Journal ArticleDOI
Evaluation of neonatal-intensive-care program.
John C. Sinclair,George W. Torrance,Michael H. Boyle,Sargent P. Horwood,Saroj Saigal,David L. Sackett +5 more
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It is concluded that neonatal-intensive care programs require further evaluation with rigorous scientific methods because much of the non-experimental evidence supporting their value is based on the experience of referral units and does not measure the impact on the populations they serve.Abstract:
Within the past 15 years, regional neonatal-intensive-care programs have been introduced and have expanded rapidly. The efficacy of some of the individual interventions that constitute neonatal intensive care has been validated in randomized, controlled clinical trials. It is therefore generally assumed that neonatal-intensive-care programs that incorporate these maneuvers are effective in reducing death and disability. However, the overall effectiveness of these programs has not been tested experimentally. Moreover, much of the non-experimental evidence supporting their value is based on the experience of referral units and does not measure the impact on the populations they serve. A definitive economic evaluation of neonatal intensive care has not yet been reported, despite the high cost of such programs. We conclude that neonatal-intensive care programs require further evaluation with rigorous scientific methods.read more
Citations
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Journal ArticleDOI
A clinician's guide to cost-effectiveness analysis.
A S Detsky,I G Naglie +1 more
TL;DR: Because clinicians should participate in policy making, they must understand the role of this technique in setting funding priorities and demonstrate the consequences of allocation decisions.
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Application of Multi-Attribute Utility Theory to Measure Social Preferences for Health States
TL;DR: A four-attribute health state classification system designed to uniquely categorize the health status of all individuals two years of age and over is presented and the modified method is found to be applicable to the task--no insurmountable difficulties are encountered.
Journal ArticleDOI
Economic Evaluation of Neonatal Intensive Care of Very-Low-Birth-Weight Infants
TL;DR: By every measure of economic evaluation, the impact of neonatal intensive care was more favorable among infants weighing 1000 to 1499 g than among those weighing 500 to 999 g.
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West Berkshire perineal management trial.
TL;DR: Findings provide little support either for liberal use of episiotomy or for claims that reduced use of the operation decreases postpartum morbidity.
Journal ArticleDOI
Annual summary of vital statistics--1998.
Bernard Guyer,Donna L. Hoyert,Joyce A Martin,Stephanie J. Ventura,Marian F. MacDorman,Donna M. Strobino +5 more
TL;DR: Most vital statistics indicators of the health of Americans were stable or showed modest improvements between 1997 and 1998, halting the steady decline in the number of births and birth and fertility rates in the 1990s.
References
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Foundations of cost-effectiveness analysis for health and medical practices.
Abstract: Limits on health-care resources mandate that resource-allocation decisions be guided by considerations of cost in relation to expected benefits. In cost-effectiveness analysis, the ratio of net health-care costs to net health benefits provides an index by which priorities may be set. Quality-of-life concerns, including both adverse and beneficial effects of therapy, may be incorporated in the calculation of health benefits as adjustments to life expectancy. The timing of future benefits and costs may be accounted for by the appropriate use of discounting. Current decisions must inevitably be based on imperfect information, but sensitivity analysis can increase the level of confidence in some decisions while suggesting areas where further research may be valuable in guiding others. Analyses should be adaptable to the needs of various health-care decision makers, including planners, administrators and providers.
Journal Article
A utility maximization model for evaluation of health care programs.
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The utility of different health states as perceived by the general public
TL;DR: The resulting mean daily health state utilities differ among disorders and vary with age, the duration of the disorder, the ‘label’ used to describe the disorder and the health status of the respondent.
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Maternal attachment. Importance of the first post-partum days.
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The influence of the thermal environment upon the survival of newly born premature infants
TL;DR: Infants who were placed in incubators with an air tamperature of 31.7°C (89°F) had a higher survival rate than controls who were in incubator maintained at 28.9°C(84°F).