scholarly journals Evaluating the Relationship between Productivity and Quality in Emergency Departments

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Hyojung Kang ◽  
Nathaniel D. Bastian ◽  
John P. Riordan
Keyword(s):  
Logistic Regression ◽  
Emergency Departments ◽  
Relative Efficiency ◽  
Multinomial Logistic Regression ◽  
Working Hours ◽  
The United States ◽  
Regression Result ◽  
Quality Performance ◽  
Trade Offs ◽  
The Relationship

Background.In the United States, emergency departments (EDs) are constantly pressured to improve operational efficiency and quality in order to gain financial benefits and maintain a positive reputation.Objectives.The first objective is to evaluate how efficiently EDs transform their input resources into quality outputs. The second objective is to investigate the relationship between the efficiency and quality performance of EDs and the factors affecting this relationship.Methods.Using two data sources, we develop a data envelopment analysis (DEA) model to evaluate the relative efficiency of EDs. Based on the DEA result, we performed multinomial logistic regression to investigate the relationship between ED efficiency and quality performance.Results.The DEA results indicated that the main source of inefficiencies was working hours of technicians. The multinomial logistic regression result indicated that the number of electrocardiograms and X-ray procedures conducted in the ED and the length of stay were significantly associated with the trade-offs between relative efficiency and quality. Structural ED characteristics did not influence the relationship between efficiency and quality.Conclusions.Depending on the structural and operational characteristics of EDs, different factors can affect the relationship between efficiency and quality.

scholarly journals Prior Hospitalization Burden and the Relatedness of 30-Day Readmissions in Patients Receiving Hemodialysis

2019 ◽  
Vol 30 (2) ◽  
pp. 323-335 ◽  
Author(s):  
Eugene Lin ◽  
Jay Bhattacharya ◽  
Glenn M. Chertow
Keyword(s):  
United States ◽  
Health Care ◽  
Logistic Regression ◽  
Multinomial Logistic Regression ◽  
Quality Measures ◽  
The United States ◽  
Hospitalization Rate ◽  
Organ System ◽  
Index Hospitalization ◽  
High Background

BackgroundThirty-day readmissions are common in patients receiving hemodialysis and costly to Medicare. Because patients on hemodialysis have a high background hospitalization rate, 30-day readmissions might be less likely related to the index hospitalization than in patients with other conditions.MethodsIn adults with Medicare receiving hemodialysis in the United States, we used multinomial logistic regression to evaluate whether prior hospitalization burden was associated with increased 30-day readmissions unrelated to index hospitalizations with a discharge date from January 1, 2013 to December 31, 2014. We categorized a hospitalization, 30-day readmission pair as “related” if the principal diagnoses came from the same organ system.ResultsThe adjusted probability of unrelated 30-day readmission after any index hospitalization was 19.1% (95% confidence interval [95% CI] 18.9% to 19.3%), 22.6% (95% CI, 22.4% to 22.8%), and 31.2% (95% CI, 30.8% to 31.5%) in patients with 0–1, 2–4, and ≥5 hospitalizations, respectively. Cardiovascular index hospitalizations had the highest adjusted probability of related 30-day readmission: 10.4% (95% CI, 10.2% to 10.7%), 13.6% (95% CI, 13.4% to 13.9%), and 20.8% (95% CI, 20.2% to 21.4%), respectively. Renal index hospitalizations had the lowest adjusted probability of related 30-day readmission: 2.0% (95% CI, 1.8% to 2.3%), 3.9% (95% CI, 3.4% to 4.4%), and 5.1% (95% CI, 4.3% to 5.9%), respectively.ConclusionsHigh prior hospitalization burden increases the likelihood that patients receiving hemodialysis experience a 30-day readmission unrelated to the index hospitalization. Health care payers such as Medicare should consider incorporating clinical relatedness into 30-day readmission quality measures.

Children's Rights, Family Rights

2011 ◽  
Vol 4 (2) ◽  
pp. 171-188
Author(s):  
Karen M. Staller
Keyword(s):  
Human Rights ◽  
Social Work ◽  
Children's Rights ◽  
The United States ◽  
Qualitative Inquiry ◽  
Children’S Rights ◽  
Rights Of The Child ◽  
Trade Offs ◽  
Depth Study ◽  
The Relationship

In this article I explore the intersections of children's human rights, social policy, and qualitative inquiry from a social work perspective. First, I consider the relationship between human rights work and social work. Second, I argue that children add complexity to the human rights debate. In doing so, I briefly examine the conflict between children's rights as developed in the United States and that of the United Nation's Convention on the Rights of the Child. Third, I turn to a specific qualitative research project in which a team of researchers conducted an in-depth study of the prosecution of child sexual abuse in one U.S. jurisdiction. I argue that the findings from this study illustrate how qualitative inquiry can reveal conflicting and often hidden value trade-offs that must be addressed when enacting and enforcing children's human rights. This study demonstrates what qualitative inquiry has to offer policy advocates who seek to promote children's human rights.

Physician Prescribing Patterns of Innovative Antidepressants in the United States: The Case of MDD Patients 1993–2007

2011 ◽  
Vol 42 (4) ◽  
pp. 353-368 ◽  
Author(s):  
Hsien-Chang Lin ◽  
Steven R. Erickson ◽  
Rajesh Balkrishnan
Keyword(s):  
Logistic Regression ◽  
Multinomial Logistic Regression ◽  
Private Insurance ◽  
Selection Procedure ◽  
The United States ◽  
Prescribing Patterns ◽  
Insurance Status ◽  
Cross Sectional ◽  
Physician Practices ◽  
Sociological Factors

Objective: Innovative antidepressants such as SSRIs and SNRIs have been widely adopted. However, the differences in their adoption across patients' and physicians' characteristics, geographic regions, and insurance status need to be further explored. This study was trying to disentangle the patterns of physician antidepressant prescribing and medication choice for major depressive disorder treatment. Method: A retrospective cross-sectional study was conducted using the 1993–2007 National Ambulatory Medical Care Survey database. A multinomial logistic regression with the Heckman two-step selection procedure was applied to capture the two-step nature of physician prescription decision making. Results: The weighted logistic regression indicated that patients' race/ethnicity and primary source of payment for services, physician ownership status, and physicians' practice regions were associated with differential likelihood of physician' antidepressant prescribing. Non-Hispanic white patients were more likely to be prescribed antidepressants compared to Hispanic patients (OR=1.52, 95% CI 1.24–1.87). Physicians' choice on antidepressant varied across with patient age and health insurance status. Compared to private insurance, patients who were primarily covered by Medicare were less likely to be prescribed only SSRIs/SNRIs or other newer antidepressants (RRRs=0.42 and 0.39; 95% CIs 0.21–0.83 and 0.18–0.84, respectively). Conclusions: We observed strong associations between sociological factors and physicians' antidepressant prescribing patterns. Possible health disparities and gaps between optimal and suboptimal healthcare for patient mental health caused by systematic differences in sociological factors need to be mitigated. We need policy makers to design effective policy interventions to improve physician practice guidelines adherence to eliminate possible variations among physician practices.

scholarly journals A trend of Korean older adults’ awareness as a threat to society during the COVID-19 pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1030-1030
Author(s):  
Soonhyung Kwon ◽  
Jaesung An ◽  
Oejin Shin
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Health Outcomes ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Demographic Characteristics ◽  
Younger Age ◽  
Negative Cognition ◽  
High Level ◽  
The Relationship

Abstract Background Unlike ageism that consists of one’s prejudice, stereotype, and discrimination toward older adults, age-based threats are one’s negative cognition (Levy, 2001). Previous studies indicated that the younger generation stigmatizes the older generation as unworthy during the COVID-19 pandemic (Meisner, 2021). However, there is no study looking at how older adults perceive themselves as threats to society during this time of the pandemic. Thus, our study aimed to understand the varying trend of older adults’ awareness as a threat to society in association with socio-economic profiles before and during the pandemic. Method: This study included 637 Korean older adults who answered the older generation’s threats to society from 2018 to 2020. We used Latent Class Analysis (LCA) to categorize participants into different subgroups that shared distinct patterns of threats to society. Multinomial logistic regression examined how the subgroups in threats to society were associated with socio-demographic characteristics in each year. Results For three waves, three clusters of threats to society (low, mid, and high) were identified. Although the mid-level of threat remained the same (60% of the sample for three years), the high level of threats has been doubled in 2019 (25%) compared to 2018 (11%) and 2020 (13%). Regarding the associated socio-demographic characteristics with threats to society, those who being female in 2018 and younger age in 2020 were more likely to be associated with mid-level of threats to society. Discussion Further study needs to identify the relationship between awareness as a threat to society and health outcomes.

scholarly journals Breaking up the play: The relationship between legal stops and winning in team handball

2022 ◽  
pp. 174795412110707
Author(s):  
Aron Laxdal ◽  
Andreas Ivarsson
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Multinomial Logistic Regression ◽  
Time Analysis ◽  
Multinomial Logistic Regression Analysis ◽  
Real Time Analysis ◽  
Team Handball ◽  
Game Outcome ◽  
Males And Females ◽  
The Relationship

The purpose of this study was to examine the relationship between legal stops and winning in team handball. Real-time analysis was performed on all games played in the Icelandic elite division for both males and females (regular season and playoffs) between 2017–2021 (854 games [570 male games, 284 female games], 32,392 legal stops in total). Legal stops were assessed as any physical action by a defensive player that resulted in the stop of play, without the defensive player being penalized or the offensive player receiving a 7-meter throw. The results from a multinomial logistic regression analysis indicated that legal stops were significantly associated with winning games in the male league. No statistically significant relationship was found between illegal stops and game outcome for either sex. However, 2-minute suspensions were found to be positively associated with winning in the male league.

Topic-marking prepositions in Swedish: A corpus-based analysis of adpositional synonymy

2014 ◽  
Vol 37 (2) ◽  
pp. 257-296 ◽  
Author(s):  
Anton Granvik ◽  
Susanna Taimitarha
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Multinomial Logistic Regression ◽  
Initial Position ◽  
The Other ◽  
Data Set ◽  
Multinomial Logistic Regression Analysis ◽  
Usage Patterns ◽  
Head Element ◽  
The Relationship

This study analyses the relationship between four near-synonymous Swedish prepositions, namely angående, beträffande, gällande and rörande, which are used to establish what we call a topic-marking relation, as in statens avtal angående finansieringen ‘the agreement of the state regarding the financing’. By focusing on a single, loosely defined genre consisting of the written texts included in the Swedish PAROLE corpus, we address the question of what differences there are among these four prepositions, which intuitively seem highly similar and mutually interchangeable. In order to find out which contextual and grammatical factors might influence the choice of one preposition over the others, two complementary analyses were performed. First, a so-called collostructional analysis (see Stefanowitsch & Gries 2003, Gries & Stefanowitsch 2004) was performed on 791 cases of these prepositions found in the PAROLE corpus. Secondly, the corpus examples were annotated according to ten syntactic and four semantic criteria and a multinomial logistic regression analysis was performed on the annotated data set. The results show some tendencies pointing to differing usage patterns of the four prepositions. Beträffande stands out as the most frequent of them all and is also preferably used when no explicit head element is present, typically in sentence-initial position. Angående prefers words of communication while rörande is used when another topic-marking preposition is also present. On the other hand, neither of the two analyses leads to a clear distinction among the four prepositions, thus pointing to the fact that these topic-marking prepositions indeed constitute a fairly good case of adpositional synonymy, with few distinguishing factors separating one from the other.

scholarly journals The effect of socioeconomic status among adult married females on informal caregiving for parents: Evidence from China

2020 ◽  
Author(s):  
Yi Wang ◽  
Jiajia Li ◽  
Lulu Ding ◽  
Yuejing Feng ◽  
Xue Tang ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Logistic Regression ◽  
Informal Care ◽  
High Intensity ◽  
Multinomial Logistic Regression ◽  
Family Characteristics ◽  
Regression Result ◽  
Nutrition Survey ◽  
Low Intensity ◽  
Married Female

Abstract Background: Married female caregivers face a higher risk of informal care burden. There is no study to explore the effect of socioeconomic status (SES) among married female caregivers on informal care intensity in China. The purpose of this study is to empirically examine how the SES of married female caregivers affects the amount of informal care they provide for their parents/in-law in China.Methods: 8 waves of the China Health and Nutrition Survey were pooled, and that the selection comprised only those women whose parents/in law had a need for care and were living in the same city. Informal caregivers were divided into three categories: non-caregivers (0 hrs/week), low-intensity caregivers (less than 10 hrs/week), and high-intensity caregivers (10 hrs/week and above). Chi-square tests and one-way analysis of variance (ANOVA) were used to compare the SES of the women between non-, low-, and high-intensity caregivers. Multinomial logistic regression analysis was used to calculate relative risk ratios (RRR) for various SES variables to assess the relation of SES on the likelihood of a low- and high-intensity caregiving in the household, adjusting for age, marital status, family characteristics and wave. Results: Of the 2741 respondents, high-intensity and low-intensity caregivers account for 16.42% and 21.38% respectively. Multinomial logistic regression result shows that the likelihood of being a high-intensity caregiver versus (vs.) a non-caregiver increases as the caregiver’s education attainment increases (p<0.05), and high income is related to the likelihood of being a high-intensity caregiver, but it is only significant at 10% level. Urban females are 1.34 times more likely than their rural counterparts to provide low-intensity care vs. no care (p<0.05) and are 1.34 times more likely to provide high-intensity care vs. no care (p<0.05). Employed females are 1.27 times more likely than those non-employed to provide low-intensity care vs. no care (p<0.05).Conclusions: Differences in SES are found between high-intensity caregivers and low-intensity caregivers. Women with high educational attainment and urban Hukou are more likely to provide high-intensity informal care, and women who are employed and with urban Hukou are more likely to provide low-intensity care.

Infertility and Self-identification: The Indeterminacy of the Illness-self Relationship

2019 ◽  
Vol 63 (3) ◽  
pp. 388-405 ◽  
Author(s):  
Katherine M. Johnson ◽  
Arthur L. Greil ◽  
Julia McQuillan ◽  
Ophra Leyser-Whalen ◽  
Karina M. Shreffler
Keyword(s):  
United States ◽  
Logistic Regression ◽  
National Survey ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
The Self ◽  
Symbolic Interactionist ◽  
Fertility Problem ◽  
Over Time

Nearly one-third to one-half of U.S. women meets the medical criteria for infertility at some point in their reproductive lives. Yet many do not view lack of conception as problematic. Why might some women self-identify as having a fertility problem but others do not? Using two waves of the National Survey of Fertility Barriers, we conducted binary and longitudinal multinomial logistic regression to answer this question. Results suggest that only a portion of women actually experience infertility as a “spoiled identity” or as disruptive to their lives. Rather, consistent with symbolic interactionist perspectives, there is evidence that infertility symptoms (i.e., not conceiving) depend upon interpretations and definitions of the situation. Multiple patterns of self-identification over time (identity non-adopters, maintainers, adopters, and relinquishers) suggest an indeterminate association between illness and impacts on the self, even for a condition that is highly medicalized in the United States.

scholarly journals THE RELATIONSHIP BETWEEN MOTHER'S BEHAVIOR IN SEEKING TREATMENT WITH THE RECURRENCE RATE OF PNEUMONIA AMONG CHILDREN UNDER FIVE

2021 ◽  
Vol 1 (1) ◽  
pp. 44-55
Author(s):  
Supiani Supiani ◽  
Mufdlilah Mufdlilah ◽  
Djauhar Ismail
Keyword(s):  
Logistic Regression ◽  
Recurrence Rate ◽  
Multiple Logistic Regression Analysis ◽  
Regression Result ◽  
Multiple Logistic Regression ◽  
Cost Of Treatment ◽  
Children Under Five ◽  
Under Five ◽  
The Cost ◽  
The Relationship

Introduction: Pneumonia is a global problem with a significant cause of death for more than 2 million children under five every year. Mothers’ behavior in seeking treatment is one of the main factors of delay in getting proper treatment by increasing the risk of recurrence pneumonia among children under five. This study aimed to investigate the relationship between the mother's behavior in seeking treatment with the recurrence rate of pneumonia among children under five. Method: This research method was an observational analytic study with the cross-sectional approach. The number of samples in this study was 47 mothers with toddlers pneumonia. The sampling technique was using purposive sampling and data analysis used Chi-square and multiple logistic regression. Result: The study found, there was a relationship between the mothers’ behavior in seeking treatment with the recurrence rate of pneumonia among children under five (PR = 12,000; CI95%=2,275-63,285; p = 0.003). One of confounding variables namely the cost of treatment had relationship with the recurrence rate of pneumonia. Whereas the variables of mother's knowledge, access to services, and distance of residence are not related to the recurrence rate of pneumonia in infants. The results of multiple logistic regression analysis found that mothers’ behavior in seeking of the treatment, treatment cost, and distance of residence affect 51.2% of the recurrence rate of pneumonia among children under five in Yogyakarta. Conclusion: The mothers’ behavior in seeking treatment, the cost of treatment, and distance of residence affect the recurrence rate of pneumonia among children under five.

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