scholarly journals 3200 Balancing Cost and Quality of Care in the US and Denmark: Lessons for Nations Transitioning from Volume-Based to Value-Based Care

2019 ◽  
Vol 3 (s1) ◽  
pp. 140-140
Author(s):  
Negin Fouladi ◽  
Margit Malmmose
Keyword(s):  
Decision Making ◽  
Quality Of Care ◽  
Control Strategies ◽  
Decision Makers ◽  
Sources Of Information ◽  
Healthcare Organizations ◽  
Regulatory Oversight ◽  
Physician Practices ◽  
The Us

OBJECTIVES/SPECIFIC AIMS: Promote knowledge translation and evidence-informed decision-making by assessing barriers and facilitators to balancing cost and quality of care within the US state of Maryland and nation of Denmark. METHODS/STUDY POPULATION: Open-ended and semi-structured key-informant interviews were conducted in 2016 and 2017 among high level decision-makers in Maryland (N=21) and the Danish (N=17) healthcare systems, including hospital, local, regional, and cross-organizational administrators and elected officials. The interviews consisted of questions related to: (1) currently practiced and preferred approaches to resource allocation and development and use of quality performance measures, and (2) preferred sources, formats/styles, modes of information, and decision-making strategies based on a shift from volume to quality-driven care. RESULTS/ANTICIPATED RESULTS: Decision-makers in Maryland expressed the need for collaboration in a changing environment, yet increasingly rely on cost and quality outcomes data to drive decisions and note the struggle to identify credible and useful information. Maryland decision-makers also face challenges in regulating utilization and costs without mandated participation of physician practices within the global budget cap model, which is perceived to be a primary driver of healthcare utilization in the hospital sector. Similarly, decision-makers in Denmark conveyed the importance of quantitative data to aid decisions, however, stress collaboration and dialogue as driving factors and important sources of information. Danish decision-makers also express challenges to wide-spread adoption of a quality-driven approach due to unsustained quality assurance regulatory bodies. DISCUSSION/SIGNIFICANCE OF IMPACT: The findings suggest implementation of value-based healthcare is highly driven and influenced by availability of credible data, which may significantly impact development of policies and innovative cost control strategies, and regulatory oversight to promote adoption of quality measures in decision-making. Furthermore, collaboration within and across healthcare organizations remains a key component to health system improvement as it fosters dialogue and sharing of best practices among stakeholders.

IMPACTOS DO CONTEXTO PANDÊMICO NA SAÚDE MENTAL DOS PROFISSIONAIS DA ÁREA DA SAÚDE

2021 ◽  
Vol 7 (2) ◽  
pp. 253-272
Author(s):  
Amanda Cristina dos Santos Nogueira ◽  
Constance Rezende Bonvicini
Keyword(s):  
Quality Of Life ◽  
Work Environment ◽  
Social Economic ◽  
Sources Of Information ◽  
Front Line ◽  
Healthcare Organizations ◽  
Psychological Suffering ◽  
Health Area ◽  
Cultural Processes

The COVID-19 pandemic reflects in an intense and complex way in social, economic and cultural processes globally, also due to its sanitary nature in the work environment, a phenomenon that impacts and can have repercussions on workers' health. The general objective of this article was to analyze the influence that the pandemic scenario has on the mental health of professionals working in the health area, taking into account their work, quality of life and satisfaction with the organization. The methodology selected for the research was descriptive, qualitative, classified as a bibliographic research, in which the following descriptors were applied: satisfaction and quality of life in the work context, selecting academic sources of information that responded to the proposed objectives and that presented in the context of the pandemic. The results point to the fact that teams from healthcare organizations can be more affected in the context of the scenario, such as the nurses' class. It is portrayed that these professionals are doubly affected by the pandemic, in their work environment, while occupying the front line in the fight against the virus, and in their personal life, when they face the effects of social isolation, the absence of schools as partners, financial insecurity and related issues. Thus, it is concluded that the satisfaction and quality of life in the work environment was significantly affected by the pandemic, contributing to the development even psychological suffering in various spheres, including work stress, especially in environments where professionals from health.

scholarly journals Interaction of race and pathology for neuroendocrine tumors: Epidemiology, natural history, or racial disparity?

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 376-376
Author(s):  
Rachel M Lee ◽  
Danielle K DePalo ◽  
Alexandra G Lopez-Aguiar ◽  
Mohammad Yahya Zaidi ◽  
Flavio G. Rocha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Neuroendocrine Tumors ◽  
Prognostic Value ◽  
Oncologic Outcomes ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Curative Intent ◽  
Black And White ◽  
The Us

376 Background: The prognostic value of pathologic variables is not consistent for gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We previously demonstrated a limited prognostic role of lymph node (LN) positivity in small bowel NETs (SBNET) compared to pancreatic NETs (panNET). Although minority race is often associated with worse cancer outcomes, the interaction of race with pathologic and oncologic outcomes of pts with GEP-NETS is not known. Methods: Pts with GEP-NETs who underwent curative intent resection at eight institutions of the US NET Study Group from 2000-16 were included. Given few pts of other races, only Black and White race pts were analyzed. Results: Of 2,182 pts, 1,143 met inclusion criteria. Median age was 58 yrs, median follow up was 3 yrs, 48% were male, 14% (n = 157) were Black, and 86% (n = 986) were White. Black pts were more likely uninsured (7 vs 2%, p = 0.005), had symptomatic bleeding (13 vs 7%, p = 0.006), required emergency surgery (7 vs 3%, p = 0.003), and had LN positive disease (47 vs 36%, p = 0.016). Despite this, Black pts had improved 5 yr recurrence free survival (RFS) compared to White pts (90 vs 80%, p = 0.008). The quality of care received was comparable between both groups, demonstrated by similar LN yield at surgery, neg margin resection rate, post-op complications, and need for reoperation or readmission (all p > 0.05). Black pts were more likely to have SBNET (22 vs 13%) and less likely to have panNET (43 vs 68%) compared to White pts (p < 0.001). Consistent with prior data, pts with LN pos panNET had decreased 5yr RFS (67 vs 83%, p = 0.001); however, for SBNET, LN involvement was not prognostic (77 vs 96%, p = 0.08). The prognostic value of LN pos disease was similar between Black and White pts in both SBNET (p = 0.34) and panNET (p = 0.95). Conclusions: Black pts with GEP-NET present with more advanced disease, including higher LN positivity. Despite this, Black pts have improved RFS compared to White pts. Although there may be delays in seeking or reaching care, Black pts received similar quality of care compared to White pts. The improved RFS seen in Black pts may be attributed to the epidemiologic differences in the site of presentation of GEP-NETs and variable prognostic value of LN pos disease.

scholarly journals Tracking patients healthcare experiences during the COVID-19 outbreak: Topic modeling and sentiment analysis of doctor reviews

2021 ◽  
Vol 9 (3A) ◽  
Author(s):  
Adnan M. Shah ◽  
◽  
Xiangbin Yan ◽  
Samia tariq ◽  
Syed Asad A. Shah ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Sentiment Analysis ◽  
Topic Modeling ◽  
Swot Analysis ◽  
Vaccine Development ◽  
Time Slice ◽  
Healthcare Organizations ◽  
Physician Rating ◽  
Physician Rating Website

Emerging voices of patients in the form of opinions and expectations about the quality of care can improve healthcare service quality. A large volume of patients’ opinions as online doctor reviews (ODRs) are available online to access, analyze, and improve patients’ perceptions. This paper aims to explore COVID-19-related conversations, complaints, and sentiments using ODRs posted by users of the physician rating website. We analyzed 96,234 ODRs of 5,621 physicians from a prominent health rating website in the United Kingdom (Iwantgreatcare.org) in threetime slices (i.e., from February 01 to October 31, 2020). We employed machine learning approach, dynamic topic modeling, to identify prominent bigrams, salient topics and labels, sentiments embedded in reviews and topics, and patient-perceived root cause and strengths, weaknesses, opportunities, and threats (SWOT) analyses to examine SWOT for healthcare organizations. This method finds a total of 30 latent topics with 10 topics across each time slice. The current study identified new discussion topics about COVID-19 occurring from time slice 1 to time slice 3, such as news about the COVID-19 pandemic, violence against the lockdown, quarantine process and quarantine centers at different locations, and vaccine development/treatment to stop virus spread. Sentiment analysis reveals that fear for novel pathogen prevails across all topics. Based on the SWOT analysis, our findings provide a clue for doctors, hospitals, and government officials to enhance patients’ satisfaction and minimize dissatisfaction by satisfying their needs and improve the quality of care during the COVID-19 crisis.

Decision-Making Model for Convention Site Selection

2012 ◽  
Vol 538-541 ◽  
pp. 895-900 ◽  
Author(s):  
Han Chen Huang
Keyword(s):  
Decision Making ◽  
Site Selection ◽  
Political Conflict ◽  
Decision Makers ◽  
City Image ◽  
Analytic Hierarchy ◽  
Number Of Factors ◽  
Decision Making Model ◽  
Hierarchy Process

A number of factors must be considered when selecting a convention site. Typically, most selections are based on the decision makers’ knowledge and experience, which may lead to biased decisions based on the decision makers’ subjective judgment. This study establishes decision-making evaluation factors and attributes for convention site selection based on a literature review. After surveying experts’ opinions using questionnaires, we employed the fuzzy analytic hierarchy process (FAHP) to analyze the weighting of the factors and attributes. The results show that of the five evaluation factors, site environment is the most important, followed by meeting and accommodation facilities, local support, extraconference opportunities, and costs. Additionally, the five most important attributes among the 20 evaluation attributes are the suitability of convention facilities, suitability and quality of local infrastructure, climate, city image, and political conflict or terrorist threats.

Analysis and Intuition in Strategic Decision Making

2011 ◽  
pp. 1531-1542
Author(s):  
Zita Zoltay Paprika
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Strategic Decision ◽  
Strategic Decision Making ◽  
Decision Making Process ◽  
Strategic Decisions ◽  
Managerial Skills ◽  
Research Scholarship ◽  
Empirical Tests

Many management scholars believe that the process used to make strategic decisions affects the quality of those decisions. However, several authors have observed a lack of research on the strategic decision-making process. Empirical tests of factors that have been hypothesized to affect the way strategic decisions are made are notably absent (Fredrickson, 1985). This article reports the results of a study that attempts to assess the effects of decision-making circumstances, focusing mainly on the approaches applied and the managerial skills and capabilities the decision makers built on during concrete strategic decisionmaking procedures. The study was conducted in California between September 2005 and June 2006 and it was sponsored by a Fulbright research scholarship grant.

Cost Containment and Mental Health Outcomes: Experiences from US Studies

1995 ◽  
Vol 166 (S27) ◽  
pp. 43-51 ◽  
Author(s):  
Kenneth B. Wells
Keyword(s):  
Mental Health ◽  
Quality Of Care ◽  
Cost Containment ◽  
Cost Savings ◽  
Poor People ◽  
Fee For Service ◽  
Us Studies ◽  
Outcomes Of Care ◽  
The Us

Background. Cost containment mechanisms, such as prepayment, are being considered or implemented in the US and elsewhere, but there have been few studies of the effects of such mechanisms on quality or outcomes of care for individuals with serious psychiatric disorders.Method. Key results from US studies on cost containment and their implications are reviewed.Results. Cost savings in out-patient mental health care can be achieved through increasing the share of costs paid by the covered individual or through prepayment, but individuals with the greatest psychological distress or poor people may achieve worse outcomes under greater cost containment. Quality of care may be poorer under some forms of prepayment than under fee-for-service care, yet a national prospective payment mechanism for depressed elderly in-patients was not associated with a marked drop in quality or outcomes of care among those admitted.Conclusions. Prepayment, relative to fee-for-service is not always associated with lower outcomes or quality of care for affective disorders. Under cost containment, quality and outcomes of care, especially for the sick poor, should be monitored to identify adverse consequences.

scholarly journals How Cognitive Biases Influence the Data Verification of Safety Indicators: A Case Study in Rail

Safety ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. 69
Author(s):  
Burggraaf ◽  
Groeneweg ◽  
Sillem ◽  
van Gelder
Keyword(s):  
Decision Making ◽  
Cognitive Biases ◽  
Decision Makers ◽  
Human Cognition ◽  
Quality Data ◽  
Verification Process ◽  
Support Decision Making ◽  
Good Quality Data

The field of safety and incident prevention is becoming more and more data based. Data can help support decision making for a more productive and safer work environment, but only if the data can be, is and should be trusted. Especially with the advance of more data collection of varying quality, checking and judging the data is an increasingly complex task. Within such tasks, cognitive biases are likely to occur, causing analysists to overestimate the quality of the data and safety experts to base their decisions on data of insufficient quality. Cognitive biases describe generic error tendencies of persons, that arise because people tend to automatically rely on their fast information processing and decision making, rather than their slow, more effortful system. This article describes five biases that were identified in the verification of a safety indicator related to train driving. Suggestions are also given on how to formalize the verification process. If decision makers want correct conclusions, safety experts need good quality data. To make sure insufficient quality data is not used for decision making, a solid verification process needs to be put in place that matches the strengths and limits of human cognition.

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