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Biomedical subjects

A Leiken

Publications and source records attributed to A Leiken.

6 recordsLinked to original sources
PubMed1988

Test-ordering by multiple physicians increases unnecessary laboratory examinations.

In modern teaching hospitals, patients typically receive direct care from a succession of different physicians, each of whom may order diagnostic tests on the same patient. We examined the association of test-ordering by multiple physicians with unnecessary duplication of 20-test chemistry profiles in 198 consecutively admitted patients. In a multivariate regression model, the number of duplicate chemistry profiles ordered for a patient was significantly correlated with the number of physicians ordering profiles after controlling for the overall intensity of profile testing. In a case-control analysis comparing duplicate with nonduplicate profiles, redundant tests were significantly more likely to have been ordered by a new physician who had not ordered a patient's previous profile than by the same physician who had ordered the previous chemistry panel. We conclude that test ordering by multiple physicians, the prevalent pattern in almost all teaching hospitals, predisposes to unnecessary laboratory examinations.

Clinical Laboratory Techniques↗
PubMed1986

A model to assess the quality-cost tradeoff in nursing homes.

We develop a model for assessing quality-cost tradeoffs as they arise in nurse staffing and task assignment decisions commonly faced by nursing home administrators and industry regulators. As prospective reimbursement schemes and resource utilization groups (RUGs) are implemented, we expect that tradeoffs such as these will become even more critical than they are now. The model permits the inclusion of quality-related considerations, such as restricting tasks to personnel at specified skill levels, requiring minimum staff levels at each skill level, and selective raising of wage rates. The model is also sensitive to changes in patient needs, labor availability, and technological innovations, permitting its use for general staffing purposes. Because it utilizes linear programming techniques, standard computer software can be used to find solutions very quickly, even on a small personal computer. We describe the application of this model to a nursing home in upstate New York, but the procedure is widely applicable to other health care facilities.

Aged↗
PubMed1985

Government subsidy of critical-need occupations: the case of nurses.

This paper undertakes an econometric evaluation of governmental policies aimed at increasing the labor force supply of nurses and at effecting greater hospital substitution among auxilliary health personnel, in times of nurse shortage. The methodology is to employ a simultaneous equation, multi-nurse econometric model which is estimated by a three-stage least-squares procedure incorporating use of logit transformation to deal with limited dependent variables and use of weighted least squares to deal with heteroskedasticity.

Analysis of Variance↗
PubMed1985

A historiography of a model statewide allied health manpower supply/demand study.

Noting the absence of unified data on the supply and demand of allied health practitioners in New York State, a study was conducted at the State University of New York at Stony Brook of 16 professional groups. The study consisted of a statewide census; a market survey of professional leaders, hospitals, long-term care facilities, and practicing professionals; and an analysis of educational programs available and minority enrollment in those programs. The results indicated that, in general, the supply and demand for the services of allied health professionals in New York State are in rough equilibrium, with some shortages in rural and inner-city locations. It was further noted that while the educational institutions are preparing adequate numbers of professionals to meet the employment demand, minority groups are significantly underrepresented in the enrollment figures.

Allied Health Personnel↗