ABSTRACT
OBJECTIVES: To describe a unique specialized seating delivery model for children with disabilities that focuses on cost containment and environmental preservation. To determine whether this delivery model achieves cost containment. DESIGN: A retrospective cost analysis using data from billing records and annual statistical reports of the specialized seating program, for the 2004 to 2009 billing period. SETTING: The specialized seating program is a service provided on a referral basis by the Saskatchewan Abilities Council, which is under contract to Saskatchewan Health. PARTICIPANTS: Pediatric patients (N=40) with physical disabilities (cerebral palsy, developmental delay, acquired brain injury, spinal cord injury, Down syndrome, other) who were referred, assessed, and met inclusion criteria. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Relative cost (in Canadian dollars) of providing units with recycled components compared with purchasing new units. RESULTS: The average cost of a used wheelchair was Can $698.11. The average cost of a new chair was $2143.69, leading to an average savings per chair of $1445.58. Of the 49 chairs issued, this resulted in a total cost savings of $85,393.97. When labor costs were taken into account ($50,060.26), the savings amounted to $35,333.71. Overall cost reduction was 41.3%. CONCLUSIONS: A retrospective analysis shows evidence of cost containment. Long-term sustainability of the program requires ongoing analysis of the cost and environmental advantages of a recycling program and review of benefits provided in relation to the ability to meet patient needs. This delivery model does incorporate accountability and a policy framework, which could serve as a model for other centers.
Subject(s)
Cost Savings , Equipment Reuse/economics , Self-Help Devices/economics , Wheelchairs/economics , Adolescent , Alberta , Child , Child, Preschool , Cost-Benefit Analysis , Disability Evaluation , Disabled Children , Female , Humans , Infant , Longitudinal Studies , Male , Models, Economic , Retrospective StudiesABSTRACT
OBJECTIVES: To determine if lorazepam or zopiclone is more effective in providing a restful night of sleep and to assess the effects of these medications on cognition. DESIGN: A randomized, double-blinded, crossover trial was performed at a tertiary care rehabilitation inpatient unit in a teaching hospital. A total of 18 brain-injured and stroke patients, aged 20-78 yrs, were administered lorazepam, 0.5-1.0 mg, orally at bedtime as needed for 7 days and zopiclone, 3.75-7.5 mg, orally at bedtime as needed for 7 days. Total sleep time and characteristics of sleep were measured. Effects on cognition were also measured using the Folstein Mini Mental Status Exam. RESULTS: There was no difference in average sleep duration or in subjective measures of sleep. Cognition as assessed by the Mini Mental Status Exam revealed no difference in the zopiclone arm compared with the lorazepam arm. CONCLUSION: Zopiclone is equally effective as lorazepam in the treatment of insomnia in stroke and brain-injured patients.
