Thesis (M.S.)--University of Michigan, 1993.

Day care surgical services have been marketed as a cost saving alternative for inpatient care. There is evidence that the cost per episode of day care surgery is 50-70 percent less than a comparable episode in an inpatient ward. In addition, avoiding hospitalization has particular relevance for paediatrics, because of the undesirable effects of hospital stay on children. However, both cost savings and the quality-based need to decrease hospitalizations of children will be fullfilled only if each patient cared for in a day care surgery unit would otherwise have been an inpatient and the bed vacated by day care surgery use would not be filled in by other patients. In a previous B.C. study based on the total population a significant component of day care surgery was found to augment total utilization, suggesting generation of surgical activity rather than substitution. The present study was designed to examine the substitution/generation issue in the paediatric (0-14 years) population, both because experts questioned the generalizability of the findings to the paediatric population, and because of the dramatic reduction in paediatric utilization in Canada during the period since the mid-1960s. The contention was that the introduction of day care surgery may have been an important factor in this downtrend. The relationship between paediatric day care surgery use and hospital inpatient utilization was analyzed in B.C. in each of the years 1968-1976 and 1981/82-1982/83 and using a time series/cross-section study design. The data frame consisted of all B.C. school districts, in each of the study years, yielding 825 data points. Using a multivariate regression analysis, it was possible to estimate what hospital utilization patterns would have been in the absence of day care surgery capacity, and hence isolate estimates of the net impact of day care surgery on paediatric inpatient use. Findings on the relationship between day care surgery use and paediatric medical/surgical and surgical inpatient utilization strongly support the view that paediatric day care surgery has been largely an add-on to the total hospital care system. Statistically significant substitution effect was revealed only for the most narrowly defined inpatient surgery category which more closely resembled day care surgery-type cases, after controlling for potential confounding effects of age and sex, paediatric bed capacity, different socioeconomic characteristics and time- and district-specific factors. Even here, less than 10 percent of day care surgery represented substitution for inpatient surgery and over 90 percent appeared to be generation of new activity to the hospital system as a whole. Furthermore, paediatric beds which were "saved" by day care surgery use were filled with increased utilization by non-day care surgery eligible surgical patients and by medical cases. The main driving force behind hospital utilization in the 0-14 year age group was paediatric bed availability even after standardization for age, sex, physician stock, measures of socioeconomic status, and other district- and year-specific effects. According to this study paediatric day care surgery has not been a cost saving alternative for inpatient care in B.C. in 1968-1982/83. Neither has it reduced overall hospitalizations in the paediatric population. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

No description available.

Insurance is a vital factor in the billed cost to the patient, but to what degree does insurance explain the amount a patient is left to pay? Also, does obesity further influence patient’s billed cost? This thesis assesses the type of thoracic trauma patient, insurance status, and their billed cost. Database variables were analyzed in IBM SPSS 25. Table 1 characteristics were evaluated based on demographics and systematic hospital factors. Linear regressions used Private0_Government1 and BMI Obese n_y_ as independent variables while Total Patient Cost was the dependent variable. Private0_Government1 insurance explained .03% of Total Patient Charges. Private0_Government1 and BMI Obese n_y_ explained 1.4% of Total Patient Charges. Private0_Government1 and BMI Obese n_y_ explained a low percentage of Total Patient Charges. This shows that there are factors other than insurance type and obesity that are influential upon patient charges.

No description available.

Thesis (M.H.A.)--University of Michigan, 1968.

Thesis (M.H.S.A.)--University of Michigan, 1984.

Thesis equivalent submitted in partial fulfillment of the requirements for the degree of Master of Hospital Administration, University of Michigan, 1972. / "Field work in Hospital Administration III."

Thesis (M.H.A.)--University of Michigan, 1968.

Thesis equivalent submitted in partial fulfillment of the requirements for the degree of Master of Hospital Administration, University of Michigan, 1972. / "Field work in Hospital Administration III."