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Andreas J. Krüger - One of the best experts on this subject based on the ideXlab platform.

  • The Scandinavian pre-Hospital Physician and documentation of clinical data in the trauma patient
    Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2013
    Co-Authors: Andreas J. Krüger
    Abstract:

    Background Documentation of clinical data in the pre-Hospital emergency care is important for research purposes. Collecting complete patient level data can be challenging as time is limited and patient management must have priority. In the current study we aimed to examine the ability of Scandinavian pre-Hospital Physicians to record of fourteen clinical variables during pre-Hospital trauma missions.

  • Scandinavian pre-Hospital Physician-manned Emergency Medical Services--same concept across borders?
    Resuscitation, 2010
    Co-Authors: Andreas J. Krüger, Eirik Skogvoll, Maaret Castrén, Jouni Kurola, Hans Morten Lossius
    Abstract:

    Abstract Background In Scandinavia, scattered populations and challenging geographical and climatic conditions necessitate highly advanced medical treatment by qualified pre-Hospital services. Just like every other part of the health care system, the specialized pre-Hospital EMS should aim to optimize its resource use, and critically review as well as continuously assess the quality of its practices. This study aims to provide a comprehensive profile of the pre-Hospital, Physician-manned EMS in the Scandinavian countries. Methods The study was designed as a web-based cross-sectional survey. All specialized pre-Hospital, Physician-manned services in Scandinavia were invited, and data concerning organization, qualification and medical activity in 2007 were mapped. Results Of the 41 invited services, 37 responded, which corresponds to a response rate of 90% (Finland 86%, Sweden 83%, Denmark 92%, Norway 94%). Organization and education are basically identical. All services provide advanced life support and have short response intervals. Services take care of a variety of patient groups, and skills are needed not only in procedures, but also in diagnostics, logistics, intensive care, and mass-casualty management. Consistent and detailed medical documentation was often lacking, however. Differences are mainly related to time variables, patient volume, and service area. The Danish and Swedish services have higher volumes of patient care encounters while the Finnish and Norwegian ones provide a wider variety of medical services. Conclusions This survey documented several significant similarities among pre-Hospital Physician-staffed EMS systems in Scandinavia. Although medical data registration is currently under-developed, Scandinavian Physician-manned EMS is a feasible arena for future multi-centre research.

William J Sullivan - One of the best experts on this subject based on the ideXlab platform.

Hans Morten Lossius - One of the best experts on this subject based on the ideXlab platform.

  • Scandinavian pre-Hospital Physician-manned Emergency Medical Services--same concept across borders?
    Resuscitation, 2010
    Co-Authors: Andreas J. Krüger, Eirik Skogvoll, Maaret Castrén, Jouni Kurola, Hans Morten Lossius
    Abstract:

    Abstract Background In Scandinavia, scattered populations and challenging geographical and climatic conditions necessitate highly advanced medical treatment by qualified pre-Hospital services. Just like every other part of the health care system, the specialized pre-Hospital EMS should aim to optimize its resource use, and critically review as well as continuously assess the quality of its practices. This study aims to provide a comprehensive profile of the pre-Hospital, Physician-manned EMS in the Scandinavian countries. Methods The study was designed as a web-based cross-sectional survey. All specialized pre-Hospital, Physician-manned services in Scandinavia were invited, and data concerning organization, qualification and medical activity in 2007 were mapped. Results Of the 41 invited services, 37 responded, which corresponds to a response rate of 90% (Finland 86%, Sweden 83%, Denmark 92%, Norway 94%). Organization and education are basically identical. All services provide advanced life support and have short response intervals. Services take care of a variety of patient groups, and skills are needed not only in procedures, but also in diagnostics, logistics, intensive care, and mass-casualty management. Consistent and detailed medical documentation was often lacking, however. Differences are mainly related to time variables, patient volume, and service area. The Danish and Swedish services have higher volumes of patient care encounters while the Finnish and Norwegian ones provide a wider variety of medical services. Conclusions This survey documented several significant similarities among pre-Hospital Physician-staffed EMS systems in Scandinavia. Although medical data registration is currently under-developed, Scandinavian Physician-manned EMS is a feasible arena for future multi-centre research.

Julia Adler-milstein - One of the best experts on this subject based on the ideXlab platform.

  • Achieving Adherence to Evidence-Based Practices: Are Health IT and Hospital–Physician Integration Complementary or Substitutive Strategies?
    Medical care research and review : MCRR, 2016
    Co-Authors: Jordan Everson, Shoou Yih D. Lee, Julia Adler-milstein
    Abstract:

    In response to evolving policies and conditions, Hospitals have increased health information technology (HIT) adoption and strived to improve Hospital-Physician integration. While evidence suggests that both HIT and integration confer independent benefits, when combined, they may provide complementary means to achieve high performance or overlap to offset each other's contribution. We explore this relationship in the context of Hospital adherence to evidence-based practices (EBPs). Using the American Hospital Association's Annual and IT Supplement surveys, and Centers for Medicare and Medicaid Services's Hospital Compare, we estimate the independent relationships and interactions between HIT and Hospital-Physician integration with respect to EBP adherence. HIT adoption and tight (but not loose) integration are independently associated with greater adherence to EBPs. The interaction between HIT adoption and tight integration is negative, consistent with an offsetting association between HIT adoption and integration in their relationship to EBP adherence. This finding reveals the need to be aware of potential substitutive effects from simultaneous pursuit of multiple approaches to performance improvement.

  • The dependent effect of health it and Hospital-Physician integration on evidence based practices
    Academy of Management Proceedings, 2015
    Co-Authors: Jordan Everson, Shoou Yih D. Lee, Julia Adler-milstein
    Abstract:

    Health IT adoption and Hospital-Physician integration are both increasing, with the goal of improving healthcare, specifically, increasing adherence to evidence-based practices (EBPs). We sought to determine if Hospital adoption of HIT and Hospital-Physician integration are synergistic strategies to high adherence to EBPs or overlap with each other in ways that produce less than the "sum of their parts". Using data from the American Hospital Association’s Annual and IT Supplement surveys, and CMS’s Hospital Compare, we conducted pooled OLS regression with clustered standard errors to estimate the relationship between EBP adherence, HIT adoption, Hospital-Physician integration and their interactions, controlling for key Hospital characteristics. Both HIT adoption and tight Hospital-Physician integration are associated with increased adherence to EBPs (s=0.22; p

Daniel P Kessler - One of the best experts on this subject based on the ideXlab platform.

  • the effect of Hospital Physician integration on Hospital choice
    Journal of Health Economics, 2016
    Co-Authors: Laurence C Baker, Kate M Bundorf, Daniel P Kessler
    Abstract:

    In this paper, we estimate how Hospital ownership of Physicians' practices affects their patients' Hospital choices. We match data on the Hospital admissions of Medicare beneficiaries, including the identity of their Physician, with data on the identity of the owner of their Physician's practice. We find that a Hospital's ownership of a Physician dramatically increases the probability that the Physician's patients will choose the owning Hospital. We also find that patients are more likely to choose a high-cost, low-quality Hospital when their Physician is owned by that Hospital.

  • the effect of Hospital Physician integration on Hospital choice
    National Bureau of Economic Research, 2015
    Co-Authors: Laurence C Baker, Kate M Bundorf, Daniel P Kessler
    Abstract:

    In this paper, we estimate how Hospital ownership of Physicians’ practices affects their patients’ Hospital choices. We match data on the Hospital admissions of Medicare beneficiaries, including the identity of their admitting Physician, with data on the identity of the owner of the admitting Physician’s practice. We find that a Hospital's ownership of an admitting Physician’s practice dramatically increases the probability that the Physician's patients will choose the owning Hospital. We also find that patients are more likely to choose a high-cost, low-quality Hospital when their admitting Physician’s practice is owned by that Hospital.

  • vertical integration Hospital ownership of Physician practices is associated with higher prices and spending
    Health Affairs, 2014
    Co-Authors: Laurence C Baker, Kate M Bundorf, Daniel P Kessler
    Abstract:

    We examined the consequences of contractual or ownership relationships between Hospitals and Physician practices, often described as vertical integration. Such integration can reduce health spending and increase the quality of care by improving communication across care settings, but it can also increase providers’ market power and facilitate the payment of what are effectively kickbacks for inappropriate referrals. We investigated the impact of vertical integration on Hospital prices, volumes (admissions), and spending for privately insured patients. Using Hospital claims from Truven Analytics MarketScan for the nonelderly privately insured in the period 2001–07, we constructed county-level indices of prices, volumes, and spending and adjusted them for enrollees’ age and sex. We measured Hospital-Physician integration using information from the American Hospital Association on the types of relationships Hospitals have with Physicians. We found that an increase in the market share of Hospitals with the ti...