scholarly journals Comparative Costs of Treating Adults and Children within Selected Diagnosis-related Groups

2002 ◽  
Vol 48 (1) ◽  
pp. 150-160
Author(s):  
Donald S Young ◽  
Bruce S Sachais ◽  
Leigh C Jefferies
Keyword(s):  
Large Scale ◽  
Diagnosis Related Groups ◽  
Hospital Costs ◽  
University Hospitals ◽  
Patient Admissions ◽  
Nominal Condition ◽  
Adults And Children ◽  
Pediatric Populations ◽  
The University ◽  
Effect Of Age

Abstract Background: There have been no large-scale analyses of resource utilization comparing the overall costs to treat pediatric patients vs adult patients. Likewise, there have been no studies evaluating the costs of the various components of hospitalization (e.g., accommodation, laboratory, radiology, and drugs) among adult and pediatric populations. Methods: To study the effect of age on the costs of treating patients, we have evaluated 43 conditions with matching diagnosis-related groups (DRGs) for children and adults. Using a database developed by the University HealthSystems Consortium, we examined the major non-physician components of hospital costs, including accommodation, surgery, pharmacy, radiology, and laboratory for 1 346 028 patient admissions to 60 University hospitals. These costs were derived from the ratio of costs to charges based on the Centers for Medicare and Medicaid Services PPS UB-2 cost reports. Results: The total non-physician cost of treating adults was generally greater than that for children within paired DRGs. Some of this difference may be attributable to the overall longer stay of adults in hospital. For conditions that were nominally the same, radiology, laboratory, and drug costs, especially tended to be higher for adults than for children. This was most marked when the costs were evaluated on a per diem basis. There tended to be greater variability in the costs of treating children than adults within the paired DRGs, as evidenced by greater differences between the median and mean costs. Conclusions: Among University hospitals, the costs of managing children are typically less than for adults with the same nominal condition. In these hospitals, there tends to be less use of laboratory, radiology, and pharmacy services for children than for adults.

scholarly journals Effect of Disease Complications on Hospital Costs

2002 ◽  
Vol 48 (1) ◽  
pp. 140-149 ◽  
Author(s):  
Donald S Young ◽  
Bruce S Sachais ◽  
Leigh C Jefferies
Keyword(s):  
Length Of Stay ◽  
Diagnosis Related Groups ◽  
Hospital Costs ◽  
Drug Costs ◽  
University Hospitals ◽  
Use Of Resources ◽  
The Individual ◽  
The Cost ◽  
The University ◽  
Complicated Conditions

Abstract Background: To test the hypothesis that complications increase the use of resources in managing patients in hospitals, we examined the costs of managing patients with the same disease with and without complications. Methods: We used a database developed by the University HealthSystems Consortium that contains the costs of managing more than 1 million patients in 60 University hospitals. We created a simplified database of the costs of 457 445 patients in 111-paired diagnosis-related groups (DRGs) that were classified as either having or not having complications and/or comorbidities. Costs were calculated from the ratio of costs to charges within the individual hospitals. Results: The median costs of managing patients with complications were higher than those for managing patients without complications, confirming the appropriateness of the dual classification. Notably, these extra costs were largely incurred through increased length of stay. Of note, the cost per day for DRGs with complications and/or comorbidities was most often less than that for the corresponding uncomplicated conditions. Although accommodation costs generally were the largest single component of total costs for both complicated and uncomplicated conditions, in only 31 DRGs (15 with complications, 16 without) did they account for more than one-half the total costs. Laboratory and drug costs were higher for complicated conditions, but as a proportion of total costs were comparable for complicated and uncomplicated conditions. Conclusions: Complications in patients are associated with increased hospital costs, although the costs per day of hospitalization are often less than in patients without such complications.

scholarly journals The Costs of Disease

2000 ◽  
Vol 46 (7) ◽  
pp. 955-966 ◽  
Author(s):  
Donald S Young ◽  
Bruce S Sachais ◽  
Leigh C Jefferies
Keyword(s):  
Length Of Stay ◽  
Diagnosis Related Groups ◽  
Hospital Costs ◽  
University Hospital ◽  
Medical Diagnoses ◽  
Nursing Services ◽  
Costs Of Disease ◽  
Surgical Conditions ◽  
The University ◽  
Cost Components

Abstract Background: To date there have been no studies identifying and comparing the component costs to treat a large number of diseases for hospitalized inpatients. Methods: Hospital costs were analyzed for 486 diagnosis-related groups (DRGs) relating to >1.3 million patient discharges from 60 University Hospital members of the University HealthSystems Consortium. For each DRG, length of stay, total cost, and key cost components were analyzed, including accommodation, intensive care, and surgery. Results: In general, total costs of diseases classified as surgical exceeded those classified as medical. Diseases involving organ transplantation typically cost more than other diseases. However, within the studied population, the two DRGs accounting for most total healthcare dollars were percutaneous cardiovascular procedures and management of neonates with immaturity or respiratory failure. Conclusions: Considering six key cost components, as well as disease complexity and length of stay, the best predictors of total costs for medical conditions were the length of stay and accommodation (housing, meals, nursing services) costs, whereas for surgical conditions, the best predictor of total costs was laboratory costs. This analysis may be used within an individual institution to identify surgical or medical diagnoses with total or component costs at variance with the group mean. A hospital may focus its cost reduction efforts to make decisions to expand, alter, or eliminate particular clinical programs based on comparison of its own total and component costs with those from other hospitals in the database.

SOCIAL PROJECT AS A PLATFORM FOR THE IMPLEMENTATION OF PROFESSIONAL SKILLS OF FUTURE INFORMATICS TEACHERS

2019 ◽  
pp. 16-22
Author(s):  
E. V. Klimenko ◽  
N. S. Buslova
Keyword(s):  
Large Scale ◽  
Modern Society ◽  
Professional Competencies ◽  
Future Teachers ◽  
Professional Skills ◽  
Knowledge And Skills ◽  
Theoretical Reasoning ◽  
Social Project ◽  
The University

The article is devoted to the consideration of ways to solve one of the actual problems in theory and methodology of training and upbringing — the problem of developing professional skills of future informatics teacher. As a way to adapt students to the profession, the possibility of their involvement in social designing was chosen. Participation in social projects contributes to the approbation and introduction of new forms and methods in teaching informatics. Expanding the experience of future teachers in carrying out large-scale events contributes to the formation of a socially adapted personality competitive in modern society. The potential of a social project in consolidating the knowledge and skills obtained during the theoretical training at the university is indicated. In the article, theoretical reasoning is accompanied by examples of real social projects and activities aimed at the formation of professional competencies of future informatics teachers.

Disruptive innovation and operationalization in local and sustainable food systems: Examining the University of Toronto-Local Food Plus partnership

2019 ◽  
Vol 6 (1) ◽  
pp. 120-139
Author(s):  
Lori Stahlbrand
Keyword(s):  
Food Systems ◽  
Large Scale ◽  
Food System ◽  
Local Food ◽  
Disruptive Innovation ◽  
Government Support ◽  
Sustainable Food ◽  
University Of Toronto ◽  
The University

This paper traces the partnership between the University of Toronto and the non-profit Local Food Plus (LFP) to bring local sustainable food to its St. George campus. At its launch, the partnership represented the largest purchase of local sustainable food at a Canadian university, as well as LFP’s first foray into supporting institutional procurement of local sustainable food. LFP was founded in 2005 with a vision to foster sustainable local food economies. To this end, LFP developed a certification system and a marketing program that matched certified farmers and processors to buyers. LFP emphasized large-scale purchases by public institutions. Using information from in-depth semi-structured key informant interviews, this paper argues that the LFP project was a disruptive innovation that posed a challenge to many dimensions of the established food system. The LFP case study reveals structural obstacles to operationalizing a local and sustainable food system. These include a lack of mid-sized infrastructure serving local farmers, the domination of a rebate system of purchasing controlled by an oligopolistic foodservice sector, and embedded government support of export agriculture. This case study is an example of praxis, as the author was the founder of LFP, as well as an academic researcher and analyst.

Psychosocial Consequences of Body Weight and Obesity

2018 ◽  
pp. 274-286
Author(s):  
Deborah Carr ◽  
Vera K. Tsenkova
Keyword(s):  
Body Weight ◽  
Interpersonal Relationships ◽  
Large Scale ◽  
Well Being ◽  
The United States ◽  
Overweight And Obesity ◽  
The Body ◽  
Integrative Health ◽  
Psychosocial Consequences ◽  
Adults And Children

The body weight of U.S. adults and children has risen markedly over the past three decades. The physical health consequences of obesity are widely documented, and emerging research from the Midlife in the United States study and other large-scale surveys reveals the harmful impact of obesity on adults’ psychosocial and interpersonal well-being. This chapter synthesizes recent research on the psychosocial implications of body weight, with attention to explanatory mechanisms and subgroup differences in these patterns. A brief statistical portrait of body weight is provided, documenting rates and correlates of obesity, with a focus on race, gender, and socioeconomic status disparities. The consequences of body weight for three main outcomes are described: institutional and everyday discrimination, interpersonal relationships, and psychological well-being. The chapter concludes with a discussion of the ways that recent integrative health research on the psychosocial consequences of overweight and obesity inform our understanding of population health.

scholarly journals COVD-26. TELEPHONE CONSULTATIONS IN NEURO-ONCOLOGY DURING THE COVID-19 PANDEMIC: LEVELS OF PATIENT SATISFACTION AND COMPARISON WITH TRADITIONAL FACE-TO-FACE CONSULTATIONS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii26-ii26
Author(s):  
Emma Toman ◽  
Claire Goddard ◽  
Frederick Berki ◽  
William Garratt ◽  
Teresa Scott ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
University Hospitals ◽  
Health Crisis ◽  
Patient Satisfaction Questionnaire ◽  
Telephone Consultation ◽  
Exact Test ◽  
Face To Face ◽  
Significant Difference ◽  
The Face ◽  
The University

Abstract INTRODUCTION Controversy exists as to whether telephone clinics are appropriate in neurosurgical-oncology. The COVID-19 pandemic forced neuro-oncology services worldwide to re-design and at the University Hospitals Birmingham UK, telephone clinics were quickly implemented in select patients to limit numbers of patients attending hospital. It was important to determine how these changes were perceived by patients. METHODS A 20-question patient satisfaction questionnaire was distributed to patients who attended neuro-oncology clinic in person (“face-to-face”), or via the telephone. Fisher’s exact test was used to determine significance, which was set at p< 0.05. RESULTS Eighty questionnaires were distributed between June 2020 and August 2020. Overall, 50% (n=40) of patients returned the questionnaire, 50% (n=23) of face-to-face and 50% (n=17) telephone patients. Of those who received telephone consultations, 88% (n=15) felt the consultation was convenient, 88% (n=15) were satisfied with their consultation and 18% (n=3) felt they would have preferred to have a face-to-face appointment. Of those who attended clinic in person, 96% (n=22) felt their consultation was convenient, 100% (n=23) were satisfied with their consultation and 13% (n=3) would have preferred a telephone consultation. Within the face-to-face clinic attendees, only 13% (n=3) were concerned regarding the COVID risk associated with attending hospital. There was no significant difference in patient convenience or satisfaction (p=0.565 and p=0.174 respectively) between face-to-face and telephone clinics. There was no significant difference in whether patients would’ve preferred the alternative method of consultation (p > 0.999). CONCLUSION Our study suggests that careful patient selection for neuro-oncology telephone clinic is not inferior to face-to-face clinic. Telephone clinic during COVID-19 pandemic proved to be convenient, safe and effective. This global health crisis has transformed telephone neuro-oncology consultations from an experimental innovation into established practice and should be continued beyond the pandemic in select cases.

scholarly journals 415 Improving Preoperative Computed Tomography Staging for Men with Suspected Testicular Cancer

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S A Stanley ◽  
C T Berridge ◽  
T R L Griffiths
Keyword(s):  
Computed Tomography ◽  
Testicular Cancer ◽  
Median Time ◽  
University Hospitals ◽  
Treatment Pathway ◽  
Pathway Data ◽  
Life Threatening ◽  
Neo Adjuvant Chemotherapy ◽  
The University ◽  
Urology Clinic

Abstract Introduction Neo-adjuvant chemotherapy may be considered for suspected testicular malignancy if widespread life-threatening metastases are identified on computed tomography (CT) imaging. Staging preoperatively enables this and may prevent delays in ongoing oncological care. This project aimed to increase the proportion of staging scans performed preoperatively in the University Hospitals of Leicester NHS trust. Method All referrals between 01/01/2016 and 31/12/2018 to the urology multidisciplinary team for suspected testicular cancer were reviewed. Exclusion criteria were applied prior to collecting treatment pathway data for each patient. Based on initial audit findings, clinicians were advised to request staging CT scans at the first urology clinic appointment. Re-audit was between 01/01/2019 and 31/12/2019. Results Initial audit included 95 patients and re-audit included 23 patients. The proportion of preoperative scans increased from 28.4% to 82.6% following intervention. Median time from first ultrasound to CT was reduced from 44 days to 17 days without affecting median time to orchidectomy (27 to 23 days) or oncology appointment (61 days). Conclusions Requesting a staging CT scan as part of the first clinic assessment improved the proportion of preoperative scans without affecting time to surgery or oncology appointment.

Age, gender and season dependent 25(OH)D levels in children and adults living in Istanbul

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Zeynep Yildiz ◽  
Özlem Hürmeydan ◽  
Özlem Çakır Madenci ◽  
Asuman Orçun ◽  
Nihal Yücel
Keyword(s):  
Large Scale ◽  
Population Characteristics ◽  
Healthcare Outcomes ◽  
Hydroxyvitamin D ◽  
Large Scale Data ◽  
Laboratory Results ◽  
Turkish People ◽  
Adults And Children ◽  
25 Hydroxyvitamin D ◽  
Scale Data

AbstractBackgroundWe evaluated population characteristics of serum 25-hydroxyvitamin D (25(OH)D) levels and determined the influence of age, gender and season in an extensive dataset.Materials and methodsLaboratory results of 103,509 adults and 19,186 children were retrospectively evaluated. Study group was classified regarding ages as; <40, 40–50, 50–60 and >60 years for adults and 0–1, 1–12 months,1–3, 4–6, 7–9, 10–12, 13–15 and 16–18 years for children. Seasonal values were also determined. Levels were measured by Architect i1000 SR (Abbott Diagnostics, USA).ResultsThe median (2.5–97.5 percentiles) of 25(OH)D levels were 38.75 (9.5–158.25) nmol/L for adults and 43.25 (11.25–125.5) nmol/L for children. There were significant gender differences for both adults and children. Values differed significantly among age subgroups (p’s < 0.01). A total of 63% of adults and 59.5% of children had 25(OH)D levels below 50 nmol/L (p < 0.001). 25(OH)D levels were significantly lower in the winter compared with summer (p’s < 0.001). Even levels in summer were moderate deficient for all group.ConclusionThe rate of 25(OH)D deficiency was remarkable during the whole year. This will provide large-scale data about 25(OH)D status in Turkish people and may contribute to the prevention and treatment of this condition for better healthcare outcomes.

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