Laboratory Testing Patterns by Day of Hospital Stay for Medical and Surgical Hospitalizations

Introduction/Objective Studies of laboratory test utilization and costs by specific hospital day of stay (DOS) have yet to be widely published. Evaluation of laboratory test use by DOS would be helpful to better predict laboratory test reduction as hospital length of stay (LOS) is shortened, since testing on the final day of hospitalization is likely to differ from the average daily figures. Methods/Case Report Using an internal cost accounting database, we evaluated laboratory tests and costs by hospital DOS over one year (2017) at a large health system (N=133,139 hospital days). To evaluate changes over the first days of hospitalization, we set day 1 of hospitalization as a baseline and determined subsequent days as a percentage of day 1 figures. We also calculated laboratory variable cost as a percent of aggregate variable costs per DOS. We limited our analysis to the first week of hospitalization. We employed Medicare Severity Diagnosis Related Groups (MSDRG), used by the US Centers for Medicare and Medicaid Services (CMS), to aggregate hospital encounters into medical or surgical hospitalizations using MSDRG grouping methods. Results (if a Case Study enter NA) For medical inpatient stays, average laboratory tests (variable costs) were 10.8 ($74.11) on day 1, 7.7 ($38.53) on day 2, and 5.8 ($23.75) on day 3, with little change over the next four hospital DOS. Laboratory testing, as a percent of day 1 testing, for days 2-7 was: 70.7%, 53.4%, 54.3%, 54.5%, 55.1%, and 54.0%. Laboratory variable costs represented 7.8% of aggregate variable costs on hospital day 1 and declined sequentially over days 2-7: 5.6%, 4.3%, 3.9%, 3.8%, 3.8%, and 3.5%. For surgical hospitalizations, average laboratory tests (variable costs) were 18.2 ($130.02) on day 1, 11.9 ($57.38) on day 2, and 8.4 ($35.32) on day 3. As with medical stays, there was little change over the next four hospital DOS. Laboratory testing, as a percent of day 1 testing, for days 2-7 was: 65.6%, 46.1%, 44.6%, 46.3%, 45.9%, and 44.9%. Laboratory variable costs represented 3.2% of aggregate variable costs on hospital day 1 and remained essentially unchanged over the following days (range 3.3%-3.7%). Conclusion Laboratory variable costs are highest on the first day of hospitalization and decline over subsequent days to flatten by day 3.

The Behavioral Problems in 2.5–5 Years Old Children Linked with Former Neonatal/Infantile Surgical Parameters

Studies report the link between exposure to major neonatal surgery and the risk of later neurodevelopmental disorders. The aim of this study was to find out the behavioral problem scores of 2.5–5 years old children who had undergone median/major non-cardiac surgery before the age of 90 days, and to relate these to intraoperative cerebral tissue oxygenation values (rSO2), perioperative duration of mechanical ventilation (DMV) and doses of sedative/analgesic agents. Internalizing (IP) and externalizing problems (EP) of 34 children were assessed using the CBCL for ages 1½–5. Median (range) IP and EP scores were 8.5 (2–42) and 15.5 (5–33), respectively and did not correlate with intraoperative rSO2. DMV correlated and was predictive for EP (β (95% CI) 0.095 (0.043; 0.148)). An aggregate variable “opioid dose per days of ventilation” was predictive for EP after adjusting for patients’ gestational age and age at the day of psychological assessment, after further adjustment for age at the day of surgery and for cumulative dose of benzodiazepines (β (95% CI 0.009 (0.003; 0.014) and 0.008 (0.002; 0.014), respectively). Neonatal/infantile intraoperative cerebral oxygenation was not associated with later behavioral problems. The risk factors for externalizing problems appeared to be similar to the risk factors in preterm infant population.

Forgotten agritourism: abandoned websites in the promotion of rural tourism in Poland

Purpose Until recently, a large number of owners of small agritourism farms in Poland, for promotional purposes, used the (“abandoned”) websites made in an amateur manner at the lowest possible cost. The main purpose of this study is to characterize these websites. To achieve this goal, an attempt was made to evaluate the quality of these sites. Design/methodology/approach Two sets of websites were studied: the set of archaic sites (n = 282) and the set of modern sites (n = 282). The study consisted in the evaluation of selected attributes of the website development technology. The obtained results were normalized using the method of zero unitarization. Subsequently, the value of the aggregate variable was determined, which made it possible to describe each website with one synthetic quality index (SQI). Findings “Abandoned websites” do not perform marketing and sales functions. Owing to the frequent lack of content, they also lack an informative function. These websites have documentary value, as well as a historical function. Originality/value The paper presents the assessment of websites using one of the unification methods and the SQI. It has been shown that websites, in addition to having typical functions such as information, marketing or contact, may also have a historical function.

Assessment of households living standard by voivodships — meanders of taxonomic analysis

The article presents the results of the household living standards research based on the analysis of consumption expenditure by voivodships. The research was conducted with the exception of voivodship capitals as they are national development centers with higher consumption. The assessment of the level and structure of consumption in the Mazowieckie voivodship made the authors narrow the scope of data, which showed a significant overestimation of the results due to the presence of Warsaw in the dataset. Taxonomic analysis methods in the form of classical and order measure were used in the research. The analysis was based on the set of characteristics generated on the basis of data for 2014 from the Household Budget Survey carried out by the CSO. Particular attention was paid to the households expenditure for which the need of aggregate variable construction was emphasized, related to leisure time spending as one of the living standard measure.

The Use Of Statistical Methods in Creation of the Urgency Ranking of the Land Consolidation and Land Exchange Works

In the analyzes of the urgency of the land consolidation and land exchange works, and particularly in the spatial comparative analyzes it is helpful to use methods of multivariate statistics, which allows the determination of synthetic measure. Synthetic measures substitute the large set of attributes of the object with one aggregate variable, allowing ordering the analyzed objects (villages) in terms of the phenomenon in question of the urgency of carrying out the work of consolidation and exchange of land. The aim of the paper is to determine measures for the urgency of carrying out the works of consolidation and exchange of land according to the method proposed by Z. Hellwig and comparison of the obtained results with the results obtained using the zero unitarisation method (ZUM). The aim of the analyzes is to verify (check), how the use of different methods of aggregation of the same diagnostic variables affects the results of research. The subject of the research consists of 14 precincts located in the municipality Białaczów, in the Łódzkie voivodship region. To construct the synthetic measure for the urgency of carrying out the works of consolidation and exchange of land 5 groups of features characterizing the works related to consolidation and exchange of land were adopted.