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Chapter 7 – MEDICAL MANAGEMENT IN POPULATION HEALTH CARE

Chapter 7 – MEDICAL MANAGEMENT IN POPULATION HEALTH CARE. MR. MARC ONEEL C. ALVAREZ, RN, RM, MAN. VALIDITY VERSUS RELIABILITY. CLINICAL EFFECTIVENESS Appropriate use of CLINICAL RESOURCES: TESTS and TREATMENT Guide question: 1. Are the test accurate?

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Chapter 7 – MEDICAL MANAGEMENT IN POPULATION HEALTH CARE

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  1. Chapter 7 – MEDICAL MANAGEMENT IN POPULATION HEALTH CARE MR. MARC ONEEL C. ALVAREZ, RN, RM, MAN Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  2. VALIDITY VERSUS RELIABILITY Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  3. CLINICAL EFFECTIVENESS • Appropriate use of CLINICAL RESOURCES: TESTS and TREATMENT • Guide question: 1. Are the test accurate? 2. Are the resources used appropriately? 3. What is the impact of testing information? 4. What is the diagnostic ability of the tests? INDICATORS OF TEST PERFORMANCE ACCURACY- condition of being true, correct or exact EFFICACY - is the capacity of producing a desired result or effect (effectiveness) EFFICIENCY – is the ability to accomplish a job with a minimum expenditure of time and effort. MEDICAL MANAGEMENT Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  4. Constructs that measures the ACCURACY OF A TEST. • Quantified by the parameters known as sensitivity, specificity and predictive values 1. VALIDITY Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  5. Sensitivity = a/(a+c) • Specificity = d/(b+d) • Predicitive Value + = a(a + b) • Predicitive Value + = a(a + b) Validity by 2 x 2 Contingency Table Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  6. Sensitivity and Specificity are test for accuracy. Absolute Value range from 0 to 1. The nearer the value to 1 means the test is more ACCURATE Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  7. a.) Increase in Prevalence of the Disease = Increase in the Positive Predictive Value and Decrease in the Negative Predictive Value b.) Decrease in Prevalence of the Disease = Decrease in the Positive Predictive Value and Increase in the Negative Predictive Value Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  8. VALIDITY PARAMETERS FOR ATHRITIS SCREENING TESTS WITH A PREVALENCE OF 10 % Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  9. VALIDITY PARAMETERS FOR COLORECTAL CANCER SCREENING TESTS Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  10. Predictive Validity of a PREADMISSION SCREENING TEST • Test whether pre-admission screening test to Home care is accurate MANAGERIAL ASPECTS OF VALIDITY Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  11. Degree to which repeated observations result in similar result on the same individual, under the same conditions. • Often referred to as PRECISION, REPRODUCIBILITY, REPEATABILITY • Important in diagnostic and therapeutic testing • Causes of VARIATIONS: a. IMPROPER CALIBRATION OF MEASURING INSTRUMENTS b. Observer-based variation c. Temporal changes in the subject/person (BP) • RELIABILITY INDEX - used to identify Level of acceptable Variation 2. RELIABILITY = (a+d) / (a+b+c+d) Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  12. RELIABILITY INDEX OF 2 PATHOLOGISTS TESTING THE WBC MORPHOLOGY RELIABILITY = (a+d) / (a+b+c+d) Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  13. MANAGING CHRONIC DISEASES Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  14. CONTRACTED CARVE-OUT > provision of care to the client by contracting with Disease Management Companies • PRIMARY CARE MODEL > focuses on specialized teamwork within HMO’s and other comprehensive health care systems that assist primary care providers in caring for chronically ill patients. Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  15. MANAGING INFECTIOUS DISEASES Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  16. INFECTIOUS DISEASE EPIDEMIOLOGY Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  17. Infectious epidemics Mr. Marc Oneel C. Alvarez, RN, RM, MAN

  18. Question? Mr. Marc Oneel C. Alvarez, RN, RM, MAN

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