PubMed Health⌕ Search

Biomedical subjects

K G Brege

Publications and source records attributed to K G Brege.

9 recordsLinked to original sources
PubMed2002

Cataract surgery and quality of life in patients with age related macular degeneration.

BACKGROUND: The coexistence of cataract and age related macular degeneration (AMD) is not unusual, especially in the very elderly. The outcome of cataract surgery in these cases depends on the effect of AMD on vision. In this study the authors have compared the outcome of cataract patients with AMD to that of cataract patients with no vision threatening ocular comorbidity, and analysed possible predictors of good or poor outcome. METHODS: An observational prospective study on consecutive cases operated for cataract during 1 month at six surgical departments affiliated to the Swedish National Cataract Register (NCR). Data were collected according to the protocol of NCR and subjects completed the Catquest questionnaire before and 6 months after surgery. 90 subjects with AMD were compared to 335 subjects with no sight threatening ocular comorbidity. RESULTS: Difficulties in performing various daily life activities improved significantly for AMD subjects after surgery (p<0.001, Wilcoxon signed rank test). Satisfaction with vision also improved significantly after surgery (p<0.001, Wilcoxon signed rank test). Activity level and independence were unchanged. Subjects with no ocular comorbidity had a still better outcome. The most important variable related to a good self assessed functional outcome was postoperative visual acuity irrespective of the presence of AMD. AMD subjects scheduled for second eye surgery and AMD subjects dissatisfied with their vision before surgery had a poorer outcome. CONCLUSION: Subjects with various stages of dry AMD and cataract improved their self assessed visual function and satisfaction with vision significantly after cataract extraction.

Activities of Daily Living↗
PubMed2001

[Patient based care registries as a tool to follow up services].

The Federation of Swedish County Councils and six medical specialties are working together in a project aiming to support and stimulate the development of patient based case registers as a tool to follow up, evaluate, develop and manage medical units. The project is based on participation on the part of the medical professions in a process-oriented way. Each case register shall be based on the individual patient, and will integrate inpatient and outpatient care, all medical professions and important procedures. In hematology the project also seeks to merge case costing data with the patient based case registers in order to facilitate more comprehensive cost analysis and comparison. This episodic perspective is useful for providers per se as well as in discussions between purchasers and providers as a method for understanding and analyzing medical services. The six specialties are hematology, obstetrics and gynecology, ophthalmology, otorhinolaryngology, dermatology and sexually transmitted diseases, and lastly psychiatry.

Databases, Factual↗
PubMed2001

Cataract surgery and effectiveness. 2. An index approach for the measurement of output and efficiency of cataract surgery at different surgery departments.

PURPOSE: To describe a model for comparing the performance of cataract surgery among ophthalmology departments in terms of economic efficiency. METHODS: An index approach for the measurement of outcome of cataract surgery is modeled. The index approach uses information about activities and difficulties in daily life as well as visual acuity and age. The change in activities and difficulties after surgery is expressed by changes in distances, and an overall index score is calculated as ratios of values to distances. Values to distances are estimated as solutions to linear programming problems. Index scores are calculated for two groups of patients, those with an ocular co-morbidity and those without. Economic efficiency is also estimated by use of an index approach. In the estimation of efficiency we use the calculated index scores of outcome of surgery as a measure of output of the ophthalmology department. Four different departments providing cataract surgery are compared. RESULTS: The studied departments showed differences to a great extent when traditional measures of cataract surgery outcomes were used. These differences changed when the outcomes were compared by use of index scores. When economic efficiency was calculated the difference between the departments was further reduced and only one department was considered inefficient according to the model. CONCLUSION: An index approach was used to study outcomes of cataract surgery and economic efficiency in four departments. This approach takes into account the complexity of cost in relation to feasible outcome. The ranking between the departments described by traditional methods turned out differently using the model.

Cataract Extraction↗
PubMed2000

Impaired visual function after cataract surgery assessed using the Catquest questionnaire.

PURPOSE: To evaluate and explain why some patients report more difficulties performing everyday activities 6 months after a cataract extraction than they did before surgery. SETTING: Cataract surgeons from 4 departments of ophthalmology affiliated with the National Swedish Cataract Outcome Register. METHODS: Patients were recruited from those having cataract extraction during March 1995, 1996, or 1997 at the participating units. Only patients who completed Catquest questionnaires before and after surgery and were evaluated to have a "no-benefit" outcome were included. The no-benefit outcomes were analyzed by using medical records and surgeon opinions. Possible and/or probable reasons for the outcome were identified. RESULTS: Several possible and/or probable reasons were identified as a single reason or combined with other reasons. The 5 most frequent reasons were ocular co-morbidity in the operative eye, anisometropia after surgery, problems with the nonoperative eye during follow-up, low disability score sum before surgery (no difficulties), and postoperative complications. CONCLUSION: In about a third of the cases, the no-benefit outcome could probably have been avoided by better planning for both eyes; that is, both eyes should have surgery within a short time and waiting for second-eye surgery in cases with anisometropia should be avoided.

Activities of Daily Living↗
PubMed2000

Cataract surgery and effectiveness. 1. Variation in costs between different providers of cataract surgery.

PURPOSE: To describe and analyse the cost of cataract surgery in four community-run eye clinics in Sweden and also to analyse differences in cost between these clinics. METHODS: The average cost of a cataract surgery episode was calculated including one pre-operative visit, the surgery itself and the post-operative visits. Included in the analysis were the costs of disposables, personnel, rent, depreciation, general anaesthesia, bed days and education. Excluded were the costs of complications and overhead costs. RESULTS: The average cost for one cataract surgery episode was 5052/6915 SEK (1 Euro = 8.57 SEK) with a variation from 4436/6202 to 6130/8293 between the clinics. The lower sum represents a minimum cost of personnel, the higher sum a maximum cost. CONCLUSION: A large variation in costs of cataract surgery was found in four providers of cataract surgery. Nearly all clinics studied had one or more areas with much higher costs than average.

Cataract Extraction↗