Showing papers by "Saskatchewan Health published in 1997"
TL;DR: The findings suggest that more specific and severe psychiatric diagnoses are likely to be recorded accurately and consistently in the Saskatchewan datafiles, however, disorders with multiple manifestations or those for which there are several possible codes should be examined with caution and ways sought to validate them.
Abstract: Administrative data have long been used in psychiatric epidemiology and outcomes evaluation. This article examines the reliability of the recording of schizophrenia and depressive disorder in three Saskatchewan administrative health care utilization datafiles. Due to their comprehensive nature, these datafiles have been used in a wide range of epidemiologic studies. Close agreement was found between hospital computer data and patients' charts for personal and demographic factors (≥94.7%). Diagnostic concordance between computerized hospital data and medical charts was very good for schizophrenia (94%) but poor for depressive disorder (58%). Appropriate physician services were identified for 60% and 72% of hospital discharges for schizophrenia and depressive disorder, respectively, andexact diagnostic agreement between hospital and physician datafiles was 62% for schizophrenia and 66% for depressive disorder. Appropriate provincial mental health branch services were found for 83% and 38% of hospital discharges for schizophrenia and depressive disorder, respectively;exact diagnostic concordance between these datafiles was 75% for schizophrenia and 0% for depressive disorder. A significant number of patients with major or neurotic depression appeared to be wrongly coded as having depressive disorder in the hospital file. The differences in diagnostic agreement may also be partly a function of how the two conditions are differentially treated in the health system. These findings suggest that more specific and severe psychiatric diagnoses are likely to be recorded accurately and consistently in the Saskatchewan datafiles. However, disorders with multiple manifestations or those for which there are several possible codes should be examined with caution and ways sought to validate them. Attention should also be paid to which service sectors are involved in the treatment of specific disorders.
65 citations
TL;DR: The incremental health benefits obtained from using oral sumatriptan rather than oral caffeine/ergotamine were achieved at moderately acceptable incremental costs, if past decisions on the adoption of other health technologies are used as a guide.
Abstract: We conducted an economic comparison of oral sumatriptan with oral caffeine/ergotamine in the treatment of patients with migraine. Cost-effectiveness, cost-utility and cost-benefit analyses were conducted from societal and health-departmental perspectives. A decision tree was used. Utilities were assigned to health states using the Quality of Weil-Being Scale. Simple and probabilistic sensitivity analyses were also carried out. From a societal perspective, using sumatriptan instead of caffeine/ergotamine resulted in an incremental cost-effectiveness ratio of-25 Canadian dollars ($Can) per attack aborted, an incremental cost-utility ratio of -$Can7507 per quality-adjusted life-year (QALY), and a net economic benefit of $Can42 per patient per year (1995 values). From the perspective of the health department, the incremental cost-effectiveness ratio was $Can98 per attack aborted, the incremental cost-utility ratio was $Can29 366 per QALY; the grade of recommendation based on past decisions regarding health technology for adoption into health insurance plans was ‘moderate’. Sensitivity analysis showed that the results were robust to relatively large changes in the input variables. The incremental health benefits obtained from using oral sumatriptan rather than oral caffeine/ergotamine were achieved at moderately acceptable incremental costs, if past decisions on the adoption of other health technologies are used as a guide.
40 citations
9 citations
TL;DR: PCP is rapidly eliminated, largely as the free acid, from the human body by urinary excretion and if the earlier study by Murphy had been capable of achieving a lower detection limit for PCP, it is highly likely that the frequency of positive detection would have been greater than 79%.
Abstract: Pentachlorophenol (PCP) is a synthetic chemical which has been extensively used for wood preservation and protection, with other minor applications as a herbicide. Over the past half century, PCP was used in many formulations both commercially and domestically. Laboratory animal studies have suggested that PCP is a potential carcinogen although there is a lack of human data to confirm this hypothesis. The widespread use and persistence of this chemical has resulted in its existence throughout the environment as well as the food chain. Health and Welfare Canada has estimated that approximately 78% of non-occupationally related exposure to PCP is via the food chain (Health and Welfare Canada 1992). The next most significant route of human exposure to PCP is through the ambient atmosphere. PCP is rapidly eliminated, largely as the free acid, from the human body by urinary excretion. In a study of urine samples collected from 6000 individuals from the general population of the United States, 79% of the urine samples tested were found to contain detectable quantities of PCP (Murphy 1983). In subsequent studies of smaller groups of subjects from the United States and Canada, PCP has been found in virtually 100% of the urine samples which were tested (Holler 1989; Thompson 1994, 1995a; Treble 1996). If the earlier study by Murphy had been capable of achieving a lower detection limit for PCP, it is highly likely that the frequency of positive detection would have been greater than 79%.
4 citations