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Biomedical subjects

Y Shaw-Taylor

Publications and source records attributed to Y Shaw-Taylor.

6 recordsLinked to original sources

Workforce diversity and cultural competence in healthcare.

This paper presents a discussion of workforce diversity in healthcare and its attendant requisite of cultural competency. The first section of the paper argues that self-assessments and diversity training are integral to workforce diversity management. This paper maintains that diversity training should be a part of overall strategic goals, and that the development of management goals should be based on self-assessments. The second section of the review offers a framework of cultural competency in healthcare delivery based on the relationship between patient and provider, and the community and health system. For this relationship to be successful, this review argues that health systems should foster providers that can also be cultural brokers. The cultural broker role is seen as core to achieving cultural competency.

Clinical Competence↗

U.S. hospital care for HIV-infected persons and the role of public, private, and Veterans Administration hospitals.

Hospitals are a major provider of medical care for human immunodeficiency virus (HIV)-infected persons. Although utilization and patterns of care profiles in public and private hospitals have been evaluated for acquired immunodeficiency syndrome (AIDS)-related Pneumocystis carinii pneumonia (PCP), one of the most costly and common severe complications of AIDS, information from Veterans Administration (VA) hospitals has not been reported previously. This article reports on inpatient care for PCP patients by obtaining data from VA, private, and public hospitals. Cost and resource utilization data were obtained from reviews of medical records, claims, and provider bills from 26 non-VA hospitals and 18 VA hospitals in 10 cities in the United States. Data on severity of illness, patterns of care, and outcomes for PCP were obtained from medical record reviews from 2,174 PCP cases treated in 82 non-VA and 14 VA hospitals in five U.S. cities. Estimates were made of the average costs and the rates of use of diagnostic tests, anti-PCP medications, and intensive care units for samples of public hospital, private hospital, and VA patients with PCP. With mean charges for a single PCP episode of $14,500 to $16,060, PCP remains one of thea most costly complications of AIDS. Although the severity of PCP illness at admission was greatest at public hospitals, the intensity of care was lowest: for frequency of cytologic diagnosis (48% at public, 62% at VA, and 66% at private hospitals), bronchoscopy (45% at public, 60% at VA, and 66% at private hospitals), and intensive care unit use (11% at public, 22% at VA, and 19% at private hospitals). In-hospital mortality rates for PCP also differed in the three types of hospitals (20% at public, 24% at VA, and 18% at private hospitals). Patterns of PCP care differ among VA, public, and private hospitals. Future studies on the HIV epidemic should include data collected from uniform data sources from VA hospitals, in addition to public and private hospitals, to provide insight on the processes of care and outcomes for HIV-infected persons.

AIDS-Related Opportunistic Infections↗

The social and health characteristics of California cities.

This DataWatch presents information from nationally recognized sources on sociodemographic characteristics, crime, and hospitals for the sixteen largest cities in California. Recognizing that effective health system changes will require attention to these critical issues, the report identifies their status in a single year and documents changes since 1980. It also provides comparisons among these cities and for the 100 largest U.S. cities. Synthesis of information indicates a wide range in status among these cities for most characteristics but concludes that, on a number of specific measures, the largest California cities have lost ground compared with their U.S. city counterparts.

Adolescent↗

Error in medicine.

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Diagnostic Errors↗

U.S. hospital care for HIV-infected persons and the role of public and private teaching hospitals: 1988-1991.

Hospitals are a major provider of resources for individuals with HIV-related conditions. With the changing nature of HIV, tracking the dependence on and impact of related care delivered in these institutions is critical to monitoring overall resource need. This report documents HIV inpatient care in U.S. hospitals during 1991 by surveying 1,931 acute care institutions (19% of all acute care institutions). In addition, this report documents changes in HIV care in 124 teaching hospitals between 1988 and 1991. Of the 1,081 hospitals completing the 1991 survey (56%), 773 reported treating at least one HIV inpatient and a total of 58,211 inpatients. Northeastern and public hospitals provided significantly more care. Public-related payer sources financed almost 90% of care in public institutions and > 60% in private institutions. Hospitals reported an average loss of $ 92,025 and an estimated total cost-based loss of $ 71.1 million among all responding institutions. The number of HIV inpatients increased 68% between 1988 and 1991. During these years, substantial increases in revenue and modest reductions in per patient use led to a decrease in total inpatient losses of $ 540,748 to $ 260,331 per hospital. Results show that HIV-associated inpatient care is extensive and increasing and that support for care has become a predominantly public sector responsibility. Teaching hospitals' increase in care suggests that they have become "magnets" for patients with HIV-related disease. However, treatment economies and reimbursement rate improvements have worked to lower losses. Any HIV financing policies should work to balance support for non-hospital care with the continuing need for inpatient treatment.

Acquired Immunodeficiency Syndrome↗