# Category Archives: Healthcare

## Describe the difference between the ratios of crude and age-adjusted outpatient department visit rates.

An alternative method for selecting a standard population for direct adjustment is to use a “combined” population.

a. Complete Tables 5.23 and 5.24 using the population distributions from Study Question 1.

b. What is the ratio of the age-adjusted outpatient department visit rate in the population served by Hancock Regional Hospital Network to the age-adjusted outpatient department visit rate in the population served by Harrison Hospital System?

c. Describe the difference between the ratios of crude and age-adjusted outpatient department visit rates.

d. Do the ratios in part (c) differ from the adjusted rates calculated using the 2000 U.S. population as the standard? What is the significance of any differences?

Study Question 1

Tables 5.16 and 5.17 contain information on outpatient department visits in the populations….

## What do these age-specific rates indicate with respect to policy and planning for hospital services?

Tables 5.25 and 5.26 present data for the number of inpatient complications due to myocardial infarction during 2003 in Jefferson County, the service area for East Bank Regional Hospital, and Washington County, the service area for Westside Memorial Hospital.

a. Using these data, calculate age-specific inpatient MI complication rates for the two counties per 1,000 population.

b. Compare age-specific complication rates between Jefferson and Washington Counties. Which county has the higher age-specific complication rates?

c. Describe the general pattern of the change in complication rate with age.

d. Calculate the crude complication rate for Jefferson and Washington Counties for 2003.

e. What is the ratio of the crude complication rate in Jefferson County to that in Washington County?

f. Do you draw the same conclusion about the….

## . Based on these data, determine the sensitivity, specificity, and predictive values of a positive test result.

East Bank Regional Hospital is considering the purchase of new diagnostic testing equipment, which has a purchase price of \$500,000 and an annual maintenance fee of \$15,000. In an attempt to evaluate the performance of the equipment, the CEO of East Bank Regional Hospital asks the hospital epidemiologist to gather information from the manufacturer. In tests conducted by the manufacturer, using 100 individuals known to have the disease for which the testing equipment was designed and 200 individuals known to be free of the disease, 90 of the diseased individuals had a positive test result, and 170 individuals without the disease had a negative test result.

a. Based on these data, determine the sensitivity, specificity, and predictive values of a positive test result.

b. Should the hospital epidemiologist….

## As the prevalence of breast or cervical cancer increases, how are the sensitivity and specificity of the screening tests affected?

lliance Health System is an integrated delivery system comprising five hospitals, multiple ambulatory care sites, and a closed-panel medical staff of nearly 700 employed physicians. Its South Suburban Hospital has been a subject of much controversy, due to the large number of breast and cervical cancer deaths among patients who are regularly treated by the hospital’s medical staff. In fact, the case-fatality rate of breast and cervical cancers is twice that of the rest of the state and three times that of the United States. As CEO, you are particularly concerned about the adverse publicity and notoriety the hospital is receiving. The most recent press release from the regional office of the American Cancer Society has highlighted these facts. You have convened the leaders of the hospital’s medical….

## What medical care protocols, if any, should be reviewed?

You have been designated the chair of an outbreak investigation and prevention committee by the CEO of South Suburban Hospital. Your committee’s charge is to investigate a concern presented by the state health department, which maintains registries for most infectious diseases. Review of these registries revealed that over the past five years, sixteen cases of acute Hepatitis B virus (HBV) infection had a commonality: all sixteen patients had visited the same hospital-based medical practice, housed at South Suburban Hospital, before the onset of the infection. The state health department conducted an investigation, consisting of the collection of blood samples from health care personnel coupled with a series of comprehensive interviews. Results of the investigation indicated the following: none of the health care personnel had a history of acute….

## Select the perspective of either the oncology group or the acute care hospital.

You live in a state with a certificate of need program. The CON program attempts to balance the growth of health care facilities and services with need. Need is determined from many perspectives, based on multiple and conflicting objectives. Assume that there are three stakeholders in the CON planning process: the state regulatory agency that issues the CON, a group of oncologists who wish to invest in a freestanding cancer treatment center, and the CEO and board of directors of a very competitive acute care hospital that wishes to deliver cancer treatment using a new machine that has not yet been purchased. The regulatory agency can issue only one CON for cancer treatment this fiscal year: to either the oncology group or the acute care hospital.

a. Identify….

## A philanthropist wishes to bequest \$500,000 for a cancer program.

A philanthropist wishes to bequest \$500,000 for a cancer program. After some investigation, the philanthropist decides that the following interventions are possible: donate to building a new cancer treatment facility, initiate a comprehensive cancer screening program, and purchase an MRI scanner to diagnose cancer, or purchase the latest cancer therapy equipment. You have been selected to recommend one of these options to the philanthropist.

a. What types of information would you require to make a recommendation?

b. What additional information would you require, if any, from the philanthropist to make your recommendation?

c. Write a two- to three-page report to the philanthropist supporting your recommendation.

## Calculate the estimated number of persons with cerebrovascular disease in the targeted service area in the previous year.

Stuart Pettingill, chief of the medical staff at East Bank Regional Hospital, has decided to recruit a neurologist to increase the staff of the hospital’s existing cerebrovascular disease (CVD) clinical care center. This new physician will begin work on the first day of the following year. Pettingill needs to present a proposal to the hospital board for approval. To prepare, he asks Dana Lopez, who has recently been hired as vice president for clinical practice, to gather some information to “put some meat” into his planned presentation. Lopez reviews data from the CDC, the Census Bureau, and other sources for the defined population service area of East Bank Regional Hospital, which can be described as a moderate-sized metropolitan area. Partial results of this review are listed in Table….

## There are at least ten other hospitals in East Bank Regional Hospital’s service area.

There are at least ten other hospitals in East Bank Regional Hospital’s service area. These hospitals (including East Bank Regional) treated 7,060 patients with a CVD diagnosis in the previous year. East Bank Regional Hospital’s market share for the CVD product line is 6.66%. a. How many patients with CVD were treated at East Bank Regional Hospital the previous year? b. Assuming no changes in market share, estimate how many patients with CVD could potentially have been treated at East Bank Regional Hospital the previous year. c. Assuming no changes in market share, no deaths among the patients in the population with CVD, and static growth in the population of East Bank Regional Hospital’s service area, estimate how many patients with CVD can be expected to be treated….

## What is the marginal cost-effectiveness ratio to determine the cost per health benefit associated with the additional charge of the placental cultures?

Placental examination has been controversial for many years. Differing views are held about the rationale and economic impact of such examination. On one hand, advocates argue that placental examinations are essential for clinical and medicolegal concerns. Others argue that these procedures waste resources and that inadequate empirical evidence exists to indicate whether they are cost-effective. They believe that placental examinations should be performed only on the basis of well-defined criteria. Clinical benefits of placental evaluation are twofold. First, information from this evaluation can improve management of subsequent pregnancies through diagnosis of pathology. Second, placental evaluation provides for assessing the risk of long-term neurological developmental conditions of the newborn. Several physicians at East Bank Regional Hospital began to perform routine placental cultures on all women at delivery. The hospital’s….