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363 results on '"Becker, Edmund R."'

1. Nurse Work Environment and Hospital-Onset Clostridioides difficile Infection

Author

Jung, Olivia S, Aiken, Linda H, Sloane, Douglas M, Fridkin, Scott K, Li, Yin, Kang, Yu Jin, Becker, Edmund R, Joski, Peter J, and Cimiotti, Jeannie P

Subjects
Health Services and Systems, Nursing, Health Sciences, Clinical Research, Infectious Diseases, Emerging Infectious Diseases, Prevention, Good Health and Well Being, Humans, Clostridioides difficile, Working Conditions, Hospitals, Clostridium Infections, Cross Infection, Clostridioides difficile infection, infection control, infection prevention, work environment, nursing care, Public Health and Health Services, Applied Economics, Health Policy & Services, Applied economics, Health services and systems, Policy and administration
Abstract

BackgroundClostridioides difficile is the leading cause of hospital-onset diarrhea and is associated with increased lengths of stay and mortality. While some hospitals have successfully reduced the burden of C. difficile infection (CDI), many still struggle to reduce hospital-onset CDI. Nurses-because of their close proximity to patients-are an important resource in the prevention of hospital-onset CDI.ObjectiveDetermine whether there is an association between the nurse work environment and hospital-onset CDI.MethodsSurvey data of 2016 were available from 15,982 nurses employed in 353 acute care hospitals. These data, aggregated to the hospital level, provided measures of the nurse work environments. They were merged with 2016 hospital-onset CDI data from Hospital Compare, which provided our outcome measure-whether a hospital had a standardized infection ratio (SIR) above or below the national average SIR. Hospitals above the average SIR had more infections than predicted when compared to the national average.ResultsIn all, 188 hospitals (53%) had SIRs higher than the national average. The odds of hospitals having higher than average SIRs were significantly lower, with odds ratios ranging from 0.35 to 0.45, in hospitals in the highest quartile for all four nurse work environment subscales (managerial support, nurse participation in hospital governance, physician-nurse relations, and adequate staffing) than in hospitals in the lowest quartile.ConclusionsFindings show an association between the work environment of nurses and hospital-onset CDI. A promising strategy to lower hospital-onset CDI and other infections is a serious and sustained commitment by hospital leaders to significantly improve nurse work environments.

Published
2023

27. The impact of electronic health records on workflow and financial measures in primary care practices

Author

Fleming, Neil S., Becker, Edmund R., Culler, Steven D., Cheng, Dunlei, McCorkle, Russell, Graca, Briget da, and Ballard, David J.

Subjects
Medical records -- Analysis, Family medicine -- Analysis, Electronic records -- Analysis, Workflow software, Business, Health care industry
Abstract

Objective. To estimate a commercially available ambulatory electronic health record's (EHR's) impact on workflow and financial measures. Data Sources/Study Setting. Administrative, payroll, and billing data were collected for 26 primary care practices in a fee-for-service network that rolled out an EHR on a staggered schedule from June 2006 through December 2008. Study Design. An interrupted time series design was used. Staffing, visit intensity, productivity, volume, practice expense, payments received, and net income data were collected monthly for 2004-2009. Changes were evaluated 1-6, 7-12, and >12 months postimplementation. Data Collection/Extraction Methods. Data were accessed through a SQLserver database, transformed into SAS®, and aggregated by practice. Practice-level data were divided by full-time physician equivalents for comparisons across practices by month. Principal Findings. Staffing and practice expenses increased following EHR implementation (3 and 6 percent after 12 months). Productivity, volume, and net income decreased initially but recovered to/close to preimplementation levels after 12 months. Visit intensity did not change significantly, and a secular trend offset the decrease in payments received. Conclusions. Expenses increased and productivity decreased following EHR implementation, but not as much or as persistently as might be expected. Longer term effects still need to be examined. Key Words. Electronic health records, workflow, financial performance, Despite electronic health records' (EHRs') perceived potential to improve care, the 2011 National Ambulatory Medical Care Survey revealed that only 55 percent of U.S. physicians had adopted an EHR (Jamoom [...]

Published
2014
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31. Cost and cost-effectiveness of an early invasive vs conservative strategy for the treatment of unstable angina and non-ST-segment elevation myocardial infarction

Author

Mahoney, Elizabeth M., Jurkovitz, Claudine T., Chu, Haitao, Becker, Edmund R., Culler, Steven, Kosinski, Andrzej S., Robertson, Debbie H., Alexander, Charles, Nag, Soma, Cook, John R., Demopoulos, Laura A., DiBattiste, Peter M., Cannon, Christopher P., and Weintraub, William S.

Subjects
Transluminal angioplasty -- Evaluation, Unstable angina -- Care and treatment, Heart attack -- Care and treatment
Abstract

Performing angioplasty on patients with unstable angina or a form of heart attack called non-ST-segment elevation heart attack may be cost-effective, according to a study of 2,220 patients. Angioplasty uses a balloon-tipped catheter to open up blocked arteries.

Published
2002

36. Inpatient uterine fibroid costs and complications: national trends and impacts on health care costs

Author

Becker, Edmund R., Fuldeore, Mahesh J., Horowitz, Ira R., and Dabbous, Omar H.

Subjects
Medical care, Cost of -- Reports, Uterine fibroids -- Diagnosis, Uterine fibroids -- Care and treatment, Uterine fibroids -- Complications and side effects, Business, Health care industry
Abstract

Objective: To report national uterine fibroid inpatient charges, costs, lengths-of-stay, and complications by major inpatient treatments and estimate the national costs of uterine fibroids and their complications. Methods: We analyzed [...]

Published
2008

39. National trends and determinants of hospitalization costs and lengths-of-stay for uterine fibroids procedures

Author

Becker, Edmund R.

Subjects
Medical care, Cost of -- Research, Uterine fibroids -- Research, Uterine fibroids -- Economic aspects, Uterine fibroids -- Care and treatment, Business, Health care industry
Abstract

Uterine fibroid admissions in the nation's hospitals have grown more than 20 percent over the past five years. Substantial variations exist in inpatient treatment patterns. In spite of this dramatic [...]

Published
2007

44. Organizational rationality, performance, and social responsibility: results from the hospital industry

Author

Becker, Edmund R. and Potter, Sharyn J.

Subjects
Hospitals -- Finance, Health care industry -- Finance, Corporate social responsibility -- Analysis, Business, Health care industry
Abstract

Drawing on stakeholder theory and Weber's distinction between formal and substantive rationality, we posit that: (1) for-profit organizations manage stakeholders in ways that result in the organization being more efficient [...]

Published
2002

45. Payment levels, resource use, and insurance risk of Medicaid versus private insured in three states

Author

Adams, E. Kathleen, Bronstein, Janet M., Becker, Edmund R., and Hood, Cheryl Raskind

Subjects
Medicaid -- Prices and rates, Medical care -- Prices and rates, Health care industry -- Prices and rates, Business, Health care industry
Abstract

Concerns with access and costs in the Medicaid program often lead policy makers to consider alternatives. These include subsidizing poor persons' purchases of health insurance in private markets or integrating [...]

Published
2001

47. Physician services in an academic neurology department: using the resource-based relative-value scale to examine physician activities

Author

Becker, Edmund R. and Hall, Kareen

Subjects
Physicians -- Services, Neurologists -- Services, Hospitals, University -- Services, Relative value scale payment systems (Medical care) -- Usage, Medical fees -- Analysis, Business, Health care industry
Abstract

An analysis of physician services in an academic medical center's neurology department in 1995 using physician work relative value units in the Medicare Fee Schedule is offered. Additional information on the physician charges for neurological services is also included.

Published
2001

50. Superbugs vs.Outsourced Cleaners: Employment Arrangements and the Spread of Healthcare-Associated Infections

Author

Litwin, Adam Seth, Avgar, Ariel, and Becker, Edmund R.

Subjects
Health Care, 111708 Health and Community Services, FOS: Political science, 111709 Health Care Administration, 111799 Public Health and Health Services not elsewhere classified, 160508 Health Policy, FOS: Health sciences
Abstract

On any given day, about one in 25 hospital patients in the U.S. has a healthcare-associatedinfection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately,the spread of most HAIs can be halted through proper disinfection of surfaces and equipment.Consequently, cleaners—“environmental services” (EVS) in hospital parlance—must take on theimportant task of defending hospital patients (as well as employees and the broader community)from the spread of HAIs. Nevertheless, despite the importance of this task, hospitals frequentlyoutsource this function, increasing the likelihood that these workers are under-rewarded,undertrained, and detached from the organization and the rest of the care team. As a result, theoutsourcing of EVS workers could have the unintended consequence of increasing the incidenceof HAIs. We demonstrate this relationship empirically, finding support for our theory by usinga self-constructed dataset that marries infection data to structural, organizational, and workforcefeatures of California’s general acute care hospitals. The study thus advances the literature onnonstandard work arrangements—outsourcing, in particular—while sounding a cautionary noteto hospital administrators and healthcare policymakers.

Published
2018
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