The American journal of managed care
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Randomized Controlled Trial Comparative Study Clinical Trial
The impact of schizophrenic patient functionality on service utilization and cost. Based on a presentation by Sandra L. Tunis, PhD.
With the advent of atypical agents in the treatment of schizophrenia, physicians and policy makers must consider the costs that may accompany greater clinical efficacy. Analyses reveal that olanzapine shows a greater clinical cost effectiveness, as well as a greater functional cost effectiveness, than haloperidol, and that functional outcomes, in particular, show promise as important measures of effectiveness. ⋯ When comparing olanzapine with haloperidol, cost savings are seen throughout the treatment period (1 year), with physical functioning most highly affected over time. Functional outcomes can therefore serve 2 purposes: to enhance compliance by improving health-related quality of life and to assist in making both treatment and formulary decisions.
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To determine if patients perceived a difference in the efficacy, side effects, and value of omeprazole versus lansoprazole for gastroesophageal reflux disease (GERD) maintenance therapy after a formulary conversion, and to evaluate the costs of the conversion. ⋯ Omeprazole was the medication preferred by patients for GERD maintenance therapy. Patients were willing to pay an additional fee for their preferred agent. Fewer adverse events were reported with omeprazole. The potential cost savings of the formulary conversion may have been at the expense of patient satisfaction.
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To describe adherence to a number of quality indicators and clinical outcomes for asthma, diabetes mellitus, hypertension, coronary heart disease, atrial fibrillation, and cerebrovascular disease in the primary care practices of the Practice Partner Research Network (PPRNet). ⋯ The findings of this study are comparable to others in documenting that most clinical practice guidelines for chronic illness are not followed for a majority of patients and that large majorities do not reach desired clinical outcomes.
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To demonstrate the potential value and current limitations of using resource allocation models for selecting health services. ⋯ Resource allocation models have the potential for assisting MCOs in selecting a set of preventive services that will maximize population health. Before this potential can be fully realized, additional methodological development and cost-effectiveness studies are needed. The use of resource allocation should be examined for selecting all healthcare services.
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To evaluate the clinical, financial, and parent/patient satisfaction impact of critical pathways on the postoperative care of pediatric cardiothoracic patients with simple congenital heart lesions. ⋯ Implementation of critical pathways reduced resource utilization and costs after repair of three simple congenital heart lesions, without obvious complications or patient dissatisfaction.