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Hospital Topics

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April 2016: Hospital Topics
Marisa Borelli, David P Paul, Michaeline Skiba
The incidence of end-stage renal disease (ESRD) and its associated comorbidities such as diabetes and hypertension continue to increase as the population ages. As most ESRD patients qualify for Medicare coverage, the U.S. government initiated reforms of the payment system for dialysis facilities in an effort to decrease expenditures associated with ESRD reimbursement. The effects of reduced reimbursement rates, bundled payment options, and quality incentives on the current dialysis system, including kidney dialysis units, physicians, and patients, are examined...
April 2016: Hospital Topics
Anuradha Agarwal, Maithili R P Singh
One of the most important parts of healthcare system is diagnostics. Nowadays, Indians have become more aware of their health, due to improved and better availability of health related information, increase in medical tourism, and expanding health insurance. The demand for better diagnostic facilities have increased with the increase in lifestyle related diseases, excesses use of chemicals in agriculture practices and change in food habits. It is expected that the Indian diagnostic market will grow from USD $5 billion in the year 2012 to USD $32 billion by the year 2020 with 20% CAGR (India Brand Equity Foundation 2015 )...
April 2016: Hospital Topics
Darcy K McMaughan, John C Huber, Samuel N Forjuoh, Ann M Vuong, Janet Helduser, Marcia G Ory, Jane N Bolin
The authors examined the responses of 63 primary care physicians to diabetes clinical protocols (DCPs) for the management of type II diabetes (T2DM). We measured physician demographics, current diabetes patient loads, and responses to DCPs (physician attitudes, physician familiarity, and physician recommendation of DCPs) using a 20-question electronic survey. Results of the survey indicate that primary care physicians may be unfamiliar with the benefits of diabetes clinical protocols for the self-management of T2DM...
2016: Hospital Topics
Nathaniel D Bastian, Hyojung Kang, Harriet B Nembhard, Andrew Bloschichak, Paul M Griffin
Healthcare associated infections have significantly contributed to the rising cost of hospital care in the United States. The implementation of pay-for-performance (P4P) programs has been one approach to improve quality at a reduced cost. We quantify the impact of Highmark's Quality Blue (QB) hospital P4P program on central line-associated blood stream infections (CLABSI) in Pennsylvania. The impact of years of participation in QB on CLABSI is also evaluated. Data from 149 Pennsylvania hospitals on CLABSI from 2008-2013 are used...
2016: Hospital Topics
James H Stephens, Gerald R Ledlow, Thomas V Fockler
Implementing the International Classification of Diseases, Ninth Revision (ICD-9) to International Classification of Diseases, Tenth Revision (ICD-10) conversion on October 1, 2015, in the United States has been a long-term goal. While most countries in the world converted more than 10 years ago, the United States was still using ICD-9. Many countries in the world have a single-payer healthcare system, while there are thousands of different healthcare organizations (providers and payers) that presently exist in the United States...
2016: Hospital Topics
Behrooz Noori
In the present work, critical success factors (CSFs) of lean implementation within hospitals were investigated. The published lean CSFs were analyzed and grouped in five constructs. Each construct included several measures. The author also hypothesized that five constructs of lean implementation positively impacted lean success. To clarify the interrelations among these constructs, structural equation modeling was used to assess the criticality of the measures included in each CSF category. The results illustrated a close relationship between the CSFs and lean success...
April 2015: Hospital Topics
Nashat Zuraikat, Catherine Dugan
The purpose of this study was to identify the prevalence of overweight and obesity among 5,158 school-age children and to evaluate the effectiveness of a walking program to encourage physical activity among children in Western Pennsylvania. According to the National Health and Nutrition Examination Survey (NHANES), obesity in school-age children affects approximately 19% of children 6-11 years old in the United States (Centers for Disease Control and Prevention 2010c ). Data were collected over six years. The results of the study revealed the prevalence of obesity and overweight was higher than the national averages: 36% versus 20%...
April 2015: Hospital Topics
Eric S Hall, Matthew D Lang, Linda Levin, Vivek Narendran
In an analysis of all Ohio newborn infants discharged home alive between 2007 and 2012, the authors identified that significant variation in hospital charges (among Medicare Severity Diagnostic Related Group categorizations), previously identified nationally, persists at the state and local levels among term and preterm infants (p <.0001). Additionally, the authors identified variation in length of stay among infants with extreme immaturity or respiratory distress syndrome (p <.0001). Charge data remain the best available proxy for closely guarded hospital cost figures; increased pricing transparency would further support comparison of hospital newborn care costs...
April 2015: Hospital Topics
Laquanda T Leaven
Laboratory services in healthcare delivery systems play a vital role in inpatient care. Studies have shown that laboratory data affects approximately 65% of the most critical decisions on admission, discharge, and medication. Laboratory testing accounts for approximately 10% of hospital billing. Reducing laboratory costs and improving laboratory performance would contribute to reducing total healthcare cost, which is one of the major goals for the U.S. healthcare delivery system. The objective of this paper is to review and analyze the diverse research approaches applied to improve the performance of hospital laboratories in large healthcare delivery systems...
April 2015: Hospital Topics
Dennis Emmett, Ashish Chandra
Many healthcare professionals have stated that obesity is a major problem in the United States. The rate of obesity in young people has been rising until just recently, when it was reported to have leveled off. The authors examine the problem in terms of people's perception of how great a problem it is, along with examining their perception of the causes and possible remedies for the problem. If the general population does not believe that a problem exists, then corrective action will be hampered. Then, the authors examine what impact this has on marketing products to address this problem...
2015: Hospital Topics
Robert Curtis, Anetta Caplanova, Marcel Novak
While the United States and Slovakia offer different healthcare delivery systems, each country faces the same challenges of improving the health status of their populations. The authors explore the impact of their respective systems on the health of their populations and compare the health outcomes of both nations. They point out that socioeconomic factors play a far more important role in determining population health outcomes than do the structures of the systems surrounding the care delivery. The authors illustrate this finding through a comparison of the poverty and education levels of a selected minority group from each country in relation to the health outcomes for each population group...
2015: Hospital Topics
Camille Payne, Kathleen Farrell
Interprofessional (IP) education has emerged globally as a means of improving overall healthcare quality, and to increase healthcare provider understanding of other roles. However, in situations of moral uncertainly, there are not clear procedures to address IP role interactions when tension and conflict emerge. This study reports secondary analysis findings from data in a large study related to moral distress in IP ethics consultations and collaborations. A basic qualitative, exploratory approach was utilized for data analysis with overtones of grounded theory...
2015: Hospital Topics
Daniel J Koys, Wm Marty Martin, Helen LaVan, Marsha Katz
The authors address the hospital outcomes of patient satisfaction, healthcare quality, and net income per bed. They define union density as the percentage of a hospital's employees who are in unions, healthcare quality as its 30-day acute myocardial infraction (AMI; heart attack) mortality rate, and patient satisfaction as its overall Hospital Consumer Assessment of Healthcare Providers and Systems score. Using a random sample of 84 union and 84 nonunion hospitals from across the United States, multiple regression analyses show that union density is negatively related to patient satisfaction...
2015: Hospital Topics
Nandakumar Mekoth, Vidya Dalvi
Patient adherence is extremely important to achieve positive outcome. While quality of healthcare service has been studied as a determinant of patient satisfaction and loyalty, its impact on patient adherence has not been examined. The authors attempt to determine dimensions of quality and their impact on patient adherence in primary healthcare in India. Exploratory factor analysis resulted into seven factors. Factor scores were used for regression to identify the influence of dimensions of service quality on patient adherence...
2015: Hospital Topics
Daniel A Handel, Benjamin Sun, James J Augustine, Charles M Shufflebarger, Rongwei Fu
The authors examined the association between the size of an emergency department (ED), volume increases over time, length of stay (LOS), and left before treatment complete (LBTC). EDs participating in the Emergency Department Benchmarking Alliance providing at least two years of data from 2004 to 2011 were included in the analysis. The impact of volume on LOS and LBTC varied depending on annual ED volume. Based on this, EDs can anticipate better how changes in volume will impact patient throughput in the future...
2015: Hospital Topics
William Kent Willis, Ahmet Ozzie Ozturk, Ashish Chandra
Patients have to wait in waiting rooms prior to seeing the physician. But there are few studies that demonstrate what they are actually doing in the waiting room. This exploratory study was designed to investigate the types of discussions that patients in the waiting room typically engage in with other patients and how the conversations affected their opinion on general reputation of the clinic, injections/blocks as treatment procedures, waiting time, time spent with the caregiver, overall patient satisfaction, and the pain medication usage policy...
January 2015: Hospital Topics
Rajakrishnan Vijayakrishnan, Aparna Ramasubramanian, Suneel Dhand
 Delirium is a common occurrence in hospitalized patients, especially in the geriatric age group. Data was retrospectively reviewed for patients who developed delirium during hospitalization. Acute intracranial changes on imaging were noted only in four patients (11%) and all had preimaging clinical symptoms and signs, which warranted imaging. Imaging should be considered only in the presence of head injury, fall, history of anticoagulation, focal neurological signs, fever, and raised intracranial pressure...
January 2015: Hospital Topics
Angela R Craig, Koichiro Otani, Patrick A Herrmann
The authors evaluated whether a patient's perceived pain control influenced the relationships between four attributes (nursing, physician, staff, and environment) and patient satisfaction. Multiple linear regression analyses were conducted to examine overall satisfaction and intention to recommend, controlling for race, gender, age, and education. The authors found that no matter the level of pain control, nursing was always the most influential attribute in patient satisfaction. The influence of the other attributes varied, depending on the patients' pain control...
January 2015: Hospital Topics
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