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Articles 1 - 23 of 23
Full-Text Articles in Medicine and Health Sciences
Financial Incentives: Pay For Performance (P4p) And The Chronically Ill Patients, David Conley, Alberto Coustasse
Financial Incentives: Pay For Performance (P4p) And The Chronically Ill Patients, David Conley, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
P4P is the reimbursement incentive that is based on quality improvement, efficiency, which is dominating the healthcare landscape and CMS. A literature review was conducted to search for and review significant information regarding P4P and how it pertains to chronic conditions and reimbursement methods. This literature review displayed while some programs were able to display a benefit/ profit for those involved such as insurance companies, hospitals, physicians and/or patients, most programs were unable to establish quality measures, cost effectiveness and positive program outcomes worth noting.
Computer Physician Order Entry And Clinical Decision Support Systems: Benefits And Concerns, Joseph Shaffer, Alberto Coustasse
Computer Physician Order Entry And Clinical Decision Support Systems: Benefits And Concerns, Joseph Shaffer, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Computerized Physician Order Entry has emerged as the greatest potential to decrease medications errors and improve efficiency. A literature review was conducted in systematic stages that included the research data from the last 25 years. Efficiencies were found with a decrease in overall workload of nurses, pharmacists and clerical workers. This led to decreased operating expenses. A secure way of transferring physician orders electronically will help hospitals and physicians practice a more efficient and higher quality of care in the US healthcare system.
Treating Methicillin-Resistant Staphylococcus Aureus With The Drug Vancomycin In A Home Infusion Therapy Setting, Joshua L. Webb, Alberto Coustasse, Dennis Emmett
Treating Methicillin-Resistant Staphylococcus Aureus With The Drug Vancomycin In A Home Infusion Therapy Setting, Joshua L. Webb, Alberto Coustasse, Dennis Emmett
Alberto Coustasse, DrPH, MD, MBA, MPH
The basic purpose of this paper is to examine the effects the home infusion therapy has on the cost, duration of, and effectiveness of treatment between those individuals under 60 and those 60 and over. The results show that those 60 and over had a slightly higher cost/day. The older age group had slightly smaller treatment duration, then the younger group. The number of adverse effects was small. The results suggest that home infusion therapy appears to be a viable alternative to hospitalization.
Benefits And Constraints Of Telepsychiatry Utilization In The United States, Bruce A. Stec, Alberto Coustasse
Benefits And Constraints Of Telepsychiatry Utilization In The United States, Bruce A. Stec, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
This conference presentation describes the benefits and constraints of utilizing telemedicine primarily focusing on the field of psychiatry in the United States with the current system of healthcare. The utilization of telemedicine in the field of psychiatry is believed to provide better access, quality and care to the patients who necessitate psychiatric care in their overall medical care. Telemedicine has been a successfully integrated program into psychiatric facilities reaching rural, prisons or city facilities based on that it has increased the volume of patients in which physicians can reach out to and diagnose, as well as treat patients with limitations …
Physician Incentives: Managed Care And Ethics, Douglas A. Mains, Alberto Coustasse, Kristine Lykens
Physician Incentives: Managed Care And Ethics, Douglas A. Mains, Alberto Coustasse, Kristine Lykens
Alberto Coustasse, DrPH, MD, MBA, MPH
The authors review the principle features of the managed care system in an effort to understand the ethical assumptions inherent in managed care. The interrelationships among physician incentives, responsibilities of patients and the physician-patient relationship are examined in light of the ethical concerns identified in the managed care system. The managed care system creates ethical tensions for those who influence the allocation of scare resources. Managed care's administrative controls have increasingly changed the doctor-patient relationship to the businessperson-consumer relationship. Managed care goals of quality and access demand that physicians be both patient advocate and organizational advocate, even though these roles …
The Emergence And Potential Impact Of Medicine 2.0 In The Healthcare Industry, Terra Stump, Sarah Zilch, Alberto Coustasse
The Emergence And Potential Impact Of Medicine 2.0 In The Healthcare Industry, Terra Stump, Sarah Zilch, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Medicine 2.0 has emerged within healthcare information technology to enable more defined relationships among providers and patients. Physicians, hospitals, and patients are using Medicine 2.0 through social networking to maintain their foothold in the evolution of medical technologies. The authors’ purpose was to determine potential improvements that Medicine 2.0 has on communication and collaboration of healthcare information. Research has shown that Medicine 2.0 has integrated into the healthcare industry and is enabling an increase in communication in healthcare matters. The provider-patient relationship is improving through the use of Medicine 2.0 and has positively impacted society so far.
Organizational Culture In A Terminally Ill Hospital, Alberto Coustasse, Douglas A. Mains, Kristine Lykens, Sue G. Lurie, Fernando Trevino
Organizational Culture In A Terminally Ill Hospital, Alberto Coustasse, Douglas A. Mains, Kristine Lykens, Sue G. Lurie, Fernando Trevino
Alberto Coustasse, DrPH, MD, MBA, MPH
This study analyzed an organizational culture in a community hospital in Texas to measure organizational culture change and its impact on Patient Satisfaction (PS). The study employed primary and secondary data, combining quantitative and qualitative methods for a case study. Participant observation was used and archival data were collected to provide a better understanding of the organizational culture and the context in which change was taking place. This study also applied a “Shared Vision” of the organization as the central process in bringing forth the knowledge shared by members of the community hospital who were both subjects and research participants. …
Can Kawasaki Disease Be Managed?, Alberto Coustasse, Julius Larry, Doohee Lee
Can Kawasaki Disease Be Managed?, Alberto Coustasse, Julius Larry, Doohee Lee
Alberto Coustasse, DrPH, MD, MBA, MPH
Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but management of KD has received relatively little attention. In the US alone, about 5500 cases were estimated in 2009. KD is most common among Asian and Pacific Islander children but can affect all ethnicities and races. Timely and accurate diagnosis remains critical, but difficult: the etiology of KD is unknown, and no accurate diagnostic laboratory test has been developed. Continuing medical education can help physicians, clinicians, and nurse practitioners accurately diagnose and treat KD. A registry specific to KD or a surveillance system may be necessary …
Disparities In Access To Healthcare: The Case Of A Drug And Alcohol Abuse Detoxification Treatment Program Among Minority Groups In A Texas Hospital, Alberto Coustasse, Karan P. Singh, Fernando M. Trevino
Disparities In Access To Healthcare: The Case Of A Drug And Alcohol Abuse Detoxification Treatment Program Among Minority Groups In A Texas Hospital, Alberto Coustasse, Karan P. Singh, Fernando M. Trevino
Alberto Coustasse, DrPH, MD, MBA, MPH
The authors analyzed ethnic/racial disparities in healthcare access and length of stay from a defined population of individuals seeking medical detoxification services at a hospital in Texas. Results indicated Blacks were more likely to be insured compared with Whites, mostly by public insurance, but this did not hold for Hispanics, who were about three times more likely to be uninsured compared with Blacks. In addition, the authors observed lower median of length of stay in the Medicaid category among Hispanics. These results can be explained by aggressive case management, sociocultural barriers, or discriminatory practices, both intentional and unintentional.
Pharmaceutical Counterfeiting And The Rfid Technology Intervention, Alberto Coustasse, Cody Arvidson, Phil Rutsohn
Pharmaceutical Counterfeiting And The Rfid Technology Intervention, Alberto Coustasse, Cody Arvidson, Phil Rutsohn
Alberto Coustasse, DrPH, MD, MBA, MPH
Both nationally and internationally, pharmaceutical counterfeiting has become a problem that is threatening economic stability and public health. The purpose of the present research study review was to analyze the scope and severity of pharmaceutical counterfeiting and to establish if the implantation of the Radio Frequency Identification Device (RFID) model can more efficiently be used within the pharmaceutical supply chain to reduce the problem counterfeit drugs impose on public health and international economic stability. Results indicated that implementing the RFID model for tracking drugs at the item level in the pharmaceutical supply chain has potential to alleviate the scope of …
The Case Of South African And Chilean Health Systems: Comparison Of Financial, Economic And Health Indicators, Alberto Coustasse, Peter Hilsenrath, Patricio Silva Rojas
The Case Of South African And Chilean Health Systems: Comparison Of Financial, Economic And Health Indicators, Alberto Coustasse, Peter Hilsenrath, Patricio Silva Rojas
Alberto Coustasse, DrPH, MD, MBA, MPH
The purpose of this study is to identify similarities and differences between healthcare systems of South Africa and Chile. The World Health Report 2000, the Human Development Index, and financial indicators were used for comparison. Chile showed better performance than South Africa in most of the measures used. Significant progress has been made in South Africa, bringing better education, healthcare and housing to the deprived black majority. However, the HIV/AIDS epidemic, weighs heavily on health indicators. Chile decentralized its health services and implemented economic reforms during the 1980's and has had steady improvement in its healthcare indicators. Finally, these counties …
Gender Disparities: A Medical Detoxification Program, Alberto Coustasse, Karan P. Singh, Sue G. Lurie, Yu-Sheng Lin, Claudia S. Coggin, Fernando Trevino
Gender Disparities: A Medical Detoxification Program, Alberto Coustasse, Karan P. Singh, Sue G. Lurie, Yu-Sheng Lin, Claudia S. Coggin, Fernando Trevino
Alberto Coustasse, DrPH, MD, MBA, MPH
Significant gaps exist in health care regarding gender in the United States. Health status, social roles, culturally patterned behavior and access to health care can be influenced by gender. Women have been the primary users of health care and minority women usually have received poorer quality care than Non-Hispanic White (NHW) females. The objectives of this study were to identify gender, racial and ethnic disparities in access to substance abuse treatment in a Texas hospital. Secondary data collected on 1,309 subjects who underwent detoxification were studied. Gender, race/ethnicity, drug of abuse, relapse and financial classification were included in the analysis. …
Cost Of Medical Detoxification Among Drug And Alcohol Users In A Private Texas Hospital, Alberto Coustasse
Cost Of Medical Detoxification Among Drug And Alcohol Users In A Private Texas Hospital, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Purpose – The purpose of this paper is to estimate the costs of medical detoxification among patients with alcohol and substance abuse disorders. Design/methodology/approach – The study data was drawn from a medical detoxification program in a community hospital in Texas. Secondary data analysis of 1337 cases from three years was reviewed. Age, gender, race, alcohol, cocaine, cannabis, amphetamines, sedatives, opioids, financial classification, cost, length of stay (LOS) and cost by LOS were analyzed using Kruskal-Wallis test and Mann-Whitney U-test. Findings – The sample comprised of 42.8 percent women and 57.2 percent males. The mean cost and cost by LOS …
Electronic Medical Records: Is It Working In Long Term Health Care?, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse
Electronic Medical Records: Is It Working In Long Term Health Care?, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …
Kawasaki Syndrome In Texas, Alberto Coustasse, Julius J. Larry, Witold Migala, Cody Arvidson, Karan P. Singh
Kawasaki Syndrome In Texas, Alberto Coustasse, Julius J. Larry, Witold Migala, Cody Arvidson, Karan P. Singh
Alberto Coustasse, DrPH, MD, MBA, MPH
The authors examined hospitalization rates of Kawasaki Syndrome (KS) among Texas children to isolate clusters, identify demographic disparities, and suggest possible causative factors. Using a retrospective cross-sectional study design, they studied 330 KS cases from 2,818,460 hospital discharges. The majority of the cases (61.5%) occurred within the 1-4-years-old category, representing the highest hospitalization rate (14.3 per 100,000 children). Almost 75% of the KS population was less than 5 years old, with hospitalization rates approximately 8 times higher than that of all other children (p < .05). KS diagnosis occurred for only 49.4% of all KS cases upon admission. Along with high-density …
To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie
To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie
Alberto Coustasse, DrPH, MD, MBA, MPH
Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …
Electronic Medical Records In Long-Term Care, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse
Electronic Medical Records In Long-Term Care, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …
Accountable Care Organization Musical Chairs: Will There Be A Seat Remaining For The Small Group Or Solo Practice?, Amy Vaughan, Alberto Coustasse
Accountable Care Organization Musical Chairs: Will There Be A Seat Remaining For The Small Group Or Solo Practice?, Amy Vaughan, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
When it was introduced in the Affordable Care Act of 2010 as the new 2012 payment model for Medicare, an accountable care organization (ACO) was a new and untested concept in healthcare delivery and payment. The authors estimated the likelihood of engagement in ACOs by small group and solo healthcare practitioners. An evaluation of five case studies showed that significant organizational, financial, and technological challenges had to be met in order to launch an ACO. Sufficient resources to meet those challenges were best supplied by large organizations. Small or solo practices participated only through varying levels of integration as salaried …
Uncompensated Care And Quality Assurance Among Rural Hospitals, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse
Uncompensated Care And Quality Assurance Among Rural Hospitals, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Health care disparities in rural areas remain significant in the U.S. health care industry. Uncompensated care makes health care 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. Given that many rural residents experience difficulty accessing high quality care and given 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 and suggested strategies to strengthen the position of rural hospitals …
Disparities In Disability Among Non-Hispanic Black Elders: Results From The National Interview Survey 2001–2003, Alberto Coustasse, Dennis Emmett, Nimisha Patel, Alicia Pekar
Disparities In Disability Among Non-Hispanic Black Elders: Results From The National Interview Survey 2001–2003, Alberto Coustasse, Dennis Emmett, Nimisha Patel, Alicia Pekar
Alberto Coustasse, DrPH, MD, MBA, MPH
A drastically increasing elderly population and disparity among disability poses a concern for the US health care industry. This retrospective cross-sectional study analyzed whether ADL and IADL disabilities were different among non-Hispanic white (NHW) and non-Hispanic black (NHB) populations age 65 and over. Data was retrieved from the 2001–2003 National Health Interview Survey (NHIS) for comparing NHBs and NHWs using chi-square analysis for bivariate comparisons. For both elderly NHBs and elderly NHWs, increased rates of disability were reported for being over 75, female, single, and having lower education. NHBs reported statistically higher disability rates for ADL, IADL, and for any …
Uncompensated Care Cost: A Pilot Study Using Hospitals In A Texas County, Alberto Coustasse, Andrea L. Lorden, Vishal Nemarugommula, Karan P. Singh
Uncompensated Care Cost: A Pilot Study Using Hospitals In A Texas County, Alberto Coustasse, Andrea L. Lorden, Vishal Nemarugommula, Karan P. Singh
Alberto Coustasse, DrPH, MD, MBA, MPH
The financial ramifications of uncompensated care cost (UCC) on the healthcare industry have been difficult to quantify. With the lack of a standardized definition of uncompensated care and the need to account for the uninsured, indigent, and immigrant populations, the authors identified $190 million of UCC from Southwestern border hospitals for emergency room treatment of undocumented immigrants and $934 million of uncompensated care charges for 23 hospitals in a Texas county, which translated to $353 million of UCC. Although lawmakers passed the Medicare Prescription Drug Improvement and Modernization Act (2003) to address the growing imbalance, the shortfall of funds highlights …
Disparities In Adl And Iadl Disabilities Among Elders Of Hispanic Subgroups In The United States: Results From The National Health Interview Survey 2001-2003, Alberto Coustasse, Sejong Bae, Cody Arvidson, Karan P. Singh, Fernando Trevino
Disparities In Adl And Iadl Disabilities Among Elders Of Hispanic Subgroups In The United States: Results From The National Health Interview Survey 2001-2003, Alberto Coustasse, Sejong Bae, Cody Arvidson, Karan P. Singh, Fernando Trevino
Alberto Coustasse, DrPH, MD, MBA, MPH
The authors compared disability and functional limitation among elder Hispanic subgroups by using data from the 2001-2003 National Health Interview Survey (National Center for Health Statistics 2008a). The authors applied chi-square analysis for bivariate comparisons and used multiple logistic regression analyses for making comparisons, estimating odds ratios, and predicting disabilities. Results revealed a 21.4% rate of disability of any type in Hispanics. Puerto Ricans reported the highest rates of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) disabilities compared with other Hispanic subgroups (Mexicans, Cubans, Central and South Americans) and reported a higher rate than did …
Ethical Considerations Of Genetic Presymptomatic Testing For Huntington's Disease, Alberto Coustasse, Alicia Pekar, Andrew Sikula Sr., Sue Lurie
Ethical Considerations Of Genetic Presymptomatic Testing For Huntington's Disease, Alberto Coustasse, Alicia Pekar, Andrew Sikula Sr., Sue Lurie
Alberto Coustasse, DrPH, MD, MBA, MPH
The aim of this literature review was to determine if there is adequate ethical justification for presymptomatic genetic testing on potential Huntington's disease patients. Huntington's disease is a neurological genetic disorder characterized by midlife onset which consists of cognitive, physical, and emotional deterioration. Although genetic testing has traditionally been guided by the principle of autonomy, severe psychological consequences such as depression, anxiety, survival guilt, and suicide have complicated the ethical issue of providing a presymptomatic yet definitive diagnosis for an incurable disease. An analysis of available articles yielded inconclusive findings, namely due to insufficient evidence, self-selection bias of test participants, …