International journal of technology assessment in health care
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Int J Technol Assess Health Care · Jan 1996
Multicenter StudyPredicting nursing home length of stay and outcome with a resource-based classification system.
The anticipated demographic changes with an increasing number of elderly force us to plan and use health care resources more efficiently. In this study we have used the components of a case-mix measure for nursing homes; the Resource Utilization Groups (RUG-II), to predict length of stay (LOS) and outcome in geriatric institutions. We have shown that the RUG categories and an activities of daily living (ADL) index differ significantly in both respects, but that other variables might be of more clinical value when establishing a prospective payment system, based on LOS in geriatric institutions.
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Int J Technol Assess Health Care · Jan 1996
ReviewInfluences on the quality of published drug studies.
To practice evidence-based medicine, physicians need data on the clinical effectiveness, toxicity, convenience, and cost of new drugs compared with available alternatives. We give examples of published drug studies that are defective, sometimes because pharmaceutical industry funding has affected their content and quality. We make recommendations on how to avoid these defects.
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Int J Technol Assess Health Care · Jan 1995
Evaluating translations of health status questionnaires. Methods from the IQOLA project. International Quality of Life Assessment.
There is growing demand for translations of health status questionnaires for use in multinational drug therapy studies and for population comparisons of health statistics. The International Quality of Life Assessment (IQOLA) Project is conducting a three-stage research program to determine the feasibility of translating the SF-36 Health Survey, widely used in English-speaking countries, into other languages. ⋯ In stage 3, the equivalence of the interpretation of questionnaire scores across countries is tested using methods that closely approximate their intended use, and empirical results are compared. Data analyses from Sweden and the United Kingdom, as well as other research cited, support the feasibility of cross-cultural health measurement using the SF-36.
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Int J Technol Assess Health Care · Jan 1995
ReviewInvesting in health wisely. The role of needs-based technology assessment.
Countries worldwide spend huge sums on health--about $1,700 billion a year, or roughly 8% of global income. But the World Development Report 1993: Investing in Health shows that these monies could be spent much more wisely, in the process doing a great deal to help the world's 1 billion poor. ⋯ This is a good example of the concept of needs-based technology assessment, combining the disciplines of epidemiology, economics, and policy formulation. When applied, it should lead to improved effectiveness, efficiency, and equity.
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Int J Technol Assess Health Care · Jan 1995
Is there a relationship between the volume of work carried out in intensive care and its outcome?
This paper reports the results of a study of the association between volume of activity and patient outcome in 26 intensive care units in the United Kingdom. Hospital fatality rates showed a statistically significant (p = .016) negative association with volume. ⋯ Thus, one explanation of the lower death rates at higher volumes is that larger units admit less severely ill patients. For patients admitted immediately after surgery, the correlation between severity standardized mortality ratios and volume (while not significant, p < .1) suggests there may be a volume-output effect unexplained by severity.