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  1. Hospital Mortality


    Provide a Case Study In-Hospital Mortality In-Hospital Mortality from Hip Fractures in the Elderly 


Subject Nursing Pages 4 Style APA


Case Study In-Hospital Mortality In-Hospital Mortality from Hip Fractures in the Elderly

Question 2

The subject of higher mortality related to hip fracture in men compared to women, even though the latter registers a higher incidence rate, is chiefly explained by comorbidity. Observations indicate that although patients with hip fractures, either female or male, have a higher exposure rate to death than the general population, males with fractured hips mortality remain higher due to multimorbidity. This implies that other underlying health complications contribute to higher mortality rates among patients with hip fractures in the male gender compared to females. Similarly, other observations suggest that differences in medical care utilization add to the higher rate of mortality among the male the gender. The general assumption underlines that females are more likely to adhere to medication plans than men who may rush to escalate the process of recovery. It is also expected that men would resist hospitalization after hip injury compared to females, significantly increasing the exposure rate to mortalities.

Questions 3

Pooling data in a research analysis recognize that research groups may carry comparable elements. In any research analysis, considerations into data pooling must be put into perspective as it allows the combining of data (Xu et al., 2016). Data combining allows for additional assessment of research questions. In the case provided, pooling the data over ten years present critical advantages including enhanced statistical power, provides the ability to compare outcomes and validate models across the different data entities while it also advances the ability to develop new measures. Observing the pooled data features in the case study provides a crucial attribute; it is possible for a researcher to input more significant participant variations and treatments.


Question 4

There are numerous other sources of mortality data apart from hospital discharge abstract provided they meet the criterion for relevance, completeness, accessibility, and accuracy. In the United Kingdom, for instance, mortality data can be obtained from the Office for National Statistics (ONS). ONS provides a comprehensive set of data on mortality in the United Kingdom, including gender, age, and race-specific mortalities. Further sources that can be of significant contribution include publications of morbidity data, clinical registers, and hospital episode statistics.

Question 5

Measurement errors are common in computational analysis, and in the case of hospital abstract discharge data, one of the likely mistakes is the gross error. Gross errors occur due to human mistakes where individuals take the wrong reading or recording of measures. Clinicians may record incorrect data on gender, age, and race-specific mortalities, and that can generate to influence the estimates of mortality rates. Random and observational errors can also occur, and their implications on estimates of mortality rate may come in the form of overestimating or underestimation of mortality rates.

Question 6

The subject of bundled versus single payment reimbursement of Medicare continues to attract divergent opinion in the public domain. In the perspective of hip injury treatment, however, one factor that needs to be considered involves the cost of care and hospitalization. Hip fractures are treatment and cost of hospitalization are generally expensive, and it would be necessary that Medicare approaches identify reimbursement models that cut the cost. In that view, ‘bundled’ payment becomes the preferred approach to reimbursement as it improves pricing transparency. In bundled pricing, unnecessary medical services are discouraged, and patients enjoy decreased financial risks.

Bundled payment

In the patients’ perspective, bundled payment provides significant advantages, including reduced financial risks, better predictability of costs, and low out-of-pocket expenses. However, it may offer limitations in terms effectiveness of providers in providing care. From the perspective of the provider, bundled reimbursement offers pros in terms of simplified payment structures while it also improves coordination and accountability. However, the cons include the introduction of strains to providers not used on working together, and it creates difficulties in payments. The perspective of the public looks at bundled payment through improved quality of care, minimum financial risk, and predictability of costs. However, concerns may arise from the fact that it can negatively influence care quality as providers may face challenges in receiving payments (Burton, 2012).

Separate payment

Also known as global payment involves payment to a single healthcare organization. The perspectives of patients regarding a separate payment plan for Medicare recognize its contribution to improving the overall quality of care and effectiveness on medical practices are implemented. However, the model offers more cons, especially in terms of increasing financial risks and out of pocket expenses. The model of more encourages unnecessary treatment plans and tests, which increase the cost of care. Additionally, patients identify that separate payment reduces the predictability of costs.

Global payment is the preference of most healthcare providers as it reduces difficulties in payment reception. Most healthcare providers find it challenging to work in coordination with others. The other advantage of the model providers involves flexibility in the pricing of services. However, providers recognize that separate payment attracts intense scrutiny from Medicare. From the perspective of the public, separate fee opens the avenue for the exploitation of patient investment in Medicare (Burton, 2012). Society deems the method of payment to be vulnerable to corruption and lack of accountability. However, since it promotes more manageable reimbursement payments, public views consider it sufficient for access to quality care plans.



Payment Reform: Bundled Episodes vs. Global Payments A debate between Francois de Brantes and Robert Berenson Timely Analysis of Immediate Health Policy Issues September 2012 Moderated by Rachel Burton. Retrieved from: https://www.urban.org/sites/default/files/publication/25816/412655-Payment-Reform-Bundled-Episodes-vs-Global-Payments.PDF

Xu, X., Qian, P. Z., & Liu, Q. (2016). Samurai Sudoku-based space-filling designs for data pooling. The American Statistician70(1), 1-8.


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