How Home Health Agencies’ Ownership Affects Practice Patterns

This study explores whether for‐profit home health agencies responded differently from non‐profit agencies to financial incentives embedded in the Medicare prospective payment system. Agencies were able to receive higher reimbursement per patient under the prospective payment system if they adjusted the number of therapy visits or the type of visits for a two‐month‐long episode. Agencies could also increase reimbursement by treating a patient for multiple episodes of care, because prospective payments were made on a per‐episode basis. Using the Medicare Claims and Provider of Services Files from 2001 to 2009, we examine differences between for‐profit and non‐profit agencies in these practice patterns during the first nine years of the prospective payment system. We find that for‐profit agencies were more likely to adopt most of these practice patterns than were non‐profit agencies. This finding suggests that for‐profit agencies were more responsive to financial incentives, and therefore disproportionately contributed to the increase in Medicare home health spending under the prospective payment system. Policymakers could consider revising the current prospective payment system that gives agencies incentives to distort practice patterns regardless of a patient’s health care needs.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138406/1/fisc12136_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138406/2/fisc12136-sup-0001-text.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138406/3/fisc12136.pd

Diclomezine: 6-(3,5-dichloro-4-methyl­phen­yl)pyridazin-3(2H)-one

In the title compound, C11H8Cl2N2O, the benzene and pyridazine rings are tilted by 8.6 (1)° relative to each other. In the crystal, pairs of inter­molecular N—H⋯O hydrogen bonds form centrosymmetric dimers. π–π contacts with centroid–centroid distances of 3.698 (2) and 3.751 (1) Å and halogen–halogen inter­actions [3.379 (1) Å] also stabilize the structure

Flutolanil [N-(3-isopropoxyphen­yl)-2-(trifluoro­meth­yl)benzamide]

The title compound, C17H16F3NO2, crystallizes with two independent mol­ecules in the asymmetric unit. The dihedral angles between the isopropoxyphenyl and trifluoro­methyl­phenyl rings are 85.78 (5) and 63.15 (6)° in the two mol­ecules. In the crystal structure, inter­molecular N—H⋯O and C—H⋯π inter­actions are observed

Methidathion: S-(5-meth­oxy-2-oxo-2,3-dihydro-1,3,4-thia­diazol-3-yl)methyl O,O-dimethyl phospho­rodithio­ate

The title compound, C6H11N2O4PS3, crystallizes with two independent mol­ecules in the asymmetric unit. The dihedral angles between the thia­diazole ring planes and the PS2 planes of the phospho­rodithio­ate group are 86.51 (5) and 56.33 (5)° in the two mol­ecules. In the crystal, weak inter­molecular S⋯S [3.570 (8) Å] inter­actions and C—H⋯O and C—H⋯N hydrogen bonds contribute to the stabilization of the packing

Effects of remote ischemic postconditioning on hepatic injury in lipopolysaccharide-induced endotoxemic rats

Background Remote ischemic postconditioning (RIPoC) is induced by several cycles of brief, reversible, mechanical blood flow occlusion, and reperfusion of the distal organs thereby protecting target organs. We investigated if RIPoC ameliorated liver injury in a lipopolysaccharide (LPS)-induced endotoxemic rats. Methods Protocol 1) Rats were administered LPS and samples collected at 0, 2, 6, 12, and 18 h. 2) After RIPoC at 2, 6, and 12 h (L+2R+18H, L+6R+18H, and L+12R+18H), samples were analyzed at 18 h. 3) RIPoC was performed at 2 h, analysis samples at 6, 12, 18 h (L+2R+6H, L+2R+12H, L+2R+18H), and RIPoC at 6 h, analysis at 12 h (L+6R+12H). 4) Rats were assigned to a control group while in the RIPoC group, RIPoC was performed at 2, 6, 10, and 14 h, with samples analyzed at 18 h. Results Protocol 1) Liver enzyme, malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), and nuclear factor-κB (NF-κB) levels increased while superoxide dismutase (SOD) levels decreased over time. 2) Liver enzyme and MDA levels were lower while SOD levels were higher in L+12R+18H and L+6R+18H groups when compared with L+2R+18H group. 3) Liver enzyme and MDA levels were lower while SOD levels were higher in L+2R+6H and L+6R+12H groups when compared with L+2R+12H and L+2R+18H groups. 4) Liver enzyme, MDA, TNF-α, and NF-κB levels were lower while SOD levels were higher in RIPoC group when compared with control group. Conclusions RIPoC attenuated liver injury in the LPS-induced sepsis model by modifying inflammatory and oxidative stress response for a limited period

Practice Patterns among Entrants and Incumbents in the Home Health Market after the Prospective Payment System was Implemented

Home health care expenditures were the fastest growing part of Medicare from 2001–2009, despite the implementation of prospective payment. Prior research has shown that home health agencies adopted two specific strategies to take advantage of Medicare policies: provide at least 10 therapy visits to get an enormous marginal payment and recertify patients for additional episodes. We study whether there is heterogeneity in the adoption of those strategic behaviors between home health agency entrants and incumbents and find that entrants were more likely to adopt strategic practice patterns than were incumbents. We also find that for‐profit incumbents mimicked one of the practice patterns following entrants in the same market. Our findings suggest that it is important to understand the heterogeneity in providers' behavior and how firms interact with each other in the same market. These findings help explain the rapid rise in expenditures in the home health care market. Copyright © 2015 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110854/1/hec3147-sup-0001-SI_appendix.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/110854/2/hec3147.pd

네트워크, 문화 및 경력 성공: 강한 연결 관계(strong tie)가 중요할 때에 관한 연구

Traditionally, research on career success was developed with human capital or organizational structural approach. This paper extends this research stream by adding social capital approach on determining career success. Previous research on career success based on social capital approach emphasizes the importance of weak-ties in career success. However, by constraining the cultural context in non-Western culture which has interdependent self-construals, this paper proposes that strong ties rather than weak ties are important for career success and specifies how the types and qualities of resources acquired through these strong ties affect career success. In addition, this paper shows how global and local network structure interacts to affect one's career success.전통적으로 경력 성공(career success)에 관한 연구는 인적 자본 접근방법 (human capital approach)나 조직 구조적 접근 방법(organizational structural approach)에 기반하여 왔다. 이 논문은 경력 성공에 관한 기존 연구를 확장하여 경력 성공을 연구하는데 있어서 사회 자본 접근방법(social capital approach)을 취해본다. 사회 자본 접근방법을 취하는 기존 경력 성공 관련 연구에서는 대부분 약한 연결 관계(weak ties)가 경력성공에 도움을 준다고 알려져 있지만, 상호의존적 자기관(interdependent selfconstruals)을 지니고 있는 비서구권 문화에서는 서구권 문화와 달리 강한 연결 관계(strong ties)가 약한 연결 관계보다 더 중요할 수 있다고 제언한다. 이를 위해 다양한 네트워크 연결 관계에서 경력과 관련해 얻게 되는 자원을 세분화/구체화하고 행위자의 글로벌 및 로컬 네트워크가 어떻게 상호작용을 일으키며 경력 성공에 영향을 미치는지를 논한다.This work was supported by the Institute of Industrial Relations, Seoul National Universit

Effects of the Ten Percent Cap in Medicare Home Health Care on Treatment Intensity and Patient Discharge Status

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113702/1/hesr12290-sup-0001-AuthorMatrix.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/113702/2/hesr12290.pd

다양한 문화권에서의 실패에 대한 존중: 집단의 심리적 안정감(Team psychological safety)의 집단 창의성에 대한 인지 측면, 동기부여 측면, 및 사회적 측면의 영향력

Team climate is known to be a critical factor affecting team creative performance. In this paper, I examine the effect of team psychological safety on team creative performance in various team climate situations. Team psychological safety is defined as the shared belief that [a] team is safe for interpersonal risk taking (Edmondson, 1999). I examine the underlying mechanisms by which team psychological safety affects cognitive, motivational, and social processes at both the individual and team levels, and how these mechanisms affect overall team creative performance. In addition, I examine culture as a moderator of these relationships. This will contribute to our understanding of how different cultures affect creative performance, as well as the importance of considering the cultural background of teams in a global economy when constructing team climates.집단 문화(team climate)는 집단의 창의성에 영향을 주는 핵심 요소로 알려져 있다. 이 논문은 집단 문화 중 하나인 집단의 심리적 안정감 (team psychological safety)이 집단의 창의성에 어떠한 영향을 주는지에 대한 제언을 한다. 집단의 심리적 안정감은 대인관계에서 발생할 수 있는 리스크를 감수할 수 있는 심리적 안정감에 대한 집단 내 공유된 신뢰도를 의미한다(Edmondson, 1999). 이 논문은 집단의 심리적 안정감이 개인 및 집단 수준에서 인지, 동기부여, 및 사회적 측면에서 어떠한 영향을 주는지에 대한 내재된 원리를 분석하고, 궁극적으로 이러한 변화들이 집단의 창의성에 어떤 영향을 주는지에 대해 제언한다. 또한, 이러한 관계성에서 서로 다른 민족문화가 어떠한 영향을 미치는지에 대해 제언한다. 이 논문은 집단의 심리적 안정감에 대한 심도있는 고찰을 통해 특히, 서로 다른 문화가 어떻게 창의성에 영향을 주는지, 또한 더 나아가 글로벌화 시대에 집단의 문화를 구성하는데 있어서, 서로 다른 문화 배경을 이해하는 것이 얼마나 중요한지에 대한 문제제기를 한다.This work was supported by the Institute of Industrial Relations, Seoul National University

Considerations regarding anesthesia for renal transplantation

Renal transplantation is a complex surgical procedure requiring meticulous anesthetic planning to ensure patient safety and optimal graft function. In this comprehensive review, we examined various aspects of anesthesia management during renal transplantation, including preoperative, intraoperative, and postoperative care. Preoperative optimization involves the identification and management of risks to mitigate perioperative complications. Treatment with erythropoiesis-stimulating agents is recommended to correct anemia in transplant recipients with hemoglobin levels below 9-10 g/dl. Intraoperative management focuses on hemodynamic monitoring, maintenance of intravascular volume, and careful selection of anesthetic techniques. Neuromuscular monitoring and the appropriate use of neuromuscular blocking and reversal agents are considered essential. Further, hemodynamic goals include maintaining the mean arterial pressure within the range of 80-110 mmHg. In addition, attention should be paid to perioperative glycemic control, temperature management, and diuretic use. In postoperative management, multimodal analgesia and the prevention of postoperative delirium contribute to optimal recovery. The implementation of enhanced recovery after surgery principles can further improve outcomes. Collaborative efforts among surgical teams, anesthesiologists, and healthcare professionals are crucial for achieving successful renal transplantation outcomes