A robust technique based on VLM and Frangi filter for retinal vessel extraction and denoising.

The exploration of retinal vessel structure is colossally important on account of numerous diseases including stroke, Diabetic Retinopathy (DR) and coronary heart diseases, which can damage the retinal vessel structure. The retinal vascular network is very hard to be extracted due to its spreading and diminishing geometry and contrast variation in an image. The proposed technique consists of unique parallel processes for denoising and extraction of blood vessels in retinal images.

Electronic sharing of diagnostic information and patient outcomes.

Objectives: Hospital sharing of electronic health record (EHR) diagnostic data has the potential to improve communication across providers and improve patient outcomes. However, implementing EHR systems can be difficult for hospitals. This study uses Hospital Compare (HC) and American Hospital Association (AHA) Annual Information Technology Survey data to estimate the association between sharing EHR data and patient outcomes.

The Impact of Hospital Characteristics on the Availability of Radiology Services at Critical Access Hospitals.

Purpose: Although all critical access hospitals (CAHs) provide basic medical and radiographic imaging services, it remains unclear how CAHs provide additional imaging services given relatively low patient volumes and high resource costs. The aim of this study was to examine whether CAHs with more resources or access to resources through affiliation with larger systems are more likely to offer other imaging services in their communities.

Methods: Linking data from the American Hospital Association's annual hospital surveys and the American Hospital Directory's annual surveys from 2009 to 2011, multivariate logistic regressions were performed to estimate the likelihood of individual CAHs with greater financial resources or network affiliations providing specific imaging services (MRI, CT, ultrasound, mammography, and PET/CT), while adjusting for the number of beds, personnel, inpatient revenue share, case mix, rural status, year, and geographic location.

Technology versus humanism: how patients perceive the use of electronic health records in physicians' offices--a qualitative study.

Electronic Health Records (EHRs) have the potential to improve the quality of care. In view of the accelerated adoption of EHRs, there is a need to understand conditions necessary for their effective use. Patients are the focus of healthcare and their perceptions and expectations need to be included in developing and implementing EHRs.

The scope and distribution of imaging services at critical access hospitals.

Purpose: The purpose of this study was to better understand the availability and scope of imaging services at critical access hospitals (CAHs) throughout the United States.

Methods: Recent American Hospital Association (AHA) annual survey data (containing 1,063 variables providing comprehensive information on organizational characteristics and availability of various services at 6,317 hospitals nationwide) and US census data were merged. Imaging survey data included mammography, ultrasound, CT, MRI, single photon emission CT, and combined PET/CT.

The use of the HIV test: a conflict choice approach.

The study introduces the "Conflict-Choice model" (C-C) as an analytic framework for studying consumer demand for health and healthcare. The proposed approach integrates the Theory of Consumer Behavior (TCB), the Investment Theory of Demand (ITD), and the Health Belief Model (HBM) into a single model that might be applied to a wide spectrum of health behavior and use of health services. Separating the episode of care into the two phases (patient initiated and physician dominated), the C-C model is limited to the individual's decision to seek service.

The effect of macroeconomic conditions on the care decisions of the employed.

Background: Medical care utilization has been found to be affected indirectly by changes in economic conditions through associated changes in employment or insurance status. However, if individuals interpret external macroeconomic conditions as employment risk, they may alter decisions to seek care even if they remain both employed and insured.

Objective: To examine the relationship between macroeconomic fluctuations and the medical care usage of Americans who are both employed and insured.

The current state of electronic health record (EHR) use in Oklahoma.

There is ample evidence of the positive impact of electronic health records (EHR) on operational efficiencies and quality of care. Yet, growth in the adoption of EHR and sharing of information among providers has been slow. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provides financial incentives for eligible providers to adopt and implement EHR.

Predictors of hospital CEO affiliation with a professional association.

Based on a 2008 cross-sectional survey of 582 hospital CEOs in the United States, this study reports the findings of two logistic regression models designed to identify CEO and hospital characteristics associated with Member and Fellow status in the American College of Healthcare Executives (ACHE). The purpose of the study was to understand the personal and organizational characteristics of those CEOs who choose to be Members and Fellows of a professional association such as ACHE. The results showed that most (74 percent) of the respondents considered ACHE to be their primary professional association.

The Saudi health care system: a view from the minaret.

This review article provides information about the origins, history, evolution and current status of the Saudi healthcare system, which is currently being transformed from a publicly financed and managed welfare system to a market-oriented, employment-based, insurance-driven system. Since its inception in the 1920s, the system has provided free healthcare to all Saudi nationals at publicly owned facilities run by government-employed administrators and healthcare providers. For millions of foreign workers in the country, healthcare at privately owned for-profit facilities has been paid for either by the employer or by the individual.

Factors affecting the value of professional association affiliation.

Background: The resource-based view of the firm suggests that organizations must obtain valuable resources from external sources to obtain lasting benefits. Professional associations today exist in every industry and offer resources to assist their affiliates' organizations and individual members. Today, there are more than 23,000 national and 64,000 state, local, and regional professional associations that claim to significantly benefit their affiliates.

A planning model for the short-term management of cash.

This paper develops a model that enables the health administrator to identify the balance that minimizes the projected cost of holding cash. Adopting the principles of mathematical expectation, the model estimates the expected total costs of adopting each of the several strategies concerning the cash balance that the organization might maintain. Expected total costs consist of anticipated short costs, resulting from a potential shortage of funds.

Factors affecting the continuing education of hospital CEOs and their senior managers.

This article examines the influences on executives' continuing education in hospitals. It uses data from a national survey on professional development conducted in 2009 by the American College of Healthcare Executives (ACHE) to explore how organizational and individual characteristics are related to the amount of continuing education (CE) taken by chief executive officers (CEOs) and the commitment to CE by their senior managers. Our findings suggest that the organizational characteristics of ownership, size, and region and the individual characteristics of gender, professional affiliation, and the focus of CE may influence how much CE CEOs take.

Hospital chief executive officer perspective on professional development activities.

A study was undertaken to develop understanding of hospital chief executive officers' (CEOs') perspectives concerning importance and impact of professional development activities in US hospitals. It was also intended to reveal CEO preferences for various modalities of professional development including membership in professional societies, attainment of credentials, and coaching by mentors. A mail survey of 582 hospital CEOs made use of a pilot-tested questionnaire with 30 close ended multipart questions.

Global nurse migration: its impact on developing countries and prospects for the future.

The worldwide shortage of nurses which results from a global undersupply and high attrition rates affects developed countries in the West the same way as it affects developing countries in Asia, Africa and Latin America. The difference lies in the fact that developing countries serve as a readily available source of trained nurses for developed countries in Europe, North America and parts of Oceania. Strong "pull" and "push" factors favour wealthier nations in the West in their efforts to deal with domestic shortages through overseas recruitment.

Global nurse migration: its impact on developing countries and prospects for the future.

The worldwide shortage of nurses, which results from a global undersupply and high attrition rates, affects developed countries in the West the same way as it affects developing countries in Asia, Africa and Latin America. The difference lies in the fact that developing countries serve as a readily available source of trained nurses for developed countries in Europe, North America and parts of Oceania. Strong "pull" and "push" factors favour wealthier nations in the West in their efforts to deal with domestic shortages through overseas recruitment.

Incoming and outgoing hospital CEOs: what kind of help do they want?

CEO turnover, although common, is expensive and disruptive for everyone involved. Both incoming and outgoing CEOs would welcome help in making the transition a painless experience. Through a 2005 nationwide survey of 805 current hospital CEOs, the authors obtained comments and suggestions in response to three open-ended questions about specific activities or processes that would help incoming and outgoing CEOs.

Is chief executive officer turnover good for the hospital?

This study examined the general characteristics of chief executive officers (CEOs) and their hospitals and the perceived impact of CEO turnover on various organizational activities. A mail-based survey included 156 hospital CEOs in 6 states in the West South Central, West North Central, and Mountain regions. Neither hospital and CEO characteristics nor the impact on various organizational activities and performance indicators was significantly different among the 6 states compared.

Which hospitals give discounts? The role of institutional and environmental factors.

Offering discounts on list prices in exchange for a large volume of business is a common practice in the healthcare industry. However, little is known about the characteristics of hospitals that engage in this practice or about the circumstances that promote this strategy. On the basis of data from the American Hospital Association and the Centers for Medicare and Medicaid Services, the authors reveal that hospital size, Medicare patient volume, net income, medical school affiliation, location in a metropolitan statistical area, and hospital system membership are factors positively linked with the amount of discounts provided by hospitals to third-party payers.

Comparison of resource utilization and clinical outcomes between teaching and nonteaching medical services.

Purpose: To compare the resource utilization and clinical outcomes of medical care delivered on general internal medicine inpatient services at teaching and nonteaching services at an academic hospital.

Methods: From February to October 2002, 2189 patients admitted to a 450-bed university-affiliated community hospital were assigned either to a resident-staffed teaching service (n = 1637) or to a hospitalist- or clinic-based internist nonteaching service (n = 552). We compared total hospital costs per patient, length of hospital stay (LOS), hospital readmission within 30 days, in-hospital mortality, and costs for pharmacy, laboratory, radiology, and others between teaching and nonteaching services.

Perceptions of hospital CEOs about the effects of CEO turnover.

Empirical evidence is scarce on chief executive officer (CEO) turnover in U.S. hospitals, with potentially serious implications for many of these organizations.

Co-morbidity in an elderly inpatient population: are the risks of co-existing conditions differentially distributed?

This study examines the distribution of co-morbidity among 167,738 inpatients, aged 65 or more, who experienced an episode of hospitalization during 1999 in short-term institutions that are located in Oklahoma. The analysis was conducted in two phases. In the first, logistic regression analysis was used to examine covariates that separate inpatients who presented at least one secondary diagnosis from those who were not co-morbid.

Hospital admissions: who is admitted through the emergency department?

This study examines the co-variates that separate patients who presented an emergent condition without a physician referral and were admitted through the hospital emergency department (ED) from their counterparts who were referred by a physician for the treatment of an elective or urgent condition and were admitted through the admissions department. The analysis was based on 295,945 inpatient admissions in 1999 to short-term acute-care hospitals in Oklahoma. Employing hospital admission as the unit of analysis, logistic regression was used to examine the differential likelihood of admission without a physician referral and through the ED of the uninsured, Medicare beneficiaries, Medicaid recipients, African Americans and Native Americans.

Disciplinary action against physicians: who is likely to get disciplined?

Purpose: We sought to determine the characteristics of disciplined physicians at-large and the risk of disciplinary action over time and to report the type and frequency of complaints and the nature of disciplinary actions against allopathic physicians in Oklahoma.

Methods: Descriptive statistics, Kaplan-Meier analysis, and Cox proportional hazards modeling of publicly available data on physicians licensed by the Oklahoma Board of Medical Licensure and Supervision.

Results: Among 14,314 currently or previously licensed physicians, 396 (2.