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The comparison of prevalence, medical expenditure and related factors between open appendectomy and laparoscopic appendectomyVi Lu, David 12 August 2009 (has links)
Abstract
Background and Objectives:
Since 1894, open appendectomy (OA) has been the treatment of choice for acute appendicitis. In 1981 Semm performed the first laparoscopic appendectomy (LA). More than 2 decades later, the benefits of LA are still controversial. The goal of the present investigation was to compare the effectiveness of LA and OA based on a large administrative (The Bureau of National Health Insurance, BNHI) Research Database. The source of data analyzed was the administrative claims data from the BNHI Research Database.
Methods:
The objective of this retrospective study was based on the ICD-9-CM procedure code of 4701 (Laparoscopic appendectomy, LA) and 4709 (Open appendectomy, OA) respectively from a database of 20 million insurance population, Separate analyses were performed for uncomplicated (ICD-9-CM, 540.9) and complicated (presence of appendiceal perforation or abscess; ICD-9-CM 540.0 and 540.1) appendicitis. Exclusive criteria were: (1) Average length of stay exceeds 3 S.D. (n=1,262). (2) Gender unmentioned (n=243). All these data will analyze in multiple dimensions including length of hospital stay, in-hospital complications, in-hospital mortality, and rate of routine discharge between laparoscopic (LA) and open appendectomy (OA) based on The Bureau of National Health Insurance (BNHI) database.
Results:
We enrolled 11,118 patients underwent LA and 47,725 patients underwent OA during 2004 to 2007. The prevalence of LA increases gradually from 6.97 per 100,000 populations in 2004 to 21 per 100,000 populations in 2007. The prevalence of OA decreases gradually from 57.5 per 100,000 populations in 2004 to 44.86 per 100,000 populations in 2007. Patients underwent LA (3.25¡Ó1.51day) have significant lower length of hospital stay than OA (3.57¡Ó1.49 day) (p<0.001). We also found the trend that the annual medical expenditure of LA increases gradually but OA decreases gradually. In general, LA spends higher medical expenditure than OA. With respect to medical expenditure, higher length of hospital stay and co-morbidity are associated with more medical expenditure significantly.
Conclusions:
LA is the current developing trend of surgical treatments for appendicitis. LA can reduce length of hospital stay significantly. OA can reduce the medical expenditure in Taiwan. In our opinion, the results represent the native data in Taiwan and are very important for a good administration of public resources distribution.
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Empirical Likelihood Inference for the Accelerated Failure Time Model via Kendall Estimating EquationLu, Yinghua 17 July 2010 (has links)
In this thesis, we study two methods for inference of parameters in the accelerated failure time model with right censoring data. One is the Wald-type method, which involves parameter estimation. The other one is empirical likelihood method, which is based on the asymptotic distribution of likelihood ratio. We employ a monotone censored data version of Kendall estimating equation, and construct confidence intervals from both methods. In the simulation studies, we compare the empirical likelihood (EL) and the Wald-type procedure in terms of coverage accuracy and average length of confidence intervals. It is concluded that the empirical likelihood method has a better performance. We also compare the EL for Kendall’s rank regression estimator with the EL for other well known estimators and find advantages of the EL for Kendall estimator for small size sample. Finally, a real clinical trial data is used for the purpose of illustration.
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NEZAMĚSTNANOST MLADÝCH LIDÍ V ČESKÉ REPUBLICE / Unemployment of young people in Czech RepublicZemanová, Ivana January 2013 (has links)
This thesis focuses on unemployment of young people. Young people are among disadvantaged groups in the labor market, so they are given special attention. The main goal of this work is to analyze unemployment of young people in the Czech Republic, monitor its development and evaluate the changes. Attention is paid to the relationship between unemployment and education. The indicator of average length of education is used along with educational structure to evaluate the level of education. The work also focuses on the economic activity of young people, which has significantly reduced in recent years. At the end of this thesis is analyzed unemployment and education of young people in the regions of the Czech Republic.
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Tamanho amostral para estimar a concentração de organismos em água de lastro: uma abordagem bayesiana / Sample size for estimating the organism concentration in ballast water: a Bayesian approachCosta, Eliardo Guimarães da 05 June 2017 (has links)
Metodologias para obtenção do tamanho amostral para estimar a concentração de organismos em água de lastro e verificar normas internacionais são desenvolvidas sob uma abordagem bayesiana. Consideramos os critérios da cobertura média, do tamanho médio e da minimização do custo total sob os modelos Poisson com distribuição a priori gama e binomial negativo com distribuição a priori Pearson Tipo VI. Além disso, consideramos um processo Dirichlet como distribuição a priori no modelo Poisson com o propósito de obter maior flexibilidade e robustez. Para fins de aplicação, implementamos rotinas computacionais usando a linguagem R. / Sample size methodologies for estimating the organism concentration in ballast water and for verifying international standards are developed under a Bayesian approach. We consider the criteria of average coverage, of average length and of total cost minimization under the Poisson model with a gamma prior distribution and the negative binomial model with a Pearson type VI prior distribution. Furthermore, we consider a Dirichlet process as a prior distribution in the Poisson model with the purpose to gain more flexibility and robustness. For practical applications, we implemented computational routines using the R language.
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Tamanho amostral para estimar a concentração de organismos em água de lastro: uma abordagem bayesiana / Sample size for estimating the organism concentration in ballast water: a Bayesian approachEliardo Guimarães da Costa 05 June 2017 (has links)
Metodologias para obtenção do tamanho amostral para estimar a concentração de organismos em água de lastro e verificar normas internacionais são desenvolvidas sob uma abordagem bayesiana. Consideramos os critérios da cobertura média, do tamanho médio e da minimização do custo total sob os modelos Poisson com distribuição a priori gama e binomial negativo com distribuição a priori Pearson Tipo VI. Além disso, consideramos um processo Dirichlet como distribuição a priori no modelo Poisson com o propósito de obter maior flexibilidade e robustez. Para fins de aplicação, implementamos rotinas computacionais usando a linguagem R. / Sample size methodologies for estimating the organism concentration in ballast water and for verifying international standards are developed under a Bayesian approach. We consider the criteria of average coverage, of average length and of total cost minimization under the Poisson model with a gamma prior distribution and the negative binomial model with a Pearson type VI prior distribution. Furthermore, we consider a Dirichlet process as a prior distribution in the Poisson model with the purpose to gain more flexibility and robustness. For practical applications, we implemented computational routines using the R language.
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Motivy vybraných segmentů cestovního ruchu k návštěvě České republiky / The motives of selected travel segments for the visit to the Czech RepublicValentová, Jana January 2011 (has links)
This Ph.D. thesis is aimed at inbound tourism in the Czech Republic, analysis of statistical data and their development in the period of years 2004 -- 2013, characteristics of the main source markets for the Czech Republic, and analysis of motives regarding participants of outbound tourism to the Czech Republic in the observed countries. The principal aim is to analyze and compare intensity of motives of the selected geographic, demographic, socio-economic, and behavioral segments for visits to the Czech Republic. An integral part of the aim is to suggest further possibilities of the motivation research and their exploitation in the marketing practice of the tourism industry. The author defines all theoretical terms closely connected with the tourism market segmentation, motives and motivations to travel including interesting view of them throughout history. It is evident that the travel motives influenced by various factors are differentiated parallely with the human society development. The author characterizes the Czech Republic destination offer and evaluates its inbound tourism in the period of years 2004 -- 2013 by means of 4 main indicators: number of guests, number of overnight stays, average length of stay, foreign currency incomes. The author also evaluates the researches focused on perception of the Czech Republic abroad that was carried out by the institutions representing the Czech Republic abroad. The detailed analysis of travel motivations was performed by the author herself in the form of questionnaires. Results of these analyses bring impulses to other possibilities of the research in the field of inbound tourism not only in the academic sphere but also in research work of state and public authorities, and in practice when creating tourism products and communications mix.
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Cost analysis of economic impact of HIV and AIDS on length of stay in one hospital in the northern Cape Province in South AfricaGumbo, Nomhle Orienda 11 1900 (has links)
Background and purpose. The purpose of the study was to determine the costs incurred on the average length of stay (ALOS) on patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) related illnesses admitted in hospital and whether there are any other significant costs involved.
Method. A quantitative approach was used to collect data; analysed; interpretation and report writing. Purposive sampling and data collection was done using data collection sheet. This was a retrospective cost analysis data from in-patients records (record review) of ages from 15 years to 49 years both gender. Data analysis and presentation of information was presented by the use of tables; different types of graphs and the interpretation thereof.
Results. The study found that males (63%) with HIV Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) related illnesses had longer average length of stay in a hospital compared to females. However, females illustrated higher in-patient costs but majority of patients had costs of between R0–R17 500. Patients with longer hospital stay (>3 days of hospitalisation) had higher in-patient costs.
Conclusion. The findings also showed that in-patient care costs were directly proportional to length of stay with higher costs for HIV and AIDS patient management care. Our findings are consistent with other studies regarding higher economic implications of care for HIV infected persons being almost as twice as people who are HIV negative due to longer periods of hospitalisation. / Health Studies / M.A. (Public Health)
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