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- Arrelöv, B, et al.
(författare)
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The influence of change of legislation concerning sickness absence on physicians' performance as certifiers : A population-based study
- 2003
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Ingår i: Health Policy. - 0168-8510 .- 1872-6054. ; 63:3, s. 259-268
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, a change of the legislation for sickness absence became effective on 1st October, 1995. The purpose of the change was to reduce costs for sickness absence by exclusion of non-medical criteria for sick-listing, more part-time sick-listing and faster rehabilitation. This study was conducted in order to describe and analyse certification practice of various physician categories, before and after the change in legislation. Thirty-one thousand seven hundred and thirty certificates for sickness absence, collected by the local offices of the National Social Insurance Board in eight Swedish counties, fulfilled the inclusion criteria. The number of certificates decreased temporarily. The number of certified net days, i.e. crude days multiplied by degree, tended to increase and there was no shift from full to partial sick-listing during the period. There were small changes regarding case mix, i.e. patient characteristics, and sick-listing physician category. The results were almost unchanged when these small changes were taken into account. General practitioners issued significantly shorter periods of sick-leave than the other categories both years. The goals of the legislative change were thus not met. The result of the study indicates that other factors than the legislation may be more important for physicians' practice. ⌐ 2002 Elsevier Science Ireland Ltd. All rights reserved.
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| 4. |
- Blumenschein, Karen, et al.
(författare)
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An experimental test of question framing in health state utility assessment
- 1998
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Ingår i: Health policy (Amsterdam). - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 45:3, s. 187-193
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Tidskriftsartikel (refereegranskat)abstract
- In the standard gamble and time trade-off methods of health state utility assessment, a specified health state and an alternative are compared. This alternative can be framed in terms of a loss or a gain in reference to the first health state. In this paper, we test whether this framing affects the estimated health state utilities. The experiment was carried out on a group of pharmacy students, randomly divided between the loss or gain version ( n=182). The null hypothesis of no difference between the loss and gain versions is rejected for the standard gamble method, but not for the time trade-off method.
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| 5. |
- Blumenschein, Karen, et al.
(författare)
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Incorporating quality of life changes into economic evaluations of health care: an overview
- 1996
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Ingår i: Health policy (Amsterdam). - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 36:2, s. 155-166
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Tidskriftsartikel (refereegranskat)abstract
- The demand for economic evaluations of health care programs, especially pharmaceuticals, is steadily increasing. One of the most important issues in this field is how to measure, value and incorporate changes in quality of life into the economic evaluation. We provide an overview of the different approaches to measure changes in quality of life: quality of life instruments, the quality-adjusted life-year (QALY) approach and the willingness to pay approach. Quality of life instruments have major practical advantages since they are easy to administer. The results of these instruments cannot, however, be used in economic evaluations. In economic evaluations, the quality of life has to be measured on the 0 (death) to 1 (full.health) scale necessary to construct QALYs, or the willingness to pay for the change in quality of life has to be measured. Such measurements are, however, much less straightforward to carry out. It would therefore be a major advance if it would be possible to directly translate the quality of life score into a QALY weight or the willingness to pay. It is recommended that more systematic research should be carried out on the relationship between quality of life, QALY weights, and willingness to pay.
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| 8. |
- Burström, Kristina, et al.
(författare)
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Health-related quality of life by disease and socio-economic group in the general population in Sweden
- 2001
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Ingår i: Health policy (Amsterdam). - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 55:1, s. 51-69
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Tidskriftsartikel (refereegranskat)abstract
- Measuring health-related quality of life (HRQoL) on population level, is becoming increasingly important for priority setting in health policy. In the health economics field, it is common to measure HRQoL in terms of health-state utilities or QoL weights. This study investigates the feasibility of obtaining mean QoL weights by mapping survey data to the generic HRQoL measure EQ-5D and to describe the HRQoL in terms of mean QoL weights in certain disease and socio-economic groups. Data from the 1996–1997 Survey of Living Conditions, interviews with a representative sample (16–84 years) of the Swedish population (n=11 698) were used. The mean QoL weight decreased from 0.91 among the youngest to 0.61 among the oldest, and was lower for women than for men. The QoL weight was 0.88 in the highest socio-economic group and 0.78 in the lowest socio-economic group. The QoL weight was lowest (0.38) among persons with depression and highest among persons with hypertension (0.71). The QoL weight decreased from 0.95 for persons with very good global self-rated health to 0.20 for persons with very poor global self-rated health. The results support the feasibility and validity of the mapping approach. HRQoL varies greatly between socio-economic groups and different disease groups.
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| 9. |
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| 10. |
- Dong, Hengjin, et al.
(författare)
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Association between health insurance and antibiotics prescribing in four counties in rural China
- 1999
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Ingår i: Health Policy. - 0168-8510 .- 1872-6054. ; 48:1, s. 29-45
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Tidskriftsartikel (refereegranskat)abstract
- A cross-sectional study was carried out at county, township and village health care facilities in four counties in rural China in order to describe and compare the effects of health financing systems on antibiotic prescribing in outpatient care. A total of 1232 outpatients at the health care facilities was selected by multi-stage random sampling and were interviewed over 2 weeks. The results showed that health financing systems appeared to influence antibiotic prescribing in outpatient care, both in terms of frequency and of the types prescribed. The insured group had lower prescribing of antibiotics at township and village health care facilities, and for respiratory tract infections, but had higher prescribing of newer antibiotics at county and village health care facilities, for respiratory tract and g-i infections. Because there was a high patient compliance rate (94.3%) in this study the prescribing of antibiotics (supply side behavior) reflected the use of antibiotics (demand side behavior) to a great extent. Thus the results imply that antibiotics prescribing and using might be biased by the patient's health financing systems and antibiotic prescribing was the result of the interaction between physicians and patients.
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