Validation of ACG Case-mix for equitable resource allocation in Swedish primary health care

<p>Abstract</p> <p>Background</p> <p>Adequate resource allocation is an important factor to ensure equity in health care. Previous reimbursement models have been based on age, gender and socioeconomic factors. An explanatory model based on individual need of primary health care (PHC) has not yet been used in Sweden to allocate resources. The aim of this study was to examine to what extent the ACG case-mix system could explain concurrent costs in Swedish PHC.</p> <p>Methods</p> <p>Diagnoses were obtained from electronic PHC records of inhabitants in Blekinge County (approx. 150,000) listed with public PHC (approx. 120,000) for three consecutive years, 2004-2006. The inhabitants were then classified into six different resource utilization bands (RUB) using the ACG case-mix system. The mean costs for primary health care were calculated for each RUB and year. Using linear regression models and log-cost as dependent variable the adjusted R²was calculated in the unadjusted model (gender) and in consecutive models where age, listing with specific PHC and RUB were added. In an additional model the ACG groups were added.</p> <p>Results</p> <p>Gender, age and listing with specific PHC explained 14.48-14.88% of the variance in individual costs for PHC. By also adding information on level of co-morbidity, as measured by the ACG case-mix system, to specific PHC the adjusted R²increased to 60.89-63.41%.</p> <p>Conclusion</p> <p>The ACG case-mix system explains patient costs in primary care to a high degree. Age and gender are important explanatory factors, but most of the variance in concurrent patient costs was explained by the ACG case-mix system.</p

Gradient microfluidics enables rapid bacterial growth inhibition testing

Bacterial growth inhibition tests have become a standard measure of the adverse effects of inhibitors for a wide range of applications, such as toxicity testing in the medical and environmental sciences. However, conventional well-plate formats for these tests are laborious and provide limited information (often being restricted to an end-point assay). In this study, we have developed a microfluidic system that enables fast quantification of the effect of an inhibitor on bacteria growth and survival, within a single experiment. This format offers a unique combination of advantages, including long-term continuous flow culture, generation of concentration gradients, and single cell morphology tracking. Using Escherichia coli and the inhibitor amoxicillin as one model system, we show excellent agreement between an on-chip single cell-based assay and conventional methods to obtain quantitative measures of antibiotic inhibition (for example, minimum inhibition concentration). Furthermore, we show that our methods can provide additional information, over and above that of the standard well-plate assay, including kinetic information on growth inhibition and measurements of bacterial morphological dynamics over a wide range of inhibitor concentrations. Finally, using a second model system, we show that this chip-based systems does not require the bacteria to be labeled and is well suited for the study of naturally occurring species. We illustrate this using Nitrosomonas europaea, an environmentally important bacteria, and show that the chip system can lead to a significant reduction in the period required for growth and inhibition measurements (&lt;4 days, compared to weeks in a culture flask)

Fermilab E791

Fermilab E791, a very high statistics charm particle experiment, recently completed its data taking at Fermilab's Tagged Photon Laboratory. Over 20 billion events were recorded through a loose transverse energy trigger and written to 8mm tape in the the 1991-92 fixed target run at Fermilab. This unprecedented data sample containing charm is being analysed on many-thousand MIP RISC computing farms set up at sites in the collaboration. A glimpse of the data taking and analysis effort is presented. We also show some preliminary results for common charm decay modes. Our present analysis indicates a very rich yield of over 200K reconstructed charm decays.Comment: 4 pages, 1 figure, LaTe

Measurement of the Ds Lifetime

We report the results of a precise measurement of the Ds meson lifetime based on 1662 +/- 56 fully reconstructed Ds -> phi pi decays, from the charm hadroproduction experiment E791 at Fermilab. Using an unbinned maximum likelihood fit, we measure the Ds lifetime to be 0.518 +/- 0.014 +/- 0.007 ps. The ratio of the measured Ds lifetime to the world average D0 lifetime is 1.25 +/- 0.04. This result differs from unity by six standard deviations, indicating significantly different lifetimes for the Ds and the D0.Comment: 12 pages, 3 figures, 2 table. LaTe

Search for the Flavor-Changing Neutral-Current Decays D+→π+μ+μ−D^+\to \pi^+ \mu^+ \mu^- and D+→π+e+e−D^+\to \pi^+ e^+ e^-

We report the results of a search for the flavor-changing neutral-current decays $D^+\rightarrow \pi^+ \mu^+ \mu^-$ and $D^+\rightarrow \pi^+ e^+ e^-$ in data from Fermilab charm hadroproduction experiment E791. No signal above background is found, and we obtain upper limits on branching fractions, $B(D^+\rightarrow \pi^+ \mu^+ \mu^-) < 1.8 \times 10^{-5}$ and $B(D^+\rightarrow \pi^+ e^+ e^-) < 6.6 \times 10^{-5}$, at the 90\% confidence level.Comment: nine pages with figures; compressed, uuencoded postscrip

Study of the Ds+→π−π+π+D^+_s \to \pi^- \pi^+ \pi^+ decay and measurement of f0f_0 masses and widths

From a sample of 848 $\pm$ 44 $D_s^+ \to \pi^- \pi^+ \pi^+$ decays, we find $\Gamma(D_s^+ \to \pi^- \pi^+ \pi^+) / \Gamma(D_s^+ \to \phi \pi^+) = 0.245 \pm 0.028^{+0.019}_{-0.012}$. Using a Dalitz plot analysis of this three body decay, we find significant contributions from the channels $\rho^0(770)\pi^+$, $\rho^0(1450)\pi^+$, $f_0(980)\pi^+$, $f_2(1270)\pi^+$, and $f_0(1370)\pi^+$. We present also the values obtained for masses and widths of the resonances $f_0(980)$ and $f_0(1370)$.Comment: 10 pages, 3 eps figure

Direct measurement of the pion valence quark momentum distribution, the pion light-cone wave function squared

We present the first direct measurements of the pion valence quark momentum distribution which is related to the square of the pion light-cone wave function. The measurements were carried out using data on diffractive dissociation of 500 GeV/c $\pi^-$ into di-jets from a platinum target at Fermilab experiment E791. The results show that the $|q\bar {q}>$ light-cone asymptotic wave function, which was developed using perturbative QCD methods, describes the data well for $Q^2 \sim 10 ~{\rm (GeV/c)^2}$ or more. We also measured the transverse momentum distribution of the diffractive di-jets.Comment: 13 pages, 4 figure