Objective: Since its implication, case payment system prevailed and increased cases number in the following years. Hospitals in Taiwan face continous challenge with emerging policies such as global budget and TW-DRG system, which is soon on the way. Remarkable medical resource comsuption is seen in patients with congenital heart deseases, with presence of structural heart defects at birth. The corrective treatment of congenital heart diseases, surgical and transcather, is usually undertaken in large-scale Hospitals in Taiwan.Congenital heart diseases. Items of case payment for congenital heart diseases treatment were implented years ago. However, in the literature there is yet no research about the results of its implentation. This study focus on three objectives: 1.To study of medical resource consumption of case payment system with congenital heart diseases. 2.To study the effect of patient and provider attributes on medical resource consuption in the case payment with congenital heart diseases. 3.To provide the evidence-based information for forcoming NHI policies. Materials and Methods: Retrospectively, claims data from Bureau of National Health Research Insurance (BNHI) for resource utilization of case payment for congenital heart diseases was analyzed. The data includes DD(Inpatient expenditures by admissions) and HOSB(Registry for contracted medical facilities) files ranged from 1997 to 2005. Data items meeting the criteria of both CHD and case payment were extracted. The relationships between patient factors (age, sex, DRG code), healthcare provider (contract type, accreditation type, ownership, area) and resource utilization (length of stay, expenditure) were studied. Results: A total of 4,366 admissions for CHD case payment was enrolled. The mean patients¡¦ age is 14.56 years. Female accounts for 55.46 % of the admissions. Among them there are 3954 open heart surgeries and 412 transcatheter treatments. Average hospital day is 11.6 and 3.37 days respectively. Average payment per case is NT$215,355 and NT$61,819 respectively. Different degrees of resource utilization occur with different patient or hospital characteristics, with statistical signifcance. More resource utilization tends to occur in extremes of age groups, e.g., newborn and elderly populations, regardless open heart surgery or transcatheter treatment cases. Also more hospital fee occurred in private hospital than public hospital, but less in medical centers when compared to metropolitian hospitals. For regression analysis of dependence of resource consumption on patient and hospital factors, the overall power of explanation is higher in transcather treatment cases. Among the factors influencing medical resource utilization, age_group and ownership are respectively the most significant factors. Conclusion: We have verify the hypothesis in this study, which emphasize that resource utlization differs by different patient and hospital factors. The pattern of resource utilization for this unique disease (CHD) and its discrepancy with concurrent payment criteria are evaluated in this study. Based on our results, adjustment of payment criteria should be reasonable to ensure early and adequate treatment for these patients. Thus this study provides strong insight for implication of TW-DRG for disease management. Further study will include aspects of resource utlization such as direct, indirect costs, tangle and intangle, and related complication and comorbidities.

Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 57-62).

The diffusion of sales force automation (SFA) systems has enabled a far more systematic approach to sales force management. This opens new avenues for the academic study of the industrial selling process as well: new arenas for investigation, new windows into salesperson behavior, and new methodological pitfalls. The purpose of this dissertation is to develop a better understanding of SFA from an academic perspective, and then apply these insights to resolve gaps in our understanding of how sales forces behave and how they might be better managed. To do this, three areas of analysis are explored: methodological, behavioral, and theoretical.

published_or_final_version / Medicine / Master / Master of Philosophy

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Cloud computing stands as a revolution in IT world in recent years. This technology facilitates resource sharing by reducing hardware costs for business users and promises energy efficiency and better resource utilization to the service providers. CPU utilization is a key metric considered in resource management across clouds. The main goal of this thesis study is directed towards investigating CPU utilization behavior with regard to host and guest, which would help us in understanding the relationship between them. It is expected that perception of these relationships would be helpful in resource management. Working towards our goal, the methodology we adopted is experi- mental research. This involves experimental modeling, measurements and observations from the results. The experimental setup covers sev- eral complex scenarios including cloud and a standalone virtualization system. The results are further analyzed for a visual correlation. Results show that CPU utilization in cloud and virtualization sce- nario coincides. More experimental scenarios are designed based on the first observations. The obtaining results show the irregular behav- ior between PM and VM in variable workload. CPU utilization retrieved from both cloud and a standalone system is similar. 100% workload situations showed that CPU utilization is constant with no correlation co-efficient obtained. Lower workloads showed (more/less) correlation in most of the cases in our correlation analysis. It is expected that more number of iterations can possibly vary the output. Further analysis of these relationships for proper resource management techniques will be considered.

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