Miika Linna

Follow-up of the Finnish Asthma Programme 2000–2010: reduction of hospital burden needs risk group rethinking

The Finnish Asthma Programme 1994–2004 focused on early intervention and disease control, thereby resulting in a significant reduction of asthma morbidity. During the follow-up period from 2000 to 2010, the number of hospital days continued to fall by 54%. Patients ≥65 years, especially women, accounted for 39% of the hospital days, and they need attention if the hospital burden is to be reduced further.

Impact of Very Preterm Birth on Health Care Costs at Five Years of Age

OBJECTIVE: We assessed the effects of very preterm birth (gestational age <32 weeks or birth weight <1501 g) and prematurity-related morbidities on health care costs during the fifth year of life. METHODS: The study population consisted of 588 very preterm children and 176 term control subjects born in 2001–2002. Costs of hospitalizations, visits to health care professionals and therapists, and the use of other social welfare services were assessed during the fifth year of life. Hospital visits were derived from register data and other health care contacts, and the use of social welfare services were derived from parental reports. The effects of 6 prematurity-related morbidities (cerebral palsy [CP], seizure disorder, obstructive airway disease, hearing loss, visual disturbances or blindness, and other ophthalmologic problems) on the costs of health care were studied. RESULTS: The average health care costs during the fifth year of life were 749€ in the term control subjects, 1023€ in the very preterm children without morbidities, and 3265€ in those with morbidities. The costs of social welfare services and therapies exceeded the hospitalization costs in all groups. Among children who were born preterm, CP was associated with 5125€ higher costs, whereas later obstructive airway diseases increased the costs by 819€ compared with individuals without these morbidities. CONCLUSIONS: The health care costs during the fifth year of life in very preterm children with morbidities were 4.4-fold and in those without morbidities 1.4-fold compared with those of term control subjects. This emphasizes the importance of prevention of morbidities, especially CP, to reduce the long-term costs of prematurity.

Hospital costs and quality of life during 4 years after very preterm birth.

OBJECTIVE To evaluate the effect of gestational age and prematurity-related morbidities on hospital costs and cost per quality-adjusted life-year (QALY) during the first 4 years of life. DESIGN Population-based study using national register data and parental questionnaires. SETTING Finland. PARTICIPANTS All 2064 very preterm children (gestational age <32 weeks or birth weight <1501 g) and all 200 609 full-term control individuals (mean [SD] gestational age, 37 [0] to 41 [6] weeks) born from January 1, 2000, through December 31, 2003. MAIN EXPOSURE Prematurity. MAIN OUTCOME MEASURES Costs of hospital care and cost per QALY at 4 years of age according to gestational age and prematurity-related morbidities. RESULTS By 4 years of age, the cost per QALY for full-term controls (in 2008 currency) was euro1181 (US

Reimbursing for the costs of teaching and research in finnish hospitals: A stochastic frontier analysis

1736). In very preterm children, the average cost per QALY was euro19 245 (

Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis

28 290), ranging from euro11 824 to euro54 324 (

Differences in the length of initial hospital stay in very preterm infants

17 381 to

Reduced severity and improved control of self-reported asthma in Finland during 2001-2010

79 856) and increasing with decreasing gestational age. The cost per QALY was euro14 368 (

Use of an Electronic Patient Portal Among the Chronically Ill: An Observational Study

21 121) for those without any of the studied morbidities and euro36 110 (

The Finnish experience to save asthma costs by improving care in 1987-2013

53 082) for those with 2 or more morbidities. The costs of the initial hospital stay comprised 79.5% of the total 4-year hospital costs in very preterm children. CONCLUSIONS We conclude that the cost per QALY in this patient group is at an acceptable level by 4 years of age. Because the initial hospital care episode accounted for most of the costs, the cost per QALY will decrease with each additional follow-up year.

The Effect of a Patient Portal With Electronic Messaging on Patient Activation Among Chronically Ill Patients: Controlled Before-and-After Study

In this study stochastic frontier cost function was used to estimate the teaching and research costs of Finnish hospitals. Predicted efficiency adjusted costs were calculated and compared to evaluate the current level of teaching and research reimbursement. The efficiency adjustment had significant impact on the marginal and average cost estimates of the teaching and research output.The results suggest that the average rate of teaching and research reimbursement should be approximately 14.6% of the total operating costs in university teaching hospitals. The main finding was that the university teaching hospitals were underfunded with respect to both research and teaching output.