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- Forberg, Jakob L., et al.
(författare)
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Negative predictive value and potential cost savings of acute nuclear myocardial perfusion imaging in low risk patients with suspected acute coronary syndrome : A prospective single blinded study
- 2009
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Ingår i: BMC Emergency Medicine. - 1471-227X. ; 9:12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies from the USA have shown that acute nuclear myocardial perfusion imaging (MPI) in low risk emergency department (ED) patients with suspected acute coronary syndrome (ACS) can be of clinical value. The aim of this study was to evaluate the utility and hospital economics of acute MPI in Swedish ED patients with suspected ACS. Methods: We included 40 patients (mean age 55 ± 2 years, 50% women) who were admitted from the ED at Lund University Hospital for chest pain suspicious of ACS, and who had a normal or non-ischemic ECG and no previous myocardial infarction. All patients underwent MPI from the ED, and the results were analyzed only after patient discharge. The current diagnostic practice of admitting the included patients for observation and further evaluation was compared to a theoretical "MPI strategy", where patients with a normal MPI test would have been discharged home from the ED. Results: Twenty-seven patients had normal MPI results, and none of them had ACS. MPI thus had a negative predictive value for ACS of 100%. With the MPI strategy, 2/3 of the patients would thus have been discharged from the ED, resulting in a reduction of total hospital cost by some 270 EUR and of bed occupancy by 0.8 days per investigated patient. Conclusion: Our findings in a Swedish ED support the results of larger American trials that acute MPI has the potential to safely reduce the number of admissions and decrease overall costs for low-risk ED patients with suspected ACS.
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| 3. |
- Hjalte, Krister, et al.
(författare)
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Dags att subventionera rökning?
- 1991
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Ingår i: Ekonomisk Debatt. - 0345-2646. ; 19, s. 423-429
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 5. |
- Hjalte, Krister, et al.
(författare)
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Health-health analysis - An alternative method for economic appraisal of health policy and safety regulation Some empirical Swedish estimates
- 2003
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Ingår i: Accident Analysis and Prevention. - 1879-2057. ; 35:1, s. 37-46
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Tidskriftsartikel (refereegranskat)abstract
- Health-health analysis (HHA) focuses on statistical lives themselves as a numeraire. The underlying principle is that the expected gains in health and safety of reduced risks in one area may result in increasing risks somewhere else in society. By reducing one risk other risks may increase due to changed individual behaviour. In addition to this direct effect, another indirect effect will also be present. Expenditure on a particular health policy or safety regulation must be financed in one way or another. which will result in an opportunity cost or income effect leaving less resources for other health and safety promoting activities in society. Thus, we will have an effect that reduces safety and health benefits induced by that income loss. Whether the total net health effect from a specific safety regulation or health policy is positive or negative must be empirically analysed. One way of estimating the income loss that induces one death, which we call the value of an induced death (VOID), is to estimate it as a multiple of the traditional value to avert a statistical death, also named the value of a statistical life (VOSL). A contingent valuation (CV) study eliciting the willingness-to-pay (WTP) for reducing the overall risk of dying was performed as a postal questionnaire in Sweden in 1998. By use of data from this study, it was possible to estimate the VOID and the VOSL in Sweden amounting to SEK116 and SEK20.8 million respectively, indicating that the net health result confined to mortality effects, will be negative (more lives will be lost than saved) if a health policy or safety regulation will cost more than SEK116 million per life saved.
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