Biomedical subjects

U Kunzmann

Publications and source records attributed to U Kunzmann.

5 recordsLinked to original sources

PubMed2006

[Computer-assisted process simulation: a suitable instrument for process optimization in hospitals].

The increasing financial pressure on hospitals resulting from changes in the health system demands detailed knowledge about the cost and earnings situation in the hospital. An essential part of strategic controlling now entails establishing structured cost-unit accounting. This can then be used for example through process optimization to ascertain savings potential and rationalization measures. This paper illustrates a possibility of using computer-assisted process simulation to find ways for prozess optimization. The simulation has been based on the treatment process "operative procedure" of a clinical pathway "CABG" developed in our hospital. The starting points for simulation possible prozess optimization consisted in the elimination of existing waiting times, respectively the parallel organization of certain partial processes. The software used for the simulation was Coral iGrafix Process 2003. The results of 1000 simulation processes reveal a clear reduction in the whole lead-time for the patient, both in avoiding waiting times and also in parallel process organization. In contrast to the initial situation (triangular distribution), the overall duration of the treatment section can be described approximately with normal distribution and a clear cluster of minimum overall durations. Computer-assisted process simulation is a suitable instrument for revealing and establishing possibilities for process optimization in hospitals, and therefore makes a valuable contribution to strategic controlling.

Cardiac Surgical Procedures↗

PubMed2005

Cost unit accounting based on a clinical pathway: a practical tool for DRG implementation.

Setting up a reliable cost unit accounting system in a hospital is a fundamental necessity for economic survival, given the current general conditions in the healthcare system. Definition of a suitable cost unit is a crucial factor for success. We present here the development and use of a clinical pathway as a cost unit as an alternative to the DRG. Elective coronary artery bypass grafting was selected as an example. Development of the clinical pathway was conducted according to a modular concept that mirrored all the treatment processes across various levels and modules. Using service records and analyses the process algorithms of the clinical pathway were developed and visualized with CorelTM iGrafix Process 2003. A detailed process cost record constituted the basis of the pathway costing, in which financial evaluation of the treatment processes was performed. The result of this study was a structured clinical pathway for coronary artery bypass grafting together with a cost calculation in the form of cost unit accounting. The use of a clinical pathway as a cost unit offers considerable advantages compared to the DRG or clinical case. The variance in the diagnoses and procedures within a pathway is minimal, so the consumption of resources is homogeneous. This leads to a considerable improvement in the value of cost unit accounting as a strategic control instrument in hospitals.

Accounting↗

PubMed2002

Simulation methods for the online extraction of ECG parameters under Matlab/Simulink.

The classification of cardiac pathologies in the human ECG greatly depends on the reliable extraction of characteristic features. This work presents a complete simulation environment for testing ECG classification algorithms under Matlab/Simulink. Evaluation of algorithm performance is undertaken in full compliance with the ANSI/AAMI standards EC38 and EC57, and ranges from beat-to-beat analysis to the comparison of episode markers (e.g., for VT/VF detection algorithms). For testing the quality of waveform boundary detection, our own testing methods have been implemented in compliance with existing literature.

Algorithms↗

PubMed2002

Parameter extraction of ECG signals in real-time.

In order for a mobile ECG recorder to be able to classify a heart rhythm online, the significant parameters must be extracted. The relevant parameters are the beginning, peak and end of the QRS-complex, the P- and T-waves, the ST-segment and other significant intervals, such as the RR-interval. The aim of the development was, firstly, stable, real-time-capable QRS detection, which finally achieved values for sensitivity of 98.9% and a positive predictivity of 99.9% on standard ECG databases. Also, a filter-based detection of P- and T-waves was implemented, which can also be performed in real-time on a microcontroller platform.

Artifacts↗

PubMed2000

Is age-related stability of subjective well-being a paradox? Cross-sectional and longitudinal evidence from the Berlin Aging Study.

Subjective well-being is thought to remain relatively stable into old age despite health-related losses. Age and functional health constraints were examined as predictors of individual differences and intraindividual change in subjective well-being, as indicated by positive and negative affect, using cross-sectional (N = 516) and longitudinal (N = 203) samples from the Berlin Aging Study (age range 70-103 years). In cross-sectional and longitudinal analyses, age and functional health constraints were negatively related to positive affect but unrelated to negative affect. Cross-sectionally, controlling for functional health constraints reversed the direction of the relationship between age and positive affect and produced a negative association between age and negative affect. Findings suggest two qualifications to the average stability of overall subjective well-being: Only some dimensions of subjective well-being remain stable, while others decline; age per se is not a cause of decline in subjective well-being but health constraints are.

Affect↗