Medicine and Health Sciences Commons^™

What's Happening: May, 2005, Maine Medical Center

What's Happening

No abstract provided.

Impact Of A Multifaceted Quality Improvement Initiative To Implement Jcaho Core Measures For Ami And Chf, Michael A. Rossi Md, Zubina M. Mawji Md, Mph, Patricia Parker Rn, Joshua B. Skibba Md, Katrina A. Fritz Bsn, Tamara Masiado Ma, Thomas E. Wasser Phd

Administration & Leadership

No abstract provided.

Effectiveness Of A Progress Note On Quality Care Indicators In A Get With The Guidelines Hospital, Michael A. Rossi Md, Zubina M. Mawji Md, Mph, Patricia Parker Rn, Joshua B. Skibba Md, Katrina A. Fritz Bsn, Tamara Masiado Ma, Thomas E. Wasser Phd

Administration & Leadership

No abstract provided.

Health Insurance Coverage For Small Employers, Dawn Gencarelli

National Health Policy Forum

For workers of small employers, access to affordable health insurance coverage is a growing concern. This paper examines the problems these firms and their employees face in obtaining health insurance coverage they can afford. The degree to which these challenges become obstacles varies greatly, depending on, for instance, the size of the employer and the characteristics of its employees. Reviewed here are these challenges to access, as well as some of the efforts made through state and federal reforms to address them, including rules regarding guaranteed issue and guaranteed renewability. This paper also explores some of the more recent initiatives …

Fundamentals Of Underwriting In The Nongroup Health Insurance Market: Access To Coverage And Options For Reform, Mark Merlis

National Health Policy Forum

Although the majority of Americans with health insurance obtain coverage through their employers, many individuals must negotiate the nongroup insurance market alone. Insurers use a process called medical underwriting to identify applicants with current or recent medical problems. Because these applicants are likely to cost the insurer more in claims than a healthier person, insurers may charge them higher premiums or restrict or deny coverage. This background paper reviews the practice of underwriting, state and federal regulation of insurers offering nongroup health coverage, and several proposed options for improving access to coverage for applicants who are in poor health.

Health Savings Accounts: The Fundamentals, Beth Fuchs, Julie A. James

National Health Policy Forum

This paper explores the fundamentals of health savings accounts (HSAs). While not intended to be an exhaustive review of these accounts, it describes their intellectual and legislative origins and the mechanics of how they work, explores the early returns on how they are faring in the insurance market, and identifies major issues and controversies that they raise. The paper looks specifically at the basic rules for HSAs and the requirements for health insurance that qualifies as a high-deductible health plan (HDHP) for HSA purposes. Also considered are issues related to provider payments under HSAs and the administration of the benefit …

What's Happening: April, 2005, Maine Medical Center

What's Happening

No abstract provided.

Exploring California's Rural Health System: From The Redwood Forests To The Baja Border, Eileen Salinsky, Jessamyn Taylor

National Health Policy Forum

This three day site visit to California explored the state’s rural health system with a particular focus on the financial health of inpatient and outpatient providers and how that affects access to care. The role of telemedicine as a tool for expanding access was explored as well as the special needs of vulnerable populations such as farmworkers. Participants learned how state and federal regulation and payment policies and state budget deficits impact the viability of rural health systems.

C4i Roadmap March 2005

Articles - Patient Care

Patients expect to be safe from harm inside the walls of a hospital. Increasing reports of medical errors and adverse events have brought these concerns to public attention. Although we have celebrated many scientific advances over the past several decades, many patients do not benefit because the healthcare infrastructure is inadequate to deliver care to all. Studies confirm opportunities to improve in areas such as inpatient vaccination for flu and outpatient screening for breast, cervical or colon cancer. (Institute of Medicine, (IOM), 2000, 2001, 2004). This document outlines the steps needed to further increase our focus on patient safety in …

What's Happening: March, 2005, Maine Medical Center

What's Happening

No abstract provided.

Scope Of Services Offered By Critical Access Hospitals: Results Of The 2004 National Cah Survey, David Hartley Phd, Mha, Stephenie L. Loux Ms

Rural Hospitals (Flex Program)

No abstract provided.

The Price Of Palliative Care: Towards A Complete Accounting Of Costs And Benefits, Alexander A. Boni-Saenz, David Dranove, Linda L. Emanuel, Anthony T. Lo Sasso

All Faculty Scholarship

The costs and benefits of hospice and palliative care have recently received attention for many compelling reasons. First, the cost of medical care over a lifetime is largely expended near the end-of-life. The impending demographic bulge of aging baby boomers will only heighten concerns about costs. Second, hospice and palliative care have been offered as potential vehicles for reducing late-in-life spending. Third, palliative care has gained legitimacy as a distinct medical specialty, having as it does a characteristic philosophy, specialized skill sets, and specific service delivery needs. This philosophy of care is consistent with and, to some degree, builds on …

What's Happening: January, 2005, Maine Medical Center

What's Happening

No abstract provided.

Children's Mercy Annual Report 2004, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Mandated Healthcare Will It Work?, Anna Vira

Seton Hall University Dissertations and Theses (ETDs)

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The Effects Of Variable Practice And Subjective Estimation On Error-Detection Capabilities, Colleen E. Donakowski

Master's Theses and Doctoral Dissertations

Retention and transfer for ballistic open motor skills may best be achieved through specific + variable practice along with error estimation. Inconsistent support for the variability of practice hypothesis warrants a cross-testing of this hypothesis. Estimation had been used and found beneficial on ballistic closed motor skills, but what about ballistic open motor skills?

This study tests ballistic open motor skills on an anticipation timer. Specific and specific + variable practice groups coupled estimation and no-estimation conditions for testing purposes.

The results indicated that although there were no significant differences during acquisition, significant differences did exist for retention and transfer …

Intuitive Decision Making And Leadership Style Among Healthcare Executives In The United States, Cherie Whiting

Dissertations

The purpose of this two-phased, sequential, exploratory, mixed-methods study was to survey a sample of Fellows in the American College of Healthcare Executives in the United States and then interview selected individuals who scored in the highly intuitive category on the intuition survey to explore how they made intuitive decisions. In the first phase, quantitative research questions addressed the relationship between leadership style and the potential to make intuitive decisions, as well as the relationship and interaction between the potential to make intuitive decisions and age, gender, and size of company. In the second phase, qualitative interviews were used to …

Variations In Quality Outcomes Among Hospitals In Different Types Of Health Systems, Askar S. Chukmaitov

Theses and Dissertations

Although prior research has found differences in costs and financial performance across different types of hospital systems, there has been no systematic study of variations in patient quality of care or safety indicators across different systems. Our study examines whether five main types of health systems - centralized (CHS), centralized physician/insurance (CPIHS), moderately centralized (MCHS), decentralized (DHS), and independent (IHS) - as well as other hospital characteristics are associated with differences in quality of patient care. Data were assembled for 6 years (1995 - 2000) from multiple sources. We used 4 AHRQ risk adjusted inpatient quality indicators (IQIs) and 5 …

The Effects Of A University-Based Academic Detailing Program For Primary Care Providers On Hemoglobin A1c Assessment Frequency In Type Ii Diabetics, Christopher Maloy

MPA/MPP/MPFM Capstone Projects

Diabetes is a serious illness affecting millions of people in the United States today. The disease is characterized by the chronic and acute complications of poorly regulated blood glucose concentrations. These complications lead to significant morbidity and mortality in the diabetic population. It is estimated that diabetes accounts for over $1.9 billion in Kentucky healthcare expenditure annually, a figure that continues to grow each year. In order to address this serious public health problem, many states have adopted healthcare initiatives to target increased diabetes awareness and care. The Commonwealth of Kentucky has implemented numerous such initiatives, including an innovative program …

Identifying Inaccuracies On Emergency Medicine Residency Applications., Eric D Katz, Lee Shockley, Lawrence Kass, David Howes, Janis P Tupesis, Christopher Weaver, Osman R Sayan, Victoria Hogan, Jason Begue, Diamond Vrocher, Jackie Frazer, Timothy Evans, Gene Hern, Ralph Riviello, Antonio Rivera, Keith Kinoshita, Edward Ferguson

Department of Emergency Medicine Faculty Papers

BACKGROUND: Previous trials have showed a 10-30% rate of inaccuracies on applications to individual residency programs. No studies have attempted to corroborate this on a national level. Attempts by residency programs to diminish the frequency of inaccuracies on applications have not been reported. We seek to clarify the national incidence of inaccuracies on applications to emergency medicine residency programs. METHODS: This is a multi-center, single-blinded, randomized, cohort study of all applicants from LCME accredited schools to involved EM residency programs. Applications were randomly selected to investigate claims of AOA election, advanced degrees and publications. Errors were reported to applicants' deans …

The Changing Face Of Rural General Practice: An Ethnographic Study Of General Practitioners And Their Spouses, Angela Durey

Theses: Doctorates and Masters

Rural general practice is general practice at its best: a comment by one GP interviewed for this study was echoed by colleagues who viewed their work in a rural setting as challenging, diverse, rewarding and satisfying. Despite reported difficulties associated with rural general practice, many GPs argued that the benefits outweigh the disadvantages. Few wanted to leave. Nonetheless, too few Australian trained GPs are willing to move from cities to work in the country. Consequently, overseas trained doctors have been recruited to fill vacancies or nurses provide health services in communities unable to attract a GP.

Quality Improvement In Maryland: Partnerships And Progress, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-and-a-half-day site visit to Easton, Maryland, explored the activities of the Delmarva Foundation, the Quality Improvement Organization (QIO) for Maryland and the District of Columbia. The program reviewed Delmarva’s responsibilities under their Medicare contract and the initiatives they have undertaken with hospitals and other providers to improve health care outcomes and to define, collect, and report quality data. Local hospital officials added their perspective on quality programs and working with Delmarva. Topics of particular interest were health information technology, patient safety, and quality reporting both to government agencies and to consumers.

What's Happening: December, 2004, Maine Medical Center

What's Happening

No abstract provided.

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

Management Faculty Research

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 …

The Use Of Increased Clinical Opportunities For Student Nurses At Two Different Intervals Within The Undergraduate Nursing Curriculum, Jerrilee Lamar

All-Inclusive List of Electronic Theses and Dissertations

This study examined the effects of two hospital-based clinical programs for student nurses on six dimensions of nursing. The two programs included a I 0-week student nurse summer extern program which was offered to nursing students who had completed a minimum of two clinical semesters of nursing school. The second program, a 12-week student nurse intern program, was offered to student nurses during their last semester of nursing school prior to eligibility for the national registered nurse licensure exam. The Schwirian Six-Dimension Scale of Nursing was used as a pretest and posttest self-assessment at the beginning and endings of each …

What's Happening: November, 2004, Maine Medical Center

What's Happening

No abstract provided.

The Provider System For Children's Mental Health: Workforce Capacity And Effective Treatment, Jane Koppelman

National Health Policy Forum

This issue brief examines two issues that are key to meeting children’s unmet needs for mental health care: ensuring that the provider supply is adequate and that the care delivered is effective. It describes the shortage of qualified providers to address children’s mental disorders, as well its possible causes; it describes how managed care, to a certain extent, drives practice patterns; and it discusses the gray areas in deciding which providers are most qualified to deliver what care. In addition, this paper introduces what is known about evidence-based care in children’s mental health, the extent to which it is being …

What's Happening: October, 2004, Maine Medical Center

What's Happening

No abstract provided.

Application Of Queuing Theory And Procedure Time Estimation In A Local Healthcare System, Galina Tsoy

Engineering Management & Systems Engineering Theses & Dissertations

People in the United States pay more for their basic healthcare needs than do people in any other nation in the world. When we consider that the United States is the wealthiest nation in the world, controlling the majority of the world's resources, it seems only reasonable to ask: Why should it be this way?

In an effort to address this problem, this thesis examines two possible methods of improving health care efficiency in hospitals. The thesis is thus in two parts: the first part examines resource allocation in medical units using Queuing Theory, and the second part examines a …

Electronic Health Records: How Close? How Far To Go?, Lisa Sprague

National Health Policy Forum

This paper looks at the central role of the electronic health record (EHR) in health information technology. It considers the extent to which EHRs are in use and initiatives designed to increase their prevalence, as well as barriers to the widespread adoption of EHRs and efforts to surmount them. Particular attention is given to such obstacles as cost, the professional culture of physicians, standardization, and legal questions.