Biomedical subjects

M A Keyes

Publications and source records attributed to M A Keyes.

6 recordsLinked to original sources

PubMed1996

Mitochondrial myopathies: an unusual cause of hypotonia in infants and children.

Children frequently undergo muscle biopsy for the workup of hypotonia under general anaesthesia which poses unique risks in patients with undiagnosed muscle disease. Mitochondrial myopathies are a relatively newly recognized cause of myopathy and multisystem disease in both adults and children. The diagnosis is complex. In addition to causing myopathy, there are metabolic derangements present in some cases that may be life-threatening. We present three cases of children with hypotonia where the diagnosis was suspected in two patients, and confirmed in the third. The question of whether patients with mitochondrial myopathies are at increased risk for developing malignant hyperthermia is discussed.

Anesthesia, General↗

PubMed1995

Express admission: an experiment in front-end redesign.

A redesigned admitting procedure includes simplifying and compressing all processes that occur during the first 24 hours after admission. Centralizing admissions procedures resulted in reducing actual admitting time to 80 minutes. Decreased length of stay is indicated as a probable result of the redesign.

Hospital Restructuring↗

PubMed1994

Recognition and reward: a unit-based program.

Reward and recognition programs often are the tools that hospital administrators use when morale is low. Yet, when developing a program, staff nurses seldom are involved in meaningfully impacting the structure. Through the process of empowerment and decentralization, a large non-profit hospital encourages innovative programs to reward and recognize nurses.

Career Mobility↗

PubMed1991

Developing, assessing, and refining quality of care criteria for a CHAMPUS mental health services demonstration.

CHAMPUS established a contracted provider arrangement demonstration in the Norfolk, Virginia area. This article describes the development, assessment, and refinement of the quality monitoring criteria used to assess quality of care. Of 3,303 cases reviewed, 66% failed one or more criteria in two levels of review by nonphysician reviewers and were referred to peer reviewers. The referral problem was confirmed by the peer reviewer in at least 57% of the 2,177 cases. The criteria should undergo complete specificity and sensitivity testing, be expanded to include more outcome measures, and be applied to other geographic areas before use by other third party payors.

Clinical Protocols↗

PubMed1991

Lifetime Medicaid service utilization and expenditures for AIDS in New York and California.

Several important gaps exists in information on the health care resources used by people with AIDS, including patterns of outpatient care, differences between populations at risk of the disease, and services paid for by Medicaid. To address the shortage of information in these areas, this study examined average Medicaid expenditures and service use for the time period a person has AIDS. The study population was Medicaid enrollees with AIDS in New York and California who died between October 1985 and September 1986. The study focused on the differences between the two states and between four groups that were proxies for at-risk populations: children, women, drug-using men, and non-drug-using men. Mean lifetime Medicaid expenditures were about $30,000 in New York and $20,000 in California. Inpatient use was higher and outpatient service use was lower in New York than in California after controlling for risk group, diagnosis, and Medicaid eligibility group (a proxy for income level). In California, women had higher expenditures and inpatient use than men. In New York, women and drug-using men had higher expenditures and use of inpatient and outpatient services (except home health care) than the non-drug-using men. Children in New York had higher expenditures and hospital use than adults but similar outpatient service use. Multivariate analyses suggest that differences between risk groups were largely attributable to differences in diagnosis and income level (as measured by Medicaid eligibility group).

Acquired Immunodeficiency Syndrome↗

PubMed1976

Public accountability, quality assurance and social work.

The growing demand for public accountability and quality assurance mechanisms affords the social work profession an opportunity to take a more forceful hand in the shaping of the health care delivery system. This paper surveys the impact of public accountability developments on the practice of social work in the health care fields, analyzes what has been done in social work qualtiy assurance, and suggests some strategies for enlarging the scope of social work to include productive new endeavors. Emphasis is placed upon resolution of the conflict between medical and human service treatment models.

Delivery of Health Care↗