Death of a child is a very painful experience for parents and remaining siblings who experience physiological and emotional symptoms as described by the parents. There are few reports from the remaining siblings on their physical and emotional health and even less data on their treatments and associated health care costs after sibling loss. The purpose of this study in children who have lost a sibling in the NICU/PICU, ER or those who have been sent home on technology dependent equipment to die, is to compare parents’ and children’s perceptions of the surviving sibling’s health, identify factors related to these perceptions, and describe treatments for the sibling’s physical and mental health at 2 and 4 months after a sibling’s death. Sixty four surviving siblings and their parents reported on the siblings’ mental and overall health. Available treatment charges (visits to the emergency room, physician office, hospitalization, and any health services (mental & physical) since the sibling death were collected from bills and insurance receipts. Cause of child death (acute or chronic) was collected from the deceased child’s hospital record. The relationship between parent and sibling’s perception of the surviving sibling’s health, and anxiety and depression at 2 and 4 months post the death were measured using the Children’s Depression Inventory and the Spence Anxiety Scales. Data were analyzed using: T-Tests, ANOVA, Pearson correlations, frequencies and descriptive statistics. Findings indicated that at 2 and 4 months parent’s perceived their surviving siblings’ health to be better than the child perceived his/her health to be. At 4 months fathers rated the siblings’ health compared to their peers lower than the siblings. Greater child anxiety was related to lower father’s ratings of the child’s health now and compared to peers. Treatments and charges increased from 2 months to 4 months with males having more treatments than females. The majority of the treatments consisted of routine physician visits, non-routine physician visits, emergency room/urgent care visits and counseling. Study findings can help guide healthcare providers and educators in identifying those children that are at high risk for negative health effects after the death of a sibling.

Por causa do aumento expressivo da poluiÃÃo ambiental ocorrido nas Ãltimas dÃcadas, a eutrofizaÃÃo artificial vem recebendo maior atenÃÃo por parte da comunidade cientÃfica e concessionÃrias de saneamento. Devido a esse problema, houve considerÃvel elevaÃÃo nos custos de tratamento da Ãgua para adequar aos padrÃes exigidos pela Portaria do MinistÃrio da SaÃde (2914/2011). O presente trabalho levantou, avaliou e comparou, entre janeiro de 2010 a dezembro de 2012, os custos de produÃÃo de Ãgua na EstaÃÃo de Tratamento de Ãgua (ETA) que abastece a cidade de Maranguape, considerando as captaÃÃes nos aÃudes GaviÃo e Acarape do Meio. Neste contexto, procurou-se o entendimento dos processos atravÃs da analise dos custos com Ãgua bruta, energia elÃtrica, produtos quÃmicos, operaÃÃo e perda de Ãgua nas lavagens dos filtros. A pesquisa mostra que a mÃdia dos custos de produÃÃo de Ãgua na saÃda da ETA à de R$ 0,26/m utilizando como manancial de abastecimento o aÃude Acarape do Meio e R$ 0,44/m quando utilizado o aÃude GaviÃo. Observou-se que estes custos sÃo fortemente influenciados pela diferenÃa das tarifas da Ãgua bruta, sendo o custo da Ãgua vinda do aÃude GaviÃo trÃs vezes maior que a Ãgua do aÃude Acarape do Meio. Observou-se que, apesar de ter uma pior qualidade, o que influencia nas perdas por lavagem e no aumento do consumo de produtos quÃmicos, a Ãgua do aÃude Acarape do Meio permite uma reduÃÃo mÃdia de 66% dos custos de produÃÃo de Ãgua tratada quando comparado com os meses em que a ETA Maranguape à alimentada pelo aÃude GaviÃo. / Because of the significant increase in enviromental pollution that happened in the last decades, the artificial eutrophication has received a bigger attention of cientific comunity and concessionaires sanitation. Because of this problem there was a considerable elevation in the water treatment costs to conform to the standards required by the PortÃria do MinistÃrio da SaÃde (2914/2011). This work showed, evaluated and compered, between january of 2010 and december of 2012, the cost of water production in the EstaÃÃo de Tratamento de Ãgua (ETA) that supplies Maranguape city, considering the catchment in the GaviÃo and Acarape do Meio weirs. In this context, sought to understand the process through analysis of gross water costs, eletric energy, chemicals, operation and loss of water in the wash filters. The reserch shows that the average cost of water production at the exit of the ETA is R$ 0,26/m using as supply fountainhead the Acarape do Meio weir and R$ 0,44/m when used the GaviÃo weir. It was noted that these costs are strongly influenced by the rates of gross water, being the cost of water that came from GaviÃo weir three times bigger than the water of Acarape do Meio weir. It was noted that, despite having a lower quality, what influences in the washing losses and increased consumption of chemicals, the water of Acarape do Meio weir allows an average reduction of 66% of the production costs of treated water when compared with the months in which the ETA Maranguape is fueled by the GaviÃo weir.

Foram estimados custos diretos de diferentes opções de tratamento para artrite reumatóide com base em dados de eficácia obtidos por revisão de literatura. O modelo analítico de tomada de decisão para o tratamento e desfechos durante um período de 48 meses baseado no modelo de Markov foi fundamentado em protocolos clínicos recomendados pela Sociedade Brasileira de Reumatologia, com esquemas alternativos para cinco ciclos de tratamento durante o período de quatro anos. O paciente pode permanecer em algumas das etapas ou migrar entre elas, de acordo com a resposta à terapia. Foram analisados custos diretos (medicamentos, materiais médico-hospitalares e exames laboratoriais). As doses dos medicamentos e o monitoramento foram baseados no Consenso Brasileiro para o Diagnóstico e Tratamento da Artrite Reumatóide, considerando-se o peso médio do paciente de 70 kg. Na comparação entre o custo das cinco etapas de tratamento os resultados mostram que a etapa que usa o medicamento infliximabe tem um custo superior às outras, este causado pelo preço de aquisição do medicamento. O custo do monitoramento tem impacto nas etapas que utilizam os medicamentos com preço de aquisição menor. O ciclo com a menor razão custo/efetividade foi o 1 (respondedor ao MTX). Aquele que usa o biológico desde o início do tratamento é responsável pela maior razão de custo/efetividade. A variação do custo entre os outros ciclos não foi muito grande, mas todas devem ser consideradas quando da escolha do prescritor. Estes resultados se mostraram robustos com a análise de sensibilidade. / The costs of the different rheumatoid arthritis therapy options were estimated and they were compared by cos/efficacy reason, through the development of an analytical model for a 48-month period. For the calculation of these costs, it was developed an analytical decision model based on the Markov Analysis, where five different therapy stages were elaborated based on clinical protocols recommended by the Brazilian Society of Rheumatology, and then five therapy cycles, where patients may continue in some of those stages or shift between them according to the therapy response, for a time horizon of 4 years. Only direct costs with drugs, medical-hospital materials for drug administration and laboratory examinations required for the patient monitoring because of the use of some drugs, were comprised in the analyzed data. The doses of drugs and the monitoring were based on the Brazilian Consensus for the Diagnosis and Treatment of Rheumatoid Arthritis, considering the average patient weight of 70 kg. When comparing the cost of the five treatment stages, the results show that the stage in which the infleximabe drug is used has a cost higher than that of the other stages and that the impact is caused by the drug acquisition price. The monitoring cost impacts the stages that employ drugs with smaller acquisition price. The cost-effectiveness cycle was the number 1 (good response with MTX). When we use de biologic in the beginning, it is responsible for the higher cost-effectiveness reason. The cost variation between cycles 2, 3 and 4 was smaller, but they have to be considered for the decision maker. The sensitivity analysis confirm this results.

Made available in DSpace on 2014-06-11T19:22:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-08Bitstream added on 2014-06-13T19:49:05Z : No. of bitstreams: 1 codogno_js_me_rcla.pdf: 551723 bytes, checksum: 7289c811872adb9358d081f132ed9cf5 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / A hipótese inicial do trabalho é a de que a maior prática de atividades físicas entre indivíduos diabéticos pode diminuir o custo total do tratamento do DM2 e suas complicações. Objetivo: Avaliar se pacientes diabéticos e com maior envolvimento com a prática de atividades físicas apresentam menor custo com medicamentos, consultas e exames médicos. Métodos: Trabalho transversal realizado junto a dois núcleos de saúde, na cidade de Bauru-SP. A casuística foi composta por 121 diabéticos tipo 2, de ambos os sexos, e com idade inferior a 75 anos. Foram analisados os prontuários clínicos dos pacientes (cálculo do custo), avaliada a presença de neuropatia, o estado nutricional, aferida a pressão arterial e aplicados questionários (atividade física, condição econômica e risco coronariano). A análise dos dados foi realizada após a divisão dos indivíduos em grupos de atividade física: Ativo, Moderadamente ativo e Sedentário. ANOVA one-way e ANOVA two-way avaliaram a interação da prática de atividades físicas e indicadores de custo médico. Para as variáveis categóricas, o teste qui-quadrado foi utilizado para verificar a existência de associações. As regressões linear e logística também foram aplicadas. Resultados: Neuropatia diabética aproximou-se dos 30% e diabéticos não acometidos representaram maiores custos para a saúde no que se refere às consultas com clínico geral. Diabéticos sedentários, quando comparados com ativos, apresentaram custo com clínico geral 63% maior (P= 0,012). Quando comparados com os não insulino-dependentes, os doentes que utilizam insulina apresentaram custos mais elevados para medicamentos (R$40.554,9±2976 vs R$2.454,4±216; p= 0,001) e consultas de enfermagem (R$8.064,8±487 vs R$6.147,9±208; p= 0,001). Entre os insulino-dependentes, a atividade física não exerceu efeito aparente sobre nenhuma das variáveis de custo... / The initial hypothesis of this work is that the higher physical activity level among diabetic individuals may reduce the total cost treatment of DM2 and its complications. Objective: To analyze whether diabetics patients and with increased physical activity levels show lower cost with medicines, medical consultations and examination. Methods: A cross-sectional research conducted at two health centers in the city of Bauru - SP, Brazil. The sample consisted of 121 type 2 diabetic patients of both sexes and aged below 75 years. For this research we analyzed the clinical records of patients (calculating cost), evaluated the presence of neuropathy, assessed the nutritional status, measured blood pressure and applied questionnaires (physical activity, status economical and coronary risk). Data analysis was performed after the division of individuals into groups for physical activity: Active, Moderately active and Sedentary. One-way ANOVA and two-way ANOVA evaluated the interaction between practice of physical activities and indicators of medical cost. For categorical variables, the chi-square was used to verify the existence of associations. Logistic and linear regressions were also applied. Results: Diabetic neuropathy rate was approximately 30% and diabetic patients without its diagnosis presented higher costs for the health regarding consultations with the general practitioner. Sedentary diabetic subjects had 63% higher cost for general practitioner than active ones (p = 0.012). Diabetics insulin-dependent had higher costs for drugs (R$40.554,9±2976 vs R$2.454,4±216; p= 0,001) and nursing visits (R$8.064,8±487 vs R$6.147,9±208; p= 0,001) than those ones non-insulin-dependent. Among those using insulin, physical activity had no apparent effect on cost. The therapeutic scheme also influenced the cost, and diet increased the cost of treatment and exercise reduced it. Conclusion:... (Complete abstract click electronic access below)

Orientador: Henrique Luiz Monteiro / Banca: Eduardo Kokubun / Banca: Alex Antonio Florindo / Resumo: A hipótese inicial do trabalho é a de que a maior prática de atividades físicas entre indivíduos diabéticos pode diminuir o custo total do tratamento do DM2 e suas complicações. Objetivo: Avaliar se pacientes diabéticos e com maior envolvimento com a prática de atividades físicas apresentam menor custo com medicamentos, consultas e exames médicos. Métodos: Trabalho transversal realizado junto a dois núcleos de saúde, na cidade de Bauru-SP. A casuística foi composta por 121 diabéticos tipo 2, de ambos os sexos, e com idade inferior a 75 anos. Foram analisados os prontuários clínicos dos pacientes (cálculo do custo), avaliada a presença de neuropatia, o estado nutricional, aferida a pressão arterial e aplicados questionários (atividade física, condição econômica e risco coronariano). A análise dos dados foi realizada após a divisão dos indivíduos em grupos de atividade física: Ativo, Moderadamente ativo e Sedentário. ANOVA one-way e ANOVA two-way avaliaram a interação da prática de atividades físicas e indicadores de custo médico. Para as variáveis categóricas, o teste qui-quadrado foi utilizado para verificar a existência de associações. As regressões linear e logística também foram aplicadas. Resultados: Neuropatia diabética aproximou-se dos 30% e diabéticos não acometidos representaram maiores custos para a saúde no que se refere às consultas com clínico geral. Diabéticos sedentários, quando comparados com ativos, apresentaram custo com clínico geral 63% maior (P= 0,012). Quando comparados com os não insulino-dependentes, os doentes que utilizam insulina apresentaram custos mais elevados para medicamentos (R$40.554,9±2976 vs R$2.454,4±216; p= 0,001) e consultas de enfermagem (R$8.064,8±487 vs R$6.147,9±208; p= 0,001). Entre os insulino-dependentes, a atividade física não exerceu efeito aparente sobre nenhuma das variáveis de custo... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The initial hypothesis of this work is that the higher physical activity level among diabetic individuals may reduce the total cost treatment of DM2 and its complications. Objective: To analyze whether diabetics patients and with increased physical activity levels show lower cost with medicines, medical consultations and examination. Methods: A cross-sectional research conducted at two health centers in the city of Bauru - SP, Brazil. The sample consisted of 121 type 2 diabetic patients of both sexes and aged below 75 years. For this research we analyzed the clinical records of patients (calculating cost), evaluated the presence of neuropathy, assessed the nutritional status, measured blood pressure and applied questionnaires (physical activity, status economical and coronary risk). Data analysis was performed after the division of individuals into groups for physical activity: Active, Moderately active and Sedentary. One-way ANOVA and two-way ANOVA evaluated the interaction between practice of physical activities and indicators of medical cost. For categorical variables, the chi-square was used to verify the existence of associations. Logistic and linear regressions were also applied. Results: Diabetic neuropathy rate was approximately 30% and diabetic patients without its diagnosis presented higher costs for the health regarding consultations with the general practitioner. Sedentary diabetic subjects had 63% higher cost for general practitioner than active ones (p = 0.012). Diabetics insulin-dependent had higher costs for drugs (R$40.554,9±2976 vs R$2.454,4±216; p= 0,001) and nursing visits (R$8.064,8±487 vs R$6.147,9±208; p= 0,001) than those ones non-insulin-dependent. Among those using insulin, physical activity had no apparent effect on cost. The therapeutic scheme also influenced the cost, and diet increased the cost of treatment and exercise reduced it. Conclusion:... (Complete abstract click electronic access below) / Mestre

Foram estimados custos diretos de diferentes opções de tratamento para artrite reumatóide com base em dados de eficácia obtidos por revisão de literatura. O modelo analítico de tomada de decisão para o tratamento e desfechos durante um período de 48 meses baseado no modelo de Markov foi fundamentado em protocolos clínicos recomendados pela Sociedade Brasileira de Reumatologia, com esquemas alternativos para cinco ciclos de tratamento durante o período de quatro anos. O paciente pode permanecer em algumas das etapas ou migrar entre elas, de acordo com a resposta à terapia. Foram analisados custos diretos (medicamentos, materiais médico-hospitalares e exames laboratoriais). As doses dos medicamentos e o monitoramento foram baseados no Consenso Brasileiro para o Diagnóstico e Tratamento da Artrite Reumatóide, considerando-se o peso médio do paciente de 70 kg. Na comparação entre o custo das cinco etapas de tratamento os resultados mostram que a etapa que usa o medicamento infliximabe tem um custo superior às outras, este causado pelo preço de aquisição do medicamento. O custo do monitoramento tem impacto nas etapas que utilizam os medicamentos com preço de aquisição menor. O ciclo com a menor razão custo/efetividade foi o 1 (respondedor ao MTX). Aquele que usa o biológico desde o início do tratamento é responsável pela maior razão de custo/efetividade. A variação do custo entre os outros ciclos não foi muito grande, mas todas devem ser consideradas quando da escolha do prescritor. Estes resultados se mostraram robustos com a análise de sensibilidade. / The costs of the different rheumatoid arthritis therapy options were estimated and they were compared by cos/efficacy reason, through the development of an analytical model for a 48-month period. For the calculation of these costs, it was developed an analytical decision model based on the Markov Analysis, where five different therapy stages were elaborated based on clinical protocols recommended by the Brazilian Society of Rheumatology, and then five therapy cycles, where patients may continue in some of those stages or shift between them according to the therapy response, for a time horizon of 4 years. Only direct costs with drugs, medical-hospital materials for drug administration and laboratory examinations required for the patient monitoring because of the use of some drugs, were comprised in the analyzed data. The doses of drugs and the monitoring were based on the Brazilian Consensus for the Diagnosis and Treatment of Rheumatoid Arthritis, considering the average patient weight of 70 kg. When comparing the cost of the five treatment stages, the results show that the stage in which the infleximabe drug is used has a cost higher than that of the other stages and that the impact is caused by the drug acquisition price. The monitoring cost impacts the stages that employ drugs with smaller acquisition price. The cost-effectiveness cycle was the number 1 (good response with MTX). When we use de biologic in the beginning, it is responsible for the higher cost-effectiveness reason. The cost variation between cycles 2, 3 and 4 was smaller, but they have to be considered for the decision maker. The sensitivity analysis confirm this results.

Thesis (MBA)--Stellenbosch University, 2008. / ENGLISH ABSTRACT: The cost of medical care, in particular the cost of cancer care, has seen significant increases globally in the last few years. These cost increases in part are a result of tremendous advancements in new health technologies to diagnose, treat and care for cancer sufferers. The development of these highly specialised treatment modalities is not expected to slow down in the next few years, as potentially new treatments are already in the pipeline. On the other hand, cancer is becoming more prevalent. affecting more people worldwide. The condition remains life threatening, causing patients to become dependent and desperately hopeful of their requested treatments. Managed care, which includes the processes of rationing, has been implemented by medical aid schemes in the private health care industry in an effort to curtail the escalating costs of health care. Currently medical aids in the country are under immense pressure to comply with financially demanding legislation as well as to increase their membership risk by keeping contributions low and subsequently improve access to private health care in the country. Notwithstanding the fact that rationing might be justified from an economic perspective, the implications of transposing free market principles into an almost sacred health care environment challenges current morals and ethics in this arena. The price consciousness in cancer care is almost creating a scenario where clinical reasons are becoming subservient to fiscal reasons or, put differently, it is placing a price tag on human lives. In its true glory, the rationale of rationing is to challenge the individual patient needs against that of the bigger medical aid society. The distributive justice principles of rationing are creating immense conflict between the virtue-based, principle-based and contemporary ethics, which are currently governing medical practice in the country. As a result rationing creates serious vexing funding decisions with long-ranging effects. Its against this background that the study further consider the implications of managed care and rationing as it creates serious questions about the fairness, decision-making power and authority of managed care organizations. The implication of this is that the treating physician seems to have lost all autonomy and control in trying to treat and care for his cancer patient. Hence the perception that managed care does not act in the best interest of the vulnerable and desperate cancer suffering patient. As a result of th is view of managed care it becomes important to ensure the fairness and or legitimacy of managed care and rationing decisions. Therefore, the final section of the study considers the fair and just rationing of medical care as well as setting limits that are morally and ethically acceptable, in a cancer related setting. The studies of Daniels and Sabin are utilized extensively in particular the suggested criteria required by managed care organisations to ensure their rationing decisions are fair and legitimate. The implications of this and the assurances to cancer sufferers in a medical scheme is that the decisions to fund new health technologies are based on a process that is transparent and collaborative and that cost consideration of treatment has merit if it is made within the confines of this process. / AFRIKAANSE OPSOMMING: Die koste van mediese sorg, en spesifiek die koste van kankersorg, het in die afgelope paar jaar wereldwyd aansienlik toegeneem. Hierdie toename in koste is gedeeltelik die resultaat van geweldige vooruitgang in nuwe gesondheidstegnologiee om kankerlyers te diagnoseer, te behandel en vir hulle te sorgo Daar word nie verwag dat die ontwikkeling van hierdie hoogs gespesialiseerde behandelingsmodaliteite oor die volgende paar jaar sal afneem nie, aangesien nuwe behandelings steeds geregistreer word. Aan die ander kant is die voorkomssyfer van kanker besig om toe te neem, en be"invloed dit mense oor die hele wereld. Die toestand is steeds lewensbedreigend, en veroorsaak dat pasiente afhanklik van en desperaat vol hoop is vir die nodige behandeling. Bestuurde sorg, wat die proses van rantsoenering insluit, is deur mediesefondsskemas in die privaat gesondheidsorgbedryf ge"lmplementeer in 'n poging om die stygende koste van mediese sorg te verminder. Mediese fondse in die land is tans onder geweldige druk om aan finansieel veeleisende wetgewing te voldoen en om hulle lidmaatskaprisiko te verhoog deur bydraes laag te hou en gevolglik toegang tot privaat gesondheidsorg in die land te verbeter. Ondanks die feit dat rantsoenering moontlik vanuit 'n ekonomiese perspektief geregverdig kan word, daag die implikasies van die omsetting van vryemarkbeginsels in 'n amper heilige gesondheidsorgomgewing huidige morele waardes en etiek in hierdie veld uit. Die prysbewustheid in kankersorg skep amper 'n scenario waar kliniese redes ondergeskik aan fiskale redes gestel word of, om dit anders te stel, dit plaas 'n prys op mense se lewens. In sy volle glorie is die rasionaal van rantsoenering om die individuele pasient se behoeftes teenoor die van die groter mediesefondssamelewing te stel. Die beginsels van verdelende regverdigheid van rantsoenering skep enorme konflik tussen die deug..gebaseerde, beginselgebaseerde en kontemporere etiek wat tans die mediese praktyk in die land beheer. Gevolglik skep rantsoenering ernstige, moeilike befondsingsbesluite met effekte oor die lang termyn. Oit is teen hierdie agtergrond dat die studie die verdere implikasies van bestuurde sorg en rantsoenering moet oorweeg, aangesien dit ernstige vrae rondom die billikheid , besluitneming en outoriteit van bestuurde sorg maatskappye lig. By implikasie beteken dit dat die geneesheer wat die pasient behandel, feitlik aile beheer verloor het om die pasient vir aile praktiese doeleindes optimaal te behandel. Oaarom die persepsie dat bestuurde sorg nie in die beste belang van die kwesbare en desperaat kanker pasiente is nie. As gevolg van die persepsie van bestuurde sorg, raak dit meer belangrik om die bilikheid en regverdigheid van gesondheid sorg besluite te verseker. Met dit in ag genome, oorweeg die finale deel van die studie die bilikheid en regverdigheid van mediese rantsoenering so-ook die set van perke wat eties en moreel aanvaarbaar is, in 'n kanker verwante agtergrond. Die werke van Daniels en Sabin word in aansienlike detail hersien in besonder hul voorgestelde kriteria wat vereis word deur bestuurde sorg organisasies om te verseker hul besluite ten opsigte van rantsoenering is redelik en regverdig. Die implikasies hiervan en die versekering tot kanker Iyers in 'n mediese skema is dat die besluite om nuwe gesondheidstegnologiee te befonds, is gebasseer op In deursigtige en samehorende proses en dat aile koste oorwegings vir behandeling meriete het, indien dit is gemaak is binne die raamwerk van hierdie proses.

Suizidale Handlungen, also Suizide und Suizidversuche, sind mit großem Schmerz, großer Trauer und auch großem Schamgefühl verbunden. Dies betrifft nicht nur die Suizidenten selbst, sondern auch Angehörige und Freunde. Weltweit sterben etwa eine Million Menschen jährlich durch Suizid und in Deutschland steht der Suizid auf Platz sieben der häufigsten Todesursachen. Schätzungen zu Folge ist die Anzahl der Suizidversuche pro Jahr, im Vergleich zu den Suiziden, bis zu 30-fach höher. Dies zeigt, dass suizidale Handlungen zusätzlich eine hohe Relevanz für das Gesundheitssystem darstellen. Diese Arbeit entstand im Zuge des OSPI-Projektes in Leipzig. Einem europäischen Projekt zur Einführung eines Präventionsprogramms gegen suizidale Handlungen. Es wurden alle Suizidenten, die innerhalb eines Zeitraums von drei Jahren im Universitätsklinikum Leipzig behandelt wurden, erfasst. Die elektronischen Patientenakten wurden dafür, unter Verwendung der entsprechenden ICD-Kodierungen für Selbstverletzungen bzw. Selbstvergiftungen, durchsucht. Ziel war es, neben der lückenlosen Erfassung und epidemiologischen Auswertung aller Fälle, Aussagen über die Art der Behandlung von Suizidenten und den damit verbundenen direkten und indirekten Kosten zu machen. Es zeigten sich, im Vergleich zu bereits bestehenden Studien aus anderen Ländern, keine signifikante epidemiologischen Unterschiede, während deutlich mehr Patienten intensivmedizinisch versorgt und psychiatrisch untersucht wurden, als dies in anderen Ländern der Fall war. Im Hinblick auf die Gesamtkosten, in Höhe von rund 3,9 Millionen Euro, konnte diese Arbeit, abgesehen vom menschlichen Aspekt, die ebenfalls wichtige gesundheits-ökonomische Bedeutung solcher Fälle aufzeigen.

Aim: To describe and analyze the demographic profile and the dental treatment needs, workload and costs of the 2007 and 2008 CF recruit population (N=10,641). Method: Treatment procedures and costs were aggregated and calculated, beginning from the date of a member’s enrolment, over a period that ranged between 13 to 36 months. Associations between treatment services and the demographic variables were tested using one-way ANOVA and chi-square tests. Independent samples T-test was used to compare means. Linear regression models were used to determine the influence of demographic variables on treatment cost. Results: Treatment needs and costs varied with recruit age, gender, rank, first language (French/English), birthplace (Canada/Foreign), tobacco use, province and census tract. The cost of treatment for the entire population was $13.9M. Mean cost per recruit was $1224 over an average period of 26 months. Outsource costs ($2.9M) were driven by referrals for restorative, endodontic and oral surgery procedures.

Aim: To describe and analyze the demographic profile and the dental treatment needs, workload and costs of the 2007 and 2008 CF recruit population (N=10,641). Method: Treatment procedures and costs were aggregated and calculated, beginning from the date of a member’s enrolment, over a period that ranged between 13 to 36 months. Associations between treatment services and the demographic variables were tested using one-way ANOVA and chi-square tests. Independent samples T-test was used to compare means. Linear regression models were used to determine the influence of demographic variables on treatment cost. Results: Treatment needs and costs varied with recruit age, gender, rank, first language (French/English), birthplace (Canada/Foreign), tobacco use, province and census tract. The cost of treatment for the entire population was $13.9M. Mean cost per recruit was $1224 over an average period of 26 months. Outsource costs ($2.9M) were driven by referrals for restorative, endodontic and oral surgery procedures.