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Using Multivariate Statistics

Economic profit = total revenue total economic cost • Total economic cost includes the value of all inputs used in production. • Normal profit is an economic cost since it occurs when economic profit is zero. It represents the opportunity cost of labor and capital contributed to the production process by the producer. • Accounting profits are computed only on the basis of explicit costs, including labor and capital. Since they do not take "normal profits" into consideration, they overstate true profits.

Principles of microeconomics (I)

Surgical mortality and type of anesthesia provider.

Watchful Care: A History of America??s Nurse Anesthetists

Inadequate access to anesthesia and surgical services is often considered to be a problem of low- and middle-income countries. However, affluent nations, including Canada, Australia, and the United States, also face shortages of anesthesia and surgical care in rural and remote communities. Inadequate services often disproportionately affect indigenous populations. A lack of anesthesia care providers has been identified as a major contributing factor to the shortfall of surgical and obstetrical care in rural and remote areas of these countries. This report summarizes the challenges facing the provision of anesthesia services in rural and remote regions. The current landscape of anesthesia providers and their training is described. We also explore innovative strategies and emerging technologies that could better support physician-led anesthesia care teams working in rural and remote areas. Ultimately, we believe that it is the responsibility of specialist anesthesiologists and academic health sciences centers to facilitate access to high-quality care through partnership with other stakeholders. Professional medical organizations also play an important role in ensuring the quality of care and continuing professional development. Enhanced collaboration between academic anesthesiologists and other stakeholders is required to meet the challenge issued by the World Health Organization to ensure access to essential anesthesia and surgical services for all.

Improving Access to Safe Anesthetic Care in Rural and Remote Communities in Affluent Countries

DETERMINANTS OF HOSPITAL ADMINISTRATORS’ CHOICE OF ANESTHESIA PRACTICE MODEL By Maribeth Leigh Massie, Ph.D., CRNA A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2017 Director: Suzanne Wright, PhD, CRNA Vice Chair of Academic Affairs and Director of Doctoral Education Department of Nurse Anesthesia Hospital administrators are being held accountable by patients, insurers, and other stakeholders in evaluating their overall hospital performance to reduce costs and improve efficiency. With the move to alternative payment models and value-based purchasing, hospital administrators must understand the economic viability and value that their specialty services bring to their facility. The purpose of this study was to identify the determinants New England acute care hospital administrators’ utilize in making the choice of anesthesia practice model for their facility. A quantitative, exploratory study of factors hospital administrators use when choosing an anesthesia practice model utilizing a non-experimental, correlational research design was completed. The research was descriptive in nature to determine the factors that influenced a hospital administrator when making decisions about the type of anesthesia practice model that would be the best for their hospital. This research examined seventeen independent variables that were hypothesized to determine hospital administrators’ choice of anesthesia practice model. After the final logistic regression analysis, it was determined that the presence of a hospital being located in a medically underserved area (MUA) alone was a predictor of type of anesthesia practice model utilized. In light of the study limitations and prior literature on the CRNA-only model being present in almost 100% of rural facilities, more exploration is necessary to come to more robust conclusions on predictors of choice of anesthesia practice model determined by hospital administrators. This study showed that there are definitive areas that hospital administrators identify as high importance to the healthy functioning of their facility. By addressing these needs, an anesthesia department could contribute to the overall stability of the hospital, while at the same time, making themselves a more valuable asset overall. Value-driven services offered by anesthesia departments may be the determining factor in choice of anesthesia practice model. By measuring and analyzing anesthesia provider and hospital demographics and hospital administrators’ perceptions of anesthesia services, the objective data collected may assist in defining the most appropriate practice model for a hospital.

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Maribeth L. Massie

Papers

Determinants of Hospital Administrators' Choice of Anesthesia Practice Model