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Biomedical subjects

C M Jacobs

Publications and source records attributed to C M Jacobs.

At least 19 recordsLinked to original sources
PubMed1997

Managing demand using clinical decision support tools.

Managing patient and physician demand for resources is crucial to the cost-effective delivery of high-quality patient care. This task is complicated by the expectations for better medical care that patients and physicians developed before prospective payment systems were instituted. The use of clinical decision support tools, which may combine appropriateness criteria with practice guidelines, can help manage demand rationally, control costs, and minimize concerns about overutilization and underutilization of healthcare services.

Cost-Benefit Analysis↗
PubMed1997

Pharmacologically rich clinical decision support provides extra measure for managed care success.

Gatekeepers are currently being asked to do more, including managing referrals to specialists. When a physician appropriately continues care at the primary level in order to pursue a more conservative course of treatment, prescription drugs often play an important role. According to the author, physicians can easily turn to utilization management, not disease management programs, for clinical guidance. Adding a pharmaceutical component with clear indications for drug use to the clinical decision support criteria or guidelines used by physicians helps them to decide when a trial of first-line pharmaceutical management is warranted and at what point to switch to an alternative drug therapy or to refer.

Cost Control↗
PubMed1995

Competitive inhibition of HIV-1 protease by biphenyl carboxylic acids.

A novel series of nonpeptidic compounds that contain a biphenyl carboxylic acid group have been shown to inhibit HIV-1 protease. The active compounds, most of which are highly soluble, have IC50 values in the range of 3.4-74 microM. The structure-inhibitory activity relationship demonstrates the necessity of the biphenyl carboxylic acid group for inhibition, which is enhanced by the presence of a sulfone group and by halogenation of an adjacent phenyl group. A double reciprocal plot of inhibition data on two of the compounds clearly shows that the inhibition occurs in a competitive manner, with Ki values of 1.1 and 3.4 microM. Inhibition by several of the compounds was found to be reversible and fast-binding, while one of the biphenyl carboxylic acids inhibits in a reversible slow-binding manner. Time-dependent inhibition studies were conducted on this compound, and it was determined to have the kinetic values of kon = 0.18 microM-1min-1, koff = 9.7 x 10(-2)min-1, and Ki = 0.14 microM. Thus, the slow-binding inhibitor is the most potent in the series. Molecular modeling has provided information on a possible binding mode for two different biphenyl carboxylic acid inhibitors of HIV-1 protease.

Amino Acid Sequence↗
PubMed1985

Measuring the effect of illness severity on revenue under DRGs.

Hospital financial managers have come to recognize that to profitably operate a hospital under DRGs, they must consider factors other than length of stay. They must also look at illness severity, medical care effectiveness, and treatment efficiency. It is therefore advantageous to develop a method that measures the effect of admission severity on DRG payment and provides information on medical care effectiveness and treatment efficiency improvements. The method described in this article, the admission severity measure, allows the manager to consider both these quality and cost issues.

Costs and Cost Analysis↗
PubMed1985

MEDISGRPS: a clinically based approach to classifying hospital patients at admission.

The Medical Illness Severity Grouping System--called MEDISGRPS--is an admission-oriented patient severity grouping system that uses objective, key clinical findings to place patients in one of five severity groupings. Data from five hospitals indicate that severity level at admission is an important predictor of resource use, is essential for analysis of patients who deteriorate and/or respond poorly to therapy, and is useful to further specify DRGs. Measures of effectiveness and efficiency using MEDISGRPS are suggested.

Diagnosis-Related Groups↗