Medical Care Expenditures in Patients with Chronic Obstructive Pulmonary Disease - Research Proposal Example

Research Critique - Utilization and Medical Care Expenditures in Patients with Chronic Obstructive Pulmonary Disease: A Managed Care Claims Data Analysis - Summary COPD such as emphysema and chronic bronchitis is a major cause of serious illness in the U.S. Patients with COPD with ages ranging from 55 – 64 years old have two to three times higher healthcare utilization than those without COPD. The research study aims to determine the estimated annual healthcare utilization and expenditures of patients with chronic obstructive pulmonary disease (COPD). Strengths and Weaknesses of the Research Weaknesses The three researchers, none of them are registered nurse. This can be inferred from the fact that none of them are affiliated with a medical hospital or a nursing facility. None of them indicated they had are in the nursing profession. The fact that all of them works for pharmaceutical companies make their paper less credible. Another weak area is the dearth of review of literature contained in the study. There were no references to previous and current studies using managed care claims in the US or in other continents of the world. One gets the impression that this is a landmark study since it has not built on previous studies done in the US. Strength The study specified clearly the various components of the health expenditures incurred by the patients. It also has a concise abstract. The discussion portion of the study was detailed and it helped explain the extent of medical expenditures incurred by the COPD and non-COPD patients. Researcher/Title/Abstract Researcher(s) Kristina S. Yu-Isenberg, Ann Vanderplas, and Eunice Chang are all affiliated with Pharmaeconomics and Health Outcomes Research Department of Prescription Solutions in California. Despite their Ph.D. title, the authors are not considered as a qualified since most of the papers they have written are mostly for Prescription Solutions also known as Rx Solutions which is a pharmaceutical company.1, 2, 3, 4, 5, 6, 7 On the other hand, Hermal Shah works for Boehringer Ingelheim, also a pharmaceutical company.8 Their written documents can be concluded as bias since these people are working for a pharmaceutical company which is mainly after earning profit. Title The title of the study gives the reader a rough idea on where the study will focus. Abstract The abstract tackled mostly the objective of the study; the methodology; results; and conclusion. From the abstract alone, the reader could easily have an idea on several issues that will be discussed throughout the study. However, the authors did not mention in the objective of the study several issues such as: the research questions they intend to address and the reason for the choice of the sample. Introduction / Problem / Purpose The introduction does not contain the statement of purpose, the problem statement, and the research questions or even the hypotheses. The introduction part of the study only highlighted the significance of the study and the extent of the gravity of the related symptoms of the COPD which include chronic cough and sputum production. Literature Review The study does not contain a concise and comprehensive review of literature to help the study. It did not also seek to promote and support scientific research on COPD and related illnesses. Definition of Terms This study also lacks a brief section for the definition of terms. It assumes that all the readers have a medical or nursing background. Theoretical / Conceptual Framework The study also failed to explain the theoretical and the conceptual framework which the researchers had utilized. Research Design The use of descriptive statistics was indicated but the study did not explain how these descriptive statistics and the research design fit into a tight research structure. It failed to cite the reliability in using the Deyo-adapted Charlson Index (DCI) for the analysis of the health expenditures of the patients. There was no reference to other COPD clinical studies using this DCI as a study variable. The authors did not attempt to explain how the research method helped them attain the answers to the main research question. Assumptions and Limitations The study clearly identified the several limitations of the study such as the resource utilization including the healthcare spending does not reflect the utilization and spending patterns in other health care settings; and the evaluation of the costing on COPD could be understated due to other internal factors such as the use of oxygen on patients, etc. The authors also mentioned that the conclusion part of the study is not precise. Hypothesis The study did not state the hypothesis/hypotheses of the study. Population / Sample / Setting A specific weakness of the study is the failure of the researchers to indicate whether they have obtained an informed consent agreement with the sample covered by the study or not. The patients should have been informed that their personal health data would be used for this study. Most of the COPD studies offer compensation and require voluntary participation in this study. This very important particular data point was missing from this research. Data Collection / Analysis Data Collection Method The study did not specify and explain the methodology which was used to analyze the claims data. The study did not also justify the choice and selection of the sample size and the kind of sample that was chosen. One just infers that the particular sample was chosen because the researchers simply had access to that sample due to the cooperation of the managed care corporation. There was no justification for the use of that particular study sample. Instrument(s) The researchers did not adequately explain the mathematical model they used in the research. They did not indicate the importance of using the Deyo-adapted Charlson Index for each patient. The statistical methods were just enumerated. Data Analysis Methods In the analysis portion of the study, the authors did not tie up the study with the existing studies on this field and expound on its similarities and differences from the other COPD clinical studies. Even though there was an explanation of the independent variables, the study was silent on the dependent variables. The researchers assumed that one could derive the dependent Variables easily from the discussion presented. Discussion of Findings The findings of the research study had been logically arranged and written. The authors did use graphical presentation and table to help the readers fully understand the result of their study. Conclusion The research study does not make any attempt to relate the conclusions to other clinical studies (past or present) on COPD or on the efforts of other health institutions to shed some understanding regarding this lung disease. Justification for Managed Care Claims This study did not justify the use of managed care claims data to derive health expenditures among COPD patients. It does not declare the advantages and disadvantages of using managed care claims data to project or profile health expenditures. Relevance to Nursing Practice Determining the health resources used and expenditures that that may incur on patients with COPD do not have a direct relevance to the nursing practice. Perhaps the study could provide the nurses with the outcome of the topic but there is really not much help in terms of improving the nursing practices on COPD. Recommendations for Future Research Studies Although the authors mentioned to do some further research study on the relationship between COPD and diabetes mellitus or other diseases, the study did not include areas for future research that is directly related to the main topic of this study. The authors also failed to identify areas in which further clinical research may lead to significant improvements in the care of patients with COPD. Reflection of the Research This research report on COPD needs to be improved and refined a lot. It failed to follow the rigors of the research process. The report was prepared with the least professional preparation needed for a scientific study. The study does not contain a concise and comprehensive review of literature to help the study. Moreover, this study does not make any attempt to relate the conclusions to other clinical studies (past or present) on COPD or on the efforts of other health institutions to shed some understanding regarding this lung disease. *** End *** Main Journal Used for the Critique: Yu-Isenberg, K. et al. (2005) ‘Utilization and Medical Care Expenditures in Patients with Chronic Obstructive Pulmonary Disease’ Dis Manage Health Outcomes. 2005; 13(6): 406 – 412. References: 1 Yu-Isenberg, K. (2002) ‘Housing Status and Health Services Use in Urban HIV Infected Women’ Johns Hopkins University. Publication # 3046563. 2002, 239 pages. 2 Yu-Isenberg, K. (1999) ‘Compliance with Anti-retroviral Therapy in HIV + Women’ John Hopkins University. Sponsored by National Institute of Mental Health. Retrieved: June 14, 2007 < http://www.rand.org/ > 3 Taylor, J. (2004) ‘Treatment Adequacy Appears More Likely with Venlafaxine Extended Release than Fluoxetine in Depressed Patients’ Retrieved: June 14, 2007 < http://www.docguide.com/ > path: news 4 Melikian, C. et al., (n.d.) ‘Adherence to Oral Antidiabetic Therapy in a Managed Care Organization: A Comparison of Monotherapy, Combination Thrapy, and Fixed Dose Combination Therapy’ Prescription Solutions. Retrieved: June 14, 2007 < http://www.rxsolutions.com/ > 5 Melikian, C. et al., (n.d.) ‘Diabetes Medication Compliance, Glycemic Control, and Economic Outcomes: A Managed Care Perspective’ Prescription Solutions. Retrieved: June 14, 2007 < http://www.rxsolutions.com/ > 6 Yu-Isenberg, K. et al. (n.d.) ‘Comparison of Health Resource Utilization and Costs in Chronic Obstructive Pulmonary Disease and Asthmatic Patients: A Managed Care Claims Data Analysis’ Retrieved: June 14, 2007 < http://www.rxsolutions.com/ > 7 Prescription Solutions (2007) ‘Official Website’ Retrieved: June 14, 2007 < http://www.rxsolutions.com/ > 8 Boehringer Ingelheim ‘Official Website’ Retrieved: June 14, 2007 < http://www.boehringer-ingelheim.com/ > Read More