ORCID Profile
0000-0002-2680-6999
Current Organisations
University of Southern Denmark
,
SDU
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Publisher: The Journal of Health Economics and Outcomes Research
Date: 28-03-2016
DOI: 10.36469/9827
Abstract: Objective: General practitioners (GPs) play an important role in caring for people with Alzheimer’s disease (AD). However, the cost and the extent of service utilization from GPs due to AD patients are difficult to assess. This study aimed to explore the principles of propensity score matching (PSM) technique to assess the additional GP service use and cost imposed by AD in persons aged ≥60 years in Denmark. Design: PSM was used to estimate the additional use and cost of GP services attributable to AD. Case and control baseline characteristics were compared with and without the application of PSM. Propensity scores were then estimated using the generalized boosted model, a multivariate, nonparametric and automated algorithm technique. Setting: Observational data from Statistics Denmark registry. Subjects: 3368 cases and 3368 controls cases with AD were defined as patients with diagnoses G30 and F00 and/or those with primary care prescriptions for anti-AD drugs from the years 2004 until 2009. Main Outcome Measures: GP service utilisation and costs attributable to AD. Results: PSM brought a large improvement to the balance of observed covariates among the cases and control groups. AD patients received around 20% more GP services and utilized services that cost 15% more than non-AD controls during a calendar year. Conclusion: AD patients utilize more GP services and incur higher costs as compared to their matched controls. The PSM technique can be an effective tool to reduce imbalance of observable confounders from register based data and improve the estimations.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.YGYNO.2019.05.027
Abstract: The majority of cost-studies related to robotic surgery has a short follow-up and primarily report the costs from the index surgery. The aim of this study was to evaluate the long-term resource consequences of introducing robotic surgery for early stage endometrial cancer in Denmark. The study included all women with early stage endometrial cancer who underwent robotic, laparoscopic and open access surgery from January 2008 to June 2015. Data was linked from national databases to determine resource consumption and costs from hospital treatments, outpatient contacts, primary health care sector visits, labor market affiliation and prescription of medication. Each patient was observed in a period of 12 months before- and after surgery. The key exposure variable was women who were exposed to robotic surgery compared to those who were not. A total of 4133 women underwent surgery for early stage endometrial cancer. The study found additional costs of $7309 (95% confidence interval [CI] 2100-11,620, P = 0.001) per patient in the group exposed to robotic surgery including long-term costs post-surgery compared to the non-exposed group (non-robotic group). When controlling for time trends, the introduction of robotic surgery did not reduce the number of bed days (mean diff -0.42, 95% CI -3.03-2.19, P = 0.752). The introduction of robotic surgery for early stage endometrial cancer did not generate any long-term cost savings. The additional costs of robotic surgery were primarily driven by the index surgery. Any reduction in bed days could be explained by time trends.
Publisher: Springer Science and Business Media LLC
Date: 05-09-2019
DOI: 10.1007/S11136-018-1987-0
Abstract: Assessing health-related quality of life (HRQOL) in people with advanced dementia is challenging but important for informed decision-making. Proxy measurement of this construct is difficult and is often rated lower than self-report. Accurate proxy rating of quality of life in dementia is related to identification of concepts important to the person themselves, as well as the sensitivity of the measures used. The main aim of this study was to compare the performance of two instruments-QUALID and EQ-5D-5L-on measuring HRQOL in people with advanced dementia. In a sub-study nested within a cluster-RCT we collected proxy(nurse)-completed EQ-5D-5L and QUALID measures at baseline, 3, 6, 9 and 12 months' follow-up for people with advanced dementia, residing in 20 nursing homes across Australia. Spearman's rank correlations, partial correlations and linear regressions were used to assess the relationship between the HRQOL instrument scores and their changes over time. The mean weight from 284 people for the EQ-5D-5L and QUALID at baseline were 0.004 (95% CI - 0.026, 0.033) and 24.98 (95% CI 24.13, 25.82), respectively. At 12 months' follow-up, 115 participants remained alive. EQ-5D-5L weights and QUALID scores at baseline and at follow-up were moderately correlated (r = - 0.437 p < 0.001 at 12 months). Changes within QUALID and EQ-5D-5L across the same follow-up periods were also correlated (r = - 0.266 p = 0.005). The regression analyses support these findings. Whilst these quality of life instruments demonstrated moderate correlation, the EQ-5D-5L does not appear to capture all aspects of quality of life that are relevant to people with advanced dementia and we cannot recommend the use of this instrument for use within this population. The QUALID appears to be a more suitable instrument for measuring HRQOL in people with severe dementia, but is not preference-based, which limits its application in economic evaluations of dementia care.
No related grants have been discovered for Liza (Elizaveta) Sopina.