Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.

Previous research indicates that patient self-measured blood pressure (SMBP) is a cost-effective strategy for improving hypertension (HTN) diagnosis and control. However, it is unknown which specific uses of SMBP produce the most value. Our goal is to estimate, from an insurance perspective, the return-on-investment (ROI) and net present value associated with coverage of SMBP devices when used (a) only to diagnose HTN, (b) only to select and titrate medication, (c) only to monitor HTN treatment, or (d) as a bundle with all three uses combined.

Cost-benefit analysis of home blood pressure monitoring in hypertension diagnosis and treatment: an insurer perspective.

Home blood pressure (BP) monitoring has been shown to be more effective than clinic BP monitoring for diagnosing and treating hypertension. However, reimbursement of home BP monitoring is uncommon in the United States because of a lack of evidence that it is cost beneficial for insurers. We develop a decision-analytic model, which we use to conduct a cost-benefit analysis from the perspective of the insurer.

A model for estimating the economic impact of secondhand smoke exposure: a study in Indiana.

Objective: This study estimated the economic cost of health services and premature loss-of-life costs from secondhand smoke (SHS) exposure in Indiana.

Design And Setting: Costs of SHS-related mortality and morbidity were estimated using national attributable risk values for diseases that are causally related to SHS exposure both for adults and children. Estimated direct costs included hospital inpatient costs, loss-of-life costs, and ambulatory care costs where available, based on the most currently available Indiana hospital discharge data, vital statistics, census data, and nationally published research.

Effect of personal characteristics on individual support for indoor smoke-free air laws, Indiana, 2008.

Introduction: Policy makers should understand the attitudes and beliefs of their constituents regarding smoke-free air legislation. The purpose of this study was to evaluate the effect of selected personal characteristics on attitudes and beliefs about secondhand smoke in Indiana and on support for smoke-free air laws.

Methods: Data were obtained from the 2008 Indiana Adult Tobacco Survey of 2,140 adults and included 11 sociodemographic variables.

Perspective: is it time for advocacy training in medical education?

As the modern medical system becomes increasingly complex, a debate has arisen over the place of advocacy efforts within the medical profession. The authors argue that advocacy can help physicians fulfill their social contract. For physicians to become competent in patient-centered, clinical, administrative, or legislative advocacy, they require professional training.

A decade of sustaining best practices for tobacco control: Indiana's story.

The Indiana Tobacco Prevention and Cessation Agency (ITPC) was created in 2000 to address high tobacco use rates. This independent state agency, using Centers for Disease Control and Prevention (CDC) Best Practices for Comprehensive Tobacco Control Programs, administered a comprehensive program that supported community health coalitions and evidence-based public policy changes. From 2000 to 2011, ITPC operated in difficult budgetary and political environments and with less than 20% of the funding recommended by CDC.

A cross-sectional survey on the inclusion of tobacco prevention/cessation, nutrition/ diet, and exercise physiology/fitness education in medical school curricula.

Chronic diseases are currently the major cause of death and disability worldwide. Addressing the main causes of chronic diseases from a preventive perspective is imperative for half ing a continual increase in premature deaths. Physicians occupy a unique position to assist individuals with chronic disease prevention.

Applying the theory of planned behavior to explore the relation between smoke-free air laws and quitting intentions.

Smoke-free air policies have been shown to reduce smoking, but the mechanism of behavior change is not well understood. The authors used structural equation modeling to conduct a theory of planned behavior analysis with data from 395 smokers living in seven Texas cities, three with a comprehensive smoke-free air law and four without a comprehensive law. Agreement with regulating smoking in public places was significantly associated with attitudes and perceived normative pressure about quitting.

The combined effect of behavioral intention and exposure to a smoke-free air law on taking measures to quit smoking.

Because of the large burden of disease attributable to cigarette smoking, a variety of tobacco control interventions, some focused on changing individual behavior and others focused on influencing societal norms, have been introduced. The current study tested the combined effect of behavioral intention and exposure to a comprehensive smoke-free air law as a prospective predictor of taking measures to quit smoking. Participants were 187 adults living in 7 Texas cities, 3 with a comprehensive smoke-free air law and 4 without such a law, who reported current cigarette smoking at baseline and completed a 1-month follow-up interview.

Trends in adult attitudes toward secondhand smoke in Indiana, 2002-2007: the impact of smoking status.

Purpose: As more research has been distributed through the media about the negative health impact of exposure to secondhand smoke (SHS), the public's support for smoke-free policies has increased. The purpose of this study was to evaluate trends in knowledge and attitudes about SHS exposure among Indiana adults by smoking status.

Methods: Study data were from four cross-sectional studies previously conducted by the Indiana Tobacco Prevention and Cessation Agency using the Adult Tobacco Survey protocol between the years 2002 and 2007.

Planners to the rescue: spatial planning facilitating the development of offshore wind energy.

The development of offshore wind energy has started to take place surprisingly quickly, especially in North European waters. This has taken the wind energy industry out of the territory of planning systems that usually govern the siting of wind farms on land, and into the world of departmental, sectoral regulation of marine activities. Although this has favoured the expansion of offshore wind energy in some respects, evidence suggests that the practice and principles of spatial planning can make an important contribution to the proper consideration of proposals for offshore wind arrays.

Leroy E. Burney, MD, MPH: quiet champion of American dentistry and dental research at mid-century.

Leroy E. Burney was a preeminent Surgeon General and was recognized for modernizing the Public Health Service. He promoted environmental public health and access to health care for the poor.

Tobacco cessation and nicotine replacement therapy for dental practice.

Addictive tobacco use is the single greatest cause of disease and premature death in America today, responsible for more than 430,000 deaths annually. Smoked and smokeless tobacco intake have profound ill effects on oral tissues, especially those tissues associated with periodontal structures. This article describes the interactive aspects of addictive cigarette smoking and presents specific clinical and systems-based tobacco cessation interventions that can be utilized by health care providers.

Estimating the economic impact of secondhand smoke on the health of a community.

Purpose: This study provides a model to estimate the health-related costs of secondhand smoke exposure at a community level.

Model Development: Costs of secondhand smoke-related mortality and morbidity were estimated using national attributable risk values for diseases that are causally related to secondhand smoke exposure for adults and children. Estimated costs included ambulatory care costs, hospital inpatient costs, and loss of life costs based on vital statistics, hospital discharge data, and census data.

Evaluating the capability of information technology to prevent adverse drug events: a computer simulation approach.

Background: The annual cost of morbidity and mortality due to medication errors in the U.S. has been estimated at $76.

Modeling the costs and outcomes of cardiovascular surgery.

Coronary artery bypass graft (CABG) operations consume more health care resources than any other single procedure. The objective of this study was to develop a computer simulation model that can be used to predict costs and patient outcomes of CABG surgery. The analysis is based on a systems dynamic model developed using STELLA software.