Economic evaluation of aquatic exercise for persons with osteoarthritis.

Abstract:

OBJECTIVES:To estimate cost and outcomes of the Arthritis Foundation aquatic exercise classes from the societal perspective. DESIGN:Randomized trial of 20-week aquatic classes. Cost per quality-adjusted life year (QALY) gained was estimated using trial data. Sample size was based on 80% power to reject the null hypothesis that the cost/QALY gained would not exceed $50,000. SUBJECTS AND METHODS:Recruited 249 adults from Washington State aged 55 to 75 with a doctor-confirmed diagnosis of osteoarthritis to participate in aquatic classes. The Quality of Well-Being Scale (QWB) and Current Health Desirability Rating (CHDR) were used for economic evaluation, supplemented by the arthritis-specific Health Assessment Questionnaire (HAQ), Center for Epidemiologic Studies-Depression Scale (CES-D), and Perceived Quality of Life Scale (PQOL) collected at baseline and postclass. Outcome results applied to life expectancy tables were used to estimate QALYs. Use of health care facilities was assessed from diaries/questionnaires and Medicare reimbursement rates used to estimate costs. Nonparametric bootstrap sampling of costs/QALY ratios established the 95% CI around the estimates. RESULTS:Aquatic exercisers reported equal (QWB) or better (CHDR, HAQ, PQOL) health-related quality of life compared with controls. Outcomes improved with regular class attendance. Costs/QALY gained discounted at 3% were $205,186 using the QWB and $32,643 using the CHRD. CONCLUSION:Aquatic exercise exceeded $50,000 per QALY gained using the community-weighted outcome but fell below this arbitrary budget constraint when using the participant-weighted measure. Confidence intervals around these ratios suggested wide variability of cost effectiveness of aquatic exercise.

journal_name

Med Care

journal_title

Medical care

authors

Patrick DL,Ramsey SD,Spencer AC,Kinne S,Belza B,Topolski TD

doi

10.1097/00005650-200105000-00002

keywords:

subject

Has Abstract

pub_date

2001-05-01 00:00:00

pages

413-24

issue

5

eissn

0025-7079

issn

1537-1948

journal_volume

39

pub_type

临床试验,杂志文章,随机对照试验
  • Whither triazolam?

    abstract:OBJECTIVES:The authors compare the extent and nature of triazolam use before and after its deletion from a health maintenance organization's (HMO) open and advisory-type drug formulary. METHODS:Benzodiazepine dispensings of HMO members were collected for the 3 years before (1989-1991) and for the 2 years after (1992-1...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199704000-00002

    authors: Johnson RE,McFarland B,Woodson GT

    更新日期:1997-04-01 00:00:00

  • Access to inpatient or residential substance abuse treatment among homeless adults with alcohol or other drug use disorders.

    abstract:OBJECTIVES:We conducted a theoretically guided study of access to inpatient or residential treatment among a probability sample of homeless adults with alcohol or drug use disorders in Houston, Texas. METHODS:This study used a cross-sectional, retrospective design with data collected from a multistage random sample of...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200111000-00003

    authors: Wenzel SL,Audrey Burnam M,Koegel P,Morton SC,Miu A,Jinnett KJ,Greer Sullivan J

    更新日期:2001-11-01 00:00:00

  • A study of central-city hospital changes.

    abstract::This study was initiated to determine the extent of hospital capacity reduction in large U.S. cities. In addition, hospital bed and service additions were analyzed. Study data indicate that between 1976 and 1978 more than 5,000 beds were closed in the 36 cities surveyed. This constitutes 2.7% of total hospital beds in...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198007000-00004

    authors: Ermann D,Aronoff R

    更新日期:1980-07-01 00:00:00

  • The effects of ownership, operating environment, and strategic choices on nursing home efficiency.

    abstract::This article reports on a study of the labor efficiency of 461 nursing homes located in Pennsylvania. Data envelopment analysis was used to estimate efficiency scores. Tobit equations were estimated for the entire sample and for subsamples consisting of for-profit (FP) and not-for-profit (NFP) nursing homes. The autho...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199510000-00003

    authors: Rosko MD,Chilingerian JA,Zinn JS,Aaronson WE

    更新日期:1995-10-01 00:00:00

  • The influence of race and ethnicity on complications and mortality after orthopedic surgery: a systematic review of the literature.

    abstract:BACKGROUND:The decision to perform orthopedic surgery requires substantial discretion and judgment. Similar conditions have been associated with health care disparities in other fields, but the extent of racial and ethnic disparities in orthopedics is unknown. OBJECTIVE:To evaluate the quality of extant orthopedic lit...

    journal_title:Medical care

    pub_type: 杂志文章,评审

    doi:10.1097/MLR.0000000000000177

    authors: Schoenfeld AJ,Tipirneni R,Nelson JH,Carpenter JE,Iwashyna TJ

    更新日期:2014-09-01 00:00:00

  • Emergence of item response modeling in instrument development and data analysis.

    abstract::In summary, readers are encouraged to read carefully the IRT articles in this special issue. They provide theoretical as well as practical arguments in favor of using IRT models in the health outcomes measurement field. At the same time, readers should be aware that the IRT field is complex and software is limited and...

    journal_title:Medical care

    pub_type: 评论,杂志文章

    doi:10.1097/00005650-200009002-00009

    authors: Hambleton RK

    更新日期:2000-09-01 00:00:00

  • Health care CBA/CEA: an update on the growth and composition of the literature.

    abstract::Cost-benefit (CBA) and cost-effectiveness analyses (CEA) are methods that enumerate the costs and consequences associated with health-related technologies, services, and programs. This article examines the trends in published CBA and CEA of personal health services from 1979 through 1990. It is based on a bibliography...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199307001-00001

    authors: Elixhauser A,Luce BR,Taylor WR,Reblando J

    更新日期:1993-07-01 00:00:00

  • Would eliminating differences in physician practice style reduce geographic variations in cataract surgery rates?

    abstract::This study uses Medicare physician-claims data to examine patient and physician contributions to variations in cataract surgery rates across U.S. metropolitan areas. Utilization is modelled as having two phases: the decision to seek an ophthalmologist's care, which is made by patients, and the decision to perform surg...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199312000-00004

    authors: Escarce JJ

    更新日期:1993-12-01 00:00:00

  • Rates of complete colonic evaluation after incomplete colonoscopy and their associated factors: a population-based study.

    abstract:BACKGROUND:With the increasing use of colonoscopy there is growing concern about the quality of these procedures. OBJECTIVE:To evaluate the rates of complete colonic evaluation after an incomplete colonoscopy and their associated factors. METHODS:Men and women > or =50 years old living in Ontario on January 1, 1997 w...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e31817d92bc

    authors: Rizek R,Paszat LF,Stukel TA,Saskin R,Li C,Rabeneck L

    更新日期:2009-01-01 00:00:00

  • Counter-Point: Early Warning Systems Are Imperfect, but Essential.

    abstract::Sequential analysis can be used as an early warning system about potential unintended consequences of health policy decisions, generating follow-up investigations, but it should not be used as causal evidence. ...

    journal_title:Medical care

    pub_type: 评论,杂志文章

    doi:10.1097/MLR.0000000000000896

    authors: Lu CY,Simon G,Soumerai SB,Kulldorff M

    更新日期:2018-05-01 00:00:00

  • A measurement model of the Medical Outcomes Study 36-Item Short-Form Health Survey in a clinical sample of disadvantaged, older, black, and white men and women.

    abstract::The authors assess the factorial validity of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) for use in a clinical sample of disadvantaged, older adults with significant comorbidities. Confirmatory factor analysis was performed using LISREL VIII on data obtained from baseline face-to-face interview...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199606000-00004

    authors: Wolinsky FD,Stump TE

    更新日期:1996-06-01 00:00:00

  • Improving physicians' recognition and treatment of depression in general medical care. Results from a randomized clinical trial.

    abstract::A randomized clinical trial was performed to assess whether the results of a depression screening instrument, when provided to physicians, could influence their recognition and treatment of depression in a primary care setting. The intervention consisted of randomly informing or not informing physicians of the depress...

    journal_title:Medical care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005650-199003000-00004

    authors: Magruder-Habib K,Zung WW,Feussner JR

    更新日期:1990-03-01 00:00:00

  • The last phase of life: who requests and who receives euthanasia or physician-assisted suicide?

    abstract:BACKGROUND:When suffering becomes unbearable for patients they might request for euthanasia. OBJECTIVE:To study which patients request for euthanasia and which requests actually resulted in euthanasia in relation with diagnosis, care setting at the end of life, and patient demographics. DESIGN:A cross-sectional study...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3181dbea75

    authors: Onwuteaka-Philipsen BD,Rurup ML,Pasman HR,van der Heide A

    更新日期:2010-07-01 00:00:00

  • Inpatient rehabilitation volume and functional outcomes in stroke, lower extremity fracture, and lower extremity joint replacement.

    abstract:BACKGROUND:It is unclear if volume-outcome relationships exist in inpatient rehabilitation. OBJECTIVES:Assess associations between facility volumes and 2 patient-centered outcomes in the 3 most common diagnostic groups in inpatient rehabilitation. RESEARCH DESIGN:We used hierarchical linear and generalized linear mod...

    journal_title:Medical care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/MLR.0b013e318286e3c8

    authors: Graham JE,Deutsch A,O'Connell AA,Karmarkar AM,Granger CV,Ottenbacher KJ

    更新日期:2013-05-01 00:00:00

  • Access to and utilization of health care by subgroups of Latino children.

    abstract:BACKGROUND:Latinos make up the largest group of minority children in the United States. Despite great diversity among Latino children, studies have traditionally treated them as a monolithic group. Few studies have examined patterns and determinants of access to and use of health care for different subgroups of Latino ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e318190d9e4

    authors: Perez VH,Fang H,Inkelas M,Kuo AA,Ortega AN

    更新日期:2009-06-01 00:00:00

  • Administrative hospitalization database validation of cardiac procedure codes.

    abstract:BACKGROUND:Although cardiac procedures are commonly used to treat cardiovascular disease, they are costly. Administrative data sources could be used to track cardiac procedures, but sources of such data have not been validated against clinical registries. OBJECTIVES:To examine accuracy of cardiac procedure coding in a...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3182329778

    authors: Lee DS,Stitt A,Wang X,Yu JS,Gurevich Y,Kingsbury KJ,Austin PC,Tu JV

    更新日期:2013-04-01 00:00:00

  • Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods.

    abstract:BACKGROUND:Hospitals will increasingly bear the costs for healthcare-acquired conditions such as infection. Our goals were to estimate the costs attributable to healthcare-acquired infection (HAI) and conduct a sensitivity analysis comparing analytic methods. METHODS:A random sample of high-risk adults hospitalized in...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0b013e3181ef60a2

    authors: Roberts RR,Scott RD 2nd,Hota B,Kampe LM,Abbasi F,Schabowski S,Ahmad I,Ciavarella GG,Cordell R,Solomon SL,Hagtvedt R,Weinstein RA

    更新日期:2010-11-01 00:00:00

  • Lowering generic drug prices: less regulation equals more competition.

    abstract:BACKGROUND:In Ontario, Canada, the 70/90 regulations were instituted in May 1993 to establish provincial government procurement prices for generic drugs. Accordingly, the first generic entrant's price could not exceed 70% of the incumbent's branded price. Subsequent entrants' prices could not exceed 90% of the first en...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-200301000-00015

    authors: Anis AH,Guh DP,Woolcott J

    更新日期:2003-01-01 00:00:00

  • Constructing Episodes of Inpatient Care: How to Define Hospital Transfer in Hospital Administrative Health Data?

    abstract:BACKGROUND:Hospital administrative health data create separate records for each hospital stay of patients. Treating a hospital transfer as a readmission could lead to biased results in health service research. METHODS:This is a cross-sectional study. We used the hospital discharge abstract database in 2013 from Albert...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000624

    authors: Peng M,Li B,Southern DA,Eastwood CA,Quan H

    更新日期:2017-01-01 00:00:00

  • Is the prevalence of gatekeeping in a community associated with individual trust in medical care?

    abstract:BACKGROUND:Consumer concerns about the restrictions of managed care may lead to distrust. OBJECTIVES:To examine whether a community's level of gatekeeping activity is associated with an individual's trust in medical care. RESEARCH DESIGN:Cross-sectional cohort (N = 49,929). SUBJECTS:Participants in a nationally repr...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.MLR.0000062703.14190.61

    authors: Haas JS,Phillips KA,Baker LC,Sonneborn D,McCulloch CE

    更新日期:2003-05-01 00:00:00

  • Enhancing protections for human participants in clinical and health services research: a continuing process.

    abstract::The authors provide brief information about the Department of Veterans Affairs (VA) and the Veterans Health Administration, to establish an understanding of this large, multifaceted organization. They then offer an overview of the VA's Office of Research and Development, with particular emphasis on recent and ongoing ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.MLR.0000023950.96307.BD

    authors: Feussner JR,Burris JF,McGlynn G,Lavori PW

    更新日期:2002-09-01 00:00:00

  • Measuring the necessity of medical procedures.

    abstract::This is a report on the extension of the concept of the appropriateness of a procedure to the necessity, or crucial importance, of that procedure. To state that a procedure is crucial means that withholding the procedure would be deleterious to the patient's health. Appropriateness and necessity ratings for six proced...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199404000-00004

    authors: Kahan JP,Bernstein SJ,Leape LL,Hilborne LH,Park RE,Parker L,Kamberg CJ,Brook RH

    更新日期:1994-04-01 00:00:00

  • Using medical records for older patient education in ambulatory practice.

    abstract::The effectiveness of sharing medical records in improving physician-older patient communication was evaluated in 203 ambulatory chronically ill older patients (mean age, 70.1 years) by a randomized controlled trial. Ninety-five experimental group patients received copies of their physicians' progress notes 1 week afte...

    journal_title:Medical care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005650-198604000-00004

    authors: Bronson DL,Costanza MC,Tufo HM

    更新日期:1986-04-01 00:00:00

  • Nonresponse bias in a survey of patient perceptions of hospital care.

    abstract:BACKGROUND:Incomplete participation is of particular concern for surveys of patient perceptions of care because patients who have negative opinions may be least likely to participate. OBJECTIVE:We sought to examine indirect evidence of nonresponse bias. DESIGN:We re-analyzed data from a cross-sectional patient survey...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000156856.36901.40

    authors: Perneger TV,Chamot E,Bovier PA

    更新日期:2005-04-01 00:00:00

  • Mortality Associated With Emergency Department Boarding Exposure: Are There Differences Between Patients Admitted to ICU and Non-ICU Settings?

    abstract:BACKGROUND:Emergency Department (ED) boarding threatens patient safety. It is unclear whether boarding differentially affects patients admitted to intensive care units (ICUs) versus non-ICU settings. RESEARCH DESIGN AND SUBJECTS:We performed a 2-hospital, 18-month, cross-sectional, observational, descriptive study of ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000902

    authors: Reznek MA,Upatising B,Kennedy SJ,Durham NT,Forster RM,Michael SS

    更新日期:2018-05-01 00:00:00

  • Costs of Nonfatal Traumatic Brain Injury in the United States, 2016.

    abstract:BACKGROUND:Traumatic brain injury (TBI) is a serious public health problem in the United States. Each year, TBIs substantially contribute to health care costs, which vary by severity. This is important to consider given the variability in recovery time by severity. RESEARCH DESIGN:This study quantifies the annual incr...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000001511

    authors: Miller GF,DePadilla L,Xu L

    更新日期:2021-01-28 00:00:00

  • Care of disabled children and women's time use.

    abstract::Previous research has estimated the effect of children's health care needs on women's market and nonmarket roles. This article reports the results of a study on the impact of health care for disabled children on women's nonmarket work. (Effects on women's market work are reported elsewhere.) Data from 369 families of ...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-198306000-00004

    authors: Breslau N

    更新日期:1983-06-01 00:00:00

  • Sociodemographic and health characteristics, rather than primary care supply, are major drivers of geographic variation in preventable hospitalizations in Australia.

    abstract:BACKGROUND:Geographic rates of preventable hospitalization are used internationally as an indicator of accessibility and quality of primary care. Much research has correlated the indicator with the supply of primary care services, yet multiple other factors may influence these admissions. OBJECTIVE:To quantify the rel...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/MLR.0000000000000342

    authors: Falster MO,Jorm LR,Douglas KA,Blyth FM,Elliott RF,Leyland AH

    更新日期:2015-05-01 00:00:00

  • The urban health care clinic and its substance abuse population.

    abstract::The effect of large numbers of patients with a history of substance abuse upon a health care system is rarely considered, nor is the health care system's response to such a clientele ever assessed. In this preliminary study, the collective effect of large numbers of substance abuse patients upon a clinic serving the u...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/00005650-199110000-00006

    authors: Cahill DF,Hodgkins BJ

    更新日期:1991-10-01 00:00:00

  • The effect of medicare health maintenance organizations on hospitalization rates for ambulatory care-sensitive conditions.

    abstract:OBJECTIVE:The objective of this study was to estimate the effect of Medicare Health Maintenance Organization (HMO) enrollment on hospitalization rates and total inpatient days for ambulatory care-sensitive conditions (ACSCs) after controlling for selection. RESEARCH DESIGN:Simultaneous equations using a discrete facto...

    journal_title:Medical care

    pub_type: 杂志文章

    doi:10.1097/01.mlr.0000220699.58684.68

    authors: Zeng F,O'Leary JF,Sloss EM,Lopez MS,Dhanani N,Melnick G

    更新日期:2006-10-01 00:00:00