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You searched for +publisher:"University of Otago" +contributor:("Hansen, Paul"). Showing records 1 – 2 of 2 total matches.

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University of Otago

1. Pinto, Daniel. Cost consequences analysis of physiotherapy in the management of hip or knee osteoarthritis .

Degree: 2012, University of Otago

Osteoarthritis (OA) is a major source of pain and morbidity, and is responsible for a substantial economic burden worldwide. International guidelines recommend conservative treatments such as exercise and physiotherapy as first-line interventions when managing patients with hip or knee OA; however, little is known about their value for money. The objectives of this research were to: 1) assess the cost effectiveness of conservative treatments for OA by performing a systematic review of the literature; 2) develop and validate a questionnaire that collects data on health resource use and costs in patients with hip or knee OA; and 3) investigate the cost effectiveness of three physiotherapy programmes for the treatment of hip or knee OA. The systematic review assessed the current evidence for the cost effectiveness of conservative interventions in the management of hip or knee OA. Of 11 studies included, five satisfied the criteria for high quality. The best value for money intervention appears to be group exercise led by a physiotherapist. The Osteoarthritis Cost and Consequences Questionnaire was developed to collect OA-related health resource use and cost data and was validated against four administrative databases (n=50). Acceptable sensitivity (range 44%-100%) and specificity (range 59%-100%) levels were found for most health services. The numbers of visits ρc = 0.41 (95% CI: 0.19, 0.64) and medications ρc = 0.63 (95% CI:0.42, 0.78) and total cost estimate ρc = 0.997 (95% CI: 0.996, 0.999) derived from the questionnaire agreed with database records. The economic evaluation was performed alongside a randomised controlled trial (n=206) investigating the effectiveness of three interventions relative to usual care. The analysis perspectives were from the New Zealand health system and society. As a cost consequences analysis, it included the quality-adjusted life year (QALY) as an economic endpoint, and disease-specific measures as clinical endpoints at one year. Willingness-to-pay thresholds of 1-3 × New Zealand’s GDP per capita were used to define value for money. Six sensitivity analyses were performed. Each treatment gained incremental QALYs (each relative usual care); this was significant for exercise therapy, 0.026 (95% CI: 0.010, 0.042). From the New Zealand health system perspective costs were higher across all treatment groups. Exercise therapy was the only treatment to produce an incremental cost per QALY under 2 × GDP per capita (2009 New Zealand dollars) of $44 058 (95% CI: −70 885, 194 558). From the societal perspective, manual therapy was cost saving and best value for money. For the majority of scenarios considered, exercise therapy was more cost effective than usual care and combined therapy was only cost effective for participants who did not receive joint replacement surgery during the trial. Each respective therapy showed a higher probability of being cost effective relative to usual care when clinical versus economic outcomes were considered, and for participants not receiving joint… Advisors/Committee Members: Hansen, Paul (advisor).

Subjects/Keywords: cost-effectiveness; physiotherapy; osteoarthritis; economic

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Pinto, D. (2012). Cost consequences analysis of physiotherapy in the management of hip or knee osteoarthritis . (Doctoral Dissertation). University of Otago. Retrieved from http://hdl.handle.net/10523/2368

Chicago Manual of Style (16th Edition):

Pinto, Daniel. “Cost consequences analysis of physiotherapy in the management of hip or knee osteoarthritis .” 2012. Doctoral Dissertation, University of Otago. Accessed June 18, 2019. http://hdl.handle.net/10523/2368.

MLA Handbook (7th Edition):

Pinto, Daniel. “Cost consequences analysis of physiotherapy in the management of hip or knee osteoarthritis .” 2012. Web. 18 Jun 2019.

Vancouver:

Pinto D. Cost consequences analysis of physiotherapy in the management of hip or knee osteoarthritis . [Internet] [Doctoral dissertation]. University of Otago; 2012. [cited 2019 Jun 18]. Available from: http://hdl.handle.net/10523/2368.

Council of Science Editors:

Pinto D. Cost consequences analysis of physiotherapy in the management of hip or knee osteoarthritis . [Doctoral Dissertation]. University of Otago; 2012. Available from: http://hdl.handle.net/10523/2368


University of Otago

2. Sullivan, Trudy. Using MCDA (Multi-Criteria Decision Analysis) to prioritise publicly-funded health care .

Degree: 2012, University of Otago

New Zealand, like many other countries, is grappling with the problem of how to allocate limited resources across a range of health and disability support services at a time when demand for health care continues to grow faster than health budgets. It is becoming increasingly important for decision-makers to adopt robust processes for setting priorities so that limited health resources are allocated efficiently, effectively and transparently. In my thesis I use multi-criteria decision analysis (MCDA) to build a framework (at the meso-level of health care funding) which can be used by decision-makers to assist them in priority-setting. Potential criteria, elicited from six focus groups (including members of the public, private and public health care providers, health professionals and policy makers), are combined with advice from health experts and criteria from comparable studies in the literature to establish six prioritisation criteria: ‘need’, ‘individual benefit’, ‘societal benefit, ‘age’, ‘lifestyle’ and ‘no alternative treatment’. An online decision survey implemented through 1000Minds software (Ombler & Hansen 2012) and the PAPRIKA method (Hansen & Ombler 2008) is used to determine the relative importance of the criteria. According to the results of a ‘test re-test’, the decision survey accurately captures the preferences of respondents. The results of the decision survey reveal that ‘need’ and ‘individual benefit’ are the most important prioritisation criteria, and though patients are unlikely to be prioritised according to their age or lifestyle (because of discrimination), greater preference is shown for ‘age’ and ‘lifestyle’ compared to ‘societal benefit’ and ‘no alternative treatment’. Regression analysis (including the application of a fractional multinomial logit model) and cluster analysis are used to determine whether the demographic characteristics of respondents can predict preferences. Several relationships are found. For example, health care workers, respondents on low incomes and Maori place more importance on ‘need’ (relative to the other criteria) compared to respondents who do not work in health care, respondents on middle or high incomes and non-Maori. Though several statistically significant results are found, it appears that overall the variation in preferences is largely due to the idiosyncrasies of respondents and not to particular demographic characteristics. The criteria weights from the random sample are then brought together with cost and other additional factors in a prioritisation framework. With the aid of a Value for Money (VfM) chart and associated budget allocation table, decision-makers can consider all the prioritisation variables in a transparent and consistent way. The framework can be used as a communication tool, to allocate fixed budgets across a range of services, to keep track of previous decisions or to re-allocate resources when the budget has been cut. The framework developed in this thesis illustrates how health care can be prioritised at the meso-level of… Advisors/Committee Members: Hansen, Paul (advisor).

Subjects/Keywords: priority-setting; prioritisation; PAPRIKA; decision; decision-makers; framework; transparent; choice; trade-off; health; healthcare; NewZealand; budget; criteria; multi-criteria; stakeholders

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Sullivan, T. (2012). Using MCDA (Multi-Criteria Decision Analysis) to prioritise publicly-funded health care . (Doctoral Dissertation). University of Otago. Retrieved from http://hdl.handle.net/10523/2651

Chicago Manual of Style (16th Edition):

Sullivan, Trudy. “Using MCDA (Multi-Criteria Decision Analysis) to prioritise publicly-funded health care .” 2012. Doctoral Dissertation, University of Otago. Accessed June 18, 2019. http://hdl.handle.net/10523/2651.

MLA Handbook (7th Edition):

Sullivan, Trudy. “Using MCDA (Multi-Criteria Decision Analysis) to prioritise publicly-funded health care .” 2012. Web. 18 Jun 2019.

Vancouver:

Sullivan T. Using MCDA (Multi-Criteria Decision Analysis) to prioritise publicly-funded health care . [Internet] [Doctoral dissertation]. University of Otago; 2012. [cited 2019 Jun 18]. Available from: http://hdl.handle.net/10523/2651.

Council of Science Editors:

Sullivan T. Using MCDA (Multi-Criteria Decision Analysis) to prioritise publicly-funded health care . [Doctoral Dissertation]. University of Otago; 2012. Available from: http://hdl.handle.net/10523/2651

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