International journal of technology assessment in health care
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Int J Technol Assess Health Care · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialEconomic evaluation of antineoplasic chemotherapy administered at home or in hospitals.
Comparative economic evaluations of chemotherapy administered in hospital day-care units or in the home are relatively scarce. Furthermore, most existing evaluations do not include methodologic studies. This study seeks to compare the costs of anticancer chemotherapy with hospital at-home care versus a hospital day-care unit in the Rhône-Alpes region of France. ⋯ The results show that the interest of developing home care in anticancer chemotherapy is questionable regarding costs. In the French healthcare system, where there is a surplus of hospital beds, marginal costs seem to be more relevant indicators in most cases than average costs.
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Int J Technol Assess Health Care · Jan 2002
Comparative StudyRecommendations for the prevention of osteoporosis and fragility fractures. International comparison and synthesis.
This review included the following objectives: a) to synthesize recommendations made by public agencies in Western countries concerning screening for osteoporosis; b) to compare these recommendations and sort out the similarities and discrepancies; and c) to propose a strategy for the fight against osteoporosis and fragility fractures. ⋯ Prevention of osteoporosis and fragility fractures is an attainable goal. Existing resources are currently badly targeted. Compromises must be negotiated between the different stakeholders and biomedical disciplines to achieve efficiency and accessibility in the reduction of fragility fractures. A first compromise to reconcile social and scientific realities would be to use a best-evidence synthesis instead of an evidence-based medicine approach in future analyses and recommendations by public authorities. A second compromise would be to recognize the complementary roles of public health and clinical professionals toward the common objective of preventing fragility fractures.
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Int J Technol Assess Health Care · Jan 2002
How to report and monitor the performance of waiting list management.
Potential problems concerning waiting list management are often monitored using mean waiting times based on empirical samples. However, the appropriateness of mean waiting time as an indicator of access can be questioned if a waiting list is not managed well, e.g., if the queue discipline is violated. This study was performed to find out about the queue discipline in waiting lists for elective surgery to reveal potential discrepancies in waiting list management. ⋯ A routine waiting list reporting should be used to guarantee the quality of waiting list management and to pinpoint potential problems in access. It is important to monitor not only the number of patients in the waiting list but also the queue discipline and the balance between demand and supply of surgical services. The purpose for this type of reporting is to ensure that the priority setting made at health policy level also works in practise.
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Int J Technol Assess Health Care · Jan 2002
Health technology assessment for medical devices in Europe. What must be considered.
To inform about the specifics of medical devices and the resulting consequences for health technology assessment (HTA) and to present the European industry position on this topic. ⋯ The European medical device industry can commit to an HTA that takes into consideration the specifics of medical technologies, which is appropriate and fair, and which is done under full participation of industry. Under these circumstances HTA can be a useful tool to support rational decision making in health care.