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B Hamory

Publications and source records attributed to B Hamory.

5 recordsLinked to original sources
PubMed1996

Data initiatives: building a managed care network utilizing clinical performance data.

Responding to the rising health care costs of its traditional indemnity health care plan, Hershey Foods Corporation developed its own managed care plan as part of the company strategy to better control its health care costs. In developing a provider network for its managed care plan, Hershey Foods utilized data from the Pennsylvania Health Care Cost Containment Council and the expertise of many different groups, health care data consultants (Healthcare Research Affiliates), the insurance provider (Capital Blue Cross/Pennsylvania Blue Shield), health care providers, as well as the employees and their union representatives. Selection of providers for the network necessitated a data initiative that analyzed indicators of quality and cost efficiency. This article explores the roles of these different groups in building the managed care network for Hershey and examines the organizational changes within these different groups to accommodate the Hershey Foods project.

Blue Cross Blue Shield Insurance Plans↗
PubMed1993

Randomized, prospective comparison of first- and second-generation cephalosporins as infection prophylaxis for cardiac surgery.

Surgical wound infections after cardiovascular surgery may be life threatening and are resource intensive. Second-generation cephalosporins are purported to have a broader antimicrobial spectrum than first-generation cephalosporins and, therefore, may be more efficacious for infection prophylaxis. We have conducted a randomized prospective study of 702 patients undergoing open heart surgery to test the hypothesis that the second-generation cephalosporin, cefuroxime, will be more efficacious for infection prophylaxis than the first-generation cephalosporin, cefazolin. Patients were randomized to receive cefazolin 1 g intravenously every 8 hours for 48 hours begun 1 hour preoperatively plus 1 g after 4 hours of surgery (8 doses, n = 425) or cefuroxime 1.5 g 1 hour prior to surgery plus 1.5 g every 12 hours for 3 additional doses (4 doses, n = 277). Infection was defined as a draining wound with or without a positive culture. There was no difference in the wound infection rate between the groups (p = 0.68). Chest wound infections occurred in 2.1% of patients treated with cefazolin and 2.9% of patients treated with cefuroxime (p = 0.79). The rate of true mediastinitis requiring exploration and drainage was 0.7% in both groups (p = 0.084). Leg infections occurred in 6.6% of cefazolin-treated patients and 5.6% of cefuroxime-treated patients (p = 0.83). The second-generation cephalosporin, cefuroxime, did not reduce the incidence of wound infection when compared with the first-generation cephalosporin, cefazolin. Since institutional antibiotic acquisition and administration costs vary, careful analysis of these factors will allow determination of the most cost-effective infection prophylaxis regimen in cardiac surgery.

Cardiac Surgical Procedures↗
PubMed1989

Effects of acute viral respiratory tract infections in patients with cystic fibrosis.

To determine the effects of acute viral respiratory infections (ARI) in cystic fibrosis (CF) we studied all episodes of ARI in ten patients over a 2 year period. A daily diary card was kept on which they recorded all illnesses, including specific upper and lower respiratory symptoms, antibiotic use, and daily peak flow measurements. Recording of concurrent similar illnesses in other household members aided in confirming the onset of ARI, as did a home viral culturing technique and serial serum antibody levels against specific viral types. A total of 80% of the 35 recorded onsets of ARI (1.75/yr/subject) were confirmed by one or more of these methods. Five subjects with moderate to severe pulmonary function scores at the outset of the study had significantly greater decreases in PEFR during ARI episodes (42.4%) than those with milder disease (15.4%), and it took them significantly longer to recover to their baseline measurements (22 days vs. 15 days respectively). The majority of hospital admissions for pulmonary exacerbations were preceded by viral infections (7/8).

Acute Disease↗