Rob McNeill

Current and future economic burden of osteoporosis in New Zealand

BackgroundOsteoporosis is recognized as a serious health condition in developed as well as developing countries. There are no accurate estimates of the extent of the burden of osteoporosis in New Zealand. The purpose of this study was to estimate the economic burden of osteoporosis in New Zealand using data from international studies and population and health services information from New Zealand.ObjectiveTo estimate the number of osteoporotic fractures and cost of treatment and management of osteoporosis and osteoporotic fractures to the health system in New Zealand in 2007 and to project the future burden in 2013 and 2020.MethodsHospitalizations for hip fractures were combined with New Zealand census data and estimates from previous studies to estimate the expected number of osteoporotic vertebral, humeral, pelvic and other sites fractures in 2007. Health services usage and costs were estimated by combining data from New Zealand hospitals, the New Zealand Health Survey on the number of people diagnosed with osteoporosis, and the New Zealand Health Information Service (NZHIS) on pharmaceutical treatments. All prices are in New Zealand dollars (

Functional and psychological outcomes following burn injury: reduced income and hidden emotions are predictors of greater distress.

NZ), year 2007 values. Losses in QALYs resulting from osteoporotic fractures were used to indicate the impact on morbidity and mortality. The lost QALYs and economic cost associated with osteoporosis were projected to 2013 and 2020 using population projections from the New Zealand census.ResultsThere were an estimated 84 354 osteoporotic fractures in New Zealand in 2007, including 3803 hip and 27994 vertebral fractures. Osteoporosis resulted in a loss of 11249 QALYs. The total direct cost of osteoporosis was

Understanding Evaluation Influence within Public Sector Partnerships: A Conceptual Model.

NZ330 million, including

Investigating the relationship between quality, format and delivery of feedback for written assignments in higher education

NZ212 million to treat the fractures,

Geographical access to termination of pregnancy services in New Zealand

NZ85 million for care after fractures and

Reducing disablement with adequate and appropriate resources: a New Zealand perspective

NZ34 million for treatment and management of the estimated 70 631 people diagnosed with osteoporosis. Sensitivity analysis suggested the results were robust to assumptions regarding the number of fractures receiving medical treatment. Hospitalization costs represented a significant component of total costs. The cost of treatment and management of osteoporosis is expected to increase to over

Factors affecting delays in first trimester pregnancy termination services in New Zealand

NZ391 million in 2013 and

To live an ordinary life: resource needs and additional costs for people with a physical impairment

NZ458 million in 2020, with the number of QALYs lost increasing to 13 205 in 2013 and 15 176 in 2020.ConclusionsOsteoporosis and osteoporotic fractures create a significant burden on the health system in New Zealand. This study highlights the significant scope of the burden of osteoporosis and the potential gains that might be made from introducing interventions to mitigate the burden.

Ladies in waiting: the timeliness of first trimester services in New Zealand.

The aim of this study is to determine whether functional and psychosocial outcomes after burn injury in New Zealand are consistent with the international literature. Fifty participants with burns >10% TBSA and a mean of 5.1 years since burn completed a survey that included questionnaires and open-ended questions. The rates of psychosocial distress for this sample were consistent with international reports. Psychological distress was predicted by negative change in income and by reports that the individual has hidden thoughts and emotions from others. Respondents also described positive changes in their life as a result of the burn injury that were independent of negative outcomes. Participants indicated good long-term functional improvement but ongoing psychological distress. Important indicators for poor outcome may be loss of income and reluctance to discuss emotions.

Patient perceptions of barriers to the early diagnosis of lung cancer and advice for health service improvement

The importance of evaluation use has led to a large amount of theoretical and empirical study. Evaluation use, however, is still not well understood. There is a need to capture the complexity of this phenomenon across a diverse range of contexts. In response to such complexities, the notion of “evaluation influence” emerged. This article presents a theory of evaluation influence within public sector partnerships. An analysis of key concepts is used to develop propositions about the relationships between evaluation attributes, partnership functioning and characteristics, partnership evaluation behavior, individual characteristics, contextual factors, and evaluation influence. The model highlights the complexities of evaluation influence and identifies a range of factors that evaluators can consider in practice. The model also extends on existing theories of evaluation influence in considering the role of individual characteristics, stakeholder evaluation behavior, and partnership contexts.