Healthcare Delivery

State the topic

A comparative quantitative analysis of how many admissions at St. Mary's Hospital vs. University of Minnesota Medical Center using Minnesota Hospitals Admissions by Care Unit Database

Identify the hypothesis

St. Mary's Hospital acute care admissions are higher and used more than University of Minnesota Center.

Literature Review (1 - 2 pages)

Using the Minnesota hospitals admission by care unit database for the year 2012, our topic is to compare the number of admissions in St. Mary’s and the University of Minnesota hospital center. We chose these two organizations because of their important number of admissions.

What have been published in the database that we used to analyze the admissions in St. Mary and UMHC are the different number of admissions for acute care and non- acute care during the year 2012.  At first glance, the database shows that St. Mary has more admissions than the University of Minnesota Hospital Center. Being the database of Minnesota hospitals admission by care unit, we can deduct that the present data are accurate and correct. While Saint Mary’s has 40,615 admissions for acute care, UMHC has 34,416. St. Mary’s do not have any admissions for acute care and UMHC do have 1,971.  St. Mary hospital is located in Rochester, a city with a population of 106,769 according to the 2010 United States census in the Olmsted county. Rochester being the seat of the county, the big number of non-acute admission at St. Mary’s is just normal.

The number of admissions in a hospital can be related to many reasons that a hospital may not even be aware of. Some organizations just do not have the power to influence how many patients they receive a year on acute and non-acute care. The primary reason is specialty. A hospital with many specialties will definitely see itself having more patients than a one with few specialties. In the article “Shift to outpatient care, payer pressure hit hospitals”, the authors Kutcher and Evans mention that hospitals that will do well are those that tap into the demand from the growing number of older Americans, as well as for specialty service lines such as orthopedics and oncology (2013). The generation of baby boomers already starting to turn 65 and will more and more need services related to aging. Hospitals that get that can start providing these services in other to have more patients. Another reason that affects the number of admission is the reimbursement by government payer such as Medicare and Medicaid. These programs want to reduce the number of readmission making hospitals keep lot of Medicare patients longer for proper and thorough care aiming to avoid readmission that can tarnish their image. Payers are also reducing volume at some facilities and increasing it at others by creating narrow provider networks, which direct patients to hospitals and medical groups showing high marks on measures of quality and cost-effectiveness. The more efficient a hospital is, the more admission it will get. It is matter of quality of care.

The drop in admissions is also related to the U.S. healthcare system's success stories, such as treating heart patients effectively without hospitalization.  Some health conditions are treated in less time and short sequels of visit making it unnecessary for the patient to stay in a hospital for the whole length of treatment. St. Mary’s is a 1,265-bed hospital with 55 operating rooms. It offers many cutting-edge services, including a Level One Trauma Center, computer-assisted neurosurgery and heart transplant. No wonder it has more admissions than University of Minnesota Hospital center.

By using the cross tabulation method, the data between the two hospitals can be compared and a pattern can be identified. In the article, Using Cross Tabulation and Chi-Square: The Survey Says… the author explains the use of Minitab and how to customize tables to analyze data using the methods of cross tabulation and Chi-Square. Eston Martz (2012) states we can use cross tabulation and Chi-Square analysis to summarize observations by categories. In order to conduct cross tabulation and Chi-Square analysis, data must be collected on categorical variables. The data must be placed in its own column if using statistical software with each row signifying one respondent in the survey (Martz, 2012). The author explains how the Chi-Square test further helps to determine if two variables are associated based on the distribution of one variable compared to a second (Martz, 2012). With Chi-Square, the researcher should compare the p-value to the alpha-level to determine if the variables are associated or independents. If the p-value is less than or equal to the alpha, the variables are associated; if the p-value is greater than alpha, they are independent of each other (Marz, 2012). The author concludes the article with letting the reader know that to find out more about the strength of the association and statistical software; they must include Cramer’s V-square, Goodman-Kruskal lamba, and tau statistics (Marz, 2012).

Boston University Metropolitan College’s Introduction to Cross-Tabulation begins by reintroducing statistical techniques that focus on one variable at a time. It then goes on to introduce the concept of univariate, bivariate, and multivariate and explains that the lesson will be focusing primarily on cross-tabulation when there are nominal or ordinal variables in a table. According to the text, “Cross-tabulation is one important approach to bivariate analysis aimed at explaining the relationships between variables and uncovering the regular patterns among events and variables” (Introduction to Cross-Tabulation, 2015).

Health care database description. Include a description of the data, i.e. sampling frame (One paragraph description. Students are required to use one of the databases available in Course Content> week 6.)

The data being used for this qualitative analysis is current as of February 6, 2014 and describes the admissions to two of the hospitals in Minnesota organized by care unit within the hospitals. The two hospitals are St. Mary's hospital and University of Minnesota Medical Center - Fairview. The source of this information is the Health Care Cost Information System Hospital Annual Report Data. St. Mary's Hospital is located in Rochester and is associated with the Mayo Clinic. The University of Minnesota Medical Center - Fairview is located in Minneapolis and is associated with Fairview Health Services. St. Mary's hospital is significantly larger with 1700 licensed beds and 168 licensed bassinets. The University of Minnesota trails behind with 1265 licensed beds and 26 bassinets. The following admissions are for St. Mary's hospital: Med/Surg unit: 14,516, Cardiac: 8,520, Chemical dependency: 408, Mental Health: 2,466, Neurology: 4,091, Neonatal (excluding routine births): 283, Obstetrics: 73, Orthopedic: 4,032, Rehabilitation: 718, Other: 4,356. The total amount of admissions for the preceding acute care units was 40,615. The following admissions are for The University of Minnesota: Med/Surg unit: 9,492, Cardiac: 2,528, Chemical dependency: 1,525, Mental Health: 6,309, Neurology: 1,589, Neonatal (excluding routine births): 1,183, Obstetrics: 2,820, Orthopedic: 2,682, Rehabilitation: 546, Other: 4,416. The total amount of admissions for the preceding acute care units was 34,416 (Minnesota Hospitals Admissions by Care Unit of the Hospital, Fiscal Year 2012, 2014).

Indicate your variables of interest and justify your choice (1 -2 paragraph description of the variables you selected and why.)

In any a hospital set up, there are several factors that are taken in to account when collecting patients’ medical data. These variables may be used to measure the efficacy of a certain health facility. In the extraction for the two Minnesota Hospital admissions, we have two hospitals to make comparisons from. The dependent variable, being the care unit for the hospitals, is divided into two subcategories. We have the acute care units and the non-acute care unit. We need to assess the two levels of care across the two hospitals, making the two hospitals our variables of interest in studying the care units of the hospitals. Under these two hospitals, we have those individual factors that will enable us to compare the care units for individual hospitals; these we shall consider sub variables of our independent variables. These sub variables measured in that day include the bed capacity licensed, bassinets, beds available, medical surgeries, cardiac admission, chemical dependency admissions, neurology admissions, neonatal routines, obstetrics admissions, orthopedic admissions, other acute care specialty admissions, and the balancing admissions.  Under non acute care, we have births, swing beds, transactional care admissions, and other non-acute care admissions. After having identified these variables of interest, we can measure the wider aspect of care offered by the hospitals and make a comparison amongst them. This will help establish the performance between the two and also know if there is enough room for service delivery within the two hospitals.

Indicate the statistical analysis method you plan to use in Assignment #3 (1 -2 paragraph description of the variables you selected and why.)

The statistical analysis method chosen is the cross tabulation method. This method is used 90% in all research analysis due to the fact that it one of the most useful tools when collecting data (Introduction to Cross-Tabulation, 2015). The cross tabulation method is a two, can be more, dimensional table that allows the relationship between two variables to be compared (Introduction to Cross-Tabulation, 2015). The cross tabulation method consists of a table that will list the different variables and their percentages in two different categories (Martz, 2012).

This method will work for the quantitative project because it will show the difference in the two hospitals and how many admissions at Saint Mary's Hospital vs University of Minnesota Medical Center using Minnesota Hospitals Admissions by Care Unit Database. The cross tabulation method has a purpose of visually showing the relationship between admissions through the table and will show a pattern between the two hospitals. Having a clear and simple method to use, such as the cross tabulation, will provide the information to conduct the quantitative analysis.

Writes clearly, concisely, and with few errors. APA format is followed. Citations are used. Clearly presents material graphically. Easy to understand.

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