Skp Matwankar

DEVELOPING AN OPERATIONAL DECISION RULE FOR IDENTIFYING THE FATAL CASE DOCUMENTS AT RISK OF BEING RETURNED THROUGH MATHEMATICAL MODELLING

Incomplete or inaccurately filled fatal case documents are often returned to the hospital by higher headquarters, causing delay in the completion of procedural formalities. A mathematical model was developed to identify those fatal case documents which are at an increased risk of being returned so that the corrective action may be taken a priori. The data was subjected to a multiple logistic regression analysis. Diagnostic test characteristics were worked out and a Receiver Operating Curve analysis was done to find out optimum operating points on the slope, and the following mathematical rule was developed: 7.06=1 (if age > 50 years) - 4.5 (if age <= 12 years) + 9.88 (if serving person) + 2.75 (if ex-serviceman) + 4.5 (if dependent son or daughter) + 6.38 (if time lag > 10 days). This rule carries a sensitivity of 53 per cent and specificity of 75 per cent.

Contemporary IssueDEVELOPING AN OPERATIONAL DECISION RULE FOR IDENTIFYING THE FATAL CASE DOCUMENTS AT RISK OF BEING RETURNED THROUGH MATHEMATICAL MODELLING

Incomplete or inaccurately filled fatal case documents are often returned to the hospital by higher headquarters, causing delay in the completion of procedural formalities. A mathematical model was developed to identify those fatal case documents which are at an increased risk of being returned so that the corrective action may be taken a priori. The data was subjected to a multiple logistic regression analysis. Diagnostic test characteristics were worked out and a Receiver Operating Curve analysis was done to find out optimum operating points on the slope, and the following mathematical rule was developed: 7.06=1 (if age > 50 years) - 4.5 (if age <= 12 years) + 9.88 (if serving person) + 2.75 (if ex-serviceman) + 4.5 (if dependent son or daughter) + 6.38 (if time lag > 10 days). This rule carries a sensitivity of 53 per cent and specificity of 75 per cent.

A MATHEMATICAL DECISION MODEL TO PREDICT THE OPTIMAL NUMBER OF BEDS IN LABOUR ROOM AND MATERNITY WARD OF A LARGE TEACHING HOSPITAL

The pattern of deliveries taking place at a Command Hospital were studied with a view to predict the optimal number of beds required in the labour room. The data was collected on the basis of authentic records maintained in the labour room and a mathematical decision model was built up. The number of deliveries per day and shift-wise were found to be close to corresponding values of variance. Further, the application of chi-square test confirmed that Poisson distribution could be applied for such forecasts. The study revealed that optimal number of beds required in the labour room should be a maximum of 8 in a day. Further analysis on an 8-hourly shift basis revealed that the maximum number of deliveries in any given shift would be 4, the probability of higher number of deliveries being very small (p<0.05). Thus catering to 4 deliveries per shift should be the optimum provision in such a large teaching hospital.

MANAGEMENT OF MEDICAL TECHNOLOGY: AN ENIGMA

Health care facilities, whether in developed or developing countries, are increasingly finding themselves carrying out a balancing act between the available financial resources and demand for rapidly changing medical technology. The current situation on management of medical technology, especially sophisticated medical equipment, in India and developed countries is discussed and managerial methods suggested to make technology more need-based than demand-based. Lack of standardization of medical equipment in India is highlighted and the formation of an internal technology assessment group in each hospital is recommended along with scientific planning and evaluation of each new medical equipment to be brought into use.