scholarly journals Videoconference Interviews: A Timely Primary Care Residency Selection Approach

2020 ◽  
Vol 12 (6) ◽  
pp. 737-744
Author(s):  
Rebecca McAteer ◽  
Shala Sundaram ◽  
Shantie Harkisoon ◽  
Julia Miller
Keyword(s):  
Primary Care ◽  
Residency Program ◽  
Selection Process ◽  
Cost Savings ◽  
Cost Effective ◽  
Structured Interview ◽  
Recruitment Process ◽  
Medical Specialties ◽  
Application Service ◽  
Program Costs

ABSTRACT Background Videoconference interviews (VCIs) are increasingly being used in the selection process of residency program candidates across a number of medical specialties, but nevertheless remain an underutilized approach, particularly in the field of primary care. Objective This retrospective data review with cost analysis explores financial and acceptability outcomes of VCI implementation over a 9-year period. Methods VCIs were incorporated into the recruitment process at a community-based academic family medicine residency program in 2011, whereby suitable candidates were selected for VCIs after Electronic Residency Application Service (ERAS) application review. Based on the outcome of VCI, candidates were invited via a structured interview tool for a subsequent in-person interviews to determine final rank decisions. Costs of the interview process were tracked, as well as perceptions of VCIs. Results VCI implementation over 9 years demonstrated a median 48% reduction of in-person interviews—or 95 applicants eliminated out of a total 195 VCIs performed. This represents a mean annual direct cost savings estimated at $9,154, equating to a 55% reduction in allocated program costs, in addition to indirect cost savings to both applicants and the program. Conclusions Compared to exclusively in-person interviewing, the utilization of VCIs is potentially more cost-effective for residency programs and candidates, while creating a more personal experience for applicants early in the recruitment process. Limited data of acceptability among faculty and candidates is generally favorable but remains mixed.

scholarly journals Comparative Reliability of Structured Versus Unstructured Interviews in the Admission Process of a Residency Program

2011 ◽  
Vol 3 (4) ◽  
pp. 517-523 ◽  
Author(s):  
Danielle Blouin ◽  
Andrew G. Day ◽  
Andrey Pavlov
Keyword(s):  
Residency Program ◽  
Variance Components ◽  
Critical Incident ◽  
Selection Process ◽  
Job Analysis ◽  
Structured Interview ◽  
Structured Interviews ◽  
Admission Process ◽  
Resident Selection ◽  
Overall Reliability

Abstract Background Although never directly compared, structured interviews are reported as being more reliable than unstructured interviews. This study compared the reliability of both types of interview when applied to a common pool of applicants for positions in an emergency medicine residency program. Methods In 2008, one structured interview was added to the two unstructured interviews traditionally used in our resident selection process. A formal job analysis using the critical incident technique guided the development of the structured interview tool. This tool consisted of 7 scenarios assessing 4 of the domains deemed essential for success as a resident in this program. The traditional interview tool assessed 5 general criteria. In addition to these criteria, the unstructured panel members were asked to rate each candidate on the same 4 essential domains rated by the structured panel members. All 3 panels interviewed all candidates. Main outcomes were the overall, interitem, and interrater reliabilities, the correlations between interview panels, and the dimensionality of each interview tool. Results Thirty candidates were interviewed. The overall reliability reached 0.43 for the structured interview, and 0.81 and 0.71 for the unstructured interviews. Analyses of the variance components showed a high interrater, low interitem reliability for the structured interview, and a high interrater, high interitem reliability for the unstructured interviews. The summary measures from the 2 unstructured interviews were significantly correlated, but neither was correlated with the structured interview. Only the structured interview was multidimensional. Conclusions A structured interview did not yield a higher overall reliability than both unstructured interviews. The lower reliability is explained by a lower interitem reliability, which in turn is due to the multidimensionality of the interview tool. Both unstructured panels consistently rated a single dimension, even when prompted to assess the 4 specific domains established as essential to succeed in this residency program.

Implementation of an integrated care model between general practitioner and cardiologist

2019 ◽  
Vol 27 (4) ◽  
pp. 305-315 ◽  
Author(s):  
Marijke Paula Margaretha Vester ◽  
Greetje Johanna de Grooth ◽  
Tobias Nicolaas Bonten ◽  
Bas Leendert van der Hoeven ◽  
Marieke Susanne de Doelder ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Integrated Care ◽  
Healthcare Delivery ◽  
Real Life ◽  
Cost Savings ◽  
Care Model ◽  
Potential Cost ◽  
Content Type ◽  
Program Costs

Purpose Integrated care models have shown to deliver efficient healthcare, but implementation has proven to be difficult. The Support Consultation is an integrated care model, which enables full integration by bundled payment, insurer involvement, predefined care pathways and strengthening of primary care. The purpose of this paper is to provide an indication of the improvements in healthcare delivery after implementation of this proposed model and to create a base for extension to similar interfaces between primary and secondary care. Design/methodology/approach A retrospective study was used to compare the effect on the number of referred patients with non-acute cardiac complaints and the cost effectiveness before and after implementation of the Support Consultation. Patients who previously would have been referred to the cardiologist were now discussed between general practitioner and cardiologist in a primary care setting. Findings The first consecutive 100 patients (age 55±16 years, male 48 percent), discussed in the Support Consultation, were analyzed. Implementation of the Support Consultation resulted in a net costs (program costs and referral costs) reduction of 61 percent compared with usual care. All involved parties were positive about the program. Research limitations/implications The Support Consultation has the ability to provide more effective healthcare delivery and to reduce net costs. The setting of the current study can be used as example for other specialties in countries with a similar healthcare system. Originality/value This study provides the potential cost savings after implementation of an integrated care model, based on real-life data.

Teleconsultation: changes in technology and costs over a 12-year period

2011 ◽  
Vol 17 (8) ◽  
pp. 412-416 ◽  
Author(s):  
Johanna Lamminen ◽  
Heikki Forsvik ◽  
Ville Vopio ◽  
Keijo Ruohonen
Keyword(s):  
Primary Care ◽  
Health Centre ◽  
Cost Savings ◽  
Cost Effective ◽  
The Other ◽  
Attractive Alternative ◽  
Care Centre ◽  
Patient Travel ◽  
Conventional Alternative ◽  
The Cost

In our previous study, in 1997, we evaluated the cost of teleconsultations in a primary care centre compared with the cost of the conventional alternative, travelling to the hospital. The results showed that teleconsultations were cheaper than patient travel when the annual workload was more than 110 patients in ophthalmology and 115 patients in dermatology. Using the same method of analysis for 2009 data showed that cost savings would occur if the annual workload was 20 patients in ophthalmology and 17 patients in dermatology. The main differences between the two studies are the reduced cost of the technology (which was based on PCs in 2009) and the increased cost of staff. Both studies show that teleconsultations can be cost-effective in a relatively small health centre. The cost of technology continues to decrease, although the other costs in our break-even analysis continue to increase. However, the usability of technology continues to improve, and this will make telemedicine a more attractive alternative in the future.

scholarly journals Cost-Effectiveness of Using Mass Media to Prevent Tobacco Use among Youth and Young Adults: The FinishIt Campaign

2019 ◽  
Vol 16 (22) ◽  
pp. 4312
Author(s):  
Elizabeth C. Hair ◽  
David R. Holtgrave ◽  
Alexa R. Romberg ◽  
Morgane Bennett ◽  
Jessica M. Rath ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Mass Media ◽  
Cost Savings ◽  
Cost Effective ◽  
Cost Utility ◽  
Base Case ◽  
Tobacco Prevention ◽  
Prevention Campaign ◽  
Program Costs ◽  
The Cost

Mass media campaigns have been hailed as some of the most effective tobacco prevention interventions. This study examined the cost-effectiveness of the national tobacco prevention campaign, truth® FinishIt, to determine the cost per quality-adjusted life year (QALY) saved and the return on investment (ROI). The cost–utility analysis used four main parameters: program costs, number of smoking careers averted, treatment costs, and number of QALYs saved whenever a smoking career is averted. Parameters were varied to characterize cost-effectiveness under different assumptions (base case, conservative, optimistic, and most optimistic). The ROI estimate compared campaign expenditures to the cost saved due to the campaign implementation. Analyses were conducted in 2019. The base case analysis indicated the campaign results in a societal cost savings of $3.072 billion. Under the most conservative assumptions, estimates indicated the campaign was highly cost-effective at $1076 per QALY saved. The overall ROI estimate was $174 ($144 in costs to smokers, $24 in costs to the smoker’s family, and $7 in costs to society) in cost savings for every $1 spent on the campaign. In all analyses, the FinishIt campaign was found to reach or exceed the threshold levels of cost savings or cost-effectiveness, with a positive ROI. These findings point to the value of this important investment in the health of the younger generation.

scholarly journals Novel Implementation of Virtual Interviews for Otolaryngology Resident Selection: Reflections Relevant to the COVID-19 Era

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2098823
Author(s):  
Morgan E. Davis ◽  
Aria Jafari ◽  
Kayva Crawford ◽  
Bridget V. MacDonald ◽  
Deborah Watson
Keyword(s):  
Residency Program ◽  
Average Cost ◽  
Selection Process ◽  
Cost Savings ◽  
Eye Contact ◽  
Virtual Technology ◽  
Future Studies ◽  
Positive Attitudes ◽  
Residency Selection ◽  
Resident Selection

To address financial and scheduling conflicts associated with residency interviews for otolaryngology candidates, our residency program implemented virtual interviews as an alternative to the traditional in-person format for our visiting subinterns during the 2018-2019 and 2019-2020 interview cycles. Applicants then completed an anonymous survey about their interview experience. We found that, overall, positive attitudes toward virtual interviews increased among 2019-2020 candidates as compared with the year prior. Our results demonstrated an average cost savings per interview of $500 to $1000 when virtual technology was utilized. Based on feedback, improvements may be considered regarding eye contact, minimizing distractions, and providing the option to extend the interview length. Our experience provides a preliminary framework for transitioning to virtual interviews in the upcoming 2020-2021 otolaryngology residency selection process during the COVID-19 era, as well as for future studies assessing the utility of this method and its impact on overall match statistics.

Do Orthopedic Surgery Residency Program Web Sites Address Diversity and Inclusion?

2021 ◽  
pp. 155633162110376
Author(s):  
Ryan J. Mortman ◽  
Alex Gu ◽  
Peter Berger ◽  
Samrat Choudhury ◽  
Simone A. Bernstein ◽  
...  
Keyword(s):  
Web Sites ◽  
Residency Program ◽  
Orthopedic Surgery ◽  
Specific Information ◽  
Medical Specialties ◽  
Residency Programs ◽  
Diversity And Inclusion ◽  
Application Service ◽  
Residency Application ◽  
Surgery Residency Program

Background: Orthopedic surgery is one of the least diverse medical specialties. Other medical specialties have employed diversity-related initiatives to increase the number of students underrepresented in medicine (URM). Furthermore, with the suspension of visiting student rotations during the COVID-19 pandemic, medical students used residency program Web sites as a main source of program-specific information. Aims/Purpose: The purpose of this study was to measure the extent to which orthopedic surgery residency program Web sites describe diversity and inclusion initiatives. Methods: The Electronic Residency Application Service (ERAS) was used to identify U.S. orthopedic surgery residency programs. The programs’ Web sites were reviewed, and data on commitments to diversity and inclusion were collected. Descriptive statistics of these data were generated. Results: There were 192 residency programs identified and 3 were excluded from the analysis due to lack of Web sites. Of the remaining 189 residency program Web sites, only 55 (29.10%) contained information on diversity and inclusion. Information on a commitment to improving diversity and inclusion was the most prevalent data point found among program Web sites, although it was found on only 15% of program Web sites. Conclusion: Orthopedic surgery residency programs rarely address topics related to diversity and inclusion on their program Web sites. An emphasis on opportunities for URM students and initiatives related to diversity and inclusion on program Web sites may improve URM outreach and serve as one method for increasing URM matriculation into orthopedic surgery.

scholarly journals Cost-Savings and Patient Experience with a Pharmacy-Led Medicare Part D Consultation Service

2020 ◽  
Vol 11 (2) ◽  
pp. 10
Author(s):  
Logan Murry ◽  
Brandon Gerleman ◽  
Huiwen Deng ◽  
Julie Urmie
Keyword(s):  
Patient Experience ◽  
Selection Process ◽  
Descriptive Analysis ◽  
Cost Savings ◽  
Cost Effective ◽  
Medicare Part D ◽  
Medicare Part ◽  
Patient Specific ◽  
Consultation Service ◽  
Part D

Background: There are many Medicare Part D plans, making it difficult for patients to choose the optimal plan. The decision to remain on current Medicare plans is reinforced by patient inertia and uncertainty associated with plan-switching decisions. By helping patients identify more cost-effective plans, pharmacists and pharmacy personnel have the ability to inform plan-switching decisions resulting in lower out-of-pocket (OOP) costs. Objectives: This study evaluates 1) patient experience with a pharmacy Medicare Part D consultation service and 2) potential out-of-pocket savings based on a patient’s best plan for 2019 compared to continuation of a patient’s 2018 Medicare Part D plan.  Methods: This study was a retrospective descriptive analysis and took place at a single, independently owned community pharmacy. Patients received free individual consultations with a pharmacist that included a medication review and information on all available Part D plans. Patients were selected to receive the service using pharmacy software to identify potential inefficiencies in current Part D plans. Data on satisfaction and perceived pharmacist role in providing Medicare Part D information were collected via an in-person survey administered at the pharmacy. Potential out-of-pocket cost savings were determined using cost information provided for patient specific medication regimens entered into Medicare.gov, the online platform for Medicare Part D plan information. Results: Of the 318 patients identified, 79 used the consultation service. Out of 79 patients who used the service in fall of 2017, 44 completed the survey for a response rate of 56%. Patients generally reported good experiences with the service. Open-ended responses revealed patients utilize a variety of helpers for plan information and decisions. A subset of 14 patients were identified as having clear plan-switching decisions and were included in the cost-savings analysis. Conclusions: Patients using a free Medicare Part D plan consultation were satisfied with the service, suggesting that helpers were an important resource n their plan-selection process. Using the pharmacist-led Part D consultation may result in decreases in out-of-pocket cost savings due to identification of optimal Medicare Part D plans.   Article Type: Note

scholarly journals Remote interviews for medical residency selection during the initial COVID-19 crisis: a national survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamad-Hani Temsah ◽  
Fadiah Alkhattabi ◽  
Fadi Aljamaan ◽  
Khalid Alhasan ◽  
Adi Alherbish ◽  
...  
Keyword(s):  
Residency Program ◽  
Medical Training ◽  
Cost Savings ◽  
Nationwide Survey ◽  
Medical Residency ◽  
Application Process ◽  
Cross Sectional ◽  
Medical Specialties ◽  
Promising Tool ◽  
Residency Application

Abstract Background Medical training programs candidate’s interview is an integral part of the residency matching process. During the coronavirus disease 2019 (COVID-19) pandemic, conducting these interviews was challenging due to infection prevention restrains (social distancing, namely) and travel restrictions. E-interviews were implemented by the Saudi Commission for Healthcare Specialties (SCFHS) since the matching cycle of March 2020 to hold the interviews in a safer virtual environment while maintaining the same matching quality and standards. Aim This study was conducted to assess the medical training residency program applicants’ satisfaction, stress, and other perspectives for the (SCFHS) March 2020 Matching-cycle conducted through an urgently implemented E-interviews process. Method A cross-sectional, nationwide survey (Additional file 1) was sent to 4153 residency-nominated applicants to the (SCFHS) March 2020 cycle. Results Among the 510 candidates who responded, 62.2% applied for medical specialties, 20.2% applied for surgical specialties, and 17.6% applied for critical care and emergency specialties. Most respondents (61.2%) never had previous experience with web-based video conferences. Most respondents (80.2%) used the Zoom application to conduct the current E-interviews, whereas only 15.9% used the FaceTime application. 63.3% of the respondents preferred E-interviews over in-person interviews, and 60.6% rated their experience as very good or excellent. 75.7% of the respondents agreed that all their residency program queries were adequately addressed during the E-interviews. At the same time, 52.2% of them agreed that E-interviews allowed them to represent themselves accurately. 28.2% felt no stress at all with their E-interviews experience, while 41.2% felt little stressed and only 8.2% felt highly stressed. The factors that were independently and inversely associated with applicants’ level of stress with E-interviews experience were their ability to represent themselves during the interviews (p = 0.001), cost-savings (p < 0.001), their overall rating of the E-interviews quality (p = 0.007) and the speed of the internet connection (p < 0.006). Conclusion Videoconferencing was implemented on an urgent basis during the COVID-19 pandemic in the medical residency application process in Saudi Arabia. It was perceived as an adequate and promising tool to replace in-person interviews in the future. Applicants’ satisfaction was mainly driven by good organization, cost-saving, and their ability to present themselves. Future studies to enhance this experience are warranted.

scholarly journals Cost-effectiveness of brief structured interventions to discontinue long-term benzodiazepine use: an economic analysis alongside a randomised controlled trial

2020 ◽  
Vol 3 ◽  
pp. 33
Author(s):  
Dominic Trépel ◽  
Shehzad Ali ◽  
Simon Gilbody ◽  
Alfonso Leiva ◽  
Dean Mcmillan ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Controlled Trial ◽  
Cost Effective ◽  
Structured Interview ◽  
Treatment As Usual ◽  
Benzodiazepine Use ◽  
Structured Interventions

Background: In Spain, long-term use of benzodiazepine is prevalent in 7% of the population; however, this longer-term use lacks clinical benefits, costs €90million per year and side-effects further add extra cost through adverse health outcomes. This study aims to estimate the cost-effectiveness of primary care services stepped dose reduction of long-term benzodiazepines using either Structured Interview with Follow-up (SIF) or Without Follow-up (SIW), compared to Treatment as Usual (TAU). Design: Cost-effectiveness analysis was conducted alongside randomised control utilizing data from three arm cluster randomized trial. Setting: Primary care. Participants: 75 general practitioners were randomised to one of the three arms (TAU, SIW, SIF). Measurements: Cost and Cost per Quality-Adjusted Life Year (QALY) Results: Compared to usual care, providing SIW per participant costs an additional €117.94 and adding patient follow-up, €218.4. As a result of intervention, participants showed a gain of, on average, for SIW 0.0144 QALY (95% CI -0.0137 to 0.0425) and for SIF 0.0340 QALYs (0.0069 to 0.0612). The Incremental Cost Effectiveness Ratio was €8190.28/QALY (SIW) and €6423.53/QALY (SIF). At the Spanish reimbursement threshold (€45,000 per QALY) the chance interventions are cost effective is 79.8% for SIW and 97.7% for SIF. Conclusions: Brief structured interventions to discontinue long-term benzodiazepine use represent value for money, particularly with scheduled follow-up appointments, and would represent a cost-effective investment by the Spanish healthcare to reduce prevalence of long-term use.

The use and understanding of CA125 as a tumor marker for ovarian cancer: a questionnaire-based survey

2008 ◽  
Vol 18 (3) ◽  
pp. 439-445 ◽  
Author(s):  
E. L. Moss ◽  
J. Hollingworth ◽  
M. Holland ◽  
D. J. Murphy ◽  
I. Fernando ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Primary Care ◽  
Tumor Marker ◽  
Overall Response Rate ◽  
Cost Savings ◽  
Substantial Cost ◽  
Medical Specialties ◽  
Significant Difference ◽  
Level Of Understanding

The aim of this study was to assess the level of understanding of the role of the tumor marker CA125 in ovarian cancer among doctors of different grades specializing in obstetrics and gynecology (O&G), medicine, surgery, and primary care (general practitioners [GPs]). The study involves a questionnaire-based survey. Two hundred and fifty-nine questionnaires were distributed. An overall response rate of 47.1% was achieved. All grades of doctors and all major specialties were represented. There was a significant difference in the level of self-reported CA125 ordering between the medical specialties, O&G being the most frequent users and primary care the least (P< 0.001), and between the grade of doctors, senior house officers/preregistration house officers and GPs less than consultants and middle grade doctors (P< 0.001). Electronic literature was the first source of advice for the majority of respondents (38.5%). The knowledge of false-positive causes for a raised CA125 was low in medicine, surgery, and primary care specialties, as was the awareness of the sensitivity and specificity of CA125 in epithelial and nonepithelial ovarian cancers. The role of CA125 in ovarian cancer is poorly understood, especially among doctors working outside O&G. Guidelines should be developed to aid clinicians from all specialties in the most appropriate application of CA125 in their practice. Substantial cost savings could be made by the introduction of clear protocol-driven ordering in an attempt to reduce the number of inappropriate tests performed.

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