scholarly journals Educating Physicians-in-Training About Resource Utilization and Their Own Outcomes of Care in the Inpatient Setting

2010 ◽  
Vol 2 (2) ◽  
pp. 175-180 ◽  
Author(s):  
C. Jessica Dine ◽  
Jean Miller ◽  
Alexander Fuld ◽  
Lisa M. Bellini ◽  
Theodore J. Iwashyna
Keyword(s):  
Health Care ◽  
Resource Utilization ◽  
Resource Use ◽  
Practice Patterns ◽  
Action Plan ◽  
Inpatient Setting ◽  
Health Care Market ◽  
Outcomes Of Care ◽  
Attending Physician ◽  
The Impact

Abstract Background Despite significant policy concerns about the role of inpatient resource utilization on rising medical costs, little information is provided to residents regarding their practice patterns and the effect on resource use. Improved knowledge about their practice patterns and costs might reduce resource utilization and better prepare physicians for today's health care market. Methods We surveyed residents in the internal medicine residency at the Hospital of the University of Pennsylvania. Based on needs identified via the survey, discussions with experts, and a literature review, a curriculum was created to help increase residents' knowledge about benchmarking their own practice patterns and using objective performance measures in the health care market. Results The response rate to our survey was 67%. Only 37% of residents reported receiving any feedback on their utilization of resources, and only 20% reported receiving feedback regularly. Even fewer (16%) developed, with their attending physician, a concrete improvement plan for resource use. A feedback program was developed that included automatic review of the electronic medical record to provide trainee-specific feedback on resource utilization and outcomes of care including number of laboratory tests per patient day, laboratory cost per patient day, computed tomography scan ordering rate, length of stay, and 14-day readmission rate. Results were benchmarked against those of peers on the same service. Objective feedback was provided biweekly by the attending physician, who also created an action plan with the residents. In addition, an integrated didactic curriculum was provided to all trainees on the hospitalist service on a biweekly basis. Conclusions Interns and residents do not routinely receive feedback on their resource utilization or ways to improve efficiency. A method for providing objective data on individual resource utilization in combination with a structured curriculum can be implemented to help improve resident knowledge and practice. Ongoing work will test the impact on resource utilization and outcomes.

scholarly journals Evaluating real-world national and regional trends in definitive closure in US burn care: A survey of US Burn Centers

2021 ◽  
Author(s):  
Jeffrey E Carter ◽  
H Amani ◽  
Damien Carter ◽  
Kevin N Foster ◽  
John A Griswold ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Resource Use ◽  
Real World ◽  
Practice Patterns ◽  
Treatment Patterns ◽  
Inpatient Setting ◽  
Burn Treatment ◽  
Burn Care ◽  
Burn Center ◽  
Number Of Patients

Abstract To better understand trends in burn treatment patterns related to definitive closure, this study sought benchmark real-world survey data with national data contained within the National Burn Repository version 8.0 (NBR v8.0) across key burn center practice patterns, resource utilization, and clinical outcomes. A survey, administered to a representative sample of US burn surgeons, collected information across several domains: burn center characteristics; patient characteristics including number of patients and burn size and depth; aggregate number of procedures; resource use such as autograft procedure time, and dressing changes; and costs. Survey findings were aggregated by key outcomes (number of procedures, costs) nationally and regionally. Aggregated burn center data were also compared to the NBR to identify trends relative to current treatment patterns. Benchmarking survey results against the NBR v8.0 demonstrated shifts in burn center patient mix, with more severe cases being seen in the inpatient setting and less severe burns moving to the outpatient setting. An overall reduction in the number of autograft procedures was observed compared to NBR v8.0, and time efficiencies improved as the intervention time per TBSA decreases as TBSA increases. Both nationally and regionally, an increase in costs were observed.The results suggest resource use estimates from NBR v8.0 may be higher than current practices, thus highlighting the importance of improved and timely NBR reporting and further research on burn center standard of care practices. This study demonstrates significant variations in burn center characteristics, practice patterns, and resource utilization thus increasing our understanding of burn center operations and behavior.

scholarly journals Perception of the Progressing Digitization and Transformation of the German Health Care System Among Experts and the Public: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Arne Hansen ◽  
Maximilian Herrmann ◽  
Jan P Ehlers ◽  
Thomas Mondritzki ◽  
Kai Oliver Hensel ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care System ◽  
Delphi Method ◽  
Machine Learning Algorithms ◽  
Mixed Methods Study ◽  
Health Care Market ◽  
German Health ◽  
The Impact ◽  
Care System

BACKGROUND Health care systems worldwide are struggling to keep rising costs at bay with only modest outcome improvement among many diseases. Digitization with technologies like Artificial Intelligence or Machine Learning algorithms might address this. Although digital technologies have been successfully applied in clinical studies the effect on the overall health care system so far was limited. The regulatory ecosystem or data privacy might be responsible, but other reasons may also predominate. OBJECTIVE We analyzed how the digitization of the German health care market is currently perceived among different stakeholders and investigated reasons for its slow adaption. METHODS This was a mixed methods study split into a qualitative Part A using the conceptual approach of the Grounded Theory and a quantitative Part B using the Delphi method. For Part A we interviewed experts in the health care system and converted the results into 17 hypotheses. The Delphi method consisted of an online survey which was sent to the participants via email and was available for three months. For the assessment of the 17 hypotheses, the participants were given a six-point Likert scale. The participants were grouped into patients, physicians, and providers of services within the German health care market. RESULTS There was a strong alignment of opinions on the hypotheses between experts (N=21) and survey participants (N=733), with 70.5% overall agreement on 12/17 hypotheses. Physicians demonstrated the lowest level of agreement with the expert panel at 88% (15/17) disagreement, with the hypotheses “H8: Digitization in the health care system will free up jobs,” and “H6: Digitization in the health care system will empower the patients,” perceived to be in profound disagreement (<italic>P</italic>=.036 and <italic>P</italic>&lt;.001, respectively). CONCLUSIONS Despite the firm agreement among participants and experts regarding the impact of digitization on the health care system, physicians demonstrated a more negative attitude. We assume that this might be a factor contributing to the slow adoption of digitization in practice. Physicians might be struggling with changing power structures, so future measures to transform the market should involve them to a larger degree.

Sign in / Sign up

Export Citation Format

Share Document