This report defines database design and implementation technology as applicable to healthcare. The relationship of technology to various healthcare settings is explored, and the effectiveness on healthcare costs, quality and access is evaluated. A summary of relevant development directions is included. Detailed examples of 5 typical clinical applications (public health, clinical trials, clinical research, ambulatory care, and hospitals) are appended. There is an extended bibliography.

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Databases in healthcare

Although many previous analytical studies indicate that physicians' assistants can substantially increase productivity and reduce costs, the utilization of physicians' assistants in ambulatory health care settings has grown at a disappointing rate. This apparent discrepancy may be explained in part through close examination of the models used in the analytical studies. This paper describes the limitations of previous studies and shows how analysis can be improved through the use of a combined optimization-simulation model. The model is applied to a hypothetical example to demonstrate how productivity and income benefits can be overstated, and to test the sensitivity of such benefits to a range of management policies for the ambulatory care practice regarding patient load, physical resources, appointment scheduling, and more flexible assignment of providers to patients.

Ingeborg M. Kuhn

Papers

The productivity potential of physicians' assistants: an integrated approach to analysis.