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Biomedical subjects

J M Horne

Publications and source records attributed to J M Horne.

11 recordsLinked to original sources
PubMed1993

Cost-effectiveness of neonatal screening for Duchenne muscular dystrophy--how does this compare to existing neonatal screening for metabolic disorders?

Costs of screening a series of 18,152 newborn males for Duchenne muscular dystrophy (DMD) in Canada were evaluated. The final aim of neonatal screening for DMD is the avoidance of additional cases in the families identified. Total costs to avoid one case of DMD were estimated at Cdn. $172,000, while the incremental costs were found to be $83,000. Reagent costs, test sensitivity, efficacy of screening and compliance with genetic advice were identified as factors crucial for cost-effectiveness. Costs of neonatal screening for DMD are compared with costs of neonatal screening for inborn metabolic disorders. It is found that the two programmes are similar in costs. Earlier predictions of inordinate costs of screening for DMD are refuted.

Cost-Benefit Analysis↗
PubMed1989

Healthcare in rural Manitoba: resources and related issues of access.

This paper reviews the existing allocation of healthcare resources to and within rural Manitoba. The geographic distribution of hospital, medical and long-term care resources is described and discussed in relation to widely held perceptions of continuing problems in access to publicly insured care among residents of rural communities. Opportunities for more effective and efficient allocation of resources are identified, including various arrangements for sharing both facilities and personnel between communities.

Health Expenditures↗
PubMed1987

Day-care versus inpatient pediatric surgery: a comparison of costs incurred by parents.

The cost-effectiveness for parents of day-care pediatric surgery was assessed by comparing time and financial costs associated with two surgical procedures, one (squint repair) performed exclusively as a day-care procedure, the other (adenoidectomy) performed exclusively as an inpatient procedure. All but 1 of 165 eligible families participated. The children underwent surgery between February and July 1981. The day-care surgery group (59 families) incurred average total time costs of 16.1 hours, compared with 37.1 hours for the inpatient surgery group (105 families), as parents in the latter group remained with their child during the longer hospital stay. Parents from out of town incurred the greater time and financial costs. In both groups parents of younger children tended to spend more time at the hospital than parents of older children. Type of surgical management was not a significant factor in out-of-pocket expenses. Loss of income was associated with employment of the mother as a professional or a manager and may reflect inequalities in access to compassionate leave between men and women in equivalent positions. Opening day-care surgery facilities on weekends might reduce the financial burden on working mothers. Overall, day-care surgery was found to be cost-effective for families.

Adenoidectomy↗
PubMed1987

Pediatric day-care surgery: a 30-year hospital experience.

Over a 30-year period (may 1955 to December 1985), day care surgery was performed on 39,654 patients at the Winnipeg Children's Hospital (WCH). Up to 51% of all pediatric surgical cases and 59% of elective pediatric cases, involving more than 50 different procedures, were performed annually on a day-care basis. The overall incidence of postoperative problems and admission to hospital was 1.5% and 1.1%, respectively. A unique preoperative home visiting program by nurses was demonstrably effective in reducing late cancellations by 75%. The WCH experience adds further evidence that day-care surgery in a pediatric hospital is safe and effective for a large proportion of infants and children requiring operation.

Ambulatory Surgical Procedures↗
PubMed1980

Utilization of publicly insured health services in Saskatchewan before, during and after copayment.

This study examines the effects both of introducing and of removing copayment charges under a universal public medical care and hospital insurance program. For a period between 1968 and 1971, the Province of Saskatchewan imposed user charges of approximately 33 per cent and 6 per cent on medical and hospital services, respectively. The effects of these charges are analyzed using pooled cross-section samples of families and using both multivariate methods and experimental/control groups designs. Diagnostic- and procedure-specific analysis is also performed on the hospital data using the individual as the unit of observation. The findings of the study indicate a copayment effect of 5.6 per cent for physicians' services. No evidence could be adduced that would support the conclusion of a copayment effect for hospital services.

Deductibles and Coinsurance↗
PubMed1979

Preoperative electrocardiography: its cost-effectiveness in detecting abnormalities when a previous tracing exists.

In 812 patients who underwent routine preoperative electrocardiography a mean of 24.6 months after undergoing electrocardiography at the same institution, the frequency of new abnormalities was estimated to evaluate the cost-effectiveness of this procedure prior to an operation. New abnormalities were judged to be either relevant or irrelevant to the assessment of operative risk, depending upon their previously demonstrated correlation with operative and postoperative morbidity and mortality. Since new abnormalities, especially new relevant abnormalities, were found to be relatively infrequent, the cost-effectiveness of routine preoperative electrocardiography was considered to be low. The evidence suggested that when a previous tracing exists preoperative electrocardiography is most clearly indicated for patients who are 60 years of age or older or whose previous tracing exhibited abnormalities. However, further research is required to develop more sensitive and specific protocols, and to evaluate the role of repeat electrocardiography in clinical decision-making.

Cost-Benefit Analysis↗
PubMed1978

Temporal patterns in the use of health services leading to cholecystectomy: a process evaluation using insurance records.

Data from Saskatchewan's public medical and hospital insurance programs are used to estimate a multivariate model of health services utilization among cholecystectomy patients. A methodology is developed which partitions the care process into an assessment period, a waiting period, and a hospitalization period. The general hypothesis is that presurgical and surgical decisions of physicians are influenced by extra-medical factors, including the social condition of the patient and the availability of health resources. This hypothesis is only weakly supported by the data.

Adult↗