Prior to beginning work on this discussion forum, read the following articles:

· Bending the Cost Curve: Time Series Analysis of a Value Transformation Programme at an Academic Medical Centre

· Geographic Variation in the Delivery of High-Value Inpatient Care

· A New Instrument to Measure High Value, Cost-Conscious Care Attitudes Among Healthcare Stakeholders: Development of the MHAQ

· Reducing Healthcare Costs Through Patient Targeting: Risk Adjustment Modeling to Predict Patients Remaining High-Cost (Links to an external site.)

Watch the following video:

· What If All US Health Care Costs Were Transparent? | Jeanne Pinder (Links to an external site.)

Researchers have documented systematic variation in Medicare spending and health services utilization across various geographic regions for decades. The findings also evidence that high Medicare spending is unrelated to health outcomes. Policymakers have changed Medicare payment systems to promote high-value care. As key stakeholders in the health care delivery system, health care organizations and providers play an important role in health care spending.

You are taking on the role of a new CEO of a hospital that was identified as having high health care cost and utilization. In the first meeting with the board, you are tasked to reduce health care spending and utilization in your hospital. Your board provides a list of factors influencing health care spending and service uses. Your board asks you to prioritize the list and select two to three of the most critical determinants to implement a strategic plan.

Some categories of the factors influencing health care spending and service uses are the following:

· The operating cost regarding the supplies needed to care for patients.

· Diversity within patient populations, patients’ current state of health, access to care, insurance coverage, and patients’ preferences for their care.

· Physicians’ decisions on what care to give and the availability of reliable medical evidence to guide those decisions.

In the next meeting, you are required to present your strategic plan to your board. Be sure to include the appraised factors in the list that you deemed the most important. Justify your rationales for your selections.

In your initial post,

· Propose your solutions to achieve a reduction in health care spending and utilization while maintaining quality of care.

· Support your response with a minimum of two scholarly sources that were published in the last 5 years. Be sure to cite your references using proper APA Style (see APA: Formatting Your References List (Links to an external site.) for assistance).

Your initial discussion thread is due on Day 3 (Thursday) and you have until Day 7 (Monday) to respond to your classmates. Your grade will reflect both the quality of your initial post and the depth of your responses. Refer to the Discussion Forum Grading Rubric under the Settings icon above for guidance on how your discussion will be evaluated.

Prior to beginning work on this discussion forum, read or watch the following:

· Staying on Track in Changing Landscapes: Mapping Complex Projects in Health Services

· Management Tools for Quality Performance Improvement in Italian Hospitals

· Make It Complicated: A Qualitative Study Utilizing a Complexity Framework to Explain Improvement in Health Care

· The Implementation of Change Model Adds Value to Value-Based Healthcare: A Qualitative Study

· Challenges of Quality Improvement in Healthcare (Links to an external site.)

· Institute for Healthcare Improvement (Links to an external site.)

· American Society for Quality (Links to an external site.)

To understand the latest trends in quality improvement (QI), it is necessary to review articles related to health care quality from professional, medical, or health care journals. Research a health care quality improvement project in the library published in the last 5 years.

In your initial post,

· Summarize your selected article by stating the following:

o Introduction and reason for selecting the article.

o Ideas or thoughts presented by the article.

o Your analysis of the article and a critique.

o Conclusion that may be derived from the article.

· Describe a situation or scenario with the identified issue(s) in your current job or a health care setting. Alternatively, you might present a hypothetical situation or scenario.

· Explain how you can apply the lessons learned from that quality improvement project in your selected article to solve the identified issue(s).

o Examples of the lessons learned could be the entire QI project, QI tools, QI strategies, QI methodologies, QI team composite, which you can use to streamline workflow, redesign jobs, and more.

· Hypothesize the desired outcomes.

· Support your response with a minimum of two scholarly sources that were published in the last 5 years. Be sure to cite your resources using proper APA Style (see APA: Formatting Your References List (Links to an external site.) for assistance).

Prior to beginning work on this discussion forum, read the following article:

· A Comprehensive Environmental Scanning and Strategic Analysis of Iranian Public Hospitals: A Prospective Approach

This discussion forum is designed to guide you as you start your research for the Capstone Project. Review the requirements for your Capstone Project: Business Plan in Week 5.

You are planning to own a health care business such as a clinic, home care business, adult day care center, IT or management consulting firm, a small store selling medical supplies, or other health care related business.

In your initial post,

· Describe the mission, vision, nature of your business, services and/or products, stakeholders, and customers of your business.

· Assess the competitive environment of your business (e.g., culture/social, legal/regulatory, economic, technological, and/or competitive factors) along with your major competitors.

Your initial post must be a minimum of 250 words. Support your plan with at least two scholarly sources published within the last 5 years. Relevant professional experience may also be shared. All referenced materials must include citations and references in APA Style 7th edition format. Please see directions for including APA elements on these Writing Center pages: APA: Citing Within Your Paper (Links to an external site.) and Formatting Your References List (Links to an external site.).

 

Descriptive statistics allow us to describe the distribution of a single variable. This is very useful when needing to know the how one parameter behaves, but it does not provide a definitive answer to questions like:
Is the mean above a certain value?
Is the deviation less than a desired amount?
How do the results for two different groups compare?

Hypothesis testing allows a definitive answer to such questions. A hypothesis tests consists of several elements:
i. null hypothesis
ii. test statistic cut-off (value based on the specified confidence interval)
iii. test statistic sample (value based on the data collected)
iv. decision to “reject the null hypothesis” or to “fail to reject the null hypothesis”
v. explanation of what that result meets in context

Give an example of a hypothesis test. You may choose an example from the textbook, an example from another source, or your own example. Be sure that you provide a citation for any example used.

For your hypothesis test example, identify each of the following:

1) null hypothesis – Explain this null hypothesis. Explain what the alternative hypothesis is. Explain what rejecting the null hypothesis would allow you to conclude.

2a) test statistic utilized – Specify what distribution (z, t, chi-squared, F, etc is considered) is considered.
2b) test statistic cut-off – What is the percent confidence and what value does that give for the border between rejecting and failing to reject the null hypothesis?
2c) test statistic calculated – What value does the test statistic have for the data?

3) decision – Is the calculated test statistic greater than or less than the cut-off value? Do you “reject” or “fail to reject” the null hypothesis?

4) explanation – Explain what this decision means in the context of the problem. Be sure you include the percent confidence and the null/alternative hypothesis in your explanation.

 Please attach all the code from R and the output you get. Justify you findings at every step.

Run an OLS regression with price as your dependent variable (using the first 16

regressors).

Include your summary output and the standardized residual-leverage plot. Do you see

any

“problematic” observations? What would that mean? Manually standardize the residuals

and calculate how many standard deviations each is from the residual mean. Which

observations have residuals that are more than 4 standard deviations from the mean?

Describe those observations and whether or not you see implausible values.

After removing any observations for which you DID find implausible values in (1) run the

regression again. Use a Q-Q plot and a Jarque-Bera test to determine whether

residuals appear to be normally distributed. Use a RESET test to determine whether a

linear functional form appears to be appropriate.

Which variables do you think might have nonlinear relationships with price? Why?

Which

variables might require interaction terms? Why?

Use a series of F tests to determine the best polynomial structure to use and whether or

not

to include the interaction terms that you suggest in (3). Run an OLS regression with

your new, nonlinear model and include your summary output. Run the Jarque-Bera and

RESET tests again, does the result change? Do you see evidence of misspecification?

 

Module 05 Content

1. In the lecture for this module, we read this study from the American Academy of Pediatrics (2011): http://pediatrics.aappublications.org/content/127/4/800.full.pdf.

   800.full.pdf

   The site demonstrates some of the issues inherent in social media and its effect on children, adolescents, and families, and it gives guidance on the risks and benefits, cyber-bullying, online harassment, sexting, and privacy concerns.

   After reading the recommendations or doing your own search on general recommendations about the use of social media (if the link above does not work, definitely do your own search), write a minimum 3 page paper that includes:

   • Benefits and risks of using social media
   • One specific topic you find applicable or interesting (e.g. cyber-bullying)
   • A brief analysis of your family social media usage / a hypothetical family’s social media usage.
   • Be sure to include the source(s) you used and submit an APA formatted reference page. Submit your completed assignment by following the directions linked below.

     Please check the Course Calendar for specific due dates.

     Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:
     Jstudent_exampleproblem_101504