Biomedical subjects
Publications and source records attributed to D Neuhauser.
Rising medical care costs are not the problem they seem to be, in part because quality of care is not considered. The problem may be more the absence of choice of alternative health benefit packages with price differences. The future of health services in the United States will have more competing alternatives requiring physicians to be more cost conscious.
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A professional layman speculates on the role of public voice in medical care--on ways of making organizations responsive to the public's wishes. Research conducted as a participant observer in the functioning of human subjects committees, hospital trustees, and a government regulatory body reveals the public interest to be no match for the special interest. Unusual proposals are offered to improve the public's control mechanisms; the marketplace and the polling place may yet serve well.
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Explore the source record for details and available documents.
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When an attempted suicide jumps off the Golden Gate Bridge, should money be spent on saving him, or on safety nets for the bridge? It's up to the director of the health service's new Suicide Division--and he'll get a bonus if he makes the right decision.
MEU is a simple way of Measuring Efficient Utilization of hospital services. It looks at the part of the patient's hospital stay that depends on the tests and treatment required. Are these tests ordered in a way that does not waste time? Is the turnaround time from test ordering to reported results fast or slow? MEU produces a numerical index of efficient utilization; here are some of the ways it has been put to use.
One of the difficult problems facing managers is how to evaluate the benefits to be gained from introducing a new diagnostic test that may be more accurate--but also more expensive. What analyses can be applied to help the hospital make the choice to switch or not?
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The six sequential stool guaiac protocol has been advocated for screening of colonic cancer. Analysis of the expenditures involved in such a program shows that the cost of detecting cancer rises exponentially so that the marginal cost of the sixth test may be 20,000 times the average cost. The marginal cost is decreased with lower test sensitivity and increased with lower prevalence of colonic cancer. This result shows that even an inexpensive test can become quite costly in terms of cases detected. The marginal cost per case detected depends on the prevalence of the condition in the population screened and the sensitivity of the test applied.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.