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Articles 1 - 20 of 20
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 …
Adoption Of The Icd-10 Standard In The United States: The Time Is Now, Alberto Coustasse, David P. Paul Iii
Adoption Of The Icd-10 Standard In The United States: The Time Is Now, Alberto Coustasse, David P. Paul Iii
Alberto Coustasse, DrPH, MD, MBA, MPH
The United States is facing a revolution in the health care system soon when the present coding system (International Classification of Diseases, Ninth Revision) will be replaced with what has for some years been the international standard: International Statistical Classification of Diseases, 10th Revision (ICD-10). The ICD-10 system will provide a tremendous opportunity for better capturing information in the increasingly complex delivery of health care. Although the transition to ICD-10 will undoubtedly result in substantial short-term costs, the long-term benefits make the transition imperative.
Physicians, Patients, And Facebook: Could You? Would You? Should You?, Joy Peluchette, Katherine Karl, Alberto Coustasse
Physicians, Patients, And Facebook: Could You? Would You? Should You?, Joy Peluchette, Katherine Karl, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
This paper investigates the opinions of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. We analyzed 290 comments posted on online discussion boards and found that most (51.7%) were opposed to physicians being Facebook “friends” with patients and many (42%) were opposed to physicians having any kind of Facebook presence. The primary reasons for this opposition were concerns about privacy and the need to maintain professional boundaries in the physician-patient relationship. Others expressed concerns about HIPAA violations. Some believed it was acceptable for physicians to use Facebook as long as they were …
Expanding Technology In The Icu: The Case For The Utilization Of Telemedicine, Stacie Deslich, Alberto Coustasse
Expanding Technology In The Icu: The Case For The Utilization Of Telemedicine, Stacie Deslich, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Introduction: Telemedicine has been utilized in various healthcare areas to achieve better patient outcomes, lower costs of providing services, and increase patient access to care. Tele-intensive care unit (ICU) technology has been introduced as a way to provide effective ICU services to patients with reduced access, as well as to decrease costs and improve patient care. Materials and Methods: The methodology for this qualitative study was a literature search and review of case studies. The search was limited to sources published in the last 10 years (2003–2013) in the English language. In total, 55 references were used for this research …
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 …
Medical Tourism And International Healthcare Options, David Conley, Andrew Sikula Sr., William Willis, Alberto Coustasse
Medical Tourism And International Healthcare Options, David Conley, Andrew Sikula Sr., William Willis, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Medical tourism has evolved from traveling to the United States (U.S.) and a select few other countries, such as India and Thailand, to a global trend in affordable alternative healthcare. Medical tourism in the U.S. and in other countries has evolved because of cost and lengthy waiting periods. Some insurance companies are marketing kidney transplants and joint replacements through medical choice programs in order to save overall expense. As an economical approach to controlling rising health care costs in the U.S., medical tourism is becoming a valid alternative.
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 …
Ethics, Physician Incentives And Managed Care, Alberto Coustasse, Douglas Mains, Kristine Lykens
Ethics, Physician Incentives And Managed Care, Alberto Coustasse, Douglas Mains, 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 business person-consumer relationship. Managed care goals of quality and access demand that physicians be both patient advocate and organizational advocate, even though these …
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.
Management Of Kawasaki Disease In Texas: Policy Implications, Alberto Coustasse, Doohee Lee, Cody Arvidson, Julius J. Larry Iii, Witold Migala
Management Of Kawasaki Disease In Texas: Policy Implications, Alberto Coustasse, Doohee Lee, Cody Arvidson, Julius J. Larry Iii, Witold Migala
Alberto Coustasse, DrPH, MD, MBA, MPH
Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but KD has received little attention on its management from a policy perspective. The core objective of this paper is to review the literature, identify problems related to KD, and evaluate and offer some policy alternatives to effectively prevent and treat KD epidemiologically in Texas. Policy options suggested in this paper include, among others, (1) establishing a mandatory national KD registry system (along with active surveillance), (2) introducing sentinel providers, (3) requiring mandatory reporting of KD by hospitals, and (4) sponsoring policy KD research and practice.
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 …
Rfid And Its Impacts To The Hospital Supply Chain, Dan Feng Lu, Hai Do, Anna Jones, Alberto Coustasse
Rfid And Its Impacts To The Hospital Supply Chain, Dan Feng Lu, Hai Do, Anna Jones, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
A radio frequency identification device (RFID) is a type of information technology used to improve supply chain management through an enhanced visualization of products. The RFID market in the U.S healthcare industry has been projected to be approximately $297 million and has been expected to grow at a rapid speed. RFID had a great impact on the hospital supply chain. It has been demonstrated that 30% of large healthcare organization that had IT budgets over $100 million had already deployed RFID technology. RFID is the latest technology to reduce costs by tracking both equipment and employees. This technology can also …
A Review Of Radio Frequency Identification Technologies And Impacts On The Hospital Supply Chain: 2002–2012, Alberto Coustasse, Shane Tomblin, Chelsea Slack
A Review Of Radio Frequency Identification Technologies And Impacts On The Hospital Supply Chain: 2002–2012, Alberto Coustasse, Shane Tomblin, Chelsea Slack
Alberto Coustasse, DrPH, MD, MBA, MPH
Supply costs are the second largest expenditure in hospitals, accounting for more than one third of the average operating budget. RFID technology can reduce these costs, improve patient safety, and supply chain management by increasing the ability to track and locate equipment, as well as monitoring theft prevention, distribution management, and patient billing. Findings of this study have shown that the application of RFID on medical equipment and supplies have resulted in efficiency increase in healthcare with lower costs and increased quality services. Even though the cost of RFID implementation is decreasing, the total expenditures are still significant and the …
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 …
Case Studies In Medical Futility, Douglas A. Mains, Alberto Coustasse, Sue G. Lurie
Case Studies In Medical Futility, Douglas A. Mains, Alberto Coustasse, Sue G. Lurie
Alberto Coustasse, DrPH, MD, MBA, MPH
Technology has provided means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient. This study presents two case histories, compiled from historical patient charts, staff notes and observations, that illustrate the variety of ethical issues involved and the role culture plays in the decision making process related to possible futile medical treatment. Ethical and cultural issues related to the cases are discussed and processes are presented that can help hospitals to avoid, or decrease the level of, medically futile care, and improve the cultural appropriateness of medical care …
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.
Professionalism And Social Networking: Can Patients, Physicians, Nurses, And Supervisors All Be ‘Friends’?, Joy Peluchette, Katherine Karl, Alberto Coustasse, Philip Rutsohn, Dennis Emmett
Professionalism And Social Networking: Can Patients, Physicians, Nurses, And Supervisors All Be ‘Friends’?, Joy Peluchette, Katherine Karl, Alberto Coustasse, Philip Rutsohn, Dennis Emmett
Alberto Coustasse, DrPH, MD, MBA, MPH
This study examines the use of Facebook by certified nurse anesthetist students. Our results showed that, contrary to expectations, most were neutral about faculty, physicians, and supervisors viewing their Facebook profiles but expressed concerns about patients seeing such information. Many (30%) of our respondents had observed unprofessional content posted on the social network sites of their classmates including: intoxication or substance abuse, profanity, sexually suggestive photos or comments, and negative work-related comments. A vast majority indicated they would accept a ‘friend’ request from their supervisor and a physician but not a patient. Surprisingly, about 40% had initiated a ‘friend’ request …
Telepsychiatry In Correctional Facilities: Using Technology To Improve Access And Decrease Costs Of Mental Health Care In Underserved Populations, Stacie Anne Deslich, Timothy Thistlethwaite, Alberto Coustasse
Telepsychiatry In Correctional Facilities: Using Technology To Improve Access And Decrease Costs Of Mental Health Care In Underserved Populations, Stacie Anne Deslich, Timothy Thistlethwaite, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Objective: It is unclear if telepsychiatry, a subset of telemedicine, increases access to mental health care for inmates in correctional facilities or decreases costs for clinicians or facility administrators. The purpose of this investigation was to determine how utilization of telepsychiatry affected access to care and costs of providing mental health care in correctional facilities. Methods: A literature review complemented by a semistructured interview with a telepsychiatry practitioner. Five electronic databases, the National Bureau of Justice, and the American Psychiatric Association Web sites were searched for this research, and 49 sources were referenced. The literature review examined implementation of telepsychiatry …