Mojtabi and Nicholson (1995) asked 50 senior psychiatrists in the U.S. to differentiate between bizarre and non-bizarre symptoms and found that the inter-rater reliability had a correlation of +0.4. This shows that the central diagnostic requirement lack sufficient inter-rater reliability for it to be a reliable method of schizophrenia diagnoses. Also Whaley et al (2001) found that inter-rater reliability correlations in diagnoses were as low as +0.11. This, again, shows that there are inconsistencies amongst clinicians that are diagnosing patients, which begins to question the confidence we can have in professional diagnosis. Another issue is test-retest reliability.
Cardiac surgery models were based on previous methods published” (Khuri et al., 1998) as well. Instituting a program based on pre-surgical risk factors they were able to determine those at risk for surgically related complications. Studies involving interventions with expected outcomes (O/E) and are considered particularly suitable for determining effectiveness of the subject studied. Computer based records were examined for workload data (volume) and for risk-adjusted data; the variables and outlier information that would eventually be used or set aside to ensure that consistent, error-free data was used for the most accurate results possible. “Logistic regression analysis was used to develop predictive models for surgical death and complications” (Khuri et al., 1998, p. 494).
At MGH the decline was 87.6% in 1988 to 78.4% in 1993 as well. Because of their high medical cost and lack of primary care physicians, 30% of the hospitals revenues were at risk, giving the opportunity to other hospitals to provide these services and create price competition based on Chapter 495. The reduction of gross patient service revenue at MGH and BWH were affected by the changes in government programs such as Medicare, Medicaid and the enactment of chapter 495. These programs along with many insurance companies adopted the Prospective Payment System (PPS) which began monitoring hospital charges and refusing payment for unnecessary services. The hospitals were receiving a standardized payment for each service
Extra Credit Assignment HSA 535 Dr. Paul Emeka March 24, 2014 Abstract This paper will focus on the views of epidemiology, it will give informative information on the content about health care, it will discuss views on changed and it discuss the best way to apply the principle of epidemiology. Health care services can be made to be responsive to the prevailing population conditions, such as diseases and deaths from certain conditions, and increases in the minority and elderly subgroups. Your views on the role of epidemiology. Include informative content about health care in general and public health in particular in actively and vigilantly addressing health concerns in the United States and abroad.
For example, De Longis studied stress in 75 married couples. They gave participants a life events questionnaire and a hassle and uplifts scale. They found no relationship between life events and health, but did find a positive correlation of +.59 between daily hassles and next-day health problems such as flu, sore throats, headaches and backaches. This therefore suggests that life events are not necessarily a good predictor of health related behaviour and daily hassles may provide a more adequate account. Most of the studies on life events and illness have produced correlation data.
The senior management teams of all four hospitals identified this as a great opportunity to reduce cost, increase OR efficiencies and standardize product/equipment by developing custom clinical hip and knee packs. The goal of the understanding phase is not only to identify ways to reduce cost or improve value, but to understand options in the market, internal capabilities and end user needs. Using spend analysis will then identify the cost of the custom packs at each hospital, the number of items included in the custom packs, the total spend of the custom packs, and each suppliers current spend providing the custom packs. This information will allow categorization by common suppliers and components and establishes the baseline for measuring future improvements. Contract analysis will indicate spend that is on and off contract and the number of affected suppliers with contracts.
A key attribute of medical model is the development of companion diagnostics, which measure levels of proteins, genes or specific mutations are used to provide a specific therapy for an individual's condition by stratifying disease status, selecting the proper medication and tailoring dosages to that patient's specific needs. Additionally, such methods can be used to assess a patient's risk factor for a number of conditions and tailor individual preventative treatments. Stratified medicine has been used for the current approach. Examples of successful personalized treatments exist in the field of oncology.
There is a need for studies with higher levels of control and randomization of subjects. Of all of the quantitative studies mentioned here, only two controlled for specific hospice diagnoses (8,37). Subjects with different terminal diagnoses may constitute a confounding variable since death trajectories vary by terminal diagnosis. Lack of randomization is a limitation for most of the studies discussed here; only three used randomization (8,34,40). Of those that used randomization, only one showed significant differences supporting the use of music therapy (8).
Use a minimum of three peer-reviewed resources, and create an APA formatted reference page. Nursing Diagnosis 1: Acute pain r/t surgical intervention for cervical cancer as evidenced by a subjective pain scale rating of 8/10 Desired Outcome 1 Desired Outcome 2 Patient will state a decreased level of pain as evidenced by verbalizing a pain level less than 3 on a 1-10 pain scale within 6 hours of initial assessment (American Nurse) Patient will perform activities of recovery with an acceptable level of discomfort by end of shift, day two of intervention action. Nursing Intervention 1 Ensure the patient receives appropriate analgesic care. Evaluation method Utilize a 1-10 pain intensity scale. Observe patient
In this part of this assignment I am going to critically analyse an article by evaluating the relevance of the findings from the research. The article is “A Qualitative study investigating patients’ beliefs about cardiac rehabilitation.” I am going to use the Critical Appraisal Skills Programme (CASP) to aid my critique. The CASP tool systematically explores the research to judge its value, relevance and trustworthiness. My evaluation on this evidence is that it has many good points and many bad points. I am going to focus on some of the good and bad points by critically appraising this article.