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Case Study: Hospital K

03/28/2013

Case Study Hospital K

To fulfill the educational requirements at Our Lady of The Lake College the student

enrolled in the Pre-Professional Human Medicine Undergraduate Program shall successfully

complete the mathematical course General Statistics 2315, Instructed by Barbara Napoli.

A component of this course will focus on the practical application of concepts derived

from the course. The student will demonstrate her knowledge acquired from General Statistics

2315 by effectively drawing logical conclusions based on reason and evidence. The student shall

use concepts acquired from the course to investigate a sample of data provided by the Instructor.

The student shall demonstrate his or her knowledge in a competent manner that illustrates her

comprehension via written narrative. The narrative shall describe a sample of data (n) procured

from Hospital K for one calendar year. The student will arrive at logical conclusions from

Hospital Ks information by generating a compilation of data including the synthesis of visual

representations of the information, including, but not limited to, charts, mathematical formulas,

graphs, tables, and verbal descriptions. This paper shall accurately analyze statistical trends of

the Hospitals data, drawing inferences from the Hospitals events for the year the data was

analyzed.

This exercise shall serve as an excellent opportunity to develop and improve the efficacy

of the students analytical, logical, general reasoning, and critical thinking skills and her ability

communicate them to a diverse audience in an articulate manner. In addition to the practical

development of described skills, it shall aid the student in her preparation to develop the ability

to make informed decisions based on scientific reason and their accompanying statistical trends.

The long-term learning objective of this assignment is to better prepare the student in her

professional and personal endeavors so that she can independently identify, analyze, and predict

a potential range of outcomes, prevent and mitigate possible damages, and develop business and

life strategies for optimal results.

Statistics studies the instruction of gathering and compiling data to organize and interpret

it numerically. Statistics is the science of uncertainty while utilizing the extraction of

mathematical data to and analyzing it. 1 Statistics also consolidates detailed data into simplified

format for easy interpretation. Descriptive and Inferential statistics, a branch of mathematics that

focuses on the organization, analysis, and interpretation of a group of numbers (Aron, Aron, and

Coups, 2006, p.2). Inferential statistics are used to draw educational conclusions and inferences

based on numbers from research, but psychologists take the information further than the numbers

(Aron, Aron, and Coups, 2006).

Statistical visual representations can include bar graphs. They are appropriate for

qualitative or quantitative data. Pareto graphs are used to illustrate the decreasing (from high to

low) frequency of a data set. Pie graphs, or circle graphs are used for small categories, typically

fewer than ten, visually displaying data in a circular fashion. Histograms are complex graphs

indicating the frequency of a data value which may fall into a particular class, the uniformity or

asymmetry of data.

The statistical sample data sets will represent three categories of patients visiting Hospital

Ks Emergency Room Department. Hospital Ks data can be divided into two broad categories:

sample data or population data. Population data (N) is from all items and or persons of interest,

whereas sample data (n) is concerned with particular items or persons of interest.2 Data provided

in the case study represents n, as the information only provides a particular (unknown) year, a

portion of the Hospitals patient information, and describes patients seen in the Emergency

Room Department (ED). To provide N data the case study would be conclusive providing the

data in full with all persons and events of interest. n shall represent three categories of persons

seen in the ED: those admitted to Hospital K (AD), those seeing a physician at Hospital K(EP),

and those arriving by ambulatory services (AMB) to Hospital Ks ED.

When describing an aspect of a population numerically it can be defined as a population

parameter, whereas when describing an aspect of a sample it is sample statistic.3

There are two different ways to describe statistical numerical data. Qualitative data

describes an individual by categorically placing them into one group. 4If data was provided about

a patient such as their social security number, hospital record number, or name and it would be

qualitative data. Quantitative data provides a numerical measurement or value for which

arithmetic can be applied yielding a logical result. Because qualitative data is descriptive in

nature it cannot be summed even if the data piece represents a numeral. Examples of quantitative

data include patients height, weight, basal body temperature, etc. Note these values can be

summed and a statistical mean can be found. The mean of n (x-bar) is the sum () of an entire

data set of information, letting x represent any value in the set, divided by the number of values

P. 5, Brase and Brase, 2012,Understading Basic Statistics

4

P. 5, Brase and Brase, 2012,Understading Basic Statistics

5

P. 85, Brase and Brase, 2012,Understading Basic Statistics

3

Data can also be described to determine the level of measurement. Statistical levels of

measurement can be divided into four levels: nominal, ordinal, interval, and ratio. Nominal data

allows for its placing data into categories. This is the lowest form of data. This is ascribed to

individual names such as patient names, race, gender, language, and biological background.

Often this information serves as the primary patient identification which is used to screen

patients coming into EDs. The second is ordinal data which can range from the lowest level of

measurement to the most detailed and highest order of measurement.

differs from nominal data because there is an ordering scheme present for ordinal data.

(Sequois). An example of ordinal level data is certain financial information from patients at

Hospital K. This data is helpful by effectively allowing the Hospitals database to place patients

salary ranges into broad ranges for purposes such as billing. Data of patients earned salaries can

range from below poverty to, low, middle, or high providing a platform to determine medically

indigent individuals. These ranges do not provide the dollar or amounts earned. Poverty level

earners wages are lower than middle level earners but an exact amount is incalculable when

comparing only these ranges.

Interval data level is meaningful and its differences can be measured. (Sequois). An example of

interval level data is the initial temperature of a patient triaged at Hospital Ks ED. It can be

measured and compared to the time he or she was admitted. There is, however, no beginning

point or zero from which the numerical value will initially proceed; therefore the ratios

calculated between those two temperatures are meaningless.

Below is an example of interval data as represented by a bar graph.

Hospital K's ED By Month

3500

3000

2500

2000

1500

1000

500

0

December

November

October

September

August

July

June

May

April

March

February

Janurary

seen in the ED By Month

Source: Hospital K

Year: Unspecified

Month

Seen By An

EP

AD to

Hospital

January

February

March

April

May

June

July

August

September

October

November

December

2323

2012

2285

2328

2460

2551

2729

2735

2541

2586

2341

2332

372

304

402

338

343

370

372

370

328

403

391

396

29,233

4,389

Source: Hospital K

Year: Unspecified

Meaningful comparisons of data values are represented in ratio level data. Ratio level

data is the highest order of data. It provides information based on the meaningful and measurable

differences in the data pieces. Examples of ratio level data are the Hospitals employees ages,

the lab work results of a patients hemoglobin sedimentation rate, the exact amount of salaries

that patients and employees earn, as well as their heights and body weights. In July 549 patients

were seen in the ED arriving by AMB whereas in April there were just 417. The difference is a

calculable 132 occasions of individuals arriving by AMB.

Central measures of tendency include the mean of quantitative data that can be described

by analyzing the three categories of patients visiting the ED. The mean of those seeing an EP is

29,223.00. The mean of those AD is 4,389.00 Finally those arriving via AMB is 5,0668.00. The

mean of patients seen in the ED for this year is 2695.75.

The mode is the number that occurs with the most frequency in a data set.7 The only

category in which a mode appeared was in AD. The mode is present twice in the AD category.

372.00 patients visited the ED and were admitted, which occurred in both January and July. The

mode reappeared in June and August at 370.00 patients visiting the ED . August has the highest

total of of individuals seeing an EP out of all the twelve months in the year. Perhaps its because

August was a busy travel month that particular year and the citys population increased, thereby

increasing the number of visits to the ED. One might speculate that perhaps there is a correlation

between more school-aged children home for summer vacation playing at home and outdoors

thus an increased risk of accidental injury may present which could be reflected in the month of

August which contains the highest monthly totals of patients visiting the ED that year.

The median of patients visiting the ED in the years sample represents the ordering of

each categorys values proceeding from smallest to largest, finding the middle two values sum,

and finally dividing the sum by two. EP=2,400.00, AD=371.00, AMB=480, with the total

median equaling 2,693.00. 8

The statistical range provides a method for cross reference of all ranges of data. The range is

defined as The difference between the largest and the smallest values of a data distribution. It

is a helpful measurement to begin to understand the distribution of information but does not

allow us to measure the values of the difference. i9 The hospital data ranges (by category) are EP

= 723.00, AD = 99.00, AMB = 200.00, equaling a total from all three categories of 687.00

patients seen at the Hospital ED for the year.

Standard deviation is a measure that is used to measure the varying risk. s is the measure of

deviation or risk. The sample standard deviation is used to describe a range of data about the

mean (x-bar). 10 Each of the three categories data was measured and a standard deviation

determined. This was performed by finding the value of a data piece (x) and finding the mean

(X-bar) and then squaring the sum of x minus x-bar. The sample standard deviation of each

category visiting Hospital Ks for the duration of one calendar year, as calculated by monthly

data are the following: patients seeing EP was 206.58, those patients arriving via AMB had a

deviation of 62.98, and the patients AD was 31.47. The deviation of patients seeing an

Emergency Physician was the highest of all three categories. Emergency Department physicians

are limited. Typically they are supported by Nurse Practitioners (NP) or Physician Assistants

P.94 Brase and Brase, 2012,Understading Basic Statistics

10

P.95 Brase and Brase, 2012,Understading Basic Statistics

9

(PA). The significant increase in the sample standard deviation may likely be explained by the

theory that the patients at the ED did not see an EP but a PA or NP instead.

Correlation and regression are two statistical topics which are used to make predictions based

on relationship(s), which are the relationships between selected values of X and observed values

of Y. A scatter diagram is a graph that uses an ordered pair X and Y, which are plotted

horizontally and vertically on a grid.11 This diagram visually represents the relationship between

X and Y based on their axis, respectively. Below is a scatter diagram representing the total

number of patients seen in Hospital Ks ED and those that were admitted. Let X equal the

number of patients admitted and Y equal the total of patients seen in the ED.

11

the ED

3500

3000

2500

2000

1500

1000

500

0

0

50

100

150

200

250

300

350

400

450

It can be reasonably inferred that with this scatter diagram a line fits reasonably well. Typically

as the amount of individuals seen in the ED increases, so does the rate of patient admissions, thus

a positive correlation is determined between X and Ys relationship. Below is a table configured

to find the least square line (best fitting line).

X=AD

Y=Total n seen

372

2636

304

2295

402

2618

338

2550

343

2750

370

2789

372

2956

370

2982

328

2793

403

2814

391

2594

396

2572

SUM: 4389

32349

XY

980592

697680

1052436

861900

943250

1031930

1099632

1103340

916104

1134042

1014254

1018512

11853672

(X)2

(Y)2

138384 6948496

92416 5267025

161604 6853924

114244 6502500

117649 7562500

136900 7778521

138384 8737936

136900 8892324

107584 7800849

162409 7918596

152881 6728836

156816 6615184

1616171 87606691

The formula for the best fitting line the is: Y-hat= a + bx.

a equals the Y intercept and bx the slope. B is found by using the equation SSxy divided by SSx.

a is found by setting a to equal Y-bar - bx.

X-bar =365.75 and Y-bar equals 2695.75.

SSxy= The sum of XY minus the sum of the Xs times the sum of the Ys. SSx equals the

sum of X squared minus the sum of the Xs squared divided by n. b equals 0.0012, whereas a

equals 2695.31. The least squares line formula is Y-hat= 2695.31 + (0.0012)(365.75).

Patients Seen In the ED

Source: Hospital K

Year: Unspecified

3500

3000

2500

2000

1500

1000

500

0

0

50

100

150

200

250

300

350

400

450

Patients Admitted

can be used to predict and determine data. Inferences made from Hospital Ks sample raw data

allow opportunity to better understand the events of Hospital K, such as the ratio of patients

admitted to those being treated in the ED. This may be useful to help determine the amount of

supplies necessary for patients, the facilities and amount of services required to meet an

increasing need of patients being admitted, or provide a comparison or prediction of budget

based on its history of expenses. Statistics will not accurately predict all events or outcomes

possible, nor will it be conclusive, particularly in this instance, as this is a sample of data, not a

population.

Works Cited

Aron, A., Aron, E. N., & Coups, E. J. (2006), Statistics for psychology (4th ed. ).

Braise, C.H., and Braise, P.B. (2012), Understanding Basic Statistics (4th ed.).

Sequois, C. o. (n.d.). Levels Of Measurement. Retrieved March 20, 2013, from

http://infinity.cos.edu/faculty/woodbury/stats/tutorial/Data_Levels.htm

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