Mobile Apps for Management of Transparency-Mode Quality Report Cards on a Dashboard to Show the Performance of Case Mix Index for Hospitals in Taiwan (Preprint)

2019 ◽  
Author(s):  
Tsair-Wei Chien ◽  
Shu-Chun Kuo ◽  
Hsien-Yi Wang

BACKGROUND A quality report card is a report generated by a third-party evaluator that rates the performance of a specific health care provider. A dashboard is required to explore based on three principles—(1)anytime, anywhere, at a glance;(2)minimal interruption to workflow; and (3) protecting entity privacy—and 3 design features—(1)geographical layout; (2) entity-level alert; and (3) real-time summary data, particularly using mobile Apps to explain. However, few were successfully demonstrated in the literature. OBJECTIVE The aim of this study was to demonstrate a quality report card that can be shown on Google maps to investigate the performance of case mix index(CMI) for hospitals in Taiwan. METHODS The CMI data(from Q3 2013 to Q2 2016) were obtained from the website of Taiwan National Health Issuance Administration(NHIA). A total of 217 hospitals are eligible based on the data are complete. We used scale quality indicators (1) to assess the quality of the study data; (2) to create a dashboard-type quality report card that can be traced on the Google maps; (3) to select the hospital level that performs better in the trend and competition of CMI. RESULTS We found that (1) the CMI data fit the predictable requirements rather well(Chi-square = 10.09, df= 10, p =0.77); (2) the dashboard of quality report card shows on Google maps with multidisciplinary functionalities; (3)the level that regional hospitals earn the merit of the performance better in the CMI Growth/Improvement. CONCLUSIONS The demonstration of a quality report card on CMI using Google maps can inspire other 44 quality indicators of NHIA in use for hospitals in the future. CLINICALTRIAL Not available

2018 ◽  
Author(s):  
Wei-Chih Kan ◽  
Shu-Chun Kuo ◽  
Tsair-Wei Chien ◽  
Jui-Chung John Lin ◽  
Yu-Tsen Yeh ◽  
...  

BACKGROUND Cardiovascular disease causes approximately half of all deaths in patients with type 2 diabetes. Duplicative prescriptions of medication in patients with high blood pressure (hypertension), high blood sugar (hyperglycemia), and high blood lipids (hyperlipidemia) have attracted substantial attention regarding the abuse of health care resources and to implement preventive measures for such abuse. Duplicative prescriptions may occur by patients receiving redundant medications for the same condition from two or more sources such as doctors, hospitals, and multiple providers, or as a result of the patient’s wandering among hospitals. OBJECTIVE We evaluated the degree of duplicative prescriptions in Taiwanese hospitals for outpatients with three types of medications (antihypertension, antihyperglycemia, and antihyperlipidemia), and then used an online dashboard based on mobile health (mHealth) on a map to determine whether the situation has improved in the recent 25 fiscal quarters. METHODS Data on duplicate prescription rates of drugs for the three conditions were downloaded from the website of Taiwan’s National Health Insurance Administration (TNHIA) from the third quarter of 2010 to the third quarter of 2016. Complete data on antihypertension, antihyperglycemia, and antihyperlipidemia prescriptions were obtained from 408, 414, and 359 hospitals, respectively. We used scale quality indicators to assess the attributes of the study data, created a dashboard that can be traced using mHealth, and selected the hospital type with the best performance regarding improvement on duplicate prescriptions for the three types of drugs using the weighted scores on an online dashboard. Kendall coefficient of concordance (W) was used to evaluate whether the performance rankings were unanimous. RESULTS The data quality was found to be acceptable and showed good reliability and construct validity. The online dashboard using mHealth on Google Maps allowed for easy and clear interpretation of duplicative prescriptions regarding hospital performance using multidisciplinary functionalities, and showed significant improvement in the reduction of duplicative prescriptions among all types of hospitals. Medical centers and regional hospitals showed better performance with improvement in the three types of duplicative prescriptions compared with the district hospitals. Kendall W was 0.78, indicating that the performance rankings were not unanimous (Chi square<sub>2</sub>=4.67, <i>P</i>=.10). CONCLUSIONS This demonstration of a dashboard using mHealth on a map can inspire using the 42 other quality indicators of the TNHIA by hospitals in the future.


Author(s):  
Desti Widya Astuti Desti Widya Astuti

ABSTRAK   Berdasarkan data di RSUD Kota Prabumulih bahwa terdapat peningkatan jumlah kejadian perdarahan post partum, tahun 2014 sebanyak 178 orang, tahun 2015 sebanyak 246 orang dan tahun 2016 sebanyak 151 orang. Penelitian ini bertujuan untuk mengetahui hubungan umur ibu dan jarak kehamilan terhadap kejadian perdarahan post partum di RSUD Kota Prabumulih Tahun 2016. Penelitian ini merupakan penelitian analitik dengan rancangan cross sectional. Populasi yang digunakan adalah semua ibu bersalin di RSUD Kota Prabumulih, sebanyak 1.296 ibu bersalin dan 306 sampel. Pengambilan sampel dengan mengunakan random sampling, analisa data menggunakan analisa univariat dan bivariat dengan menggunakan uji statistik chi-square dengan derajat kemaknaan 0,05. Hasil penelitian ini menunjukan bahwa dari 288 ibu bersalin terdapat 151 yang mengalami perdarahan post partum sebagian besar adalah ibu dengan umur resiko tinggi sebanyak 43 orang  (40,9%) dan ibu dengan jarak kehamilan resiko tinggi sebanyak 21 orang (17,3%). Hasil uju chi-square umur didapatkan p.value 0,000 < α 0,05 dan uji chi-square untuk jarak kehamilan didapatkan p.value 0,000 < α 0,05. Maka ada hubungan umur ibu dan jarak kehamilan terhadap kejadian perdarahan post partum di RSUD Kota Prabumulih Tahun 2016. ABSTRACK   Based on the data at District General Hospital (RSUD) Prabumulih, there was increasing of post-partum bleeding, in 2014, there were 178 people. In 2015, there were 246 people. And in 2016, there were 151 people. The purpose of the study was to know relationship between maternal mother and the distance and old post-partum bleedingat District General Hospital (RSUD) Prabumulih in 2013. The study was analytic researchwith cross sectional design. Population thas was used in the study was all maternal mother ar District General Hospital (RSUD) Prabumulih. It was about 1.296 maternal mother and from 306. Random sampilng was done in the study, data analyses used univariate and bivariate analyses by using chi-square statistic test with significance level 0,05. The study result showed that from 306 maternal mother, there were 151 mother who experienced old post-partum bleeding, the large of that was high maternal mother 43 people  (40,9%) and mother age high distance 21 people (17,3%). The result of chi-square test was p value 0,000 < α 0,05 and chi-square test for age was p value 0,000 < α 0,05. It meant that there was relationship between maternal mother and the distance and of post-partum bleeding at District General Hospital (RSUD) Prabumulih in 2016.


2020 ◽  
Author(s):  
Reham AlTamime ◽  
Vincent Marmion ◽  
Wendy Hall

BACKGROUND Mobile apps and IoT-enabled smartphones technologies facilitate collecting, sharing, and inferring from a vast amount of data about individuals’ location, health conditions, mobility status, and other factors. The use of such technology highlights the importance of understanding individuals’ privacy concerns to design applications that integrate their privacy expectations and requirements. OBJECTIVE This paper explores, assesses, and predicts individuals’ privacy concerns in relation to collecting and disclosing data on mobile health apps. METHODS We designed a questionnaire to identify participants’ privacy concerns pertaining to a set of 432 mobile apps’ data collection and sharing scenarios. Participants were presented with 27 scenarios that varied across three categorical factors: (1) type of data collected (e.g. health, demographic, behavioral, and location); (2) data sharing (e.g., whether it is shared, and for what purpose); and, (3) retention rate (e.g., forever, until the purpose is satisfied, unspecified, week, or year). RESULTS Our findings show that type of data, data sharing, and retention rate are all factors that affect individuals’ privacy concerns. However, specific factors such as collecting and disclosing health data to a third-party tracker play a larger role than other factors in triggering privacy concerns. CONCLUSIONS Our findings suggest that it is possible to predict privacy concerns based on these three factors. We propose design approaches that can improve users’ awareness and control of their data on mobile applications


Buildings ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 260
Author(s):  
James Ellis ◽  
David John Edwards ◽  
Wellington Didibhuku Thwala ◽  
Obuks Ejohwomu ◽  
Ernest Effah Ameyaw ◽  
...  

This research explores the failure of competitively tendered projects in the UK construction industry to procure the most suited contractor(s) to conduct the works. Such work may have equal relevance for other developed nations globally. This research seeks to teach clients and their representatives that “lowest price” does not mean “best value”, by presenting a case study of a successfully negotiated tender undertaken by a small-to-medium enterprise (SME) contractor; SME studies are relatively scant in academic literature. By applying the “lessons learnt” principle, this study seeks to improve future practice through the development of a novel alternative procurement option (i.e., negotiation). A mixed philosophical stance combining interpretivism and pragmatism was used—interpretivism to critically review literature in order to form the basis of inductive research to discuss negotiation as a viable procurement route, and pragmatism to analyse perceptions of tendering and procurement. The methods used follow a three-stage waterfall process including: (1) literature review and pilot study; (2) quantitative analysis of case study data; and (3) qualitative data collection via a focus group. Our research underscores the need to advise clients and their representatives of the importance of understanding the scope of works allowed within a tender submission before discounting it based solely on price. In addition, we highlight the failings of competitive tendering, which results in increased costs and project duration once the works commence on site. These findings provide new contemporary insight into procurement and tendering in the construction industry, with emphasis on SME contractors, existing relationships, and open-book negotiation. This research illustrates the adverse effects of early cost estimates produced without first securing a true understanding of project buildability and programming. Our work concludes with a novel insight into an alternative procurement option that involves early SME contractor involvement in an open-book environment, without the need for a third-party cost control.


2019 ◽  
Vol 25 (3) ◽  
pp. 2341-2377 ◽  
Author(s):  
Pasquale Salza ◽  
Fabio Palomba ◽  
Dario Di Nucci ◽  
Andrea De Lucia ◽  
Filomena Ferrucci
Keyword(s):  

2020 ◽  
Author(s):  
Thomas Gross ◽  
Felix Amsler

Zusammenfassung Hintergrund Es galt herauszufinden, wie kostendeckend die Versorgung potenziell Schwerverletzter in einem Schweizer Traumazentrum ist, und inwieweit Spitalgewinne bzw. -verluste mit patientenbezogenen Unfall‑, Behandlungs- oder Outcome-Daten korrelieren. Methodik Analyse aller 2018 im Schockraum (SR) bzw. mit Verletzungsschwere New Injury Severity Score (NISS) ≥8 notfallmäßig stationär behandelter Patienten eines Schwerverletztenzentrums der Schweiz (uni- und multivariate Analyse; p < 0,05). Ergebnisse Für das Studienkollektiv (n = 513; Ø NISS = 18) resultierte gemäß Spitalkostenträgerrechnung ein Defizit von 1,8 Mio. CHF. Bei einem Gesamtdeckungsgrad von 86 % waren 66 % aller Fälle defizitär (71 % der Allgemein- vs. 42 % der Zusatzversicherten; p < 0,001). Im Mittel betrug das Defizit 3493.- pro Patient (allg. Versicherte, Verlust 4545.-, Zusatzversicherte, Gewinn 1318.-; p < 0,001). Auch „in“- und „underlier“ waren in 63 % defizitär. SR-Fälle machten häufiger Verlust als Nicht-SR-Fälle (73 vs. 58 %; p = 0,002) wie auch Traumatologie- vs. Neurochirurgiefälle (72 vs. 55 %; p < 0,001). In der multivariaten Analyse ließen sich 43 % der Varianz erhaltener Erlöse mit den untersuchten Variablen erklären. Hingegen war der ermittelte Deckungsgrad nur zu 11 % (korr. R2) durch die Variablen SR, chirurgisches Fachgebiet, Intensivaufenthalt, Thoraxverletzungsstärke und Spitalletalität zu beschreiben. Case-Mix-Index gemäß aktuellen Diagnosis Related Groups (DRG) und Versicherungsklasse addierten weitere 13 % zu insgesamt 24 % erklärter Varianz. Diskussion Die notfallmäßige Versorgung potenziell Schwerverletzter an einem Schweizer Traumazentrum erweist sich nur in einem Drittel der Fälle als zumindest kostendeckend, dies v. a. bei Zusatzversicherten, Patienten mit einem hohen Case-Mix-Index oder einer IPS- bzw. kombinierten Polytrauma- und Schädel-Hirn-Trauma-DRG-Abrechnungsmöglichkeit.


Author(s):  
Gregory A. Coté ◽  
Badih Joseph Elmunzer ◽  
Erin Forster ◽  
Robert A. Moran ◽  
John G. Quiles ◽  
...  

2018 ◽  
Vol 7 (3) ◽  
pp. 102
Author(s):  
Mehretie Belay

Soil damage by moving water is a somber predicament on farmlands in highland Ethiopia. Sizeable number of trial in farmland preservation has been executed to handle the crisis during the last tens of years. However, the attempts have not been vibrant to trim-down the danger to an attractive extent. This paper evaluates factors contributing to application of soil-steps (bunds) as sustainable farmland management technology (SFLMT) by smallholder farmers in one of the high-potential districts of northwest Ethiopia named Dangila Woreda (District). Mixed method triangulation designs involving concurrent acquisition and interpretation of quantitative and qualitative data were used in the study. Data were acquired from randomly chosen 201 farming households during the harvest seasons of 2011 and 2012. Ordered questionnaire, participatory field observation, key informant interview and focus group discussion were mechanisms employed during the data acquisition. Descriptive statistics (means, standard deviations and percentiles), Chi-square test, t-test and the binary logistic regression model were used to analyze the quantitative data. The qualitative information was textually narrated to augment the quantitative results. Findings of the investigation confirm that age of the household head, the number of household members, slope of the farmland, the size of the farmland held, households’ participation in indigenous labour-sharing activities and the number of farm tools owned were significantly increasing the building of soil-steps as SFLMT in the study district. Involvement in off-farm activities and pest invasions were considerably hindering farmers from building soil-steps on their farmlands. The results in general indicated that households’ access to livelihood assets are key promoters for farmers’ implementation of soil-steps on their farmlands. Local resource preservation and improvement trials should thus ponder on convalescing farmers’ material endowments to improve their capability to use soil-steps as SFLMT in their farming activities.


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