Evaluating the Strategies for Orthopedic and Spine Surgeries during COVID-19 Pandemic in India- a Retrospective Analysis of 24 Patients in a Multispecialty Hospital- Are We Heading to a New Normal?

Study Design: Retrospective study.Purpose: To present precautionary measures for the orthopedic and spine surgery patients, operating them as per the protocol and analyze findings that can be implemented in non-urgent surgeries during Covid-19 pandemic. Other aim was to analyze the role of multidisciplinary approach, average hospital stay, additional cost behind investigations and hospital bill to guide the patients.Overview of Literature: The literature mentioned to postpone or delay all non-urgent surgeries related to orthopedic and spine conditions till Covid-19 pandemic continues. However, it is not predicted when will this end. No study focusing to conduct essential but non-urgent orthopedic and spine surgeries during this pandemic. Methods: Between March 11, 2020 and May 8, 2020, information on 24 operated orthopedic and spine surgeries were prospectively collected at our institution. Patients were examined in either designated Flu Clinic or out patient department (OPD) after completing screening protocol for Covid-19. Flu clinic team examined all patients and blood investigations, x-ray chest and additional high resolution CT scan were ordered before admission. Patients with symptoms were investigated with RT-PCR for Covid-19. Standardized protocols using multidisciplinary approach were followed for outpatient clinic, admission, surgery and hospital stay regarding Covid-19. Analysis of patients’ hospital stay, hospital bill, admission time and their results of surgeries were performed.Results: 24 patients were operated for orthopedic and spine surgeries with triage as urgent surgeries. 8 and 16 patients were admitted through flu clinic and OPD, respectively; which caused average admission time 179.4+/-138.5 minutes from presentation to admission. All patients managed orthopedic and spine surgeries with improved VAS from average 8.5+/-0.6 preoperatively to 2.7+/-1.0 postoperatively. There was average increase of 5.4+/-2.4% in the overall cost compared to final bill pertaining to Covid-19 precautionary measures. There was no patient or healthcare worker who developed symptoms related to Covid-19.Conclusions: Surgeries should be conducted during Covid-19 pandemics according to their need either to save lives or to provide improved quality of life. Multidisciplinary approach following strict precautionary measures can make it a new-normal norm for the healthcare providers.

Forecasting Insurance and Patient Charges using Linear Regression

The insurance companies around the world work with very simple formula and have a very specific agenda. They convince people to deposit money on their name to the insurance company, in return the people are promised to be given a large sum of amount when they get an expensive hospital bill or when they meet with an accident. This amount to be paid, is generally taken from people on a monthly basis. Customers are convinced to join such a scheme as it is very tempting and the prospect of money troubles taken care of for nothing in a time of crisis seems wonderful. Insurance companies on the other hand pray that nothing happens to the customers or their families, so that they don’t come looking for compensation. The money that they collect from new insurance holders is what they use to pay of the losses. Data analysis is the process of understanding the behaviour of a certain dataset when measured against certain static quantities. In this paper we are proposing to use Data science and in particular regression analysis, to analyse a dataset of patients and devise a method to predict their insurance amount. There are various types of learning and broadly speaking linear regression comes under supervised learning. We have a dataset consisting of over 1300 patients each with 7 characteristics like smoker or not, do they have children, their age, sex, BMI, etc. We are also proposing to devise methods to overcome the shortcomings of Linear regression like multicollinearity and homoscedascity, and perform the required data cleaning..

A importância dos registros de enfermagem no faturamento hospitalar

RESUMO Objetivo: analisar a produção científica nacional sobre os registros de Enfermagem e sua relação direta com o faturamento hospitalar. Método: revisão integrativa, realizada em 20 artigos disponíveis on-line, no período de 2006 a 2016, nas bases de dados Medline, LILACS, BDEnf e na biblioteca SCIELO, analisados por meio de estatística descritiva simples, para a análise bibliométrica das produções encontradas, e da Análise de Conteúdo, para o aprofundamento da relação dos registros de Enfermagem com o faturamento hospitalar. Resultados: desta análise, emergiram as categorias temáticas “Ambiente Hospitalar e os Registros de Enfermagem”; “Auditoria de Enfermagem e o Faturamento Hospitalar” e “O profissional enfermeiro frente ao setor de auditoria”. Conclusão: os registros de Enfermagem expressam a qualidade da assistência dispensada ao paciente, repercutem no faturamento da conta hospitalar, balizam a gestão no acompanhamento de indicadores de qualidade e viabilizam a manutenção financeira do serviço de saúde. Ressalta-se a importância da educação permanente acerca dos registros de Enfermagem e sua interface com a saúde financeira da organização de saúde. Descritores: Auditoria de Enfermagem; Faturamento; Qualidade da Assistência à Saúde; Profissionais de Enfermagem; Registros de Enfermagem; Economia Hospitalar.ABSTRACT Objective: to analyze the national scientific production on Nursing records and its direct relationship with hospital billing. Method: integrative review, performed in 20 articles available online, from 2006 to 2016, in the Medline, LILACS, BDEnf and SCIELO databases, analyzed through simple descriptive statistics, for the bibliometric analysis of the productions found, and Content Analysis, to deepen the relationship between Nursing records and hospital billing. Results: from this analysis the thematic categories "Hospital Environment and Nursing Registers"; "Audit of Nursing and Hospital Invoicing" and "The nurse professional in front of the audit sector" emerged. Conclusion: Nursing records express the quality of the care provided to the patient, have repercussions on the billing of the hospital bill, guide the management in the monitoring of quality indicators and enable the financial maintenance of the health service. It is important to emphasize the importance of continuing education about Nursing records and its interface with the financial health of the health organization. Descriptors: Nursing Audit; Billing; Quality of Health Care; Nursing professionals; Nursing Records; Hospital economics.RESUMEN Objetivo: analizar la producción científica nacional sobre los registros de Enfermería y su relación directa como el facturación hospitalaria. Método: revisión integrativa, realizada en 20 artículos disponibles en línea, en el período de 2006 a 2016, en las bases de datos Medline, LILACS, BDEnf y en la biblioteca SCIELO, y analizados por medio de estadística descriptiva simple, para el análisis bibliométrico de las producciones encontradas, y de la Análisis de Contenido para la profundización la relación de los registros de Enfermería como la facturación hospitalaria. Resultados: de este análisis, surgió las categorías temáticas: “Ambiente Hospitalario y los Registros de Enfermería”; “Auditoría de Enfermería y la Facturación Hospitalaria” y el “Profesional enfermero frente al sector de auditoría”. Conclusión: los registros de Enfermería expresan la calidad de la asistencia dispensada al paciente, repercute en la facturación de la cuenta hospitalaria, balizan la gestión en el seguimiento de indicadores de calidad y viabilizan el mantenimiento financiero del servicio de salud. Se resalta la importancia de la educación permanente acerca de los registros de Enfermería y su interfaz con la salud financiera de la organización de salud. Descriptores: Auditoría de Enfermería; Facturación; Calidad de la Atención de Salud; Profesionales de enfermería; Registros de Enfermería; Economía Hospitalaria.

Changing Paradigm of Doctor Patient Relationship-Issues of Cost, Communication, Compassion, Consumerism or More?

Ilhealth is always considered an uninvited guest and so is the pain of spending for it. For something that is unexpected and unwelcome, a negative sentiment gets tagged with it at the very start itself. It someone falls sick, there is a feeling of victimization by the force unknown. These are the pack of emotions with which a patients walks into hospital surrounded by anxious, restless attendants and most of the anxiety and disturbed look is borne out of the forced eventuality of accompanying their own kin. Another pertinent cause is the loss of the working days which are not easy to afford in the present era of cut throat competition. And not to lag behind is the constant prayer buzzing in their mind wishing a quick discharge and slim as a Barbie doll hospital bill.

Financial burden experienced by patients undergoing treatment for malignant gliomas

Background Patients undergoing treatment for malignant gliomas (MGs) can encounter medical costs beyond what their insurance covers. The magnitude and type of costs experienced by patients are unknown. The purpose of this study was to have patients or their families report on the medical costs incurred during the patients MG treatment. Methods Patients with MG were eligible if they were within 6 months of diagnosis or tumor recurrence. Patients had to be ≥18 years of age, fluent in English, and not aphasic. Weekly logbooks were issued to patients for recording associated costs for ∼6 months or until tumor progression. “Out-of-pocket” (OOP) costs included medical and nonmedical expenses that were not reimbursed by insurance. Direct medical costs included hospital and physician bills. Direct nonmedical costs included transportation, parking, and other related items. Indirect medical costs included lost wages. Costs were analyzed to provide mean and medians with range of expenses. Results Forty-three patients provided cost data for a median of 12 weeks. There were 25 men and 18 women with a median age of 57 years (range, 24y–73y); 79% were married, and 49% reported annual income >$75 000. Health insurance coverage was preferred provider organizations for 58% of patients, and median deductible was $1 500. Median monthly OOP cost was $1 342 (mean, $2 451; range, $333.41–$17 267.16). The highest OOP median costs were medication copayments ($710; range, $0–13 611.20), transportation ($327; range, $0–$1 927), and hospital bill copayments ($403; range, $0–$4 000). Median lost wages were $7 500, and median lost days of work were 12.8. Conclusions OOP costs for MG patients can be significant and comprise direct and indirect costs across several areas. Informing patients about expected costs could limit additional duress and allow financial support systems to be implemented.