Search PubMed⌕ Search

Biomedical subjects

J T Danzi

Publications and source records attributed to J T Danzi.

11 recordsLinked to original sources
PubMed2000

Case study: clinical documentation improvement program supports coding accuracy.

Developing a comprehensive inpatient clinical documentation and coding improvement program that demonstrates successful outcomes and proves to be sustainable by the health care organization is a difficult process but significant in maintaining accurate coding and reimbursement under the Medicare system. This case study of one health care organization that undertook just such a comprehensive program, chronicles the steps involved, the categories of health care professionals necessary to support ongoing communication and education, and the need for physician partnerships to sustain the program and achieve results. The program had a positive impact with a net increase in reimbursement attributed directly to the case reviews and point of service clinical education. Creating a new position of Coding/Documentation Specialist, working at the point of care as a regulatory interpreter and coding expert, was found to be key to cementing the successful team approach to documentation quality.

Abstracting and Indexing↗
PubMed1998

Fundamentals of financial statement analysis for academic physician managers.

Academic medical centers (i.e., teaching hospitals) and academic medical practices are under pressure to control costs to compete with for-profit health care institutions. The authors explain how academic physician managers who want to control costs wisely must first understand the cost structure of the medical center or practice and compare that structure with those of for-profit institutions. Doing this requires a firm understanding of how to use a valuable tool, financial statement analysis, to assess an institution's health and performance. Such analysis consists of calculating a variety of financial ratios (e.g., operating income divided by revenues; net income divided by total assets) and then comparing them with the corresponding ratios that are considered industry norms. Three types of financial statements (defined in detail) lend themselves to this approach: the balance sheet, income statement, and statement of cash flows. The authors define standard financial ratios, point out their uses and limitations, and emphasize that a ratio's meaning derives from comparing it with the corresponding benchmark ratio in the industry as a whole. Ratios should be used not as the end point of assessing financial status, but as ways to identify possible problems that require further investigation. Analysis of trends of ratios over time within an institution is a complementary approach. The authors then discuss the use of ratios in three standard types of institutional evaluation: of performance, of liquidity and leverage, and of strategic planning. In addition, they present the financial statement of a fictitious academic medical center as an example of how to use ratios for financial statement analysis. The authors emphasize that the key to using the ratios they discuss and hundreds of others is first to decide what question needs answering and then to choose the relevant ratios to provide a basis for finding the answer.

Academic Medical Centers↗
PubMed1988

Extraintestinal manifestations of idiopathic inflammatory bowel disease.

Ulcerative colitis and Crohn's disease have reported associations with a spectrum of extraintestinal diseases. This association has been appropriately termed as extraintestinal manifestations because large case studies have demonstrated that between 25% to 36% of patients with either type of inflammatory bowel disease will have at least one such associated disease. The spectrum of diseases reported associated with either ulcerative colitis or Crohn's disease involves many organ systems. Some of these extraintestinal manifestations are related to active colitis--joint, skin, ocular, and oral; small bowel dysfunction--cholelithiasis and nephrolithiasis; and nonspecific manifestations such as amyloidosis and hepatobiliary diseases. The purpose of this review is to update the clinicians with the most recent literature concerning the etiology, clinical course and the therapy of the extraintestinal manifestations associated with both forms of idiopathic inflammatory bowel disease.

Arthritis↗
PubMed1988

Collagenous colitis.

A middle-aged female with chronic, watery diarrhea was diagnosed after extensive evaluation as having collagenous colitis. The clinical, histological, and pathological findings of our case and those previously reported are reviewed. The diagnostic importance of total colonoscopy with biopsy in a normal-appearing colon in a patient with chronic, undiagnosed, watery diarrhea is discussed.

Acute Disease↗
PubMed1976

Carcinoma of the ampulla of Vater: Review of 38 cases with emphasis on treatment and prognostic factors.

Thirty-eight cases of carcinoma of the ampulla of Vater are presented. The diagnosis has been confirmed at laparatomy in all patients. Three operations were done, a pancreaticoduodenal resection in 23 patients, a biliary-enteric bypass in 7 patients and a biliary-enteric bypass plus excision of tumor in 8 patients. The operative mortality was 8% following resection, 14% following bypass plus excision of the ampulla and 13% following biliary-enteric bypass. Five patients survived 5 or more years. The longest survivors have followed pancreaticoduodenal resections (131 and 216 months). The level of bilirubin or presence of pain did not correlate with prognosis. Prognosis was better in the absence of nodal metastases, and in the presence of papillary tumors.

Adult↗
PubMed1976

Endoscopic features of gastroduodenal Crohn's disease.

The clinical, roentgenographic and endoscopic findings in 14 patients with Crohn's disease of the stomach and/or duodenum are described. To date, this is the largest series of endoscopic findings of Crohn's disease of gastroduodenal region. The endoscopic findings include (1) mucosal nodularity or "cobblestoned" mucosa; (2) multiple aphthous-like ulcerations and/or linear ulcerations; (3) thickening of the antral folds; (4) antral narrowing with evidence of hypoperistalsis; (5) duodenal strictures. The diagnosis of gastric duodenal Crohn's disease is achieved by combining recognition of clinical features and roentgenographic and endoscopic features. The endoscopic features correlate well with the roentgenographic findings in our 14 patients. Tissue for histological diagnosis of Crohn's disease of the gastroduodenal area is rarely obtained by endoscopic biopsy, but peroral suction biopsy specimens may increase the rate of histological confirmation.

Adolescent↗
PubMed1976

Primary sclerosing cholangitis. A report of nine cases and clinical review.

Nine cases of primary sclerosing cholangitis were reviewed as to methods of diagnosis, association with other disease states and clinical course of the patients. There were four cases of primary sclerosing cholangitis occurring alone, four cases associated with inflammatory bowel disease (three with chronic ulcerative colitis and one case with proctosigmoiditis) and one case associated with porphyria cutanea tarda. All cases of primary sclerosing cholangitis occurring alone, progressed to secondary biliary cirrhosis, however, none of the cases associated with chronic ulcerative colitis progressed to secondary biliary cirrhosis. In all cases, the diagnosis was established by operative findings and biopsy results. The mode of clinical presentation was similar in all cases and was characterized by slowly progressive jaundice. Intravenous and oral cholangiography were not useful in establishing a diagnosis but endoscopic retrograde cholangiography offers preoperative diagnostic hope and use for follow-up evaluation. One case with ulcerative colitis had a Strongyloides infection and the organism was found in the fibrotic duct and pericholedochal lymph nodes. The etiological considerations are reviewed and the classification of sclerosing cholangitis associated with ulcerative colitis, as primary, is discussed. Therapeutic modalities are discussed, though therapy is mainly empirical at present.

Adult↗