摘要:

AbstractIn this paper, the principles of costing health care for economic evaluation are outlined. Hypothetical and published examples are used to illustrate these principles. First, the economic concept of opportunity cost is defined. Secondly, the techniques of economic evaluation which follow from this definition are introduced: they are cost‐benefit analysis, cost‐effectiveness analysis and cost‐utility analysis. Thirdly, a list of costs which should be considered for inclusion in either of these types of evaluation is provided, this listing being based on the concept of opportunity cost. Problems of measurement and valuation of costs are then outlined, focusing in particular on inflation, discounting, marginal costing, patient‐based versus per diem costing, allocating overheads, costing capital and equipment and adjusting distorted market valuations. An example of sensitivity analysis is provided and also a checklist of questions to ask when setting up any costing exercise within an economic eva

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00045.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThe aim of this study was to examine the effectiveness of general practitioner‐written invitations to the Breast X‐Ray Programme of the Central Sydney Area Health Service. Five out of six randomly selected general practices in Drummoyne participated. Within each practice, women aged 45 to 70 were individually randomised to receive or not receive a letter from their general practitioner (GP). Thirty‐two per cent of women attended if invited compared to 7 per cent if they were not sent an invitation. An attendance of 38 per cent was obtained for women whose GP chose to send a letter with an appointment compared to 24 per cent for women whose GP chose to send a general invitation without an appointment. Combining all practices, women who consulted their GP within the previous 6 months were more likely to attend in response to the invitation (38 per cent) than women whose last consultation was more remote, dropping to 15 per cent in those who last attended that GP over 2 years earlier. Women aged 65 to 70 years old were at least as likely to respond to the invitation as women aged 45 to 64. Reminder letters were subsequently sent to a random half of non‐respondents who had attended the practice in the previous 12 months. A further 18 per cent of women attended after the reminder letter was sent (8/45), compared with 2 per cent in the control group (1/48). Twenty‐seven per cent of women in Drummoyne had already attended for screening mammography before the trial. Two invitations with appointments from GPs had the potential to attract 49 per cent of the remaining women, resulting in 63 per cent attendanc

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00046.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThis paper describes the experience of a cohort of elderly patients who were discharged after attending the accident and emergency department of a large Australian teaching hospital. Before‐and‐after comparisons of aspects of physical functioning revealed a considerable loss of independence in the period immediately after the visit to the hospital. Subsequent hospital admission or death was observed in 30 of the 90 patients studied. It is suggested that elderly patients discharged from the accident and emergency department are at risk and require special consideration and a high index of suspicion in terms of evaluation at the time of presentation. Before discharge, account should be taken of aspects of physical and mental function, social networks, and community supports available to each patient. A lowered threshold for admission is recommended on the basis of the high rate of return found in this st

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00047.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractUsing a modification of the distorting camera technique, 50 obese women (body mass index (BMI; kg/m235.1 ± 1.1), 40 obese men (BMI 38.2 ± 1.5) and their respective normal weight controls estimated their body size. The obese women, control women and obese men overestimated their body size, whilst control weight men were accurate. The control men were satisfied with their body size, control women less so and the obese were unsatisfied. Whilst the control women considered themselves overweight (BMI 26.7 ± 0.8 compared to actual BMI 23.1 ± 0.5,P<0.001) their preferred and actual body sizes were identical. There were no differences between obese subjects and controls in the sizes they considered healthy and attractive. The accepted normal size range for a woman was lower than that accepted for men. Older men (both obese and normal weight) accepted larger sizes for women than younger men. These results show that the obese overestimated their body size and supports the notion that there is social pressure on women to strive towards a slimmer ideal, whilst overweight men are more accep

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00048.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract1130 dentists surveyed by mail from Australian capital cities (response rate 80%) answered a questionnaire on knowledge of clinical manifestations of AIDS and HIV, attitudes to treatment and referral of AIDS/HIV patients, infection control practices and personal risk factors for HIV. Despite a third of dentists being willing to treat HIV antibody‐positive patients and 22% being willing to treat AIDS patients, over 50% believe AIDS to be a major problem for dentists, with two thirds claiming that their staff would not treat AIDS patients and 55% believing they would lose patients if word spread that they were treating HIV/AIDS patients. The perhaps irreconcilable tension between variable willingness to treat and the concerns of staff and other patients suggests that a policy of improving the dental referral network among people with AIDS may be in the best interests of the dental health and well‐being of people with A

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00049.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00050.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00051.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Book reviewed in this article:Gillian Fulcher:Disabling Policies? A Comparativ Approach to Education Policy and Disability.Dan Coward:Out of Sight…Sydney's Environmental History 1851–1981.Peter A. West:Understanding the NHS: A Question of Incentives.David Blumenthal, Mark Schlesinger and Pamela Brown Drumheller (eds):Renewing the Promise: Medicare and Its Reform.Walter Willett:Nutritional Epidemiology.Jo Garcia, Robert Kilpatrick and Martin Richards (eds):The Politics of Maternity Care: Services for Childbearing Women in Twentieth‐Century Britain.Paul Barber:Vampires, Burial, and Death: Folklore and Re

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00052.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00053.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY