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Biomedical subjects

C Normand

Publications and source records attributed to C Normand.

At least 55 records · Page 3Linked to original sources
PubMed1995

An economic analysis of the resettlement of people with mild learning disabilities and challenging behaviour.

New models of care are needed following the closure of long-stay mental handicap hospitals. Based on an evaluation of a recently established assessment and treatment service in south-east England, this paper is concerned with the costs and likely benefits of different patterns of services for people with mild learning disabilities and severely challenging behaviour. Different models of provision are compared in terms of their costs and quality of life opportunities for clients. The assessment and treatment services provided a better understanding of the care needs, and achieved a reduction in challenging behaviours. It was therefore possible to give access to care settings closer to a normal life. For approximately 25% additional expenditure, 20 out of 34 clients who received the service moved to community placements, including three who had been referred following a breakdown in the community. If community care is to be implemented as a policy for clients with learning disabilities and serious challenging behaviours, it is necessary to recognise the financial implications. Better quality of life opportunities for this client group are associated with higher costs. When seen in the dynamic context of the costs and quality of life opportunities of the subsequent care, a high cost assessment and treatment service may be a good investment. On current evidence, the additional benefits of community homes, with a closer association with the local community, and greater freedom for clients is bought only at quite a high cost.

Adult↗
PubMed1994

Between Beveridge and Bismarck--options for health care financing in central and eastern Europe.

A government-run national health service (the Beveridge model) can provide care for all at a reasonable cost but cannot avoid the dangers of poor quality. An insurance-based system (the Bismarck model) can achieve high quality but cannot ensure care for all at an affordable cost. The best chance of achieving a reliable financial base for health services is to use a combination of both these approaches.

Europe, Eastern↗
PubMed1993

Comparisons among national health care systems in the European marketplace.

Most European countries have adopted either a Bismarckian system of compulsory health care insurance or a national health care system funded by taxation. For both systems, a basic level of health care is free at the point of use for all citizens. Health care has been undergoing reforms in most European countries. In the western nations, the autonomy of providers of services has increased, elements of competition and cost control have been introduced, and incentives to provide more cost-effective care have been initiated. Most central and eastern European countries have begun to return to the social insurance model for funding services. The ownership of some hospitals in these countries has been transferred to the private sector or to not-for-profit organizations. The European countries vary widely in their standards of facilities and professional staffing, and these generally reflect the prosperity of the country. During the 1980s, western countries implemented measures to limit the growth of health care expenditure, resulting in some reduction in the proportion of the gross domestic product spent on health care. Cost controls may not be as effective in the 1990s, as a result of demographic changes. More modern health care systems will likely develop in some of the central and eastern European countries, although this change will probably be slow.

Cross-Cultural Comparison↗
PubMed1990

Cost of surfactant replacement treatment for severe neonatal respiratory distress syndrome: a randomised controlled trial.

OBJECTIVE: To estimate the cost of treating babies with severe respiratory distress syndrome with natural porcine surfactant. DESIGN: Retrospective controlled survey. SETTING: Regional neonatal intensive care unit, Belfast. PATIENTS: 33 Preterm babies with severe respiratory distress syndrome who were enrolled in a European multicentre trial during 1985-7. 19 Babies were treated with surfactant and 14 served as controls. INTERVENTIONS: Treatment with natural porcine surfactant. MAIN OUTCOME MEASURE: Cost associated with surfactant replacement treatment per extra survivor in the treatment group and cost per quality adjusted life year for each extra survivor. RESULTS: Fifteen (79%) of the 19 treated babies and five (36%) of the 14 control babies survived. On average, the control babies required 20 days in hospital compared with 61 days for the treated babies (or 95 [corrected] days per extra survivor in the treatment group). The cost per extra survivor in the treatment group was pounds 13,720, with the cost per quality adjusted life year estimated at pounds 710. CONCLUSION: These costs compare favourably with those of established forms of treatment in adults. Thus surfactant replacement treatment for severe respiratory distress syndrome is fairly inexpensive and cost effective.

Combined Modality Therapy↗