Computation of Production Costs of Inpatients: Some Implications for Discharge Abstracting

1989 ◽  
Vol 19 (2) ◽  
pp. 56-62 ◽  
Author(s):  
Don Hindle ◽  
Angela Cook ◽  
John Pilla
Keyword(s):  
Resource Use ◽  
The United States ◽  
Production Costs ◽  
Data Set ◽  
Discharge Data ◽  
Perceived Needs ◽  
Area Of Interest ◽  
Related Group ◽  
American Standard ◽  
Near Future

The content of discharge abstracts (or ‘morbidity statistics forms’ as they are popularly known in Australia) is determined by perceived needs for information about inpatients. It should be sensitive to changes in those needs. The emergence of interest in diagnosis related group (DRG) data has had an impact on discharge abstracting. However, revisions have been minor because the DRG system was designed to make use of the standard discharge data set in the United States. In Australia, it has been necessary only to adjust practices to bring them more or less in line with the American standard. In the near future, however, it is likely that more significant changes will be needed. In this paper the authors discuss one new area of interest concerning measurement of resource use by DRG. They suggest that it will lead to the addition of new fields on the discharge abstract and to major changes in the way that discharges are defined. (AMRJ (1989). 19(2), 56–62).

scholarly journals Longer-term Direct and Indirect Effects of Infant Rotavirus Vaccination Across All Ages in the United States in 2000–2013: Analysis of a Large Hospital Discharge Data Set

2018 ◽  
Vol 68 (6) ◽  
pp. 976-983 ◽  
Author(s):  
Julia M Baker ◽  
Jacqueline E Tate ◽  
Claudia A Steiner ◽  
Michael J Haber ◽  
Umesh D Parashar ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Disease Transmission ◽  
Rate Ratio ◽  
Age Groups ◽  
The United States ◽  
Large Hospital ◽  
Data Set ◽  
Discharge Data ◽  
Rotavirus Vaccination ◽  
Hospitalization Rates

Abstract Background Rotavirus disease rates dramatically declined among children <5 years of age since the rotavirus vaccine was introduced in 2006; population-level impacts remain to be fully elucidated. Methods Data from the Healthcare Cost and Utilization Project State Inpatient Databases were used to conduct a time-series analysis of monthly hospital discharges across age groups for acute gastroenteritis and rotavirus from 2000 to 2013. Rate ratios were calculated comparing prevaccine and postvaccine eras. Results Following vaccine introduction, a decrease in rotavirus hospitalizations occurred with a shift toward biennial patterns across all ages. The 0–4-year age group experienced the largest decrease in rotavirus hospitalizations (rate ratio, 0.14; 95% confidence interval, .09–.23). The 5–19-year and 20–59-year age groups experienced significant declines in rotavirus hospitalization rates overall; the even postvaccine calendar years were characterized by progressively lower rates, and the odd postvaccine years were associated with reductions in rates that diminished over time. Those aged ≥60 years experienced the smallest change in rotavirus hospitalization rates overall, with significant reductions in even postvaccine years compared with prevaccine years (rate ratio, 0.51; 95% confidence interval, .39–.66). Conclusions Indirect impacts of infant rotavirus vaccination are apparent in the emergence of biennial patterns in rotavirus hospitalizations that extend to all age groups ineligible for vaccination. These observations are consistent with the notion that young children are of primary importance in disease transmission and that the initial postvaccine period of dramatic population-wide impacts will be followed by more complex incidence patterns across the age range in the long term.

No Silver Bullet

2012 ◽  
Vol 7 (4) ◽  
pp. 48-58 ◽  
Author(s):  
Nan Zhang ◽  
Liam O’Neill ◽  
Gautam Das ◽  
Xiuzhen Cheng ◽  
Heng Huang
Keyword(s):  
Domain Knowledge ◽  
Personal Information ◽  
Hospital Data ◽  
Data Set ◽  
Discharge Data ◽  
Knowledge Based ◽  
Privacy Leakage ◽  
Public Data ◽  
Related Group ◽  
Data Files

In accordance with HIPAA regulations, patients’ personal information is typically removed or generalized prior to being released as public data files. However, it is not known if the standard method of de-identification is sufficient to prevent re-identification by an intruder. The authors conducted analytical processing to identify security vulnerabilities in the protocols to de-identify hospital data. Their techniques for discovering privacy leakage utilized three disclosure channels: (1) data inter-dependency, (2) biomedical domain knowledge, and (3) suppression algorithms and partial suppression results. One state’s inpatient discharge data set was used to represent the current practice of de-identification of health care data, where a systematic approach had been employed to suppress certain elements of the patient’s record. Of the 1,098 records for which the hospital ID was suppressed, the original hospital ID was recovered for 616 records, leading to a nullification rate of 56.1%. Utilizing domain knowledge based on the patient’s Diagnosis Related Group (DRG) code, the authors recovered the real age of 64 patients, the gender of 83 male patients and 713 female patients. They also successfully identified the ZIP code of 1,219 patients. The procedure used to de-identify hospital records was found to be inadequate to prevent disclosure of patient information. As the masking procedure described was found to be reversible, this increases the risk that an intruder could use this information to re-identify individual patients.

State Medical Boards' Perceptions of a Minimum Data Set and Current Practices for Collecting Physician Information

2013 ◽  
Vol 99 (4) ◽  
pp. 40-45 ◽  
Author(s):  
Aaron Young ◽  
Philip Davignon ◽  
Margaret B. Hansen ◽  
Mark A. Eggen
Keyword(s):  
Media Coverage ◽  
The United States ◽  
Minimum Data Set ◽  
Direct Patient Care ◽  
Physician Workforce ◽  
Data Set ◽  
Minimum Data ◽  
State Medical Boards ◽  
The Impact ◽  
Current Practices

ABSTRACT Recent media coverage has focused on the supply of physicians in the United States, especially with the impact of a growing physician shortage and the Affordable Care Act. State medical boards and other entities maintain data on physician licensure and discipline, as well as some biographical data describing their physician populations. However, there are gaps of workforce information in these sources. The Federation of State Medical Boards' (FSMB) Census of Licensed Physicians and the AMA Masterfile, for example, offer valuable information, but they provide a limited picture of the physician workforce. Furthermore, they are unable to shed light on some of the nuances in physician availability, such as how much time physicians spend providing direct patient care. In response to these gaps, policymakers and regulators have in recent years discussed the creation of a physician minimum data set (MDS), which would be gathered periodically and would provide key physician workforce information. While proponents of an MDS believe it would provide benefits to a variety of stakeholders, an effort has not been attempted to determine whether state medical boards think it is important to collect physician workforce data and if they currently collect workforce information from licensed physicians. To learn more, the FSMB sent surveys to the executive directors at state medical boards to determine their perceptions of collecting workforce data and current practices regarding their collection of such data. The purpose of this article is to convey results from this effort. Survey findings indicate that the vast majority of boards view physician workforce information as valuable in the determination of health care needs within their state, and that various boards are already collecting some data elements. Analysis of the data confirms the potential benefits of a physician minimum data set (MDS) and why state medical boards are in a unique position to collect MDS information from physicians.

Failure to Accelerate

2017 ◽  
Author(s):  
Peter Scott
Keyword(s):  
United States ◽  
The United States ◽  
International Perspective ◽  
Production Costs ◽  
Car Ownership ◽  
Success Story ◽  
Car Industry ◽  
Fundamental Reason ◽  
European Standards ◽  
Market Diffusion

From an international perspective, the inter-war car industry was a British success story. Britain ranked only second to the United States as the world’s leading producer of, and market for, automobiles, owing to a relatively strong domestic market by European standards. However, while consumers’ expenditure was high, it was not deep—car ownership per capita in 1938 being around a third of US levels. This chapter examines why the British automobile sector failed to take off into mass market diffusion. A number of important factors are highlighted, including lower British wages relative to the United States; punitive vehicle and petrol taxation; and the high unit production costs incurred in serving a market too small to justify Fordist mass production. However, a more fundamental reason was the low priority given to car ownership in a relatively small, densely populated, and highly urbanized island nation with well-developed public transport networks.

scholarly journals ArcGIS Urban: an application for plan assessment

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Ellen Soward ◽  
Jianling Li
Keyword(s):  
United States ◽  
The United States ◽  
Spatial Context ◽  
Future Studies ◽  
Planning Profession ◽  
Gis Tools ◽  
Comprehensive Plans ◽  
Near Future ◽  
The City

AbstractMost cities in the United States rely on zoning to address important planning-related issues within their jurisdictions. Planners often use GIS tools to analyze these issues in a spatial context. ESRI’s ArcGIS Urban software seeks to provide the planning profession with a GIS-based solution for various challenges, including zoning’s impacts on the built environment and housing capacity.This research explores the use of ArcGIS Urban for assessing the existing zoning and comprehensive plans in meeting the projected residential growth in the near future using the City of Arlington, Texas as a case study. The exploration provides examples and lessons for how ArcGIS Urban might be used by planners to accomplish their tasks and highlights the capabilities and limitations of ArcGIS Urban in its current stand. The paper is concluded with some suggestions for future studies.

Legislative Diversity and the Rise of Women Lobbyists

2021 ◽  
pp. 106591292110093
Author(s):  
James M. Strickland ◽  
Katelyn E. Stauffer
Keyword(s):  
Gender Diversity ◽  
Personal Characteristics ◽  
The United States ◽  
Revolving Door ◽  
Women And Politics ◽  
Political Equality ◽  
Data Set ◽  
Women Legislators ◽  
Organized Interests ◽  
American States

Despite a growing body of literature examining the consequences of women’s inclusion among lobbyists, our understanding of the factors that lead to women’s initial emergence in the profession is limited. In this study, we propose that gender diversity among legislative targets incentivizes organized interests to hire women lobbyists, and thus helps to explain when and how women emerge as lobbyists. Using a comprehensive data set of registered lobbyist–client pairings from all American states in 1989 and 2011, we find that legislative diversity influences not only the number of lobby contracts held by women but also the number of former women legislators who become revolving-door lobbyists. This second finding further supports the argument that interests capitalize on the personal characteristics of lobbyists, specifically by hiring women to work in more diverse legislatures. Our findings have implications for women and politics, lobbying, and voice and political equality in the United States.

scholarly journals Actors, Partisan Inclination, and Emotions: An Analysis of Government Shutdown News Stories Shared on Twitter

2021 ◽  
Vol 7 (2) ◽  
pp. 205630512110088
Author(s):  
Colin Agur ◽  
Lanhuizi Gan
Keyword(s):  
Emotional Responses ◽  
The United States ◽  
Online Information ◽  
News Frames ◽  
Data Set ◽  
Political Issues ◽  
News Stories ◽  
News Sharing ◽  
Government Shutdown

Scholars have recognized emotion as an increasingly important element in the reception and retransmission of online information. In the United States, because of existing differences in ideology, among both audiences and producers of news stories, political issues are prone to spark considerable emotional responses online. While much research has explored emotional responses during election campaigns, this study focuses on the role of online emotion in social media posts related to day-to-day governance in between election periods. Specifically, this study takes the 2018–2019 government shutdown as its subject of investigation. The data set shows the prominence of journalistic and political figures in leading the discussion of news stories, the nuance of emotions employed in the news frames, and the choice of pro-attitudinal news sharing.

STEM-Focused Career Courses and College Pipeline for Students with Learning Disabilities

2021 ◽  
pp. 089590482110199
Author(s):  
Jennifer A. Freeman ◽  
Michael A. Gottfried ◽  
Jay Stratte Plasman
Keyword(s):  
High School ◽  
Learning Disabilities ◽  
High School Students ◽  
The United States ◽  
Students With Learning Disabilities ◽  
School Students ◽  
Data Set ◽  
Stem Majors ◽  
Career And Technical ◽  
Nationally Representative

Recent educational policies in the United States have fostered the growth of science, technology, engineering, and mathematics (STEM) career-focused courses to support high school students’ persistence into these fields in college and beyond. As one key example, federal legislation has embedded new types of “applied STEM” (AS) courses into the career and technical education curriculum (CTE), which can help students persist in STEM through high school and college. Yet, little is known about the link between AS-CTE coursetaking and college STEM persistence for students with learning disabilities (LDs). Using a nationally representative data set, we found no evidence that earning more units of AS-CTE in high school influenced college enrollment patterns or major selection in non-AS STEM fields for students with LDs. That said, students with LDs who earned more units of AS-CTE in high school were more likely to seriously consider and ultimately declare AS-related STEM majors in college.

scholarly journals The COVID Connection: Pandemic Anxiety, COVID-19 Comprehension, and Digital Confidence

2021 ◽  
pp. 000276422110031
Author(s):  
Laura Robinson ◽  
Jeremy Schulz ◽  
Øyvind N. Wiborg ◽  
Elisha Johnston
Keyword(s):  
Logistic Models ◽  
The United States ◽  
Sociodemographic Factors ◽  
Future Research ◽  
Lower Probability ◽  
Data Set ◽  
Digital Inequality ◽  
Partner Status ◽  
General Anxiety ◽  
Nationally Representative

This article presents logistic models examining how pandemic anxiety and COVID-19 comprehension vary with digital confidence among adults in the United States during the first wave of the pandemic. As we demonstrate statistically with a nationally representative data set, the digitally confident have lower probability of experiencing physical manifestations of pandemic anxiety and higher probability of adequately comprehending critical information on COVID-19. The effects of digital confidence on both pandemic anxiety and COVID-19 comprehension persist, even after a broad range of potentially confounding factors are taken into account, including sociodemographic factors such as age, gender, race/ethnicity, metropolitan status, and partner status. They also remain discernable after the introduction of general anxiety, as well as income and education. These results offer evidence that the digitally disadvantaged experience greater vulnerability to the secondary effects of the pandemic in the form of increased somatized stress and decreased COVID-19 comprehension. Going forward, future research and policy must make an effort to address digital confidence and digital inequality writ large as crucial factors mediating individuals’ responses to the pandemic and future crises.

Association of Hospital Safety Net Status With Outcomes and Resource Use for Extracorporeal Membrane Oxygenation in the United States

2021 ◽  
pp. 088506662110070
Author(s):  
Matthew Gandjian ◽  
Catherine Williamson ◽  
Yu Xia ◽  
Carlos Maturana ◽  
Nikhil Chervu ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Resource Use ◽  
Safety Net ◽  
The United States ◽  
Infectious Complications ◽  
Membrane Oxygenation ◽  
Hospital Safety ◽  
Hospitalization Costs ◽  
National Cohort ◽  
Multivariable Regression

Purpose: Safety net hospitals (SNH) have been associated with inferior surgical outcomes and increased resource use. Utilization and outcomes for extracorporeal membrane oxygenation (ECMO), a rescue modality for patients with respiratory or cardiac failure, may vary by safety net status. We hypothesized SNH to be associated with inferior outcomes and costs of ECMO in a national cohort. Materials and Methods: The 2008-2017 National Inpatient Sample was queried for ECMO hospitalizations and safety net hospitals were identified. Multivariable regression was used to perform risk-adjusted comparisons of mortality, complications and resource utilization at safety net and non-safety net hospitals. Results: Of 36,491 ECMO hospitalizations, 28.2% were at SNH. On adjusted comparison SNH was associated with increased odds of mortality (AOR: 1.23), tracheostomy use (AOR: 1.51), intracranial hemorrhage (AOR: 1.39), as well as infectious complications (AOR: 1.21, all P < .05), with NSNH as reference. SNH was also associated with increased hospitalization duration (β=+4.5 days) and hospitalization costs (β=+$32,880, all P < .01). Conclusions: We have found SNH to be associated with inferior survival, increased complications, and higher costs compared to NSNH. These disparate outcomes warrant further studies examining systemic and hospital-level factors that may impact outcomes and resource use of ECMO at SNH.

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