Forty-six million individuals in the United States used tobacco products. People who use tobacco products attempt numerous strategies before giving up smoking habit altogether. The goal of this project was to evaluate the impact of a tobacco cessation program by evaluating pre-and post-cessation program data, and hospital records of participants attending the hospital smoking cessation program over a 6-month period to ascertain the degree of reduction in tobacco use and hospitalization from smoking-related diseases. The population sample comprised of both men and women between the ages of 18 years and above. The project question addressed whether the smoking cessation program had an impact on reducing the rate of tobacco use and hospital readmissions after attending a cessation program at a medical center. A paired samples t-test was conducted to analyze the pretest and posttest results. There was a statistically significant decrease (p <.001) in the participants' (N=49) rate of smoking after completing the smoking cessation program that lasted 6 months. The mean on smoking cessation pre-participation was 13.7 (SD = 1.56). The mean on smoking cessation post-six months participation was 6.67 (SD = 1.81). There was a statistically significant decrease in the rate of hospital admissions among participants. The mean on pre-participation hospital admissions was 4.18 (SD = .727). The mean on post-participation hospital admissions was 1.41 (SD = .643). Smoking cessation programs impact social change by improving the quality of life of participants and their families and decreasing the financial impact of hospital readmission cost

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Thesis (M.S.)--Boston University

Hospital acquired pneumonia (HAP) causes significant mortality and morbidity and is now no longer reimbursed by Centers for Medicare and Medicaid (CMS). For all of these reasons, hospitals want to minimize their HAP rates. Aggressive oral care (tooth brushing 3 times a day) has been shown to reduce the incidence of HAP in the intensive care unit setting, but this has not been tested in the acute care setting, in which patients are more stable, less sick, and more ambulatory. In an attempt to address HAP rates in acute care settings, this clinical trial entailed providing all patients in four wards with a 3 times per day tooth-brushing oral care protocol, which was implemented or supervised by the nurses on each ward. Six matched wards on a separate campus that received normal standard of care served as controls. The goal of this clinical trial was to cut the pneumonia rate in half, from 2% to 1%. This clinical trial was conducted to determine whether an oral care regimen would reduce the incidence of aspiration pneumonia over the three months of intervention in the experimental group (HAC) versus the control group (ENC) from Nov 5, 2012 to Feb 15, 2013.

Thesis (M.S.)--Boston University

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Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Managed care health plans have become an important new force in the US health care system, changing the delivery of health care and the nature of competition in the health care industry. Lower health care costs of managed care emollees have led many to see 'managed care' as the solution to rising health care expenditures. Therefore, it is important to understand the impact of managed care on the health care industry. This dissertation focuses on the impact of 'managed care' on the acute care hospital industry and physicians who work in inpatient settings, using data on hospitals in Massachusetts between 1992 and 1998. In the first essay, I investigate the impact of managed care penetration on the prices and costs of hospitals. Managed care plans provide coverage for health care through a predetermined group of providers selected by the plan. Their ability to direct demand potentially gives them power to extract lower prices from providers. However, the impact of managed care penetration on prices for the overall patient population depends on whether hospitals raise prices to non-managed care insurers. Using instrumental variables estimation, I find evidence that managed care penetration leads to significant reductions in hospital prices and costs for the overall patient population. Managed care involves methods of financing and delivering health care services that manage, or intervene, in care decisions made by patients and physicians in order to reduce costs. The second essay empirically investigates whether managed care plans are able to reduce the resource use of physicians in inpatient settings. Using instrumental variables estimation, I find evidence that managed care involvement reduces physicians' resource use not only for managed care patients but for nonmanaged care patients as well. / 2999-01-01

This study examines the significance of quality when included in the specification of a hospital cost function. Also, this research estimates a value for scale economies in order to determine if the average hospital experiences increasing returns to scale in the production of hospital care, verifying such findings in previous econometric studies. Furthermore, two functional forms are compared: the Cobb-Douglas and the translog. The results of this study demonstrate that quality has a significant impact on costs. This relationship is positive meaning increasing quality will also increase the cost of producing hospital care. The results for scale economies demonstrate that the average hospital experiences increasing returns to scale in the production of hospital care, which is consistent with previous research. Lastly, based on an F-test, this study is able to accept the translog as the appropriate functional form. / Master of Arts