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The overall effectiveness of a health system can be measured in a number of different ways. Health outcomes are an obvious measure and one that is tied directly to access to quality clinical care. The tracking of health outcomes involves tracking the progress of patients who present a chronic condition, such as hypertension, and then measuring the results after drug therapy and lifestyle changes. Additionally, patient satisfaction is a reasonable measure of the effectiveness of a health system. Measures of health outcomes, patient satisfaction, and cost reduction, when coupled together, are significant performance indicators for monitoring the overall effectiveness of a health system. The catalyst of U.S. healthcare reform and modernization is identifying, monitoring, and measuring the key performance indicators of cost, access, and quality. Introduction Measuring the cost of healthcare delivery is critical to evaluating the overall effectiveness of health systems. As noted by Porter and Lee (2013), “Improving value requires either improving one or more outcomes without raising costs or lowering costs without compromising outcomes or both” (p. 52). For example, the Patient Protection and Affordable Care Act (ACA) of 2010 sought to transform the U.S. healthcare system by creating synergies, efficiencies, and economies of scale that would reduce the cost of care delivery by spreading it across population health and disease management programs (Lathrop & Hodnicki, 2014). Accountable care organizations (ACOs) are now part of value-based health services delivery and have grown in popularity since their inception over a decade ago. Despite the official-sounding description, an ACO is not a legal entity; rather ACOs are voluntarily established by healthcare providers, health plans, and hospitals to increase consumers’ access to health services and to reduce the collective costs of doing business. Case Report During the summer of 2018, Blue Cross and Blue Shield, the Texas-based health insurance behemoth, entered an ACO relationship with Baylor Scott & White Health, the largest nonprofit health system in Texas. Under the agreement, in year one Baylor Scott & White would provide high-quality care to upwards of 140,000 Blue Cross and Blue Shield members, establishing it as the most substantial value-based care agreement with a commercial insurance company in the United States (Rege, 2018). Improvements in health outcomes for those with chronic diseases such as diabetes, hypertension, and obesity can build patients’ confidence in the ACO model resulting from increased quality of life, leading to higher levels of customer satisfaction in the health system. Discussion The shift from healthcare delivery based on patient demand to a more proactive approach will require a complete commitment from all healthcare stakeholders. Due to its ACO alignment, Baylor Scott & White Health had over 1 million lives under value-based care arrangements, and stakeholders believe that their patients will receive high-value, coordinated, and quality care (Rege, 2018). Designing, implementing, coordinating, and managing the delivery of health services can increase care and oversight across the entire continuum of patient care (Wexler et al., 2014). These tighter controls at the point of service will lower costs across the entire system. Increasing emphasis on disease prevention will directly affect the rate of chronic conditions and traditional high-cost illnesses. Moreover, financial risk pools will create economies of scale as younger and healthier patients begin to purchase insurance plan resulting from the ACA mandates. Health policies and reforms such as the ACA demonstrate the government's meaningful efforts to reduce costs and increase access to and quality of care. These types of national standards are enforceable by government agencies with far-reaching authority. The lower cost of medical procedures coupled with reduced reimbursement rates from Medicare and Medicaid will fundamentally alter health care delivery in the United States. Questions
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In: Biology
In: Biology
phamacology 1 homework:
Giving examples, explain how the bioavailability of drugs would be affected by these administration routes: oral ,sublingual, and rectal administration routes
In: Biology
Pick the INCORRECT answers to the following question: (may be multiple answers)
A. ER bound ribosomes translate proteins destined to be secreted outside the cell
B. Free ribosomes translate many proteins in the cytoplasm
C. Ribosomes form a bridge between the nuclear membrane, where they capture mRNA molecules as the exit the nucleus, and the cell membrane, where they pump newly made proteins outside the cell
D. ER bound ribosomes translate proteins destined for localization in the membrane
E. Free ribosomes translate many proteins destined for localization in the membrane
In: Biology
Most fungi that cause harm to humans are not obligate human pathogens. In other words, these fungi are not highly adapted to attacking humans. How and why do these fungi cause harm?
Define what the great oxygen catastrophe was and what organisms caused it and were affected by it.
In: Biology
|
Time (minutes) |
no sugar |
glucose |
sucrose |
maltose |
lactose |
galactose |
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
5 |
0 |
3 |
0 |
0 |
2.8 |
3.1 |
|
10 |
0 |
6 |
0 |
0 |
5.6 |
6.2 |
|
15 |
0 |
9 |
0 |
0 |
8.8 |
9.3 |
|
20 |
0 |
12 |
0 |
0 |
11.5 |
12.5 |
|
25 |
0 |
15 |
0 |
0 |
13.9 |
15.7 |
|
30 |
0 |
18 |
0 |
0 |
17.2 |
18.9 |
|
35 |
0 |
21 |
0 |
0 |
20 |
22 |
|
40 |
0 |
24 |
0 |
0 |
23.5 |
25 |
|
45 |
0 |
27 |
0 |
0 |
26.5 |
28.5 |
|
50 |
0 |
30 |
0 |
0 |
29.5 |
31.6 |
|
55 |
0 |
33 |
0 |
0 |
32.3 |
34.8 |
|
60 |
0 |
36 |
0 |
0 |
35.2 |
37.8 |
a) What do you notice immediately about sugar utilization in M. tuberculosis?
b) Consider each sugar carefully, and provide a possible explanation for each of them. You may want to refer back to the structures of the sugars provided at the beginning.
In: Biology
The risk of tumor metastasis can be assessed by examining gene expression, signal cascade activity, or protein expressions of pathological sections. Imagine an adenoma (formed by epithelial cells, non-metastatic yet) next to mesenchymal stromal cells, indicate whether the following situations would promote or inhibit or N/D (not able to determine) the metastasis of the adenoma (use those words). (10 pts)
Expression of TGF- RNA in adenoma ______________________
Expression of BMP RNA in adenoma ______________________
Expression of vimentin protein in adenoma ______________________
Expression of Cox-2 in stromal cells ______________________
Nuclear localization of -catenin in adenoma ______________________
Activation of TGF- signal cascade in adenoma ______________________
Activation of TGF- signal cascade in stromal cells ______________________
Expression of E-cadherin in carcinoma epithelia ______________________
Expression Snail in adenoma ______________________
Expression of Snail in stromal cells ______________________
In: Biology
Describe the difference between a lytic and lysogenic bacteriophage cycle
Complete the following definitions with regards to viral replication:
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Retrovirus |
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Prophage |
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Burst Size |
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Burst Time |
In: Biology
PLEASE TYPE & EXPLAIN which covers both parts A&B
A) You conduct a serial dilution where you repeatedly dilute .5mL of solution into 4.5 mL of diluent three times. What is the dilution of your solution?
A.1:10 B.1:100 C.1:1000 D.1: 3, ALSO imagine you put 1ml of milk onto a plate and after 24 hours observed 135 colonies on the plate, how many CFU/mL are in the milk? NOW Imagine you put 1ml of milk onto a plate and after 24 hours observed 135 colonies on the plate, how many CFU/ mL are in the milk?
B) what do we learn of this experiment that will continue to influence us for many years to come?
In: Biology
|
Time (minutes) |
no sugar |
glucose |
sucrose |
maltose |
lactose |
galactose |
|
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
5 |
0 |
0.3 |
0.2 |
0.25 |
0.1 |
0.1 |
|
10 |
0 |
0.5 |
0.4 |
0.45 |
0.2 |
0.15 |
|
15 |
0 |
0.7 |
0.6 |
0.65 |
0.3 |
0.2 |
|
20 |
0 |
0.9 |
0.8 |
0.85 |
0.3 |
0.3 |
|
25 |
0 |
1.1 |
1 |
1.05 |
0.3 |
0.3 |
|
30 |
0 |
1.3 |
1.2 |
1.25 |
0.3 |
0.3 |
|
35 |
0 |
1.5 |
1.4 |
1.45 |
0.3 |
0.3 |
|
40 |
0 |
1.7 |
1.6 |
1.65 |
0.3 |
0.3 |
|
45 |
0 |
1.9 |
1.8 |
1.85 |
0.3 |
0.3 |
|
50 |
0 |
2.1 |
2 |
2.05 |
0.3 |
0.3 |
|
55 |
0 |
2.3 |
2.2 |
2.25 |
0.3 |
0.3 |
|
60 |
0 |
2.5 |
2.4 |
2.45 |
0.3 |
0.3 |
a) How does the rate of glucose consumption compare with the first experiment you did?
b) Do you think yeast is performing cellular respiration? Why or why not.
In: Biology
CASE STUDY #1
Review the case below and answer the following questions.
This should be original work, no references or information
from online. Please be detailed.
38-year-old female with excessive thirst, frequent urination, and weight loss.
History: Cindy Mallon, an 38 year old Caucasian female in previously good health, she has noticed that in the past month, she is increasingly thirsty. She gets up several times a night to urinate, and finds herself gulping down glassfuls of water. At the dinner table, she seems unusually hungry, yet she has lost 5 pounds in the past month. In the past three days, she has felt lethargic and had noted some visual changes where her vision is blurry.
QUESTIONS:
At the doctor's office, blood and urine samples are taken. The following lab results are noted:
blood glucose level = 445 mg/dl (normal = 50 - 170 mg/dl)
blood pH level = 7.40 (normal = 7.35 -7.45)
urine = tested positive for glucose and negative for
acetone / acetoacetate (i.e. ketone bodies)
Answer the following questions, be sure to use proper
terminology and detail your answers considering your review of your
chapter via textbook, notes and video screen cast of module
components:
1. What would be some endocrinological reasons for her blood-glucose levels to be elevated?
2. At the office, you examine her and notice that she has a dark pigmented ring around her neck and is considered to be morbidly obese. The pigmentation is called acanthosis nigricans and is sometimes noted with metabolic disorders. Do those signs have to do with her current condition?
3. Explain why Cindy is urinating so frequently in detail and physiologically how and why it occurs.
4. Explain her constant thirst in detail including what causes it.
5. What are the possible long-term complications of her disease?
In: Biology
Some fats, like oil, are liquid at room temperature, while others, such as butter, are solid. A) Explain how the structure of these molecules determines whether they are liquid or solid. B) Somethings, such as sugar, easily dissolve in water while others, like oils, don’t dissolve in water. What aspect of the molecule’s structure determine whether it dissolves in water or not?
In: Biology
Bioenergetics: What features of avian and mammalian physiology promote their high metabolic rates? How do they use this additional energy? (For each question, provide at least 3 answers involving at least 2 physiological systems)
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Physiological Features Promoting High Metabolism |
Physiological Features Requiring High Metabolism |
In: Biology
In: Biology
Darwin was not the first one to propose that living organisms evolve. What Charles Darwin did was to propose a mechanism that explains how evolution occurs, which he called Natural Selection. In less than 200 words, summarize what Natural Selection is.
In: Biology