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At least 577 records · Page 32Linked to original sources
PubMed2001

Case-mix adjustment of the National CAHPS benchmarking data 1.0: a violation of model assumptions?

OBJECTIVE: To compare models for the case-mix adjustment of consumer reports and ratings of health care. DATA SOURCES: The study used the Consumer Assessment of Health Plans (CAHPS) survey 1.0 National CAHPS Benchmarking Database data from 54 commercial and 31 Medicaid health plans from across the United States: 19,541 adults (age > or = 18 years) in commercial plans and 8,813 adults in Medicaid plans responded regarding their own health care, and 9,871 Medicaid adults responded regarding the health care of their minor children. STUDY DESIGN: Four case-mix models (no adjustment; self-rated health and age; health, age, and education; and health, age, education, and plan interactions) were compared on 21 ratings and reports regarding health care for three populations (adults in commercial plans, adults in Medicaid plans, and children in Medicaid plans). The magnitude of case-mix adjustments, the effects of adjustments on plan rankings, and the homogeneity of these effects across plans were examined. DATA EXTRACTION: All ratings and reports were linearly transformed to a possible range of 0 to 100 for comparability. PRINCIPAL FINDINGS: Case-mix adjusters, especially self-rated health, have substantial effects, but these effects vary substantially from plan to plan, a violation of standard case-mix assumptions. CONCLUSION: Case-mix adjustment of CAHPS data needs to be re-examined, perhaps by using demographically stratified reporting or by developing better measures of response bias.

Adolescent↗
PubMed2001

Differences in CAHPS adult survey reports and ratings by race and ethnicity: an analysis of the National CAHPS benchmarking data 1.0.

OBJECTIVE: To examine racial/ethnic group differences in adults' reports and ratings of care using data from the National Consumer Assessment of Health Plans (CAHPS) survey Benchmarking Database (NCBD) 1.0. DATA SOURCE: Adult data from the NCBD 1.0 is comprised of CAHPS 1.0 survey data from 54 commercial and 31 Medicaid health plans from across the United States. A total of 28,354 adult respondents (age > or = 18 years) were included in this study. Respondents were categorized as belonging to one of the following racial/ethnic groups: Hispanic (n = 1,657), white (n = 20,414), black or African American (n = 2,942), Asian and Pacific Islander (n = 976), and American Indian or Alaskan native (n = 588). STUDY DESIGN: Four single-item global ratings (personal doctor, specialty care, overall rating of health plan, and overall rating of health care) and five multiple-item report composites (access to needed care, provider communication, office staff helpfulness, promptness of care, and health plan customer service) from CAHPS 1.0 were examined. Statistical Analyses. Multiple regression models were estimated to assess differences in global ratings and report composites between whites and members of other racial/ethnic groups, controlling for age, gender, perceived health status, educational attainment, and insurance type. PRINCIPAL FINDINGS: Members of racial/ethnic minority groups, with the exception of Asians/Pacific Islanders, reported experiences with health care similar to those of whites. However, global ratings of care by Asians/Pacific Islanders are similar to those of whites. CONCLUSIONS: Improvements in quality of care for Asians/Pacific Islanders are needed. Comparisons of care in racially and ethnically diverse populations based on global ratings of care should be interpreted cautiously.

Adult↗
PubMed2001

Data-based modelling and proportional-integral-plus (pip) control of nitrate in an activated sludge benchmark.

This paper presents the result of an investigation into the Proportional Integral Plus (PIP) control of nitrate in the second zone of an activated sludge benchmark. A data-based reduced order model is used as the control model and identified using the Simplified Refined Instrumental Variable (SRIV) identification and estimation algorithm. The PIP control design is based on the Non Minimum State Space (NMSS) form and State Variable Feedback (SVF) methodology. The PIP controller is tested against dynamic load disturbances and compared with the response of a well tuned PI controller.

Benchmarking↗
PubMed2001

ASIS healthcare security benchmarking study.

Effective security has aligned itself into the everyday operations of a healthcare organization. This is evident in every regional market segment, regardless of size, location, and provider clinical expertise or organizational growth. This research addresses key security issues from an acute care provider to freestanding facilities, from rural hospitals and community hospitals to large urban teaching hospitals. Security issues and concerns are identified and addressed daily by senior and middle management. As provider campuses become larger and more diverse, the hospitals surveyed have identified critical changes and improvements that are proposed or pending. Mitigating liabilities and improving patient, visitor, and/or employee safety are consequential to the performance and viability of all healthcare providers. Healthcare organizations have identified the requirement to compete for patient volume and revenue. The facility that can deliver high-quality healthcare in a comfortable, safe, secure, and efficient atmosphere will have a significant competitive advantage over a facility where patient or visitor security and safety is deficient. Continuing changes in healthcare organizations' operating structure and healthcare geographic layout mean changes in leadership and direction. These changes have led to higher levels of corporate responsibility. As a result, each organization participating in this benchmark study has added value and will derive value for the overall benefit of the healthcare providers throughout the nation. This study provides a better understanding of how the fundamental security needs of security in healthcare organizations are being addressed and its solutions identified and implemented.

Benchmarking↗
PubMed2001

Clinical benchmarking enabled by the digital health record.

Office-based physicians are often ill equipped to report aggregate information about their patients and practice of medicine, since their practices have relied upon paper records for the management of clinical information. Physicians who do not have access to large-scale information technology support can now benefit from low-cost clinical documentation and reporting tools. We developed a hosted clinical data mart for users of a web-enabled charting tool, targeting the solo or small group practice. The system uses secure Java Server Pages with a dashboard-like menu to provide point-and-click access to simple reports such as case mix, medications, utilization, productivity, and patient demographics in its first release. The system automatically normalizes user-entered clinical terms to enhance the quality of structured data. Individual providers benefit from rapid patient identification for disease management, quality of care self-assessments, drug recalls, and compliance with clinical guidelines. The system provides knowledge integration by linking to trusted sources of online medical information in context. Information derived from the clinical record is clinically more accurate than billing data. Provider self-assessment and benchmarking empowers physicians, who may resent "being profiled" by external entities. In contrast to large-scale data warehouse projects, the current system delivers immediate value to individual physicians who choose an electronic clinical documentation tool.

Benchmarking↗
PubMed2002

Guidelines set new benchmark for emergency care of children.

This spring, the American College of Emergency Physicians and the American Academy of Pediatrics issued joint guidelines on providing optimal care to children who visit emergency departments--more than 20 million visits annually. The guidelines raise the bar on pediatric emergency care and offer new benchmarks for EDs.

Benchmarking↗
PubMed2002

Computer simulation improves on laboratory benchmarking.

Benchmarking of hospital laboratory services is about to take a new twist, as computer simulations allow managers to see proposed efficiency improvements in action before investing in new equipment or staff changes.

Benchmarking↗
PubMed2002

2002 Benchmarking Guide.

The profitability gap between hospitals in high and low managed care markets is closing. The difference in total margins is down and the change in return on equity is even more dramatic. However, even with heavier patient care demands, hospitals in high managed care markets have a firmer grip on expenses and show productivity gains. Our annual Benchmarking Guide shows that the number of HMOs operating in the United States continues to decline with industry mergers, plan consolidations and plan closures. While 2001 enrollment stabilized at 79.5 million, the number of HMOs fell to 541. The guide also compares data on hospital-owned and non-hospital-owned physician practices.

Benchmarking↗
PubMed2002

Wastewater treatment benchmark: what can be achieved with simple control?

In this paper a simple control strategy is applied to and assessed on the wastewater treatment benchmark. The controllers used in the presented control strategy are PI controllers, feedforward control and a step-feed procedure. The controlled variables are not directly the effluent concentrations but other process variables which have an effect on the effluent. The setting of set-points is also analyzed to select the values with the best performance. Set-point analysis has shown that with an optimal setting of set-points under stormy influent conditions, the achieved plant performance is also retained for rainy and dry influent conditions. The evaluation of plant performance indicates that with the proposed control strategy, a lower number of effluent violations has been achieved, as well as lower energy consumption and lower sludge production, when compared to results published up to now. Only the effluent quality criterion deteriorated.

Algorithms↗
PubMed2002

Implementation of storage tanks on the COST 624 benchmark.

To test the improvement that can be expected in terms of effluent quality of an wastewater treatment plant by activated sludge, an equalisation tank and a storm tank, designed to damp the influent variations under different weather conditions, have been implemented in front of a benchmark plant used to evaluate control strategies. The equalisation tank improves significantly the effluent quality in any weather condition but at a high operation cost due to extra pumping, while the storm tank without by-pass improves the effluent quality in rainy periods with a small increase in cost operation over the no tank case.

Benchmarking↗
PubMed2002

Benchmarking HIPAA compliance.

One of the nation's largest academic medical centers is benchmarking its operations using internally developed software to improve privacy/confidentiality of protected health information (PHI) and to enhance data security to comply with HIPAA regulations. It is also coordinating the development of a web-based interactive product that can help hospitals, physician practices, and managed care organizations measure their compliance with HIPAA regulations.

Academic Medical Centers↗
PubMed2000

Benchmarking and evidence-based practice: complementary approaches to achieving quality process improvement.

The terms benchmarking and evidence-based practice have gained a great deal of attention of late. Although these 2 processes are not identical, they are complementary and can be applied concurrently in an improvement strategy. This article aims to illustrate the strengths and potential weaknesses of the 2 processes and to explain how they may be used together to improve operational performance.

Benchmarking↗
PubMed2002

Benchmarking the billing office.

Benchmarking data related to human and financial resources in the billing process allows an organization to allocate its resources more effectively. Analyzing human resources used in the billing process helps determine cost-effective staffing. The deployment of human resources in a billing office affects timeliness of payment and ability to maximize revenue potential. Analyzing financial resource helps an organization allocate those resources more effectively.

Academic Medical Centers↗