International journal of technology assessment in health care
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Int J Technol Assess Health Care · Jan 2005
Effects of the increase in co-payments from 20 to 30 percent on the compliance rate of patients with hypertension or diabetes mellitus in the employed health insurance system.
How to contain medical expenditures is a universal problem. The Japanese government has increased patient co-payments to control it. The purpose of this study is to clarify whether the increase in co-payments to 30 percent prevented patients with hypertension or diabetes mellitus from receiving necessary care in the Employee Health Insurance System. ⋯ Increasing co-payments reduced necessary preventive care in diabetic patients without complications.
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Int J Technol Assess Health Care · Jan 2005
Assessing the in-hospital survival benefits of intensive care.
For an efficient and fair allocation of medical resources, one must know which patients benefit more from medical care. The objective of this study is to assess the differential survival benefits of a general intensive care unit (ICU) by acute diagnoses and by Acute Physiological and Chronic Health Evaluation (APACHE II) scores. ⋯ Survival benefits differ across diagnoses and APACHE II scores. Facing limited resources, admission policies should distinguish between survival probabilities (and survival maximization) and survival benefits (and maximization of ICU benefits). Actual referral and admission policies to the present ICU do not maximize the potential survival benefits of ICU resources.
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Int J Technol Assess Health Care · Jan 2005
Cost-effectiveness of pressure-relieving devices for the prevention and treatment of pressure ulcers.
The cost-effectiveness of alternating pressure-relieving devices, mattress replacements, and mattress overlays compared with a standard hospital (high-specification foam mattress) for the prevention and treatment of pressure ulcers in hospital patients in the United Kingdom was investigated. ⋯ Current information suggests that alternating pressure mattress overlays may be cost-effective for the prevention of pressure ulcers, whereas alternating pressure mattress replacements appears to be cost-effective for the treatment of superficial and severe pressure ulcers.
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This article examines European Union (EU) and member state regulation of medical devices, particularly: a) the similarities and differences between medical devices and prescription drugs, including the respective industries, market authorization pathways, and boundary issues between the two sectors; b) the political background, current nature, and future prospects for EU medical device regulation; and c) regulatory responsibilities of the member states. Included are definitions of medical devices and in vitro diagnostics, and a brief history of their treatment by European law. ⋯ Finally, the article discusses medical device reporting and surveillance systems, which may be the weakest link in the EU integrative process. If patient safety is as important to the EU regulatory scheme as free movement and competitiveness, then both Brussels and member states will require additional resources, as well as measures to overcome obstacles to implementation, evaluation, and accountability.
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Int J Technol Assess Health Care · Jan 2003
Comparative StudyHealth financing policies: patient care-seeking behavior in rural China.
To study the effects of health financing systems on patient care-seeking behavior in rural China. ⋯ The empirical data suggest that health-financing systems appear to influence patient behavior for prescription and access to health care, especially some costly health care, that is, hospitalization. The data also suggest that China needs to increase the coverage of health insurance, especially in rural areas to improve the access to health care.