University of Michigan Case Study: The Physician Group Practice Demonstration

2014 ◽  
pp. 199-213
Author(s):  
Caroline S. Blaum ◽  
Brent C. Williams ◽  
David A. Spahlinger
Keyword(s):  
Group Practice ◽  
University Of Michigan ◽  
Physician Group

Abstract P216: Heart Failure Readmission Rates: Experience of St John's Physician Group Practice Demonstration

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Joseph P Drozda ◽  
Donna A Smith ◽  
Paul C Freiman ◽  
Jeffrey A VanSlette ◽  
Timothy R Smith
Keyword(s):  
Heart Failure ◽  
Readmission Rate ◽  
Group Practice ◽  
Data Sets ◽  
Disease Registry ◽  
Readmission Rates ◽  
Annual Average ◽  
Physician Group ◽  
Period 2 ◽  
Artery Disease

Objective: The appropriateness of using readmission rates alone as markers of the quality of Heart Failure (HF) care has been questioned. The HF program of St. John's Health System's Physician Group Practice (PGP) Demonstration provided an opportunity to assess a number of outcomes that help to put readmission rates in context. The HF program included disease and case management and a disease registry in the PCP office. Methods: Several data sets were analyzed including the EHR, an inpatient database, the disease registry, and the Social Security Death Master File. Traditional Medicare patients admitted to St. John's Hospital from 2000 to 2010 with a diagnosis of HF, were included resulting in data for 5 years before (Period 1) and 5 years after (Period 2) the 2005 inception of PGP. Results: Total admissions were 3559 in Period 1 and 3514 in Period 2. The prevalence of 3 co-morbid conditions in admitted patients increased during Period 2 [diabetes 35.3% (1256/3559) to 42.7% (1499/3514), p<0.001; hypertension 54.8% (1952/3559) to 70.4% (2475/3514), p<0.0001; and coronary artery disease 62.7% (2253/3559) to 66.4% (2332/3514), p=0.015] indicating that patients were getting more complex. HF admissions trended down significantly from Period 1 (709 annual average) to 2009 (637, p=0.007). The 30 day all cause readmission rate dropped in 2005 [16.9% (137/809)] from Period 1 [annual average 18.8% (671 / 3559), p=0.04] and remained stable thereafter [annual average 16.9% (595/3514)]. The 30 day mortality rate was flat from 2000 to 2009 [2.7(15/550)-5.0% (30/597), p=0.3] and increased in 2010 [8.6% (28/327), p<0.0001]. The use of pacemakers and ICDs was unchanged during Period 2 but ACE inhibitor and beta blocker use increased in PGP practices during 2005 and was constant thereafter. Conclusions: The HF program implemented by this PGP project was associated with decreased HF admissions and with increased clinical complexity of admitted patients. Despite this increasing complexity, the 30 day all cause readmission rate dropped in the first year of the program and remained stable thereafter. Finally, 30 day mortality rates were not adversely affected until the last year of the program. The increased mortality in 2010 may be due to a change in case mix but remains unexplained.

scholarly journals Understanding PhD Latinx Career Outcomes: A Case Study

2018 ◽  
Vol 17 (2) ◽  
pp. 148-168 ◽  
Author(s):  
Mark Kamimura-Jimenez ◽  
John Gonzalez
Keyword(s):  
Doctoral Students ◽  
Contextual Factors ◽  
Educational Experience ◽  
Career Outcomes ◽  
University Of Michigan ◽  
Case Study Approach ◽  
Study Approach ◽  
Institutional Structures ◽  
The University

This study explored the career outcomes for Latinx doctoral students and the contextual factors of their educational experience influencing these outcomes. A case-study approach is taken to examine the cases of doctoral students at the University of Michigan. These students were tracked each year, for 10 years post-graduation. Furthermore, an analysis of programmatic efforts to develop doctoral students and prepare them for the marketplace is also described as institutional structures that support career success.

scholarly journals Cancer spending and accountable care organizations: Evidence from the Physician Group Practice Demonstration

Healthcare ◽  
2013 ◽  
Vol 1 (3-4) ◽  
pp. 100-107 ◽  
Author(s):  
Carrie H. Colla ◽  
Valerie A. Lewis ◽  
Daniel J. Gottlieb ◽  
Elliott S. Fisher
Keyword(s):  
Accountable Care Organizations ◽  
Group Practice ◽  
Accountable Care ◽  
Physician Group

scholarly journals Engineer and Feminist: Elsie Gregory MacGill and the Royal Commission on the Status of Women, 1967-1970

2009 ◽  
Vol 29 (2) ◽  
pp. 74-97
Author(s):  
Crystal Sissons
Keyword(s):  
Royal Commission ◽  
University Of Michigan ◽  
Canadian Society ◽  
Equal Rights ◽  
University Of Toronto ◽  
The Status ◽  
Aeronautical Engineering ◽  
The University ◽  
Status Of Women

Abstract Can a woman engineer by a feminist? This article argues in the affirmative using a case study of Elsie Gregory MacGill. Elsie Gregory MacGill was Canada's first woman electrical engineer, graduating in 1927 from The University of Toronto. She then became the first woman to earn a degree in aeronautical engineering from the University of Michigan in 1929. While establishing herself in a predominantly masculine profession, MacGill, also a third generation feminist, actively worked for women's equal rights and opportunities in Canadian society. A case study of her role in the Royal Commission of the Status of Women (RCSW), 1967-1970, is used to illustrate that not only can a woman engineering be a feminist, but more importantly that her dual background allowed her to effectively bridge the worlds of the engineering and feminism in engineering the RCSW.

Sign in / Sign up

Export Citation Format

Share Document