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- Philipsson, Anna, 1978-, et al.
(författare)
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Cost-utility analysis of a dance intervention for adolescent girls with internalizing problems
- 2013
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Ingår i: Cost Effectiveness and Resource Allocation. - : Springer Science and Business Media LLC. - 1478-7547. ; 11:1, s. 4-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The increasing prevalence of psychological health problems among adolescent girls is alarming. Knowledge of beneficial effects of physical activity on psychological health is widespread. Dance is a popular formof exercise that could be a protective factor in preventing and treating symptoms of depression. The aim of thisstudy was to assess the cost-effectiveness of a dance intervention in addition to usual school health services foradolescent girls with internalizing problems, compared with usual school health services alone.Methods: A cost-utility analysis from a societal perspective based on a randomized controlled intervention trial wasperformed. The setting was a city in central Sweden with a population of 130 000. A total of 112 adolescent girls, 13–18 years old, with internalizing problems participated in the study. They were randomly assigned to intervention (n =59) or control (n = 53) group. The intervention comprised dance twice weekly during eight months in addition to usualschool health services. Costs for the stakeholder of the intervention, treatment effect and healthcare costs wereconsidered. Gained quality-adjusted life-years (QALYs) were used to measure the effects. Quality of life was measuredwith the Health Utility Index Mark 3. Cost-effectiveness ratios were based on the changes in QALYs and net costs forthe intervention group compared with the control group. Likelihood of cost-effectiveness was calculated.Results: At 20 months, quality of life had increased by 0.08 units more in the intervention group than in the controlgroup (P = .04), translating to 0.10 gained QALYs. The incremental cost-effectiveness ratio was USD $3,830 per QALYand the likelihood of cost-effectiveness was 95%.Conclusions: Intervention with dance twice weekly in addition to usual school health services may be consideredcost-effective compared with usual school health services alone, for adolescent girls with internalizing problems.
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| 2. |
- Hagberg, Lars, 1956-, et al.
(författare)
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What is the time cost of exercise? Cost of time spent on exercise in a primary health care intervention to increase physical activity
- 2020
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Ingår i: Cost Effectiveness and Resource Allocation. - : Springer Science and Business Media LLC. - 1478-7547. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background In health care interventions aimed at increased physical activity, the individual's time spent on exercise is a substantial input. Time costs should therefore be considered in cost-effectiveness analyses. The aim of this study was to estimate the cost of time spent on exercise among 333 primary health care patients with metabolic risk factors receiving physical activity on prescription. Methods Based on a theoretical framework, a yardstick was constructed with experience of work (representing claim of salary as compensation) as the lower anchor-point, and experience of leisure activity forgone due to extended exercise time (no claim) as the higher anchor-point. Using this yardstick experience of exercise can be valued. Another yardstick was constructed with experience of cleaning at home in combination with willingness to pay for cleaning as the lowest anchor-point. Results The estimated costs of exercise time were between 14 and 37% of net wages, with physical activity level being the most important factor in determining the cost. Among sedentary individuals, the time cost was 21-51% of net wages while among individuals performing regular exercise it was 2-10%. When estimating the cost of time spent on exercise in a cost-effectiveness analysis, experience of exercise, work, leisure activity forgone, and cleaning at home (or other household work that may be relevant to purchase) should be measured. The individual's willingness to pay for cleaning at home and their net salary should also be measured. Conclusions When using a single valuation of cost of time spent on exercise in health care interventions, for employed participants 15-30% of net salary should be used. Among unemployed individuals, lower cost estimation should be applied. Better precision in cost estimations can be achieved if participants are stratified by physical activity levels. Trial registration The study was conducted as a survey of existing clinical physical activity on prescription work, and was approved by the Regional Ethical Review Board in Gothenburg, Sweden (ref: 678-14)
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| 3. |
- Jansson, Markus, 1982-, et al.
(författare)
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Cost-effectiveness of antibiotic prophylaxis in elective cesarean section
- 2018
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Ingår i: Cost Effectiveness and Resource Allocation. - : BMC. - 1478-7547. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: The proportion of pregnant women delivered by cesarean section has increased steadily during the past three decades. The risk of infection is 10-fold augmented after elective cesarean section compared to vaginal delivery. Antibiotic prophylaxis may reduce endometritis by 62% and superficial wound infection by 38% after elective cesarean section. International guidelines recommend antibiotic prophylaxis in elective cesarean section, but this procedure is not routinely followed in Sweden. Studies of costs of antibiotic prophylaxis in cesarean section show conflicting results and are based on substantially different incidence of postoperative infections. No study of costs of antibiotic prophylaxis in elective cesarean section in a Swedish or Nordic context has been pursued. The aim of this study was to investigate if antibiotic prophylaxis is cost-reducing in elective cesarean section in orebro County, Sweden.Methods: All women undergoing elective cesarean in the Region orebro County health care system during 2011-2012 were eligible for inclusion. Postoperative infections and risk factors for infections were registered. A hypothetical situation in which all participants had received antibiotic prophylaxis was compared to the actual situation, in which none of them had received antibiotic prophylaxis. The reduction in the risk of postoperative infections resulting from antibiotic prophylaxis was based on a meta-analysis. Costs for in-patient care of postoperative infections were extracted from the accounting system, and costs for out-patient care were calculated according to standard costs. Costs for antibiotic prophylaxis were calculated and compared with the cost reduction that would be implied by the introduction of such prophylaxis.Results: The incidences of deep and superficial surgical site infection were 3.5% and 1.3% respectively. Introduction of antibiotic prophylaxis would reduce health care costs by 31 Euro per cesarean section performed (95% credible interval 4-58 Euro). The probability of cost-saving was 99%.Conclusions: Antibiotic prophylaxis in elective cesarean section is cost-reducing in this health care setting. Our results indicate that the introduction of antibiotic prophylaxis in elective cesarean section can also be cost-saving in low infection rate settings.Trial registration Ethical approval was given by the Regional Ethical Review Board in Uppsala (registration number 2013/484).
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