Hasil untuk "United States"

Cynthia L Ogden, M. Carroll, K. Flegal

L. Kann, S. Kinchen, S. Shanklin et al.

T. A. Dolecek, J. M. Propp, N. Stroup et al.

J. Fry, G. Xian, Suming Jin et al.

L. Kann, Tim Mcmanus, W. Harris et al.

B. Plassman, K. Langa, Gwenith G Fisher et al.

Gary Solon

R. Lipton, W. Stewart, S. Diamond et al.

J. Birkmeyer, A. Siewers, E. Finlayson et al.

G. Armstrong, A. Wasley, Edgar P. Simard et al.

D. Addiss, N. Shaffer, Barbara S. Fowler et al.

W. Wright

R. Bleicher, K. Ruth, E. Sigurdson et al.

A. Kesselheim, J. Avorn, A. Sarpatwari

A. Goman, F. Lin

K. Kochanek, Sherry Murphy, Jiaquan Xu et al.

H. Lyu, Tim Xu, D. Brotman et al.

Background Overtreatment is a cause of preventable harm and waste in health care. Little is known about clinician perspectives on the problem. In this study, physicians were surveyed on the prevalence, causes, and implications of overtreatment. Methods 2,106 physicians from an online community composed of doctors from the American Medical Association (AMA) masterfile participated in a survey. The survey inquired about the extent of overutilization, as well as causes, solutions, and implications for health care. Main outcome measures included: percentage of unnecessary medical care, most commonly cited reasons of overtreatment, potential solutions, and responses regarding association of profit and overtreatment. Findings The response rate was 70.1%. Physicians reported that an interpolated median of 20.6% of overall medical care was unnecessary, including 22.0% of prescription medications, 24.9% of tests, and 11.1% of procedures. The most common cited reasons for overtreatment were fear of malpractice (84.7%), patient pressure/request (59.0%), and difficulty accessing medical records (38.2%). Potential solutions identified were training residents on appropriateness criteria (55.2%), easy access to outside health records (52.0%), and more practice guidelines (51.5%). Most respondents (70.8%) believed that physicians are more likely to perform unnecessary procedures when they profit from them. Most respondents believed that de-emphasizing fee-for-service physician compensation would reduce health care utilization and costs. Conclusion From the physician perspective, overtreatment is common. Efforts to address the problem should consider the causes and solutions offered by physicians.

R. Bailey, U. Fish

Mohamed Ahmed Mosilhy, Sadiah M A Aljeddani, Mahmoud H Abu-Moussa

This paper discusses the estimation of the discrete mixed Poisson-Erlang distribution (DMPED). Compared to many traditional discrete distributions, DMPED offers several surprising benefits, especially when examining count data with high variation and that are positively skewed. We have explored several statistical characteristics of the assumed distribution, such as moments, the moment-generating function, the failure rate function, the monotonicity of the probability mass function, and a couple of descriptive measures (central tendency and dispersion). We have used the maximum likelihood estimation technique to estimate the parameters of the DMPED. We conducted a simulation study to validate the proposed estimators. Finally, four applications related to cancer diseases have been discussed, where DMPED (especially DMPEIID) fits the number of doses required for treatment, remission times, and therapy type comparisons.