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J Studnicki

Publications and source records attributed to J Studnicki.

At least 37 records · Page 2Linked to original sources
PubMed1982

Analyzing inpatient hospital duration and intensity: a methodology.

As a complement to a number of existing cost-containment programs, Blue Cross of Maryland developed a length of stay (LOS) review process for its members. The method is based on the premise that the utilization of hospital inpatient services varies along two major dimensions--service duration (expressed in days of hospital stay) and service intensity (expressed as the proportion of ancillary service charges to total charges). Composed of seven steps, the method statistically analyzes the relationship between LOS and ancillary service charges as a proportion of total charges for selected diagnoses. The attempt to monitor two dimensions of inpatient care simultaneously is a departure from existing utilization review methods. Besides a detailed description of each step in this methodology, this article presents preliminary findings from a pilot study conducted in eight Baltimore hospitals.

Costs and Cost Analysis↗
PubMed1980

A performance comparison: USMG-FMG house staff physicians.

To determine whether differences exist in the performance of United States Medical Graduate (USMG) and Foreign Medical Graduate (FMG) House Staff physicians, inpatient hospital audits evaluating individual physician performance on patient histories and physical examinations were conducted in 14 Maryland and Pennsylvania non-federal, short-term hospitals. A total of 3,204 medical records were abstracted from eight diagnostic categories for 898 house staff physicians, 556 of which were USMGs and 342 were FMGs. The results from these audits indicate that while there is evidence of a strong hospital/type of physician interaction for many of the diagnoses, there was no significant overall difference in performance of USMG and FMG house staff physicians. The largest and most consistent differences in physician performance were associated with hospital characteristics, not physician characteristics.

Clinical Competence↗
PubMed1979

A performance comparison: USMG-FMG attending physicians.

To determine whether patterns of differences in performance exist between United States Medical Graduate and Foreign Medical Graduate attending Physicians, two types of inpatient hospital audits (Payne Process Audit and the Joint Committee on Accreditation of Hospitals' Performance Evaluation Program-P.E.P. Audit) were conducted in 22 Maryland and Pennsylvania non-federal, short-term hospitals. A total of 6,980 medical records were abstracted from eight diagnostic categories for 1,321 attending physicians; 985 of which were USMGs and 331 were FMGs. The results from both audits indicate that while there is evidence of a strong hospital-type of physician interaction for many of the diagnoses, there was no significant overall difference in performance between USMG and FMG attending physicians. The largest and most consistent differences in physician performance were associated with hospital characteristics, not physician characteristics.

Clinical Competence↗
PubMed1978

Comparing medical audits: correlation, scaling, and sensitivity.

A modified Payne process and the JCAH intermediate outcome medical audits were applied to 6,980 cases in eight diagnostic categories within 22 hospitals, representing 1,321 attending physicians. Overall correlations between the two audits differed substantially from diagnosis to diagnosis, allowing for generally inconsistent and conflicting results when applied to a specific research question. Methods are illustrated for comparing the relative scaling (harshness) and sensitivity (discriminating power) of these two audit methods. The effects of the specificity of items, total number of items, outcome versus process indicators, and weights of items on the measurement characteristics of the audit methods are also discussed.

Hospitals↗
PubMed1976

Foreign medical graduates and Maryland Medicaid.

To determine whether foreign medical graduates provide a disproportionate share of medical care to the poor, Medicaid vendors in Maryland were compared with all licensed physicians in the State. Foreign medical graduates constitute 22 per cent of all physicians in Maryland but 36 per cent of the Medicaid vendors. In addition, of all the vendors for fiscal 1974, 94 per cent who were licensed in 1972 or 1973 were foreign medical graduates. This disproportional representation in the Medicaid program is concentrated in the specialties of general surgery, internal medicine and general practice. Thirty-two per cent of all foreign medical graduates in Maryland are board-certified physicians, but only 22 per cent of those who are Medicaid vendors are board certified. For United States medical graduates, 48 per cent of all physicians are board certified, but this figure increases to 52 per cent for the Medicaid vendors. Finally, representation of foreign medical graduates among Medicaid vendors tends to be highest in areas with the highest physician-to-population ratios and with the highest percentages of total Medicaid payments.

Certification↗
PubMed1975

The minimization of travel effort as a delineating influence for urban hospital service areas.

Using a study population of 16,080 live births occurring to residents of Baltimore City in 16 hospitals in 1969, this research measured the existing flow of these patients against the flow "expected" in an optimal accessibility model (where each birth would occur at the hospital with the shortest travel time to the residence of the mother). The results of the study indicate that there is a general pattern of distance minimizing in travel for hospital admission with 50 per cent of the births occurring to women who travelled to one of the four closest hospitals of the 16 alternatives. However, a surprisingly large proportion (20 per cent) of the study population exhibited extreme spatial inefficiency by traveling to those four hospitals of the 16 alternatives which were farthest from their residence. A stepwise regression analysis identified five variables which best explained variation in the spatial efficiency of these urban obstetrical patients: low hospital occupancy, high total hospital admissions, average extra travel time potential (a measure of the difficulty of "spatial choices" facing patients depending upon the location of their residence with respect to the alternative hospitals), race, and the importance of the hospital's obstetrical service (a ratio of births to total admissions).

Birth Rate↗