Drug hypersensitivity: questionnaire. EAACI interest group on drug hypersensitivity.
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Biomedical subjects
Publications and source records attributed to R Kropf.
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The most frequently cited benefits of image communications systems (teleradiology) are: (1) a reduction in the travel time of radiologists, and (2) an improvement in access to services, especially in rural areas. The benefits of teleradiology services for hospitals are, however, potentially much greater. Teleradiology services could alter the competitive positions of organizations in the market for imaging services and change the nature of the competition. In this article we examine how a small community hospital and a large referral hospital might each use teleradiology strategically to improve their respective competitive positions.
This article describes how managers of outpatient diagnostic radiology services can develop a competitive advantage by increasing the value of services to patients and referring physicians. A method is presented to identify changes to services that increase their value. The method requires the definition of the "value chains" of patients and referring physicians. Particular attention is paid to the use of information systems technology to suggest and implement service changes. A narrow range of health services was selected because the approach requires a detailed understanding of consumers and how they use services. The approach should, however, be examined carefully by managers seeking to develop a competitive advantage for a wide range of health services.
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Managers of radiology and imaging services need to continually question their assumptions about competitors, particularly in highly competitive markets. The systematic collection of information about a competitor's future goals, current strategies, assumptions held and capabilities can improve the accuracy of predictions of a competitor's future behavior. The resources devoted to a competitor analysis should depend on the level of risk which a manager's organization faces. Interviews with selected professionals involved in the day-to-day operations of radiology and imaging services are the most important source of information, but published and unpublished information available to the public can provide essential background information and corroborate the information gained through interviews.
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Strategic planning, competition, marketing and the use of sophisticated analytic techniques are constantly being called essential to the survival of hospitals. The authors found no evidence in a sample of plans that these concepts and techniques are being widely adopted.
The principal concern of this paper is the development of procedures for adjusting the criteria currently being used for federally-legislated health planning activities. These procedures would enable the planner to account for the demographic, geographic and health-system conditions which cause variations in the need for health-care services in local communities. A case-mix method, hospital chart abstract data and demographic, geographic and health-system data from New Jersey were used to: create a list of diagnoses eligible for treatment in a Cardiac-Care Unit (CCU): select a sample of hospitals for study, and conduct a step-wise regression analysis of CCU utilization in these hospitals. It was concluded that CCU utilization was affected by factors such as the in-hospital availability of CCu beds, the type of hospital, CCU-patients' clinical severity, and the availability of ambulances and mobile intensive care units. Procedure for adjusting planning criteria to account for local conditions have yet to be developed. However, a method for using the types of results presented in this paper to develop such adjustment procedures was presented and illustrated. It is recommended that this method be used to create such adjustment procedures for the planning criteria for all hospital services and hence to assist Health Systems Agencies in rationalizing the distribution of our hospital care.
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A case-mix strategy was used with hospital chart-abstract data from New Jersey to estimate the hypothetical savings in the cost of Cardiac Care Unit (CCU) care in the state that would result from the state-wide implementation of the following five policies: limiting uncomplicated Acute-Myocardial Infraction (AMI) patients to seven days of hospitalization; treating uncomplicated AMI patients at home; using the CCU only for diagnoses for which it is widely accepted as effective; tightening CCU admission criteria; and tightening CCU discharge criteria. The selection of these policies was based on a review of the CCU literature and on empirical data from the New Jersey CCU system. The case-mix strategy involved; the creation and categorization of a list of diagnoses which are eligible for CCU treatment; the selection of a sample of hospitals for study; and the estimation of the savings which would result from the implementation of the hypothetical CCU policies throughout the state. The estimated savings were substantial compared to the total cost of CCU care in New Jersey, stressing the need for further investigation of the cost-effectiveness of current CCU treatment practices. In addition, the case-mix method used in this study is recommended for bringing considerations of the cost-effectiveness of clinical practice into public policy debates on the regulation of medical services.
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The principal concern of this article is the inadequacy of the planning criteria currently being used by existing federally funded health planning agencies. A case-mix method was created for developing appropriate criteria. Chart-abstract data from New Jersey were used to create a list of those diagnoses eligible for treatment in the cardiac care unit (CCU), select a sample of hospitals for study and analyze the relationship between CCU bed need and CCU clinical practice. It was shown that existing bed-need criteria for CCU planning represent current CCU clinical practice patterns, which are probably not cost effective. The method was also used to develop empirical values of these criteria, which do represent cost-effective practice. It is recommended that the method be used to strengthen and update continuously all hospital-service need criteria used in current planning activities, including Plan Development and Certificate of Need Review.
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What challenges today's healthcare executive is deciding what new technologies to purchase and exactly when to do so. Scan the marketplace for them--both in the healthcare field and in industry.