scholarly journals Specializing Nurses as An Indirect Education Program for Stoma Patients

2019 ◽  
Vol 16 (13) ◽  
pp. 2272
Author(s):  
Manuel García-Goñi
Keyword(s):  
Chronic Conditions ◽  
Cost Effective ◽  
Effectiveness Analysis ◽  
Education Strategy ◽  
Related Quality ◽  
Health Related ◽  
Low Incidence ◽  
Specialist Nurses ◽  
The Impact

Education programs are beneficial for patients with different chronic conditions. Prior studies have examined direct education, where information is transferred directly to patients. In contrast, in this program, information is transferred directly to nurses who become specialists and transfer education individually to patients. Hence, this paper evaluates the impact of having specialist nurses for stoma patients at hospitals, as those nurses provide healthcare to patients but also inform and educate patients about their condition and needs. The analysis uses an observational study with ostomized patients in Spain at hospitals with and without specialist nurses, and measures health service utilization and health-related quality of life (HRQL), besides performing a cost analysis and a cost-effectiveness analysis at both types of hospitals. The results show that patients with access to specialist nurses self-manage better, present lower adverse events and a better evolution of HRQL, and significantly demand more consultations with specialist nurses and less to A&E, primary care or specialists, resulting in important savings for the health system. Consequently, specializing or hiring nurses to provide indirect education to stoma patients is cost-effective and highly beneficial for patients. This type of indirect education strategy might be considered for specific conditions with low incidence or difficulties in identifying target patients or delivering information directly to them.

Impact of Elevated BMI and Types of Comorbid Conditions on Health-Related Quality of Life in a Nationally Representative US Sample

2021 ◽  
pp. 1-22
Author(s):  
Quang A. Le ◽  
Dimittri Delevry
Keyword(s):  
Chronic Conditions ◽  
Normal Weight ◽  
Class Iii ◽  
Comorbid Conditions ◽  
Class Iii Obesity ◽  
Related Quality ◽  
Health Related ◽  
Nationally Representative ◽  
The Impact

Abstract Objective: Elevated body mass index (BMI) is associated with multiple chronic conditions including diabetes and cardiovascular disease. Patients with overweight or obesity may also suffer from comorbidities not directly related to the pathophysiology of elevated BMI. The current study sought to determine the impact of BMI and different types of chronic conditions on health-related quality of life (HRQoL) outcomes. Design: Six weight categories by BMI were identified: Underweight, Normal weight, Overweight, Class-I obesity, Class-II obesity, and Class-III obesity. Twenty chronic conditions were considered and categorized as elevated BMI-related (concordant) or -unrelated (discordant) conditions. HRQoL outcomes were measured using Short Form-6 Dimensions (SF-6D). Multivariable regression models were performed to examine the impact of type, number of comorbid conditions, and BMI categories on SF-6D scores. Setting: Medical Expenditure Panel Survey (2013-2015). Participants: Nationally representative sample of US population; 18 years or older (n=58,960). Results: Of the sample, 1.7%, 32.9%, 34.0%, and 31.4% were classified as underweight, normal weight, overweight, and obese, respectively. The SF-6D scores were significantly decreased across all obesity classes, with the largest reduction in Class-III obesity (0.033; p < 0.001). Additionally, individuals with obesity having one or more concordant or discordant comorbidities further reduced SF-6D scores between 0.031 and 0.148 (p-values < 0.001) or between 0.080 and 0.212 (p-values < 0.001), respectively. Conclusions: Individuals with obesity had a significant reduction in HRQoL outcomes compared to those with normal BMI. Importantly, discordant comorbidity resulted in greater reduction in HRQoL outcomes compared to concordant comorbidity in subjects with elevated BMI.

The Impact of 29 Chronic Conditions on Health-related Quality of Life: A General Population Survey in Finland Using 15D and EQ-5D

2006 ◽  
Vol 15 (8) ◽  
pp. 1403-1414 ◽  
Author(s):  
Samuli I. Saarni ◽  
Tommi Härkänen ◽  
Harri Sintonen ◽  
Jaana Suvisaari ◽  
Seppo Koskinen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Chronic Conditions ◽  
Population Survey ◽  
Health Related Quality ◽  
General Population Survey ◽  
Related Quality ◽  
Health Related ◽  
The Impact

scholarly journals The impact of common chronic conditions on health-related quality of life: a general population survey in Iran using EQ-5D-5L

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ali Akbari Sari ◽  
Fereshteh Karimi ◽  
Zahra Emrani ◽  
Hojjat Zeraati ◽  
Alireza Olyaeemanesh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Ordinary Least Squares ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact ◽  
Utility Scores

Abstract Background Diseases have undeniable effects on Health-Related Quality of Life (HRQoL). Chronic diseases, in particular, limit the productive potentials and HRQoL of individuals. EQ-5D is a very popular generic instrument, which can be used to estimate HRQoL scores in any diseases. The current study investigates mean HRQoL scores in certain chronic diseases and examines the relationship between utility scores and chronic diseases in Iran. Method This cross-sectional study was carried out among the general adult population of Tehran. 3060 individuals were chosen by a stratified probability sampling method. The EQ-5D-5L questionnaire was applied. The utility scores were estimated using the Iranian crosswalk-based value set. The effect of chronic diseases on the HRQoL scores was derived by the Ordinary Least Squares (OLS) method. Data was analyzed using Stata version 13 software. Results The mean ± standard deviation utility and EQ-VAS scores were 0.85 ± 0.14 and 76.73 ± 16.55 in the participants without any chronic conditions. The scores were 0.69 ± 0.17 and 61.14 ± 20.61 in the participants with chronic conditions. The highest and lowest mean utility scores were related to thyroid disease (0.70) and Stroke (0.54), respectively. Common chronic conditions had significant negative effects on the HRQoL scores. Stroke (0.204) and cancer (0.177) caused the most reduction in the EQ-5D-5L utility scores. Lumbar disc hernia, digestive diseases, osteoarthritis, breathing problems, and anxiety/nerves cause 0.133, 0.109, 0.108, 0.087, and 0.078 reductions, respectively, in the EQ-5D-5L utility scores. Conclusion This study provides insight into some common chronic conditions and their effects on the HRQoL. Policymakers and planners should pay attention to the effects of chronic conditions especially high prevalence one. They should adopt effective interventions to control this issue and increase health. The results of this study can also be beneficial in economic evaluation studies.

scholarly journals The Impact of Common Chronic Conditions on Health-Related Quality of Life: A General Population Survey in Iran Using EQ-5D-5L

2020 ◽  
Author(s):  
Ali Akbari Sari ◽  
Fereshte Karimi ◽  
Zahra Emrani ◽  
Hojjat Zeraati ◽  
Alireza Olyaeemanesh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Ordinary Least Squares ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact ◽  
Utility Scores

Abstract Background:Diseases have undeniable effects on Health-Related Quality of Life (HRQoL). Chronic diseases, in particular, limit the productive potentials and HRQoL of individuals. EQ-5D is a very popular generic instrument, which can be used to estimate HRQoL scores in any diseases. The current study investigates mean HRQoL scores in certain chronic diseases and examines the relationship between utility scores and chronic diseases in Iran. Method:This cross-sectional study was carried out among the general adult population of Tehran. 3060 individuals were chosen by a stratified probability sampling method. The EQ-5D-5L questionnaire was applied. The utility scores were estimated using the Iranian crosswalk-based value set. The effect of chronic diseases on the HRQoL scores was derived by the Ordinary Least Squares (OLS) method. Data was analyzed using Stata version 13 software.Results:The mean ± standard deviation utility and EQ-VAS scores were 0.86 ±0.14 and 77.50 ±16.14 in the participants without any chronic conditions. The scores were 0.69 ±0.17 and 61.61 ±20.39 in the participants with chronic conditions. The highest and lowest mean utility scores were related to thyroid disease (0.70) and Stroke (0.54), respectively. Common chronic conditions had significant negative effects on the HRQoL scores. Stroke (0.204) and cancer (0.177) caused the most reduction in the EQ-5D-5L utility scores. Lumbar disc hernia, digestive diseases, osteoarthritis, breathing problems, and anxiety/nerves cause 0.133, 0.109, 0.108, 0.087, and 0.078 reductions, respectively, in the EQ-5D-5L utility scores.Conclusion:This study provides insight into some common chronic conditions and their effects on the HRQoL. Policymakers and planners should pay attention to the effects of chronic conditions especially high prevalence one. They should adopt effective interventions to control this issue and increase health. The results of this study can also be beneficial in economic evaluation studies.

scholarly journals Cost-effectiveness analysis of a chronic back pain multidisciplinary biopsychosocial rehabilitation (MBR) compared to standard care for privately insured in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Hochheim ◽  
P. Ramm ◽  
M. Wunderlich ◽  
V. Amelung
Keyword(s):  
Back Pain ◽  
Cost Effectiveness ◽  
Sick Leave ◽  
Controlled Trial ◽  
Cost Effective ◽  
Health Related Quality ◽  
Effectiveness Analysis ◽  
Related Quality ◽  
Health Related

Abstract Background Multidisciplinary biopsychosocial rehabilitation (MBR) is highly recommended for chronic lower back pain (CLBP) treatment, but its economic benefit remains to be clearly demonstrated. The purpose of this study is to analyse the effect of a 12-month MBR programme of behavioural change coaching and device-supported exercise on direct medical costs, sick leave and health-related quality of life (HRQOL) at 24 months. Methods An incremental cost-effectiveness analysis was conducted in Germany from a private health insurance perspective using data from a multi-centre, two-arm randomised controlled trial with parallel-group Zelen's randomisation and 24-month follow-up. After removing dissimilarities in characteristics between MBR and usual care (control) via propensity score matching, treatment effects were calculated using a difference-in-difference approach. Results Base-case analysis of the MBR (n=112) and usual care group (n=111) showed an incremental cost-effectiveness ratio (ICER) of €8,296 per quality-adjusted life year (QALY) gained, indicating that the intervention was cost-effective. Compared to the controls, MBR reduced economically unaccounted sick leave due to back pain in the last six months by 17.5 days (p = 0.001) and had a positive effect on health-related quality of life (HRQOL) (0.046, p=0.026). Subgroup analysis of participants with major impairment demonstrated that a dominant intervention was possible, as reflected by an ICER of - €7,302 per QALY. Savings were driven by a - €1,824 reduction in back pain-specific costs. Moreover, sick leave was 27 days (p = 0.006) less in the MBR group. Conclusions This first cost-effectiveness study with combined data from a private health insurer and a controlled trial in Germany demonstrated that long term MBR for the treatment of CLBP is cost-effective. Subgroups with major impairment from back pain benefitted more from the intervention than those with minor impairment. MBR significantly reduced sick leave in all participants. Hence, it is a profitable intervention from a societal point of view. Trial registration The trial of the evaluation study was retrospectively registered in the German Clinical Trials Register under trial number DRKS00015463 retrospectively (dated 4 Sept 2018).

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