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Hellbom, Gunn
Publications (3 of 3) Show all publications
Persson, J., Husberg, M., Hellbom, G. & Fries, A. (2007). Kostnader och effekter vid förskrivning av rollatorer. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Kostnader och effekter vid förskrivning av rollatorer
2007 (Swedish)Report (Other academic)
Abstract [en]

The aim of this study was to investigate effectiveness and cost-effectiveness of rehabilitation by means of walkers for persons with restricted mobility (fourwheeled walkers). The walkers were of a number of different brands and models.

The study group included 205 first time users with several different diagnoses. The study was designed as a pre/post study with follow-up three months after the delivery of the walker. The “functional diagnosis” of the user the walker models prescribed and labour time used by thew staff were reported by the prescribing staff (physiotherapists and occupational therapists). Background data and various outcomes were reported through questionnaires by the users themselves.

The users reported a number of positive effects of the intervention:

  • less need for help on a daily basis,
  • increased possibilities to participate in "activities outside home",
  • less problems in carrying out daily activities,
  • significant improvement in generic quality of life, measured by means of the instrument EuroQol (EQ-5D).

The average cost of the walkers amounted to SEK 1 300. In addition, there were labour costs related to examinations and the delivery of the walkers, amounting to SEK 300. The direct costs per case amounts to about SEK 1 600 on average.

The only indirect cost where a change due to the delivery of the walker could be expected was “special transport service”. There was a slight, although nonsignificant, increase in this cost, after delivery of the walkers.

With the estimated gain in quality of life of 0,07 (on the scale of EQ-5D, ranging from 0,0 to 1,0), we derived a cost per quality adjusted years gained (cost/QALY) of SEK 24 000. This means a very favourable balance between costs and effects, supporting high ranking in priority lists.

Abstract [sv]

Studiens   syfte   var  att  undersöka   effektivitet   och   kostnadseffektivitet   vid

nyförskrivning av rollatorer. Brukarnytta studeras utifrån förmåga att bemästra väsentliga   problem  i  vardagslivet   och  också  förändringar   i  hälsorelaterad livskvalitet. Vidare studerades kostnader som hänförs till rollatorförskrivning.

Målet  var  att  skapa  underlag  för  beslut  om  rollatorförskrivning.  Arbetet  har gjorts i samverkan med landstingen i Östergötlands, Kalmar och Jönköpings län och ett antal kommuner.

Studiens uppläggning och val av effektmått baserades på rollator-förskrivnings syfte vad gäller att övervinna begränsningar i individernas aktiviteter och delaktighet. Alla resultatmått bygger på skattningar gjorda av individerna själva.

Datainsamling  genomfördes  med hjälp av arbetsterapeuter  och sjukgymnaster, verksamma som förskrivare vid landsting och kommuner. Studien var upplagd som  en  före/efter-studie  med  "baseline"-mätning  före  förskrivning  och  upp- följning tre månader efter det att rollatorn levererats. Totalt ingick 205 brukare i studien.

Brukarna rapporterade ett antal positiva effekter av rollatorförskrivningen:

• mindre hjälpbehov,

• ökade möjligheter att delta i aktiviteter utanför hemmet,

• minskning av problem vad gäller att genomföra dagliga aktiviteter,

• signifikanta  förbättringar  i generisk  livskvalitet,  mätt  med  instrumentet EuroQol (EQ-5D).

Kostnaderna  för  rollatorförskrivning  uppgick  i  medel  per  brukare  till  1 300 kronor och utredningskostnader till ca 300 kronor, dvs totalt ca 1 600 kronor. En skattning  av  kostnadseffektiviteten,  baserad  på  ett  års  kalkyl  och  en  skattad hälsovinst på 0,07 (EQ-5D), ger en inkrementell kostnadseffektivitet på 24 000 kronor  per  vunnet  kvalitetsjusterat  levnadsår.  Härvid  jämfördes  effekten  av förskrivning med situationen före förskrivning. Resultatet är att betrakta som en mycket  låg  kostnad  per  vunnet  kvalitetsjusterat  levnadsår,  dvs  en  gynnsam balans   mellan   effektivitet   och   kostnad.   Resultatet   talar   för   att   rollator- förskrivning bör rankas högt i prioriteringslistor.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2007. p. 28
Series
CMT Report, ISSN 0283-1228, E-ISSN 1653-7556 ; 2007:3
Keywords
Cost-benefit-analys, rollatorer
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-40749 (URN)LIU CMT RA/0703 (ISRN)54032 (Local ID)54032 (Archive number)54032 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2018-02-20Bibliographically approved
Persson, J., Bernfort, L., Hellbom, G., Danermark, B., Borg, E., Gullbrandsson, A. & Husberg, M. (2005). Cost-effectiveness in rehabilitation of hearing impaired people.. In: Alain Pruski and Harry Knops (Ed.), Assistive Technology: From Virtuality to Reality AAATE 2005 (pp. 750-754). IOS Press
Open this publication in new window or tab >>Cost-effectiveness in rehabilitation of hearing impaired people.
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2005 (English)In: Assistive Technology: From Virtuality to Reality AAATE 2005 / [ed] Alain Pruski and Harry Knops, IOS Press , 2005, p. 750-754Chapter in book (Other academic)
Abstract [en]

The title of this book points towards the difficulty encountered in research and development carried out by laboratories to reach the users. From Virtuality to Reality aims at alerting  developers so that they pay a particular attention to the outcome of their work. Inventive research as well as new technologies which have a very high potential in the field of assistive technology are described in this publication. Despite the fact that recent products take more and more frequently into account the specific needs of the handicapped people, there remains a long road ahead until these products become available to everyone. Assistive technology has to adapt to today’s fast technological developments. Because new technologies are developing too rapidly, there is no choice but to adapt to this ceaseless evolution. The elderly or handicapped people are facing more and more difficulties in interacting with the assistive technology experts. Technology is an essential component of the activity but it is even more important to take into account the human factor if the aim is to enable users to benefit from assistive technologies. As a consequence, developers must work with a unique objective based on a user-centered approach. This requires a multidisciplinary collaboration  which is one of the prime movers of their research and also one of the keys of success.

Place, publisher, year, edition, pages
IOS Press, 2005
Series
Assistive technology research series, ISSN 1383-813X ; 16
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-31944 (URN)17779 (Local ID)1-58603-543-6 (ISBN)978-1-58603-543-3 (ISBN)17779 (Archive number)17779 (OAI)
Note

sid 750-754

Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2013-10-09Bibliographically approved
Persson, J. & Hellbom, G. (2003). Balancing societal costs and users' quality of life - priority setting of interventions for the hard-of-hearing. International Journal of Audiology, 42, S9-S12
Open this publication in new window or tab >>Balancing societal costs and users' quality of life - priority setting of interventions for the hard-of-hearing
2003 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 42, p. S9-S12Article in journal (Refereed) Published
Abstract [en]

In this paper, the need for priority setting in rehabilitation, especially in audiology, and various approaches to providing information for priority setting are discussed. A set of outcome measures is proposed, and their applicbility to vertical and horizontal prioritization are considered. Two types of measures are proposed: individual problems assessment. and utility analysis. Results from a European multicentre study and a Swedish study illustrate the performance of the measures in the areas of mobility, hearing, and speech communication. For rehabilitation in the hard-of-hearing, the two types of measures provide different kinds of information, illustrated by the results of simultaneous use of the instruments.

Keywords
hearing devices, cost-effectiveness, priority setting, outcomes, quality of life
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-48590 (URN)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
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