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Biomedical subjects

K E Boles

Publications and source records attributed to K E Boles.

16 recordsLinked to original sources
PubMed2001

Using telemedicine to avoid transfer of rural emergency department patients.

Access to emergency treatment in rural areas can often mean the difference between life and death. Telemedicine technologies have the potential of providing earlier diagnosis and intervention, of saving lives and of avoiding unnecessary transfers from rural hospital emergency departments to urban hospitals. This study examined the hypothetical impact of telemedicine services on patients served by the emergency departments of two rural Missouri hospitals and the potential financial impact on the affected hospitals. Of the 246 patients transferred to the hub hospital from the two facilities during 1996, 161 medical records (65.4 percent) were analyzed. Using a conservative approach, only 12 of these cases were identified as potentially avoidable transfers with the use of telemedicine. Of these 12, 5 were admitted to the hub hospital after transfer. In addition to this conservative estimate of avoidable transfers based on current availability of resources in the rural hospitals, two more aggressive scenarios were developed, based on an assumption of increased service availability in the rural hospitals. Economic multipliers were used to estimate the financial impacts on communities in each scenario. This evaluation study demonstrates the potential value of telemedicine use in rural emergency departments to patients, rural hospitals and rural communities.

Diagnosis-Related Groups↗
PubMed2000

An evaluation of satisfaction with telemedicine among health-care professionals.

A survey was conducted among non-doctor health-care professionals in six rural counties in Missouri. The purpose of the survey was to establish baseline data to evaluate the effect of changes in the health-care sector, especially technology changes, on the job satisfaction, career satisfaction, relationships and communication activities of health professionals. The survey included three rural counties in which integrated telecommunication and interactive video telemedicine services were being installed, but before significant activities had begun, and three comparator counties without substantial integrated telecommunications infrastructure and telemedicine services. During a one-month study period, 1108 questionnaires were distributed. The total response rate was 50.1% (n = 555). Of the respondents, 30.3% indicated that technology in health-care was having a large effect on their work, although only 18.2% indicated that telemedicine and telecommunications were having a large effect. No systematic differences were found among the health professionals in the two communities at the time telemedicine equipment was being installed.

Health Knowledge, Attitudes, Practice↗
PubMed1999

A method for identifying comparison counties: application to a rural telemedicine evaluation project.

The evaluation of telemedicine activity in rural communities is complicated by the fact that most telemedicine sites are chosen because of their existing telecommunications infrastructure and institutional relationships, not by a random selection process. In addition, it is difficult to draw conclusions about the effects of telemedicine without a careful analysis of parallel changes in communities which do not have access to telemedicine services. We have developed a method of identifying comparable counties based on an aggregate measure of health status. A set of 66 variables was collected in a previous project to develop a model to evaluate the relative health status of the population in Missouri. A stepwise regression was used to identify a subset of 15 variables that had the highest predictive value for the health status of a county. Distance measures were then used to identify six counties which were most similar to three telemedicine counties. The method can be used with any study set chosen non-randomly, to identify similar objects that can be used for comparative purposes.

Delivery of Health Care↗
PubMed1996

A compilation of state activities in legislatively mandated reporting of health services data.

The health care crisis and efforts for reform have taken a variety of forms. Apparently a majority of states have decided that the federal government will develop solutions to this problem slowly, if at all, and have undertaken a variety of activities on their own to address the problem. One state response has been to mandate the collection of data related to health services in an effort to assist purchasers of health care to make more prudent buying decisions. This article contains the results of a survey conducted among the states that have legislatively mandated the collection of health-related data and presents a compilation and discussion of their activities.

Data Collection↗
PubMed1996

Breakeven under capitation: pure and simple?

This article addresses the issue of breakeven analysis as applied to managed care under capitation. The traditional two-dimensional breakeven analysis is expanded into three dimensions: cost, enrollment, and utilization. This issue is examined and then visualized through the use of three-dimensional graphics.

Capitation Fee↗
PubMed1994

Financial and clinical performance: bridging the gap.

The article explores the relationship between the cost and the quality of hospital care by elaborating a conceptual model of hospital performance. The model relates the financial health status of an organization (financial integrity) to the quality of care provided by that organization (clinical integrity) within an environment that is characterized by various forms of risk. The model suggests that both concepts determine the corporate destiny (success, bankruptcy, or merger) of the organization. If this model proves valid empirically, the results could be used as an early warning system to identify hospitals that might experience financial or clinical distress.

Bankruptcy↗
PubMed1992

Accountability of certified long-term care administrators.

To whom and in what ways are administrators and their facilities accountable? This profile of administrators who have completed ACHCA's Professional Certification Program explores how certification increases one's social accountability and improves facility performance.

Attitude of Health Personnel↗
PubMed1992

Accounting for the costs of quality.

Total quality management (TQM) represents a paradigm shift in the organizational values that shape every aspect of a healthcare provider's activities. The TQM approach to quality management subscribes to the theory that it is not the work of employees of an organization that leads to poor quality; rather, it is the poor design of systems and procedures. In a book recently published by HFMA, Management Accounting for Healthcare Organizations, third edition, authors Suver, Neumann and Boles point out that the changes in behavioral focus and organizational climate brought about by TQM will have a major impact on management accounting function in healthcare organizations. TQM will require new methods of accounting that will enable the effects of declining quality to be recognized and evaluated. It also will require new types of management accounting reports that will identify opportunities for quality improvement and will monitor the effectiveness of quality management endeavors. The following article has been adapted from the book cited above.

Accounting↗
PubMed1986

Implications of the method of capital cost payment on the weighted average cost of capital.

The author develops a theoretical and mathematical model, based on published financial management literature, to describe the cost of capital structure for health care delivery entities. This model is then used to generate the implications of changing the capital cost reimbursement mechanism from a cost basis to a prospective basis. The implications are that the cost of capital is increased substantially, the use of debt must be restricted, interest rates for borrowed funds will increase, and, initially, firms utilizing debt efficiently under cost-basis reimbursement will be restricted to the generation of funds from equity only under a prospective system.

Capital Financing↗
PubMedDate not supplied

What accounting leaves out of hospital financial management.

As PPS and other fixed-price initiatives replace cost-based reimbursement in the hospital industry, the burden of assuming the risk for business success or failure shifts from the payor to the hospital. As a consequence, theories of risk to the business firm which have found application in other industries now deserve attention by hospital management. Incorporating such risk concepts into hospital strategies and actions requires a view of financial management that goes beyond the generally accepted accounting principles of managing and assigning costs for maximum revenue and profitability. This article examines the financial theory of risk in business firms, illustrates the various components of risk as they apply to a hospital business, and discusses how the hospital management strategies of cost-reduction, marketing, diversification, and multiorganizational affiliation can alter the risk characteristics of a hospital business.

Accounting↗
PubMedDate not supplied

Why health economics?

Explore the source record for details and available documents.

Cost-Benefit Analysis↗