Effect of heliotherapy on the cost of psoriasis.

A 2-year trial was conducted to evaluate the cost-effectiveness of heliotherapy for psoriasis. The course and cost of psoriasis of 46 Finnish patients were first closely monitored for 1 year, then the patients received a 4-week supervised heliotherapy treatment in the Canary Islands, Spain, after which they continued to be followed for another year. Heliotherapy dramatically reduced the severity of psoriasis and also seemed to have favourable long-term effects on psoriasis. The mean direct cost of the 4-week heliotherapy for one patient was FIM12,289 (1 Pound = FIM7.0 in 1989). The cost of flights and half-board in Spain formed nearly 60% (FIM7033) of the total cost. In the year preceding heliotherapy, the mean direct annual cost of antipsoriasis therapy was FIM7335 and in the year after FIM5700, a reduction of 22% in annual costs; this change was not statistically significant because there were large variations in costs among patients. The costs of heliotherapy exceeded manyfold the mean monthly cost of conventional psoriasis therapy. There were no overall savings using heliotherapy in those patients suffering mainly from moderately severe psoriasis. Heliotherapy saved costs only in those patients with severe psoriasis that required expensive medication or ward treatment. Although heliotherapy cannot be regarded as an economical treatment for the average patients with psoriasis, it clears psoriasis effectively and is preferred by patients. Thus, heliotherapy constitutes an alternative for patients suffering severe psoriasis.

Explaining the utilisation of dental care. Experiences from the Finnish dental market.

In this paper a model based on the theory of demand for health and of supplier inducement is developed to explain the utilisation of dental care. Of special interest are the effects of money price and various forms of inducement. It is also explored how the results are affected if different model specifications and estimation techniques are applied and what is the most appropriate one, when utilisation is measured by dental expenditure. The data come from a sample of 1779 employees, whose dental expenditure is refunded from 0 to 99.75%. Other things being equal, the methodological choices make a clear difference in parameter estimates. Only a log-linear two-part model and two-part tobit with selectivity were suitable for explaining expenditure and produced quite similar results. Money price elasticity was small, but significant (-0.069). General and personal inducement appear to have a considerable effect on utilisation, but did not have any systematic connection with dentist/population ratio.