The principles of cost-utility analysis have been examined for usability in the assessment of rehabilitative technologies. A case study, the choice of a type of wheelchair, is described to demonstrate how estimates of utility can be derived and how cost-utility ratios can be used to guide decision making.

Aged↗
PubMed1994

Cost analysis of different phases of acute myeloid leukaemia.

Priority lists have been formulated in several countries and cut-backs can be a threat to leukaemia treatment. We analysed the costs in different phases of disease for 54 conventionally treated patients with acute myeloid leukaemia. Thirty-two patients reached CR 1, seven patients are still alive as of May 1994. We found a cost per week and patient of 17,334 Swedish Crowns (SEK) (U.K. 1 pound = 10.57 and U.S. $1 = 5.91, 1990) in induction phase, 1854 in remission phase and 10,529 SEK in relapse phase. In the terminal phase 10% of the total cost was spent. The quality of life of the patients in relapse is discussed and palliative treatment is emphasized.

Acute Disease↗
PubMed1994

Costs over time in conventional treatment of acute myeloid leukaemia. A study exploring changes in treatment strategies over two decades.

OBJECTIVES: The aim was to analyse the consumption of different items in conventional treatment of acute myeloid leukaemia (AML) and their cost, in order to evaluate the economic consequences of new treatment strategies. DESIGN: Data on items of treatment were gathered retrospectively from case notes, including amount and date. Prices were gathered from price lists made up for internal billing/accounting. SETTING: The patients were all treated in a hospital with excellent treatment and service facilities. SUBJECTS: Seventy-three AML patients treated from 1973 to 1980, all since deceased, were compared with 54 patients treated from 1981 to 1988, of whom 14 were alive at the end of the observation period. INTERVENTIONS: The patients were treated according to randomized treatment protocols to achieve complete remission. Maintenance treatment or consolidation courses were given. In relapse, new induction treatment was given. MAIN OUTCOME MEASURES: Complete remission and survival were registered. The costs were divided into basic hospital costs and patient-specific costs. RESULTS: The mean total treatment cost for an AML patient in the 1970s was 211,138 SEK, and in 1980s 356,911 SEK. (UK 1 pound = 10.57 SEK, US$1 = 5.91 SEK 1990). All treatment costs increased between the periods: hospital costs by 20%, and patient-specific costs by 186%. Antibiotics, cytostatics and outpatient department costs had increased the most. The mean survival time almost doubled, and in the 1980s group there were several long-term survivors. CONCLUSIONS: The costs for AML treatment increased considerably from the 1970s to the 1980s. The effectiveness of these treatments increased as well, resulting in increased rate and duration of survival, and several patients were long-term survivors. It was not possible to identify the cost consequences of separate new technologies.

Acute Disease↗
PubMed1993

Treating acute leukaemias--a venture into economic uncertainty? A method for estimating the cost of treating patients with acute myelocytic leukaemia.

The objective of this paper is to report a method for estimating the cost of treating acute myelocytic leukaemia (AML). It is based on individual data from 54 patients treated with aggressive induction courses of chemotherapy. The study records the cost of the entire survival period for 40 patients and of at least 16 months' survival for the remaining 14 patients. All treatment activities were registered from the patient records and the price of each activity was estimated. As far as possible the principle of opportunity cost was used. The median survival time was 50 weeks and the average cost per patient was c. 300,000 SEK (= c. USD 50,000) in 1988 prices. A young man who achieved three remissions and lived for five years had the highest cost, c. 1 million SEK (= USD 155,000). The costs for AML treatment was higher in the 1980s than in the 1970s but led to longer survival for patients who survived the initial period.

Adult↗
PubMed1983

Changes in hospital costs for an appendectomy: 1955, 1965, and 1975.

A reduction in the number of postoperative bed days for patients who underwent appendectomy led to a study of changes in hospital costs of appendectomies for the years 1955, and 1965, and 1975. No significant changes were found in the total hospital costs. However, the postoperative costs decreased by 36 percent from 1955 to 1975 due to a decrease in the mean duration of hospital stay. During the same period of time, the perioperative costs increased by (table; see text) 90 percent due to increased length of operation time correlated with an increasing proportion of inexperienced operating surgeons. At present, there seem to be few possible ways to increase the cost efficiency of treating appendicitis.

Appendectomy↗
PubMed1983

Discomfort and pain from loaded passive joint structures.

Sensations of strain and pain from healthy elbow and knee joints kept in an extreme position were reported on Borg's category-ratio scale (4) by 12 male volunteers in an experimental situation. The purpose of the study was to find out whether passive joint structures give sensations of discomfort and pain when moderately loaded for a certain time in an extreme position. Sensations of discomfort and pain were reported every 15th second. The mean values of ratings followed a straight line of increasing values during the first four minutes. Great variations were found between individuals. The elbow joint was six times more sensitive to the loading dose expressed as the product of the moment of force and time than was the knee joint. After the load was removed the provoked sensation slowly decreased. Sometimes the initial after-load rating was higher than the last rating with the load. The results imply that static work postures should also be analyzed with respect to joint position.

Adult↗