Racial differences in the usage of information technology: evidence from a national physician survey.

Information technology (IT) is a key mechanism for improving the quality of healthcare and containing costs, but racial differences in the utilization of IT among practicing physicians are unknown. The current study, using a national physician survey (n = 6,628), investigated racial differences in the utilization of IT. White physicians and minority physicians were directly compared. We first conducted both descriptive and inferential analyses to detect the difference in IT utilization by race and then performed multiple logistic regressions to test whether race remains significant in relation to IT utilization. Results reveal racial differences in the usage of IT. Compared to their minority counterparts, white physicians underutilized a preventive service reminder system. On the other hand, white physicians favored utilizing electronic communications with patients and exchanging clinical data and images with other providers.

An assessment of the economic impact of Local Boards of Health on West Virginia's economy.

West Virginia, as is true for the nation as a whole, spends far less on public health interventions than on curative care. In 2008 the United States spent approximately $2.4 trillion on healthcare, of which approximately $72 billion was allocated for public health activities-obviously a very small percentage (Centers for Medicare and Medicaid Services, U.S. Department of Heath and Human Services 2010). In West Virginia the 2006 per capita budget allocation for Local Boards of Health (LBH) for Basic Public Health Services was about $6.91, and total public health funding was between $63 and $91 per capita depending on the definition of public health. At the same time, Medicaid expenditures by the State are approximately $269 per capita with total Medicaid expenditures around $995 per capita. The difference in funding for Medicaid is almost 10 times the amount allocated to public health. The funding differences between curative care and preventive care may not be the result of the public's lack of understanding of the benefits of prevention, but rather its focus on short term rather than long term economic benefits. For a state like West Virginia, in which per capita income is below the national average, Medicaid is good business for the State's economy. Far too often public health funding is viewed as a drain from a state's budget not as an economic contributor to the state's economy. As a result, the funding of LBHs is almost always insufficient. The authors were interested in evaluating the economic impact of Local Boards of Health on West Virginia's economy. Although the authors recognize that the greatest economic benefits of public health are the costs averted through prevention and early detection, they believe that if LBH produce a positive economic multiplier State officials may view public health allocations in a more positive light. To assess the impact of LBH in West Virginia, spending data for each was collected. The direct, indirect, and induced spending resulting from public health activity was considered. The results were modeled using the IMPLAN (IMPLAN Professional 1999) regional input-output simulation software to assess the multiplier effects of direct LBH spending. Findings suggest that LBH produce a positive economic multiplier similar to other service industries in West Virginia. The inferences from this investigation focus on West Virginia however it is possible to make a reasonable argument that the fundamental issues are similar for states with similar economies.

Pharmaceutical counterfeiting and the RFID technology intervention.

Both nationally and internationally, pharmaceutical counterfeiting has become a problem that is threatening economic stability and public health. The purpose of the present research study review was to analyze the scope and severity of pharmaceutical counterfeiting and to establish if the implantation of the Radio Frequency Identification Device (RFID) model can more efficiently be used within the pharmaceutical supply chain to reduce the problem counterfeit drugs impose on public health and international economic stability. Results indicated that implementing the RFID model for tracking drugs at the item level in the pharmaceutical supply chain has potential to alleviate the scope of the counterfeit drug problem. Recommendations for how the pharmaceutical industry may sooner adopt the RFID model are made.

The Monte Carlo method improves physician practice valuation.

This article demonstrates the use of the Monte Carlo simulation method in physician practice valuation. The Monte Carlo method allows the valuator to incorporate probability ranges into the discounted cash flow model and obtain an output indicating the probability for specified ranges of practice valuation. Given the high level of uncertainty in projected cash flows associated with physician practices, the value of this kind of information in a practice valuation decision would quite obviously be superior to any single point estimate generated by a traditional discounted cash flow model. It is postulated that virtually all hospitals support an information system that can easily accommodate a Monte Carlo simulation.

Anesthesiologists and anesthetist: are we paying for outcome or process?

The concept of Value Exchange is fundamental to any discipline that focuses on interactions between providers and consumers. In both the study of Marketing and the study of Economics, one learns that a producer and consumer will engage in an exchange relationship only so long as the value/cost relationship is positive. Once the cost of the exchange is equal to the value of that exchange, further economic activity is irrational. In a market-based economy, the market is obviously the regulator unless there is some imperfection inhibiting the interaction of the buyer and seller. When there is an imperfection, it is the government's responsibility to intervene and function as a proxy promoting rational buying and selling. In this paper, the author will attempt to demonstrate that the consumer has been economically irrational when purchasing anesthesia services and government has been slow and minimally effective when intervening to rectify this market imperfection.

An analysis of provider attitudes toward end-of-life decision-making.

The explosion of technological and biomedical interventions over the past half century appears to have enhanced the medical profession's ability to prolong life at a faster pace than society's ability to develop comprehensive bioethical laws governing end-of-life decisions. This study was conducted to determine if there was a correlation between educational and occupational backgrounds and participants' perceptions of end-of-life care. Study participants came from various areas and levels of healthcare at a large federal healthcare facility and included nurses, doctors, pharmacists, dietitians, administrators, and others. Participants completed a questionnaire providing both sociodemographic information and perceptions of end-of-life care. Respondents were classified by type of education or background (technical, professional, or medical) and by level of involvement with patient care (direct or indirect). While the results showed a general consensus about the importance of respecting patients' end-of-life wishes, there were differences among respondents in regard to specific issues.