Background: Rehabilitation is effective for multiple sclerosis, but is it value for money?
Objectives: To evaluate functional outcomes, care needs and cost-efficiency of specialist inpatient rehabilitation for adults with multiple sclerosis (MS).
Methods: A multicentre cohort study of prospectively collected clinical data from the UK Rehabilitation Outcomes Collaborative national clinical database. Data included all adults with MS ( = 1007) admitted for specialist inpatient (Level 1 or 2) rehabilitation in England, 2010-2018.
Outcome Measures: Dependency/care needs: Northwick Park Dependency Scale/Care Needs Assessment, Functional independence: UK Functional Assessment Measure (UK FIM+FAM). Cost-efficiency. Patients were analysed in three dependency groups (High/Medium/Low).
Results: All groups showed significant reduction in dependency between admission and discharge on all measures (paired -tests: < 0.001). Mean reduction in care costs/week was greatest in the most dependent patients: High: £519 (95% CI: 447-597), Medium: £148 (76-217), Low: £36 (12-83). Despite longer stays, time taken to offset the cost of rehabilitation was shortest in the most dependent patients: High: 12.9 (12.0-14.1) months; Medium: 29.3 (21.3-51.8); Low: 76.8 (0-36.1). Item-level changes corresponded with clinical experience.
Conclusions: Specialist rehabilitation provided good value for money in patients with MS, yielding improved outcomes and substantial savings in ongoing care costs, especially in high-dependency patients.
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http://dx.doi.org/10.1177/2055217320912789 | DOI Listing |
Oncoscience
January 2025
McGill Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Importance: Cervical cancer is the fourth most common cancer among women globally and a significant cause of cancer-related deaths. Understanding the impact of cervical cancer diagnosed during pregnancy on maternal, delivery, and neonatal outcomes is crucial for improving clinical management and outcomes for affected women and their children.
Objective: To determine the effects of cervical cancer diagnosed during pregnancy on maternal, delivery, and neonatal outcomes using a population based, American database.
Eur J Health Econ
January 2025
Department of Business Administration and Health Care Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany.
Introduction: Cesarean deliveries account for approximately one-third of all births in Germany, prompting ongoing discussions on cesarean section rates and their connection to medical staffing and birth volume. In Germany, the majority of departments integrate obstetric and gynecological care within a single department.
Methods: The analysis utilized quality reports from German hospitals spanning 2015 to 2019.
PeerJ
January 2025
Department of Nursing and Public Health, University of Northern Iowa, Iowa, United States of America.
Background: The risk of non-communicable diseases (NCDs) in conflict and post-conflict settings in Northeastern Nigeria has not been evaluated to date. As this region undergoes recovery, understanding the prevalence of NCDs, such as hypertension, diabetes, depression, and obesity, and the associated behavioral coping mechanisms, is crucial for developing tailored healthcare solutions. Therefore, this study aimed to assess the impact of conflict on the prevalence of NCDs in conflict-exposed areas in Northeastern Nigeria compared with non-conflict regions.
View Article and Find Full Text PDFBr J Hosp Med (Lond)
December 2024
Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK.
Child and adolescent psychiatric inpatient admissions out-of-area or to adult wards are frequently discussed in the national media. No previous systematic reviews have investigated the impact of such admissions. Systematic searches of MEDLINE, Embase, CINAHL, PsycINFO, PsycArticles, King's Fund, Google Scholar, The Health Foundation, Social Care Online, Cochrane Library, Royal College of Psychiatrists, Web of Science and Econ light databases were conducted alongside grey literature searches.
View Article and Find Full Text PDFInt J Cardiol
January 2025
Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, UK; National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK. Electronic address:
Background: Specialist cardiac care has been shown to reduce inpatient mortality following non-ST segment myocardial infarction (NSTEMI), but whether this benefit extends beyond index admission is unclear.
Methods: Using the linked Myocardial Ischaemia National Audit Project (MINAP) registry, and Office for National Statistics mortality recording, we included 425,205 NSTEMI patients admitted to UK hospitals, between January 2005 and March 2019 that survived to discharge. 217,964 (52 %) were admitted to a specialty cardiac ward.
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