J Med Syst
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Comparative Study
National data sources on the care and outcomes of patients with community acquired pneumonia.
Despite improved understanding and treatment of community acquired pneumonia (CAP), variations in clinical practice and patient outcomes still exists, resulting in excess healthcare dollars spent and decreased patient satisfaction. The use of treatment and outcomes research data can help providers improve their methods and standardize techniques to control costs and provide the best care for their patients. To better understand the utility and capabilities of this research, this article will compare several administrative and clinical databases. ⋯ CAP-Compare database and the University HealthSystem Consortium's (UHC) CAP Benchmarking Program contain clinical and utilization data specific to CAP. In addition there are several government and non-government sponsored data sources that include administrative data on many diagnosis including CAP. These include: Healthcare Benchmarking Systems International's EXPLORE database, the Center for Healthcare Industry Performance Studies database, the National Center for Health Statistics'--National Hospital Discharge Survey, and the Medicare Provider Analysis and Review data files.
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We address the problem of designing new networks for the delivery of public health care services in the United States. The paper is based on a case study design conducted with the Fulton County Health Department (Atlanta, GA). ⋯ First, it presents a planning methodology to deliver health care services through a mix of fixed health centers, satellite facilities, and mobile facilities. Second, it gives insights on how to use geographic information systems to design new health care service networks.
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Comparative Study
Standardizing the definition and measurement of catheter-related infection in home care: a proposed outcome measurement system.
The growth of home health care has not been met with an equal level of clinical outcome data to objectively evaluate the quality and cost effectiveness of care provided in that sector. In response, outcome based initiatives have been introduced to address this issue. However, none have adequately addressed the incidence and impact of catheter-related infection (CRI) in the home due to the complexities of measurement in this environment. An outcomes-oriented process to standardize the definition, measurement and reporting of CRI has been developed that addresses the realities of home care in order to foster continued outcomes research and standardized comparisons between providers.
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Secondary data sources are being used more frequently than ever in outcomes research. The speed and relative low cost of these data bases makes them ideal for analyzing outcomes. Today's researcher has numerous secondary data bases available for use. ⋯ These two data sets represent the two types of secondary data: aggregate and individual. ARF represents an aggregate data set and HCUP represents an individual data set. The advantages of each type of secondary data will also be reviewed.
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Over 50 million people in the United States (about 20% of the population) live in rural areas, but only 9% of the nation's physicians practice in rural communities. It is difficult to recruit and retain rural health care practitioners, partly because of issues relating to professional isolation. ⋯ This paper will explore some of the issues involved in using interactive video (telemedicine) networks to transmit continuing medical education programming from an academic center to multiple rural hospitals. Data from a recent University of Iowa survey of the state's health educators will be presented as one approach to assessing the health care marketplace for the deployment of tele-education services.