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At least 1,369 records · Page 76Linked to original sources
PubMed1997

Caregiver supports: outcomes from the Medicare Alzheimer's disease demonstration.

A randomized 3-year study assessed the effect of expanded community-based services and case management on 5,254 caregivers of dementia clients. A tested policy concern was whether the financing of formal care would result in a reduction of informal assistance. Unmet needs task assistance for the demonstration's treatment group caregivers decreased by 30 percent within 6 months and by about 20 percent over 36 months relative to controls. While treatment group members used slightly more formal care over time, there were no differences between treatment and control groups in primary caregiver hours after 36 months, or in the number of tasks in which primary or secondary caregivers provided assistance.

Activities of Daily Living↗
PubMedDate not supplied

Benchmarking hospital lengths of stay using histograms.

The authors demonstrated that length of stay histograms can provide considerably more benchmark information concerning hospital lengths of stay than numerical benchmarks. Examples of histograms described the complete distribution of hospital stays, as well as levels of outliers, rather than simple numerical averages. Gathering such data led to a clearer understanding of the significant LOS impact of certain DRG outliers in the two different hospitals in Syracuse, NY. Given that the other two communities represented, Seattle, Washington and San Diego, California, were more influenced by extensive managed care penetration, variations in histogram data were less in evidence there. Histograms were designed with bars to show LOS distributions at the 50th, 75th, and 90th percentiles for each of the above DRGs. The greatest variations could be shown when comparing the 1997 LOS data on the various DRGs at the two Syracuse hospitals. At both hospitals the presence of a large contingent of outliers (for different types of mostly medical patients) could be seen as the major factor in driving up their overall LOS.

Benchmarking↗
PubMed1999

Peak expiratory flow rate (PEFR) in hairdressers.

The present cross sectional study with comparison group was undertaken to assess the lung function of hairdressers by Peak Expiratory Flow Rate (PEFR) using Wright peak flow meter. Total 385 hairdressers and 770 controls were included in the study. PEFR was observed to be reduced in hairdressers compared with controls. The difference was significant (P < 0.01) above 45 years of age. Also with increasing duration of exposure observed PEFR was reduced than expected. Above 20 years of length of service, the difference was statistically significant (P < 0.01). Smokers in hairdressing occupation had reduced PEFR than in control group, though this difference was not significant. Thus, we conclude that hairdresser's environment adversly affects their lung function and smoking may potentiate the adverse effect.

Adult↗
PubMed1999

[Value of vaccination data analysis at the district level].

This study aimed to demonstrate the importance of analysing local immunization data to improve performance of national prevention programmes. From the immunization registers kept in basic health centres, we identified 1271 children receiving their first vaccine at 3 months. Examination of the age at the subsequent vaccinations and time intervals between vaccinations showed that 81.9% had received all the vaccines required by the Ministry of Health but only 48.5% had received immunization meeting the requirements for age and time interval. The analysis also helped identify health centres with best performance (fewer children lost to follow-up and better implementation of immunization schedule) and those vaccinations needing the greatest attention from health professionals.

Age Factors↗
PubMed2000

Commentary on "A methodology for identifying married couples in Medicare data".

Authors of an article appearing recently in Demography propose a retrospective method to identify husband-wife pairs in administrative records. Although their premise is correct, they over-state the power of their methodology. The error stems from a misunderstanding of how persons entitled to both primary and secondary social security benefits are classified in program data. A retrospective look four years after the reference data shows that the number of pairs is increased by less than 10%, not by more than 50%, as the authors claim.

Aged↗
PubMed2001

Indirect cost of ischemic heart disease to employers.

BACKGROUND: The management of healthcare programs by employers requires accurate information about the indirect and direct costs of important chronic diseases. OBJECTIVE: To determine the indirect costs of ischemic heart disease from the perspective of the employer in private industry in the United States. DESIGN: Indirect cost of illness analysis using the human capital approach, taking the perspective of the employer rather than that of society. METHODS: Ischemic heart disease was identified in a proprietary claims database of 3.1 million insured persons using an algorithm based on administrative codes. Economic data were derived from the Bureau of Labor Statistics, the Employment Management Association, and published sources. Work-loss data were taken from the National Center for Health Statistics' Health Interview Survey. The indirect cost was calculated as the sum of the costs due to morbidity and mortality. From the perspective of the employer, morbidity costs come from lost productivity, idle assets, and nonwage factors resulting from absenteeism and mortality costs are expenditures for replacing and retraining workers. This differs from calculations from the societal perspective, in which indirect costs are the value of an individual's lost income--both current and potential. RESULTS: The total indirect cost of ischemic heart disease to employers in private industry was $182.74 per enrollee. Ninety-five percent of the indirect cost was the consequence of work loss due to morbidity rather than of mortality costs. CONCLUSION: From the perspective of the employer, the indirect cost of ischemic heart disease is overwhelmingly due to morbidity costs.

Adult↗
PubMedDate not supplied

Levels of data: the whys and hows of selection and analysis.

There are many challenges in selecting the level of a variable for data collection and analysis. Meeting these challenges is labor intensive and requires considerable skill; however, if a performance improvement project is to produce sound results, shortcuts cannot be taken. Studies that purport to show the impact of important variables on care influence the allocation of resources. The choice of a working unit level of analysis may be highly useful in meeting project goals and statistical requirements, but familiarity with multilevel techniques remains essential. If all or some of the variables must be aggregated, information about individual response rate, the extent and treatment of missing data, and tests of the collinearity of the aggregate data need to be made before proceeding with the analysis.

Benchmarking↗
PubMed2001

Describing and predicting frequent users of an emergency department.

The objective of this study was to examine the pattern of emergency department (ED) utilization among a cohort of ED users over a 3-year period and to identify factors predicting use. Billing records were used to track one hospital's cohort of adult frequent ED users (> or = 3 visits/per year) over a 3-year period. Frequent and (< 3 visits/per year) infrequent users were compared by age, gender, marital status, insurance status, and hospitalization rates. We compared the number of ED visits by patients in the two groups during follow-up years. Logistic regression analyses were performed to identify factors predicting ED visits by patients in the two groups in the follow-up years. Results from the study showed that frequent users were younger (P < 0.01) and more likely to be male (P < .01). Patients identified as frequent users in the first year were 52 to 77% more likely to visit frequently in the following two years. Logistic regression analysis showed the pattern of prior ED use was the best predictor of future use. Other factors (including age, gender, marital status, insurance status, and hospitalization following an ED visit) were not significant independent predictors of frequent ED use. Our data revealed that the past history of frequent ED use is predictive of future frequent ED use. Studies are needed on effective interventions to determine the reasons for continued frequent ED use.

Adolescent↗
PubMed1999

[Measure of nursing care results: user satisfaction].

In nursing, the evaluation of quality of care should rely on outcome indicators that are sensitive to patients. In this article, the concept of satisfaction is analysed and key aspects for its operationalisation are suggested.

Communication↗
PubMed2002

New options may improve accuracy of risk adjustment.

While the ability to risk-adjust payments is increasingly important to provider groups and health plans, diagnosis data that have been found to be the best predictors often are not readily available. But help may be on the way in the form of predictive programs that use either pharmacy data alone or pharmacy data in combination with inpatient data.

Data Interpretation, Statistical↗