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HMGT 400 University of Maryland Hospital Beds per Population Research Paper

HMGT 400 University of Maryland Hospital Beds per Population Research Paper

Question Description

University of Maryland University College

HMGT 400 Research and Data Analysis in Health- FINAL EXAM

Dataset: HMGTFINALEXAM.csv (To be provided when you complete Assignment #3)

Required program: EXCEL

Author, Hossein Zare, PhD

Citation: Zare, H. (2019). HMGT 400 Research and Data Analysis in Health Care. FINAL EXAM. UMUC.EDU

Question #1 (15 credits):

The FINAL EXAM dataset provides some information about hospitals in 2011 and 2012. Analyze the FINAL EXAM dataset. You may calculate the “Hospital Beds per Population (Per Capita)” variable by dividing “total_hospital_beds by tot_population. Use the analysis results to complete Table 1 below.

Table 1. Descriptive statistics about hospitals in 2011 & 2012

2011

2012

t Value (Pr<|t|)

N

Mean

St. Dev

N

Mean

St. Dev

Hospital Characteristics

1. Hospital beds

2. Number of paid Employee

3. Number of non-paid Employee

4. Internes and Residents

5. System Membership

6. Total hospital cost

7. Total hospital revenues

8. Hospital net benefit

9. Available Medicare days

10. Available Medicaid days

11. Total Hospital Discharge

12. Medicare discharge

13. Medicaid discharge

Socio-Economic Variables

14. Hospital Beds per Population (Per Capita)

15. Percent of population in poverty

16. Percent of Female population in poverty

17.Percent of Male population in poverty

18. Median Household Income

Then please answer the following questions.


Question #2 (15 credits):

In the dataset, create a new variable called hospital net benefits. Do this by subtracting hospital costs from hospital revenues.

Analyze the dataset and then complete Table 2. In the last column report the T-test results, to compare hospital characteristics and the nationwide socioeconomic variables for for-profit and non-profit hospitals.

Table 2. Descriptive statistics between teaching and non-teaching hospitals, 2011 & 2012

For Profit

Non-For-Profit

p-value

N

Mean

St. Dev

N

Mean

St. Dev

Hospital Characteristics

1. Hospital beds

2. Number of paid Employee

3. Number of non-paid Employee

4. Internes and Residents

5. System Membership

6. Total hospital cost

7. Total hospital revenues

8. Hospital net benefit

9. Available Medicare days

10. Available Medicaid days

11. Total Hospital Discharge

12. Medicare discharge

13. Medicaid discharge

Socio-Economic Variables

14. Hospital Beds per Population (Per Capita)

15. Percent of population in poverty

16. Percent of Female population in poverty

17. Percent of Male population in poverty

18. Median Household Income

Then answer the following questions:

  • What are the main significant differences between for-profit and non-profit hospitals? Which test is the best fit test? Why?
  • Use a box-plot and compare Hospital net benefit between for-profit and non-profit hospitals.
  • Create a scatter plot with the correct variable and axes labels and legend. Use the plot to compare hospital cost (x-axes) and revenue (y-axes) and discuss your findings?
  • If we assume that hospital net-benefit is a good measure of hospital performance, which type of hospitals had the better performance (for-profit or non-profit hospitals)?
  • Overall, what are the main statistically significant differences between for-profit and non-for-profit hospitals?

Question #3 (15 credits):

The dataset provides the variable herf_ins called the Herfindahl–Hirschman Index which measures market concentration for the health insurance market. Please note that unlike the class exercise in which you used herf_cat, which measured market concentration for the hospital market, in this assignment you are using herf_ins which measures market concentration for the health insurance market.

Analyze the data to complete Table 3 (below):

Table 3. Comparing hospital characteristics and market, 2011 and 2012

High Competitive Market

Moderate Competitive Market

Low Competitive

Market

ANOVA/Chi-Sq (results)

N

Mean

STD

N

Mean

STD

N

Mean

STD

Hospital Characteristics

1. Hospital beds

2. Number of paid Employee

3. Number of non-paid Employee

4. Internes and Residents

5. System Membership

6. Total hospital cost

7. Total hospital revenues

8. Hospital net benefit

9. Available Medicare days

10. Available Medicaid days

11. Total Hospital Discharge

12. Medicare discharge-ratio

13. Medicaid discharge-ratio

Socio-Economic Variables

14. Hospital Beds per Population (Per Capita)

15. Median Household Income

Then answer the following questions:

  • In a short paragraph describe and explain what the Herfindahl index is. You can use the reference provided in the class exercise or any other citation.
  • Compare the following information between hospitals located in high, moderate and low competitive health insurance markets?
    • What are the main significant differences between hospitals in different insurance markets? (use the ANOVA test)
    • What is the impact of being in a high-competitive health insurance market on hospital revenues and costs?
    • Does being in a high-competitive market have a positive impact on net hospital benefits?
    • What about the number of Medicare and Medicaid discharges? Are hospitals in high competitive insurance markets more likely to accept Medicare and Medicaid patients?
    • What is the impact of other variables?

(Note: to answer the last question, please compute Medicare-discharge ratios and Medicaid-discharge ratios first and then run two t-Tests (high competitive vs. moderate competitive, and high vs. low competitive market). Please support your findings with a box-plot).

Question #4 (Credits 20)- Excel version

If you have chosen to work with Excel, please run the models and complete the following tables.

Regression Model 1:

Analyze the data by running a linear regression model as depicted in Table 4 below.


Table 4 – Regression Model 1

Coefficient

ST. ERR

T Stat

P-values

Lower 95%

Upper 95%

Intercept/Constant

Total Hospital beds

Teaching Hospital Dummy

N =

R Square =


  • Describe and discuss your findings.
  • Do the number of hospital beds or whether a hospital is a teaching hospital or not have a positive or negative impact on hospital net-benefit. (hospital performance)? In answering this question, consider statistical significance.

Regression Model 2:

Analyze the data by running a linear regression model as depicted in Table 5 below.


Table 5 – Regression Model 2

Coefficient

ST. ERR

T Stat

P-values

Lower 95%

Upper 95%

Intercept/Constant

Total Hospital beds

Teaching Hospital Dummy

N =

R Square =


  • Describe and discuss your findings.
  • Do the number of hospital beds or whether a hospital is a non-teaching hospital or not have a positive or negative impact on hospital net-benefit. (hospital performance)? In answering this question, consider statistical significance.
  • Use the results from your Regression model 1 and regression model 2 to comment on any differences or similarities in impact of teaching hospital status or non-teaching hospital status impacts on hospital net-benefit. (hospital performance)?

Regression Model 3:

Analyze the data by running a linear regression model as depicted in Table 5 below.


Table 6 – Regression Model 3

Coefficient

ST. ERR

T Stat

P-values

Lower 95%

Upper 95%

Intercept/Constant

Total Hospital beds

Teaching Hosp. Dummy

Medicare discharge ratio

Medicaid discharge ratio

N =

R Square =


  • Describe and discuss your findings.
  • Do the number of Medicare or Medicaid patients in a teaching hospital have a positive or negative impact on hospital net-benefit. (hospital performance)? In answering this question, consider statistical significance.


Regression Model 4:

Analyze the data by running a linear regression model as depicted in Table 7 below.


Table 7 – Regression Model 4

Coefficient

ST. ERR

T Stat

P-values

Lower 95%

Upper 95%

Intercept/Constant

Total Hospital beds

Non-Teaching Hosp. Dummy

Medicare discharge ratio

Medicaid discharge ratio

N =

R Square =


  • Describe and discuss your findings.
  • Do the number of Medicare or Medicaid patients in a non-teaching hospital have a positive or negative impact on hospital net-benefit. (hospital performance)? In answering this question, consider statistical significance.
  • Based on your findings please recommend three policies to improve hospital performance. Please make sure to use the final model for your recommendation

Question #5 (Credits 20)- Excel version

If you have chosen to work with Excel, please run three models and complete the following tables.

Logistic Regression Models

If you have chosen to work with RStudio, please run the following model and complete the following tables.

Logistic Model 1:

Analyze the data by running a logistic regression model as depicted in Table 8 below. Use “being a member of a hospital network” (system_member) as the dependent variable.

Table 8 – Logistic Model 1

Coefficient

ST. ERR

P-Value

Exp (coeff)

Exp (z SE)

Exp (Std. Coeff.)

Intercept/Constant

Total Hospital costs

N =

R Square =


  • Describe and discuss your findings.

Logistic Model 2:

Analyze the data by running a logistic regression model as depicted in Table 9 below.

Table 9 – Logistic Model 2

Coefficient

ST. ERR

P-Value

Exp (coeff)

Exp (z SE)

Exp (Std. Coeff.)

Intercept/Constant

Total Hospital Costs

Total Hospital Revenue

N =

R Square =


  • Describe and discuss your findings.

Logistic Model 3:

Analyze the data by running a logistic regression model as depicted in Table 10 below.

Table 10 – Logistic Regression Model 3

Coefficient

ST. ERR

P-Value

Exp (coeff)

Exp (z SE)

Exp (Std. Coeff.)

Intercept/Constant

Total Hospital Costs

Total Hospital Revenue

Medicare discharge ratio

Medicaid discharge ratio

N =

R Square =


  • Describe and discuss your findings.
  • What is the impact of having more Medicare or more Medicaid patients in the hospitals, on membership in hospital systems?
  • Based on your findings from Logistic Regression Model 3, please recommend three policies to justify whether hospitals will organize themselves into hospital systems or not.

Question 6 (15 credits)

1. Please offer a research question for the study using human subject research.

2. Explain the difference between the research process involving human subjects and the research process not involving human subjects.

3. Discuss ethical implications surrounding human subject research studies.

4. Explain the governance of the human subject research studies over the data and the process.

5. Provide examples of the consequences for not meeting IRB (Institutional Review Board) protocol requirements.


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