Systematic overview of economic evaluations of health-related rehabilitation

Wilsher, Stephanie Howard; Irvine, Lisa; Hong, Fan; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

doi:10.1016/j.dhjo.2015.08.009

Cited by 68 publications

(63 citation statements)

References 80 publications

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“…The socioeconomic status and social support of patients with disability should be thought as the major factors affecting long‐term outcome and life span 1, 16. Patients who survive a stroke may be frustrated to manage the new experience of disability or impairment by themselves.…”

Section: Discussionmentioning

confidence: 99%

“…Stroke usually causes disability or restricts daily activities, thereby resulting in long‐term reduction in quality of life for those who have had one. Stroke is listed as the most common cause of disability in adults worldwide 1, 2, 3. In Western developed countries, poststroke patients might exhibit high intolerance of their disability, and several studies have revealed notably higher rates of suicide ideation, suicide attempts, and completed suicides in poststroke patients than in the general population 4, 5, 6.…”

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confidence: 99%

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Risk of Suicide Attempt in Poststroke Patients: A Population‐Based Cohort Study

Harnod

Lin

Kao

2018

JAHA

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BackgroundThis nationwide population‐based cohort study evaluated the risk of and risk factors for suicide attempt in poststroke patients in Taiwan.Methods and ResultsThe poststroke and nonstroke cohorts consisted of 713 690 patients and 1 426 009 controls, respectively. Adults (aged >18 years) who received new stroke diagnoses according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM; codes 430–438) between 2000 and 2011 were included in the poststroke cohort. We calculated the adjusted hazard ratio for suicide attempt (ICD‐9‐CM codes E950–E959) after adjustment for age, sex, monthly income, urbanization level, occupation category, and various comorbidities. Kaplan–Meier analysis was used to measure the cumulative incidence of suicide attempt, and the Fine and Gray method was used as a competing event when estimating death subhazard ratios and 95% confidence intervals between groups. The cumulative incidence of suicide attempt was higher in the poststroke cohort, and the adjusted hazard ratio of suicide attempt was 2.20 (95% confidence interval, 2.04–2.37) compared with that of the controls. The leading risk factors for poststroke suicide attempt were earning low monthly income (<660 US dollars), living in less urbanized regions, doing manual labor, and having a stroke before age 50 years. The attempted suicide risk did not differ significantly between male and female patients in this study.ConclusionsThese results convey crucial information to clinicians and governments for preventing suicide attempt in poststroke patients in Taiwan and other Asian countries.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Risk of Suicide Attempt in Poststroke Patients: A Population‐Based Cohort Study

Harnod

Lin

Kao

2018

JAHA

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“…Many countries including the Nordic countries and UK have over decades experienced increasing numbers of people leaving the labor market because of reduced workability (MacAllister et al, 2015). The evidence of what are cost-effective methods of rehabilitation is also rather limited (Howard-Wilsher, 2016) and the health care structure for long term rehabilitation demands close collaboration between primary care, hospitals, municipalities, employers etc. But many health care reforms, marketization and new economic incentives have promoted a fragmentation rather than stronger collaboration within health care systems.…”

Section: The Policy Entry Points To Tackle the Health Dividementioning

confidence: 99%

Health inequalities – a challenge for the social investment welfare state

Diderichsen

2016

Nordisk välfärdsforskning | Nordic Welfare Research

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Professor emeritus, MD PhD, Copenhagen University, Denmark and Fundacao Oswaldo Cruz, Brazil. Finn Diderichsen has been teaching social medicine and social epidemiology at Karolinska Institutet and at the University of Copenhagen. His research has focused on determination of social inequalities in health and policies to tackle them. Currently, he is adjunct professor at Oswaldo Cruz Foundation in Brazil. fidi@sund.ku.dk ABSTRACT Social investment policy has become a central response to the demographic and economic challenges facing European welfare states. This focus on investment in human capabilities and their efficient use is, however, challenged by health inequalities where education, health and employment are increasingly linked. This paper outlines the main principles of social investment policies (learning, activation and protection) and links them to a conceptual model of health inequalities and the policy entry-points tackling them by addressing the processes of social stratification, differential exposure and vulnerability as well as differential consequences of illness. It illustrates, with reference to selected empirical studies from the Nordic countries, how the balance between the elements of social investment policies might be adjusted, resources allocated differently and policies supplemented by more direct investments in health so as to enable social investments to tackle the health divide.

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“…The role that rehabilitation plays in maximising the impact of other health services — such as surgical interventions, trauma care and management of noncommunicable diseases — and its potential for significant cost savings are also frequently misunderstood and underestimated [12]. For example, rehabilitation has been found to be beneficial in reducing length-of-stay in hospitals and decreasing re-admissions, thus mitigating the negative social and health risks associated with prolonged hospitalizations.…”

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confidence: 99%