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Biomedical subjects

M Konttinen

Publications and source records attributed to M Konttinen.

10 recordsLinked to original sources
PubMed2000

Health technology assessment in Finland.

Finland has a long tradition of supporting social programs that promote equality and the welfare state. The healthcare system is financed mainly by taxation. Everyone is insured against illness. Each of Finland's five provinces is run by a provincial government that monitors the provision of social welfare and health care. However, the municipalities actually provide the services and regulate medical equipment and regionalization of services. During the early 1990s, gross domestic product (GDP) fell dramatically, and healthcare expenditure rose to 9.4% of GDP. Due to the economy's rapid recovery, the share of healthcare expenditure has again decreased and now matches the average level of OECD countries of approximately 7.7%. The former Finnish method of central planning and norm setting has guaranteed a fairly uniform development of necessary services throughout the country and free or low-cost access. Tight central planning did not, however, create incentives to contain costs. Therefore, in the beginning of the 1990s, decision-making power was largely decentralized to the municipalities, and the principles of state subsidies were reformed. In 1995, the Finnish Office for Health Care Technology Assessment (FinOHTA) was set up as a new unit of the National Research and Development Centre for Welfare and Health (STAKES). FinOHTA is intended to function as a national central body for advancing HTA-related work in Finland, with the ultimate goal of promoting the effectiveness and efficiency of Finnish health care. At present, the importance of HTA is widely recognized in Finland, especially in the face of rising healthcare costs.

Adolescent↗
PubMed1986

Hospital cost development in coronary bypass surgery.

The rapid expansion of open-heart surgery together with steadily rising costs of health services has elicited criticism against uncontrollably expanded costs of coronary bypass surgery. However, critical analyses of the cost structures and the attempts for cost containment can only rarely be found in medical literature. This study emphasizes self-evident surgical principles which have led to surprisingly high cost reductions. Further savings can be obtained by constant financial education of the surgical staff, in spite of some controversial experiences gained elsewhere. The conditions needed are more accurate, up-to-date hospital bookkeeping and closer contacts between the hospital administration and the medical staff.

Coronary Artery Bypass↗
PubMed1985

Direct hospital costs in coronary bypass surgery.

The direct hospital costs of 100 coronary artery bypass grafting operations are calculated. The basis of the calculations is the detailed, function-based, market-priced analysis of the files, including the hospital deaths, complication and reoperations of this patient group. The price of a CABG operation proved to lie somewhere between FIM 30,000 and 50,000, the mean value being FIM 46,800. The variation range is wide: FIM 18,200-FIM 249,500 (SD +/- FIM 26,000). It must be emphasized, however, that all preoperative hospital costs including coronary angiography costs and also postoperative follow-up hospital costs fall beyond this study.

Coronary Artery Bypass↗
PubMed1984

Unexpected urethral strictures after short-term catheterization in open-heart surgery.

Urethral stricture was found in 59 of 478 male patients who had undergone open-heart surgery between June 79 and December 81. In 40/59 cases the stricture showed a string-of-pearls configuration or long narrowing of the penile urethra on the urethrogram. Burning pain and dysuria were the main symptoms, and the urinary stream started to weaken immediately after the removal of the siliconized latex catheter which had been routinely inserted at the time of the heart operation and usually kept indwelling for 3 days. The stricture epidemic stopped after change of the latex catheters to silicone-ones. The different catheters were investigated for cell toxicity. Eluates of catheters were added at different concentrations to cultures of various cell lines. The cell proliferation was measured by thymidine incorporation. The results were uniform and showed marked toxicity of the latex catheters against all investigated cell lines.

Cardiac Surgical Procedures↗
PubMed1984

Suprapubic cystostomy catheterization in open-heart surgery.

Monitoring of the urinary output is mandatory during open-heart surgery and in the immediate postoperative period. During 1980-81 we noticed an alarming rise in the number of post-catheterization urethral strictures affecting men who had undergone open-heart surgery. To avoid this serious complication, we switched from conventional urethral catheterization to suprapubic cystostomy for these patients. The first 93 cases with suprapubic drainage have now been analysed as regards the advantages and complications of this technique. The advantages were clear: The patients were satisfied with the method and no urethral strictures developed. The only side effect was haematuria, which in 9 cases led to occlusion of the catheter and required extraneous maneouvres. Suprapubic cystostomy thus seems to be a good alternative to conventional urethral catheterization in open-heart surgery. The possible causes of the urethral complications in this particular group of patients also are discussed.

Cardiac Surgical Procedures↗
PubMed1983

Fistula between abdominal aortic aneurysm and left renal vein.

A 77-year-old man with spontaneous rupture of an abdominal aortic aneurysm into the left renal vein, in the presence of an anomalous retroaortic left renal vein is described. The patient was operated and recovered without complications. In the previous literature seven similar cases were found.

Aged↗