Constructing A Measure Of Anesthesia Intensity Using Cross Sectional Claims Data

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Constructing A Measure Of Anesthesia Intensity Using Cross Sectional Claims Data

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Author : Emily Meredith Gillen
language : en
Publisher:
Release Date : 2019

Constructing A Measure Of Anesthesia Intensity Using Cross Sectional Claims Data written by Emily Meredith Gillen and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019 with categories.

With intensifying emphasis on episodes of care and bundled payments for surgical admissions, anesthesia expenditures are increasingly important in assessing variation in expenditures for surgical episodes. When comparing anesthesia expenditures across surgical settings, adjustment for anesthesia case complexity and duration of anesthesia services, also known as anesthesia service intensity, is desirable. A single anesthesia intensity measure allows researchers to make more direct comparisons between anesthesia outcomes across settings and services. We describe a process for creating a claims-based anesthesia intensity measure using Medicare claims. We create the measure using two fields: base units associated with American Medical Association Current Procedural Terminology codes on the anesthesia claim and time units associated with the service. We rescaled the time component of the anesthesia intensity measure to equally represent base units and time units. For illustration, we applied the measure to Medicare anesthesia expenditures stratified by rural/urban location. We found that adjustments for intensity were greater in urban settings because the level of intensity is greater. Compared with rural settings, unadjusted expenditures in urban settings are roughly 26 percent higher, whereas adjusted expenditures in urban settings are only 20 percent higher. Even absent longitudinal data, researchers can adjust anesthesia outcomes for intensity using our cross-sectional claims-based intensity method.

Constructing A Measure Of Anesthesia Intensity Using Cross Sectional Claims Data

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Author : Emily Meredith Gillen
language : en
Publisher: RTI Press
Release Date : 2019-10-29

Constructing A Measure Of Anesthesia Intensity Using Cross Sectional Claims Data written by Emily Meredith Gillen and has been published by RTI Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-10-29 with Medical categories.

With intensifying emphasis on episodes of care and bundled payments for surgical admissions, anesthesia expenditures are increasingly important in assessing variation in expenditures for surgical episodes. When comparing anesthesia expenditures across surgical settings, adjustment for anesthesia case complexity and duration of anesthesia services, also known as anesthesia service intensity, is desirable. A single anesthesia intensity measure allows researchers to make more direct comparisons between anesthesia outcomes across settings and services. We describe a process for creating a claims-based anesthesia intensity measure using Medicare claims. We create the measure using two fields: base units associated with American Medical Association Current Procedural Terminology codes on the anesthesia claim and time units associated with the service. We rescaled the time component of the anesthesia intensity measure to equally represent base units and time units. For illustration, we applied the measure to Medicare anesthesia expenditures stratified by rural/urban location. We found that adjustments for intensity were greater in urban settings because the level of intensity is greater. Compared with rural settings, unadjusted expenditures in urban settings are roughly 26 percent higher, whereas adjusted expenditures in urban settings are only 20 percent higher. Even absent longitudinal data, researchers can adjust anesthesia outcomes for intensity using our cross-sectional claims-based intensity method.

High Quality Care For All

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Author : Secretary of State for Health
language : en
Publisher: The Stationery Office
Release Date : 2008

High Quality Care For All written by Secretary of State for Health and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with Business & Economics categories.

This review incorporates the views and visions of 2,000 clinicians and other health and social care professionals from every NHS region in England, and has been developed in discussion with patients, carers and the general public. The changes proposed are locally-led, patient-centred and clinically driven. Chapter 2 identifies the challenges facing the NHS in the 21st century: ever higher expectations; demand driven by demographics as people live longer; health in an age of information and connectivity; the changing nature of disease; advances in treatment; a changing health workplace. Chapter 3 outlines the proposals to deliver high quality care for patients and the public, with an emphasis on helping people to stay healthy, empowering patients, providing the most effective treatments, and keeping patients as safe as possible in healthcare environments. The importance of quality in all aspects of the NHS is reinforced in chapter 4, and must be understood from the perspective of the patient's safety, experience in care received and the effectiveness of that care. Best practice will be widely promoted, with a central role for the National Institute for Health and Clinical Excellence (NICE) in expanding national standards. This will bring clarity to the high standards expected and quality performance will be measured and published. The review outlines the need to put frontline staff in control of this drive for quality (chapter 5), with greater freedom to use their expertise and skill and decision-making to find innovative ways to improve care for patients. Clinical and managerial leadership skills at the local level need further development, and all levels of staff will receive support through education and training (chapter 6). The review recommends the introduction of an NHS Constitution (chapter 7). The final chapter sets out the means of implementation.

An Introduction To Quality Assurance In Health Care

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Author : Avedis Donabedian
language : en
Publisher: Oxford University Press
Release Date : 2002-12-26

An Introduction To Quality Assurance In Health Care written by Avedis Donabedian and has been published by Oxford University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2002-12-26 with Medical categories.

Avedis Donabedian's name is synonymous with quality of medical care. He unraveled the mystery behind the concept by defining it in clear operational terms and provided detailed blueprints for both its measurement(known as quality assessment) and its improvement(known as quality assurance). Many before him claimed that quality couldn't be defined in concrete objective terms. He demonstrated that quality is an attribte of a system which he called structure, a set of organized activities whihc he called process, and an outcome which results from both. In this book Donabedian tells the full story of quality assessment and assurance in simple, clear terms. He defines the meaning of quality, explicates its components, and provides clear and systematic guides to its assessment and enhancement. His style is lucid, succinct, systematic and yet personal, almost conversational.

Equity And Excellence

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Author : Great Britain: Department of Health
language : en
Publisher: The Stationery Office
Release Date : 2010-07-12

Equity And Excellence written by Great Britain: Department of Health and has been published by The Stationery Office this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-07-12 with Medical categories.

Equity and Excellence : Liberating the NHS: Presented to Parliament by the Secretary of State for Health by Command of Her Majesty

Essential Clinical Anesthesia

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Author : Charles Vacanti
language : en
Publisher: Cambridge University Press
Release Date : 2011-07-11

Essential Clinical Anesthesia written by Charles Vacanti and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-07-11 with Medical categories.

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.

Pain Management And The Opioid Epidemic

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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2017-09-28

Pain Management And The Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-09-28 with Medical categories.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

Anesthesia For Spine Surgery

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Author : Ehab Farag
language : en
Publisher: Cambridge University Press
Release Date : 2012-05-17

Anesthesia For Spine Surgery written by Ehab Farag and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-05-17 with Medical categories.

A comprehensive guide to anesthesia specifically for spine surgery, explaining procedures from the point of view of both anesthesiologists and surgeons.

Transcranial Doppler Ultrasonography

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Author : Viken L. Babikian
language : en
Publisher: Butterworth-Heinemann
Release Date : 1999

Transcranial Doppler Ultrasonography written by Viken L. Babikian and has been published by Butterworth-Heinemann this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Medical categories.

The Second Edition of this highly regarded text provides a current reference source on the clinical and research applications of Transcranial Doppler (TCD) ultrasonography. All of the chapters have been updated to reflect the rapid evolution that has taken place in the field. New information has been included on the increased use of TCD in the operating room, the introduction of contrast media, and the development of new softwares that permit the detection of microemboli.

Ultrasound Guided Regional Anesthesia

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Author : Stuart A. Grant
language : en
Publisher: Oxford University Press
Release Date : 2016

Ultrasound Guided Regional Anesthesia written by Stuart A. Grant and has been published by Oxford University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016 with Medical categories.

This book provides a detailed, stepwise approach to performing ultrasound guided regional anesthesia, identifying pearls and pitfalls to ensure success. Basic principles are covered, followed by techniques for upper extremity, lower extremity, and chest, trunk and spine nerve blocks. Each nerve block is comprehensively explained, divided up by introduction, anatomy, clinical applications, technique, alternate techniques, complications, and pearls.