268 research outputs found
The cost of dysphagia in geriatric patients
No full textSigne Westmark,1 Dorte Melgaard,1,2 Line O Rethmeier,3 Lars Holger Ehlers3 1Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark; 2Department of Physiotherapy and Occupational Therapy, North Denmark Regional Hospital, Hjørring, Denmark; 3Danish Center for Healthcare Improvements, Aalborg University, Aalborg, Denmark Objectives: To estimate the annual cost at the hospital and in the municipality (social care) due to dysphagia in geriatric patients.Design: Retrospective cost analysis of geriatric patients with dysphagia versus geriatric patients without dysphagia 1 year before hospitalization.Setting: North Denmark Regional Hospital, Hjørring Municipality, Frederikshavn Municipality, and Brønderslev Municipality.Subjects: A total of 258 hospitalized patients, 60 years or older, acute hospitalized in the geriatric department.Materials and methods: Volume-viscosity swallow test and the Minimal Eating Observation Form-II were conducted for data collection. A Charlson Comorbidity Index score measured comorbidity, and functional status was measured by Barthel-100. To investigate the cost of dysphagia, patient-specific data on health care consumption at the hospital and in the municipality (nursing, home care, and training) were collected from medical registers and records 1 year before hospitalization including the hospitalization for screening for dysphagia. Multiple linear regression analyses were conducted to determine the relationship between dysphagia and hospital and municipality costs, respectively, adjusting for age, gender, and comorbidity.Results: Patients with dysphagia were significantly costlier than patients without dysphagia in both hospital (p=0.013) and municipality costs (p=0.028) compared to patients without dysphagia. Adjusted annual hospital costs in patients with dysphagia were 27,347 DKK (3,677 EUR, 4,282 USD) higher than patients without dysphagia at the hospital, and annual health care costs in the municipality were 46,044 DKK (6,192 EUR, 7,209 USD) higher.Conclusion: Geriatric patients with dysphagia were significantly costlier for both hospital and municipality costs compared to geriatric patients without dysphagia. Keywords: elderly, swallowing disorders, cost analysis, hospital, municipalit
Regaining Versus Not Regaining Function Following Hip Fracture—A Descriptive Study
No full textThe aim of this study was to study the prevalence of patients who did not regain pre-fracture basic mobility status (PF-BMS) at a task-specific level at discharge with 6-month follow-up. Furthermore, the objective was to make a comparative description between patients who did and did not regain PF-BMS measured with the Cumulated Ambulation Score (CAS). A cross-sectional study with follow-up at discharge and 6 months was performed from June 2015 to November 2017. Inclusion criteria: all patients ≥65 years admitted with first-time hip fracture. In all, 235 patients were included in the analyses at discharge (76% female, median age 85 (83⁻87)) and 59 patients at 6 months (48% female, median age 82 (75⁻88)). At discharge, getting in/out of bed had the highest prevalence of non-regained ability. At 6 months this was the case for getting in/out of bed and walking. At discharge, significant between-group differences were found regarding age, pre-fracture function (PFF), dementia, pre-fracture residence (PFR), comorbidity, and length of stay (LOS). At follow-up, significant differences in PFF, PFR, discharge destination (DD) and residence at 3 months after discharge (RES-3) were found. Getting in/out of bed was the most difficult task to regain both during admission and long term
What is the effect of treating secondary lymphedema after breast cancer with complete decongestive physiotherapy when the bandage is replaced with Kinesio Textape? - A pilot study
No full textPURPOSE: Secondary lymphedema (SL) following breast cancer is a well-known complication following surgery or radiation. SL may result in loss of functional ability, cosmetic deformities, physical discomfort, recurrent episodes of erysipelas, and psychological distress. There is no evidence as to what is the most effective treatment for SL.METHODS: This randomized controlled pilot study included 10 patients treated for SL following breast cancer. The patients were included and screened for SL by a physiotherapist. They were randomized to treatment with CDP with Kinesio Textape or bandage for 4 weeks. Endpoints were quality of life, circumference of the arm, costs, and working environment for the physiotherapist.RESULTS: The two groups were comparable according to baseline data. Outcomes on quality of life, costs, and working environment for the physiotherapist; the treatment with CDP with tape was superior to the CDP with bandage treatment. In regard to reducing the circumference there was no difference.CONCLUSIONS: This randomized controlled pilot study shows that CDP with tape can be an alternative to CDP with bandage. The quality of life is higher, the economy and working environment is better, and the effect measured by circumference is comparable. More RCTs are required to increase the evidence for CDP with tape.IMPLICATIONS: Treating lymphedema with CDP with tape after breast cancer is a good alternative to CDP with bandage and makes it possible to treat more patients with less resources.</p
Does strict employment protection discourage job creation? Evidence from Croatia
No full textEmployment protection legislation in Croatia is among the most strict in Europe. Firing is difficult and costly, and flexible forms of employment are limited. Is this apparent rigidity reflected-as one would expect based on standard economic theory-in low labor market dynamics? Is job creation low and hiring limited? Is the job security of insiders achieved at the cost of outsiders not being able to enter thelabor market? The author attempts to answer these questions by examining job flows. If the employment protection legislation is binding, then job and worker turnover should be low. He shows that this is indeed the case. Hiring is limited and the average job tenure is very long in Croatia. Job destruction is low, however job creation is still lower. The result is accumulation of unemployment, in large part due to new labor market entrants not being able to find a job. The high degree of job protection also seems to strengthen the bargaining position of insiders and results in relatively high wages. So, wages in Croatia are higher than among its competitors, even after adjusting for productivity. These high labor costs are likely to contribute to limited job creation in existing firms, but also are likely to discourage the entry of-and thus job creation in-new firms. The author presents evidence that firm growth has been indeed limited in Croatia, contributing to the low employment level. The author examines other potential causes of high unemployment in Croatia (the unemployment benefit system, labor taxation, the wage structure, and skill and spatial mismatches). He argues that they do not play a substantial part in accounting for poor labor market outcomes in Croatia. The author concludes that the stringent employment protection legislation is the key labor market institution behind low job creation and high unemployment. Based on this he recommends specific measures aimed at liberalizing the labor market to foster job creation and employment.Labor Management and Relations,Labor Policies,Labor Markets,Environmental Economics&Policies,Trade Finance and Investment,Labor Markets,Labor Management and Relations,Labor Standards,Banks&Banking Reform,Environmental Economics&Policies
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