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NURS 6020 Management And Analysis Of Health Data For The Doctor Of Nursing Practice

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Questions:

Directions:

You have been provided with excerpts from transcript looking at the experience of being hospitalized. You are to code the transcripts and identify the common themes that emerge. With the themes identified, you are to write up your qualitative findings remembering to tell the story- describe what the theme is, how it appeared and give illustrations supporting what you are describing.

This assignment will develop your skills in data coding and categorization in order to describe the essence or meaning from qualitative data. You are being given short responses from multiple individuals – the actual data set would be much larger.

This is a qualitative study looking at the phenomenon of the “patient experience” while being hospitalized. The purpose of the study is to gather information as to how patients view the experience- what do they perceive as excellent and what do they perceive as problematic. The overall research question is “What is the experience of quality care for adult patients hospitalized in an acute care facility?

Task:

  1. Discuss the similarities and differences between the 4 types of economic evaluations studies (i.e. cost effectiveness, cost utility, cost benefit, and cost minimization).
  1. The dataset called “DataSetInstrumentsDemographics_Correct” contains data from the HIV/AIDS Targeted Quality of Life (HAT-QoL) instrument (Bakken et al., 2000) for the variable HATTOT, which is a measure of the quality of life of HIV positive patients with regards to living with AIDS. Based on this data, the mean HATTOT score for the sample was 97.8. The possible range of raw scores for the HATTOT variable is 29 to 145, with higher scores indicating better mastery of the illness and fewer symptoms. It was also found that the mean number of years patients have lived with AIDS in this sample is 17.7 years.

    Using this information, calculate the quality of life index for this sample.
    Calculate the mean quality-adjusted life years (QALYs) for the sample.

  2. Suppose a new intervention to improve the quality of life of HIV positive patients is developed, and it is studied in an experimental study involving the same patients in this sample. Some patients received this new intervention (experimental group), while some received no intervention (control group). Consider the mean number QALYs calculated in question 2b to be the baseline measure of quality of life before the intervention is implemented for both groups. Twenty years later the quality of life of these patients is measured again, and at the conclusion of the study, the investigators measured the final mean QALYs in both groups. Table 1 below shows the results of this experiment.

Table 1. Number of QALYs at baseline and 20 years after the implementation of a new intervention to improve the quality of life of HIV positive patients.

 

QALYs at baseline

QALYs at study end

Statistical Significance

Experimental group

As per question 2b above

18

p < 0.05, t-test for independent samples

Control group

Same baseline as experimental group

13.5


What is the mean change in QALY that resulted from the experimental treatment? Be sure to also interpret this result in terms of statistical significance and what this means in practical terms.

  1. In addition to the information in question 3, you are given the information shown in Table 2 regarding the costs associated with the treatment and control groups over the 20 years of the experiment.

Table 2. 20-year average costs associated with each group in this study per participant.

 

Experimental Group

Control Group

Drug costs for the new treatment

$5000

$0

Cost of supply materials to deliver new treatment

$1000

$0

Lost productivity at work

$1000

$6000

Hospital personnel costs

$2000

$6000

Clinic healthcare costs

$1500

$2000

Intangible costs (estimated based on patient survey and qualitative research)

$1500

$4000


Based on all this information, calculate the following for each group:

  1. The financial cost of the treatment
  2. The direct cost of the treatment
  3. The societal cost of the treatment
  4. The incremental cost per QALY, based on the financial cost model
  5. The incremental cost per QALY, based on the direct cost model
  6. The incremental cost per QALY, based on the societal cost model
  1. What are the benefits and limitations of using one of these incremental cost per QALY results over the others? Be sure to use your results from question 4 in your discussion.
  1. Suppose you live in a society where it has been agreed that spending $1000 for each additional QALY gained is well worth the expense, and policy decisions are made on the basis of this cutoff value. Based on the results of question 4, would you implement this new intervention for HIV positive patients living with AIDS? Be sure to explain your reasoning.
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