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Full-Text Articles in Medicine and Health Sciences
Massachusetts Health Care Reform: Is It Working?, Joshua Mcadoo, Julian Irving, Stacie Deslich, Alberto Coustasse
Massachusetts Health Care Reform: Is It Working?, Joshua Mcadoo, Julian Irving, Stacie Deslich, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Before 2006, Massachusetts had more than 500 000 residents who lacked health insurance. Governor Mitt Romney enacted landmark legislation requiring all residents to obtain health insurance. Also, the legislation established a health insurance exchange for the purpose of broadening the choices of insurance plans made available to individuals in the state. The purpose of this research was to assess the Massachusetts health care reform in terms of access, cost, and sustainability. The methodology used was a literature review from 2006 to 2013; a total of 43 references were used. Health reform resulted in additional overall state spending of $2.42 billion …
The Balanced Scorecard Framework-A Case Study Of Patient And Employee Satisfaction: What Happens When It Does Not Work As Planned?, Andrea Lorden, Alberto Coustasse, Karan P. Singh
The Balanced Scorecard Framework-A Case Study Of Patient And Employee Satisfaction: What Happens When It Does Not Work As Planned?, Andrea Lorden, Alberto Coustasse, Karan P. Singh
Alberto Coustasse, DrPH, MD, MBA, MPH
Background: The successful utilization of the balanced scorecard (BSC) framework in health care has been demonstrated in the literature. Given these successes, a financially struggling hospital implemented a BSC framework intervention which attempted a culture change centered upon patient satisfaction which it hoped would translate to improved financial stability. Despite the evidence of BSC successes, the intervention, entitled Route 99, did not succeed in this hospital. Purpose: This case study was conducted to identify learnable lessons and confounding factors associated with the successes and failures of Route 99. Metrics for patient satisfaction and employee satisfaction were examined as reflections of …
Telepsychiatry In The 21st Century: Transforming Healthcare With Technology, Stacie Deslich, Bruce Stec, Shane Tomblin, Alberto Coustasse
Telepsychiatry In The 21st Century: Transforming Healthcare With Technology, Stacie Deslich, Bruce Stec, Shane Tomblin, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
This article describes the benefits and constraints of telemedicine, focusing primarily on the field of psychiatry in the United States with the current system of healthcare. Telepsychiatry is believed to provide better access and higher-quality care to patients who need psychiatric care and cost savings to providers of such care. Telemedicine has been successfully integrated into psychiatric facilities reaching rural areas, prisons, and urban facilities. It has increased the volume of patients that physicians can reach and diagnose, as well as allowing them to treat patients with limitations in mobility. While telepsychiatry has been shown to be beneficial, this technology …
Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack
Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack
Alberto Coustasse, DrPH, MD, MBA, MPH
Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce …
Hospital Costs And Clinical Characteristics Of Continuous Renal Replacement Therapy Patients: A Continuous Ethical Dilemma, Alberto Coustasse
Hospital Costs And Clinical Characteristics Of Continuous Renal Replacement Therapy Patients: A Continuous Ethical Dilemma, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
This study describes the clinical characteristics and examines hospital costs involved in the care of 117 patients undergoing Continuous Renal Replacement Therapy (CRRT) between January 1999 and August 2002. The majority (70.9%) of the patients undergoing CRRT expired in the hospital. Statistically significant differences were found with respect to the length of stay for discharge status and gender; and with respect to costs for surgery versus no surgery and gender. Significant differences were also found between discharge status and gender, age, and cardiovascular surgery. The results of this study raise economic and ethical questions related to the cost/benefit of CRRT …
Importance Of New Technologies For Diabetes Monitoring, David P. Paul Iii, Joey Preast, Zach Garrett, Alberto Coustasse
Importance Of New Technologies For Diabetes Monitoring, David P. Paul Iii, Joey Preast, Zach Garrett, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Diabetes and its ramifications and treatments are presented, followed by discussion of the importance of communication between patient and clinician. Improved communication approaches, including telephone consultations, blood glucose communications to a provider with feedback, and active electronic diaries on smartphones for both type 1 and type 2 diabetes mellitus, are reviewed.
Is Uncompensated Care Affecting Quality Assurance Of Rural Hospitals?, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse
Is Uncompensated Care Affecting Quality Assurance Of Rural Hospitals?, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Healthcare disparities in rural areas remain significant in the U.S. healthcare industry. Uncompensated care makes healthcare disparities in rural areas worse and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. As many rural residents experience difficulty accessing high quality care and the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality care barriers and opportunities, suggested strategies to strengthen the position of rural hospitals in response to uncompensated …
Comparative Cost Analysis Of Crrt In Icu/Ccu Patients Undergoing Cardiovascular Surgery Vs. Other Procedures At A Texas Hospital, Tejaswi Belavadi, Alberto Coustasse, Douglas Mains, Antonio A. Rene
Comparative Cost Analysis Of Crrt In Icu/Ccu Patients Undergoing Cardiovascular Surgery Vs. Other Procedures At A Texas Hospital, Tejaswi Belavadi, Alberto Coustasse, Douglas Mains, Antonio A. Rene
Alberto Coustasse, DrPH, MD, MBA, MPH
The purpose of this study was to conduct a comparative analysis of hospital costs incurred by patients undergoing Cardiovascular Surgery (CVS) and patients undergoing other medical procedures who received Continuous Renal Replacement Therapy (CRRT) in a teaching hospital. A total of 117 patients were identified through review of medical charts for the period of January 1999 to August 2002. Twenty one percent of them were identified having CVS. Eighty-eight percent of the CVS patients admitted to the ICU for CRRT died compared to 67% for non-CVS patients (p=0.047). Average actual costs of hospitalization were $47,225 for CVS patients and $51,724 …
Icd-10 In The United States: Better Late Than Never, Holly Johns, Cara Havens, Danielle Robinson, Bala S. Pothakamuri, David P. Paul Iii, Alberto Coustasse
Icd-10 In The United States: Better Late Than Never, Holly Johns, Cara Havens, Danielle Robinson, Bala S. Pothakamuri, David P. Paul Iii, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
The United States faces a revolution in the healthcare system soon, when the present coding system (ICD-9) will be replaced with what has for some years been the international standard: ICD-10. ICD-10 will provide a tremendous opportunity for better capturing the information in the increasingly complex delivery of healthcare. Although the transition to ICD-10 will undoubtedly result in substantial short-term costs, the long term benefits make the transition imperative.