Health Services Management Research最新文献_第8页

Reducing hospital admissions and transfers to long-term inpatient care: A systematic literature review. 减少住院和转移到长期住院治疗:系统的文献综述。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848211068620

Stephan Herberg, Frank Teuteberg

{"title":"Reducing hospital admissions and transfers to long-term inpatient care: A systematic literature review.","authors":"Stephan Herberg, Frank Teuteberg","doi":"10.1177/09514848211068620","DOIUrl":"https://doi.org/10.1177/09514848211068620","url":null,"abstract":"Individuals in need of long-term care and their relatives prefer to receive and give care in their domestic environment for as long as possible. Residential long-term care is to be avoided for as long as possible. To achieve this goal, the care setting must be optimally oriented to the needs of the person in need of care. Moreover, relatives who provide care must be professionally supported. The Regional Care Competence Center (ReKo), launched on October 1, 2019, is a quasi-experimental study (two groups and pre-post design), funded by the Innovation Fund. As part of the ReKo project, people in need of care and their relatives are assisted by a case management (CM) system. An independent CM, supported by an IT network that includes the most important service providers, is to establish a comprehensive CM for people in need of care. Based on a literature review, this paper aimed to take a conceptual approach to the ReKo project by drawing on previous research and comparing the findings with the ReKo approach. The review considered CM projects that defined avoidance of hospitalization and/or delay in the transition of care recipients to long-term inpatient care as endpoints. Using PubMed and Google Scholar, the study screened 270 articles, abstracted and quality-assessed data, and included eight randomized clinical trials, two other studies, and seven reviews in the analysis. The review results and ReKo approaches are presented along the dimensions of clinical and medical benefits, community and public health benefits, economic benefits, and political and legislative benefits. CM organizations will continue to be established internationally in aging societies. The questions of improving quality of care, avoiding service costs, and the costs of establishing a CM must be raised, even if clear evidence is difficult to provide.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10669641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Analysis of the effect of patients' health status on efficiency: Application of data envelopment analysis in healthcare. 患者健康状况对效率的影响分析:数据包络分析在医疗保健中的应用。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848211065464

Tamás Koltai, Rita V Dénes, Zoltán Dénes

引用次数: 1

Effect of surgeon experience on technical efficiency. 外科医生经验对技术效率的影响。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221080688

Yoshinori Nakata, Yuichi Watanabe, Hiroshi Otake

{"title":"Effect of surgeon experience on technical efficiency.","authors":"Yoshinori Nakata, Yuichi Watanabe, Hiroshi Otake","doi":"10.1177/09514848221080688","DOIUrl":"https://doi.org/10.1177/09514848221080688","url":null,"abstract":"Surgeon experience certainly improves their technical efficiency although it also causes physiological changes with aging. The authors hypothesized that surgeons’ technical efficiency improves with increasing experience up to a point where it then decreases, which is a concave relationship. The authors collected data from all the surgical procedures performed at University Hospital from April through September in 2013–19. The dependent variable was defined as surgeons’ technical efficiency scores that were calculated using output-oriented Charnes–Cooper–Rhodes model of data envelopment analysis. Inputs were defined as (1) the number of assistants and (2) the duration of surgical operation. The output was defined as the surgical fee for each surgery. Surgeon experience was defined as the number of years since medical school graduation. Five control variables were selected: surgical volume, gender, academic rank, surgical specialty, and the year of surgery. Multiple regression analysis using pooled and random-effects Tobit models was performed for our panel data. Totally 20,375 surgical procedures performed by 264 surgeons in 42 months were analyzed. The coefficients of experience and the square of experience were not significantly different from zero. The other coefficients were also insignificant. Surgeons’ technical efficiency does not have a concave relationship with experience.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10570444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Editorial. 社论。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848231151891

Federico Lega

引用次数: 0

Do policies affect management? Evidence from a survey of clinicians of the Italian National Health Service. 政策会影响管理吗?来自意大利国家卫生服务临床医生调查的证据。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848211073521

Giovanni Fattore, Dino Numerato, Domenico Salvatore

引用次数: 1

Why are there so many hospital beds in Germany? 为什么德国有这么多医院床位?

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221080691

Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl

{"title":"Why are there so many hospital beds in Germany?","authors":"Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl","doi":"10.1177/09514848221080691","DOIUrl":"https://doi.org/10.1177/09514848221080691","url":null,"abstract":"The place of hospitals in health systems is undergoing rapid change worldwide due to the high cost of hospital care and the changing health needs of the population. The Covid-19 pandemic has recently drawn public attention towards hospital capacity and has added new urgency to discussions on the future role of hospitals. In this context, recent experience in Germany provides valuable information for health systems seeking to manage hospital capacity. Despite reform efforts to reduce hospital capacity, Germany has the highest rates of intensive care beds among high-income countries and the highest overall hospital capacity in Europe. The capacity of the German hospital system can be explained in large part by the high number of elderly in-patients. This, in turn, is driven by (1) a fragmented ambulatory care system; (2) physicians admitting and maintaining elderly patients in hospital at a high rate; (3) a hospital market adding incentives to admit patients; and (4) a political commitment to egalitarian access and universal care. Additionally, recent policies to reduce hospital capacity have had limited impact because hospitals have not responded to financial incentives in the expected manner. Countries looking to learn from Germany's hospital capacity must therefore consider systemic features, political commitments, and unintended policy consequences.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9134865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

COVID-19 management at one of the largest hospitals in Germany: Concept, evaluation and adaptation. 德国最大医院之一的COVID-19管理:概念、评估和适应。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221100752

Ana Zhelyazkova, Philipp M Fischer, Nina Thies, Julia S Schrader-Reichling, Thorsten Kohlmann, Kristina Adorjan, René Huith, Karl-Walter Jauch, Stephan M Prückner

{"title":"COVID-19 management at one of the largest hospitals in Germany: Concept, evaluation and adaptation.","authors":"Ana Zhelyazkova, Philipp M Fischer, Nina Thies, Julia S Schrader-Reichling, Thorsten Kohlmann, Kristina Adorjan, René Huith, Karl-Walter Jauch, Stephan M Prückner","doi":"10.1177/09514848221100752","DOIUrl":"https://doi.org/10.1177/09514848221100752","url":null,"abstract":"Context: The LMU University Hospital is among the largest healthcare facilities in Germany. The measures implemented prior to and during the first pandemic wave of COVID-19, were evaluated in preparation of a second pandemic wave. This paper presents the pandemic management concept, evaluation and adaptation of LMU University Hospital.Methods: Between July and September 2020 the disaster management team of LMU University Hospital conducted a mixed-method evaluation of the hospital's pandemic management. A workshop series based on the After Action Review working group format was organized to examine the management structure, decision-making processes, documentation, and crisis preparedness response for a second COVID-19 wave. Further, the satisfaction of employees with the hospital's COVID-19 management was examined through an anonymous survey.Results: The workshop series highlighted a need for structural and operational adaptation of the COVID-19 management at LMU University Hospital. The results of the employee survey (N = 2182) provided positive feedback for the measures taken during the first pandemic wave. Specific actions were derived concerning the availability of personal protective equipment and emergency childcare services. A key outcome of both evaluation activities was the identified need for further improvement in communication between stakeholders. All changes were adopted prior to the second pandemic wave.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9117989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-effectiveness of future lockdown policies against the COVID-19 pandemic. 未来针对COVID-19大流行的封锁政策的成本效益。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221080687

Afschin Gandjour

{"title":"Cost-effectiveness of future lockdown policies against the COVID-19 pandemic.","authors":"Afschin Gandjour","doi":"10.1177/09514848221080687","DOIUrl":"https://doi.org/10.1177/09514848221080687","url":null,"abstract":"Aim: While the European Union (EU) has approved several COVID-19 vaccines, new variants of concern may be able to escape immunity. The purpose of this study is to project the cost-effectiveness of future lockdown policies in conjunction with a variant-adapted vaccine booster. The exemplary scenario foresees a 25% decline in the vaccine protection against severe disease.Methods: A decision model was constructed using, for example, information on age-specific fatality rates, intensive care unit (ICU) costs and outcomes, and herd protection threshold. The costs and benefits of a future lockdown strategy were determined from a societal viewpoint under three future scenarios-a booster shot's efficacy of 0%, 50%, and 95%.Results: The cost-effectiveness ratio of a lockdown policy in conjunction with a booster dose with 95% efficacy is €44,214 per life year gained. A lockdown is cost-effective when the probability of approving a booster dose with 95% efficacy is at least 48% (76% when considering uncertainty in input factors).Conclusion: In this exemplary scenario, a future lockdown policy appears to be cost-effective if the probability of approving a variant-adapted vaccine booster with an efficacy of 95% is at least 48%.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984600/pdf/10.1177_09514848221080687.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9164394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Competitive intelligence: A precursor to a learning health system. 竞争情报:学习健康系统的先兆。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848211065470

H Fred Farley, Shelly Freyn

{"title":"Competitive intelligence: A precursor to a learning health system.","authors":"H Fred Farley, Shelly Freyn","doi":"10.1177/09514848211065470","DOIUrl":"https://doi.org/10.1177/09514848211065470","url":null,"abstract":"Unlike other developed countries, the US healthcare system is largely privatized and highly competitive. This dynamic stifles effective information sharing, while the need for prompt and accurate evidence-based decision making has become crucial. Crises, like the COVID-19 pandemic, elevate the importance of quality decision making and exacerbate issues associated with the lack of a cohesive system to share information. Competitive intelligence (CI) is a discipline that encourages gathering, analyzing, and sharing information throughout a firm in order to develop and sustain competitive advantage. CI could be considered a precursor in establishing a learning organization (LO). Although CI research has focused on its process and value, little is found in the literature on how to integrate CI into an organization; this is particularly true in healthcare. A conceptual model is proposed to build and integrate a CI function and culture within a healthcare organization to encourage effective information sharing and knowledge development. In turn, this can provide a mechanism to create a learning health system (LHS). Although the model was developed specifically for US healthcare, it offers application to healthcare in other countries as well as most any industry.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9134844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between asthma control and healthcare costs: Results from a German linked data study. 哮喘控制与医疗费用之间的关系:来自德国相关数据研究的结果。

IF 2.1

Health Services Management Research Pub Date : 2023-02-01 DOI: 10.1177/09514848221100749

Thomas Wilke, Hartmut Timmermann, Sabrina Mueller, Fraence Hardtstock, Victoria Unmuessig, Robert R Welte, Ulf Maywald

{"title":"Association between asthma control and healthcare costs: Results from a German linked data study.","authors":"Thomas Wilke, Hartmut Timmermann, Sabrina Mueller, Fraence Hardtstock, Victoria Unmuessig, Robert R Welte, Ulf Maywald","doi":"10.1177/09514848221100749","DOIUrl":"https://doi.org/10.1177/09514848221100749","url":null,"abstract":"Background: This study aimed to evaluate differences in healthcare resource utilization and cost among patients with controlled and uncontrolled asthma.Methods: Claims data from a German sickness fund was linked to patient survey data. Outpatient physicians enrolled patients and assessed asthma control using the ACTTM questionnaire. All-cause and asthma-specific healthcare resource use (HCRU)/costs were compared descriptively and based on multivariable models using a continuous ACTTM score.Results: Overall, 492 asthma patients were included (mean age: 53.8, 73.8% female). The mean/median ACTTM score was 19.9/20.7, with 183 patients (37.2%) classified as having uncontrolled asthma (mean ACTTM score<20) Patients with uncontrolled asthma had significantly more hospitalizations (p = .035) and medication prescriptions (p < .001), which resulted in higher total healthcare costs for asthma-related (€1785 vs. €1615; p = .004) and all-cause care (€4695 vs. €4117; p = .009). While controlling for baseline characteristics, multivariable models confirmed a negative association between asthma control and total all-cause healthcare costs (p = .008), total asthma-related costs (p = .008), and costs of medication prescriptions (p = .001). However, no significant association was found for all-cause (p = .062) and asthma-related hospitalization costs (p = .576).Conclusion: Considering continuous patient care, improving asthma control is not only desirable from a clinical perspective, but could also be an effective approach to reduce asthma-related HCRU and cost burden.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9135356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0