ABSTRACT
This article suggests that, in evaluating and designing health care unit programs, conjoint analysis is superior to the conventional survey-research approach. Conjoint analysis can suggest unit designs that will optimize patient (or physician) satisfaction, while still controlling for unit profitability and other constraints. This article discusses the conjoint approach and illustrates its use in the design of an obstetrical unit.
Subject(s)
Hospital Units/standards , Job Satisfaction , Management Audit/methods , Patient Satisfaction , Physicians/psychology , Quality Assurance, Health Care/organization & administration , Female , Hospital Units/organization & administration , Hospital-Patient Relations , Hospitals, University/organization & administration , Hospitals, University/standards , Humans , Models, Organizational , Obstetrics and Gynecology Department, Hospital/organization & administration , Obstetrics and Gynecology Department, Hospital/standards , Philadelphia , Research Design , Surveys and Questionnaires , United StatesABSTRACT
A 4-year-old girl who had received a fetal thymus gland by intraperitoneal transplantation 41 months previously sustained acute, fatal bronchiolitis due to culture-proven cytomegalovirus despite the fact that a specific antibody response to this organism was detected. While the thymic transplantation had increased the number of circulating T lymphocytes and had permitted immune sensitization to delayed-hypersensitivity skin test antigens, there was still an incomplete state of T lymphocyte function. In particular, isolated lymphocytes failed to respond to stimulation with phytohemagglutinin at several concentrations and, more important, the pathologic examination demonstrated a severe anatomic deficiency of lymphoid tissue associated with T lymphocyte function. The unusual infection that caused the death of this child emphasized the necessity of acquiring sufficient T lymphocyte function in immunologic reconstitution attempts.
