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Biomedical subjects

K Smyth-Staruch

Publications and source records attributed to K Smyth-Staruch.

5 recordsLinked to original sources
PubMed1984

Use of health services by chronically ill and disabled children.

Hospitalization and use of outpatient health care services during a 1-year period by 369 pediatric patients with cystic fibrosis, cerebral palsy, myelodysplasia, or multiple physical handicaps and 456 randomly selected children without congenital conditions from the Cleveland area were examined. Use of hospitalization and outpatient services by the average chronically ill or disabled child was 10 times that of the average comparison child. Physician specialists, occupational and physical therapists, and school nurses were the major outpatient categories used disproportionately by children with chronic illnesses or disabilities. The major share of health care used by children with chronic conditions was attributable to a small subset of children: All hospital care was accounted for by one third of the children, and three quarters of all outpatient care was accounted for by one quarter of that sample. Hospital care was used at similar rates by the four diagnostic groups. However, amount and type of outpatient care varied by diagnosis, level of functional impairment, race, and income. Estimated average expenditure for health services used by the chronically ill or disabled sample was 10 times that of the comparison sample. Relative distribution of estimated expenditures across types of services differed for the two samples as well as among diagnostic categories.

Adolescent↗
PubMed1984

Hospice home care cost savings to third-party insurers.

A population-based, retrospective analysis of Medicare Part A and Blue Cross hospital insurance claims data was used to determine whether hospice home care cost savings to third-party insurers are substantial and result from the substitution of less expensive home care visits for more costly hospital inpatient days. The study was carried out by comparing the third-party payments of Cuyahoga County residents who died of cancer and were served by a hospice home care program (n = 152) with the insurance payments of cancer patients who never received hospice home care (n = 1,397). The data strongly supported the research hypothesis. The relative use of hospital days decreased more than 50% and the use of home care visits increased 10-fold when dying patients shifted from conventional care to hospice home care. This change in use represented a relative savings of about 40%, ranging from $1,089 per patient during the last 2 weeks of life to $2,676 per patient during the last 12 weeks of life. These results were not accounted for by group differences in age, type of cancer, or personal preference for home care.

Age Factors↗
PubMed1983

Using microcomputers to teach sensitivity analysis to medical students.

Teaching sensitivity analysis can be hampered by the large computational burden required by successive recalculation of outcomes. We designed a package of programs for an Apple II Plus microcomputer that allows rapid recalculation of two "model" decision problems currently available in the literature (hernia surgery and pharyngitis). The package presents the baseline values of the models and the expected utilities for each decision. The user can alter one or more key model values and recalculate the utilities easily and repeatedly. The threshold points for a number of variables are automatically computed. The package is interactive and prompts the user for all required input. No knowledge of computer programming is required to use the package. Students who were familiar with the basic elements of decision analysis were introduced to the modeled problems by didactic tutorials and independent reading. They were then given a set of sensitivity analyses to perform using the computerized models as a tool. Students were able to complete the sensitivity analysis assignments without difficulty and discussion of model assumptions was stimulated. The package enhances the teaching of sensitivity analysis by reducing its computational burden and promoting understanding of its nature and value.

Computer-Assisted Instruction↗