...Case Study 9 Boston Medical Center 1.) What is the marginal cost estimate of the Phase 4 hospital services, assuming that 60 percent of the designated costs are fixed and the remaining costs are variable? * The Marginal cost estimate is $ 71,468 2.) What is the ‘relevant range’ for the cost structure? In other words, at what volume might you expect the fixed and variable costs to change appreciably? * The current amount of patients treated for liver transplant volume totaled 120 patients annually, with a reimbursement rate of $140,000, providing the hospital with the ability to handle 30 more patients before the fixed costs would increase. 120 +30= 150. This means that the hospital can sufficiently handle a capacity of 150 patients, but after 150 at 151 the expected fixed and variable costs will change appreciably. * The total average cost $140,000 for 19 days of average length of stay- per diem of $6,000 a day this can be reduced by almost $12,000 dollars by decreasing LOS by 2 days. 3.) What fixed cost proportion is implied if the price for Phase 4 hospital services is set at $90,000? HINTS: This is an iterative process, arrived at by trying different fixed cost percentages in the template. Also, remember that the Center’s price at this point is based on the marginal (variable) cost. * 37 % is the fixed portion that if implied for phase 4 hospital services would set services at approximately $90,0000, * 37 percent is $89,997...
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...an organ from one body to another or from a donor site to another location on the person's own body, to replace the recipient's damaged or absent organ. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be re-grown from the person's own cells (stem cells, or cells extracted from the failing organs). Organs and/or tissues that are transplanted within the same person's body are called auto grafts. Transplants that are recently performed between two subjects of the same species are called allograft. Allograft can either be from a living or cadaveric source. Organs that can be transplanted are the heart, kidneys, liver, lungs, pancreas, intestine, and thymus. Tissues include bones, tendons (both referred to as musculoskeletal grafts), cornea, skin, heart valves, nerves and veins. Worldwide, the kidneys are the most commonly transplanted organs, followed by the liver and then the heart. Cornea and musculoskeletal grafts are the most commonly transplanted tissues; these outnumber organ transplants by more than tenfold. Organ donors may be living, brain dead, or dead via circulatory death. Tissue may be recovered from donors who die of circulatory death, as well as of brain death – up to 24 hours past the cessation of heartbeat. Unlike organs, most tissues (with the exception of corneas) can be preserved and stored for up to five years, meaning they can be "banked". Transplantation raises a number of bioethical issues, including the definition...
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...Case Study 9 Boston Medical Center 1.) What is the marginal cost estimate of the Phase 4 hospital services, assuming that 60 percent of the designated costs are fixed and the remaining costs are variable? * The Marginal cost estimate is $ 71,468 2.) What is the ‘relevant range’ for the cost structure? In other words, at what volume might you expect the fixed and variable costs to change appreciably? * The current amount of patients treated for liver transplant volume totaled 120 patients annually, with a reimbursement rate of $140,000, providing the hospital with the ability to handle 30 more patients before the fixed costs would increase. 120 +30= 150. This means that the hospital can sufficiently handle a capacity of 150 patients, but after 150 at 151 the expected fixed and variable costs will change appreciably. * The total average cost $140,000 for 19 days of average length of stay- per diem of $6,000 a day this can be reduced by almost $12,000 dollars by decreasing LOS by 2 days. 3.) What fixed cost proportion is implied if the price for Phase 4 hospital services is set at $90,000? HINTS: This is an iterative process, arrived at by trying different fixed cost percentages in the template. Also, remember that the Center’s price at this point is based on the marginal (variable) cost. * 37 % is the fixed portion that if implied for phase 4 hospital services would set services at approximately $90,0000, * 37 percent is $89,997 being the closest percentage...
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...Case Study 2-The Case of Jesica Santillon Effective communication requires messages to be conveyed clearly to the appropriate parties, but along the way there are many communication barriers that can create misunderstandings and misinterpretations of the intended message (Burns, Bradley & Weiner, 2012). Such misunderstandings and misinterpretations are apparent in the case of Jesica Santillon. This case study will identify the social and cultural barriers that may have made it difficult for the doctors to communicate with Jesica’s family. This case study will also offer recommendations to modify the transplant process to ensure that misunderstandings are eliminated or minimized; and lastly it will propose some general communication strategies to manage communication with each group involved in this tragic case. Social and Cultural Barriers to Communication There may have been many communication barriers that hindered the doctors from effectively communicating with Jesica’s family. The language differences may have been a leading obstacle to effective communication between the physicians and the family. The family recently migrated to the United States seeking treatment for Jesica's condition and were not fluent in the English language. Immigrants that lack English skills and familiarity with diagnostic techniques and treatments used in the United States are less likely to receive the care and medical information they need (Freeman, 2013). Health literacy may have...
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...miracle. The Santillon family smuggled themselves and Jesica into the states and resided in North Carolina. At that time they caught the attention of a local builder named Mark Mahoney, who started a charity in Jesica’s name to hopefully get her the medical treatment she needed. Over time enough money was raised and Jesica was able to get the heart and lung transplant to fix the disorder the doctors in her own country could not treat. Jesica’s transplant was taking place at Duke Medical Center by a team of surgeons and lead by Dr. James Jaggers. Dr. Jagger received a call from Carolina Donor Services, the local agency responsible for placing organs with compatible recipients, said they had found a donor in Boston for another one of Jaggers' patients. Dr. Jaggers said he couldn't use the organs for that patient, and asked the agency if the heart and lungs would be appropriate for Jesica Santillon. Several hours later, he was told...
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...Running head: Assignment 2: Ellen Zane – Leading Change at Tufts / NEMC 1 Ellen Zane – Leading Change at Tufts / NEMC Lynda Walker Dr. Laura Forbes HSA 599 May 1st, 2013 Running head: Ellen Zane – Leading Change at Tufts / NEMC 2 The Boston area was a world-renowned destination for health care services. The Academic Medical Centers in Boston received $2.3 billion in National Institutes Health (NIH) research grant money. Hospitals in Massachusetts accumulated large amounts of debt in the 1970’s and the 1980’s as they refurbished older facilities, expanded services, and purchased expensive new technologies. Describe the health care environment in Massachusetts. Two years after enacting health-care reform to rein in costs, Massachusetts strengthened "certificate of need laws" that prevent hospitals and other providers from competing with high- cost, entrenched suppliers. The state now requires that ambulatory surgical centers and outpatient treatment facilities get permission from regulators before they can enter the market. Their rivals invariably lobby the regulators to block competition, and usually win. Instead of attacking the real causes of the explosion in costs -- the combination of overly generous state aid and a dearth of competition among hospitals and physician groups – Massachusetts is vilifying prestigious, non-profit insurers, and punishing them, believe it nor not, with price controls. The combination...
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...Case Study 9 Boston Medical Center 1.) What is the marginal cost estimate of the Phase 4 hospital services, assuming that 60 percent of the designated costs are fixed and the remaining costs are variable? * The Marginal cost estimate is $ 71,468 2.) What is the ‘relevant range’ for the cost structure? In other words, at what volume might you expect the fixed and variable costs to change appreciably? * The current amount of patients treated for liver transplant volume totaled 120 patients annually, with a reimbursement rate of $140,000, providing the hospital with the ability to handle 30 more patients before the fixed costs would increase. 120 +30= 150. This means that the hospital can sufficiently handle a capacity of 150 patients, but after 150 at 151 the expected fixed and variable costs will change appreciably. * The total average cost $140,000 for 19 days of average length of stay- per diem of $6,000 a day this can be reduced by almost $12,000 dollars by decreasing LOS by 2 days. 3.) What fixed cost proportion is implied if the price for Phase 4 hospital services is set at $90,000? HINTS: This is an iterative process, arrived at by trying different fixed cost percentages in the template. Also, remember that the Center’s price at this point is based on the marginal (variable) cost. * 37 % is the fixed portion that if implied for phase 4 hospital services would set services at approximately $90,0000, * 37 percent is $89,997 being the...
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...chagas disease is most common in places of greater poverty in Latin America and the Caribbean. The chagas disease is a parasitic disease named after the Brazilian physician Carlos Chagas who discovered it in 1909. It is spread to animals and people through a bite of an infected insect named triatomine bugs or “kissing bugs” that carry the parasite known as Trypanosoma cruzi (Boston College). The triatomine insect feeds on the blood a mammal infected with Trypanosoma cruzi, ingesting the parasite. The insect then becomes infected and now moves on to bite a human transferring the parasite. As the insect bites, it releases its feces near the site of the bite wound allowing the parasite to enter the victim. The parasite then invades the first cells it comes in contact with. They use the victim cells to multiply then releasing itself into the victim bloodstream where they will then continue to multiple and spread into different areas in the body. There are many other ways in which the disease can be spread. For example, infections occur from mother to baby, through contaminated blood transfusions, organ transplant from an infected donor and rarely though contaminated food or drinks (FAQs). Symptoms do not show immediately after being bitten by the triatomine bug. It takes from five days to two weeks for slight symptoms to show. Some symptoms are mild fever with body ache and swelling at the site of the bite, fatigue, rash, headache, nausea, diarrhea, vomiting, enlargement of spleen...
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...Case Study 9 Boston Medical Center 1.) What is the marginal cost estimate of the Phase 4 hospital services, assuming that 60 percent of the designated costs are fixed and the remaining costs are variable? * The Marginal cost estimate is $ 71,468 2.) What is the ‘relevant range’ for the cost structure? In other words, at what volume might you expect the fixed and variable costs to change appreciably? * The current amount of patients treated for liver transplant volume totaled 120 patients annually, with a reimbursement rate of $140,000, providing the hospital with the ability to handle 30 more patients before the fixed costs would increase. 120 +30= 150. This means that the hospital can sufficiently handle a capacity of 150 patients, but after 150 at 151 the expected fixed and variable costs will change appreciably. * The total average cost $140,000 for 19 days of average length of stay- per diem of $6,000 a day this can be reduced by almost $12,000 dollars by decreasing LOS by 2 days. 3.) What fixed cost proportion is implied if the price for Phase 4 hospital services is set at $90,000? HINTS: This is an iterative process, arrived at by trying different fixed cost percentages in the template. Also, remember that the Center’s price at this point is based on the marginal (variable) cost. * 37 % is the fixed portion that if implied for phase 4 hospital services would set services at approximately $90,0000, * 37 percent is $89,997 being the...
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...Stem Cells Since being discovered, the ethics of studying stem cells for medicine has been debated. As the continuing controversy over this research continues, the funding for it diminishes, and thousands of lives that could've been saved slip away. Embryonic stem cell research, which has the potential to serve the medical field in countless ways, will remain stagnant until we as Americans realize that it can be the key to most of today's deadliest diseases and injuries. Margaret Goodell, a professor at the Baylor College of Medicine, was one of the first to suggest extracting stem cells from other sources, most notably bone marrow. Without people being able to use the ethics card, bone marrow derived cells seemed to put aborted fetuses out of the picture. But, according to Catherine Verfaillie of the University of Minnesota, bone marrow cells with the same ability as stem cells are very rare (Snow 48). Verfaillie estimates that only one out of ten billion bone marrow cells are versatile enough and have the ability to adapt into other working cells. Even though these cells would work, the process of finding them makes it difficult. Bone marrow “stem” cells, if you will, have no molecular marker that differentiates them from other bone marrow cell. (Snow 48). The only way to see the difference between them is by a long process of tests, which makes finding them incredibly difficult. They are more common in younger children, however, they have been found in some adult donors...
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...Bengali parents. She was named Nilanjana Sudeshna by her patents, but she goes by her pet name Jumpa. She moved to South Kingstown, Rhode Island when she was three years old. Jumpa Lahiri learned her Bengali heritage from her mother from a very early age. Jhumpa Lahiri is the daughter of a librarian and school teacher. She has always been inclined to creative writing. She married Alberto Vourvoulias Bush in 2001. They have two children from their marriage Octavio and Noor. Jumpa Lahiri received her B.A in English literature from Barnard College in 1989. She went on to earn an M.A. in English, an M.F.A. in Creative Writing, an M.A. in Comparative Literature, and a Ph.D. in Renaissance Studies from Boston University. From 1997-98, she held a fellowship at Provincetown's Fine Arts Work Center. Right from a very young age she felt very strong ties to her parent’s homeland, India, as well as the United States and England. A sense of homelessness and an inability to feel accepted took place as she grew up with the ties to all three countries. To her it is an inheritance of her parent’s ties to India. “The question of identity is always a difficult one, but especially so for those who are culturally displaced, as immigrants are, or those who grow up in two worlds simultaneously, as is the case for their children.”- Jhumpa Lahiri. She is indeed the storyteller who weaves the lace of love, identity, crisis, lies and faults in a matured way. Her works are enriched with sensitive dilemmas...
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...Second International Symposium on Information Science and Engineering Comparison of Several Cloud Computing Platforms Junjie Peng Xuejun Zhang Zhou Lei, Bofeng Zhang, Wu Zhang, Qing Li School of computer science & High performance computing center Shanghai University Shanghai, 200072 P.R. China School of computer science & High Qinghua machinery factory at Changzhi performance computing center Changzhi, 046012 P.R China Shanghai University Shanghai, 200072 P.R. China Abstract—Cloud computing is the development of parallel computing, distributed computing and grid computing. It has been one of the most hot research topics. Now many corporations have involved in the cloud computing related techniques and many cloud computing platforms have been put forward. This is a favorable situation to study and application of cloud computing related techniques. Though interesting, there are also some problems for so many flatforms. For to a novice or user with little knowledge about cloud computing, it is still very hard to make a reasonable choice. What differences are there for different cloud computing platforms and what characteristics and advantages each has? To answer these problems, the characteristics, architectures and applications of several popular cloud computing platforms are analyzed and discussed in detail. From the comparison of these platforms, users can better understand the different cloud platforms and more reasonablely choose what they want. Keywords-cloud computing;...
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...Imagine a 240-pound professional football player stretching his sweat-drenched body to its limits in heat of more than 110 degrees. This scene doesn’t take place on a football field, but in a heated Bikram yoga studio where many athletes and everyday people are going to cure and prevent aches and pains. Yoga, as a way to achieve higher self-awareness, was around as early as 200 B.C. in India and has been gradually growing in popularity in the western world over the past four decades. Traditional styles of yoga, including Hatha yoga, which consists of thousands of poses, have long been studied as an effective form of complimentary or alternative medicine (CAM). The biggest yoga boom has occurred over the past decade according to statistics from the International Association of Yoga Therapists. The Association estimates there were 20 million Americans practicing some form of yoga in 2002 compared to 6 million in 1994. Increased awareness of yoga as a healing method along with high-profile celebrity endorsements have contributed to the growing numbers of yoga users recently. Madonna and Kareem Abdul-Jabbar are some famous yogis that have been students of Bikram Choudhury, who founded his own style of hot yoga in India. Dina Lancour, a Hatha yoga instructor from Agawam, Massachusetts, took a Bikram yoga class under Choudhury. “It reminded me of Indian sweat tents,” Lancour said. “It becomes very meditative and deep.” Proponents of Bikram yoga and medical specialists...
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...| |Market- Based Approach |Government- Financed Approach | | |(Private Insurance, self-insured employers, Managed Care |(Medicare, Medicaid, State Children’s Health Insurance Program [SCHIP]) | | |Organizations) | | |Access for who: |Private insurance provides access to employees whose employer,|Medicare is for individuals 65 years or older. Medicaid are for families | | |union or organization qualifies for group insurance. |with children in the Temporary Assistance for Needy, the elderly, blind, | | |Self-insured employers provide access to its employees and |and disabled with low incomes, and children and pregnant women whose income| | |managed care organizations provide access to its’ insured (Shi|is 133% below the Federal Poverty Level (Shi & Singh, 2008). SCHIP provides| | |& Singh, 2008). |access to children under the age of 19 whose family income exceeds Medicaid| | | |threshold levels (Shi & Singh, 2008). ...
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...weakened or dead versions of bacteria, viruses, or other antigens that stimulate the immune system to create antibodies that prevent future infections from the disease. There are fourteen vaccine-preventable diseases that are considered potentially serious and have been routinely vaccinated against; these are: Measles, Mumps, Rubella, Meningococcal, Rotavirus, Diptheria, Tetanus, Pertussis (Whooping Cough), Polio, Hepatitis A and B, Pneumococcal disease, Varicella (Chicken Pox), and Haemophilus Influenza Type B (HIB disease). Not long ago, these diseases disabled and killed millions of American children but because of the United States high compliance with childhood immunization schedules, these diseases have now become very uncommon (Centers for Disease Control and Prevention [CDC], 2015). Immunization is a subject that evokes very strong opinions in the public and usually creates a lot of debate as to their efficacy, safety, and reliability. The main questions parents have to answer are whether to immunize or not, and do the risks of the disease outweigh the risks of the vaccine. To condense, some normal advantages of being immunized are the entire eradication of specific illnesses, the prevention of epidemics and a decline in the...
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