Browsing by Subject "inpatient"
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Item A Comparison of Medicare Prospective Payment Systems on P.T.C.A. and Stent Outcomes in an Urban Hospital(2001-05-01) Compton, Ben H.; Doug A. Mains; P. E. HilsenrathCompton, Ben H., A Comparison of Medicare Prospective Systems on P.T.C.A. and STENT Outcomes in an Urban Hospital. Master of Public Health (Health Services Administration), May 2001, 57 pp., 10 tables, 1 graph, bibliography, 51 titles. To determine if differences in outcomes exist between Medicare prospective payment systems when doing percutaneous transluminal coronary angioplasty (PTCA) or STENT surgeries. From January 1999 and December 2000, 146 Medicare patients were identified with 35 being outpatient and 111 inpatient. A separate group of 1-day inpatients was used as a comparison for the outpatient group. Results from the comparison reveal that in the three groups, the majority of patients were white, non-Hispanic males who were about 70 years of age. The 1-day inpatient group had the highest profit of all three with about $3,000 while the inpatient group broke even. The outpatient group had no in-hospital deaths or complications while all three had equal amounts of comorbidities. The conclusion is that losses will probably occur if PTCA and STENTs are done outpatient. Possible solutions are moving to an inpatient setting or determining which costs can be reduced in the outpatient setting.Item Health Care Access Patterns in Relation to Ethnic/Racial and Health Insurance Status at an Osteopathic Hospital for 1998 through 2001(2003-12-01) Mego, Charles B.W.; Lurie, Sue; Balcazar, Hector; TrevinoMego, III, Charles B.W., Health Care Access Patterns in Relation to Ethnic/Racial and Health Insurance Status at an Osteopathic Hospital for 998 through 2001. Doctor of Public Health (Social and Behavioral Sciences), December 2003, 106 p.p., 25 tables, 5 illustrations, references, 44 titles. The patient population of the Osteopathic Health System of Texas (OHST), an academic health center with a 256-bed teaching hospital, was analyzed for health care access as measured by health services utilization in 1998 through 2001. This study explored the question of whether there was less health care access among minorities than among the White non-Hispanic majority within the patient population at OHST. The Tarrant County population was compared to OHST’s population demographics. This assessment determined which Ethnic/Racial groups had the highest medical services utilization and their payment methods. Patient data obtained from the OHST’s Meditech database was analyzed using Epi-Info. White non-Hispanics made up over fifty percent of the Emergency Room (ER), Inpatient and Outpatient service utilization in 1998 through 2001. The Outpatient component made up just over fifty percent of the OHST’s patient. African-Americans were over represented in the ER, Inpatient, and Outpatient service components relative to the Tarrant County demographics for 1998 through 2001. The Hispanic ER Managed Care category increased 7% and confirmed a growth rate of 29% more ER Managed Care in 2001, as compared to 1998 (URR=1.29, [1.24-`.35], x2 = 142.49, p [less than] .01). The Hispanic ER Medicaid category decreased 4.1% and indicated a reduced growth rate of 17% less ER Medicaid in 2001 as compared to 1998 (URR = 0.83, [0.79-0/87], x2 = 57.69, p,.01). The Hispanic Inpatient Managed Care category increased 13.2% and revealed a positive growth rate with 52% more Inpatient Managed Care in 2001 as compared to 1998 (URR=1.52, [1.44-1.61]. x2 = 224.92, p [less than] .01). The Hispanic Inpatient Medicaid category decreased 14.4% and showed a reduced growth rate of 38% less Inpatient Medicaid in 2001 as compared to 1998 (URR=0.62, [0.59-0.66], x2=274.58, p [less than] .01). The Hispanic and the Other groups relied heavily upon ER Self Pay, with a general decrease in Medicaid coverage and an increase in Managed Care. The Hispanic and Other groups have medical needs that are being neglected at OHST, and may lead to serious health problems that could be more costly if still treatable.