| 1. |
- Cardell, Lars-Olaf, et al.
(författare)
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TOTALL: high cost of allergic rhinitis-a national Swedish population-based questionnaire study.
- 2016
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Ingår i: NPJ primary care respiratory medicine. - : Springer Science and Business Media LLC. - 2055-1010. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- Allergic rhinitis is a global illness with a well-recognised impact on quality of life and work performance. Comparatively little is known about the extent of its economic impact on society. The TOTALL study estimates the total cost of allergic rhinitis using a sample representing the entire Swedish population of working age. A questionnaire focused on allergic rhinitis was mailed out to a random population of Swedish residents, aged 18-65 years. Health-care contacts, medications, absenteeism (absence from work) and presenteeism (reduced working capacity at work) were assessed, and the direct and indirect costs of allergic rhinitis were calculated. Medication use was evaluated in relation to the ARIA guidelines. In all, 3,501 of 8,001 (44%) answered the questionnaire, and 855 (24%) of these reported allergic rhinitis. The mean annual direct and indirect costs because of allergic rhinitis were €210.3 and €750.8, respectively, resulting in a total cost of €961.1 per individual/year. Presenteeism represented 70% of the total cost. Antihistamines appear to be used in excess in relation to topical steroids, and the use of nasal decongestants was alarmingly high. The total cost of allergic rhinitis in Sweden, with a population of 9.5 million, was estimated at €1.3 billion annually. These unexpectedly high costs could be related to the high prevalence of disease, in combination with the previously often underestimated indirect costs. Improved adherence to guidelines might ease the economic burden on society.
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| 2. |
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| 3. |
- Hjortsberg, Catharina, et al.
(författare)
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Are Treatment Satisfaction, Quality of Life, and Self-assessed Disease Severity Relevant Parameters for Patient Registries? Experiences from Finnish and Swedish Patients with Psoriasis.
- 2011
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 91, s. 409-414
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Tidskriftsartikel (refereegranskat)abstract
- Patient registries often lack indicators of the disease as experienced by patients, e.g. treatment satisfaction and self-assessed disease severity. There is scarce information about the relationship between these assessments and currently existing instruments used in treatment evaluation. Our objective was to explore the importance of these indicators among patients with psoriasis in Finland and Sweden, in relation to treatment patterns and current measures of health-related quality of life. Data were collected from a patient survey and a retrospective chart review for 273 patients over 12 months. To assess psoriasis treatment completely, it is necessary to consider the impact of the disease on the patient in terms of treatment satisfaction, disease severity and health-related quality of life. The individual disease burden on patients should play a central role in formulating treatment goals. Clinician- and patient-based perspectives of the overall impact of psoriasis can assist clinical decision-making and evaluations of treatments.
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| 4. |
- Lanbeck, Peter, et al.
(författare)
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A cost analysis of introducing an infectious disease specialist-guided antimicrobial stewardship in an area with relatively low prevalence of antimicrobial resistance
- 2016
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobial resistance as well as societal economics are uncertain. Methods: We performed a cost analysis of an antimicrobial stewardship program introduced in Malmö, Sweden in 20 weeks 2013 compared with a corresponding control period in 2012. All direct costs and opportunity costs related to the stewardship intervention were calculated for both periods. Costs during the stewardship period were directly compared to costs in the control period and extrapolated to a yearly cost. Two main analyses were performed, one including only comparable direct costs (analysis one) and one including comparable direct and opportunity costs (analysis two). An extra analysis including all comparable direct costs including costs related to length of hospital stay (analysis three) was performed, but deemed as unrepresentative. Results: According to analysis one, the cost per year was SEK 161 990 and in analysis two the cost per year was SEK 5 113. Since the two cohorts were skewed in terms of size and of infection severity as a consequence of the program, and since short-term patient outcomes have been demonstrated to be unchanged by the intervention, the costs pertaining to patient outcomes were not included in the analysis, and we suggest that analysis two provides the most correct cost calculation. In this analysis, the main cost drivers were the physician time and nursing time. A sensitivity analysis of analysis two suggested relatively modest variation under changing assumptions. Conclusion: The total yearly cost of introducing an infectious disease specialist-guided, audit-based antimicrobial stewardship in a department of internal medicine, including direct costs and opportunity costs, was calculated to be as low as SEK 5 113.
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| 5. |
- Norrlid, Hanna, et al.
(författare)
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Cost-effectiveness of maintenance treatment with a barrier-strengthening moisturizing cream in patients with atopic dermatitis in Finland, Norway and Sweden
- 2016
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 96:2, s. 173-176
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Tidskriftsartikel (refereegranskat)abstract
- Atopic dermatitis is a chronic skin disorder with high prevalence, especially in the Nordic countries. Effective maintenance therapy during symptom-free episodes may prolong the time to eczema relapse according to a previously published clinical trial. The present study evaluates the cost-effectiveness of a barrier-strengthening moisturizer containing 5% urea, compared with a moisturizer with no active ingredients during eczema-free periods. A health economic microsimulation model, based on efficacy data from a randomized clinical trial, analysed the cost-effectiveness of the barrier-strengthening treatment in Finland, Norway and Sweden. The barrier-strengthening moisturizer was cost-saving compared with the moisturizer with no active ingredients in all 3 countries. The result was confirmed in all but 1 sensitivity analysis. In conclusion, the barrier-strengthening moisturizer is cost-effective as maintenance therapy for patients with atopic dermatitis compared with a moisturizer with no active ingredients.
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| 6. |
- Pickwell, Kristy, et al.
(författare)
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Predictors of Lower-Extremity Amputation in Patients With an Infected Diabetic Foot Ulcer.
- 2015
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 38:5, s. 852-857
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Tidskriftsartikel (refereegranskat)abstract
- Infection commonly complicates diabetic foot ulcers and is associated with a poor outcome. In a cohort of individuals with an infected diabetic foot ulcer, we aimed to determine independent predictors of lower-extremity amputation and the predictive value for amputation of the International Working Group on the Diabetic Foot (IWGDF) classification system and to develop a risk score for predicting amputation.
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| 7. |
- Ragnarson Tennvall, Gunnel, et al.
(författare)
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Annual costs of treatment for venous leg ulcers in Sweden and the United Kingdom
- 2005
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Ingår i: Wound Repair and Regeneration. - : Wiley. - 1524-475X .- 1067-1927. ; 13:1, s. 13-18
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to estimate costs of treating venous leg ulcers in Sweden and the United Kingdom during 1 year and to quantify costs in different health states, The costs of treating four different types of venous leg ulcers were estimated for 52 weeks by a stochastic health economic model, which simulated resource use data obtained from prospectively collected patient data, expert panels in the two countries, and published scientific. literature, The average cost of treating an ulcer varied between E 1332 and E2585 in Sweden and from E814 to E1994 in the United Kingdom. Cost of treating large ulcers (greater than or equal to10 cm(2)) of long duration (greater than or equal to6 months) was highest in both countries. Frequency of dressing changes and duration of time for each dressing change were higher in Sweden than in the United Kingdom, resulting in higher total cost per patient in Sweden. An important factor for the total costs was time to heal. Other important variables influencing treatment costs were frequency and duration of dressing changes, Actions to reduce time used for dressing changes and the total time to healing are thus very important in reducing costs spent on treatment of venous leg ulcers in both countries.
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| 8. |
- Ragnarson Tennvall, Gunnel, et al.
(författare)
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Health-economic consequences of diabetic foot lesions.
- 2004
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Ingår i: Clinical Infectious Diseases. - 1537-6591. ; 39 Suppl 2, s. 9-132
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedDiabetic foot complications result in huge costs for both society and the individual patients. Few reports on the health-economic consequences of diabetic foot infections have been published. In studies considering a wide societal perspective, costs of antibiotics were relatively low, whereas total costs for topical treatment were high relative to the total costs of foot infections. Total direct costs for healing of infected ulcers not requiring amputation are similar to$17,500 (in 1998 US dollars), whereas the costs for lower-extremity amputations aresimilar to$30,000-$33,500 depending on the level of amputation. Prevention of foot ulcers and amputations by various methods, including patient education, proper footwear, and foot care, in patients at risk is cost effective or even cost saving. Awareness of the potential influence of reimbursement systems on prevention, management, and outcomes of diabetic foot lesions has increased. Despite methodological obstacles, modeling studies are needed in future health-economic evaluations to determine the cost effectiveness of various strategies.
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| 9. |
- Ragnarson Tennvall, Gunnel, et al.
(författare)
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Health related quality of life in patients with actinic keratosis - an observational study of patients treated in dermatology specialist care in Denmark.
- 2015
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Actinic keratosis (AK) is a common skin condition that may progress to non-melanoma skin cancer (NMSC). The disease may influence Health Related Quality of Life (HRQoL), but studies of HRQoL in patients with AK are limited. The purpose of the study was to analyze HRQoL in patients with different severity levels of AK treated in dermatology specialist care using generic and disease-specific HRQoL instruments and to analyze their relationship.
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| 10. |
- Ragnarson Tennvall, Gunnel
(författare)
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The Diabetic Foot. Costs, health economic aspects, prevention and quality of life.
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aims were to investigate the economic consequences of foot complications in diabetic patients, to measure the influence of diabetic foot complications on health-related quality of life (HRQL), and to analyse the cost-effectiveness of interventions to prevent foot ulcers and lower extremity amputations (LEA). The economic consequences of foot ulcers and LEA are large both in a short and a longer perspective. Seventy-six percent of the total short term costs for LEA occurred after amputations had been performed and before complete healing had been achieved. The major long-term costs for the 3 years following healing were related to increased home care and social service, especially for patients who had undergone LEA. The most important determinants of the cost of an ulcer with deep foot infection were wound healing duration and repeated surgery. Costs of inpatient care and topical treatment represent a substantial part of the total costs for both primary healing and healing with minor or major amputation. The frequency of dressing changes and velocity of healing together with costs of material, staff and transportation are important factors for the total topical treatment costs. The Swedish Inpatient Registry is valid regarding completeness of registered discharges for patients who have been treated for foot ulcers, but the database is less valid with reference to reported diagnoses. Cost analyses of diabetic foot complications will be seriously underestimated when based exclusively on primary diagnosis from the database. Patients with current foot ulcers value their HRQL significantly lower than primary healed patients. HRQL is reduced in patients who have undergone major amputations. An intensified prevention strategy including patient education, foot care and footwear is cost-effective or cost saving if the risk for foot ulcers and lower extremity amputations could be reduced by 25%. The strategy would be cost-effective or cost saving in all patients with diabetes, except in those without specific risk factors for development of these complications.
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