Diss. (sammanfattning) Stockholm : Karolinska institutet, 2001. / Härtill 5 uppsatser.

Osteoporosis is a major public health problem resulting in substantial hip fracture related morbidity. Using healthcare utilization data, we determined the 1- and 2-year direct attributable healthcare costs associated with hip fractures among Ontario seniors in comparison to a matched non-hip fracture cohort. Over a four-year period (2004-2008) we identified 22,418 females and 7,611 males with an incident hip fracture. Approximately 22% of females and 30% of males died in the first year after fracture. The mean attributable cost in the first year was $36,929 ($52,232 vs. $15,503) among females and $39,479 ($54,289 vs. $14,810) among males. Primary cost drivers included acute hospitalizations, complex continuing care, and rehabilitation. Attributable costs remained elevated into the second year, particularly among those who survived the first year ($9,017 females and $10,347 males). Results from this study will aid policy decision makers in allocating healthcare resources and help feed into future health economic analyses.

Osteoporosis is a major public health problem resulting in substantial hip fracture related morbidity. Using healthcare utilization data, we determined the 1- and 2-year direct attributable healthcare costs associated with hip fractures among Ontario seniors in comparison to a matched non-hip fracture cohort. Over a four-year period (2004-2008) we identified 22,418 females and 7,611 males with an incident hip fracture. Approximately 22% of females and 30% of males died in the first year after fracture. The mean attributable cost in the first year was $36,929 ($52,232 vs. $15,503) among females and $39,479 ($54,289 vs. $14,810) among males. Primary cost drivers included acute hospitalizations, complex continuing care, and rehabilitation. Attributable costs remained elevated into the second year, particularly among those who survived the first year ($9,017 females and $10,347 males). Results from this study will aid policy decision makers in allocating healthcare resources and help feed into future health economic analyses.

Alkohol är en del av vardagen för många svenskar idag. När denna konsumtion övergår till ett missbruk uppstår det problem för individen och för samhället som stort. I denna studie har författarna genomfört en Cost of Illness studie för att beräkna samhällskostnaderna för alkoholmissbruket inom Hammarö kommun.Resultatet visar att kostnaden för samhället som helhet, för detta missbruk uppgår till 29 434 297 SEK, år 2013. Den största kostnadsbäraren är staten med sina 15 967 819 SEK av den totala kostnaden. Kommunen står för 10 230 270 SEK av den totala kostnaden. Den tredje största kostnadsbäraren är det privata som bär 2 837 355 SEK av kostnaden. Landstinget bär 1 868 182 SEK av den totala kostnaden. / Alcohol is a daily part of the Swedish society today. This consumption is usually not a problem, but when the consumption transforms from a healthy dosage to a hazardous one, problem appears for both the individual affected and the society as a whole. This is a study that tries to estimate the economic costs of alcohol abuse within the municipality of Hammarö.The results shows that the total socio-economic costs of alcoholic use and abuse rises to 29 434 297 SEK for the year 2013. The largest bearer of the costs is the state with 15 967 819 SEK. The second largest bearer is the municipality of Hammarö with 10 230 270 SEK. Next comes the costs that affects the private sector of the society with a total of 2 837 355 SEK. The county of Värmland then follows with 1 868 182 SEK for the year of 2013.

The subject of the master's thesis is identification and quantification of the cost of Treatment of Cervical Cancer. The aim is to quantify the costs of specific medical procedures, make the research on the issue of Cervical Cancer and determine the costs and benefits of nationwide vaccination against the HPV.

<p>The essay investigates the economic burden of skin, soft tissue, bone and lung infections in Sweden 2003. The cost-of-illness method, based on the human capital theory, is used in the estimation. A prevalence approach and a top-down method were chosen for direct as well as indirect costs. Also there is a discussion concerning health economic aspects of antibiotic resistance and evidence of the increasing costs because of it. The lack of data leads to a result within a large interval of uncertainty; the direct costs are estimated to 1 072 million SEK and indirect costs are estimated to 4 655 million SEK.</p>

The essay investigates the economic burden of skin, soft tissue, bone and lung infections in Sweden 2003. The cost-of-illness method, based on the human capital theory, is used in the estimation. A prevalence approach and a top-down method were chosen for direct as well as indirect costs. Also there is a discussion concerning health economic aspects of antibiotic resistance and evidence of the increasing costs because of it. The lack of data leads to a result within a large interval of uncertainty; the direct costs are estimated to 1 072 million SEK and indirect costs are estimated to 4 655 million SEK.

Problem: Financial strain has been reported by families of children with cancer. However, the specific costs and their impact on these families remain unknown. Objectives: (a) to identify the costs incurred by families of children newly diagnosed with cancer in Ontario, (b) to determine the variables that influence these costs, and (c) to explore the impact of these costs on families. Conceptual Framework: The conceptual framework incorporated the social, economic, disease, and treatment cost predictors with the direct and indirect cost of illness components. Setting: Two university-affiliated tertiary paediatric hospitals in Canada. Sample: English speaking parents of children newly diagnosed with cancer who were receiving treatment. Design: A prospective concurrent mixed method design. Instrumentation: The Ambulatory and Home Care Record © (AHCR) (Guerriere & Coyte, 1998) was used to record costs and an interview guide was developed to explore the impact of these costs on families. Procedure: Parents recorded the resources consumed and costs incurred during one week per month for three consecutive months beginning the 4th week following diagnosis and listed any additional costs incurred since diagnosis or between the face-to-face interviews. Parents also discussed the impact of these costs on their families in an audio taped interview. Data Analysis: Descriptive statistics and multiple regression modelling were used to describe families’ total costs (expressed in 2007 Canadian dollars) and to determine factors that influenced them. Descriptive qualitative content analytic methods were used to analyze the transcribed interview data. Results: In total, 99 parents including 28 fathers and 71 mothers completed three sets of cost diaries. The mean total three month expenditure was $28,475 (SD $12,670; range $2013 to $79,249) per family. There were no statistically significant factors that influenced families’ direct costs; however, 23% of the variance for indirect costs was explained by inpatient tertiary hospitalizations, language spoken at home, and distance to the hospital. Parents described the costs associated with their child’s illness and coping and management strategies used to lessen the financial impact including managing their expenses and seeking ways to increase their cash flow. Significance: Findings will inform health professionals and policy makers about families who are faced with potentially catastrophic costs following their child’s diagnosis with cancer.

Problem: Financial strain has been reported by families of children with cancer. However, the specific costs and their impact on these families remain unknown. Objectives: (a) to identify the costs incurred by families of children newly diagnosed with cancer in Ontario, (b) to determine the variables that influence these costs, and (c) to explore the impact of these costs on families. Conceptual Framework: The conceptual framework incorporated the social, economic, disease, and treatment cost predictors with the direct and indirect cost of illness components. Setting: Two university-affiliated tertiary paediatric hospitals in Canada. Sample: English speaking parents of children newly diagnosed with cancer who were receiving treatment. Design: A prospective concurrent mixed method design. Instrumentation: The Ambulatory and Home Care Record © (AHCR) (Guerriere & Coyte, 1998) was used to record costs and an interview guide was developed to explore the impact of these costs on families. Procedure: Parents recorded the resources consumed and costs incurred during one week per month for three consecutive months beginning the 4th week following diagnosis and listed any additional costs incurred since diagnosis or between the face-to-face interviews. Parents also discussed the impact of these costs on their families in an audio taped interview. Data Analysis: Descriptive statistics and multiple regression modelling were used to describe families’ total costs (expressed in 2007 Canadian dollars) and to determine factors that influenced them. Descriptive qualitative content analytic methods were used to analyze the transcribed interview data. Results: In total, 99 parents including 28 fathers and 71 mothers completed three sets of cost diaries. The mean total three month expenditure was $28,475 (SD $12,670; range $2013 to $79,249) per family. There were no statistically significant factors that influenced families’ direct costs; however, 23% of the variance for indirect costs was explained by inpatient tertiary hospitalizations, language spoken at home, and distance to the hospital. Parents described the costs associated with their child’s illness and coping and management strategies used to lessen the financial impact including managing their expenses and seeking ways to increase their cash flow. Significance: Findings will inform health professionals and policy makers about families who are faced with potentially catastrophic costs following their child’s diagnosis with cancer.

The costs for stroke management and reduced health related quality of life (QoL) can extend throughout life as mental and physical disabilities are common. The aim of this thesis was to quantify this stroke-related burden with data from Riks-Stroke (RS), the Swedish stroke register. Costs for hospital and primary care, secondary drug prevention, home and residential care services, and production losses were estimated for first-ever stroke patients registered in the RS. The present value lifetime costs were estimated from the expected survival and discounted by 3%. Quality of life was estimated with the EQ-5D instrument on a subset of patients at 3 months after the index event and mapped to patient-reported outcome measures in the RS. Standard descriptive and analytic (multivariate regressions) statistical methods were used. The life-time societal present value cost per patient in 2009 was approximately €69,000 whereof home and residential care due to stroke was 59% and indirect costs for productivity losses accounted for 21% (year 2009 prices). Women had higher costs than men in all age groups. Treatment at stroke units had a low incremental cost per life-year gained compared to patients who were not treated at such facilities. The estimated disutility from stroke was greatest for women and the oldest, and compared to 1997 the cost per patient increased after a revised assumption. Hospitalisation costs were stable while long-term costs for ADL support increased in part due to a changed age structure. Patients with atrial fibrillation (AF; 24%) had €367 higher inpatient costs compared to non-AF stroke patients €8,914 (P&lt;0.01; year 2001 prices). As the index case fatality was higher among AF patients, the cost difference was higher for patients surviving the first 28 days. A multivariate regression showed that AF, diabetes, stroke severity, and death during the 3-year follow-up period were independent cost drivers. Three regression techniques (OLS, Tobit, CLAD) were chosen for mapping EQ-5D utilities to patient-reported outcome measures in the RS. The mean utility was overestimated with all models and had lower variance than the original data. In conclusion, total societal lifetime cost for 22,000 first-ever stroke patients in 2009 amounted to €1.5 billion (whereof production losses were €314 million). About 56,600 QALYs were lost due to premature death and disability. Including a preference-based QoL instrument in the RS would allow cost-utility analyses, but it is important to control for confounders in comparator arms to avoid bias.