Epidemiology (Essay Sample)

Epidemiology
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Pneumonia Statistics
Pneumonia is a common cause of death in the modern world. It is an inflammation of the lungs caused by infections such as viruses, bacteria and other related organisms. There are however cases of non-infectious grounds. When a patient’s body is weakened by influenza or a simple viral in the respiratory tract, the situation may become complicated with time. This complication of a pre-existing infection is what is normally referred to as Pneumonia. The complication is most likely known to affect the lungs with bronchial pneumonia affecting patches right through both lungs and Lobar Pneumonia affecting the lobe of the lungs. Pneumonia is the eighth ranked cause of death in the United States. In the world, approximately 450 million people contract the illness in a year with 4 million of those being deaths. This represents 7% of the world’s deaths per annum. The rates of death and illness are more in children aged less than 5 years and in adults over 75 years CITATION Ame10 \l 2057 (Association, 2010). The condition is more prevalent in developing countries, which is over 5 times more than in developed countries. Out of the 450 million cases of Pneumonia illness in the world, 200 million of those are caused by viruses. In the United States, averages of 7 million people contact the illness in a year. Out of those 1 million are hospitalized which makes the condition the third ranked cause of hospitalization in the United States. This shows the severity of the condition with the other two positions being taken by heart disease and births. It is most common in children with over 500000 hospitalized because of conditions arising from infections around 160000 of those having Pneumonia. Pneumonia can be treated though it still kills 40000-70000 individuals every year. In the whole world, approximately 156 children had Pneumonia. Out of those, 151 million are from developing countries while the rest 6 million are children from the developed world CITATION Nob99 \l 2057 (Goldfield, 1999). This consequently led to the death of 1.6 million children in the world representing 28-34 % of all deaths in children below 5 years of age. Developing countries are most affected by Pneumonia due to lack of proper infrastructure, human resources and capital. The rate of Pneumonia stands at 10-25 % with the rate going up to 50-70 % when the patient contacts Pneumonia when already hospitalized with another condition. The condition also proves a burden to the government financially with the United States government spending over $10 million annually in maintaining 1.1 million people. According to UNICEF, the most affected countries are India, Pakistan, Iran and parts of Africa. The organization has listed 66 countries, which it considers high priority. UNICEF therefore spends around $ 109 million annually in Pneumonia diagnosis and antibiotics.
DRGs
The evolution in the medical system has led to adoption of new DRG systems to match the patient’s needs. Medicare DRG takes the range 001-999 with some of the numbers left blank to accommodate expansion in the future. Each patient is assigned a DRG by means of discharge status, sex, principal procedure, additional procedures, principal diagnoses and additional diagnosis. DRG assignment diagnosis and procedures are determined by ICD-9-CM. The accuracy and completeness of ICD-9-CM coding determines the functionality of MS-DRG assignment and ensuing reimbursement. A set fee is paid to all hospitals for their treatment of patients in MS-DRG without considering the actual cost involved in that particular case. The differences in patient’s consumption of resources and costs are adjusted by a weight assigned to each MS-DRG. Refined DRG’s were improved after criticism that non-Medicare patients were not well addressed in HCFA DRG’s CITATION PFo04 \l 2057 (Fountaine, 2004). They were therefore extended to include neonate and pediatric cases. DRG’s for other conditions such HIV and trauma were also extended. HCFA Cormordity splits (CCs) were also eliminated and swapped with refinement classes in a signal severity. The APR DRG rating method is used in determining the amount of reimbursement to be given. All patients DRG’s bears some similarity with DRG and contains a comprehensive analysis of non-Medicare patients. This means that it provides sufficient details regarding children particularly newborns. The level of reimbursement is determined by the average length of stays (ALOS), service intensity weights (SIWs) and cost outlier threshold.
After the reevaluation of co...