A nurse-directed, multidisciplinary intervention can improve quality of life and reduce hospital use and medical costs for elderly patients with congestive heart failure.

The largest portion of the cost for asthma healthcare is due to hospitalizations. Improved methods of healthcare delivery for patients with asthma are needed to prevent readmissions. From 1996 to 1999, 96 adult subjects (predominantly young African American women) hospitalized with an asthma exacerbation, who had a history of frequent healthcare use, were randomized to an asthma nurse specialist intervention (n ϭ 50) or a usual care group (n ϭ 46) for 6 months. Our aim was to decrease rates of readmissions within 6 months of hospital discharge, to reduce cost, and to improve health-related quality of life. Our results demonstrate a 60% reduction in total hospitalizations (31 readmissions in the intervention group and 71 in the control group, p ϭ 0.04), with no significant change in emergency department visits. Readmissions for asthma were reduced by 54% (21 vs. 42 in the control group; p ϭ 0.04). We found a marked reduction in lost work or school days: 246 versus 1,040 days in the control group (p ϭ 0.02). The intervention resulted in a substantial reduction in direct and indirect healthcare costs, saving $6,462 per patient (p ϭ 0.03). A brief intervention program focusing on high healthcare users with asthma can result in improved asthma control and reduced hospital use with substantial cost savings.

This paper presents a model which illustrates the interaction between the labour and real estate markets in the determination of the value of local amenities . The primary purpose of this study is to examine the importance of functional form in measuring the quality of life (QOL) in urban areas . Using 1980 data on US urban counties, this specification provides new options for QOL estimates as an extension of previous work. This study also discusses the problems associated with summarising QOL in a one-dimensional monotonic ranking . One form of a multi-dimensional rating system is presented for comparison.

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