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Biomedical subjects

D E Gagnon

Publications and source records attributed to D E Gagnon.

10 recordsLinked to original sources
PubMed2001

The distribution, practice, and attitudes of maternal-fetal medicine specialists.

OBJECTIVES: This study was carried out to determine the distribution of maternal-fetal medicine (MFM) subspecialists and to profile MFM subspecialists' (1) target patient populations, (2) practice organization, (3) workloads, (4) services provided, and (5) job satisfaction. STUDY DESIGN: The membership of the Society for Maternal-Fetal Medicine was compared with birth projections for metropolitan statistical areas. A survey was sent to Society for Maternal-Fetal Medicine members. RESULTS: The national supply of MFM subspecialists was 0.34, with individual census regions ranging from 0.22 to 0.52 per thousand births. MFM subspecialists report spending 64% of their time in clinical pursuits, 9% in research, and 12% in administration. They evaluate an average of 512 patients annually and work a 67-hour week (SD, 15.8 hours). Ninety-four percent perform deliveries and 87% perform targeted ultrasound examinations. Overall job satisfaction averages 7.4 on a 10-point scale. CONCLUSION: The data provide useful bench-marking information for MFM subspecialists exploring options for practice and for health care planners and organizations developing staffing plans. Despite changes in the health care system, MFM subspecialists continue to express a positive attitude toward their work.

Attitude of Health Personnel↗
PubMed1999

Administrative data for quality improvement.

This article discusses the use of administrative data for quality improvement in perinatal and neonatal medicine. We review the nature of administrative data and focus on hospital discharge abstract data as the primary source of hospital- and community-based assessments. Although discharge abstract data lack the richness of primary data, these data are the most accessible comparative data source for examining all patients admitted to a hospital. When aggregated to the state level as occurs in more than 30 states, hospital discharge data reflects hospital utilization and outcomes for an entire geographic population at the state and community level. This article reviews some of the weaknesses of administrative data and then focuses how these data can be used for hospital- and community-based assessment of perinatal care citing as examples the measures of perinatal process and outcome used by the National Perinatal Information Center in its Quality/Efficiency Reports for member hospitals and a study of perinatal high-risk care in the State of Florida. The use of discharge abstract data for performance measurement at either the hospital or the system level requires a thorough understanding of how to select a patient group, its characteristics, the intervention, and the outcomes relevant to that patient group. In the perinatal arena, the National Perinatal Information Center has selected and presents those measures that rely on data items shown to be the most reliable based on validity studies and clinician opinion, delineation of the intervention, and the measurement of what occurred. As hospitals respond to the recent pressures of the Joint Commission on Accreditation of Healthcare Organizations and other quality assurance entities, the accuracy of the discharge data will improve. With accepted caution, these data sets are invaluable to researchers studying comparative populations over time or across large geographic areas.

Birth Weight↗
PubMed1991

Managing the future: an examination of the neonatal intensive care unit.

The successes in neonatal intensive care have recently encountered the economic reality of the health care marketplace. Competition and cost constraints from new reimbursement formulas have affected the spirit of altruism that guided the early organization of perinatal regional care. Since high-risk neonatal care is so costly, it is more likely to be adversely affected by competition and cost containment than other inpatient services. The author proposes an examination of the concept of managed competition. Facing the reality of competition, the managers of neonatal units must strive to be cost competitive while maintaining quality of care. Hospitals with a disproportionate share of medically indigent patients must receive public support. To retain the concept of perinatal regional care, hospitals must form partnerships that assure appropriate high-risk care for the patient populations they serve. The public sector must monitor their arrangements to assure quality and access to the appropriate services by all patients in need of high-risk perinatal care. In this manner, the intent of the original perinatal regionalization concept can be preserved in an otherwise hostile competitive health care marketplace.

Economics, Hospital↗
PubMed1977

Prehospital coronary care. Proposal for a uniform reporting system.

Prehospital coronary care is becoming a common feature of community emergency medical systems. To date, results have been reported in a variety of formats, making meaningful comparison and aggregate analysis impossible. A flexible patient encounter form and data analysis scheme are proposed for universal adoption in future published accounts.

Heart Diseases↗