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TITLE OF THE PAPER 1
21
Report on Geriatrics
Professor of Course
First name, middle initial(s), last name. Omit all professional
titles and/or degrees (e.g. Dr., Rev., PhD, MA).
Joseph A. Snider
DeVoe School of Business, Indiana Wesleyan University
Author Note
2
A paper submitted in partial fulfillment of the requirements for
the degree of Masters of Business Administration.
Table of Contents
Report on Geriatrics 3
Project Background 3
Purpose of the Study 3
Context of the Problem, Challenge Opportunity, or Issue 3
Objectives of the Study 3
Limitations of the Study 4
Assumptions of the Study 4
Significance of the Study 4
Goals of the Study 4
Significance of the Topic to the Writer 4
Significance of the Topic to Stakeholders 5
Industry implications 5
Global implications 5
Information and Literature Review 6
Brief Summary of the Literature on the Subject 6
Systematic Review of the Literature 7
Descriptive Statistics 8
Descriptive Graphs 9
Project Analysis 14
Analysis of the Literature Review Research Findings 14
Simple Linear Regression Analysis 14
Single Sample Hypothesis Test of the Mean 14
Chi-Square Analysis of Age and Principal Payer 16
Project Summary 17
Conclusions 17
Specific Recommendations 17
Suggestions for Future Research 17
References 18
Appendix A 19
Data Set 19
Appendix B 22
Pictures of Analysis 22
Report on Geriatrics 3
Project Background 3
Purpose of the Study 3
Context of the Problem, Challenge Opportunity, or Issue 3
Objectives of the Study 3
Limitations of the Study 4
Assumptions of the Study 4
Significance of the Study 4
Goals of the Study 4
Significance of the Topic to the Writer 4
Significance of the Topic to Stakeholders 5
Broader Implications of the Topic 5
INFORMATION and LITERATURE REVIEW 6
Brief Summary of the Literature on the Subject 6
Systematic Review of the Literature 7
Descriptive Statistics 7
Descriptive Graphs 9
Project Analysis 13
Analysis of the Literature Review Research Findings 13
Simple Linear Regression Analysis 13
Single Sample Hypothesis Test of the Mean 14
Chi-Square Analysis of Age and Principal Payer 15
Project Summary 16
Conclusions 16
Specific Recommendations 16
Suggestions for Future Research 16
Ethical Considerations 17
References 18
Appendix A 19
Data Set 19
Appendix B 22
Pictures of Analysis 22
Report on Geriatrics Comment by Wise, Jay: The APA 7th
Edition Publication Manual’s sample professional and student
papers both include at least one paragraph that serves as an
introduction. APA does not use the word Introduction as a
heading. Based on the headings used here, I would expect to
read a short introduction that outlines the paper’s major topics
and prepares me for the kinds of information I will interact with
in the paper.Additionally, the Author Note includes the phrase
“in partial fulfillment,” which I commonly see on theses or
dissertations. This leads me to expect an Abstract. Comment by
Snider, Joseph: Took out author note to not be confusing
Comment by Snider, Joseph: As far as introduction, the
purpose and objectives go over that cost analysis is being done
on the medical data. I added more details on the analysis done
in the objectives section.Project BackgroundPurpose of the
Study
Context of the Problem, Challenge Opportunity, or Issue
Researchers Chandra, Kumar, and Ghildayal (2011) predict
the future of healthcare costs and its impact on health
insurance:
Healthcare is currently a major fiscal problem. If this trend
continues to 2010 and beyond then corporation managers will
stop offering healthcare (some already have) to employees, or
they will keep passing along premium increases to employees as
many currently do. (p. 315)
The cost of inpatient hospital care is under scrutiny by patients,
insurance providers, even government officials. With costs
continuing to skyrocket, it is more important than ever to
understand the relationships between an inpatient hospital stay
and the costs associated the patient care. “The effective
management of hospitals is an increasingly political and social
issue as demographic trends in the USA indicate that the issues
associated with better hospital management will only become
increasingly important as the domestic population continues to
age” (Stock & McDermott, 2011, p. 142).
Objectives of the Study
Raw data collected in the hospital setting was analyzed,
allowing the data to be described in terms of statistics and
explored visually through graphs. Hypothetical statements and
claims are also tested using the sample data. The analysis
represented here is simple linear regression to determine if a
relationship exists between two numeric variables, a one sample
test of a particular value of the mean, and a chi-square
independence test on a summary table made of 2 categories and
counts.
Limitations of the Study
Geriatric is defined as “a branch of medicine that deals with
the problems and diseases of old age and aging people”
(Merriam-Webster, n.d.). In the dataset from Freedom Hospital
Geriatric Patients, there appear to be anomalies. Once the
dataset is sorted, 12 patients do not fit the geriatric definition.
If the dataset is a sample of all patients in the hospital and not
specifically geriatric patients, the information should be noted
on the description for the dataset. The data also included a
patient who was not identified as either male or female.
Assumptions of the Study
It is assumed that the data in the spreadsheet used in the
analysis for this report was honest and truthful. It is assumed
that any blank information provided is not due to privacy
concerns. It is assumed that no private identifying information
was collected.Significance of the Study
Goals of the Study
Goals of this study are to analyze age, charges, gender,
length of stay, principalpayer in terms of central tendency and
variation, and specific visual explorations and hypothesis tests
on the data. After performing this analysis, the interpretations
and judgments allow for business decisions to be made. For
instance, based on the typical length of stay, a business can
strive to lower that value and look for ways to improve evidence
of outcomes.
Significance of the Topic to the Writer
The significance to this writer is personally having friends
and family in age greater than 50 years and in a hospital setting.
It would be advantageous to anyone who cares about loved ones
and friends to attain care that is efficient and effective.
Measuring for the purpose of improvement is therefore of
significance to this writer.
Significance of the Topic to Stakeholders
In this context, stakeholders could be patients, payers, and
the government. All three would be interested in the results of a
medical study on people over 50 years of age. Patients would be
informed of cost trends. Payers would know the breakdown of
the study by percentage by various payers. The government
would benefit from research to know how to legislate.
The lack of efficiency and effectiveness results in political
consequences. If people spend all their money in retirement on
medical bills, that can translate into votes for candidates that
specialize in healthcare legislation. In current times, the merits
and costs of Medicare for all is being hotly debated.
Broader Implications of the Topic
Industry implications. Comment by Wise, Jay: Format Level
4 APA Headings using Title Case, i.e. Industry Implications.
See Table 2.3 on page 48 of the APA Publication Manual, 7th
Edition. Comment by Snider, Joseph: You fixed it
The purpose of the hospital industry as a whole is to treat
patients with utmost care and concern, while not bankrupting
the patient in the process. Health care costs have been a
significant part of employee benefit packages, and the costs
have been going up faster than inflation and certainly faster
than wages.
Global implications. Comment by Wise, Jay: Format Level
4 APA Headings using Title Case, i.e. Industry Implications.
See Table 2.3 on page 48 of the APA Publication Manual, 7th
Edition. Comment by Snider, Joseph: You fixed it.
Ways of paying for medical care differs worldwide. Which is
the correct option for a country? The facts should drive the
decisions for any given country. Since no one-size-fits-all
solution exists, analysis should include data from many
countries. Research should be funded, used to make decisions,
and considered important due to the cost
ramifications.Information and Literature ReviewBrief Summary
of the Literature on the Subject
According to author Russ Richmond (2013),
Rising costs are at the heart of the cost challenges that are
prevalent in health care. Healthcare reform was designed, in
part to help alleviate this persistent cost problem, but much
work still needs to be done to fully understand the true costs of
health care. (p. 90)
This section will analyze the costs associated with an inpatient
hospital stay. The total charges, along with the individual
department charges, will be analyzed.
Hospitals estimate in different ways the costs involved in
an inpatient stay. According to Richmond (2013), ratios of costs
to charges is one of the ways a hospital can estimate patient
costs. Richmond discusses the use of ratios and highlights how
the use of ratios can cause hospitals to overestimate the
profitability of specific services, such as orthopedic procedures.
In the article, the author shares a four-step process for hospitals
to use to better estimate patient costs. The process takes time
and the ability to utilize analytical data to better project costs.
Using data can help a hospital determine whether a physician is
efficiently using resources, which directly impacts the cost of
care to the patient. Comment by Wise, Jay [2]: You may want
to decide whether or not to require a page number or location
information in any work cited in a graduate level paper. For
example, DOL students must include page or paragraph numbers
or section information to help readers locate quoted or
paraphrased information easily.The Publication Manual includes
this quotation on page 269: “Although it is not required to
provide a page or paragraph number in the citation for a
paraphrase, you may include one in addition to the author and
year when it would help interested readers locate the relevant
passage within a long or complex work (e.g., a book).”
Comment by Snider, Joseph: Page numbers or sections not
added here but if a direct quote it would be.
Systematic Review of the LiteratureSummary and Relevance of
the Literature to the Problem or Questions. The research
involves 1387 patients at a geriatric hospital. The gender and
principal payer are categorical, with values having text values.
The age, length of stay, and total charges are numeric variables
and can be used for hypothesis testing and regression
scatterplots.
The analysis being proposed is one of looking at length of stay
and charges. The impact of gender is also being analyzed. As
discussed earlier, health care costs are high and growing, which
makes measuring and analyzing data essential to improving
efficiency and effectiveness.
Thematic Findings in Literature as Applied to the Topic. Costs
for health care are high and continually increasing. Reducing
costs while maintaining quality is important and should be
balanced. Monitoring length of stay is important in order to
minimize it.
Key Definitions. Length of stay (LOS) is a key measure, and
bed census is affected when LOS is not managed effectively.
Ethical Ethical Consideration from the Literature Review.
Gathering data involves a lot of work to capture, clean, and
store the data in a usable format. People are often overcharged
for services. Many people have experienced this on a personal
level; Ppaying even 20% of the service charges can affect a
household. Deciding what services to provide and at what cost
can be an ethical dilemma for healthcare offices to resolve. Do
providers pay for new equipment knowing that care would
improve but so would costs to patients?
When dealing with the health of people, ethical guidelines
for human being research have to be enforced. Research must be
voluntary, and data must be de-identified for privacy concerns.
Large sample sizes would help to add credibility to the results.
Descriptive Statistics
This section will analyze the following questions:
· What is the breakdown by age of males and females?
· Do men or women spend more time (length in days) in the
hospital?
· Do men or women pay more for their stay in the hospital?
· Do men and women use the same principal payers?Table 1
Types of Variables in the Data Set
Variable
Variable Type
Length of Stay in Days
Numerical, Discrete, Ratio Scale
Patient Age
Numerical, Discrete, Ratio Scale
Sex
Categorical, Nominal Scale
Variable
Variable Type
Principal Payer
Categorical, Nominal Scale
Total Charges During Hospital Stay
Numerical, Continuous, Ratio Scale
To describe the raw data, our attention turns to some statistics
related to the variables being used in the research (Length of
Stay in Days, Patient Age, Sex, and Principal Payer). The
following table (Table 2) presents the descriptive statistics on
the variables being researched. The sample size (N=138) was
used to calculate the summary information in Table 2.
Table 2 Comment by Wise, Jay: Consider including a Table
note to remind the reader of the population, N = 137. Also, this
table should use accepted abbreviations for statistical measures
like the Mean, Median, and Standard Deviation. See the Sample
Tables on ages 210-224 of the APA Publication Manual for
guidance.You can find additional guidance in Table 6.5
Statistical Abbreviations and Symbols on pages 183-186.Last, I
recommend reviewing the information on pages 181-188,
Statistical and Mathematical Copy, in case you need to make
any changes to the narrative (text) explanations. Comment by
Snider, Joseph: N=138 provided in a new sentence.
Descriptive Statistics
Gender
Mean
Median
Standard
Deviation
Length of Stay in Days
M
4.92
5
2.31
F
5.31
5
2.39
Patient Age
M
78.1
80
8.94
F
77.6
78.5
9.38
Total Charges during Hospital Stay
M
8978.08
8907
885
F
8789.93
8794
729
Table 2 shows that the mean length of stay in days for
women is slightly higher. Patient age has a mean of 77.6–78.1
for females and males. The minimum amount of time spent in
the hospital was zero days up to the maximum of 12 days.
“Prior research has shown that ALOS [average length of stay] is
related to cost, efficiency, quality of care, and speed in service
delivery (Ashby et al., 2000; Glick et al., 2003; Thomas et al.,
1997; Burns et al., 1994)” (as cited in Stock & McDermott,
2011, p. 144).
Total charges average $8,978.08 for men and $8,789.93 for
women, which is slightly lower. The standard deviation for
length of stay is 2.31 days for men and 2.39 days for women.
The standard deviation for age is about one eighth of the mean
for both men and women, and total charges about one tenth for
men and a little less for women. There is not a big difference in
variation between men and women.
Descriptive Graphs
Figure 1 Comment by Wise, Jay: Consider including a Figure
note to give essential information. The APA Manual has
excellent sample figures on pages 234-250. There is a Sample
Bar Graph on page 234 that may be helpful.These comments
apply to all figures included in this paper. Comment by
Snider, Joseph: All charts in the paper have a Figure heading
now.
Length of Stay by Gender
Figure 1 shows that the shape of the column charts is similar for
men and women, but more females than males stay seven to
eight days, and fewer women than men stay one to two days.
Both distributions are heavily loaded towards the front,
indicating right skewness. The majority of the values are eight
days or less for length of stay.
Figure 2
Age by Gender
Figure 2 shows that the shape of the column charts is similar for
men and women, with only a slight difference of being higher
for females. Both distributions are heavily loaded towards the
higher end, indicating left skewness. The majority of the age
values are 60 and up, which is expected for a geriatric hospital
study set of data.
Figure 3
Total Charges by Gender
Figure 3 shows that the shape of the column charts is similar for
men and women, with some charges for males existing in the
$8,500 to $11,000 range. Both distributions are heavily loaded
towards the lower end, indicating right skew.. The majority of
the charges are $1,000 to $11,000. Comment by Wise, Jay [2]:
Note the two periods at the end of this sentence. Remind
students to use both Grammarly and Word’s Spelling &
Grammar check tool.
Figure 4 Comment by Wise, Jay [2]: Figure 4 needs a figure
note and explanation for each acronym. Comment by Snider,
Joseph: Added acronym definitions under the chart.
Primary Payer Percentages
Figure 4 shows various payer types (OGVT=Other Government
Program, BC=Blue Cross, CAID=Medicaid, CARE=Medicare,
HMO=Health Maintenance Organization, INS=Private
Insurance, OTHR=Other Form of Payment, SELF=Private Pay),
and that most of the payments for all patients are through
Medicare, which is expected since people over 60 become
eligible for those benefits as the patients age. Medicaid and
Blue Cross are the other percentages that make up the largest
portion of the payments. Table 3 below shows there is not much
difference between genders on which payers are used other than
self, insurance, and HMO.
Table 3 Comment by Wise, Jay [2]: Table 3 should have an
accompanying table note that explains each acronym, too.
Comment by Snider, Joseph: Added the appropriate
acronym definitions under the table.
Count of Primary Payers by Gender
Gender
BC
CAID
CARE
HMO
INS
OGVT
OTHR
SELF
Grand Total
F
13
3
31
9
1
1
16
74
M
3
22
16
15
8
64
Grand Total
16
25
47
9
16
1
8
16
138
The payer types are(OGVT=Other Government Program,
BC=Blue Cross, CAID=Medicaid, CARE=Medicare,
HMO=Health Maintenance Organization, INS=Private
Insurance, OTHR=Other Form of Payment, SELF=Private Pay).
Project AnalysisAnalysis of the Literature Review Research
Findings
Simple Linear Regression Analysis
Is there a correlation between drug charges and age? This
question will be answered using simple linear regression.
Figure 5
Scatterplot of Drug Charges Based on Age
Figure 5 shows a slightly downupward slope, calculated to
be -3.8068, and a relationship strength measured by R2 r-
squared is= .0064. The plot points on the scatterplot look
random, and the R2 r-squared =value of .0064 is extremely
low. This means there is almost no relationship or correlation
between drug charges and age. Comment by Wise, Jay [2]: See
the comment above with page numbers for statistical copy.
Review APA Style guidelines for narrative (written) statistical
data. Comment by Snider, Joseph: R square is now R with
superscript of 2.
Single Sample Hypothesis Test of the Mean
The research claim that will be answered using one sample
hypothesis testing is that the population mean for total charges
is $10,000.
Table 4 Comment by Wise, Jay [2]: Review the Publication
Manual’s Table Examples for statistical copy. For example,
Table 7.8 on page 214 provides sample results for multiple t
tests. Table 7.13 provides a sample Analysis of Variance
(ANOVA) table. These tables may reflect APA Style more
accurately than Table 4. Comment by Snider, Joseph: The
tables are a screen shot of the actual templates provided for the
student to perform the analysis. No change could be made here
due to that.
Hypothesis Test Using a t Test for the Mean
The hypothesis analysis in Table 4 shows the sample input
values of:
· The hypothesis value of $10,000 for the mean of total charges
· The sample mean of $8,882.64
· The sample standard deviation of $812.26
· The sample size Nof = 138
It also shows the lower critical values of -1.9774 and +1.9774,
and a t =test statistic of 16.1599. There are two methods for
making a judgment. The first is when the critical value method
compares the t test statistic against the lower and upper critical
values. If outside those values, the null hypothesis is rejected.
The second method is based on the p-value; if it is lower than
the level of significance of .05, the null hypothesis is rejected.
Chi-Square Analysis of Age and Principal Payer
Are age and principal payer independent of each other? This
question will be answered using chi-square testing.
Table 5 Comment by Wise, Jay [2]: Table 7.7 on page 214
gives a Sample Chi-Square Analysis Table. Comment by
Snider, Joseph: Table is an example of a screen shot of the
actual tool used – anything else would not be correct.
Chi-Square Test of Age and Gender (Independence Test)
Table 5 shows a chi-square analysis of age versus gender
for a test of independence. The null hypothesis is that the
variables are independent. The alternate hypothesis is that the
variables are dependent. The level of significance is .05, and the
p-value is .9255. Since the p-value is higher than the level of
significance, the null hypothesis is not rejected. The other way
to determine judgment is to compare the chi-square test statistic
of .0087 to the critical value of 3.8415; the chi-square value
would have to be greater than the critical value to reject the null
hypothesis. Hence, the null hypothesis that the age and gender
are independent is not rejected.Project SummaryConclusions
The cost of an inpatient hospital stay is expensive. The charges
a patient accumulates during their hospital stay increases each
day they remain in care. There is no correlation between the age
and drug charges of the patients in the hospital. The age and
gender were also determined to be statistically independent
variables.Specific Recommendations
A Pareto analysis would be useful to determine major
factors of cost. Is it rampant law suits? Is it poor preventive
health? Are repeat visits common? One recommendation is to
collect different types of data to facilitate this type of defect
research. Another recommendation is to add highly qualified
nursing staff’s comments into a qualitative report.Suggestions
for Future Research
Research by state and in other countries is warranted since the
impacts can be on personal, company, and political finances.
Additionally, gathering more information on each patient, like
eating habits, blood pressure, diabetes history, medications, and
income level, could add greatly to the analysis and subsequent
decision making.Ethical Considerations
When dealing with the health of people, ethical guidelines
for human being research have to be enforced. Research must be
voluntary, and data must be de-identified for privacy concerns.
Large sample sizes would help to add credibility to the results.
References
Chandra, C., Kumar, S., & Ghildayal, N. S. (2011). Hospital
cost structure in the USA: What’s behind the costs? A business
case. International Journal of Health Care Quality Assurance,
24(4), 314–28. https://doi.org/10.1108/09526861111125624
Comment by Wise, Jay [2]: I changed the DOI format to
reflect APA 7th Edition preferences. See the table on page 316
of the Publication Manual. Comment by Snider, Joseph: You
fixed it.
Merriam-Webster. (n.d.) Geriatrics. In Merriam-Webster.com
dictionary. Retrieved date, February 24, 2016, from
http://www.merriam-webster.com/dictionary/geriatric
Richmond, R. (2013, March). A better approach to cost
estimation. Healthcare Financial Management: Journal of the
Healthcare Financial Management Association, 67(3), 86–90.
http://0-
search.proquest.com.oak.indwes.edu/docview/1426765943
Stock, G. N., & McDermott, C. (2011, May 24). Operational and
contextual drivers of hospital costs. Journal of Health
Organization and Management, 25(2), 142–58.
https://doi.org/10.1108/14777261111134392
Appendix A Data Set Comment by Wise, Jay [2]: Consider
formatting this data set similarly to Table 7.2 Sample
Demographics Characteristic Table, page 210 of the 7th Edition
APA Publication Manual.Also note the label error: Total Chges
vs. Total Charges Comment by Snider, Joseph: This matches
the spreadsheet provided which has Chges vs Charges spelled
out.
Table 6
Raw Data Set of Patients and Costs
LOS
Age
Sex
Principal Payer
Total Chges
Drug Charges
Lab Charges
3
78
F
CARE
$ 5,418.85
$ 68.70
$ 273.50
3
74
F
CARE
$ 4,575.10
$ 58.65
$ 439.50
11
89
M
CARE
$ 12,031.18
$ 230.28
$ 816.50
3
81
M
CARE
$ 3,617.84
$ 142.89
$ 387.00
9
87
F
CARE
$ 12,806.88
$ 889.23
$ 795.50
3
65
CARE
$ 5,295.55
$ 102.50
$ 837.00
3
90
M
CARE
$ 3,453.21
$ 122.15
$ 323.00
3
61
M
BC
$ 1,760.03
$ 161.18
$ 35.00
3
90
F
CARE
$ 3,290.40
$ 235.65
$ 243.00
5
78
M
CARE
$ 6,253.65
$ 103.05
$ 487.50
3
78
F
CARE
$ 3,896.16
$ 229.06
$ 222.00
2
71
M
CARE
$ 1,795.35
$ 52.05
$ 58.00
3
76
M
CARE
$ 9,265.17
$ 211.37
$1,626.50
3
76
F
CARE
$ 3,282.90
$ 298.40
$ 381.50
5
79
F
CARE
$ 9,565.83
$ 477.03
$ 974.00
3
72
M
CARE
$ 3,782.15
$ 166.85
$ 345.00
4
72
M
CARE
$ 6,384.28
$ 342.98
$ 644.85
3
64
M
CARE
$ 4,904.25
$ 208.65
$ 768.00
2
72
F
CARE
$ 4,169.92
$ 545.15
$ 375.50
3
69
F
CARE
$ 5,204.41
$ 510.01
$ 870.50
4
63
M
HMO
$ 6,740.00
$ 480.20
$1,091.50
1
78
M
CARE
$ 5,016.44
$ 401.44
$ 630.00
2
83
M
CARE
$ 4,178.94
$ 604.49
$ 433.50
3
62
F
OTHR
$ 4,105.26
$ 90.46
$ 222.00
4
71
M
CARE
$ 4,717.30
$ 120.90
$ 496.00
6
83
F
CARE
$ 6,598.92
$ 380.17
$ 386.00
2
63
F
OTHR
$ 1,633.85
$ 20.85
$ 207.00
1
83
M
CARE
$ 2,200.85
$ 21.00
$ 176.00
4
76
F
CARE
$ 7,461.54
$ 508.34
$1,082.50
5
79
M
CARE
$ 11,413.23
$ 1,149.88
$1,335.50
3
65
M
CARE
$ 5,607.55
$ 230.50
$ 969.35
2
79
M
CARE
$ 4,850.62
$ 172.52
$ 867.00
4
74
M
CARE
$ 7,102.49
$ 259.09
$ 881.00
15
63
M
OGVT
$ 13,615.69
$ 438.84
$1,930.00
3
84
M
CARE
$ 5,069.18
$ 282.90
$ 476.50
6
90
F
CARE
$ 6,536.07
$ 122.85
$ 651.00
4
73
F
CARE
$ 7,401.25
$ 216.90
$ 971.50
2
81
M
CARE
$ 3,744.34
$ 176.24
$ 394.00
5
75
F
CARE
$ 8,653.68
$ 246.63
$ 859.00
9
87
F
CARE
$ 14,423.21
$ 527.63
$2,138.00
3
70
M
CARE
$ 3,742.30
$ 112.95
$ 396.50
3
73
F
CARE
$ 5,514.09
$ 368.34
$ 874.50
5
77
M
CARE
$ 7,390.15
$ 331.25
$ 696.00
5
71
M
CARE
$ 9,358.20
$ 491.35
$1,223.50
7
76
M
CARE
$ 14,570.29
$ 286.74
$1,090.00
4
49
F
CAID
$ 4,526.43
$ 203.98
$ 378.50
6
78
F
CARE
$ 6,846.77
$ 162.57
$ 657.50
2
86
M
CARE
$ 2,927.62
$ 145.42
$ 606.50
3
67
M
CARE
$ 4,404.13
$ 161.78
$ 630.00
6
69
M
CARE
$ 8,056.36
$ 331.66
$ 642.00
8
73
F
CARE
$ 10,703.34
$ 618.64
$1,297.50
4
88
F
CARE
$ 16,458.95
$ 813.55
$1,050.50
5
67
M
INS
$ 4,770.10
$ 236.30
$ 747.00
8
69
M
CARE
$ 15,282.57
$ 1,704.77
$1,860.00
7
77
M
CARE
$ 10,105.30
$ 597.30
$1,251.00
8
64
F
CAID
$ 7,871.29
$ 606.64
$ 550.00
3
76
M
CARE
$ 3,411.10
$ 124.70
$ 356.50
12
64
F
CAID
$ 10,962.17
$ 712.67
$ 697.00
2
41
M
SELF
$ 7,374.27
$ 361.47
$ 600.50
5
49
M
CAID
$ 7,788.51
$ 478.85
$ 610.00
5
59
M
BC
$ 8,191.10
$ 661.65
$ 800.00
3
81
M
CARE
$ 11,117.35
$ 142.35
$ 318.00
2
74
F
CARE
$ 5,624.54
$ 149.69
$ 542.00
4
77
F
CARE
$ 4,574.92
$ 159.82
$ 186.50
3
78
F
CARE
$ 3,644.36
$ 126.46
$ 220.50
2
73
F
CARE
$ 2,937.92
$ 50.67
$ 268.00
6
67
M
INS
$ 3,944.78
$ 602.98
$ 462.00
3
80
M
CARE
$ 6,366.10
$ 169.15
$1,130.00
3
77
F
CARE
$ 4,992.01
$ 148.66
$ 569.50
4
73
F
CARE
$ 6,929.35
$ 679.25
$1,286.50
5
67
M
CARE
$ 5,595.42
$ 582.56
$ 714.00
3
86
M
CARE
$ 3,466.70
$ 78.15
$ 408.50
7
82
F
CARE
$ 7,289.77
$ 162.77
$ 821.50
7
84
F
CARE
$ 6,375.95
$ 275.30
$1,692.50
3
73
F
BC
$ 3,585.62
$ 276.29
$ 578.00
4
82
M
CARE
$ 5,970.45
$ 156.45
$ 711.50
8
62
F
CARE
$ 10,578.14
$ 696.94
$1,329.35
2
84
M
CARE
$ 2,223.60
$ 36.25
$ 229.00
3
89
F
CARE
$ 2,250.50
$ 182.70
$ 205.50
1
84
M
CARE
$ 1,644.55
$ 19.40
$ 142.00
4
81
F
CARE
$ 2,491.45
$ 84.45
$ 114.00
3
81
F
CARE
$ 1,691.50
$ 10.45
$ 114.00
6
78
M
CARE
$ 7,931.92
$ 746.06
$ 707.00
5
84
F
CARE
$ 5,121.97
$ 479.99
$ 981.35
5
37
M
BC
$ 6,940.75
$ 768.55
$1,791.50
7
62
M
BC
$ 12,088.08
$ 592.43
$ 971.80
1
80
F
CARE
$ 2,325.60
$ 101.50
$ 440.50
2
80
F
CARE
$ 4,452.78
$ 160.38
$ 276.50
4
73
M
CARE
$ 6,157.43
$ 193.61
$ 540.50
11
80
F
CARE
$ 21,474.90
$ 1,420.14
$2,302.00
3
80
F
CARE
$ 8,566.51
$ 446.11
$1,393.50
2
80
F
CARE
$ 4,910.27
$ 307.97
$ 707.00
1
81
F
CARE
$ 3,275.03
$ 152.28
$ 414.50
4
39
M
CAID
$ 12,080.81
$ 708.40
$ 971.50
6
86
M
CARE
$ 7,436.85
$ 242.70
$ 700.50
8
79
M
CARE
$ 15,624.20
$ 462.40
$2,372.00
4
87
M
CARE
$ 4,590.48
$ 414.40
$ 966.00
2
53
F
CARE
$ 3,232.63
$ 200.90
$ 320.00
3
83
F
CARE
$ 3,768.11
$ 216.01
$ 312.50
7
80
F
CARE
$ 9,862.26
$ 432.36
$1,504.00
7
79
F
CARE
$ 10,626.42
$ 449.47
$1,011.40
4
72
F
CARE
$ 6,967.99
$ 176.89
$1,062.00
3
77
F
CARE
$ 5,891.25
$ 260.65
$1,215.50
3
81
F
CARE
$ 4,756.91
$ 104.66
$ 893.50
9
67
F
OTHR
$ 8,096.93
$ 473.98
$ 862.50
4
80
M
CARE
$ 4,620.59
$ 178.59
$ 535.00
6
67
F
OTHR
$ 5,796.49
$ 472.74
$1,007.00
1
88
M
CARE
$ 1,483.39
$ 30.34
$ 172.00
1
88
F
CARE
$ 2,510.05
$ 82.45
$ 485.00
6
92
F
CARE
$ 10,185.83
$ 403.13
$1,054.50
3
85
F
CARE
$ 3,391.90
$ 49.60
$ 588.50
5
85
M
CARE
$ 8,418.13
$ 281.48
$ 758.00
3
80
M
CARE
$ 4,346.47
$ 108.11
$ 411.00
2
98
F
CARE
$ 2,043.85
$ 49.20
$ 214.00
3
74
F
CARE
$ 2,594.85
$ 131.60
$ 496.00
5
77
M
CARE
$ 5,499.36
$ 153.91
$ 289.50
9
53
F
CARE
$ 11,244.45
$ 500.30
$ 657.00
7
93
M
CARE
$ 6,565.55
$ 710.00
$ 725.00
4
83
F
CARE
$ 6,031.15
$ 294.60
$1,313.00
7
80
M
CARE
$ 4,912.76
$ 468.01
$ 333.50
3
79
M
CARE
$ 6,182.45
$ 234.85
$ 843.50
3
87
F
CARE
$ 4,218.95
$ 183.45
$ 309.50
16
59
M
CARE
$ 40,231.27
$ 2,768.32
$4,618.00
3
81
F
CARE
$ 3,608.95
$ 290.77
$ 457.50
4
94
F
CARE
$ 3,041.44
$ 109.59
$ 484.00
1
33
F
CAID
$ 1,581.93
$ 141.78
$ 539.50
2
78
F
CARE
$ 1,468.48
$ 175.18
$ -
2
29
F
CARE
$ 2,294.55
$ -
$ 209.00
2
80
F
CARE
$ 7,138.72
$ 402.98
$1,317.50
3
63
F
INS
$ 3,845.96
$ 182.31
$ 443.00
4
86
M
CARE
$ 5,355.23
$ 376.34
$ 890.90
4
96
M
CARE
$ 4,573.05
$ 563.40
$1,310.00
5
89
M
CARE
$ 5,023.11
$ 272.51
$1,039.50
5
80
M
CARE
$ 4,238.30
$ 112.15
$ 654.75
5
55
F
CAID
$ 6,885.73
$ 351.58
$ 838.50
5
73
M
CARE
$ 5,447.63
$ 224.98
$ 660.00
7
67
F
CARE
$ 6,257.66
$ 349.81
$ 761.85
2
75
M
CARE
$ 4,601.00
$ 655.64
$1,008.00
Appendix BPictures of Analysis Comment by Wise, Jay [2]:
The information in this appendix should be broken out by Table
and Figure as appropriate. Please see my earlier comments for
possible table formats that you can use. Comment by Snider,
Joseph: All Tables and Figures now have headings.
Figure 6
Scatterplot of Drug Charges Based on Age
Table 7
Chi-Square Test of Age and Gender (Independence Test)
Table 8
Chi-Square Test of Age and Gender (Independence Test) Pivot
Table
Table 9
Chi-Square Test of Age and Gender (Independence Test)
Analysis Data Entry
TITLE OF THE PAPER121Report on GeriatricsPro

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TITLE OF THE PAPER121Report on GeriatricsPro

  • 1. TITLE OF THE PAPER 1 21 Report on Geriatrics Professor of Course First name, middle initial(s), last name. Omit all professional titles and/or degrees (e.g. Dr., Rev., PhD, MA). Joseph A. Snider DeVoe School of Business, Indiana Wesleyan University
  • 2. Author Note 2 A paper submitted in partial fulfillment of the requirements for the degree of Masters of Business Administration. Table of Contents Report on Geriatrics 3 Project Background 3 Purpose of the Study 3 Context of the Problem, Challenge Opportunity, or Issue 3 Objectives of the Study 3 Limitations of the Study 4 Assumptions of the Study 4 Significance of the Study 4 Goals of the Study 4 Significance of the Topic to the Writer 4 Significance of the Topic to Stakeholders 5 Industry implications 5 Global implications 5 Information and Literature Review 6
  • 3. Brief Summary of the Literature on the Subject 6 Systematic Review of the Literature 7 Descriptive Statistics 8 Descriptive Graphs 9 Project Analysis 14 Analysis of the Literature Review Research Findings 14 Simple Linear Regression Analysis 14 Single Sample Hypothesis Test of the Mean 14 Chi-Square Analysis of Age and Principal Payer 16 Project Summary 17 Conclusions 17 Specific Recommendations 17 Suggestions for Future Research 17 References 18 Appendix A 19 Data Set 19 Appendix B 22 Pictures of Analysis 22 Report on Geriatrics 3 Project Background 3 Purpose of the Study 3 Context of the Problem, Challenge Opportunity, or Issue 3 Objectives of the Study 3 Limitations of the Study 4 Assumptions of the Study 4 Significance of the Study 4 Goals of the Study 4 Significance of the Topic to the Writer 4 Significance of the Topic to Stakeholders 5
  • 4. Broader Implications of the Topic 5 INFORMATION and LITERATURE REVIEW 6 Brief Summary of the Literature on the Subject 6 Systematic Review of the Literature 7 Descriptive Statistics 7 Descriptive Graphs 9 Project Analysis 13 Analysis of the Literature Review Research Findings 13 Simple Linear Regression Analysis 13 Single Sample Hypothesis Test of the Mean 14 Chi-Square Analysis of Age and Principal Payer 15 Project Summary 16 Conclusions 16 Specific Recommendations 16 Suggestions for Future Research 16 Ethical Considerations 17 References 18 Appendix A 19 Data Set 19 Appendix B 22 Pictures of Analysis 22 Report on Geriatrics Comment by Wise, Jay: The APA 7th Edition Publication Manual’s sample professional and student papers both include at least one paragraph that serves as an introduction. APA does not use the word Introduction as a heading. Based on the headings used here, I would expect to read a short introduction that outlines the paper’s major topics and prepares me for the kinds of information I will interact with in the paper.Additionally, the Author Note includes the phrase “in partial fulfillment,” which I commonly see on theses or dissertations. This leads me to expect an Abstract. Comment by Snider, Joseph: Took out author note to not be confusing Comment by Snider, Joseph: As far as introduction, the purpose and objectives go over that cost analysis is being done
  • 5. on the medical data. I added more details on the analysis done in the objectives section.Project BackgroundPurpose of the Study Context of the Problem, Challenge Opportunity, or Issue Researchers Chandra, Kumar, and Ghildayal (2011) predict the future of healthcare costs and its impact on health insurance: Healthcare is currently a major fiscal problem. If this trend continues to 2010 and beyond then corporation managers will stop offering healthcare (some already have) to employees, or they will keep passing along premium increases to employees as many currently do. (p. 315) The cost of inpatient hospital care is under scrutiny by patients, insurance providers, even government officials. With costs continuing to skyrocket, it is more important than ever to understand the relationships between an inpatient hospital stay and the costs associated the patient care. “The effective management of hospitals is an increasingly political and social issue as demographic trends in the USA indicate that the issues associated with better hospital management will only become increasingly important as the domestic population continues to age” (Stock & McDermott, 2011, p. 142). Objectives of the Study Raw data collected in the hospital setting was analyzed, allowing the data to be described in terms of statistics and explored visually through graphs. Hypothetical statements and claims are also tested using the sample data. The analysis represented here is simple linear regression to determine if a relationship exists between two numeric variables, a one sample test of a particular value of the mean, and a chi-square independence test on a summary table made of 2 categories and counts. Limitations of the Study
  • 6. Geriatric is defined as “a branch of medicine that deals with the problems and diseases of old age and aging people” (Merriam-Webster, n.d.). In the dataset from Freedom Hospital Geriatric Patients, there appear to be anomalies. Once the dataset is sorted, 12 patients do not fit the geriatric definition. If the dataset is a sample of all patients in the hospital and not specifically geriatric patients, the information should be noted on the description for the dataset. The data also included a patient who was not identified as either male or female. Assumptions of the Study It is assumed that the data in the spreadsheet used in the analysis for this report was honest and truthful. It is assumed that any blank information provided is not due to privacy concerns. It is assumed that no private identifying information was collected.Significance of the Study Goals of the Study Goals of this study are to analyze age, charges, gender, length of stay, principalpayer in terms of central tendency and variation, and specific visual explorations and hypothesis tests on the data. After performing this analysis, the interpretations and judgments allow for business decisions to be made. For instance, based on the typical length of stay, a business can strive to lower that value and look for ways to improve evidence of outcomes. Significance of the Topic to the Writer The significance to this writer is personally having friends and family in age greater than 50 years and in a hospital setting. It would be advantageous to anyone who cares about loved ones and friends to attain care that is efficient and effective. Measuring for the purpose of improvement is therefore of significance to this writer. Significance of the Topic to Stakeholders
  • 7. In this context, stakeholders could be patients, payers, and the government. All three would be interested in the results of a medical study on people over 50 years of age. Patients would be informed of cost trends. Payers would know the breakdown of the study by percentage by various payers. The government would benefit from research to know how to legislate. The lack of efficiency and effectiveness results in political consequences. If people spend all their money in retirement on medical bills, that can translate into votes for candidates that specialize in healthcare legislation. In current times, the merits and costs of Medicare for all is being hotly debated. Broader Implications of the Topic Industry implications. Comment by Wise, Jay: Format Level 4 APA Headings using Title Case, i.e. Industry Implications. See Table 2.3 on page 48 of the APA Publication Manual, 7th Edition. Comment by Snider, Joseph: You fixed it The purpose of the hospital industry as a whole is to treat patients with utmost care and concern, while not bankrupting the patient in the process. Health care costs have been a significant part of employee benefit packages, and the costs have been going up faster than inflation and certainly faster than wages. Global implications. Comment by Wise, Jay: Format Level 4 APA Headings using Title Case, i.e. Industry Implications. See Table 2.3 on page 48 of the APA Publication Manual, 7th Edition. Comment by Snider, Joseph: You fixed it. Ways of paying for medical care differs worldwide. Which is the correct option for a country? The facts should drive the decisions for any given country. Since no one-size-fits-all solution exists, analysis should include data from many countries. Research should be funded, used to make decisions,
  • 8. and considered important due to the cost ramifications.Information and Literature ReviewBrief Summary of the Literature on the Subject According to author Russ Richmond (2013), Rising costs are at the heart of the cost challenges that are prevalent in health care. Healthcare reform was designed, in part to help alleviate this persistent cost problem, but much work still needs to be done to fully understand the true costs of health care. (p. 90) This section will analyze the costs associated with an inpatient hospital stay. The total charges, along with the individual department charges, will be analyzed. Hospitals estimate in different ways the costs involved in an inpatient stay. According to Richmond (2013), ratios of costs to charges is one of the ways a hospital can estimate patient costs. Richmond discusses the use of ratios and highlights how the use of ratios can cause hospitals to overestimate the profitability of specific services, such as orthopedic procedures. In the article, the author shares a four-step process for hospitals to use to better estimate patient costs. The process takes time and the ability to utilize analytical data to better project costs. Using data can help a hospital determine whether a physician is efficiently using resources, which directly impacts the cost of care to the patient. Comment by Wise, Jay [2]: You may want to decide whether or not to require a page number or location information in any work cited in a graduate level paper. For example, DOL students must include page or paragraph numbers or section information to help readers locate quoted or paraphrased information easily.The Publication Manual includes this quotation on page 269: “Although it is not required to provide a page or paragraph number in the citation for a paraphrase, you may include one in addition to the author and year when it would help interested readers locate the relevant passage within a long or complex work (e.g., a book).” Comment by Snider, Joseph: Page numbers or sections not added here but if a direct quote it would be.
  • 9. Systematic Review of the LiteratureSummary and Relevance of the Literature to the Problem or Questions. The research involves 1387 patients at a geriatric hospital. The gender and principal payer are categorical, with values having text values. The age, length of stay, and total charges are numeric variables and can be used for hypothesis testing and regression scatterplots. The analysis being proposed is one of looking at length of stay and charges. The impact of gender is also being analyzed. As discussed earlier, health care costs are high and growing, which makes measuring and analyzing data essential to improving efficiency and effectiveness. Thematic Findings in Literature as Applied to the Topic. Costs for health care are high and continually increasing. Reducing costs while maintaining quality is important and should be balanced. Monitoring length of stay is important in order to minimize it. Key Definitions. Length of stay (LOS) is a key measure, and bed census is affected when LOS is not managed effectively. Ethical Ethical Consideration from the Literature Review. Gathering data involves a lot of work to capture, clean, and store the data in a usable format. People are often overcharged for services. Many people have experienced this on a personal level; Ppaying even 20% of the service charges can affect a household. Deciding what services to provide and at what cost can be an ethical dilemma for healthcare offices to resolve. Do providers pay for new equipment knowing that care would improve but so would costs to patients? When dealing with the health of people, ethical guidelines for human being research have to be enforced. Research must be voluntary, and data must be de-identified for privacy concerns. Large sample sizes would help to add credibility to the results. Descriptive Statistics This section will analyze the following questions: · What is the breakdown by age of males and females? · Do men or women spend more time (length in days) in the
  • 10. hospital? · Do men or women pay more for their stay in the hospital? · Do men and women use the same principal payers?Table 1 Types of Variables in the Data Set Variable Variable Type Length of Stay in Days Numerical, Discrete, Ratio Scale Patient Age Numerical, Discrete, Ratio Scale Sex Categorical, Nominal Scale Variable Variable Type Principal Payer Categorical, Nominal Scale Total Charges During Hospital Stay Numerical, Continuous, Ratio Scale To describe the raw data, our attention turns to some statistics related to the variables being used in the research (Length of Stay in Days, Patient Age, Sex, and Principal Payer). The following table (Table 2) presents the descriptive statistics on the variables being researched. The sample size (N=138) was used to calculate the summary information in Table 2. Table 2 Comment by Wise, Jay: Consider including a Table note to remind the reader of the population, N = 137. Also, this table should use accepted abbreviations for statistical measures like the Mean, Median, and Standard Deviation. See the Sample Tables on ages 210-224 of the APA Publication Manual for guidance.You can find additional guidance in Table 6.5 Statistical Abbreviations and Symbols on pages 183-186.Last, I recommend reviewing the information on pages 181-188, Statistical and Mathematical Copy, in case you need to make any changes to the narrative (text) explanations. Comment by
  • 11. Snider, Joseph: N=138 provided in a new sentence. Descriptive Statistics Gender Mean Median Standard Deviation Length of Stay in Days M 4.92 5 2.31 F 5.31 5 2.39 Patient Age M 78.1 80 8.94 F 77.6 78.5 9.38 Total Charges during Hospital Stay M 8978.08 8907 885 F 8789.93
  • 12. 8794 729 Table 2 shows that the mean length of stay in days for women is slightly higher. Patient age has a mean of 77.6–78.1 for females and males. The minimum amount of time spent in the hospital was zero days up to the maximum of 12 days. “Prior research has shown that ALOS [average length of stay] is related to cost, efficiency, quality of care, and speed in service delivery (Ashby et al., 2000; Glick et al., 2003; Thomas et al., 1997; Burns et al., 1994)” (as cited in Stock & McDermott, 2011, p. 144). Total charges average $8,978.08 for men and $8,789.93 for women, which is slightly lower. The standard deviation for length of stay is 2.31 days for men and 2.39 days for women. The standard deviation for age is about one eighth of the mean for both men and women, and total charges about one tenth for men and a little less for women. There is not a big difference in variation between men and women. Descriptive Graphs Figure 1 Comment by Wise, Jay: Consider including a Figure note to give essential information. The APA Manual has excellent sample figures on pages 234-250. There is a Sample Bar Graph on page 234 that may be helpful.These comments apply to all figures included in this paper. Comment by Snider, Joseph: All charts in the paper have a Figure heading now. Length of Stay by Gender Figure 1 shows that the shape of the column charts is similar for men and women, but more females than males stay seven to eight days, and fewer women than men stay one to two days. Both distributions are heavily loaded towards the front, indicating right skewness. The majority of the values are eight days or less for length of stay.
  • 13. Figure 2 Age by Gender Figure 2 shows that the shape of the column charts is similar for men and women, with only a slight difference of being higher for females. Both distributions are heavily loaded towards the higher end, indicating left skewness. The majority of the age values are 60 and up, which is expected for a geriatric hospital study set of data. Figure 3 Total Charges by Gender Figure 3 shows that the shape of the column charts is similar for men and women, with some charges for males existing in the $8,500 to $11,000 range. Both distributions are heavily loaded towards the lower end, indicating right skew.. The majority of the charges are $1,000 to $11,000. Comment by Wise, Jay [2]: Note the two periods at the end of this sentence. Remind students to use both Grammarly and Word’s Spelling & Grammar check tool. Figure 4 Comment by Wise, Jay [2]: Figure 4 needs a figure note and explanation for each acronym. Comment by Snider, Joseph: Added acronym definitions under the chart. Primary Payer Percentages Figure 4 shows various payer types (OGVT=Other Government Program, BC=Blue Cross, CAID=Medicaid, CARE=Medicare, HMO=Health Maintenance Organization, INS=Private Insurance, OTHR=Other Form of Payment, SELF=Private Pay), and that most of the payments for all patients are through
  • 14. Medicare, which is expected since people over 60 become eligible for those benefits as the patients age. Medicaid and Blue Cross are the other percentages that make up the largest portion of the payments. Table 3 below shows there is not much difference between genders on which payers are used other than self, insurance, and HMO. Table 3 Comment by Wise, Jay [2]: Table 3 should have an accompanying table note that explains each acronym, too. Comment by Snider, Joseph: Added the appropriate acronym definitions under the table. Count of Primary Payers by Gender Gender BC CAID CARE HMO INS OGVT OTHR SELF Grand Total F 13 3 31 9 1 1 16 74 M 3 22 16
  • 15. 15 8 64 Grand Total 16 25 47 9 16 1 8 16 138 The payer types are(OGVT=Other Government Program, BC=Blue Cross, CAID=Medicaid, CARE=Medicare, HMO=Health Maintenance Organization, INS=Private Insurance, OTHR=Other Form of Payment, SELF=Private Pay). Project AnalysisAnalysis of the Literature Review Research Findings Simple Linear Regression Analysis Is there a correlation between drug charges and age? This question will be answered using simple linear regression. Figure 5 Scatterplot of Drug Charges Based on Age Figure 5 shows a slightly downupward slope, calculated to be -3.8068, and a relationship strength measured by R2 r- squared is= .0064. The plot points on the scatterplot look random, and the R2 r-squared =value of .0064 is extremely low. This means there is almost no relationship or correlation between drug charges and age. Comment by Wise, Jay [2]: See
  • 16. the comment above with page numbers for statistical copy. Review APA Style guidelines for narrative (written) statistical data. Comment by Snider, Joseph: R square is now R with superscript of 2. Single Sample Hypothesis Test of the Mean The research claim that will be answered using one sample hypothesis testing is that the population mean for total charges is $10,000. Table 4 Comment by Wise, Jay [2]: Review the Publication Manual’s Table Examples for statistical copy. For example, Table 7.8 on page 214 provides sample results for multiple t tests. Table 7.13 provides a sample Analysis of Variance (ANOVA) table. These tables may reflect APA Style more accurately than Table 4. Comment by Snider, Joseph: The tables are a screen shot of the actual templates provided for the student to perform the analysis. No change could be made here due to that. Hypothesis Test Using a t Test for the Mean The hypothesis analysis in Table 4 shows the sample input values of: · The hypothesis value of $10,000 for the mean of total charges · The sample mean of $8,882.64 · The sample standard deviation of $812.26 · The sample size Nof = 138 It also shows the lower critical values of -1.9774 and +1.9774, and a t =test statistic of 16.1599. There are two methods for making a judgment. The first is when the critical value method compares the t test statistic against the lower and upper critical values. If outside those values, the null hypothesis is rejected. The second method is based on the p-value; if it is lower than the level of significance of .05, the null hypothesis is rejected. Chi-Square Analysis of Age and Principal Payer Are age and principal payer independent of each other? This
  • 17. question will be answered using chi-square testing. Table 5 Comment by Wise, Jay [2]: Table 7.7 on page 214 gives a Sample Chi-Square Analysis Table. Comment by Snider, Joseph: Table is an example of a screen shot of the actual tool used – anything else would not be correct. Chi-Square Test of Age and Gender (Independence Test) Table 5 shows a chi-square analysis of age versus gender for a test of independence. The null hypothesis is that the variables are independent. The alternate hypothesis is that the variables are dependent. The level of significance is .05, and the p-value is .9255. Since the p-value is higher than the level of significance, the null hypothesis is not rejected. The other way to determine judgment is to compare the chi-square test statistic of .0087 to the critical value of 3.8415; the chi-square value would have to be greater than the critical value to reject the null hypothesis. Hence, the null hypothesis that the age and gender are independent is not rejected.Project SummaryConclusions The cost of an inpatient hospital stay is expensive. The charges a patient accumulates during their hospital stay increases each day they remain in care. There is no correlation between the age and drug charges of the patients in the hospital. The age and gender were also determined to be statistically independent variables.Specific Recommendations A Pareto analysis would be useful to determine major factors of cost. Is it rampant law suits? Is it poor preventive health? Are repeat visits common? One recommendation is to collect different types of data to facilitate this type of defect research. Another recommendation is to add highly qualified nursing staff’s comments into a qualitative report.Suggestions for Future Research Research by state and in other countries is warranted since the impacts can be on personal, company, and political finances. Additionally, gathering more information on each patient, like eating habits, blood pressure, diabetes history, medications, and income level, could add greatly to the analysis and subsequent
  • 18. decision making.Ethical Considerations When dealing with the health of people, ethical guidelines for human being research have to be enforced. Research must be voluntary, and data must be de-identified for privacy concerns. Large sample sizes would help to add credibility to the results. References Chandra, C., Kumar, S., & Ghildayal, N. S. (2011). Hospital cost structure in the USA: What’s behind the costs? A business case. International Journal of Health Care Quality Assurance, 24(4), 314–28. https://doi.org/10.1108/09526861111125624 Comment by Wise, Jay [2]: I changed the DOI format to reflect APA 7th Edition preferences. See the table on page 316 of the Publication Manual. Comment by Snider, Joseph: You fixed it. Merriam-Webster. (n.d.) Geriatrics. In Merriam-Webster.com dictionary. Retrieved date, February 24, 2016, from http://www.merriam-webster.com/dictionary/geriatric Richmond, R. (2013, March). A better approach to cost estimation. Healthcare Financial Management: Journal of the Healthcare Financial Management Association, 67(3), 86–90. http://0- search.proquest.com.oak.indwes.edu/docview/1426765943 Stock, G. N., & McDermott, C. (2011, May 24). Operational and contextual drivers of hospital costs. Journal of Health Organization and Management, 25(2), 142–58. https://doi.org/10.1108/14777261111134392
  • 19. Appendix A Data Set Comment by Wise, Jay [2]: Consider formatting this data set similarly to Table 7.2 Sample Demographics Characteristic Table, page 210 of the 7th Edition APA Publication Manual.Also note the label error: Total Chges vs. Total Charges Comment by Snider, Joseph: This matches the spreadsheet provided which has Chges vs Charges spelled out. Table 6 Raw Data Set of Patients and Costs LOS Age Sex Principal Payer Total Chges Drug Charges Lab Charges 3 78 F CARE $ 5,418.85 $ 68.70 $ 273.50 3 74 F CARE $ 4,575.10 $ 58.65 $ 439.50 11 89 M CARE $ 12,031.18 $ 230.28
  • 20. $ 816.50 3 81 M CARE $ 3,617.84 $ 142.89 $ 387.00 9 87 F CARE $ 12,806.88 $ 889.23 $ 795.50 3 65 CARE $ 5,295.55 $ 102.50 $ 837.00 3 90 M CARE $ 3,453.21 $ 122.15 $ 323.00 3 61 M BC $ 1,760.03 $ 161.18 $ 35.00
  • 21. 3 90 F CARE $ 3,290.40 $ 235.65 $ 243.00 5 78 M CARE $ 6,253.65 $ 103.05 $ 487.50 3 78 F CARE $ 3,896.16 $ 229.06 $ 222.00 2 71 M CARE $ 1,795.35 $ 52.05 $ 58.00 3 76 M CARE $ 9,265.17 $ 211.37 $1,626.50 3
  • 22. 76 F CARE $ 3,282.90 $ 298.40 $ 381.50 5 79 F CARE $ 9,565.83 $ 477.03 $ 974.00 3 72 M CARE $ 3,782.15 $ 166.85 $ 345.00 4 72 M CARE $ 6,384.28 $ 342.98 $ 644.85 3 64 M CARE $ 4,904.25 $ 208.65 $ 768.00 2 72
  • 23. F CARE $ 4,169.92 $ 545.15 $ 375.50 3 69 F CARE $ 5,204.41 $ 510.01 $ 870.50 4 63 M HMO $ 6,740.00 $ 480.20 $1,091.50 1 78 M CARE $ 5,016.44 $ 401.44 $ 630.00 2 83 M CARE $ 4,178.94 $ 604.49 $ 433.50 3 62 F
  • 24. OTHR $ 4,105.26 $ 90.46 $ 222.00 4 71 M CARE $ 4,717.30 $ 120.90 $ 496.00 6 83 F CARE $ 6,598.92 $ 380.17 $ 386.00 2 63 F OTHR $ 1,633.85 $ 20.85 $ 207.00 1 83 M CARE $ 2,200.85 $ 21.00 $ 176.00 4 76 F CARE
  • 25. $ 7,461.54 $ 508.34 $1,082.50 5 79 M CARE $ 11,413.23 $ 1,149.88 $1,335.50 3 65 M CARE $ 5,607.55 $ 230.50 $ 969.35 2 79 M CARE $ 4,850.62 $ 172.52 $ 867.00 4 74 M CARE $ 7,102.49 $ 259.09 $ 881.00 15 63 M OGVT $ 13,615.69
  • 26. $ 438.84 $1,930.00 3 84 M CARE $ 5,069.18 $ 282.90 $ 476.50 6 90 F CARE $ 6,536.07 $ 122.85 $ 651.00 4 73 F CARE $ 7,401.25 $ 216.90 $ 971.50 2 81 M CARE $ 3,744.34 $ 176.24 $ 394.00 5 75 F CARE $ 8,653.68 $ 246.63
  • 27. $ 859.00 9 87 F CARE $ 14,423.21 $ 527.63 $2,138.00 3 70 M CARE $ 3,742.30 $ 112.95 $ 396.50 3 73 F CARE $ 5,514.09 $ 368.34 $ 874.50 5 77 M CARE $ 7,390.15 $ 331.25 $ 696.00 5 71 M CARE $ 9,358.20 $ 491.35 $1,223.50
  • 28. 7 76 M CARE $ 14,570.29 $ 286.74 $1,090.00 4 49 F CAID $ 4,526.43 $ 203.98 $ 378.50 6 78 F CARE $ 6,846.77 $ 162.57 $ 657.50 2 86 M CARE $ 2,927.62 $ 145.42 $ 606.50 3 67 M CARE $ 4,404.13 $ 161.78 $ 630.00 6
  • 29. 69 M CARE $ 8,056.36 $ 331.66 $ 642.00 8 73 F CARE $ 10,703.34 $ 618.64 $1,297.50 4 88 F CARE $ 16,458.95 $ 813.55 $1,050.50 5 67 M INS $ 4,770.10 $ 236.30 $ 747.00 8 69 M CARE $ 15,282.57 $ 1,704.77 $1,860.00 7 77
  • 30. M CARE $ 10,105.30 $ 597.30 $1,251.00 8 64 F CAID $ 7,871.29 $ 606.64 $ 550.00 3 76 M CARE $ 3,411.10 $ 124.70 $ 356.50 12 64 F CAID $ 10,962.17 $ 712.67 $ 697.00 2 41 M SELF $ 7,374.27 $ 361.47 $ 600.50 5 49 M
  • 31. CAID $ 7,788.51 $ 478.85 $ 610.00 5 59 M BC $ 8,191.10 $ 661.65 $ 800.00 3 81 M CARE $ 11,117.35 $ 142.35 $ 318.00 2 74 F CARE $ 5,624.54 $ 149.69 $ 542.00 4 77 F CARE $ 4,574.92 $ 159.82 $ 186.50 3 78 F CARE
  • 32. $ 3,644.36 $ 126.46 $ 220.50 2 73 F CARE $ 2,937.92 $ 50.67 $ 268.00 6 67 M INS $ 3,944.78 $ 602.98 $ 462.00 3 80 M CARE $ 6,366.10 $ 169.15 $1,130.00 3 77 F CARE $ 4,992.01 $ 148.66 $ 569.50 4 73 F CARE $ 6,929.35
  • 33. $ 679.25 $1,286.50 5 67 M CARE $ 5,595.42 $ 582.56 $ 714.00 3 86 M CARE $ 3,466.70 $ 78.15 $ 408.50 7 82 F CARE $ 7,289.77 $ 162.77 $ 821.50 7 84 F CARE $ 6,375.95 $ 275.30 $1,692.50 3 73 F BC $ 3,585.62 $ 276.29
  • 34. $ 578.00 4 82 M CARE $ 5,970.45 $ 156.45 $ 711.50 8 62 F CARE $ 10,578.14 $ 696.94 $1,329.35 2 84 M CARE $ 2,223.60 $ 36.25 $ 229.00 3 89 F CARE $ 2,250.50 $ 182.70 $ 205.50 1 84 M CARE $ 1,644.55 $ 19.40 $ 142.00
  • 35. 4 81 F CARE $ 2,491.45 $ 84.45 $ 114.00 3 81 F CARE $ 1,691.50 $ 10.45 $ 114.00 6 78 M CARE $ 7,931.92 $ 746.06 $ 707.00 5 84 F CARE $ 5,121.97 $ 479.99 $ 981.35 5 37 M BC $ 6,940.75 $ 768.55 $1,791.50 7
  • 36. 62 M BC $ 12,088.08 $ 592.43 $ 971.80 1 80 F CARE $ 2,325.60 $ 101.50 $ 440.50 2 80 F CARE $ 4,452.78 $ 160.38 $ 276.50 4 73 M CARE $ 6,157.43 $ 193.61 $ 540.50 11 80 F CARE $ 21,474.90 $ 1,420.14 $2,302.00 3 80
  • 37. F CARE $ 8,566.51 $ 446.11 $1,393.50 2 80 F CARE $ 4,910.27 $ 307.97 $ 707.00 1 81 F CARE $ 3,275.03 $ 152.28 $ 414.50 4 39 M CAID $ 12,080.81 $ 708.40 $ 971.50 6 86 M CARE $ 7,436.85 $ 242.70 $ 700.50 8 79 M
  • 38. CARE $ 15,624.20 $ 462.40 $2,372.00 4 87 M CARE $ 4,590.48 $ 414.40 $ 966.00 2 53 F CARE $ 3,232.63 $ 200.90 $ 320.00 3 83 F CARE $ 3,768.11 $ 216.01 $ 312.50 7 80 F CARE $ 9,862.26 $ 432.36 $1,504.00 7 79 F CARE
  • 39. $ 10,626.42 $ 449.47 $1,011.40 4 72 F CARE $ 6,967.99 $ 176.89 $1,062.00 3 77 F CARE $ 5,891.25 $ 260.65 $1,215.50 3 81 F CARE $ 4,756.91 $ 104.66 $ 893.50 9 67 F OTHR $ 8,096.93 $ 473.98 $ 862.50 4 80 M CARE $ 4,620.59
  • 40. $ 178.59 $ 535.00 6 67 F OTHR $ 5,796.49 $ 472.74 $1,007.00 1 88 M CARE $ 1,483.39 $ 30.34 $ 172.00 1 88 F CARE $ 2,510.05 $ 82.45 $ 485.00 6 92 F CARE $ 10,185.83 $ 403.13 $1,054.50 3 85 F CARE $ 3,391.90 $ 49.60
  • 41. $ 588.50 5 85 M CARE $ 8,418.13 $ 281.48 $ 758.00 3 80 M CARE $ 4,346.47 $ 108.11 $ 411.00 2 98 F CARE $ 2,043.85 $ 49.20 $ 214.00 3 74 F CARE $ 2,594.85 $ 131.60 $ 496.00 5 77 M CARE $ 5,499.36 $ 153.91 $ 289.50
  • 42. 9 53 F CARE $ 11,244.45 $ 500.30 $ 657.00 7 93 M CARE $ 6,565.55 $ 710.00 $ 725.00 4 83 F CARE $ 6,031.15 $ 294.60 $1,313.00 7 80 M CARE $ 4,912.76 $ 468.01 $ 333.50 3 79 M CARE $ 6,182.45 $ 234.85 $ 843.50 3
  • 43. 87 F CARE $ 4,218.95 $ 183.45 $ 309.50 16 59 M CARE $ 40,231.27 $ 2,768.32 $4,618.00 3 81 F CARE $ 3,608.95 $ 290.77 $ 457.50 4 94 F CARE $ 3,041.44 $ 109.59 $ 484.00 1 33 F CAID $ 1,581.93 $ 141.78 $ 539.50 2 78
  • 44. F CARE $ 1,468.48 $ 175.18 $ - 2 29 F CARE $ 2,294.55 $ - $ 209.00 2 80 F CARE $ 7,138.72 $ 402.98 $1,317.50 3 63 F INS $ 3,845.96 $ 182.31 $ 443.00 4 86 M CARE $ 5,355.23 $ 376.34 $ 890.90 4 96 M
  • 45. CARE $ 4,573.05 $ 563.40 $1,310.00 5 89 M CARE $ 5,023.11 $ 272.51 $1,039.50 5 80 M CARE $ 4,238.30 $ 112.15 $ 654.75 5 55 F CAID $ 6,885.73 $ 351.58 $ 838.50 5 73 M CARE $ 5,447.63 $ 224.98 $ 660.00 7 67 F CARE
  • 46. $ 6,257.66 $ 349.81 $ 761.85 2 75 M CARE $ 4,601.00 $ 655.64 $1,008.00 Appendix BPictures of Analysis Comment by Wise, Jay [2]: The information in this appendix should be broken out by Table and Figure as appropriate. Please see my earlier comments for possible table formats that you can use. Comment by Snider, Joseph: All Tables and Figures now have headings. Figure 6 Scatterplot of Drug Charges Based on Age Table 7 Chi-Square Test of Age and Gender (Independence Test) Table 8 Chi-Square Test of Age and Gender (Independence Test) Pivot Table Table 9 Chi-Square Test of Age and Gender (Independence Test) Analysis Data Entry