Highlights
Objective:
This assessment task addresses the subject learning objectives :
Scenario
The Bottlebrush Hospital Executive has engaged you, as Casemix Manager, to explore the issues around the matter identified in the ‘Topic’ below.
Funds are not available to collect any additional quantitative data or to conduct surveys, interviews, or focus groups. They require you to undertake the project and provide a report using only the data they provide you – one year of the admitted episode of care data from Bottlebrush Hospital's main patient database.
The executive board wants the report provided to them in two stages. This first stage includes only the background, aims or questions, and data analysis strategy.
Topic: Diabetes Mellitus
The hospital has a problem. The managers of surgical wards C2X, C3Y, B3D, and A4E have indicated they are seeing a substantial increase in patients with a secondary diagnosis of Diabetes Mellitus receiving surgery of all types. The managers believe this increase in complexity is extending the length of stay for these patients and is, therefore, increasing costs. They have not identified any specific complications related to this group but do know that diabetes is related to many potential adverse outcomes. They are particularly concerned if these outcomes are exacerbated by surgical procedures or post-operative care. They do not know if other hospitals have experienced increases in length of stay or changes in other outcomes, and if they have, what they have done to address this.
They are highly motivated to implement actions that could address any issues but need specific guidance on plausible interventions. The managers do not know what proportion of surgical patients have a secondary diagnosis of diabetes and whether this is different from other patients in the hospital. They have not discerned patterns in the personal characteristics of this group and are not sure if they are different from other surgical patients or to patients overall. They are curious to know if there is a difference in length of stay between this group and other people in the same AR-DRG, or people with a principal diagnosis of diabetes. Finally, because they only see patients on their own ward, they do not know if there are any observable patterns for this group across the hospital. The managers emphasize that the increase they are seeing is in Diabetes Mellitus, not Diabetes Insipidus or Gestational Diabetes, so it is very important to restrict the analysis to the relevant diagnostic group. Members of the executive are unsure if the rate of diabetes is increasing or decreasing in Australia and seek guidance on whether they should make longer-term plans in addition to addressing the immediate needs of the hospital.
Task: Developing the three components for your report (1500 words)
In this assessment, you are to explore the literature related to the topic, develop clear aims or questions that address the issues that the executive has identified in addition to any that may be drawn from the literature, and propose a structured approach to the analysis of the data.
Please read carefully the information provided under each component required.
Component 1: Background (1000-1100 words)
A concise introduction to the topic, known issues related to it, and definitions of pertinent concepts.
A consideration of relevant, high-quality, literature that weighs the strength of the evidence on the topic and related issues, and provides a basis for aims or questions.
Component 2: Aims or questions (100-200 words)
Five to eight (5-8) aims or questions that directly address the topic and related issues.
Component 3: Data analysis strategy (250-350 words)
Description of a logical and structured strategy that clearly addresses the aims or questions and considers the features and limitations of the type of data available.
Important notes:
You must appropriately cite all literature and reference material. You do not need to cite the supplied dataset.
Develop an understanding of each of the data elements in the dataset. Do not limit your analysis to the most obvious variables.
The supplied dataset is relatively small so it is not expected that the analyses here would be definitive. You are expected to treat the dataset as if there were more cases than there actually are so that the solutions you may suggest should be considered to be more valid than they will actually be with this selection of data. You do not need to note this in the report.
Secondary diagnoses are defined as any diagnosis after the principal.
Note that word limits per section are guidelines only.
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