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Results for “Program Efficiency”

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At least 19 recordsLinked to original sources
PubMed1987

Use of manpower data in an integrated database for program efficiency analysis: an example from a statewide community mental health system.

This article describes a method for systematically utilizing manpower data to analyze program efficiency of community mental health services. Examples of how analyses of performance data can be substantially enhanced by integrating manpower staffing data with other key financial, client, and service volume variables are provided.

Community Mental Health Services↗
PubMed2003

The 9-A solution: how mRNA pseudoknots promote efficient programmed -1 ribosomal frameshifting.

There is something special about mRNA pseudoknots that allows them to elicit efficient levels of programmed -1 ribosomal frameshifting. Here, we present a synthesis of recent crystallographic, molecular, biochemical, and genetic studies to explain this property. Movement of 9 A by the anticodon loop of the aminoacyl-tRNA at the accommodation step normally pulls the downstream mRNA a similar distance along with it. We suggest that the downstream mRNA pseudoknot provides resistance to this movement by becoming wedged into the entrance of the ribosomal mRNA tunnel. These two opposing forces result in the creation of a local region of tension in the mRNA between the A-site codon and the mRNA pseudoknot. This can be relieved by one of two mechanisms; unwinding the pseudoknot, allowing the downstream region to move forward, or by slippage of the proximal region of the mRNA backwards by one base. The observed result of the latter mechanism is a net shift of reading frame by one base in the 5' direction, that is, a -1 ribosomal frameshift.

Bacteria↗
PubMed1997

Prospective development of a cost-efficient program for the pubovaginal sling.

OBJECTIVES: We designed and implemented a cost-containment program for patients undergoing a pubovaginal sling procedure. We sought to test the hypothesis that preoperative patient education could reduce the length of hospital stay in these patients. Our goal was to decrease hospital charges while maintaining quality of care. METHODS: A multidisciplinary group of clinic and hospital staff identified factors that contribute to a patient's hospital charges for a pubovaginal sling procedure. A program of preoperative patient education to teach intermittent self-catheterization was combined with the elimination or control of items considered unnecessary to the delivery of safe, efficient care. Patient care was standardized from the preoperative visit to discharge planning. The difference in the mean values of 38 prestudy patients was compared with 15 study patients with a Wilcoxon rank sum test. RESULTS: Length of hospital stay was reduced from a mean of 2.8 to 1.1 days after implementation of the program (P < 0.0001). This decreased length of stay, combined with a reduction in routine laboratory studies (97% decrease; P < 0.0001), operating room charges (11% decrease; P < 0.01), and medications (35% decrease; P < 0.01), led to significantly reduced hospital charges. Total hospital charges decreased by 35%, from a mean of $4862 to a mean of $3153 (P < 0.0001). There was no increase in morbidity. Patient satisfaction with length of hospital stay did not change significantly following implementation of the program. CONCLUSIONS: With a program of preoperative patient education combined with a critical review of the factors contributing to a patient's hospital charges, it is possible to implement a cost-efficient program for a pubovaginal sling, leading to a 35% reduction in mean total hospital charges. This approach directed toward other incontinence procedures could be expected to yield comparative results.

Cost of Illness↗
PubMed1997

Structural probing and mutagenic analysis of the stem-loop required for Escherichia coli dnaX ribosomal frameshifting: programmed efficiency of 50%.

Three elements are crucial for the programmed frameshifting in translation of dnaX mRNA: a Shine-Dalgarno (SD)-like sequence, a double-shift site, and a 3' structure. The conformation of the mRNA containing these three elements was investigated using chemical and enzymatic probes. The probing data show that the structure is a specific stem-loop. The bottom half of the stem is more stable than the top half of the stem. The function of the stem-loop was further investigated by mutagenic analysis. Reducing the stability of the bottom half of the stem strongly effects frameshifting levels, whereas similar changes in the top half are not as effective. Stabilizing the top half of the stem gives increased frameshifting beyond the WT efficiency. The identity of the primary RNA sequence in the stem-loop is unimportant, provided that the overall structure is maintained. The calculated stabilities of the variant stem-loop structures correlate with frameshifting efficiency. The SD-interaction and the stem-loop element act independently to increase frameshifting in dnaX.

Bacterial Proteins↗
PubMed1997

Community mental health program efficiency.

Six urban community mental health centers participated in a capitated payment system designed for persons with severe mental illness who frequently used the state hospital. The centers and their funding agency agreed that a chief outcome measure would be the length of time clients were able to remain enrolled in the outpatient program. Clients of the six agencies were quite similar to one another. During the 18-month study length of enrollment in the outpatient program did not vary among the agencies whereas agency expenditures varied by more than three-fold. Although some of this expenditure variation was due to economies of scale at larger agencies, different practice styles also contributed to variable efficiency.

Adult↗
PubMed1994

Prospective development of a cost-efficient program for radical retropubic prostatectomy.

OBJECTIVES: We designed and implemented a broad-based program to decrease costs while maintaining quality of care in patients undergoing radical retropubic prostatectomy. METHODS: This program initially involved identification of factors that contribute to patient costs after radical prostatectomy and elimination or control of items that were deemed unnecessary. Patient care was standardized with a collaborative care pathway coordinated by a clinical nurse specialist and that served as a goal for each case. RESULTS: Length of total hospital stay was reduced from a mean of 5.7 days to 3.6 days after full implementation of the program (p < 0.0001). A reduction in operating room time, material utilization, antibiotic use, routine laboratory studies, and refinements in postoperative pain management contributed significantly to cost savings. Overall, the average adjusted total hospital charges were reduced from $13,783 to $7741 (p < 0.0001) by the implementation of this program, with no discernible adverse effect on morbidity rates. CONCLUSIONS: Careful analysis of the critical components of medical care and implementation of a standardized pathway with emphasis on a collaborative approach can substantially increase the cost efficiency of medical care.

Aged↗
PubMed2003

Supported employment for persons with traumatic brain injury: a preliminary investigation of long-term follow-up costs and program efficiency.

OBJECTIVE: To investigate the long-term follow-up costs of supported employment as well as the wage and employment characteristics for individuals with moderate to severe traumatic brain injury (TBI) who participated in supported employment services over a 14-year time period. DESIGN: Longitudinal design with prospectively collected data. SETTING: A university-based supported employment program that uses the individual placement model of supported employment. PARTICIPANTS: Fifty-nine individuals with moderate to severe TBI who were consecutively referred for supported employment services. The sample was restricted to individuals who were placed into a least 1 supported employment position during the study period. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Data were collected on clients placed into at least 1 competitive supported employment position from 1985 to 1999. Analyses were performed to examine the costs of supported employment, employment characteristics (eg, wages, length of employment), and benefit-cost ratios of supported employment for individuals with TBI. RESULTS: The average length of employment for the current sample was 42.58 months. Average gross earnings were US dollars 26,129.74 for individuals during their entire duration of employment. Billing charges accrued for employment services averaged US dollars 10,349.37. Individuals with TBI earned an average of US dollars 17,515 more than the costs associated with their supported employment. CONCLUSIONS: Our investigation provides additional support for the conclusion that supported employment is cost effective for individuals with disabilities, including individuals with TBI, and that the costs of supported employment decrease over time.

Adult↗
PubMed1988

Training of personnel in schools to make health education programs efficient.

For health education to become efficient, it is necessary to improve the adult environment in school. This contributes positively to the school health environment. To achieve this goal, the consciousness and knowledge of the needs of children must be improved, broadened and deepened. A school pediatrician must use his knowledge and the advantage of being a part of the school to develop courses for the school personnel to support health services in school. In the municipality of Ostersund, Sweden, we have developed five courses for school personnel concerning children and health. We find this to be one good way of interpreting the aims of school health service: to support the development of the pupils, to preserve and improve their mental and bodily health and to work for healthy life habits.

Adolescent↗
PubMed1991

An efficient program for computing conditional maximum likelihood estimates and exact confidence limits for a common odds ratio.

This paper describes a method and associated computer program for calculating exact confidence limits and P values, along with the conditional maximum likelihood estimate of the common odds ratio for a series of 2 x 2 tables. The program can be used to calculate exact estimates for matched data and is considerably faster than others currently available.

Algorithms↗
PubMed1996

Using the telephone interview for evaluation of baccalaureate nursing programs.

Efficient use of the telephone is certainly relevant in the 20th century telecommunication age. A 20- to 30-minute phone call allows for interactive communication between the nurse educators and those who hire their graduates. Important information can be quickly obtained for assessing the outcomes of curriculum related to the perceived quality of nurse graduates practicing in various health care settings. This interview method was found to be efficient, convenient, and facilitated dynamic interchange. Feedback from respondents varied in their familiarity with the graduates and programs.

Clinical Competence↗
PubMed1997

An efficient SAS program for extract stratification of person-years.

An efficient Statistical Analysis System computer program for the exact stratification of person-years is described, in order to determine the expected number of deaths or cases of diseases in a cohort for the calculation of standardized mortality ratios or standardized morbidity ratios. A comparison of this program with Macaluso's "Method B" program shows that the speed of the former is considerably faster than that of the latter, when the widths of the categories defined by all of the time factors are identical.

Age Distribution↗
PubMed1980

An evaluation of screening programs for the detection of brucellosis in dairy herds.

Data were collected from approximately 1000 dairy herds, initially blood tested for brucellosis in 1977, in each of southeastern and southwestern Ontario. These data were used to evaluate three brucellosis screening programs, the area recertification program, the market cow program and the milk test program. The milk test program was the most efficient program at detecting brucellosis, 29.5% of the herds tested were classified as infected, but lacked the ability to detect a large proportion of "infected" herds (relative sensitivity = 24%). The market cow program was more efficient than the area recertification program at finding infected herds, 3.9% of the herds tested under the market cow program were infected, but had a low relative sensitivity of 12%. The area recertification program was least efficient, 2.3% of herds tested under the area recertification program were infected, but had the highest relative sensitivity (53%). The relative efficiency (predictive value) of the programs was not affected significantly by location of the herds, season of the initial test or herd size. The relative sensitivity of the milk test program was significantly higher in eastern than western Ontario and tended to decrease as herd size increased. The market cow program tended to be more sensitive in the summer months. The relative specificity of the milk test program (0.997) was higher than that of the market cow program (0.960) and the area recertification program (0.884).

Agglutination Tests↗
PubMed2000

Evaluation of a mobile crisis program: effectiveness, efficiency, and consumer satisfaction.

OBJECTIVE: The effectiveness and efficiency of a mobile crisis program in handling 911 calls identified as psychiatric emergencies were evaluated, and the satisfaction of consumers and police officers with the program was rated. METHODS: The study retrospectively examined differences in subjects' demographic characteristics, hospitalization and arrest rates, and costs for 73 psychiatric emergency situations handled by a mobile crisis team and 58 psychiatric emergency situations handled by regular police intervention during three months in 1995. Consumers' and police officers' satisfaction with the mobile crisis program was evaluated through Likert-type scales. RESULTS: Fifty-five percent of the emergencies handled by the mobile crisis team were managed without psychiatric hospitalization of the person in crisis, compared with 28 percent of the emergencies handled by regular police intervention, a statistically significant difference. The difference in arrest rates for persons handled by the two groups was not statistically significant. The average cost per case was 23 percent less for persons served by the mobile crisis team. Both consumers and police officers gave positive ratings to the mobile crisis program. CONCLUSIONS: Mobile crisis programs can decrease hospitalization rates for persons in crisis and can provide cost-effective psychiatric emergency services that are favorably perceived by consumers and police officers.

Adult↗
PubMed1994

Results and efficiency of programmed ventricular stimulation with four extrastimuli compared with one, two, and three extrastimuli.

BACKGROUND: Conventional programmed ventricular stimulation protocols are inefficient compared with more recently proposed protocols. The purpose of the present study was to determine if additional efficiency could be derived from a 6-step programmed ventricular stimulation protocol that exclusively uses four extrastimuli. METHODS AND RESULTS: The subjects were 209 consecutive patients with coronary artery disease and documented sustained monomorphic ventricular tachycardia, nonsustained ventricular tachycardia, aborted sudden death, or syncope. These patients underwent 159 electrophysiological tests in the absence of antiarrhythmic drug therapy and 105 electrophysiological tests in the presence of antiarrhythmic therapy. Programmed stimulation was performed with two protocols in random order in each patient. Both protocols used an eight-beat drive train, 4-s intertrain pause, and basic drive cycle lengths of 350, 400, and 600 ms. The 6-step protocol started with coupling intervals of 290, 280, 270, and 260 ms, which were shortened simultaneously in 10-ms steps until S2 was refractory. The 18-step protocol used one, two and three extrastimuli in conventional sequential fashion. The end points were 30 s of sustained monomorphic ventricular tachycardia, two episodes of polymorphic ventricular tachycardia requiring cardioversion, or completion of the protocol at two right ventricular sites. There was no significant difference in the yield of sustained monomorphic ventricular tachycardia using the two protocols, regardless of the clinical presentation or treatment with antiarrhythmic drugs. Polymorphic ventricular tachycardia occurred with the 18-step protocol twice as frequently as with the 6-step protocol (6% versus 3%, P < .001). The duration of the 18-step protocol was significantly longer than that of the 6-step protocol in patients with inducible ventricular tachycardia (5.5 +/- 7 versus 2.3 +/- 2 minutes, P < .001), as well as in patients without inducible ventricular tachycardia (25.4 +/- 7 versus 6.9 +/- 2 minutes, P < .001). CONCLUSION: A stimulation protocol that exclusively uses four extrastimuli improves the specificity and efficiency of programmed ventricular stimulation without compromising the yield of monomorphic ventricular tachycardia in patients with coronary artery disease.

Aged↗