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Biomedical subjects

B McGowan

Publications and source records attributed to B McGowan.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Cost-effectiveness of spironolactone in patients with severe heart failure.

BACKGROUND: Management of heart failure is estimated to consume between 1% and 2% of total healthcare resources with hospital admissions accounting for up to 70% of this. The ability of the aldosterone antagonist spironolactone to reduce hospital admission rates by 35% would be expected to prove cost-effective. AIM: To determine the cost-effectiveness of spironolactone when added to standard therapy in patients with severe chronic heart failure. METHODS: A Markov model of chronic heart failure was constructed using Treeage software. Irish cost data were incorporated into the model. RESULTS: The incremental cost-effectiveness ratio (ICER) for spironolactone therapy was Euro 466 per life year gained (LYG). Sensitivity analysis demonstrated an ICER range of Euro 75 to Euro 1,136 per LYG. CONCLUSION: This economic evaluation suggests that the addition of spironolactone to standard therapy for patients with severe chronic heart failure is not only safe and effective, but is highly cost-effective in the Irish healthcare setting.

Cost-Benefit Analysis↗
PubMedDate not supplied

Cost of treating heart failure in an Irish teaching hospital.

BACKGROUND: The prevalence of heart failure is 3 to 20 per 1,000 population, but may exceed 100 per 1,000 in the over 65 age group. Some 1-2% of the total healthcare budget is consumed in the management of heart failure. AIM: As hospital costs account for approximately 70% of this expenditure we determined the cost of treating heart failure in an Irish teaching hospital. METHODS: Cost evaluation was from the hospital perspective using a microcosting detailed collection of resources used. RESULTS: The average cost of a hospital admission for cardiac failure was IR 2,146 Pounds. The average cost per day was IR 193 Pounds. Approximately 75% of hospital costs were associated with ward costs. Medications accounted for 3.5% of total costs. CONCLUSION: The availability of Irish cost data is essential for the assessment of the cost-effectiveness of therapeutic interventions for the treatment of heart failure in our healthcare system.

Aged↗
PubMedDate not supplied

Self-reported stress and its effects on nurses.

AIM: The primary aim of this study was to examine the relationship between job satisfaction and self-reported stress levels among nurses working in a children's hospital in Belfast. The secondary aim was to identify the main causes of stress. METHOD: The study was descriptive and analytical. A random sample of 72 nurses completed the Nurse Stress Index questionnaire. The data were analysed using the Statistical Package for the Social Sciences (SPSS). The respondents' stress scores were correlated with job satisfaction scores using bivariate correlation and multivariate linear regression. RESULTS: The results of the bivariate analysis showed that a negative relationship existed between the subscales of the NSI and job satisfaction--as stress levels rise, job satisfaction falls. The multivariate analysis revealed that the only significant contribution to job satisfaction scores was stress resulting from a perceived lack of organisational support and involvement. The top scoring variables from each subscale were ranked to reveal the six main causes of stress for the sample. CONCLUSION: Job satisfaction is negatively affected by stress. The main sources of stress were job context variables, such as shortage of resources, time, management's lack of appreciation and initiating change.

Adaptation, Psychological↗
PubMedDate not supplied

Population based study of the cost of inpatient care for HIV-lnfected individuals in an Irish teaching hospital.

A microcosting evaluation of the cost of inpatient care of 69 HIV-infected patients in an Irish teaching hospital was conducted from the hospital perspective. The median cost per admission was 6220 Euros and median cost per inpatient day was 557 Euros. HIV related admissions were associated with a greater cost per admission than non-HIV related admissions. There was an inverse relationship between inpatient costs and CD4 count. Ward costs accounted for the majority of inpatient expenditure. This is the first detailed study of the cost of inpatient care for HIV-infected individuals in Ireland. This study provides the data necessary to estimate the burden of HIV disease in Ireland and to evaluate the cost-effectiveness of antiretroviral and other strategies to manage HIV infection in the Irish context.

Female↗