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9. Pediatrics

Author

Navero, J. L. Pérez, Kindelán, A. Alvarez, de la Rosa, I. Ibarra, Santamaría, E. Ulloa, Jabalquinto, M. J. Velasco, Mingueza, F. Barcones, Ruiz, M. Concha, Pérez-Alvarez, F., Molina, F., Foguet, A., Titus, J., Papadatos, J., Gionis, D., Kalabalikis, P., Kafetzis, D., Rosi, R., Stanca, A., Spargi, G., Zei, E., Sizun, J., Karangwa, A., Masure, O., Giroux, J. D., Sinitzis, A. M., Alix, D., Jouvet, P., Hubert, P., Rabier, D., Saudubray, J. M., Finfer, S., Cox, P., Fleming, F., Barker, G., Bohn, D., Gemke, R. J. B. J., van Vught, A. J., Bonsel, G. J., Rutten, F. F. H., Fantoni, A., Ripamonti, D., Favero, A., Franceschelli, N., Leykin, Y., Bonvicini, C., Reig, R., Delgado, M., Pérez, G., Folgado, C., Criado, F., Caturla, J., Aburto, F., Acosta, J., Morera, I., Infante, A., Barbosa, A., Castellanos, A., Teja, J. L., Santos, F., Obeso, T., Santidrian, J. P., Artiñano, E., Hostalot, A., Jovanl, L., Palomeque, A., Pastor, X., Ribas, M., Jiménez, R., Morelló, A., Rosa, C. de la, Orteu, N., Quiñones, E., Moreno, A., Guerola, J., Mortera, C., Mulet, J., Rodríguez-Núñez, A., Redondo, L., Martinón, J. M., Leclerc, F., Riou, Y., Martinot, A., Storme, L., Hue, V., Flurin, V., Primožič, J., Zupančič, Ž., Raphaelly, R. C., Gadzinowski, J., Szymankiewicz, M., Halliday, H. L., Murillo-Cabezas, F., Dominguez-Roldan, J. M., Muñoz-Sanchez, A., Santamaria-Mifsut, J. L., Barrera-Chacon, J. M., and Maestre, A.

Published
1992
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18. Abstracts of papers Rational use of drugs: 18th European Symposium on Clinical Pharmacy

Author

Dukes, M. N. G., Elenbaas, Robert M., Tognoni, G., Smith, Dorothy L., Lunde, Inga, Leufkens, H. G. M., Hekster, Y. A., Bakker, A., Ostino, G., Petri, H., Sturmans, F., Banta, H. D., Rutten, F. F. H., Martens, L. L., Noyce, P. R., Merkus, F. W. H. M., de Jong-v.d.Berg, Lolkje, Haaijer-Ruskamp, Flora, Dukes, Graham, Vidgren, B. -M., Vidgren, S., Martini, N., Sala, M. L., Scroccaro, G., Olivencia, P., McLcod, D. C., Coln, W. G., Hartzcma, A. G., Thaver, C. F., Rodriguez-Sasiain, J. M., Sangroniz, B., Mauleon, M. D., Wood, M. A., Martinez, M. J., Leinebø, O., Saugen, J. N., Marini, P., Olivato, R., Alberola, C., Cruz-Martos, E., Cruz, T., Marfagon, N., de Tejada, A. Herreros, Denig, P., Haaijer-Ruskamp, F. M., Wesseling, H., Versluis, A., Gascón, M. P., Horne, Robert, Hough, Jane, Klazinga, N. S., van Everdingen, J. J. -E., van den Broek, P. J., Roberts, D. K., Veitch, G. B. A., Tan K. K. C., Holland D. A., Allwood M. C., Nicholls, A., Astobieta, A., Calvo, R., Rodriquez-Sasiain, J. M., Barriquand, D., Pochon, C., Aulagner, G., Vial, A., Dumarest, C., Maire, P. H., Jelliffe, R. W., Brouwers, J. R. B. J., Cramer, K., Gulyas, J., vd Kam, H. J., Sijtsma, J., Donadio, C., Tramonti, G., Garcea, G., Costagli, M., Lucchetti, A., Giordani, R., Paizis, G., Pierotti, R., Falcone, G., Bianchi, C., Gallastegui C., Farré R., Jiménez I., Mangues M. A., Guasch E., Ginovart G., Sagrera X., Raspall F., Queralto J. M., Kovarik, J. M., Rademaker, C. M. A., Verhoef, J., Silvestri, L., Caputo, M., Andrew, M., Toverud, E. -L., Jimenez I., Castro I., Alvarez E., Altimiras J., van de Leur, J. J. J. P. M., Muller, N. F., Van Turnhout, J. M., Mendizabal, L., Sasiain, J. M. Rodriguez, Morana, G., Ofstad, K. Moss, Timenes, A. -M., Vroom, J. K. F., de Jong-van den Berg, L. T. W., van den Berg, P. B., de Gier, J. J., Ferres J., Recoder O., Sanchez Rio T., Garcia M. P., Julia A., Balet A., Farre R., Manques M. A., Berod, T., Dufay, E., Naveau, C., Combe, M., Sauvageon, A., Hansen, Erik Wind, Christensen, Jens Dencker, Lie-A-Huen, L., Kinqma, J. H., Meijer, D. K. P., Le Meur, F., Isoard, P., Salek, M. S., Finlay, A. Y., Khan, G. K., Luscombe, D. K., Stuurman, A., Boidin, M. P., Wallenius, K., Ojala, R., Kariluoto, A., Ikonen, M., Paes, A. H. P., Blom, A. Th. G., Bakker, A., Wallenius, S., Enlund, H., Vainio, K., Codina, C., Roca, M., Sardà, P., Corominas, N., Massó, J., Ribas, J., Kentra, K., Myllyntausta, M., Saarenpää, M., Airaksinen, M. S. A., Mendarte, L., Rimola, A., Meisters, R., Hekster, Y., Janssen, W., Cox, A., Kempen, R., Aerdts, S. J. A., van Dalen, R., Clasener, H. A. L., Festen, J., Schjphorst, PP, Benraad, HB, van Asten, P., de Wit, R., Muller, N. F., Limbeek, R. J. G., Nagel, H. G. M., Mgyboom, R. H. B., Stricker, B. H. C., van den Berg, B. A. M., Nelen, T. H. A., Tijssen, T. A. G., Wassink, P., Wassink-L'Ortije, M. J. E., Gascón, P., Selva, C., Bassons, T., Pardo, C., Mas, M. P., Saqalés, M., Sánchez, F., Mercade, V., Pujol, R., Agustí, C., Cano, M., Gurrera, T., Gorchs, M., Fabregas, X., Murgui, L. L., Verdaguer, A., Witjes, W. P. J., Vollaard, E. J., Crul, B. J. P., Limpens, C., Ahonen, K., Klaukka, T., Vohlonen, I., Martikainen, J., Goldenberg, Daniel, Brodsky, Andres, Aparici, Ines, Argeri, Cecilia, Goldenberg D., Saidman C., Sevinski L., Allevato N., Mujico B., Ubogui J., Dorfman P., Rodriguez Lupo L., Varela M., Higa J., Fourrier, Annie, Larrouturou, Philippe, Samarran, Claire, Huchet, Jacqueline, Barber, N. D., Party, N., Wilson, P., Eide, Grethe, Horvei, Kari, Kruse-Jensen, Angelika, Wold, Ingrid, Møark, Turid, Barrett, C. W., Tugwell, A. C., Søndergaard, B., Rasmussen, M., Davidsen, F., Hey, H., Kierkeby, L., Riis, L., Korhonen, M., Vidgren, P., Ojanen, T., Vidqren, M., Ferrés J., Sanchez T., Gallastequi C., Julià A., Herings, R. M. C., Stricker, B. H. Ch., Janssen, A. J. H. H., Dinter, Heike, Janssen, A. J. H. M., Barbaut, X., Proust, S., Amlagner, G., Eskens, F. A. L. M., Clasener, H. A. L., Vollaard, E. J., Arnoldussen, E., Sieradzki, E., Wanat-Słupska, E., Zlółkowska, M., Pankowska, I., Mazur, R., Ksiazkiewicz, B., Jankowski, A., Marzec, A., Marzec, C., Marzec, M. O., Marzec, J. P., Marzec, A., Mungall, D. R., Portnoy, Lynne, Lucas, F., Kadir, F., Pijpers, A., Vulto, A., Zuidema, J., Tan, K. K. C., Sutton, P., Samu, Antal, Murphy, John E., Chapman, Ronnie, Wieringa, Nicolien, de Gier, J. J., Rolloos, J., Voesten, M. T. P. J., de Meijer, P. J. J., de Koning, G. H. P., Salek, S., Reerink, E., Mungall, D. R., Farrow, L., Raskob G., Rosenbloom D., Hull R., Ferres J., Torras A., Farre R., Recorder O., Garcia M. P., Torras C., Cubellsl J., Font, M., Madridejos, R., Catalán, A., Huguet, M., Franquesa, N., Gratacós, J., Martinez, M., Saltó, A., van der Kleijn, E., ter Wee, R. J. M., Holmberg, N., and Brenninkmeijer, R. F.

Published
1989
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19. Reviews

Author

Donkers, H. W. J., Siegers, J. J., Keizer, P. K., Wemelsfelder, J., Bomhoff, Eduard J., van de Gevel, A. J. W., Hartog, F., Heertje, A., Vermaat, A. J., Rutten, F. F. H., Jacobs, H., and Rinnooy Kan, A. H. G.

Published
1983
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20. Boekbesprekingen

Author

Jepma, C. J., van der Hoek, M. P., Withagen, C., Weddepohl, H. N., Postma, J. K. T., de Roos, F., Admiraal, P. H., Rutten, F. F. H., Plantenga, J., and van der Zwan, A.

Published
1982
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24. The role of a decision rule in symptomatic pulmonary embolism patients with a non-high probability ventilation-perfusion scan

Author

Michel, B. C., Kuijer, P. M., McDonnell, J., van Beek, E. J., Rutten, F. F., Büller, H. R., and Other departments

Abstract

In order to improve the use of information contained in the medical history and physical examination in patients with suspected pulmonary embolism and a non-high probability ventilation-perfusion scan, we assessed whether a simple, quantitative decision rule could be derived for the diagnosis or exclusion of pulmonary embolism. In 140 consecutive symptomatic patients with a non-high probability ventilation-perfusion scan and an interpretable pulmonary angiogram, various clinical and lung scan items were collected prospectively and analyzed by multivariate stepwise logistic regression analysis to identify the most informative combination of items. The prevalence of proven pulmonary embolism in the patient population was 27.1%. A decision rule containing the presence of wheezing, previous deep venous thrombosis, recently developed or worsened cough, body temperature above 37 degrees C and multiple defects on the perfusion scan was constructed. For the rule the area under the Receiver Operating Characteristic curve was larger than that of the prior probability of pulmonary embolism as assessed by the physician at presentation (0.76 versus 0.59; p = 0.0097). At the cut-off point with the maximal positive predictive value 2% of the patients scored positive, at the cut-off point with the maximal negative predictive value pulmonary embolism could be excluded in 16% of the patients. We derived a simple decision rule containing 5 easily interpretable variables for the patient population specified. The optimal use of the rule appears to be in the exclusion of pulmonary embolism. Prospective validation of this rule is indicated to confirm its clinical utility

Published
1997

25. Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. 2. Cost-effectiveness and quality of life analysis. Dutch Study Group on Sacral Anterior Root Stimulation

Author

Wielink, G., Essink-Bot, M. L., van Kerrebroeck, P. E., Rutten, F. F., and Other departments

Abstract

OBJECTIVES: To present a cost-effectiveness analysis of sacral rhizotomies and electrical bladder stimulation compared with conventional care of neurogenic bladder dysfunction in patients with spinal cord injury. METHODS: During a 3-year inclusion period, data on costs and quality of life before the intervention were collected to describe conventional care. Data on the pre-implantation period, the implantation and a follow-up period of 2 years were collected following a strict protocol simultaneous with medical and urodynamic data and were used to calculate the costs and effects on quality of life of the implantation of the stimulator. RESULTS: Between June 1991 and June 1994, 52 patients with complete cervical or thoracic spinal cord lesions underwent sacral posterior rhizotomies and implantation of a Finetech-Brindley sacral anterior root stimulator. Although the initial costs of sacral anterior root stimulation are high, they are earned back in this series in about 8 years after the implantation. General indicators of the quality of life show no significant changes after the implantation. Factors related to psychological well-being and the patients' satisfaction with the emptying of the bladder increased significantly whereas the experienced problems of micturition and incontinence all decreased significantly. CONCLUSION: Sacral rhizotomies and electrical bladder stimulation make a cost-effective method of treatment of lower urinary tract dysfunction in patients with spinal cord injury. Considerable savings on health care costs are possible in the long run with simultaneous positive effects on aspects of health status

Published
1997

26. Kosten van diagnostiek en behandeling wegens longembolie lager door toepassing van de consensusstrategie

Author

Michel, B. C., Seerden, R. J., van Beek, E. J., Büller, H. R., Rutten, F. F., Erasmus School of Health Policy & Management, and Other departments

Abstract

To compare the costs of diagnosis and treatment of patients clinically suspected of pulmonary embolism, before and after the adoption of the Dutch consensus for the diagnosis of pulmonary embolism. Study of the records, followed by a prospective study with a follow-up lasting 6 months. Academic Medical Centre and Slotervaart Hospital, Amsterdam, the Netherlands. Data were collected on 120 patients from the preconsensus period and on 452 patients examined according to the consensus strategy. This established the average patterns of medical consumption of patients before and after adoption of consensus. The mean costs per patient were then estimated. Diagnosis and treatment of a patient according to the consensus strategy on the basis of our estimates were considerably less expensive than non-protocolled diagnosis and treatment (Dfl. 4,413 as against Dfl. 5,115 per patient). This difference mainly resulted from shorter hospital stays owing to more rapid completion of the diagnosis. Considering the large number of annual hospital admissions in the Netherlands in connection with this diagnosis, savings of up to Dfl. 26 million would appear possible if the consensus were followed nationwide. Considerable amounts are involved in the diagnosis and treatment of pulmonary embolism in the Netherlands. Accordingly, further research into possibilities to make these more efficient would appear advisable

Published
1996

28. Cost-effectiveness of HA-1A treatment for patients with sepsis

Author

van Hout, B. A., Birnie, E., Redekop, W. K., Lorijn, R. H., Bossuyt, P. M., Rutten, F. F., and Other departments

Subjects
health care economics and organizations
Abstract

The cost-effectiveness of prescribing HA-1A for sepsis patients was analyzed by comparing effectiveness and direct medical costs. Effectiveness was estimated on the basis of published data from a randomized clinical trial. Costs were determined by combining data from the same trial with expectations about hospital days. Average costs per life year gained were estimated at 25,000 Dutch guilders (1 Dutch guilder is approximately 53 US cents). Sensitivity analyses were applied and showed that the effectiveness and cost-effectiveness of treating patients with HA-1A depend a great deal on the expected duration of survival after successful treatment. If the objective is to maximize the cost-effectiveness of treatment, this means that the prognosis of the patient should be considered when deciding about the appropriateness of treatment with HA-1A. As one would expect, another way to increase cost-effectiveness would be to increase the proportion of gram-negative sepsis patients amongst those receiving treatment

Published
1994

29. More co‐morbid depression in patients with Type 2 diabetes with multiple complications. An observational study at a specialized outpatient clinic

Author

van Steenbergen‐Weijenburg, K. M., primary, van Puffelen, A. L., additional, Horn, E. K., additional, Nuyen, J., additional, Sytze van Dam, P., additional, van Benthem, T. B., additional, Beekman, A. T. F., additional, Rutten, F. F. H., additional, Hakkaart‐van Roijen, L., additional, and van der Feltz‐Cornelis, C. M., additional

Published
2010
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34. Randomized placebo-controlled trial of granulocyte-macrophage colony-stimulating factor in patients with chemotherapy-related febrile neutropenia.

Author

Vellenga, E, primary, Uyl-de Groot, C A, additional, de Wit, R, additional, Keizer, H J, additional, Löwenberg, B, additional, ten Haaft, M A, additional, de Witte, T J, additional, Verhagen, C A, additional, Stoter, G J, additional, Rutten, F F, additional, Mulder, N H, additional, Smid, W M, additional, and de Vries, E G, additional

Published
1996
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36. The cost of treatment of Alzheimer's disease in The Netherlands: a regression-based simulation model.

Author

McDonnell, J., Redekop, W.K., van der Roer, N., Goes, E., Ruitenberg, A., Busschbach, J.J.V., Breteler, M.M.B., Rutten, F.F.H., Busschbach, J J, Breteler, M M, and Rutten, F F

Subjects
ALZHEIMER'S disease treatment, MEDICAL economics, NURSING care facilities, SENIOR housing, ALZHEIMER'S disease, COMPARATIVE studies, ECONOMIC aspects of diseases, RESEARCH methodology, MEDICAL cooperation, PSYCHOLOGICAL tests, RESEARCH, EVALUATION research, EDUCATIONAL attainment, SEVERITY of illness index, ECONOMICS
Abstract

Objective: To examine the potential economic impact of treatment of Alzheimer's disease.Design: Regression-based simulation estimation of the long term costs of Alzheimer's disease under a number of treatment scenarios. Data from an epidemiological study conducted in Rotterdam, The Netherlands, was used to simulate disease progression. Comparison of the costs and effectiveness experienced by the patients were used to measure the impact of treatment.Patients and Intervention: 2 theoretical cohorts of patients with Alzheimer's disease, one of which receives standard treatment, while the other receives a treatment which slows cognitive decline as measured by the Mini-Mental State Examination (MMSE).Main Outcome Measures and Results: Under one of the scenarios examined, the baseline cost of Alzheimer's disease was 97,866 euro (EUR; 1996 values) per patient over 10 years' follow-up; the cost was almost EUR100,000 under all scenarios. Life expectancy following onset was about 4.5 years and MMSE decline was approximately 2 points per year for a typical prevalent (existing) patient and almost twice as much for incident (newly diagnosed) patients (1.82 vs 3.42 points per year, respectively). Slowing the rate of cognitive decline results in a slightly increased life expectancy, with more time being spent at home and less in a nursing home. Total costs (excluding those of therapy) will decrease, but savings will be modest and may well be less than the cost of therapy. Under the same scenario, total savings were EUR1,571 per patient which corresponds to an annual break-even cost of just EUR453. Decisions regarding the initiation or termination of therapy will affect both the number of patients treated and the costs and potential savings of treatment.Conclusions: The savings made in treating Alzheimer's disease will almost certainly be small in comparison with total costs and may well be offset by the cost of the treatment itself. Simulation models can be used to estimate the effect of therapy on the costs of care and can be useful tools in clinical decision-making and allocation of resources. These results show the need for further research into the costs and effects of treatment of Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Published
2001
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37. Cost effectiveness of continuous terbinafine compared with intermittent itraconazole in the treatment of dermatophyte toenail onychomycosis: an analysis of based on results from the L.I.ON. study. Lamisil versus Itraconazole in Onychomycosis.

Author

Jansen, R., Redekop, W.K., Rutten, F.F.H., and Rutten, F F

Subjects
ONYCHOMYCOSIS, DERMATOPHYTES, THERAPEUTICS, CLINICAL trials, ANTIFUNGAL agents, COMPARATIVE studies, COST effectiveness, FOOT diseases, RESEARCH methodology, HYDROCARBONS, MEDICAL cooperation, RESEARCH, EVALUATION research, RANDOMIZED controlled trials, ITRACONAZOLE, ECONOMICS
Abstract

Objective: To compare the costs and effectiveness of 2 oral antifungal treatment regimens in patients with dermatophyte toenail onychomycosis.Design and Methods: A cost-effectiveness analysis using a model based on data from the Lamisil versus Itraconazole in Onychomycosis (L.I.ON.) study, a randomised controlled trial comparing continuous terbinafine with intermittent itraconazole. The trial included 4 treatment arms: terbinafine 250 mg/day for 12 or 16 weeks (T12, T16) and itraconazole 400 mg/day for 1 week in every 4 weeks for 12 or 16 weeks (I3, I4). Cost calculations for 6 countries (Finland, Germany, Iceland, Italy, The Netherlands, UK) included costs for medication, physician visits, laboratory tests, management of adverse events and management of relapse. Effectiveness was based on complete cure rates (mycological cure plus 100% toenail clearing). Costs per complete cure were determined and both average and incremental cost-effectiveness ratios were calculated.Perspective: Healthcare system.Main Outcome Measures and Results: In the L.I.ON. study, terbinafine was seen to be more effective than itraconazole (cure rates, 45.8 vs 23.4%). In most comparisons (5 of the 6 countries), the costs of T12 were statistically significantly lower than those of I3 [range: -37 to -173 euros (EUR); 1998 values; 1.172 US dollars = EUR1], indicating that T12 was the dominant strategy (i.e. less expensive and more effective). One exception (Finland) showed an incremental cost-effectiveness ratio of EUR524 per additional cure. In the other 5 countries, T16 and 14 were essentially equal in cost, but the greater effectiveness of T16 (cure rates, 55.1 vs 25.9%) resulted in a situation of extended dominance.Conclusion: From a healthcare system perspective, continuous terbinafine is less costly and more effective than intermittent itraconazole in the treatment of dermatophyte toenail onychomycosis. [ABSTRACT FROM AUTHOR]

Published
2001
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38. Differences in attitudes, knowledge and use of economic evaluations in decision-making in The Netherlands. The Dutch results from the EUROMET Project.

Author

Zwart-van Rijkom, J.E.F., Leufkens, H.G.M., Busschbach, J.J.V., Broekmans, A.W., Rutten, F.F.H., Zwart-van Rijkom, J E, Leufkens, H G, Busschbach, J J, and Rutten, F F

Subjects
MEDICAL care, DECISION making, ATTITUDE (Psychology), COMPARATIVE studies, COST effectiveness, INTELLECT, RESEARCH methodology, MEDICAL cooperation, RESEARCH, EVALUATION research
Abstract

Objective: To investigate differences in attitudes, knowledge and actual use of economic evaluations in different groups of decision-makers, and to compare the results from the Netherlands with the overall European results of the European Network on Methodology and Application of Economic Evaluation Techniques (EUROMET) project.Design and Setting: Members of the EUROMET group conducted interviews and surveys with politicians, regulators, hospital pharmacists and physicians in The Netherlands. Three approaches of investigation could be adopted: (i) a postal questionnaire survey, (ii) semi-structured interviews, and (iii) a focus-group approach.Main Outcome Measures and Results: In the Netherlands, decision-makers generally have a positive attitude towards economic evaluations. Nevertheless, their actual use and knowledge of economic evaluations are still limited. Hospital pharmacists and regulators are more objective than physicians and politicians, who also base their judgements on other societal values. Hospital pharmacists and regulators have a greater knowledge of economic evaluations, and they use them more often than the other groups. Most decision-makers do not want to base their decisions strictly on a cost-effectiveness ranking alone. Our findings were similar to the findings in other European countries.Conclusions: Decision-makers prefer to make their own broad comparisons of advantages and disadvantages, and do not base their decisions solely on a single summary measure. [ABSTRACT FROM AUTHOR]

Published
2000
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39. Cost of illness in adult patients with hypopituitarism.

Author

Ehrnborg, C., Hakkaart-van Roijen, L., Jonsson, B., Rutten, F.F.H., Bengtsson B-Å., Rosén, T., Rutten, F F, Bengtsson, B A, and Rosén, T

Subjects
MEDICAL care costs, SHEEHAN'S syndrome
Abstract

Objective: To compare the healthcare costs of patients with hypopituitarism with those of individuals from the general population.Design: A retrospective study of costs over 1 year. Estimates of direct and indirect health-related costs were calculated for patients from the general population using existing databases, and for patients with hypopituitarism using records of all patients eligible to participate on 31 December 1989 who could be traced, were willing to participate and had not been treated for acromegaly or Cushing's disease.Setting: The catchment area of the Endocrine Unit, Sahlgrenska Hospital, Gothenburg. The study was conducted from the societal perspective. Reference data were collected from official regional and national registries.Patients: 199 patients with adult-onset hypopituitarism in whom replacement therapy was given to maintain the adrenal, thyroid and gonadal (but not the somatotropic) axes.Main Outcome Measures and Results: Direct and indirect costs incurred by patients with hypopituitarism were higher than those incurred by individuals from the general population. The total direct costs per patient were Swedish Crowns (SEK)22,920 vs SEK12,080 (p < 0.003) in the general population, and the highest costs were related to inpatient care. Of the patients aged 16 to 64 years, 22% had drawn a disability pension versus the expected 11.3% (p < 0.003) in the general population, and the patients had a mean sick leave of 38.4 days vs 23.5 (p < 0.001). Total excess costs for all patients with hypopituitarism were SEK 35,768 per patient (p < 0.007).Conclusions: Patients with hypopituitarism incur more health-related costs than individuals from the general population. They also take more sick leave days and are more likely to claim a disability pension than members of the general population. Further cost analyses are needed to determine whether improvements in diagnostic and surgical procedures, and hormone replacement therapy, can reduce the healthcare costs of patients with hypopituitarism. [ABSTRACT FROM AUTHOR]

Published
2000
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41. Technology assessment of the Dutch Lung Transplantation Program.

Author

Van Enckevort, Petra J., Tenvergert, Elisabeth M., Bonsel, Gouke J., Geertsma, Albert, Van Der Bij, Wim, De Boer, Wim J., Koopmanschap, Marc A., Al, Maiwenn J., Ruttten, Frans F.h., van Enckevort, P J, TenVergert, E M, Bonsel, G J, Geertsma, A, van der Bij, W, de Boer, W J, Koopmanschap, M A, Al, M J, and Rutten, F F

Published
1998
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43. Aggregated Dynamic Demand Equations for Specialistic-outpatient Medical Care.

Author

van der Gaag, J., Rutten, F. F. H., Van de Ven, W., and Van Praag, B. M. S.

Subjects
OUTPATIENT medical care, PATIENTS, INSURANCE, MEDICAL care
Abstract

In this paper a dynamic model is presented which describes the development of the demand for specialistic medical care in The Netherlands, during the period 1960-1972. The "regionally correlated, time-wise auto-regressive" model is consistently estimated from a time-series of cross-sections, using a modified Aitken estimator. The dependent variables are the number of publicly insured patients referred from general care to specialistic care, and the amount of care consumed per patient referred. As independent variables we took demographic factors, the supply of different levels of medical care and the insurance system. The estimation results show a.o. important substitution possibilities between general and specialistic care, and a significant influence of supply and supply-related variables on the demand for specialistic care. [ABSTRACT FROM AUTHOR]

Published
1977
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