scholarly journals Costs of Hospitalisation Due to Stroke: Linked Registry and Administrative Clinical Costing Study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Joosup Kim
Keyword(s):  
Length Of Stay ◽  
Disease Burden ◽  
Linear Regression Analysis ◽  
Quality Data ◽  
Clinical Registry ◽  
Costing Study ◽  
Multivariable Linear Regression Analysis ◽  
Hospital Administrative ◽  
Mean Cost ◽  
Administrative Datasets

IntroductionRoutine clinical costing of hospital care provided for a representative sample of patients informs a national price for hospital reimbursement according to the diagnosis related group of a patient. These clinical costing data are available for linkage as part of hospital administrative datasets. Objectives and ApproachThe Australian Stroke Clinical Registry (AuSCR) is a national data collection program used to monitor the quality of care provided to patients who have been hospitalised with a clinical diagnosis of stroke or transient ischaemic attack (TIA). For the Stroke123 project, registrants from the Australian Stroke Clinical Registry in 2009-2013 were linked to hospital administrative datasets in four states (Victoria, Queensland, New South Wales and Western Australia). Clinical costing data were obtained for the cohort in Queensland only. Using these clinical costing data, we aimed to determine the costs of hospitalisations according to clinical and demographic characteristics of patients. Reliability of clinical costing data were tested by assessing the association with disease burden and length of stay using multivariable linear regression analysis. ResultsOf the 5522 patient episodes (from 23 hospitals), clinical costing data were available for 3909 (71%, from 22 hospitals). Patients with clinical costing data were more often aged <65 years (30% vs 24%, p<0.001) and more often male (56% vs 49%, p<0.001) than those without these data. Mean cost of an episode was $12,129. Episodes of intracerebral haemorrhage had a mean cost of $18,315, which was greater than the mean costs of ischaemic stroke ($13,925), TIA ($5,247) and undetermined stroke ($8,996). Greater costs were associated with greater disease burden according to the Charlson Comorbidity Index (p<0.001) and length of stay (p<0.001). Conclusion / ImplicationsIntegration of clinical quality data and costs will enable more holistic assessment and monitoring of the effects of quality improvement initiatives and therapeutic advances.

Costing day case anesthesia: obtaining accurate patient-based costs for adults and children

2004 ◽  
Vol 20 (4) ◽  
pp. 552-561 ◽  
Author(s):  
Rachel A. Elliott ◽  
Linda M. Davies ◽  
Katherine Payne ◽  
Julia K. Moore ◽  
Nigel J. N. Harper
Keyword(s):  
United Kingdom ◽  
Length Of Stay ◽  
Day Surgery ◽  
Fixed Costs ◽  
Anesthetic Agents ◽  
The United Kingdom ◽  
Costing Study ◽  
Adults And Children ◽  
Mean Cost ◽  
Care Costs

Objectives: This study proposes the method requirements for a valid costing study in anesthesia to allow differences to be identified between treatments and uses these method requirements to design and conduct a robust costing study.Methods: A prospective, patient-based costing study was carried out in adult and pediatric day surgery in the United Kingdom. The perspective was that of the National Health Service and the patient. Data were collected for each patient until 7 days after hospital discharge.Results: Data were collected for 1,063 adults and 322 children undergoing day surgery between October 1999 and January 2001. Statistically significant differences were found only between variable costs, which accounted for 11.4 percent and 9.0 percent of adult and pediatric costs, respectively. There were no differences in length of stay, fixed costs, or semi-fixed costs. Differences were not found in total costs in adults but were found in children. By day 7, postdischarge primary and secondary care costs were not different between groups in either study. No differences were found in costs to patients or parents.Conclusions: The use of prospective, patient-based cost data enabled the detection of differences in variable costs between difference anesthetic regimens in day surgery. The stochastic nature of the data provided a measure of variability around mean cost estimates. Practice patterns in the study reflected normal practice in the United Kingdom so the costing data have direct clinical relevance. The use of different anesthetic agents only affected variable costs and had no effect on larger cost drivers such as length of stay or staff input.

scholarly journals Patient Characteristics and Medical Provider Factors Are Associated With Length of Stay in Total Hip Arthroplasty Patients: a Retrospective Chinese Cohort Study

2020 ◽  
Author(s):  
Hui Zeng ◽  
Guoqing Li ◽  
Fei Yu ◽  
Jian Weng ◽  
Ao Xiong ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Hip Arthroplasty ◽  
Linear Regression ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Linear Regression Analysis ◽  
Patient Characteristics ◽  
Medical Provider ◽  
Multivariable Linear Regression Analysis ◽  
The Relationship

Abstract Background Total hip arthroplasty (THA) is a successful treatment in the improvement of quality of life. Diagnosis-related groups (DRGs) payment has a significant impact on the hospital market in China and length of stay (LOS) is one of its crucial manifestations. Patient characteristics and medical provider factors can affect LOS but the relationship is uncertain. We intent to explore the relationship between patient characteristics and medical provider factors and LOS of primary THA patients. Methods We reviewed the database containing 461 patients who underwent primary THA between January 2014 to January 2019 and regressed the LOS against a variety of perioperative factors. A multivariable linear regression model was performed to assess the difference. Results For parts of patient characteristics, multivariable linear regression analysis revealed that comorbidities, pre-operation albumin < 30 g/L, and pre-operation CRP ≥ 5 mg/L were all significantly associated with LOS (p < 0.05). For parts of medical provider factors, multivariable linear regression analysis revealed that date of surgery, urinary catheter, and incision drainage were all significantly associated with LOS (p < 0.05). Conclusions Patient characteristics and medical provider factors are associated with LOS of THA patients. Evaluation and identification of risk factors are beneficial in patients' education, perioperative discussion and surgery decisions in the different primary THA patient populations.

scholarly journals Postoperative use of hypnotics is associated with increased length of stay after uncomplicated surgery for colorectal cancer

2016 ◽  
Vol 4 ◽  
pp. 205031211666700 ◽  
Author(s):  
Morten Westergaard Noack ◽  
Anne Sofie Bisgård ◽  
Mads Klein ◽  
Jacob Rosenberg ◽  
Ismail Gögenur
Keyword(s):  
Colorectal Cancer ◽  
Length Of Stay ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Linear Regression Analysis ◽  
Cancer Surgery ◽  
Colorectal Cancer Surgery ◽  
Multivariable Linear Regression Analysis ◽  
New Treatment ◽  
Perioperative Blood Transfusion

Background/Aims: Hypnotics are used to treat perioperative sleep disorders. These drugs are associated with a higher risk of adverse effects among patients undergoing surgery. This study aims to quantify the use of hypnotics and factors influencing the administration of hypnotics in relation to colorectal cancer surgery. Method: A retrospective cohort study of 1979 patients undergoing colorectal cancer surgery. Results: In all, 381 patients (19%) received new treatment with hypnotics. Two of the six surgical centres used hypnotics less often (odds ratio (95% confidence interval), 0.24 (0.16–0.38) and 0.20 (0.12–0.35)). Active smokers (odds ratio (95% confidence interval), 1.57 (1.11–2.24)) and patients receiving perioperative blood transfusion (odds ratio (95% confidence interval), 1.58 (1.10–2.26)) had increased likelihood of receiving hypnotics. In the uncomplicated cases, a multivariable linear regression analysis showed that consumption of hypnotics postoperatively was significantly associated with increased length of stay (1.5 (0.9–2.2) days). Conclusion: One in five patients began treatment with hypnotics after colorectal cancer surgery. Postoperative use of hypnotics was associated with an increased length of stay for uncomplicated cases of colorectal cancer surgery.

PENGARUH KUALITAS PELAYANAN DAN WORD OF MOUTH TERHADAP KEPUTUSAN PEMBELIAN DI KAFE POTRET MEDAN

2019 ◽  
Vol 13 (2) ◽  
pp. 199
Author(s):  
Asrye Tutur Sinaga ◽  
Nurul Wardani
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Service Quality ◽  
Word Of Mouth ◽  
Hypothesis Test ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Quality Data ◽  
Purchasing Decisions ◽  
Study Hypothesis

AbstrakPenelitian ini bertujuan untuk mengetahui dan dapat menjelaskan pengaruh Kualitas Pelayanan dan Word Of Mouth terhadap Keputusan pembelian di Kafe Potret Medan. Populasi dalam penelitian ini adalah 700 orang ditentukan dari jumlah pengunjung Kafe Potret Medan dalam kurun waktu satu minggu, dan sampel yang digunakan berjumlah 88 pengunjung. Sedangkan tehnik pengumpulan data menggunakan angket (kuesioner) dan pengujiannya yaitu uji kualitas data dan uji asumsi klasik.Pengujian hipotesis menggunakan analisis regresi linier berganda, uji F, uji t, dan uji R2. Hipotesis penelitian dimensi Kualitas Pelayanan dan Word Of Mouth secara parsial terhadap Keputusan Pembelian diterima jika t hitung > t tabel dengan tingkat signifikan 0.05.Nilai t tabel dalam penelitian ini 1,662. Nilai t hitung variabel X1 sebesar 1,990 t hitung  > t tabel maka hipotesis diterima, nilai t hitung variabel X2 sebesar 2,628 t hitung > t tabel maka hipotesis diterima. Dari 2 variabel, variabel Word Of Mouth yang paling dominan mempengaruhi Keputusan Pembelian  sebesar 2,628. Kata Kunci : Kualitas Pelayanan, Word Of Mouth, Keputusan Pembelian AbstractThe purpose of this study is to identify and able to explain the influence of Service Quality and Word Of Mouth to Purchasing Decisions of Kafe Potret Medan. The population in this study were 700 people from visitors Kafe Potret Medan in one week, and the samples used were 88 visitors. While the techniques of data collection using the questionnaire and use the test of quality data and classical assumption. The hypothesis test uses multiple linear regression analysis, F test, R square and t test. The study hypothesis was partially of Service Quality and Word Of Mouth dimension to  Purchasing Decisions is acceptable if t hitung > t tabel with a significant level 0.05. The t tabel value in this study 1.662. The t hitung X1 is 1.990 that mean t hitung > t tabel then the hypothesis is accepted, t hitung X2 is 2.628 that mean t hitung > t tabel then the hypothesis is accepted. From 2 variables fascination that the most dominant variable for Purchasing Decisions is Word Of Mouth of 2.628. Keywords : Service Quality, Word Of Mouth, Purchasing Decisions

Abstract 1122‐000067: Radial Versus Femoral Artery Access for Mechanical Thrombectomy Following IV tPA Administration

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Joshua S Catapano ◽  
Andrew Ducruet ◽  
Felipe C Albuquerque ◽  
Ashutosh Jadhav
Keyword(s):  
Length Of Stay ◽  
Acute Stroke ◽  
Mechanical Thrombectomy ◽  
Average Length ◽  
Linear Regression Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Access Site ◽  
Femoral Access ◽  
Iv Tpa

Introduction : The transradial artery (TRA) approach for neuroendovascular procedures has been demonstrated as a safe and effective alternative to the transfemoral artery (TFA) approach. The present study compares the efficiency and periprocedural outcomes of the TRA and TFA approach for acute stroke interventions in patients receiving intravenous alteplase. Methods : The study was designed as a retrospective analysis of patients who underwent acute mechanical thrombectomy at a large cerebrovascular center between January 2014 and March 2021. Intervention cohorts (TRA and TFA) were compared on baseline characteristics, periprocedural efficiency/efficacy, and in‐hospital outcomes. Results : A total of 314 patients underwent acute mechanical thrombectomy following IV tPA via TRA (6.7%, 21/314) or TFA (93.3%, 293/314) approach. The overall complication rate appeared higher in TFA (6.8%, 20/314) compared to TRA (4.8%,1/21) patients. Access site complications were present in 4.1%(12/293) of TFA patients and 0.0%(0/21) of TRA patients. The average length of stay (days ± standard deviation) was significantly greater in TFA (8.8 ± 8.5) vs. TRA (4.8 ± 2.9) patients (P = 0.02). Linear regression analysis found femoral access (p = 0.046), Medicaid (p = 0.004) insurance, and discharge NIHSS >10 (p = 0.045) as predictors of increased length of stay. However, when time to initial physical/occupation session was added to the model, access site was no longer significant. Conclusions : The TRA (vs. TFA) approach for acute stroke interventions following IV tPA administration may potentially reduce periprocedural complications and hospital length of stay. The reduction in length of stay with TRA access appears to be associated with earlier initiation of therapies.

scholarly journals Factors Affecting Birthweight Decline in Recent Japan Based on Birth Certificates

2020 ◽  
Author(s):  
Noriko Kato ◽  
Catherine Sauvaget ◽  
Honami Yoshida ◽  
Tetsuji Yokoyama ◽  
Nobuo Yoshiike
Keyword(s):  
Birth Order ◽  
Gestational Age ◽  
Maternal Diet ◽  
Linear Regression Analysis ◽  
Vital Statistics ◽  
Birth Certificates ◽  
Factors Affecting ◽  
New Information ◽  
Multivariable Linear Regression Analysis ◽  
Birth Records

Abstract Background:Birthweight is declining consistently for more than 30 years in Japan. Rapid rise in low birth weight infant counts one of the worst among OECD countries.Objective: To add new information for clarifying the factors associated with the decline in birthweight in Japan.Methods: Government vital statistics records were used under permission. 40,968,266 birth records born between 1980 and 2004 were analyzed. Multivariable linear regression analysis was used to examine whether the decline in the birthweight could be explained by obstetrical variables such as gestational age and plurality.Results: From 1980 to 2004, we observed a decline in mean birthweight with yearly effect of -8.07g, which got steeper after 1985 and persisted until 1999, and plateaued thereafter. After adjustment for gestational age, neonatal gender, birth order, plurality, father age, yearly effect became -5.13g, between 1980 and 2004. Conclusion：Recent decreases in birthweight among Japanese neonates were not fully explained by trends of gestational age, sex, birth order, plurality and father age. We should consider additional factors such as pre-pregnant maternal BMI and maternal diet.

scholarly journals Decision Making Processes and Outcomes

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Julie Hicks Patrick ◽  
Jenessa C. Steele ◽  
S. Melinda Spencer
Keyword(s):  
Decision Making ◽  
Working Memory ◽  
Information Search ◽  
Linear Regression Analysis ◽  
Individual Characteristics ◽  
Decision Quality ◽  
Quality Data ◽  
Solution Quality ◽  
Strategic Processing ◽  
Domain Specific

The primary aim of this study was to examine the contributions of individual characteristics and strategic processing to the prediction of decision quality. Data were provided by 176 adults, ages 18 to 93 years, who completed computerized decision-making vignettes and a battery of demographic and cognitive measures. We examined the relations among age, domain-specific experience, working memory, and three measures of strategic information search to the prediction of solution quality using a 4-step hierarchical linear regression analysis. Working memory and two measures of strategic processing uniquely contributed to the variance explained. Results are discussed in terms of potential advances to both theory and intervention efforts.

The Association of Atherosclerotic Cardiovascular Disease and Statin Use With Inflammation and Treatment Outcomes in Tuberculosis

2021 ◽  
Author(s):  
Vignesh Chidambaram ◽  
Jennie Ruelas Castillo ◽  
Amudha Kumar ◽  
Justin Wei ◽  
Siqing Wang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Linear Regression Analysis ◽  
Elevated Serum ◽  
University Hospital ◽  
Sputum Smear ◽  
Atherosclerotic Cardiovascular Disease ◽  
All Cause Mortality ◽  
Multivariable Linear Regression Analysis ◽  
Related Mortality ◽  
Statin Use

Abstract Objective: Tuberculosis (TB) and atherosclerotic cardiovascular disease (ASCVD) have a close epidemiological and pathogenetic overlap. Thus, it becomes essential to understand the relationship between ASCVD and TB outcomes.Methods:From our retrospective cohort on drug-susceptible TB patients at the National Taiwan University Hospital, we assessed the association of pre-existing ASCVD (coronary artery disease (CAD) and atherothrombotic stroke (ATS)) with 9-month all-cause and infection-related mortality and the extent of mediation by systemic inflammatory markers. We determined the effect of pre-existing ASCVD on 2-month sputum microbiological status. Among ASCVD patients, we assessed the association of statin use on mortality.Results:Nine-month all-cause mortality was higher in CAD patients with prior acute myocardial infarction (CAD+AMI+) (adjusted HR 2.01, 95%CI 1.38-3.00) and ATS patients (aHR 2.79, 95%CI 1.92-4.07) and similarly, for infection-related mortality was higher in CAD+AMI+ (aHR 1.95, 95%CI 1.17-3.24) and ATS (aHR 2.04, 95%CI 1.19-3.46) after adjusting for confounding factors. Pre-existing CAD (AMI- or AMI+) or ATS did not change sputum culture conversion or sputum smear AFB positivity at 2 months. The CAD+AMI+ group had significantly higher levels of CRP at TB diagnosis in the multivariable linear regression analysis (Adjusted B(SE) 1.24(0.62)). CRP mediated 66% (p=0.048) and 25% (p=0.033) of the association all-cause mortality with CAD+AMI- and CAD+AMI+, respectively. ConclusionsIn summary, patients with ASCVD have higher hazards of 9-month all-cause and infection-related mortality, with elevated serum inflammation mediating one to three-quarters of this association when adjusted for confounders. Statin use was associated with lower all-cause mortality among patients with ASCVD.

scholarly journals Effect of Number of Clinics and Panel Size on Patient Continuity for Medical Residents

2009 ◽  
Vol 1 (2) ◽  
pp. 310-315 ◽  
Author(s):  
Maureen D. Francis ◽  
Whitney E. Zahnd ◽  
Andrew Varney ◽  
Steven L. Scaife ◽  
Mark L. Francis
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Linear Regression Analysis ◽  
Medical Residents ◽  
Panel Size ◽  
Medical Education Program ◽  
Internal Medicine Residency Training ◽  
Multivariable Linear Regression Analysis ◽  
Linear Regression Modeling ◽  
Attending Physician

Abstract Background Accreditation Council for Graduate Medical Education program requirements for internal medicine residency training include a longitudinal, continuity experience with a panel of patients. Objective To determine whether the number of resident clinics, the resident panel size, and the supervising attending physician affect patient continuity. To determine the number of clinics and the panel size necessary to maximize patient continuity. Design We used linear regression modeling to assess the effect of number of attended clinics, the panel size, and the attending physician on patient continuity. Participants Forty medicine residents in an academic medicine clinic. Measurements Percent patient continuity by the usual provider of care method. Results Unadjusted linear regression analysis showed that patient continuity increased 2.3% ± 0.7% for each additional clinic per 9 weeks or 0.4% ± 0.1% for each additional clinic per year (P  =  .003). Conversely, patient continuity decreased 0.7% ± 0.4% for every additional 10 patients in the panel (P  =  .04). When simultaneously controlling for number of clinics, panel size, and attending physician, multivariable linear regression analysis showed that patient continuity increased 3.3% ± 0.5% for each additional clinic per 9 weeks or 0.6% ± 0.1% for each additional clinic per year (P &lt; .001). Conversely, patient continuity decreased 2.2% ± 0.4% for every additional 10 patients in the panel (P &lt; .001). Thus, residents who actually attend at least 1 clinic per week with a panel size less than 106 patients can achieve 50% patient continuity. Interestingly, the attending physician accounted for most of the variability in patient continuity (51%). Conclusions Patient continuity for residents significantly increased with increasing numbers of clinics and decreasing panel size and was significantly influenced by the attending physician.

scholarly journals Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative

2015 ◽  
Vol 7 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Maureen D. Francis ◽  
Mark L. Wieland ◽  
Sean Drake ◽  
Keri Lyn Gwisdalla ◽  
Katherine A. Julian ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Linear Regression Analysis ◽  
Internal Medicine Resident ◽  
Cross Sectional Study ◽  
Analysis Of Covariance ◽  
Block Model ◽  
Cross Sectional ◽  
Educational Innovations ◽  
Medicine Resident ◽  
Multivariable Linear Regression Analysis

Abstract Background Many internal medicine (IM) programs have reorganized their resident continuity clinics to improve trainees' ambulatory experience. Downstream effects on continuity of care and other clinical and educational metrics are unclear. Methods This multi-institutional, cross-sectional study included 713 IM residents from 12 programs. Continuity was measured using the usual provider of care method (UPC) and the continuity for physician method (PHY). Three clinic models (traditional, block, and combination) were compared using analysis of covariance. Multivariable linear regression analysis was used to analyze the effect of practice metrics and clinic model on continuity. Results UPC, reflecting continuity from the patient perspective, was significantly different, and was highest in the block model, midrange in combination model, and lowest in the traditional model programs. PHY, reflecting continuity from the perspective of the resident provider, was significantly lower in the block model than in combination and traditional programs. Panel size, ambulatory workload, utilization, number of clinics attended in the study period, and clinic model together accounted for 62% of the variation found in UPC and 26% of the variation found in PHY. Conclusions Clinic model appeared to have a significant effect on continuity measured from both the patient and resident perspectives. Continuity requires balance between provider availability and demand for services. Optimizing this balance to maximize resident education, and the health of the population served, will require consideration of relevant local factors and priorities in addition to the clinic model.

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