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High Utilization (high + utilization)
Selected AbstractsUtility and outcomes of fine-needle aspiration biopsy in Hodgkin's diseaseDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2002Wendy S. Moreland M.D. Abstract We present our 10-year experience, including clinical utilization and outcomes, with fine-needle aspiration biopsy (FNAB) in Hodgkin's disease (HD). Eighty-six cases from 68 patients with HD that were evaluated by FNAB were identified over a 10-year period. Medical records of these 68 patients were reviewed. Thirty-seven patients with primary HD underwent 41 aspirates. A diagnosis of HD was yielded in 12 and suggested in 13 cases (sensitivity 86.2%, false-positive 0%). Nine were diagnosed as atypical lymphoid cells, four as hyperplasia/other, and three as unsatisfactory. With these diagnoses, six patients began treatment without tissue exam. Thirty-five patients with suspected recurrent HD underwent 45 FNABs. Recurrent HD was confirmed in 15 and suggested in 12 aspirates (sensitivity 81.3%, false-suspicious 14.3%). With these diagnoses, 22 patients began treatment for recurrence without tissue exam. FNAB is useful both for establishing a primary diagnosis and confirming recurrence in HD and thus has a high utilization at our institution. In many instances, patients can begin therapy, negating the need for formal tissue exam. Diagn. Cytopathol. 2002;26:278,282. © 2002 Wiley-Liss, Inc. [source] Cycle analysis of low and high H2 utilization SOFCs/gas turbine combined cycle for CO2 recoveryELECTRONICS & COMMUNICATIONS IN JAPAN, Issue 10 2008Takuya Taniuchi Abstract Global warming is mainly caused by CO2 emission from thermal power plants, which burn fossil fuel with air. One of the countermeasure technologies to prevent global warming is CO2 recovery from combustion flue gas and the sequestration of CO2 underground or in the ocean. SOFC and other fuel cells can produce high-concentration CO2, because the reformed fuel gas reacts with oxygen electrochemically without being mixed with air, or diluted by N2. Thus, we propose to operate the multistage SOFCs under high utilization of reformed fuel for obtaining high-concentration CO2. In this report, we have estimated the multistage SOFCs' performance considering H2 diffusion and the combined cycle efficiency of multistage SOFC/gas turbine/CO2 recovery power plant. The power generation efficiency of our CO2 recovery combined cycle is 68.5% and the efficiency of conventional SOFC/GT cycle is 57.8% including the CO2 recovery amine process. © 2009 Wiley Periodicals, Inc. Electron Comm Jpn, 91(10): 38,45, 2008; Published online in Wiley InterScience (www.interscience. wiley.com). DOI 10.1002/ecj.10165 [source] Progressive segmented health insurance: Colombian health reform and access to health servicesHEALTH ECONOMICS, Issue 1 2007Fernando Ruiz Abstract Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal. Copyright © 2006 John Wiley & Sons, Ltd. [source] A study on a receiver-based management scheme of access link resources for QoS-controllable TCP connectionsINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 7 2006Kazuhiro Azuma Abstract Although the bandwidth of access networks is rapidly increasing with the latest techniques such as DSL and FTTH, the access link bandwidth remains a bottleneck, especially when users activate multiple network applications simultaneously. Furthermore, since the throughput of a standard TCP connection is dependent on various network parameters, including round-trip time and packet loss ratio, the access link bandwidth is not shared among the network applications according to the user's demands. In this thesis, we present a new management scheme of access link resources for effective utilization of the access link bandwidth and control of the TCP connection's throughput. Our proposed scheme adjusts the total amount of the receive socket buffer assigned to TCP connections to avoid congestion at the access network, and assigns it to each TCP connection according to characteristics in consideration of QoS. The control objectives of our scheme are (1) to protect short-lived TCP connections from the bandwidth occupation by long-lived TCP connections, and (2) to differentiate the throughput of the long-lived TCP connections according to the upper-layer application's demands. One of the results obtained from the simulation experiments is that our proposed scheme can reduce the delay of short-lived document transfer perceived by the receiver host by up to about 90%, while a high utilization of access link bandwidth is maintained. Copyright © 2006 John Wiley & Sons, Ltd. [source] The Identification of Seniors At Risk Screening Tool: Further Evidence of Concurrent and Predictive ValidityJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Nandini Dendukuri PhD Objectives: To evaluate the validity of the Identification of Seniors at Risk (ISAR) screening tool for detecting severe functional impairment and depression and predicting increased depressive symptoms and increased utilization of health services. Setting: Four university-affiliated hospitals in Montreal. Design: Data from two previous studies were available: Study 1, in which the ISAR scale was developed (n=1,122), and Study 2, in which it was used to identify patients for a randomized trial of a nursing intervention (n=1,889 with administrative data, of which 520 also had clinical data). Participants: Patients aged 65 and older who were to be released from an emergency department (ED). Measurements: Baseline validation criteria included premorbid functional status in both studies and depression in Study 2 only. Increase in depressive symptoms at 4-month follow-up was assessed in Study 2. Information on health services utilization during the 5 months after the ED visit (repeat ED visits and hospitalization in both studies, visits to community health centers in Study 2) was available by linkage with administrative databases. Results: Estimates of the area under the receiver operating characteristic curve (AUC) for concurrent validity of the ISAR scale for severe functional impairment and depression ranged from 0.65 to 0.86. Estimates of the AUC for predictive validity for increased depressive symptoms and high utilization of health services ranged from 0.61 to 0.71. Conclusion: The ISAR scale has acceptable to excellent concurrent and predictive validity for a variety of outcomes, including clinical measures and utilization of health services. [source] The cost of health care for children and adults with sickle cell diseaseAMERICAN JOURNAL OF HEMATOLOGY, Issue 6 2009Teresa L. Kauf Although sickle cell disease (SCD) is marked by high utilization of medical resources, the full cost of care for patients with SCD, including care not directly related to SCD, is unknown. The purpose of this study was to estimate the total cost of medical care for a population of children and adults with SCD. We used data from individuals diagnosed with SCD enrolled in the Florida Medicaid program during 2001,2005 to estimate total, SCD-related, and non-SCD-related cost per patient-month based on patient age at the time of health care use. Across the 4,294 patient samples, total health care costs generally rose with age, from $892 to $2,562 per patient-month in the 0,9- and 50,64-year age groups, respectively. Average cost per patient-month was $1,389. Overall, 51.8% of care was directly related to SCD, the majority of which (80.5%) was associated with inpatient hospitalizations. Notably, non-SCD-related costs were substantially higher than those reported for the general US population. These results suggest a discounted (3% discount rate) lifetime cost of care averaging $460,151 per patient with SCD. Interventions designed to prevent SCD complications and avoid hospitalizations may reduce the significant economic burden of the disease. Am. J. Hematol. 2009. © 2009 Wiley-Liss, Inc. [source] | |||||||||||||