A/an ________________ occurs when a patient has been discharged from a healthcare facility but later has to be admitted again for the same condition.

What is the first step in constructing an outcome measurement?

Table 1 shows the cost per QALY figures for a number of interventions. Imagine that you must decide how many of these interventions to introduce in a health authority. The Interventions listed are independent, which means that more than one can be implemented.  *Note: This is for illustrative purposes only, the figures presented are not valid and reliable.     Table 1. Cost and cost per QALY gained for a set of independent interventions. Interventions Cost per QALY gained (USD $) Number of individuals who would receive the intervention  Intervention cost per person per annum (USD $) Hip replacement 1,677 94 30,000 Kidney transplant 6,706 612 78,000 Haemodialysis at home 24,590 105 35,000 Breast cancer screening 7,397 2,890 300 Beta-interferon 809,900 5 20,200 Smoking cessation 890 1,100 240 Social media campaign for physical activity 81,537 5,000 11   Suppose that your health authority has an annual budget constraint of $52 million. Which interventions would you introduce? (Multiple answers; select all that apply) *Hint: Work out the annual cost of implementing each intervention and rank the interventions from lowest to highest QALY per gained.  

Extra Credit Question (no word limit) What 1 or 2 topics do you think the most important (or interesting) in this course? And what 1 or 2 topics (related to HSR) would you like to be covered in the rest of the semester? 

Which type of review is used to identify the strengths and weaknesses of the existing designs for a particular topic?

Which of the following best describes the traditional healthcare paradigm emphasizing “heads in beds” and a “more is better” philosophy?

Which of the following best describes an accountable care organization (ACO)?

In class, we argue that value should define performance in healthcare; this value should be structured around the patient and based on outcomes. 

Which of the following is not identified in the class discussion as a key element of clinical innovations to eliminate waste?

Using PICOT framework, analyze the abstract provided below and formulate the research question.  *Note: ‘T’ is optional; but ‘PICO’ parts are necessary.      ——————————————————– Abstract   BACKGROUND: Weight loss is recommended for overweight or obese patients with type 2 diabetes on the basis of short-term studies, but long-term effects on cardiovascular disease remain unknown. We examined whether an intensive lifestyle intervention for weight loss would decrease cardiovascular morbidity and mortality among such patients. METHODS:  In 16 study centers in the United States, we randomly assigned 5145 overweight or obese patients with type 2 diabetes to participate in an intensive lifestyle intervention that promoted weight loss through decreased caloric intake and increased physical activity (intervention group) or to receive diabetes support and education (control group). The primary outcome was a composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for angina during a maximum follow-up of 13.5 years. RESULTS:  The trial was stopped early on the basis of a futility analysis when the median follow-up was 9.6 years. Weight loss was greater in the intervention group than in the control group throughout the study (8.6% vs. 0.7% at 1 year; 6.0% vs. 3.5% at study end). The intensive lifestyle intervention also produced greater reductions in glycated hemoglobin and greater initial improvements in fitness and all cardiovascular risk factors, except for low-density-lipoprotein cholesterol levels. The primary outcome occurred in 403 patients in the intervention group and in 418 in the control group (1.83 and 1.92 events per 100 person-years, respectively; hazard ratio in the intervention group, 0.95; 95% confidence interval, 0.83 to 1.09; P=0.51). CONCLUSIONS: An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes. (Funded by the National Institutes of Health and others; Look AHEAD ClinicalTrials.gov number, NCT00017953)